Search Results for: Il dolore neuropatico: review

Objective
To develop models to predict opportunities for improvement in trauma care and compare the performance of these models to the currently used audit filters.

Design
Retrospective registry-based study.

Setting
Single-centre, Scandinavian level one equivalent trauma centre.

Participants
8220 adult trauma patients screened for opportunities for improvement between 2013 and 2022.

Primary and secondary outcome measures
Two machine learning models (logistic regression and XGBoost) and the currently used audit filters were compared. Internal validation by an expanding window approach with annual updates was used for model evaluation. Performance measured by discrimination, calibration, sensitivity and false positive rate of opportunities for improvement prediction.

Results
A total of 8220 patients, with a mean age of 45 years, were analysed; 69% were men with a mean injury severity score of 12. Opportunities for improvement were identified in 496 (6%) patients. Both the logistic regression and XGBoost models were well-calibrated, with intercalibration indices of 0.02 and 0.02, respectively. The models demonstrated higher areas under the receiver operating characteristic curve (AUCs) (logistic regression: 0.71; XGBoost: 0.74). The XGBoost model had a lower false positive rate at a similar sensitivity (false positive rate: 0.63). The audit filters had an AUC of 0.62 and a false positive rate of 0.67.

Conclusions
The logistic regression and XGBoost models outperformed audit filters in predicting opportunities for improvement among adult trauma patients and can potentially be used to improve systems for selecting patients for trauma peer review.

Introduction
Medical comorbidity at diagnosis is associated with treatment outcome in cancer. The aim of this project is to synthesise the evidence on the association between medical comorbidities and paediatric acute lymphoblastic leukaemia and lymphoblastic lymphoma outcomes.

Methods and analysis
A systematic review of the literature will be conducted by developing a search strategy that will combine medical subject headings and natural language key words related to acute lymphoblastic leukaemia or lymphoma, medical comorbidities and treatment-related outcomes. We will search MEDLINE and EMBASE to identify studies in human subjects and written in English from the inception of each database to 30 September 2022. Two authors will independently screen the titles and abstracts of retrieved studies based on the inclusion and exclusion criteria to identify potentially eligible studies. Full-text articles of eligible studies and final included articles will be retrieved and reviewed in a similar manner by two independent reviewers. Data extraction from included articles will be conducted independently by two authors using a standardised data extraction form. Risk of bias in the included studies will be assessed using existing relevant tools. A narrative and tabular summary of the data, including outcomes, will be provided if the data do not warrant a meta-analysis. If a meta-analysis is feasible, we will pool all the effect estimates. Heterogeneity among study effect sizes will be tested with Cochran’s Q test and quantified by the I2 statistic.

Ethics and dissemination
This study will not include the collection of original data, but it will be a summary of aggregate existing data. Thus, ethics approval is not applicable. The findings of the study will be disseminated through peer-reviewed publications.

PROSPERO registration number
CRD42022366669.

Objectives
We aimed to analyse the trends, age distribution and disease burden of maternal sepsis and other maternal infections (MSMI) to improve management strategies.

Design
We extracted data from the global burden of disease (GBD) 2021 database to evaluate MSMI burden with different measures for the whole world, 21 GBD regions and 204 countries from 1990 to 2021.

Setting
Studies from the GBD 2021 database generated by population-representative data sources identified through a literature review and research collaborations were included.

Participants
Patients with an MSMI diagnosis.

Outcomes
Total numbers, age-standardised rates (ASRs) of incidence, prevalence, mortality and disability-adjusted life years (DALYs) on MSMI from the GBD 2021 study and their estimated annual percentage changes (EAPCs) were the primary outcomes.

