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Choice of primary healthcare providers among population in urban areas of low- and middle-income countries-a protocol for systematic review of literature. 中低收入国家城市地区居民对初级医疗服务提供者的选择--文献系统性回顾协议。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-22 DOI: 10.1186/s13643-024-02714-x
Md Zahid Hasan, Edward J D Webb, Zahidul Quayyum, Tim Ensor

Introduction: Strengthening and reforming the urban primary healthcare (PHC) system is essential to efficiently deliver need-based healthcare services to the rapidly increasing urban poor population. Such reforms of PHC system need to emphasize the opinion of patients in co-designing services in order that delivery of services can be accessed effectively by the urban population in a timely and low-cost way. Hence, it is important to identify the preference of urban population while choosing healthcare providers. The aim of this proposed protocol is to summarize a planned systematic review of existing evidence on the attributes considered for choosing PHC providers in urban settings of low- and middle-income countries (LMICs), as classified by the World Bank. METHODS AND ANALYSES: An inclusive literature search will be conducted in electronic databases including Pubmed/MEDLINE, Embase, Global Health, Cochrane Library, Web of Science, and Scopus. Databases will be searched from the earliest date of entry until March 30, 2024. Database search will be supplemented by manual search of citations, reference lists, and grey literature sources. Following the pre-set inclusion and exclusion criterion, two researchers will independently screen all the retrieved studies in Covidence. Any discrepancies will be resolved through a discussion between two researchers, and if disagreements persist, a third reviewer will be consulted. The methodological quality of included studies will be appraised using checklist for Conjoint Analysis studies and the Mixed Methods Appraisal Tool (MMAT). An Excel-based data extraction table will be developed, piloted, and refined during the review process. Preference attributes will be identified and analyzed according to their types. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines.

Discussion: The identification of attributes, their influence on preference, and heterogeneity with socioeconomic characteristics of the population will help the policymakers and researchers to design targeted PHC interventions. Such evidence will be also useful to design choice experiment studies to quantify the preferred attributes of PHC providers in urban context of LMICs.

Systematic review registration: PROSPERO CRD42023409720.

导言:加强和改革城市初级医疗保健(PHC)系统对于向迅速增加的城市贫困人口有效提供以需求为基础的医疗保健服务至关重要。初级医疗保健系统的这种改革需要强调患者在共同设计服务时的意见,以便城市人口能够以低成本的方式及时有效地获得服务。因此,确定城市人口在选择医疗服务提供者时的偏好非常重要。本建议书旨在对现有证据进行有计划的系统综述,这些证据涉及在世界银行划分的中低收入国家(LMIC)的城市环境中选择初级保健服务提供者时所考虑的属性。方法与分析:将在 Pubmed/MEDLINE、Embase、Global Health、Cochrane Library、Web of Science 和 Scopus 等电子数据库中进行全面的文献检索。数据库将从最早的输入日期开始搜索,直至 2024 年 3 月 30 日。除数据库检索外,还将对引文、参考文献目录和灰色文献来源进行人工检索。按照预先设定的纳入和排除标准,两名研究人员将在 Covidence 中独立筛选所有检索到的研究。如有任何分歧,两名研究人员将通过讨论解决;如果分歧持续存在,将咨询第三位审稿人。纳入研究的方法学质量将通过联合分析研究检查表和混合方法评估工具(MMAT)进行评估。在评审过程中,将开发、试用和完善基于 Excel 的数据提取表。将根据偏好属性的类型对其进行识别和分析。系统综述将根据系统综述和元分析首选报告项目(PRISMA)指南进行报告:讨论:确定属性、其对偏好的影响以及与人口社会经济特征的异质性将有助于政策制定者和研究人员设计有针对性的初级保健干预措施。这些证据还有助于设计选择实验研究,以量化低收入国家城市中初级保健服务提供者的偏好属性:系统综述注册:prospero crd42023409720。
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引用次数: 0
Computer-assisted screening in systematic evidence synthesis requires robust and well-evaluated stopping criteria. 系统性证据综合中的计算机辅助筛选需要稳健且经过充分评估的停止标准。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-22 DOI: 10.1186/s13643-024-02699-7
Max Callaghan, Finn Müller-Hansen, Melissa Bond, Candyce Hamel, Declan Devane, Wojciech Kusa, Alison O'Mara-Eves, Rene Spijker, Mark Stevenson, Claire Stansfield, James Thomas, Jan C Minx
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引用次数: 0
Patient-related prognostic factors for function and pain after shoulder arthroplasty: a systematic review. 与患者相关的肩关节置换术后功能和疼痛预后因素:系统综述。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-22 DOI: 10.1186/s13643-024-02694-y
Brechtje Hesseling, Nisa Prinsze, Faridi Jamaludin, Sander I B Perry, Denise Eygendaal, Nina M C Mathijssen, Barbara A M Snoeker

Background: While shared decision making is a cornerstone of orthopedic care, orthopedic surgeons face challenges in tailoring their advice and expectation management to individual shoulder arthroplasty patients due to the lack of systematically summarized evidence-based knowledge. This systematic review aims to provide an overview of current knowledge on independent predictive effects of patient-related factors on functional and pain-related outcomes after shoulder arthroplasty.

