This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of vaginal energy‐based devices for women with vulvovaginal dryness related to genitourinary syndrome of menopause (GSM) or hormone therapy.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of endometrial injury for reproductive outcomes in women following sexual intercourse or intrauterine insemination compared to placebo or no intervention.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of acupuncture in newborn infants undergoing painful procedures.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of intraperitoneal chemotherapy (IPC) in people with primary gastric cancer, with or without peritoneal metastasis.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of different early interventions for people with high‐risk smoldering multiple myeloma compared to placebo/observation alone.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness and safety of lymphadenectomy and sentinel node biopsy for the management of women with endometrial cancer, comparing different head‐to‐head comparisons in a network meta‐analysis, thereby allowing ranking of alternative treatment strategies.

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To evaluate the benefits and harms of complex stent-graft fenestrated endovascular aneurysm repair (FEVAR) versus open surgical repair or conservative (non-operative) management for people with complex abdominal aortic aneurysms.

Objectives This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To evaluate the diagnostic accuracy of procalcitonin in culture proven early‐ or late‐onset neonatal sepsis. Secondary objectives To evaluate the diagnostic accuracy of procalcitonin in all sepsis (including both culture‐proven and culture‐negative early‐ or late‐onset neonatal sepsis). To evaluate the diagnostic accuracy of procalcitonin in all sepsis at the most common threshold ranges used (0.5 to 1 ng/mL and ≥ 2 ng/mL). We plan to investigate heterogeneity with respect to the following covariates if adequate data are available. Timing of sepsis onset: a) EOS (≤ 72 hours), b) LOS (> 72 hours). Maturity of infant: a) term (≥ 37 week gestation) b) preterm gestation (< 37 weeks gestation). Pathogen type: a) bacterial b) fungal. Nature of threshold determination: a) threshold identified a priori b) post‐hoc ascertainment of threshold.

Cystic fibrosis (CF) is a life-limiting genetic condition affecting various organ systems including the gastrointestinal tract, endocrine system and especially the respiratory tract. Pulmonary exacerbations in CF result in increased symptoms, an acceleration in the rate of lung decline and an increased need for treatment. Early detection of infections or clinical worsening provides an opportunity for proactive treatment that may affect clinical outcomes. To evaluate whether digital technology can effectively predict pulmonary exacerbations to allow earlier intervention and improved health outcomes without increasing the burden of treatment in people with CF. We used standard, extensive Cochrane search methods. We searched the Cochrane Cystic Fibrosis Trials Register and the reference lists of relevant articles and reviews on 13 October 2022. We searched Embase and the clinical trial registries on 3 January 2023. We included randomised controlled trials (RCTs) or quasi-RCTs in people with CF looking at whether digital technology can effectively predict pulmonary exacerbations to allow earlier intervention and improved health outcomes without increasing the burden of treatment. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were 1. pulmonary exacerbations and 2. quality of life (QoL). Our secondary outcomes were 3. lung function, 4. hospitalisations, 5. intravenous (IV) antibiotics, 6. microbiology, 7. cost-effectiveness and 8. We used GRADE to assess certainty of evidence. We included three studies (415 participants) in people with CF aged 15 to 41 years over a 12-month period. One was a multicentre RCT, whilst two were single-centre RCTs. The three studies were mostly similar in their risk of bias, having low or unclear risk of selection bias but a high risk of detection bias, due to the unblinded design of these studies. The studies used a variety of digital technologies to monitor symptoms such as a digital symptom diary either with or without home spirometry monitoring. As the trials only included adults and older children, we are not certain that the results would apply to younger children. One of our primary outcomes was to assess time to detection of pulmonary exacerbation and number of pulmonary exacerbations identified between the intervention and routine care groups. We were largely unable to pool results in a meta-analysis due to the variety of methodologies and ways of reporting data. Two studies noted a shorter time to detection of exacerbations in the intervention group and one of these also reported that the intervention group had a shorter time to first exacerbation (hazard ratio for time to first exacerbation 1.45, 95% confidence interval (CI) 1.09 to 1.93), whilst a further study reported a shorter time to detection of exacerbations in the intervention group requiring oral or IV antibiotics compared to the control group (median: 70 (interquartile range (IQR) 123) days with intervention versus 141 (IQR 140) days with control; P = 0.02). However, all three studies were concordant in finding no probable effect on spirometry in the intervention groups when compared with their routine care groups over a 12-month period. We found that there is probably no difference between groups with regard to QoL scores across most domains except for Weight and Body Image, which favoured the usual care group. There is also probably no difference in the number of days of additional IV antibiotics needed or newly detected pathogens. No studies reported serious adverse events directly linked to the intervention and one study reported their smartphone application was generally well received. Pulmonary exacerbations are universally accepted to be detrimental to progression of CF-related lung disease, therefore, it is intuitive that early detection and intervention would help to improve outcomes. Digital technology provides an opportunity to detect physiological and symptomatic changes to identify exacerbations early. Our review found that digital technologies based on recording physiological change (spirometry) and symptoms probably allow earlier identification of exacerbations as a group. However, this may not reduce the number of exacerbations warranting IV antibiotics and there is probably no effect on lung function. This may be partly due to inconsistent definitions of pulmonary exacerbations and discrepancy in the management strategies for pulmonary exacerbations. Overall, the intervention may make little or no difference to QoL scores. The adherence to and uptake of digital technologies, especially those which include physiological measurements, are not well sustained and the costs of these need to be balanced against the clinical efficacy.

Objectives This is a protocol for a Cochrane Review (overview). The objectives are as follows: To summarise the evidence from Cochrane and non‐Cochrane systematic reviews of pharmacological disease‐modifying treatments for amyotrophic lateral sclerosis/motor neuron disease.