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International Journal of Rheumatic... Jul 2023Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease, thought to be influenced by both genetics and the environment. Identifying... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease, thought to be influenced by both genetics and the environment. Identifying environmental factors associated with disease risk will improve knowledge of disease mechanisms and ultimately benefit patients. This review aimed to collate and synthesize the current evidence of environmental factors associated with JIA.
METHODS
MEDLINE (Ovid), EMBASE (Ovid), Cumulative Index of Nursing and Related Health Literature (EBSCOhost), science network (WOS, Clarivate Analytics), Chinese National Knowledge Infrastructure, and Chinese Biological Medical Database were systematically searched. Study quality was rated using the Newcastle-Ottawa Scale. Pooled estimates for each environmental factor were generated using a random-effects, inverse-variance method, where possible. The remaining environmental factors were synthesized in narrative form.
RESULTS
This review includes environmental factors from 23 studies (6 cohorts and 17 case-control studies). Cesarean section delivery was associated with increased JIA risk (pooled relative risk [RR] 1.103, 95% CI 1.033-1.177). Conversely, maternal smoking of more than 20 cigarettes/day (pooled RR 0.650, 95% CI 0.431-0.981) and gestational smoking (pooled RR0.634, 95% CI 0.452-0.890) were associated with decreased JIA risk.
CONCLUSION
This review identifies several environmental factors associated with JIA and demonstrates the huge breadth of environmental research. We also highlight the challenges of combining data collected over this period due to limited study comparability, evolution in healthcare and social practices, and changing environment, which warrant consideration when planning future studies.
Topics: Humans; Child; Pregnancy; Female; Arthritis, Juvenile; Cesarean Section; Smoking; Quality of Life; Case-Control Studies
PubMed: 37309290
DOI: 10.1111/1756-185X.14729 -
Journal of Nephrology Aug 2014The metabolic syndrome is a cluster of cardiometabolic alterations at least partly dependent on reduced insulin sensitivity and hyperinsulinemia that can have several... (Meta-Analysis)
Meta-Analysis Review
The metabolic syndrome is a cluster of cardiometabolic alterations at least partly dependent on reduced insulin sensitivity and hyperinsulinemia that can have several renal implications. A systematic review and meta-analysis of studies available in the international literature in English language demonstrates that the metabolic syndrome occurrence is associated with a significantly higher prevalence of nephrolithiasis (odds ratio 1.29, 95% confidence intervals: 1.11-1.51). The pathophysiological bases of this association are currently not completely understood, however. Potential pathogenetic links between the two conditions include metabolic factors that promote insulin resistance as well as stone formation in urine, environmental factors such as diet, oxidative stress and inflammation, and molecular changes impacting the transport of some analytes in urine. Metabolic syndrome-related nephrolithiasis shows peculiar clinical and biochemical characteristics and should be considered a multifactorial systemic disorder needing a multidisciplinary approach for adequate prevention and management in pediatric and adult age.
Topics: Age Factors; Feeding Behavior; Humans; Kidney Calculi; Metabolic Syndrome; Nephrolithiasis
PubMed: 24696310
DOI: 10.1007/s40620-014-0085-9 -
JMIR Medical Education Jun 2020The use of artificial intelligence (AI) in medicine will generate numerous application possibilities to improve patient care, provide real-time data analytics, and... (Review)
Review
BACKGROUND
The use of artificial intelligence (AI) in medicine will generate numerous application possibilities to improve patient care, provide real-time data analytics, and enable continuous patient monitoring. Clinicians and health informaticians should become familiar with machine learning and deep learning. Additionally, they should have a strong background in data analytics and data visualization to use, evaluate, and develop AI applications in clinical practice.
OBJECTIVE
The main objective of this study was to evaluate the current state of AI training and the use of AI tools to enhance the learning experience.
METHODS
A comprehensive systematic review was conducted to analyze the use of AI in medical and health informatics education, and to evaluate existing AI training practices. PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols) guidelines were followed. The studies that focused on the use of AI tools to enhance medical education and the studies that investigated teaching AI as a new competency were categorized separately to evaluate recent developments.
RESULTS
This systematic review revealed that recent publications recommend the integration of AI training into medical and health informatics curricula.