Methods: We included longitudinal cohort studies including patients receiving total or reverse shoulder arthroplasty or hemiarthroplasty for primary osteoarthritis or cuff tear arthropathy. Studies with only univariable analyses were excluded. MEDLINE, Embase, and CINAHL databases were last searched on June 27, 2023. Risk of bias was evaluated using the QUIPS tool. For the analyses, we divided outcomes into three domains (Functional Recovery, Pain, and Functional Recovery & Pain) and four time points (short term, medium-short term, medium-long term and long term). When appropriate, meta-analyses were conducted to pool regression coefficients or odds ratios. Otherwise, results were summarized in a qualitative analysis. We used the GRADE approach to rate the certainty of the evidence.

Results: Thirty-three studies analyzing over 6900 patients were included; these studied 16 PROMs and 52 prognostic factors. We could perform meta-analyses for six combinations of prognostic factor, domain, and time point. Only the meta-analysis for medium-long term poor ASES scores indicated worse outcomes for previous shoulder surgery (OR (95%CI) of 2.10 (1.33-3.33)). The majority of reported factors showed unclear or neutral independent effects on functional outcomes.

Conclusions: Methodological heterogeneity and selective/incomplete reporting prevented us from pooling most results, culminating in a largely qualitative analysis. Depression, preoperative opioid use, preoperative ASES and SST scores, surgery on the dominant side, previous surgery, male gender, no. of patient-reported allergies, back pain, living alone, CTA vs OA, diabetes, and greater preoperative external ROM predicted neutral to worse or worse outcomes. In contrast, higher electrical pain threshold on the operative side, OA/RCA vs other diagnosis, and private insurance vs Medicaid/Medicare predicted neutral to better or better outcomes. These results can help orthopedic surgeons tailor their advice and better manage expectations.

Systematic review registration: PROSPERO CRD42021284822.

背景:虽然共同决策是骨科护理的基石,但由于缺乏系统总结的循证知识,骨科医生在为肩关节置换术患者量身定制建议和期望管理方面面临挑战。本系统综述旨在概述目前关于患者相关因素对肩关节置换术后功能和疼痛相关结果的独立预测作用的知识:我们纳入了纵向队列研究,包括因原发性骨关节炎或袖撕裂关节病而接受全肩关节置换术或反向肩关节置换术或半关节置换术的患者。仅进行单变量分析的研究被排除在外。最后一次检索MEDLINE、Embase和CINAHL数据库是在2023年6月27日。使用 QUIPS 工具评估了偏倚风险。在分析中,我们将结果分为三个领域(功能恢复、疼痛和功能恢复与疼痛)和四个时间点(短期、中短期、中长期和长期)。在适当的情况下,进行荟萃分析以汇集回归系数或几率比。否则,我们将对结果进行定性分析总结。我们采用 GRADE 方法对证据的确定性进行评分:共纳入了 33 项研究,分析了 6,900 多名患者;这些研究涉及 16 个 PROMs 和 52 个预后因素。我们对预后因素、领域和时间点的六种组合进行了荟萃分析。只有针对中长期不良 ASES 评分的荟萃分析表明,既往肩部手术的预后较差(OR (95%CI) 为 2.10 (1.33-3.33))。所报告的大多数因素对功能预后的独立影响不明确或呈中性:结论:方法学上的异质性和选择性/不完整的报告使我们无法汇总大多数结果,最终只能进行基本定性的分析。抑郁、术前使用阿片类药物、术前ASES和SST评分、优势侧手术、既往手术、男性、患者报告的过敏症数量、背痛、独居、CTA与OA、糖尿病以及术前更大的外部ROM等因素预示着中性或更差的结果。相比之下,手术侧电痛阈值较高、OA/RCA 与其他诊断、私人保险与医疗补助/医疗保险则预示着中性至较好或较好的结果。这些结果可以帮助骨科医生调整建议,更好地管理预期:系统综述注册:PREMCORD42021284822。
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引用次数: 0
Barriers and facilitators to enrollment in pediatric clinical trials: an overview of systematic reviews. 参加儿科临床试验的障碍和促进因素:系统综述。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-20 DOI: 10.1186/s13643-024-02698-8
Veronika Bencheva, Nina-Kristin Mann, Tanja Rombey, Dawid Pieper, Sven Schmiedl

Background: Recruiting a sufficient number of patients is often a challenge for conducting clinical trials. Published data reveal that only 10% of eligible patients according to inclusion and exclusion criteria are enrolled in clinical trials. Consequentially, identifying barriers and facilitators may improve enrollment. These factors may differ in the pediatric population, for example, due to the involvement of parents in the decision-making process. We aimed to conduct an overview of systematic reviews to summarize the barriers and facilitators influencing the enrollment of pediatric participants in clinical trials.

Methods: A systematic literature search in PubMed and Epistemonikos of published systematic reviews focusing on barriers and facilitators influencing the enrollment of pediatric patients in clinical trials was conducted. Study selection, data extraction, and quality assessment were performed by two authors independently. The methodological quality was judged using a critical appraisal tool. Finally, data were narratively synthesized.

Results: Of 283 identified systematic reviews, four met the inclusion criteria and were included in the overview. Parents belonging to an ethnic minority or having low socioeconomic status were identified as barriers to enrollment whereas higher parental education and higher age served as facilitators. Additionally, existing expectations, previous treatment experiences and preferences, study duration, type of control group, and the child's attitude toward study participation could favor or hinder participation. Furthermore, physicians' opinions of study-related treatments may also influence the enrollment process.

Conclusion: This overview provides a summary of barriers and facilitators to the enrollment of pediatric patients in clinical trials. Taking into account this information may enhance the enrollment of this hard-to-reach population.

