Are encapsulated pesticides less harmful to human health than their conventional alternatives? Protocol for a systematic review of in vitro and in vivo animal model studies.

BACKGROUND: The gradual increase in the global population has led to the rising demand for agricultural products worldwide. This required the introduction of environment- and public health-friendly advanced technologies for plant protection to guard yields from pest destruction in a sustainable way. Encapsulation technology is a promising procedure to increase the effectiveness of pesticide active ingredients while reducing human exposure and environmental impact. Despite the presumed favorable properties of encapsulated pesticide formulations on human health, it is necessary to systematically assess whether they are less harmful to human health than conventional pesticide products. OBJECTIVES: We aim to systematically review the literature to answer the question of whether micro- or nano-encapsulated pesticide formulations exert different degrees of toxicity than their conventional (not-encapsulated) counterparts in in vivo animal and in vitro (human, animal, and bacterial cell) non-target models. The answer is important to estimate the possible differences in the toxicological hazards of the two different types of pesticide formulations. Because our extracted data will come from different models, we also aim to perform subgroup analyses to investigate how toxicity varies across different models. A pooled toxicity effect estimate will also be performed by meta-analysis when appropriate. METHODS: The systematic review will follow the guidelines developed by the National Toxicology Program's Office of Health Assessment and Translation (NTP/OHAT). The protocol adheres to the Preferred Reporting Items for Systematic Reviews and meta-analyses Protocol (PRISMA-P) statement. PubMed (NLM), Scopus (Elsevier), Web of Science Core Collection (Clarivate), Embase (Elsevier), and Agricola (EBSCOhost) electronic databases will be comprehensively searched in September 2022 to identify eligible studies using multiple search terms of "pesticide", "encapsulation" and "toxicity" along with their synonyms and other words that are semantically related. The reference lists of all eligible articles and retrieved reviews will be manually screened to identify additional relevant papers. ELIGIBILITY CRITERIA: We will include peer-reviewed experimental (non-target in vivo animal model and in vitro human, animal, and bacterial cell cultures) studies published as full-text articles in English language that simultaneously investigate the effect of any micro- or nano-encapsulated pesticide formulation, applied in all ranges of concentrations, duration, and routes of exposure, and its corresponding active ingredient(s) or its conventional non-encapsulated product formulation(s) used in the same ranges of concentrations, duration, and routes of exposure on the same pathophysiological outcome. We will exclude studies that examine pesticidal activity on target organisms, cultures of cells isolated from target organisms exposed in vivo or in vitro, and those using biological materials isolated from target organisms/cells. STUDY APPRAISAL AND SYNTHESIS: Studies identified by the search will be screened and managed according to the review inclusion and exclusion criteria in the Covidence systematic review tool by two reviewers, who will also blindly extract the data and assess the risk of bias of included studies. The OHAT risk of bias tool will be applied to evaluate the quality and risk of bias in the included studies. Study findings will be synthesized narratively by important features of the study populations, design, exposure, and endpoints. If findings make it possible, a meta-analysis will be performed on identified toxicity outcomes. To rate the certainty in the body of evidence, we will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Bibliotherapy: Reading OVID During COVID.

An epidemic of an infectious disease such as COVID-19 is often a source of emotional distress, even among those who have not been directly exposed to the disease. The period following the acute phase of the coronavirus epidemic and the mitigation measures will likely be hardest for medical professionals in terms of psychological impact. Bibliotherapy is a systematic intervention regarding the use of carefully selected reading materials in order to help persons to cope with stress and personal problems. This therapy can be used easily during the pandemic. The review of evidence shows that this kind of intervention can be helpful in educational and clinical contexts. During the crisis, it can be an alternative to video and film entertainment and a transition from serious medical journal clubs to a softer medical humanities experience. In this article, we summarized the historical background of bibliotherapy. We also proposed a reading list from different times, and cultures relating to pandemic, quarantine, symptoms, confinement, and social impacts (e.g., Camus, Moravia, London, Le Clezio etc.). Bibliotherapy can be a way for doctors and healthcare workers fighting on the frontline of the pandemic to find psychological support and for debriefing. Bibliotherapy can help individuals that need support for emotional distress during the pandemic to verbalize their feelings and emotions and identify new ways of addressing problems.