Results
There were 19 047 404 (95% uncertainty interval (UI) 14 608 563 to 24 086 486) annual incident cases, 2 376 876 (95% UI 1 678 868 to 3 421 377) prevalent cases at a single time point, 17 665 (95% UI 14 628 to 21 191) death cases and 1 144 233 (95% UI 956 988 to 1 352 034) DALYs of total MSMI in 2021. From 1990, the case number and ASRs of incidences and prevalence showed decreasing trends, while the case number and ASRs of mortality and DALYs gradually increased with time, reaching the peak in 2001, and then declined. In 2021, the ASRs of incidence, prevalence, mortality and DALYs sharply increased with age, which reached the peak in the 20–24 age group. The ASRs were decreased with increasing sociodemographic index (SDI). In 2021, it showed a positive correlation between EAPC and ASR of DALYs (r=0.3398, p

Background
Despite the growth of the population of older people living with HIV (PLWH), data on cognitive disorders among older PLWH, particularly in low- and middle-income countries, are scarce. These data are especially underrepresented in the literature from eastern Europe and central Asia (EECA).

Objectives
This scoping review aimed to describe the peer-reviewed literature on cognitive health among PLWH in the EECA region.

Eligibility criteria
We selected articles from peer-reviewed journals that reported on cognitive assessments or the prevalence and characteristics of cognitive disorders among adult (≥18 years) PLWH in EECA countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan). Studies assessing cognition among PLWH related to traumatic brain injury, brain tumours, COVID-19, meningitis, neurosyphilis and/or other central nervous system infections were excluded.

Source of evidence
We searched for relevant data published up to March 2025 using four online databases (PubMed, CINAHL, Web of Science and PsycINFO).

Charting methods
Covidence, a web-based collaborative software platform, was used for data screening and extraction. Two independent reviewers screened abstracts and full texts, resolving disagreements through consensus. The data were extracted based on the predefined data extraction criteria.

Results
A total of 1388 peer-reviewed articles were identified; 295 articles were removed due to duplication; and 1053 and 25 articles were excluded based on the abstract/title and full-text screenings, respectively. Finally, 15 articles met the inclusion criteria. All 15 studies used different neuropsychological assessments to measure cognitive performance by domain and/or cognitive disorders among various subgroups of PLWH. One cross-sectional study focused on older populations (≥40 years old), using standardised cognitive performance assessment tests. However, it neither provided information about the prevalence estimate of cognitive disorders nor identified risk factors.

Conclusion
Existing literature on cognitive disorders among older PLWH in the EECA region is limited and insufficient to estimate prevalence, or identify risk factors, and ultimately develop appropriate policy addressing the needs of older PLWH in this region. This scoping review underscores the urgent need for large-scale, longitudinal studies employing standardised, culturally adapted neuropsychological batteries and adherence to rigorous reporting standards.

This meta-analysis provides an up-to-date comprehensive global overview that cancer survivors had increased risk of CVD and 17 CVD subtypes than non-cancer controls. CVD risk evaluation and management need to be prioritized in cancer survivors, particularly among male, younger, and specific cancer survivors (brain, hematological, respiratory, male genital, and breast). This study provides supporting evidence that may inform future updates to guidelines for CVD prevention in cancer survivors, highlighting its public health relevance.

High-certainty evidence supported the therapeutic and secondary preventive benefits of colchicine in patients with ASCVD when dose and duration were appropriately controlled. Future studies could focus on identifying ASCVD subgroups with pharmacogenomic and ethnographic predictors of colchicine response heterogeneity to guide precision therapy.

Introduction
The first 3 months post partum is a critical transition period for women and families, which is characterised by physical, psychological and social adaptation. The first year post partum is also a critical phase for women’s health, given their physical recovery and adjustment to motherhood. The WHO 2023 recommendations highlight the importance of a postnatal care focus, including maternal health assessment, mental health support, nutritional interventions, postpartum contraceptive use and home care visits. This scoping review aims to map the evidence of the effectiveness of postpartum care on women’s health and quality of life in the Southeast Asia region.

