GEM/cochrane-simplification huggingface dataset:
Abstract: The review includes three studies with a total of 130 participants. Short-term results for hospital admissions showed no clear difference between chlorpromazine and penfluridol (1 RCT, n = 29, RR 0.19, 95% CI 0.01 to 3.60, low-quality evidence). No clear difference in the incidence of akathisia was found at medium term (2 RCTs, n = 85, RR 0.19, 95% CI 0.04 to 1.06, low-quality evidence), and similar numbers of participants - nearly half - from each treatment group left the study early (3 RCTs, n = 130, RR 1.21, 95% CI 0.83 to 1.77, low-quality evidence). The risk of needing additional antiparkinsonian medication was less in the chlorpromazine group (2 RCTs, n = 74, RR 0.70, 95% CI 0.51 to 0.95). No useable data reported clinically important change in global or mental state. No data were reported for relapse. No deaths were reported by the trials. Only three small studies provided data and the quality of reporting and evidence is low. Limited data indicate the efficacy and adverse effects profiles of chlorpromazine and penfluridol are generally similar. Penfluridol, however, may confer advantage by needing to be given only once per week. Firm conclusions are not possible without good-quality trials, and where these treatments are used, such trials are justified.

Plain-language summary: Only three randomised controlled trials, with a total of 130 participants met the review requirements and provided useable data. The quality of evidence available was low, no real difference was noted between chlorpromazine and penfluridol for hospital admissions, incidence of akathisia or numbers of participants leaving the study early. There were no deaths during the trials. We were unable to use the available data for global and mental state due to poor reporting, and no studies reported relapse data. We can not make firm conclusions regarding the comparable effectiveness between chlorpromazine and penfluridol with such poor quality data - but penfluridol only needs to be given once per week - which could help the poor adherence to medication common with schizophrenia. Remarkably, for such old drugs, more trials that report high-quality data are needed.
Abstract: We identified one trial that satisfied the inclusion criteria for this review. This trial (N = 21) showed that cranial electrotherapy stimulation (CES) decreased inertia, which is a component of apathy, while no changes were seen in the sham treatment or no treatment control groups. Given that no between-group analysis was reported, it was not possible to determine if the CES treatment group improved significantly more than the control group. No evidence was provided to support the use of CES treatment for inertia, a component of apathy. Between-group statistical analyses were not conducted and it was therefore not possible to determine the efficacy of the treatment relative to no treatment or sham treatment. Results regarding the effectiveness of treatment can only be inferred, and this evidence is based on only one trial with a small sample size. More randomised controlled trials evaluating different ways of treating apathy would be valuable. Trials should have larger sample sizes and use rigorous research designs and statistical analyses appropriate for examining between-group differences.

Plain-language summary: The review authors searched the literature for treatment studies of apathy, or a component of apathy, in people who have had a traumatic brain injury. One randomised controlled trial was found which examined the use of cranial electrotherapy stimulation for inertia, which is a component of apathy. Evidence for the effectiveness of this treatment is particularly restricted by the small number of participants and the lack of statistical analyses to demonstrate that the cranial electrotherapy stimulation treatment was more successful than sham or no treatment. More methodologically rigorous studies need to be conducted to investigate different methods of effectively treating apathy in people with traumatic brain injury.
Abstract: We included six trials involving 800 women. Of the six trials, we judged the risk of bias for three as 'low risk' for random sequence generation, blinding of participants and personnel, blinding of outcome assessment, completeness of outcome data and selective reporting. There was no statistically significant average difference in the development of stretch marks in women who received topical preparations with active ingredients compared to women who received a placebo or no treatment (average risk ratio (RR) 0.74; 95% confidence interval (CI) 0.53 to 1.03; five trials, 474 women; random-effects model, Tau² = 0.09, I² = 65%) (Analysis 1.1). Results were consistent with the main effects when we performed a sensitivity analysis excluding studies judged to be at high risk of bias for random sequence generation, allocation concealment or more than 20% missing data for a given outcome (average RR 0.81; 95% CI 0.60 to 1.10; four trials, 424 women; random-effects model, Tau² = 0.05, I² = 57%). The was no statistically significant average mean difference in the severity of stretch marks (standardised mean difference (SMD) -0.31; 95% CI -1.06 to 0.44; two trials, 255 women; Tau² = 0.26, I² = 87%). There was no statistically significant difference in the development of stretch marks in women who received topical preparations with active ingredients compared to women who received other topical preparations with active ingredients (average RR 0.51; 95% CI 0.16 to 1.60; two trials, 305 women; Tau² = 0.53, I² = 74%). There was no statistically significant difference in the severity of stretch marks (mean difference (MD) -0.20; 95% CI -0.53 to 0.13; one trial, 206 women; heterogeneity not applicable). We found no high-quality evidence to support the use of any of the topical preparations in the prevention of stretch marks during pregnancy. There is a clear need for robust, methodologically rigorous randomised trials involving larger sample sizes to evaluate the effects of topical preparations on the development of stretch marks in pregnancy. In addition, it is important that preparations commonly used by women to prevent and treat stretch marks are evaluated within the context of robust, methodologically rigorous and adequately powered randomised trials.