Interprofessional education in health professions education programmes in the Arab world: a scoping review protocol.

INTRODUCTION: Interprofessional education is a relatively new addition to health professional education curricula in the Arab world. To understand current practice in this area, a scoping review will enable reporting of essential elements for the implementation of interprofessional education. The objective of this scoping review is to report on the implementation components, including presage, process and product, of interprofessional education in prelicensure health professions education programmes in the Arab world. METHODS AND ANALYSIS: A comprehensive and systematic search for literature will be conducted using eight electronic databases from their inception to September 2022. A presearch was devised in PubMed, Scopus and CINAHL using a combination of terms related to population, context and concept. The Covidence Systematic Review tool will be used for blind screening, selection and conflict resolution. Data will be presented in tabular format and as a narrative synthesis and will include elements that support the implementation of interprofessional education. This review will be presented according to the Joanna Briggs Institute methodology.Studies conducted with students and/or faculty in prelicensure health professions education programmes will be included. The concept to be explored is interprofessional education. The context is the region commonly known as the Arab world, which includes 18 countries, sharing many common social and cultural traditions and where Arabic is the first language.Excluded will be studies conducted on collaborative practice of health professionals and postlicensure interprofessional education. ETHICS AND DISSEMINATION: No ethical approval was required. Findings will be disseminated in conference presentations and peer-reviewed articles.

The prevalence of psychological consequences of COVID-19: A systematic review and meta-analysis of observational studies.

A systematic review and a meta-analysis were conducted to examine the overall prevalence of psychological health outcomes during COVID-19. Seven databases were systematically searched to include studies reporting on at least one psychological outcome. The pooled prevalence of primary psychological outcomes was 26% (95%CI: 21-32). Pooled prevalence for symptoms of PTSD was 33% (0-86), anxiety 28% (21-36), stress 27% (14-43), and depression 22% (13-33). The prevalence of psychological outcomes was similar in healthcare workers and in the general population (34% [24-44] and 33% [27-40] respectively). High prevalence figures support the importance of ensuring adequate provision of resources for mental health.

Systematic review of the effects of pandemic confinements on body weight and their determinants.

Pandemics and subsequent lifestyle restrictions such as 'lockdowns' may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in grey sources from their inception until 1 July 2020 with an update in PubMed and Scopus on 1 February 2021. In total, 2361 unique records were retrieved, of which forty-one studies were identified eligible: one case­control study, fourteen cohort and twenty-six cross-sectional studies (469, 362 total participants). The participants ranged in age from 6 to 86 years. The proportion of female participants ranged from 37 % to 100 %. Pandemic confinements were associated with weight gain in 7·2­72·4 % of participants and weight loss in 11·1­32·0 % of participants. Weight gain ranged from 0·6 (sd 1·3) to 3·0 (sd 2·4) kg, and weight loss ranged from 2·0 (sd 1·4) to 2·9 (sd 1·5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lockdown. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.

Effect of pharmacological interventions on lipid profiles and C-reactive protein in polycystic ovary syndrome: A systematic review and meta-analysis.