背景:招募足够数量的患者往往是开展临床试验的一项挑战。已公布的数据显示,只有 10% 符合纳入和排除标准的合格患者被纳入临床试验。因此,找出障碍和促进因素可能会提高注册率。这些因素在儿科人群中可能有所不同,例如,由于父母参与了决策过程。我们的目的是对系统综述进行概述,总结影响儿科参与者参与临床试验的障碍和促进因素:方法:我们在 PubMed 和 Epistemonikos 上对已发表的系统综述进行了系统性文献检索,重点关注影响儿科患者参与临床试验的障碍和促进因素。研究选择、数据提取和质量评估由两位作者独立完成。方法学质量采用批判性评价工具进行评判。最后,对数据进行叙述性综合:在已确定的 283 篇系统性综述中,有 4 篇符合纳入标准并被纳入综述。属于少数民族或社会经济地位较低的父母被认为是入学的障碍,而父母受教育程度较高和年龄较大则是入学的有利因素。此外,现有的期望、以往的治疗经验和偏好、研究持续时间、对照组的类型以及儿童对参与研究的态度都会对参与研究产生有利或不利的影响。此外,医生对与研究相关的治疗方法的看法也会影响入组过程:本文概述了儿科患者参与临床试验的障碍和促进因素。考虑到这些信息可能会提高这一难以接触人群的入组机会。
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引用次数: 0
The psychometric properties of instruments measuring ethical sensitivity in nursing: a systematic review. 护理伦理敏感性测量工具的心理测量特性:系统综述。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-20 DOI: 10.1186/s13643-024-02473-9
Lu Zhou, LiXiong Bi, YuMing Wu, Lei Wang, Gao Liu, EnLi Cai
<p><strong>Background: </strong>Recognizing and appropriately responding to ethical considerations is a crucial element of ethical nursing practice. To mitigate instances of ethical incongruity in healthcare and to promote nurses' comprehension of their professional ethical responsibilities, it is imperative for researchers to accurately evaluate ethical sensitivity. Conducting a systematic review of the available instruments would enable practitioners to determine the most suitable instrument for implementation in the field of nursing.</p><p><strong>Aim: </strong>This review aims to systematically assess the measurement properties of instruments used to measure ethical sensitivity in nursing.</p><p><strong>Methods: </strong>A systematic literature search was conducted in July 2022 in the following electronic databases: Scopus, CINAHL, APAPsycINFO, Embase, Web of Science, and PubMed. Two reviewers independently screened and assessed the studies in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The updated criteria for good measurement properties are used to rate the result of measurement properties, and the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to grade the quality of the summarized evidence.</p><p><strong>Results: </strong>This review encompasses a total of 29 studies that describe 11 different instruments. Neither cross-cultural validity nor responsiveness was examined in any of the included studies. Whereas the majority of the instruments were conducted with at least some type of validity assessment, nearly all of the reliability results rated were indeterminate. Two instruments were recommended, the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units. It is recommended that new self-administration instruments for special nursing settings be developed in accordance with the item response theory (IRT)/Rasch model.</p><p><strong>Conclusion: </strong>The selection of ethical sensitivity measurement instruments in nursing, and further research on the development, psychometric, and cross-cultural adaptation of these instruments, could be conducted in accordance with the findings and suggestions of this systematic review.</p><p><strong>Strengths and limitations: </strong>• This review was conducted to assess 11 instruments that were used to measure ethical sensitivity in nursing in 29 studies. • The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units can be recommended, but further reliability and cross-cultural validity testing are needed. • The IRT/Rasch model is also recommended to measure ethical sensitivity in nursing. • The potential limitation of utilizing the COSMIN checklist for assessing methodological quality is worth considering. • Test-retest was con
背景:认识并适当应对伦理方面的考虑是护理伦理实践的关键要素。为了减少医疗保健中的伦理不协调现象,促进护士对其职业道德责任的理解,研究人员必须准确评估伦理敏感性。目的:本综述旨在系统评估用于测量护理伦理敏感性的工具的测量属性:2022 年 7 月,在以下电子数据库中进行了系统的文献检索:Scopus、CINAHL、APAPsycINFO、Embase、Web of Science 和 PubMed。两名审稿人根据基于共识的健康测量工具选择标准(COSMIN)核对表对研究进行了独立筛选和评估。采用最新的良好测量特性标准对测量特性结果进行评分,并采用修改后的建议评估、发展和评价分级法(GRADE)对总结的证据质量进行分级:本综述共包括 29 项研究,介绍了 11 种不同的工具。所有纳入的研究均未对跨文化有效性和响应性进行审查。虽然大多数工具都至少进行了某种有效性评估,但几乎所有的可靠性结果都不确定。建议使用两种工具,即护理专业学生伦理敏感性问卷(ESQ-NS)和重症监护病房护士伦理意识量表。建议根据项目反应理论(IRT)/Rasch 模型开发新的特殊护理环境自我管理工具:结论:可根据本系统综述的结论和建议,选择护理伦理敏感性测量工具,并进一步研究这些工具的开发、心理测量和跨文化适应性:- 本综述对 29 项研究中用于测量护理伦理敏感性的 11 种工具进行了评估。- 护生伦理敏感性问卷(ESQ-NS)和重症监护室护士伦理意识量表值得推荐,但还需要进一步的可靠性和跨文化有效性测试。- 此外,还推荐使用 IRT/Rasch 模型来测量护理人员的伦理敏感性。- 利用 COSMIN 核对表评估方法质量的潜在局限性值得考虑。- 重测被认为是不恰当的;因此,伦理敏感性测量工具的可靠性测试仍需探索。
{"title":"The psychometric properties of instruments measuring ethical sensitivity in nursing: a systematic review.","authors":"Lu Zhou, LiXiong Bi, YuMing Wu, Lei Wang, Gao Liu, EnLi Cai","doi":"10.1186/s13643-024-02473-9","DOIUrl":"10.1186/s13643-024-02473-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Recognizing and appropriately responding to ethical considerations is a crucial element of ethical nursing practice. To mitigate instances of ethical incongruity in healthcare and to promote nurses' comprehension of their professional ethical responsibilities, it is imperative for researchers to accurately evaluate ethical sensitivity. Conducting a systematic review of the available instruments would enable practitioners to determine the most suitable instrument for implementation in the field of nursing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This review aims to systematically assess the measurement properties of instruments used to measure ethical sensitivity in nursing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search was conducted in July 2022 in the following electronic databases: Scopus, CINAHL, APAPsycINFO, Embase, Web of Science, and PubMed. Two reviewers independently screened and assessed the studies in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The updated criteria for good measurement properties are used to rate the result of measurement properties, and the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to grade the quality of the summarized evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This review encompasses a total of 29 studies that describe 11 different instruments. Neither cross-cultural validity nor responsiveness was examined in any of the included studies. Whereas the majority of the instruments were conducted with at least some type of validity assessment, nearly all of the reliability results rated were indeterminate. Two instruments were recommended, the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units. It is recommended that new self-administration instruments for special nursing settings be developed in accordance with the item response theory (IRT)/Rasch model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The selection of ethical sensitivity measurement instruments in nursing, and further research on the development, psychometric, and cross-cultural adaptation of these instruments, could be conducted in accordance with the findings and suggestions of this systematic review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;• This review was conducted to assess 11 instruments that were used to measure ethical sensitivity in nursing in 29 studies. • The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) and the Ethical Awareness Scale for nurses in intensive care units can be recommended, but further reliability and cross-cultural validity testing are needed. • The IRT/Rasch model is also recommended to measure ethical sensitivity in nursing. • The potential limitation of utilizing the COSMIN checklist for assessing methodological quality is worth considering. • Test-retest was con","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"87"},"PeriodicalIF":6.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence of gonococcal and chlamydial infections among men who have sex with men in sub-Saharan Africa: a systematic review and meta-analysis. 撒哈拉以南非洲男男性行为者中淋球菌和衣原体感染的流行率:系统综述和荟萃分析。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-16 DOI: 10.1186/s13643-024-02704-z
Kehinde Charles Mofolorunsho, Vinogrin Dorsamy, Chauntelle Bagwandeen, Nathlee Samantha Abbai

