Additional file 1: of Single leg squat performance in physically and non-physically active individuals: a cross-sectional study

Supplementary material –S1. Clinical rating performances between physically active and non- physically active groups. (DOCX 14 kb

Additional file 2: of Assessing imprecision in Cochrane systematic reviews: a comparison of GRADE and Trial Sequential Analysis

Cochrane systematic reviews with general characteristics. (DOCX 24 kb

Additional file 1: of Assessing imprecision in Cochrane systematic reviews: a comparison of GRADE and Trial Sequential Analysis

Trial Sequential Analysis as supplement of GRADE assessment for imprecision. (DOCX 13 kb

Additional file 3: of Assessing imprecision in Cochrane systematic reviews: a comparison of GRADE and Trial Sequential Analysis

Logistic regressions results. (DOCX 273 kb

Table_1_Revolutionizing orthopedic healthcare: a systematic review unveiling recombinant antimicrobial peptides.XLSX

The increasing demand for orthopedic surgeries, including joint replacements, is driven by an aging population and improved diagnosis of joint conditions. Orthopedic surgeries carry a risk of infection, especially in patients with comorbidities. The rise of antibiotic resistance exacerbates this issue, necessitating alternatives like in vitro bioengineered antimicrobial peptides (AMPs), offering broad-spectrum activity and multiple action mechanisms. This review aimed to assess the prevalence of antimicrobial potential and the yield after purification among recombinant AMP families. The antimicrobial potential was evaluated using the Minimum Inhibitory Concentration (MIC) values against the most common bacteria involved in clinical infections. This systematic review adhered to PRISMA guidelines, focusing on in vitro studies of recombinant AMPs. The search strategy was run on PubMed, Scopus and Embase up to 30th March 2023. The Population, Exposure and Outcome model was used to extract the data from studies and ToxRTool for the risk of bias analysis. This review included studies providing peptide production yield data and MIC values against pathogenic bacteria. Non-English texts, reviews, conference abstracts, books, studies focusing solely on chemical synthesis, those reporting incomplete data sets, using non-standard MIC assessment methods, or presenting MIC values as ranges rather than precise concentrations, were excluded. From 370 publications, 34 studies on AMPs were analyzed. These covered 46 AMPs across 18 families, with Defensins and Hepcidins being most common. Yields varied from 0.5 to 2,700 mg/L. AMPs were tested against 23 bacterial genera, with MIC values ranging from 0.125 to >1,152 μg/mL. Arenicins showed the highest antimicrobial activity, particularly against common orthopedic infection pathogens. However, AMP production yields varied and some AMPs demonstrated limited effectiveness against certain bacterial strains. This systematic review emphasizes the critical role of bioengineered AMPs to cope infections and antibiotic resistance. It meticulously evaluates recombinant AMPs, focusing on their antimicrobial efficacy and production yields. The review highlights that, despite the variability in AMP yields and effectiveness, Arenicins and Defensins are promising candidates for future research and clinical applications in treating antibiotic-resistant orthopedic infections. This study contributes significantly to the understanding of AMPs in healthcare, underscoring their potential in addressing the growing challenge of antibiotic resistance.Systematic review registration:https://osf.io/2uq4c/.</p