Systematic Reviews最新文献

Background: Two genes are synthetically lethal if loss of function of either one of the two genes does not result in cell death, whereas loss of function of both genes together results in being detrimental to cell survival. This concept has been the basis for developing personalized, precision treatments, which can selectively damage tumor cells and minimize toxicity to normal tissues. Tumor cells often harbor mutations in genes involved in DNA repair pathways, forcing them to switch to alternative repair pathways, leading to chemotherapeutic resistance. These interactions, if targeted, could be synthetically lethal. We aimed to summarize synthetically lethal gene pairs that could be utilized to selectively target cancer cells and minimize side effects on normal tissues. The objective of this review is to study druggable synthetically lethal gene pairs for targeted cancer therapy that have been identified through various genetic screens and functional studies.

Methods: A systematic literature search will be conducted to extract synthetically lethal gene pairs that can be specifically targeted to cancer cells. Owing to the relatively recent research pertaining to this field, the literature search will incorporate data from 1956. The search will be conducted on PubMed, Web of Science, Embase, and Scopus. The narrative approach will guide the analysis and synthesis of the results.

Discussion: This review highlights scientific articles that report druggable synthetically lethal gene pairs by testing the efficacy of targeted inhibitors in clonogenic assays. These include research studies that identify synthetically lethal gene pairs detected through CRISPR screens by knocking out one or two genes within the same cell and testing the potency of inhibitors to specifically kill malignant cells.

Systematic review registration: https://doi.org/10.17605/OSF.IO/5BCW6 .

Objective: This study aimed to systematically evaluate the efficacy of electroacupuncture and manual acupuncture for treating vascular dementia and to determine the optimal acupuncture point combination scheme for efficacy.

Methods: The PubMed, Embase, Web of Science, Cochrane, CNKI, VIP, and Wanfang electronic databases were searched up to July 2024 to identify relevant randomized controlled trials. RevMan 5.4 software and Addis software were used to assess the risk of bias for each study, determine subgroup classifications, and conduct meta-analyses.

Results: A total of 29 RCTs involving 659 animals were ultimately included. The meta-analysis results revealed that acupuncture treatment had a significant effect compared with the vascular dementia model group [mean difference (MD) = - 21.68, 95% confidence interval (CI) (- 25.77, - 17.59), P < 0.00001]. Manual acupuncture demonstrated better efficacy than electroacupuncture did [MD = - 0.42, 95% CI (- 12.72, 12.27)]. Among the different acupuncture point combinations, the Baihui (GV20) + Dazhui (GV14) combination yielded the best efficacy [MD = - 23.03, 95% CI (- 30.02, - 16.04), P < 0.00001]. Compared with other acupuncture protocols, the experiment conducted by Caiyu Peng et al. exhibited superior efficacy [MD = - 24.96, 95% CI (- 92.68, - 40.76)].

Conclusion: Acupuncture significantly improves cognitive function in rats with vascular dementia. Manual acupuncture is more effective than electroacupuncture. Among the different acupuncture point combinations, manual acupuncture at GV20 and GV14 yields the best results. Compared with other acupuncture protocols, the best efficacy was observed when the two-vessel occlusion (2VO) model was used in 230 ± 10 g SD rats; when the Mingmen (GV4), Dazhui (GV14), Fengfu (GV16), Baihui (GV20), Shenting (GV24), Shuigou (GV26), Neiguan (PC6), Dalin (PC7), and Laogong (PC8) acupoints were selected; and when manual acupuncture with reinforcing and reducing methods was used for 30 min per day for 14 days.

Systematic review registration: PROSPERO CRD42024551402.

Background: Stakeholder involvement in evidence syntheses has the potential to enhance the quality and relevance of reviews. However, adolescents rarely participate in evidence synthesis, mainly because their role and influence in shaping the synthesis process relating to health outcomes are poorly understood. To fully unlock the potential of evidence syntheses for adolescent health, it is crucial to understand how adolescents can contribute at various stages of the review process and how their involvement can influence outcomes.

Methods: To achieve this, we conducted an umbrella review examining adolescent involvement in reviews related to adolescent health research, complemented by a case study that highlights how adolescents were engaged at various stages of this review. We ran a search across 11 databases, screened reference lists and 12 journals, and consulted experts in youth involvement.

Results: We found only 10 reviews which involved adolescents. In those reviews, adolescents were engaged at almost every stage of the review process, with most involvement centred around interpreting findings or co-authoring the final reports. While adolescent participation was often consultative, there were examples of more collaborative involvement using a wide range of methods, even at technical stages like study selection and data analysis. However, reviews did not report on the impacts or benefits of adolescent involvement in evidence syntheses.

Conclusion: To maximise the impact of adolescent involvement, we call for engagement of adolescents throughout the review process and the adoption of frameworks to ensure transparency and consistency in reporting.

Systematic review registration: PROSPERO CRD42021287467.