Plain-language summary: We included six trials (involving 800 women) in this review. We found that the application of a skin preparation to the areas affected by stretch marks during pregnancy did not prevent the development of stretch marks in the women during pregnancy. Only three trials (involving 461 women) looked at the severity of the stretch marks and did not show a clear difference. The preparations used included Alphastria, Trofolastin, Verum, olive oil and cocoa butter, which all contain vitamin E; Alphastria and Verum also have hyaluronic acid. Of the six trials, we judged three to be at low risk of bias. All trials were relatively small, with four of the six trials each including less than 100 women. The trials were also different in terms of when the women first started to use the topical applications, ranging from the first trimester to the first 20 weeks.
Abstract: Twenty studies (49 reports) were included in the review. Most of the studies applied bright light as adjunctive treatment to drug therapy, sleep deprivation, or both. In general, the quality of reporting was poor, and many reviews did not report adverse effects systematically. The treatment response in the bright light group was better than in the control treatment group, but did not reach statistical significance. The result was mainly based on studies of less than 8 days of treatment. The response to bright light was significantly better than to control treatment in high-quality studies (standardized mean difference (SMD) -0.90, 95% confidence interval (CI) -1.50 to -0.31), in studies applying morning light treatment (SMD -0.38, CI -0.62 to -0.14), and in sleep deprivation responders (SMD -1.02, CI -1.60 to -0.45). Hypomania was more common in the bright light group compared to the control treatment group (risk ratio 4.91, CI 1.66 to 14.46, number needed to harm 8, CI 5 to 20). For patients suffering from non-seasonal depression, light therapy offers modest though promising antidepressive efficacy, especially when administered during the first week of treatment, in the morning, and as an adjunctive treatment to sleep deprivation responders. Hypomania as a potential adverse effect needs to be considered. Due to limited data and heterogeneity of studies these results need to be interpreted with caution.

Plain-language summary: The reviewers conclude that the benefit of light treatment is modest though promising for non-seasonal depression. The short-term treatment as well as light administered in the morning and with concomitant sleep deprivation in sleep deprivation responders appear to be most beneficial for treatment response. Hypomania as a potential adverse effect needs to be considered. Due to limited data and heterogeneity of studies these results need to be interpreted with caution.
Abstract: Two RCTs in HIV-positive children aged 1 to 12 years were identified. One trial was the pilot study for the larger second trial and both compared initiation of cART regardless of clinical-immunological conditions with deferred initiation until per cent CD4 dropped to <15%. The two trials were conducted in Thailand, and Thailand and Cambodia, respectively. Unpublished analyses of the 122 children enrolled at ages 2 to 5 years were included in this review. There was one death in the immediate cART group and no deaths in the deferred group (RR 2.9; 95% CI 0.12 to 68.9). In the subgroup analysis of children aged 24 to 59 months, there was one CDC C event in each group (RR 0.96; 95% CI 0.06 to 14.87) and 8 and 11 CDC B events in the immediate and deferred groups respectively (RR 0.95; 95% CI 0.24 to 3.73). In this subgroup, the mean difference in CD4 per cent at study end was 5.9% (95% CI 2.7 to 9.1). One cohort study from South Africa, which compared the effect of delaying cART for up to 60 days in 573 HIV-positive children starting tuberculosis treatment (median age 3.5 years), was also included. The adjusted hazard ratios for the effect on mortality of delaying ART for more than 60 days was 1.32 (95% CI 0.55 to 3.16). This systematic review shows that there is insufficient evidence from clinical trials in support of either early or CD4-guided initiation of ART in HIV-infected children aged 2 to 5 years. Programmatic issues such as the retention in care of children in ART programmes in resource-limited settings will need to be considered when formulating WHO 2013 recommendations.

Plain-language summary: This systematic review was undertaken to help inform the 2013 WHO guidelines which aimed to revise the recommendations of when to start therapy in 2 to 5 years old children. The authors identified two randomised controlled trials (RCTs) that compared immediate with deferred initiation of cART in HIV-positive children aged 1 to 12 years in Thailand or Cambodia. Additional analyses of 122 children enrolled in the two studies at ages 2 to 5 years were made available for this review. A cohort study from South Africa in HIV-positive children (median age 3.5 years) starting tuberculosis treatment and ART was also included. Results showed that we still lack enough evidence to determine whether early or late initiation of cART is best in children aged 2 to 5 years. The authors recognized the lack of evidence but highlighted the potential value of simplifying WHO recommendations to start cART in all children below five years with the goal of providing programmatic advantage to treatment programmes in resource-limited settings.
Abstract: Four randomised controlled trials were found comparing beta-blocker therapy with placebo in patients with idiopathic Parkinson's disease. These were double-blind cross-over studies involving a total of 72 patients. Three studies did not present data from the first arm, instead presenting results as combined data from both treatment arms and both placebo arms. The risk of a carry-over effect into the second arm meant that these results were not analysed. The fourth study presented data from each arm. This was in the form of a mean total score for tremor for each group. Details of the baseline scores, the numbers of patients in each group and standard deviations were not provided, meaning that the magnitude and significance of any changes due to therapy could not be calculated. One study reported a substantial fall in heart rate in 14 of the 22 patients, with one patient withdrawing after his heart rate dropped to 56 beats per minute (baseline heart rate was not reported). In view of this lack of evidence, it is impossible to determine whether beta-blocker therapy is effective and safe for the treatment of tremor in Parkinson's disease. The high frequency of bradycardia in one trial raises some concerns about the prescription of beta-blockers to normotensive elderly patients but the study was too small for the true degree of risk to be calculated.

Plain-language summary: However, the review found there is not enough evidence from trials to show whether beta-blockers are safe and effective for tremor in Parkinson's disease. The blood pressure lowering effect of beta-blockers may be a problem to people with Parkinson's disease and normal blood pressure.