Background: Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STI) including Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct). The lack of robust data on STIs among African MSM has limited the development of evidence-based screening strategies. This study aimed at documenting the pooled prevalence of Ng/Ct among MSM in sub-Saharan Africa (SSA).

Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020 guidelines. Relevant articles from the following databases were searched: PubMed, Scopus, ISI Web of Science, and the Directory of Open Access Journals (DOAJ). Eligible studies reported on the prevalence of Ng/Ct among the MSM population in SSA. Publication bias was assessed using the Hoy tool, Doi plot, and LFK ratio. Due to heterogeneity among studies, subgroup analyses were performed using the MetaXL add-on tool for Microsoft Excel.

Results: Of 525 articles screened, 20 were selected for inclusion. Six were cross-sectional, four had a prospective cohort study design, and one was an epidemiological study. The pooled prevalence of Ng/Ct in MSM was 27% (95% CI, 19-39%), with an I2 of 98% signifying heterogeneity among the studies. Subgroup analysis by country revealed South Africa had the highest prevalence (38%).

Discussion: Interpretation The high prevalence of Ng/Ct infection among MSM in SSA is of concern. Limitations Due to limited data available on Ng/Ct prevalence, the true prevalence of SSA and its associated risk factors is uncertain.

Conclusion: As the first study to systematically review the available literature on STI prevalence among the MSM population in SSA, it showed the burden of Ng/Ct is higher than in other regions, warranting the strengthening of health systems to improve education, testing, and treatment in MSM population.

Systematic review registration: PROSPERO CRD42022327095.

背景:包括淋病奈瑟菌(Ng)和沙眼衣原体(Ct)在内的性传播感染(STI)对男男性行为者(MSM)的影响尤为严重。由于缺乏有关非洲男男性行为者性传播感染的可靠数据,以证据为基础的筛查策略的制定受到了限制。本研究旨在记录撒哈拉以南非洲(SSA)男男性行为者中Ng/Ct的总体流行率:本系统综述根据《系统综述与元分析首选报告项目》(PRISMA)2020 指南进行。检索了以下数据库中的相关文章:PubMed、Scopus、ISI Web of Science 和 Directory of Open Access Journals (DOAJ)。符合条件的研究报告了Ng/Ct在SSA地区MSM人群中的流行情况。采用 Hoy 工具、Doi 图和 LFK 比值对发表偏倚进行了评估。由于研究之间存在异质性,因此使用 Microsoft Excel 的 MetaXL 附加工具进行了亚组分析:在筛选出的 525 篇文章中,有 20 篇被选中纳入研究。其中 6 篇为横断面研究,4 篇为前瞻性队列研究,1 篇为流行病学研究。汇总的男男性行为者Ng/Ct患病率为27%(95% CI,19%-39%),I2为98%,表明研究之间存在异质性。按国家进行的分组分析显示,南非的患病率最高(38%):释义 在撒哈拉以南非洲地区的男男性行为者中,Ng/Ct 感染的高流行率令人担忧。局限性 由于有关Ng/Ct感染率的数据有限,SSA的真实感染率及其相关风险因素尚不确定:作为第一项系统回顾性传播疾病在 SSA MSM 人口中流行情况的现有文献的研究,该研究表明,Ng/Ct 的负担高于其他地区,因此有必要加强卫生系统,以改善 MSM 人口的教育、检测和治疗:系统综述注册:prospero crd42022327095。
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引用次数: 0
Review of the target trial methodological approach on treatment effect estimates in kidney failure: protocol for a systematic assessment. 肾衰竭治疗效果估计目标试验方法回顾:系统评估协议。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-14 DOI: 10.1186/s13643-024-02672-4
Jule Pinter, David J Tunnicliffe, Pooshwikaa Karunikaikumar, Anastasios Anastasiadis, Robert K Hills