CONCLUSIONS
To the best of our knowledge, this is the first systematic review exploring the current state of AI education in both medicine and health informatics. Since AI curricula have not been standardized and competencies have not been determined, a framework for specialized AI training in medical and health informatics education is proposed.
PubMed: 32602844
DOI: 10.2196/19285 -
Anesthesia and Analgesia Feb 2023Several frailty screening tools have been shown to predict mortality and complications after surgery. However, these tools were developed for in-person evaluation and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several frailty screening tools have been shown to predict mortality and complications after surgery. However, these tools were developed for in-person evaluation and cannot be used during virtual assessments before surgery. The FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) scale is a brief assessment that can potentially be conducted virtually or self-administered, but its association with postoperative outcomes in older surgical patients is unknown. The objective of this systematic review and meta-analysis (SRMA) was to determine whether the FRAIL scale is associated with mortality and postoperative outcomes in older surgical patients.
METHODS
Systematic searches were conducted of multiple literature databases from January 1, 2008, to December 17, 2022, to identify English language studies using the FRAIL scale in surgical patients and reporting mortality and postoperative outcomes, including postoperative complications, postoperative delirium, length of stay, and functional recovery. These databases included Medline, Medline ePubs/In-process citations, Embase, APA (American Psychological Association) PsycInfo, Ovid Emcare Nursing, (all via the Ovid platform), Cumulative Index to Nursing and Allied Health Literature (CINAHL) EbscoHost, the Web of Science (Clarivate Analytics), and Scopus (Elsevier). The risk of bias was assessed using the quality in prognosis studies tool.
RESULTS
A total of 18 studies with 4479 patients were included. Eleven studies reported mortality at varying time points. Eight studies were included in the meta-analysis of mortality. The pooled odds ratio (OR) of 30-day, 6-month, and 1-year mortality for frail patients was 6.62 (95% confidence interval [CI], 2.80-15.61; P < .01), 2.97 (95% CI, 1.54-5.72; P < .01), and 1.54 (95% CI, 0.91-2.58; P = .11), respectively. Frailty was associated with postoperative complications and postoperative delirium, with an OR of 3.11 (95% CI, 2.06-4.68; P < .01) and 2.65 (95% CI, 1.85-3.80; P < .01), respectively. The risk of bias was low in 16 of 18 studies.
CONCLUSIONS
As measured by the FRAIL scale, frailty was associated with 30-day mortality, 6-month mortality, postoperative complications, and postoperative delirium.
Topics: Humans; Aged; Frailty; Frail Elderly; Emergence Delirium; Geriatric Assessment; Postoperative Complications
PubMed: 36638509
DOI: 10.1213/ANE.0000000000006272 -
German Medical Science : GMS E-journal 2022The goal of this review was to identify decision-analytic modeling studies in early health technology assessments (HTA) of high-risk medical devices, published over the... (Review)
Review
OBJECTIVE
The goal of this review was to identify decision-analytic modeling studies in early health technology assessments (HTA) of high-risk medical devices, published over the last three years, and to provide a systematic overview of model purposes and characteristics. Additionally, the aim was to describe recent developments in modeling techniques.
METHODS
For this scoping review, we performed a systematic literature search in PubMed and Embase including studies published in English or German. The search code consisted of terms describing early health technology assessment and terms for decision-analytic models. In abstract and full-text screening, studies were excluded that were not modeling studies for a high-risk medical device or an in-vitro diagnostic test. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram was used to report on the search and exclusion of studies. For all included studies, study purpose, framework and model characteristics were extracted and reported in systematic evidence tables and a narrative summary.
