BackgroundEpithelial and endothelial barrier integrity, essential for homeostasis, is maintained by cellular boarder structures known as tight junctions (TJs). In critical illness, TJs may become disrupted, resulting in barrier dysfunction manifesting as capillary leak, pulmonary edema, gut bacterial translocation, and multiple organ failure. We aim to provide a clinically focused overview of TJ structure and function and systematically review and analyze all studies assessing markers of endothelial and epithelial TJ breakdown correlated with clinical outcomes in critically ill humans.MethodsWe systematically searched MEDLINE, EMBASE, and PubMed. Additional articles were identified by targeted searches. We included studies that looked at the relationship between biomarkers of endothelial or epithelial TJ structure or function and critical illness. Results were qualitatively analyzed due to sample size and heterogeneity.ResultsA total of 5297 abstracts met search criteria, of which 150 articles met requirements for full text review. Of these, 30 studies met inclusion criteria. Fifteen of the 30 reports investigated proteins of endothelial tight junctions and 15 investigated epithelial TJ markers, exclusively in the gastrointestinal epithelium. No studies investigated TJ-derived proteins in primary cardiac or pulmonary pathology.ConclusionsTJ integrity is essential for homeostasis. We identified multiple studies that indicate TJs are disrupted by critical illness. These studies highlight the significance of barrier disruption across many critical disease states and correlate TJ-associated markers to clinically relevant outcomes. Further study on the role of multiple tissue-specific claudins, particularly in the setting of respiratory or cardiac failure, may lead to diagnostic and therapeutic advances.Systematic review registrationThis systematic review is registered in the PROSPERO database: CRD42017074546.Electronic supplementary materialThe online version of this article (10.1186/s40635-018-0203-4) contains supplementary material, which is available to authorized users.
Objective: We sought to identify optimal strategies for integrating HIV-and opioid use disorder-(OUD) screening and treatment in diverse settings. Design: Systematic review. Methods: We searched Ovid MEDLINE, PubMed, Embase, and PsycINFO and pre-identified websites. Studies were included if they were published in English on or after 2002 through May 2017, and evaluated interventions that integrated, at an organizational level, screening and/or treatment for HIV and OUD in any care setting in any country. Results: Twenty-nine articles met criteria for inclusion, including 23 unique studies: six took place in HIV care settings, 12 in opioid treatment settings, and five elsewhere. Eight involved screening strategies, 22 involved treatment strategies, and seven involved strategies that encompassed screening and treatment. Randomized controlled studies demonstrated low to moderate risk of bias and observational studies demonstrated fair to good quality. Studies in HIV care settings (n=6) identified HIV-and OUD-related clinical benefits with the use of buprenorphine/naloxone for OUD. No studies in HIV care settings focused on screening for OUD. Studies in opioid treatment settings (n=12) identified improving HIV screening uptake and clinical
The authors present a systematic review of elementary school universal school-based (USB) social and emotional learning (SEL) interventions from 2008 through 2020 for two groups of minoritized students in education research and practice: students with disabilities and/or minoritized racial identities. Completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards, in this review the authors identified 269 studies for inclusion, which reflected 107 USB SEL interventions. Eleven studies explicitly excluded students with disabilities. Studies varied widely in how disability and racial identity were categorized within and across studies and provided limited evidence of effectiveness through the use of subgroup analyses to support meaningful assessment of how students with disabilities and racially minoritized elementary school age students are benefiting from USB SEL interventions. The authors discuss the limitations of findings, education research best practices, and the minimum reporting standards necessary to ensure ability and racially minoritized youth representation in future USB SEL research.
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