Background: Patients with kidney failure often lack robust evidence because they are excluded from randomized trials. Trial emulation provides an alternative approach to derive treatment effect estimates when randomized trials cannot be conducted. Critical questions about the comparative efficacy and safety of interventions in kidney failure are now being answered using this approach or parts of it. However, variations and inconsistencies in reporting cast doubt on the reliability and validity of effect estimates not derived from randomized trials. The aim of this methodological systematic review is to understand the extent to which the target study approach is used in kidney failure and the appropriateness of this approach. By identifying and evaluating studies that qualify as emulating a target trial, compared with studies that did not apply the principles. We aim to provide more specific methodological guidance to increase the clarity and reliability of reporting treatment effect estimates when running a trial in kidney failure is not feasible.

Methods: This protocol is developed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols (PRISMA-P) statement. MEDLINE, Embase, and reference lists (backwards citation chasing) will be searched up until 1st July 2023 and the search updated prior to publication to identify all studies evaluating patient outcomes in late-stage kidney disease and failure that use target trial emulation as the primary approach for analysis. Two authors (A. A., P. K.) will select articles based on title and abstract and then full text, with a third reviewer settling disagreements (J. P.). The prespecified variables will be extracted, and the risk of bias will be assessed by at least two authors (A. A., P. K., A. N.) using prespecified data forms. This will enable the determination of the robustness of the methodological quality of observational studies in using the whole or elements of the target trial approach. We will thereby assess their ability to reliably report treatment effect estimates.

Discussion: We will provide specific methodological recommendations on how to design target trials and model assumptions for emulation to get reliable treatment effect estimates for therapeutic interventions in kidney failure.

Methodological systematic review registration: Open Science Framework: Identifier https://doi.org/10.17605/OSF.IO/Z4Y29 .

背景:肾衰竭患者往往被排除在随机试验之外,因此缺乏有力的证据。在无法进行随机试验的情况下,试验仿真为得出治疗效果估计值提供了另一种方法。目前,有关肾衰竭干预措施的比较疗效和安全性的关键问题正在通过这种方法或部分方法得到解答。然而,报告中的差异和不一致性使人们对非随机试验得出的疗效估计值的可靠性和有效性产生了怀疑。本方法学系统综述旨在了解目标研究法在肾衰竭中的应用程度以及该方法的适宜性。通过识别和评估符合目标试验条件的研究,并与未采用目标试验原则的研究进行比较。我们旨在提供更具体的方法学指导,以提高在肾衰竭中进行试验不可行时报告治疗效果估计值的清晰度和可靠性:方法:本方案根据系统综述和荟萃分析首选报告项目(PRISMA-P)声明制定。我们将检索MEDLINE、Embase和参考文献列表(反向引用追溯),直至2023年7月1日,并在发表前更新检索结果,以确定所有评估晚期肾病和肾衰竭患者预后的研究,这些研究以目标试验模拟作为主要分析方法。两位作者(A. A. 和 P. K.)将根据标题和摘要选择文章,然后再选择全文,由第三位审稿人(J. P.)解决分歧。至少两名作者(A. A.、P. K.、A. N.)将使用预先指定的数据表格提取预先指定的变量并评估偏倚风险。这将有助于确定观察性研究在使用目标试验方法的全部或部分内容时方法质量的稳健性。因此,我们将评估这些研究可靠地报告治疗效果估计值的能力:我们将就如何设计目标试验和模型假设提供具体的方法学建议,以便为肾衰竭的治疗干预获得可靠的治疗效果估计值:开放科学框架:标识符 https://doi.org/10.17605/OSF.IO/Z4Y29 。
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引用次数: 0
Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach. 声门上喷射供氧和通气以最大限度减少镇静相关低氧血症的有效性和安全性:采用 GRADE 方法进行的荟萃分析。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-14 DOI: 10.1186/s13643-024-02707-w
I-Wen Chen, Wei-Ting Wang, Pei-Chun Lai, Chun-Ning Ho, Chien-Ming Lin, Yao-Tsung Lin, Yen-Ta Huang, Kuo-Chuan Hung

Introduction: Hypoxemia is a common complication of sedation. This meta-analysis aimed to evaluate the efficacy and safety of supraglottic jet oxygenation and ventilation (SJOV) in preventing hypoxemia during sedative procedures.