Methods and analysis
This scoping review will be guided by the methodological principles developed by Arksey and O’Malley. This review will also consider observational studies, including cohort studies, case-control studies and cross-sectional studies. For inclusion, studies should be selected for eligibility based on the following criteria: articles investigating the uptake of postpartum women (women who have had childbirth up to 42 days after delivery) in Southeast Asian countries. The search will comprise peer-reviewed articles from 2013 to 2023 from the following electronic databases: PubMed/MEDLINE, ProQuest, EBSCO, Scopus, Web of Science and Google Scholar. We use both keywords in the title and/or abstract and subject headings as appropriate. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Protocols to develop the protocol and use the PRISMA flow diagram to present the results for scoping reviews.

Ethics and dissemination
A scoping review is a novel approach for examining the breadth of literature regarding the connection between the effectiveness of postpartum care and women’s health and quality of life and, as a secondary analysis, does not require ethics approval. The results of this review will be submitted for publication in a peer-reviewed journal and presented at relevant conferences.

Introduction
The menopause transition is a critical period of life for women associated with a variety of symptoms that may impact health status and quality of life. Menopause education can improve menopause knowledge and self-efficacy, leading to the adaptation of self-management strategies that may reduce menopause symptom burden and enhance quality of life. The purpose of this review is to systematically evaluate the research on the effect of menopause education interventions among midlife women (age 35–55 years) on menopause knowledge, self-efficacy, symptoms and quality of life.

Methods and analysis
This protocol is guided by the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will comprehensively search for articles published from all publication years through December 2024 in PubMed, Embase, CINAHL, PsycINFO, ProQuest Dissertation and Theses, and Scopus. The search strategy will include the following key terms and Medical Subject Headings terms: ‘menopause’, ‘menopausal’, ‘menopause transition’, ‘climacteric’, ‘health promotion’, ‘health education’ and ‘patient education’. Eligible studies will be experimental or quasi-experimental and include midlife women (age 35–55 years) who have received a menopause education intervention. Studies must report on the impact of menopause education interventions on menopause knowledge, self-efficacy, symptoms or quality of life. Only peer-reviewed articles and dissertations in English and Spanish will be included. Behavioural interventions (diet, physical activity, yoga) and medical interventions will be excluded. Two reviewers will independently perform data extraction and assess study quality/risk of bias with the Cochrane Risk of Bias tool for randomised experimental studies (RoB2) and the Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-I). A narrative approach will be used to synthesise findings.

Ethics and dissemination
Ethical approval is not required for this systematic review of published literature. Findings will be disseminated via peer-reviewed journal publications, presentations at professional scientific meetings and social media.

PROSPERO registration number
CRD42024599106.

Introduction
Striking the balance in 24-hour movement behaviour (sedentary behaviour, physical activity and sleep) is expected to reduce the risk of a new major cardiovascular event or death (MACE). We aim to determine the effectiveness and cost-effectiveness of the RISE (Reduce and Interrupt sedentary behaviour using a blended behavioural intervention to Empower people at risk towards sustainable 24-hour movement behaviour change) intervention by improving 24-hour movement behaviour for prevention of MACE and gaining quality-adjusted life years (QALYs) in community-dwelling people at risk with a first-ever stroke.

Methods and analysis
This assessor-blinded multicentre randomised controlled trial includes about 1000 participants with a first-ever stroke, of which 752 participants require secondary prevention based on their 24-hour movement behaviour. Participants will be randomly assigned to the experimental group (RISE intervention + usual care) or control (usual care) group. RISE is a 15-week blended care intervention: primary care physiotherapists coach people in their home setting using behaviour change techniques and the RISE eCoaching system. This system consists of: (1) an activity monitor, (2) a smartphone application that provides real-time feedback and contains e-learning modules and (3) a monitoring dashboard for the physiotherapist. A close relative of the participant is involved during the intervention to provide social support. The primary outcome is the effectiveness of the RISE intervention regarding the prevention of MACE measured at one year post randomisation using survival analysis comparing the experimental and control groups. Secondary outcomes include cost-effectiveness for MACE prevention and QALYs and changes in 24-hour movement behaviour over time using compositional data analysis.