Background: Chronic inflammation is a critical public health concern that, in children and adolescents, increases the long-term risk of a variety of different health issues. While mind-body therapies like yoga, meditation, and acupuncture have shown promise in modulating immune responses in adults, their safety and effectiveness in pediatric populations remain underexplored. This protocol outlines the methodology for a systematic review and meta-analysis aimed at evaluating the effects of mind-body therapies on immune modulation in children and adolescents.

Methods: This systematic review and meta-analysis will follow PRISMA 2020 guidelines. We will include randomized controlled trials, non-randomized controlled trials, cohort studies, and case-control studies that examine the relationship between mind-body therapies and immune markers in pediatric populations. Electronic searches will be conducted in MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and the Cochrane Library, supplemented by trial registries. Risk of bias will be assessed using the Cochrane Risk of Bias Tool (RoB 1), the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I), and the Newcastle-Ottawa Scale (NOS). Two independent reviewers will screen studies, extract data, and assess study quality, with a third reviewer resolving any discrepancies. Results will be synthesized both narratively and through meta-analysis using R software.

Discussion: The review will evaluate the effectiveness and safety of mind-body therapies on immune markers in children and adolescents. The synthesized evidence will guide clinical practice and public health policies in integrating mind-body therapies into pediatric care. The findings will also provide a foundation for future research and policymaking in this area.

Systematic review registration: PROSPERO CRD42024546585.

Background: Children exposed to severe malaria may recover with gross neurologic deficits (GND). Several risk factors for GND after cerebral malaria (CM), the deadliest form of severe malaria, have been identified in children. However, there is inconsistency between previously reported and more recent findings. Although CM patients are the most likely group to develop GND, it is not clear if other forms of severe malaria (non-CM) may also contribute to malaria-related GND. The objective of this systematic review is to synthesize evidence on the prevalence and risk factors for GND in children after severe malaria.

Methods: The systematic review will be conducted according to recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P). Relevant research articles will be identified using relevant search terms from the following databases: MEDLINE, Embase, Web of Science, and Global Index Medicus (GIM). The articles will be screened at title and abstract and then at full text for inclusion using a priori eligibility criteria. Data extraction will be carried out using a tool developed and optimized in an Excel spreadsheet. Risk of bias will be assessed using appropriate tools including Risk Of Bias In Non-randomized Studies of Exposures (ROBINS-E) and the Cochrane Risk of Bias 2.0 (ROB2) for randomized control trials (RCTs), and where appropriate, publication bias will be assessed using a funnel plot. A random-effects meta-analysis or synthesis without meta-analysis (SWiM) will be performed as appropriate, and the results will be presented in tables and graphs.

Conclusion: Findings from this systematic review will inform policymakers on the planning, design, and implementation of interventions targeting the treatment and rehabilitation of GND following severe malaria in children.

Systematic review registration: PROSPERO CRD42022297109.

Background: Sarcopenic obesity (SO) in older adults is associated with certain adverse outcomes, including falls, fractures, and disability, all of which affect patient quality of life, represent an economic burden, and potentially enhance the risk of death. Although a number studies have examined the effects of exercise, nutrition, and combined exercise and nutritional interventions on older adults with SO, the optimal therapeutic approach has yet to be sufficiently established. In this systematic review and network meta-analysis (NMA) protocol for SO in older adults, we aim to compare the combined effects of exercise and nutrition with those of exercise or nutritional interventions alone on the body composition and physical performance of older adults with SO.

Methods: The PubMed, Web of Science, Embase, OVID, CINAHL, CNKI, Wanfang Data, and VIP databases will be used to systematically search for randomized controlled trials published from the time of database inception to December 2024. Outcomes will include body composition and physical performance, and data will be extracted independently by two researchers. In cases of disagreement, a consensus will be reached by consulting a third researcher. The Cochrane risk-of-bias tool will be used to assess randomized controlled trials, and data analysis will be performed using Stata 15.0 and R software, based on homogeneity, sensitivity, transitivity, consistency, and publication bias tests.

Discussion: By comprehensively assessing the relative efficacies of exercise, nutrition, and combined interventions in older adults with SO, we aim in this systematic review and NMA to fill an important gap in the existing literature. These findings will provide a reference for healthcare providers and policymakers and facilitate the development of evidence-based guidelines that will contribute to optimizing SO management and gaining more favorable outcomes for this vulnerable population.

Systematic review registration: CRD42024504706.

Background: Prior studies have 3suggested that theta burst stimulation (TBS) may be a promising intervention for the rehabilitation of aphasia after stroke. However, the results of these investigations have been inconsistent, with no definitive consensus on its efficacy and safety. Given the inconclusive nature of the existing evidence, this study aims to conduct a comprehensive and systematic review to evaluate the therapeutic effects of TBS on aphasia in stroke patients.