RESULTS
Out of 206 identified studies, 19 studies were included in the review. Studies were either conducted for hypothetical devices or for existing devices after they were already available on the market. No study extrapolated technical data from early development stages to estimate potential value of devices in development. All studies except one included cost as an outcome. Two studies were budget impact analyses. Most studies aimed at adoption and reimbursement decisions. The majority of studies were on in-vitro diagnostic tests for personalized and targeted medicine. A timed automata model, to our knowledge a model type new to HTA, was tested by one study. It describes the agents in a clinical pathway in separate models and, by allowing for interaction between the models, can reflect complex individual clinical pathways and dynamic system interactions. Not all sources of uncertainty for in-vitro tests were explicitly modeled. Elicitation of expert knowledge and judgement was used for substitution of missing empirical data. Analysis of uncertainty was the most valuable strength of decision-analytic models in early HTA, but no model applied sensitivity analysis to optimize the test positivity cutoff with regard to the benefit-harm balance or cost-effectiveness. Value-of-information analysis was rarely performed. No information was found on the use of causal inference methods for estimation of effect parameters from observational data.
CONCLUSION
Our review provides an overview of the purposes and model characteristics of nineteen recent early evaluation studies on medical devices. The review shows the growing importance of personalized interventions and confirms previously published recommendations for careful modeling of uncertainties surrounding diagnostic devices and for increased use of value-of-information analysis. Timed automata may be a model type worth exploring further in HTA. In addition, we recommend to extend the application of sensitivity analysis to optimize positivity criteria for in-vitro tests with regard to benefit-harm or cost-effectiveness. We emphasize the importance of causal inference methods when estimating effect parameters from observational data.
Topics: Humans; Technology Assessment, Biomedical; Equipment and Supplies
PubMed: 36742459
DOI: 10.3205/000313 -
Behavior Modification Sep 2017Within relational frame theory, a distinction has been made between three types of rule-governed behavior known as pliance, tracking, and augmenting. This review... (Review)
Review
Within relational frame theory, a distinction has been made between three types of rule-governed behavior known as pliance, tracking, and augmenting. This review examined whether there is support for the concepts of pliance, tracking, and augmenting in the experimental analysis of behavior; whether these concepts refer to distinct functional classes of behavior; and how these concepts have been operationalized in experimental (behavioral-analytic) research. Given that the concepts of pliance, tracking, and augmenting were first defined by Zettle and Hayes, we confined our review to studies published in or after 1982. Our results indicate that (a) experimental research investigating pliance, tracking, and/or augmenting is extremely limited; (b) it is difficult to determine the extent to which the concepts of pliance, tracking, and augmenting allow for relatively precise experimental analyses of distinct functional classes of behavior; and
Topics: Behavioral Research; Humans; Psychological Theory
PubMed: 28776429
DOI: 10.1177/0145445517693811 -
Molecules (Basel, Switzerland) Aug 2021The biosynthesis of silver nanoparticles and the antibacterial activities has provided enormous data on populations, geographical areas, and experiments with bio silver...
The biosynthesis of silver nanoparticles and the antibacterial activities has provided enormous data on populations, geographical areas, and experiments with bio silver nanoparticles' antibacterial operation. Several peer-reviewed publications have discussed various aspects of this subject field over the last generation. However, there is an absence of a detailed and structured framework that can represent the research domain on this topic. This paper attempts to evaluate current articles mainly on the biosynthesis of nanoparticles or antibacterial activities utilizing the scientific methodology of big data analytics. A comprehensive study was done using multiple databases-Medline, Scopus, and Web of Sciences through PRISMA (i.e., Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The keywords used included 'biosynthesis silver nano particles' OR 'silver nanoparticles' OR 'biosynthesis' AND 'antibacterial behavior' OR 'anti-microbial opposition' AND 'systematic analysis,' by using MeSH (Medical Subject Headings) terms, Boolean operator's parenthesis, or truncations as required. Since their effectiveness is dependent on particle size or initial concentration, it necessitates more research. Understanding the field of silver nanoparticle biosynthesis and antibacterial activity in Gulf areas and most Asian countries also necessitates its use of human-generated data. Furthermore, the need for this work has been highlighted by the lack of predictive modeling in this field and a need to combine specific domain expertise. Studies eligible for such a review were determined by certain inclusion and exclusion criteria. This study contributes to the existence of theoretical and analytical studies in this domain. After testing as per inclusion criteria, seven in vitro studies were selected out of 28 studies. Findings reveal that silver nanoparticles have different degrees of antimicrobial activity based on numerous factors. Limitations of the study include studies with low to moderate risks of bias and antimicrobial effects of silver nanoparticles. The study also reveals the possible use of silver nanoparticles as antibacterial irrigants using various methods, including a qualitative evaluation of knowledge and a comprehensive collection and interpretation of scientific studies.