Methods: Randomized controlled trials (RCTs) that compared SJOV with conventional oxygen therapy in sedated patients were searched in five databases (MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], and Google Scholar) from their inception to March 2024. The primary outcome was the proportion of patients who developed hypoxia (SpO2 < 90%). The secondary outcomes included subclinical respiratory depression (90% ≤ SpO2 < 95%), severe hypoxemia (SpO2 < 75%), airway interventions, adverse events, hemodynamics, propofol dosage, and procedure time. The certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results: Twelve trials (n = 3058) were included in the analysis. The evidence suggests that SJOV results in a large reduction in the risk of hypoxemia (risk ratio [RR], 0.26; 95% confidence interval, 0.19-0.36; low certainty) and subclinical respiratory depression (RR, 0.40; low certainty) compared with the control. SJOV likely resulted in a large reduction in the risk of severe hypoxemia (RR, 0.22; moderate certainty). In addition, it may result in a large reduction in the need for jaw lift (RR, 0.22; low certainty) and mask ventilation (RR, 0.13; low certainty). The risk of sore throat probably increases with SJOV (RR, 1.71; moderate certainty), whereas SJOV may result in little to no difference in nasal bleeding (RR, 1.75; low certainty). Evidence is very uncertain regarding the effect of SJOV on hemodynamics (very low certainty) and procedure time (very low certainty). SJOV probably resulted in little to no difference in sedative doses between the groups (moderate certainty).

Conclusion: According to the GRADE approach, SJOV likely results in a large reduction in the risk of severe hypoxemia but probably increases the risk of sore throat. Compared with the control, evidence suggests that SJOV results in a large reduction in the risk of hypoxemia, subclinical respiratory depression, and the need for airway manipulation, with little to no difference in nasal bleeding. The integration of SJOV into clinical practice may help minimize hypoxemic events in at-risk patients.

简介低氧血症是镇静过程中常见的并发症。本荟萃分析旨在评估声门上喷射供氧和通气(SJOV)在镇静手术中预防低氧血症的有效性和安全性:方法:在五个数据库(MEDLINE、EMBASE、Cochrane Library、中国国家知识基础设施[CNKI]和谷歌学术)中检索了从开始到2024年3月对镇静患者进行SJOV与传统氧疗比较的随机对照试验(RCT)。主要结果是出现缺氧的患者比例(SpO2 2 2 结果:12 项试验(n = 3058)被纳入分析。证据表明,与对照组相比,SJOV 可大幅降低低氧血症(风险比 [RR],0.26;95% 置信区间,0.19-0.36;低确定性)和亚临床呼吸抑制(RR,0.40;低确定性)的风险。SJOV 很可能会大大降低严重低氧血症的风险(RR,0.22;中等确定性)。此外,SJOV 还可大大减少下颌抬高(RR,0.22;低度确定性)和面罩通气(RR,0.13;低度确定性)的需要。SJOV 可能会增加喉咙痛的风险(RR,1.71;中等确定性),而 SJOV 可能导致的鼻出血差异很小甚至没有(RR,1.75;低确定性)。关于 SJOV 对血液动力学(确定性极低)和手术时间(确定性极低)的影响,证据非常不确定。SJOV可能导致各组间镇静剂剂量几乎没有差异(中等确定性):根据 GRADE 方法,SJOV 可能会大大降低严重低氧血症的风险,但可能会增加喉咙痛的风险。与对照组相比,有证据表明 SJOV 可大大降低低氧血症、亚临床呼吸抑制和气道操作需求的风险,而鼻出血方面几乎没有差异。将 SJOV 纳入临床实践可能有助于最大限度地减少高危患者的低氧血症事件。
{"title":"Efficacy and safety of supraglottic jet oxygenation and ventilation to minimize sedation-related hypoxemia: a meta-analysis with GRADE approach.","authors":"I-Wen Chen, Wei-Ting Wang, Pei-Chun Lai, Chun-Ning Ho, Chien-Ming Lin, Yao-Tsung Lin, Yen-Ta Huang, Kuo-Chuan Hung","doi":"10.1186/s13643-024-02707-w","DOIUrl":"10.1186/s13643-024-02707-w","url":null,"abstract":"<p><strong>Introduction: </strong>Hypoxemia is a common complication of sedation. This meta-analysis aimed to evaluate the efficacy and safety of supraglottic jet oxygenation and ventilation (SJOV) in preventing hypoxemia during sedative procedures.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) that compared SJOV with conventional oxygen therapy in sedated patients were searched in five databases (MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], and Google Scholar) from their inception to March 2024. The primary outcome was the proportion of patients who developed hypoxia (SpO<sub>2</sub> < 90%). The secondary outcomes included subclinical respiratory depression (90% ≤ SpO<sub>2</sub> < 95%), severe hypoxemia (SpO<sub>2</sub> < 75%), airway interventions, adverse events, hemodynamics, propofol dosage, and procedure time. The certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Twelve trials (n = 3058) were included in the analysis. The evidence suggests that SJOV results in a large reduction in the risk of hypoxemia (risk ratio [RR], 0.26; 95% confidence interval, 0.19-0.36; low certainty) and subclinical respiratory depression (RR, 0.40; low certainty) compared with the control. SJOV likely resulted in a large reduction in the risk of severe hypoxemia (RR, 0.22; moderate certainty). In addition, it may result in a large reduction in the need for jaw lift (RR, 0.22; low certainty) and mask ventilation (RR, 0.13; low certainty). The risk of sore throat probably increases with SJOV (RR, 1.71; moderate certainty), whereas SJOV may result in little to no difference in nasal bleeding (RR, 1.75; low certainty). Evidence is very uncertain regarding the effect of SJOV on hemodynamics (very low certainty) and procedure time (very low certainty). SJOV probably resulted in little to no difference in sedative doses between the groups (moderate certainty).</p><p><strong>Conclusion: </strong>According to the GRADE approach, SJOV likely results in a large reduction in the risk of severe hypoxemia but probably increases the risk of sore throat. Compared with the control, evidence suggests that SJOV results in a large reduction in the risk of hypoxemia, subclinical respiratory depression, and the need for airway manipulation, with little to no difference in nasal bleeding. The integration of SJOV into clinical practice may help minimize hypoxemic events in at-risk patients.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"281"},"PeriodicalIF":6.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The pyroptosis and fibrotic diseases: a bibliometric analysis from 2010 to 2024. 热病与纤维化疾病:2010 年至 2024 年的文献计量分析。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-13 DOI: 10.1186/s13643-024-02703-0
Long Zhu, Lijia Ou, Binjie Liu, Yang Yang, Chang Su, Ousheng Liu, Hui Feng