CONTEXT: Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age. It is associated with dyslipidaemia and elevated plasma C-reactive protein (CRP), which increase the risks of cardiovascular disease (CVD). OBJECTIVE: To review the existing evidence on the effects of different pharmacological interventions on lipid profiles and CRP of women with PCOS. DATA SOURCES: We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library, and Web of Science in April 2020 and updated the results in March 2021. STUDY SELECTION: The study included randomized controlled trials (RCTs) and follows the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). DATA EXTRACTION: Two independent researchers extracted data and assessed for risk of bias using the Cochrane risk of bias tool. Covidence systematic review software were used for blinded screening and study selection. DATA SYNTHESIS: In 29 RCTs, there were significant reductions in triglycerides with atorvastatin versus placebo [mean difference (MD): -0.21 mmol/L; 95% confidence interval (CI): -0.39, -0.03, I2 = 0%, moderate grade evidence]. Significant reductions were seen for low-density lipoprotein cholesterol (LDL-C) with metformin versus placebo [standardized mean difference (SMD): -0.41; 95% CI: -0.85, 0.02, I2 = 59%, low grade evidence]. Significant reductions were also seen for total cholesterol with saxagliptin versus metformin (MD: -0.15 mmol/L; 95% CI: -0.23, -0.08, I2 = 0%, very low grade evidence). Significant reductions in C-reactive protein (CRP) were seen for atorvastatin versus placebo (MD: -1.51 mmol/L; 95% CI: -3.26 to 0.24, I2 = 75%, very low-grade evidence). CONCLUSION: There were significant reductions in the lipid parameters when metformin, atorvastatin, saxagliptin, rosiglitazone and pioglitazone were compared with placebo or other agents. There was also a significant reduction of CRP with atorvastatin.

Sharps injuries and splash exposures among healthcare workers in Arab countries: protocol of a systematic review and meta-analysis.

INTRODUCTION: Sharps injuries, including needlestick injuries and splash exposures, constitute serious occupational health problems for healthcare workers, carrying the risk of bloodborne infections. However, data on such occupational incidents and their risk factors in healthcare settings are scarce and not systematically summarised in the Arab countries.The aim of this study is to conduct a systematic review and meta-analysis to review published literature about sharps injuries and splash exposures of healthcare workers in Arab countries, with the objectives to determine the incidence and/or prevalence of these events, their identified risk factors and the applied preventive and postexposure prophylactic measures. METHODS AND ANALYSIS: The protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. A comprehensive presearch developed in January to March 2021 in the database PubMed will be followed by a systematic search of six, core medical and health science databases: PubMed, EMBASE, Scopus, CINAHL, Web of Science and Africa-Wide Information in May 2021. The search will be performed without any filters or restrictions for publication years. Covidence systematic review tool will be used for document management, blinded screening and study selection. Two reviewers will independently screen the records, extract data and conduct risk of bias assessment. Results will be synthesised narratively in summary tables, and, if findings allow, meta-analysis will be conducted on the incidence and/or prevalence of sharps injuries and splash exposures, and on the effect size of risk factors. ETHICS AND DISSEMINATION: The systematic review methodology does not require ethics approval due to the nature of the study design based only on published studies. The results of the systematic review will be published in a peer-reviewed journal, disseminated to stakeholders and made publicly available. PROSPERO REGISTRATION NUMBER: CRD42021242416.

Benefits of the addition of continuous or flash glucose monitoring versus standard practice using self-monitored blood glucose and haemoglobin A1c in the primary care of diabetes mellitus: a systematic review protocol.

INTRODUCTION: Studies demonstrate that optimal glycaemic control reduces morbidity from diabetes mellitus but remains elusive in a significant portion of patients. Although research shows that continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) improves glycaemic control in selected subsets of patients with diabetes in specialty practices, we found no systematic reviews evaluating the use of CGM/FGM in primary care, where the majority of patients with diabetes are cared for.This systematic review aims to answer the questions: 'compared with usual care of self-monitoring blood glucose and haemoglobin A1c (HbA1c), does the addition of CGM/FGM use in the primary care of patients with diabetes improve glycaemic control, decrease rates of hypoglycaemia, and improve patient and physician satisfaction?' and if so, 'what subgroups of primary care patients with diabetes are most likely to benefit?'. METHODS AND ANALYSIS: Aligning with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines, a search will be conducted in PubMed, EMBASE, Scopus, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science. We will include studies investigating CGM/FGM use and reporting the primary outcome measure of HbA1c and secondary outcome measures of hypoglycaemia, time in range, time below range, time above range and patient/staff satisfaction. We will examine which patient populations appear to benefit from CGM/FGM. Three independent researchers will use the Covidence systematic review software for blinded screening and study selection. The National Heart, Lung, and Blood Institute quality assessment tool and Grading of Recommendations Assessment, Development and Evaluation will be used to assess the risk of bias and quality of evidence. ETHICS AND DISSEMINATION: The systematic review methodology does not require ethics approval due to the nature of the study design. Study findings will be publicly available to a wide readership across disciplines and will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021229416.