Ethics and dissemination
Ethical approval is obtained from Medical Ethics Review Committee Utrecht, NedMec NL83940.000.23. Findings will be disseminated through international peer-reviewed journals and conferences. A sustainable 24-hour movement behaviour change is needed to gain long-term benefits of lowering MACE in patients with stroke. The RISE intervention offers this foundation by integrating behaviour change techniques, the RISE eCoaching system, involvement of participatory support and extensively trained RISE physiotherapists. Consequently, the RISE intervention is expected to be (cost-)effective compared with usual care, and hence, this study will offer a foundation for implementing the RISE intervention in standard poststroke care.

Trial registration number
NCT06124248.

Introduction
Targeted oxygenation protocols in mechanically ventilated patients are critical in avoiding the deleterious effects of hypoxaemia and hyperoxaemia. Peripheral oxygen saturation (SpO2) is a practical metric that commonly drives oxygen titration protocols and guidelines but has inaccuracies attributable to patient variability that can lead to occult hypoxaemia. Conversely, arterial oxygen saturation (SaO2) offers accuracy but is costly and invasive. We aim to develop a novel approach to targeted oxygenation that collectively uses the accuracy of SaO2 and the feasibility of SpO2 to mitigate occult hypoxaemia and prevent hyperoxaemia.

Methods and analysis
The Optimization of Inspired Oxygen during Mechanical Ventilation trial is a pragmatic stepped wedge, open label, cluster-randomised controlled trial of an algorithm-based SpO2-SaO2 electronic alert-based oxygen titration protocol. The intervention arm includes targeted oxygenation via an electronic SpO2-SaO2 driven alert protocol. The control group will be subjected to oxygen titration according to standard practice. Within the intervention arm, patients will be assigned to groups with different SpO2 targets based on the degree of SpO2-SaO2 difference. In the ‘Conserve O2’ group, where SpO2SaO2 by 1–2%, electronic alerts will be used to titrate FiO2 to a target SpO2 of 90–94%. In the ‘Boosted O2’ group, where SpO2 >SaO2 by 3–5%, electronic alerts will be used to titrate FiO2 to a target SpO2 of 93–97%. Patients with an SpO2-SaO2 difference >5% in either direction will be monitored but not assigned to either group. The sample size to determine efficacy is 1620 subjects, randomised over 60 weeks. The primary outcome is the proportion of time during mechanical ventilation spent within the target range, SpO2 of 90–94% (Conserve O2) or SpO2 of 93–97% (Boosted O2) at any FiO2. Secondary outcomes include the proportion of time with SpO2 >94% or SpO2 >97% with FiO2 ≤0.4 within each respective algorithm, the proportion of time with SpO2

Introduction
The integration of dental services within the broader healthcare landscape is crucial for achieving integrated healthcare delivery. However, we lack a clear representation of the full spectrum of possible dental service integration, which is necessary for policymakers, healthcare system organisers, researchers, professionals and patients themselves to optimise organisations. Our present research aims to establish the foundation for a taxonomy of dental services that is fully integrated into the health domain, while minimising historical, cultural or epistemological biases.

Methods and analysis
This protocol outlines a scoping review that will adhere to the framework of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. It has also been registered on the Open Science Framework. The research team, including a patient representative, advocate and transdisciplinary researcher, who has been involved from the inception, describes a two-phase dynamic screening process. An initial search will be conducted in the PubMed database using a Boolean search strategy based on theoretical frameworks that view health through a biopsychosocial continuum. New taxa will be progressively identified, and in the second phase, we will develop a new search strategy based on the results obtained and will explore deeper into certain categories or subcategories of taxa. Iterative strategies may also involve using new databases and even grey literature. This process will be repeated until taxon saturation is achieved and will be updated prior to submission to capture the latest literature, ultimately resulting in a comprehensive taxonomy, at the scale of individual healthcare pathways (micro- and meso-levels of organisation).