Background: Fibrosis is the ultimate, common pathological ending of most chronic inflammatory diseases and increases the chances of developing life-threatening illnesses. Pyroptosis, a newfound form of lytic programmed cell death initiated by the inflammasome, has received more and more attention because of its association with fibrotic diseases. Therefore, this study visualizes the connection between pyroptosis and fibrosis research through bibliometric methods, aimed at providing global research hits and tendencies in the field.

Methods: We collected and analyzed the articles on pyroptosis and fibrosis from 2010 to 2024 via Web of Science. Visual data analysis was performed for countries, institutions, authors, references, and keywords in the field using VOSviewer, CiteSpace software, the "Bibliometrix" R package, the bibliometric website ( https://bibliometric.com/ ), and Excel software. We analyzed the data by utilizing the bibliometric review method.

Results: A total of 566 articles and reviews relating to pyroptosis and fibrosis were identified in the Web of Science. The number of publications in the domain has continued to grow since 2010. These scientific outputs were mainly from 129 countries/regions and 1919 institutions, particularly China (n = 423) and the USA (n = 83). More importantly, although China publishes a vast majority of articles, its centrality is lower than that of the USA (0.59 vs 0.61). Among the 3833 authors involved in this field, Feldstein, A. E. is the most prolific author. Shi, J. J. is the world's most-cited author among the 12,143 authors in these academic journals. Frontiers in Immunology was a prolific contributor, and Nature was the most frequently cited journal. After analysis, Cleavage of GSDMD by inflammatory caspases determines pyroptotic cell death were the top-cited articles. The analysis of keywords displayed that pyroptosis, fibrosis, and pathways were the main research hotspots and frontier directions in recent years.

Conclusion: We analyzed the characteristics of published articles and drew a fundamental knowledge structure on pyroptosis and fibrosis research via bibliometric analysis. The potential mechanism between fibrosis and pyroptosis is deeply tied to the current moment. Our findings can help researchers make clear the research status and value of fibrosis and pyroptosis and provide new directions for future research as soon as possible.

背景:纤维化是大多数慢性炎症性疾病的最终常见病理结局,会增加患上危及生命的疾病的几率。由炎性体引发的一种新发现的细胞溶解性程序性死亡形式--裂解酶,因其与纤维化疾病的关联而受到越来越多的关注。因此,本研究通过文献计量学方法直观地展示了热蛋白沉积症与纤维化研究之间的联系,旨在提供该领域的全球研究热点和趋势:我们通过 Web of Science 收集并分析了 2010 年至 2024 年有关热蛋白沉积症和纤维化的文章。我们使用 VOSviewer、CiteSpace 软件、"Bibliometrix "R 软件包、文献计量学网站 ( https://bibliometric.com/ ) 和 Excel 软件对该领域的国家、机构、作者、参考文献和关键词进行了可视化数据分析。我们利用文献计量学审查方法对数据进行了分析:结果:我们在 Web of Science 上共找到了 566 篇与热病和纤维化相关的文章和综述。自 2010 年以来,该领域的论文数量持续增长。这些科学成果主要来自 129 个国家/地区和 1919 个机构,尤其是中国(n = 423)和美国(n = 83)。更重要的是,尽管中国发表了绝大多数文章,但其中心度却低于美国(0.59 对 0.61)。在该领域的 3833 位作者中,Feldstein, A. E. 是最多产的作者。在这些学术期刊的 12,143 位作者中,Shi, J. J. 是世界上被引用次数最多的作者。免疫学前沿》是多产作者,《自然》是被引用次数最多的期刊。经过分析,GSDMD 被炎性 Caspases 分解决定了细胞的热解死亡是被引用最多的文章。关键词分析表明,热变态、纤维化和通路是近年来的主要研究热点和前沿方向:我们分析了已发表文章的特点,并通过文献计量学分析得出了热解和纤维化研究的基本知识结构。纤维化与热蛋白沉积之间的潜在机制与当下的研究息息相关。我们的研究结果可以帮助研究人员明确纤维化和热病的研究现状和价值,并尽快为未来的研究提供新的方向。
{"title":"The pyroptosis and fibrotic diseases: a bibliometric analysis from 2010 to 2024.","authors":"Long Zhu, Lijia Ou, Binjie Liu, Yang Yang, Chang Su, Ousheng Liu, Hui Feng","doi":"10.1186/s13643-024-02703-0","DOIUrl":"10.1186/s13643-024-02703-0","url":null,"abstract":"<p><strong>Background: </strong>Fibrosis is the ultimate, common pathological ending of most chronic inflammatory diseases and increases the chances of developing life-threatening illnesses. Pyroptosis, a newfound form of lytic programmed cell death initiated by the inflammasome, has received more and more attention because of its association with fibrotic diseases. Therefore, this study visualizes the connection between pyroptosis and fibrosis research through bibliometric methods, aimed at providing global research hits and tendencies in the field.</p><p><strong>Methods: </strong>We collected and analyzed the articles on pyroptosis and fibrosis from 2010 to 2024 via Web of Science. Visual data analysis was performed for countries, institutions, authors, references, and keywords in the field using VOSviewer, CiteSpace software, the \"Bibliometrix\" R package, the bibliometric website ( https://bibliometric.com/ ), and Excel software. We analyzed the data by utilizing the bibliometric review method.</p><p><strong>Results: </strong>A total of 566 articles and reviews relating to pyroptosis and fibrosis were identified in the Web of Science. The number of publications in the domain has continued to grow since 2010. These scientific outputs were mainly from 129 countries/regions and 1919 institutions, particularly China (n = 423) and the USA (n = 83). More importantly, although China publishes a vast majority of articles, its centrality is lower than that of the USA (0.59 vs 0.61). Among the 3833 authors involved in this field, Feldstein, A. E. is the most prolific author. Shi, J. J. is the world's most-cited author among the 12,143 authors in these academic journals. Frontiers in Immunology was a prolific contributor, and Nature was the most frequently cited journal. After analysis, Cleavage of GSDMD by inflammatory caspases determines pyroptotic cell death were the top-cited articles. The analysis of keywords displayed that pyroptosis, fibrosis, and pathways were the main research hotspots and frontier directions in recent years.</p><p><strong>Conclusion: </strong>We analyzed the characteristics of published articles and drew a fundamental knowledge structure on pyroptosis and fibrosis research via bibliometric analysis. The potential mechanism between fibrosis and pyroptosis is deeply tied to the current moment. Our findings can help researchers make clear the research status and value of fibrosis and pyroptosis and provide new directions for future research as soon as possible.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"279"},"PeriodicalIF":6.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review and meta-analysis of factors contributing to post-kidney transplant anemia and the effect of erythropoietin-stimulating agents. 对导致肾移植后贫血的因素及促红细胞生成素药物效果的系统回顾和荟萃分析。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-12 DOI: 10.1186/s13643-024-02709-8
Kittiphan Chienwichai, Supitchaya Phirom, Thunyatorn Wuttiputhanun, Asada Leelahavanichkul, Natavudh Townamchai, Yingyos Avihingsanon, Suwasin Udomkarnjananun