Impact of cardiac rehabilitation on mortality and morbidity in diabetic versus non-diabetic patients: protocol for a systematic review and meta-analysis.

BACKGROUND: Cardiac rehabilitation (CR) decreases the morbidity and mortality risk among patients with cardiac diseases; however, the impact of CR on patients with diabetes remains underexplored. This is a protocol for a systematic review and meta-analysis methodology to explore if the effect of CR on mortality and morbidity is the same in patients with type 2 diabetes compared with patients without diabetes. METHODS AND ANALYSIS: Interventional and non-interventional studies comparing the effect of CR, for at least 1 month, on all-cause mortality and cardiovascular outcomes including fatal and non-fatal myocardial infarction, revascularisation and rehospitalisation in adults with cardiac diseases will be deemed eligible for inclusion. Studies published between 1990 and 2020 will be searched in PubMed, Embase, Cochrane, CINAHL, Scopus and in registries for randomised controlled trials. Eligible studies will be selected using the Covidence software, and their salient details regarding the design, population, tested interventions and outcomes of interest will be gathered. The quality of studies to be deemed eligible and reviewed will be assessed using the Cochrane Collaboration and National Heart, Lung, and Blood Institute's tools. The appraisal process will be based on the study design (interventional and non-interventional). In the meta-analysis step, the pooled effect of CR on the outcomes will be estimated. All meta-analyses will be done using the random-effects model approach (inverse-variance method). I2 and p value of χ2 statistics will guide the heterogeneity assessment. Subgroup analyses will also be performed. The small study effect will be investigated by generating the funnel plots. The symmetry of the latter will be tested by performing Egger's test. ETHICS AND DISSEMINATION: The systematic review will use data from published literature; hence, no ethical approval will be required. Findings of the systematic review and meta-analysis will be published in peer-reviewed international journals and will be disseminated in local and international scientific meetings. PROSPERO REGISTRATION NUMBER: CRD42020148832.

Risk factors associated with quad bike crashes: a protocol for systematic review of observational studies.

INTRODUCTION: Quad bikes are four-wheeled vehicles, driven off-road on uneven terrains by farmers for work or young adults for leisure. Quad bike accidental crashes result mostly due to the unique ecosystem of uneven terrain, where these unstable vehicles are commonly driven, in addition to numerous distinctive sociodemographic characteristics related to drivers. This is a protocol for a systematic review of observational studies from all geographical regions and demographic groups in the world to summarise the common risk factors relating to quad bike crashes. METHODS AND ANALYSIS: A comprehensive search for the literature on quad bike crashes and related injuries will be conducted in six electronic databases: PubMed, Embase, Scopus, Web of Science, IEEE and PsycINFO. Proquest Dissertation and Thesis, OpenGrey and BASE will be searched for grey literature. Five researchers will be involved in the screening, and the review of full text articles, using the inclusion and exclusion criteria. Disagreements between reviewers will be resolved by discourse. Three researchers will help resolving conflicts that may arise during the screening process and will resolve eventual conflicts identified in the process with the help of the systematic review software 'Covidence' for automatic deduplication and blinded screening. Information on crashes leading to injuries and death, target population characteristics and risk factors involved will be extracted from eligible articles in addition to the assessment of the quality of the researched articles. ETHICS AND DISSEMINATION: Since this is a systematic review of published literature, a formal ethical approval is not needed. Results of the review will be disseminated through peer-reviewed publications, conference presentations and reports to the concerned authorities. PROSPERO REGISTRATION NUMBER: CRD42020170245.