Ethics and dissemination
This scoping review will analyse published secondary data and does not require ethical review. The findings will be disseminated through publication in scientific journals, presentation at conferences and sharing through professional networks.

Introduction
Diabetic foot osteomyelitis (DFO) poses a serious threat to the quality of life and survival of patients, and systemic antibiotic therapy is effective and plays a pivotal role in the management of patients with DFO without amputation. However, the optimal duration of systemic antibiotic therapy is not clear. We aim to perform a network meta-analysis (NMA) to assess the efficacy and safety of different durations of antibiotic therapy for patients with DFO without amputation.

Methods and analysis
We will search multiple databases, including the China National Knowledge Infrastructure, VIP database, Wanfang Data, ScienceDirect, EBSCO, EMBASE, Web of Science, Cochrane Library, and PubMed. The outcome indicators are remission rate, time needed for complete wound healing, major amputation rates and the rate of antibiotic-related adverse events. Risk of bias will be evaluated using the Cochrane risk-of-bias tool. NMA will be performed using STATA/MP V.15.0. The surface under the cumulative ranking area will be calculated to rank each treatment.

Ethics and dissemination
This study is a systematic review protocol collecting data from published literature and does not require approval from an institutional review board. Results from this systematic review will be published in a peer-reviewed journal.

PROSPERO registration number
CRD42023486089.

Introduction
Uterine serous carcinoma (USC) accounts for 40% of endometrial cancer-related deaths. The standard of care for stages III and IV USC yields a 20%–30% survival at 2 years and a 10%–20% survival at 3–5 years. Recent advances in the second-line treatment of advanced or recurrent USC are rapidly evolving. Targeted therapeutic approaches with the use of lenvatinib plus pembrolizumab, as well as the use of trastuzumab deruxtecan, offer new hope for successful second-line therapies for patients. However, further investigation into novel targeted therapeutic approaches is warranted, given the high burden of disease associated with this aggressive histological subtype. USC shares clinical and genomic similarities with epithelial ovarian cancer, suggesting a correlation with ‘BRCAness’. Niraparib, a potent PARP1 and PARP2 inhibitor, was shown to have a positive impact on platinum-sensitive recurrent ovarian cancer, regardless of the presence or absence of BRCA status. Our hypothesis is that patients with stage III, stage IV and platinum-sensitive recurrent USC receiving niraparib maintenance in addition to standard therapy for USC may have an improved progression-free survival.

Methods and analysis
Participating sites include the primary site, Northwell Health Zucker Cancer Centre, and secondary site, Rutgers Cancer Institute of NJ. Females over the age of 18 with stage III, stage IV or platinum-sensitive recurrent USC will be recruited and enrolled based on inclusion/exclusion criteria. 24 subjects will be enrolled during phase 1 and 21 subjects will be enrolled during phase 2, over a total of 3 years. Patients will receive an individualised dose of niraparib daily every 28 days per cycle for 1 year or until progression of disease. Follow-up of disease status will continue for 5 years poststudy treatment. This phase II clinical trial will employ a Simon two-stage minimax design to test the null hypothesis that the 1 year response rate is

Objectives
To compile and compare the Comprehensive Geriatric Assessment (CGA) models that exist worldwide and their applicability in primary healthcare (PHC).

Introduction
The world’s population is ageing rapidly, but health systems are slow to keep up with this trend, making it difficult to provide care for older adults. The broad concept of frailty has prompted a comprehensive and holistic approach to patients, where the assessment is related not only to functional, physical and cognitive abilities of the older adults, but also their social, environmental and economic context. In recent decades, the approach to frailty has taken the CGA as the gold standard. With this project, we intend to carry out a scoping review to identify and describe tools to help standardise and generalise CGA in PHC.

Inclusion criteria
Individuals aged 65 years or over; CGA in a PHC setting; the CGA methods reported must include at least three domains: physical, cognitive and social; Articles without language restrictions; Articles published in the last 30 years.