Background: The effects of various risk and associated factors on post-kidney transplant anemia (PTA) have not been fully compared and estimated. This meta-analysis aims to elucidate factors contributing to PTA and determine the influence of erythropoietin-stimulating agents (ESAs) on renal outcomes, thus offering potential pathways for enhanced management strategies post-transplant.

Methods: A systematic review was conducted in electronical database. Studies reporting on risk factors (with cause-effect relationships) and associated factors (without definite cause-effect relationships) of PTA, and the effects of ESAs on post-kidney transplant outcomes, were included. Pooled odds ratios (ORs) and weighted mean differences (WMDs) were analyzed using random-effects models.

Results: This systematic review encompassed 38,233 patients from 85 studies. Factors increased PTA risk included African American, older donor age, human antigen leukocyte mismatches, and low pre-transplant hemoglobin levels. Poor allograft function, high interleukine-6, Cytomegalovirus, delayed graft function, allograft rejections, immunosuppressive medications, and renin-angiotensin system blockades were associated with PTA. Native autosomal dominant polycystic kidney disease was a protective factor against PTA. Administration of ESAs with the aim of normalizing hemoglobin levels in patients with chronic allograft dysfunction slowed the decline in eGFR and reduce the risk of death, with a pooled OR of 0.36 (95% CI: 0.14 to 0.89; p = 0.040).

Conclusions: The risks and associated factors for PTA have been elucidated, underscoring the need for individualized treatment approaches. Late ESA therapy, aimed at hemoglobin normalization, suggests a renal-protective effect and reduced mortality, which should be considered in the management of PTA.

Systematic review registration: PROSPERO CRD42024545330.

背景:各种风险和相关因素对肾移植后贫血(PTA)的影响尚未得到充分比较和估计。本荟萃分析旨在阐明导致 PTA 的因素,并确定促红细胞生成素(ESAs)对肾脏预后的影响,从而为加强移植后管理策略提供潜在途径:方法:在电子数据库中进行了系统性回顾。方法:在电子数据库中进行了系统性综述,纳入了报告 PTA 风险因素(有因果关系)和相关因素(无明确因果关系)以及 ESA 对肾移植后预后影响的研究。采用随机效应模型分析了汇总的几率比(ORs)和加权平均差(WMDs):本系统综述涵盖了 85 项研究中的 38,233 名患者。增加 PTA 风险的因素包括非裔美国人、供体年龄较大、人类抗原白细胞不匹配以及移植前血红蛋白水平低。异体移植功能差、白细胞介素-6 高、巨细胞病毒、移植功能延迟、异体移植排斥、免疫抑制药物和肾素-血管紧张素系统阻断与 PTA 相关。原发性常染色体显性多囊肾是 PTA 的保护因素。为使慢性异体移植功能障碍患者的血红蛋白水平恢复正常而服用ESAs,可减缓eGFR的下降并降低死亡风险,汇总OR值为0.36(95% CI:0.14至0.89;P = 0.040):结论:PTA 的风险和相关因素已被阐明,强调了个体化治疗方法的必要性。以血红蛋白正常化为目标的晚期ESA治疗具有肾脏保护作用,并能降低死亡率,在治疗PTA时应加以考虑:系统综述注册:PREMCORD42024545330。
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引用次数: 0
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