Methods: We will perform an extensive search of eight online databases from their inception to August 1, 2024, to identify relevant randomized controlled trials (RCTs) that examine the impact of TBS on aphasia in stroke patients. The primary outcome will be the severity of aphasia, assessed using a suite of standardized evaluation tools. Secondary outcomes will include measures of naming, repetition, comprehension, spontaneous speech, aphasia quotient, quality of life, and documentation of adverse events. The review process will involve rigorous study selection, data extraction, risk of bias assessment, and evaluation of the certainty of evidence by two independent reviewers. Data synthesis and statistical analysis will be conducted using Review Manager (RevMan) software, version 5.3. If significant heterogeneity is not detected among the studies, a meta-analysis will be performed. Otherwise, a narrative qualitative summary will be provided. The quality of evidence will be assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system.

Discussion: This study will be the first systematic review to comprehensively synthesize the existing evidence regarding the application of TBS in the treatment of aphasia in stroke patients. The findings are expected to provide valuable insights for clinicians and policymakers, facilitating the development of more equitable and high-quality healthcare services for this patient population.

Systematic review registration: PROSPERO CRD42024521347.

Background: While growing evidence highlights the harmful effects of waterpipe smoking (WPS), detailed information about its association to chronic diseases remains limited. This systematic review and meta-analysis exploring the association between WPS and various health conditions.

Methods: A systematic search of MEDLINE (via PubMed), Embase, Scopus, and Web of Science was conducted from inception to January 2025. Eligible observational studies on WPS and health outcomes were selected through a duplicate, independent process. Data extraction, including study details, participant characteristics, methods, and results, was performed independently by two reviewers using a standardized form. Methodological quality was assessed using the Newcastle-Ottawa scale (NOS), and studies were classified as high, moderate, or poor quality. The GRADE approach was applied to evaluate evidence certainty for each outcome, considering factors such as study design, risk of bias, consistency, precision, and publication bias.

Results: A total of 191 studies with 807,174 participants were included, comprising 98 case-control, 77 cross-sectional, and 16 cohort studies from 24 countries. The median number of studies analyzed per outcome was 5, with a range of 3 to 30. Among the 62 outcomes evaluated, 31 (50%) demonstrated statistically significant effect sizes based on a random-effects model, with stroke, coronary artery disease (CAD), and cancer mortality exhibiting a significant prediction interval. Credibility evaluations identified low-quality evidence for birth weight, CAD, and cardiovascular and cancer mortality, whereas the evidence for the remaining outcomes was graded as very low quality. Significant associations were found between WPS and several health outcomes: gastric cancer, lung cancer, bladder cancer, esophageal cancer, CAD, stroke, diabetes, metabolic syndrome, overall mortality, cardiovascular mortality, cancer mortality, infertility, sperm normal form, sperm DNA fragmentation, chronic bronchitis, cough, sputum, low birth weight (LBW), spirometry parameters, and several dental health indicators.

Conclusion: This study reveals strong links between WPS and adverse health outcomes, but low evidence quality calls for rigorous research and public health interventions to mitigate its effects.

Introduction: Tobacco consumption continues to pose a substantial global public health threat, resulting in more than 8 million preventable deaths annually. The WHO Framework Convention on Tobacco Control (FCTC) negotiated as the first global public health treaty under the auspices of the WHO, which serves as a critical instrument in combating the global tobacco epidemic. The WHO FCTC prioritizes a comprehensive approach that addresses both the demand for and supply side interventions for curbing tobacco epidemic globally. Strong evidence demonstrates the efficacy of these measures in safeguarding individuals, regardless of age, from tobacco initiation, and the associated harms. WHO FCTC Article 9 and 10 emphasizes upon testing and disclosure of tobacco product contents. This scoping review aims to explore the Implementation Landscape of WHO FCTC Articles 9 and 10 globally by adopting Consolidated Framework for Implementation Research (CFIR) framework.

Methods: The planned scoping review will adhere to the methodology outlined by "Arksey and O'Malley and Levac et al." Through an exhaustive search strategy, relevant literature published from 2013 onwards will be sourced from databases including PubMed, CINAHL, EMBASE, Web of Science, Scopus, government websites, and reports. A predetermined set of criteria for study inclusion and exclusion will be applied independently by four reviewers to assess study eligibility. The findings will be synthesized narratively and qualitatively analyzed, incorporating the Consolidated Framework for Implementation Research (CFIR) framework for discussion and outlining. The review will adhere to the reporting standards outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Review (PRISMA-ScR)" guidelines.

Conclusions/discussion: Analyzing the implementation of FCTC Articles 9 and 10 across global contexts is expected to offer valuable insights into the need for context-specific adjustments and customized interventions. Understanding regional variations in efforts to regulate tobacco products is crucial for formulating specific strategies that effectively address cultural, economic, and regulatory challenges. This comparative examination has the potential to guide policymakers, public health professionals, and researchers in optimizing tobacco control initiatives to expedite progress toward effective implementation of Articles 9 and 10 in both the WHO-SEAR region and globally.

Ethics approval: This review will identify the landscape of the implementation of WHO FCTC Article 9 and 10. This review will also identify the best practices, policies, and strategies across the globe. An ethics committee approval was not sought for this since this involve secondary data.