Methods
All studies that refer to CGA models and fulfil the inclusion criteria will be selected. A bibliographic search of articles will be carried out using the following electronic scientific publication databases: MEDLINE-PubMed, Embase, Cochrane Library and Web of Science. We will search for grey literature on sites such as ‘OpenGrey’ and thesis repositories such as RCAAP, EBSCO and EThOS, as well as on the WHO pages. The articles will be independently selected by two reviewers, and the data will be presented in narrative format, structured according to the objective, focus and question of the review.

Ethics and dissemination
Approved by the ethics committee of the regional health administration of the centre, registered as Project 11/2024 and approved on 8 May 2024. The findings of this study will be disseminated through peer-reviewed publications and national or international conference presentations. Updates of the review will be conducted, as necessary.

Trial registration number
Open Science (DOI 10.17605/OSF.IO/REH43).

Introduction
Homelessness across the early life course poses a grave and largely preventable challenge. Those who experience homelessness early are at increased risk of a range of health, education and social inequities that can extend across the life course. Better understanding of the modifiable factors on the pathway to homelessness is needed to inform prevention at the earliest possible point in the life course and reduce the rate of child and adolescent homelessness at the population level. Here we address this gap in real-time knowledge by establishing a living systematic review of population studies of social determinants of homelessness from childhood to adolescence.

Methods and analysis
We will search MEDLINE, Embase, PubMed and PsycINFO for population-based prospective cohort studies reporting on social determinants of child and adolescent homelessness from 0 to 24 years. No study eligibility restrictions will be placed on the date, country of origin or language of publications. Study quality will be assessed using the Methodological Standards for Epidemiological Research scale. Associations between social determinants and homelessness will be reported using pooled relative risk ratios with 95% CI. If sufficient data are available, the influence of subgroup and methodological factors will be examined using meta-regression.

Ethics and dissemination
The study will synthesise published studies that have previously been granted ethics approval, meaning that it is exempt from ethics review or approval. Study findings will be disseminated through a peer-reviewed journal article, conference and seminar presentations. The authors will distribute a plain language summary through their academic and professional networks.

PROSPERO registration number
CRD42024577716.

Objectives
Understand the relational influences on help-seeking for mental health and substance use problems among people experiencing social marginalisation, with a focus on research applying social capital theory and social network analysis methods.

Design
Scoping review.

Data sources
EMBASE, Web of Science, Criminal Justice Abstracts and SocINDEX were searched up to June 2023, and Web of Science email alerts were used to capture any further publications up to June 2024.

Eligibility criteria
English-language, peer-reviewed publications that (1) focused on/discussed help-seeking for mental health or substance use problems; (2) included adults experiencing social marginalisation beyond sociodemographic factors; and (3) applied social capital theory or social network analysis methods.

Data extraction and synthesis
We extracted and charted data pertinent to review objectives and narratively synthesised results.

Results
Twenty-seven papers were included. Most (n=19) focused on the experiences of people who used drugs. Five specifically focused on help-seeking, four of which applied quantitative social network analysis, one was framed by network theories of social capital and one referred to social capital in interpreting findings. The remaining 22 papers discussed help-seeking while focused on different phenomena. Seven of these framed their approach with social capital, but none explicitly applied social capital to help-seeking. Eight papers used social network analysis, with four focused on help-seeking and seven using personal networks. Social/relational influences identified included: fear of losing social capital, the risks of high bonding capital, service providers as social capital, selective help-seeking, trust and network culture. Social capital, interconnected with the tight-knit bonds within marginalised groups, could deter help-seeking. Knowledge and attitudes towards help and help-seeking, shaped by past experiences and network cultures, influenced help-seeking and contributed to a cautious and selective approach.

Conclusion
Theoretical elaboration and empirical research are required to better appreciate the relational influences on help-seeking for mental health and substance use problems among people experiencing social marginalisation. Social capital may provide a useful theoretical approach. While social network analysis methods have been applied, they are under-utilised.