Topics: Animals; Anti-Bacterial Agents; Humans; Metal Nanoparticles; Particle Size; Silver
PubMed: 34443644
DOI: 10.3390/molecules26165057 -
Sleep Medicine Reviews Feb 2023Cognitive models of insomnia highlight internal and external cognitive-biases for sleep-related "threat" in maintaining the disorder. This systematic review of the... (Meta-Analysis)
Meta-Analysis Review
Cognitive models of insomnia highlight internal and external cognitive-biases for sleep-related "threat" in maintaining the disorder. This systematic review of the sleep-related attentional and interpretive-bias literature includes meta-analytic calculations of each construct. Searches identified N = 21 attentional-bias and N = 8 interpretive-bias studies meeting the inclusion/exclusion criteria. Seventeen attentional-bias studies compared normal-sleepers and poor-sleepers/insomnia patients. Using a random effects model, meta-analytic data based on standardized mean differences of attentional-bias studies determined the weighted pooled effect size to be moderate at 0.60 (95%CI:0.26-0.93). Likewise, seven of eight interpretive-bias studies involved group comparisons. Meta-analytic data determined the weighted pooled effect size as moderate at .44 (95%CI:0.19-0.69). Considering these outcomes, disorder congruent cognitive-biases appear to be a key feature of insomnia. Despite statistical support, absence of longitudinal data limits causal inference concerning the relative role cognitive-biases in the development and maintenance of insomnia. Methodological factors pertaining to task design, sample and stimuli are discussed in relation to outcome variation. Finally, we discuss the next steps in advancing the understanding of sleep-related biases in insomnia.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Sleep; Attention; Attentional Bias; Bias
PubMed: 36459947
DOI: 10.1016/j.smrv.2022.101713 -
Frontiers in Genetics 2023In the last years, liquid biopsy gained increasing clinical relevance for detecting and monitoring several cancer types, being minimally invasive, highly informative and... (Review)
Review
In the last years, liquid biopsy gained increasing clinical relevance for detecting and monitoring several cancer types, being minimally invasive, highly informative and replicable over time. This revolutionary approach can be complementary and may, in the future, replace tissue biopsy, which is still considered the gold standard for cancer diagnosis. "Classical" tissue biopsy is invasive, often cannot provide sufficient bioptic material for advanced screening, and can provide isolated information about disease evolution and heterogeneity. Recent literature highlighted how liquid biopsy is informative of proteomic, genomic, epigenetic, and metabolic alterations. These biomarkers can be detected and investigated using single-omic and, recently, in combination through multi-omic approaches. This review will provide an overview of the most suitable techniques to thoroughly characterize tumor biomarkers and their potential clinical applications, highlighting the importance of an integrated multi-omic, multi-analyte approach. Personalized medical investigations will soon allow patients to receive predictable prognostic evaluations, early disease diagnosis, and subsequent treatments.
PubMed: 37077538
DOI: 10.3389/fgene.2023.1152470 -
Perspectives in Psychiatric Care Oct 2022This study aimed to clarify the mixed conclusions regarding work engagement and job satisfaction in the nursing research literature by conducting a systematic review and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This study aimed to clarify the mixed conclusions regarding work engagement and job satisfaction in the nursing research literature by conducting a systematic review and meta-analysis.
DESIGN AND METHODS
This meta-analytic review synthesized 15 independent studies published between 2007 and 2021.
FINDINGS
An overall effect size of random-effect model was calculated as r = 0.47 (k = 15, N = 3,818, 95% confidence interval [0.43;0.51]). Data collection method and presence of control variable, as significant moderators, accounted for 43.6% and 43.8%, respectively, of the effect size heterogeneity.
PRACTICE IMPLICATIONS
While the positive relationship between work engagement and job satisfaction was higher in studies using the face-to-face data collection method, it was lower in studies using the control variable in their research models.
Topics: Humans; Job Satisfaction; Work Engagement; Nursing Research; Nursing Staff, Hospital; Surveys and Questionnaires
PubMed: 35383388
DOI: 10.1111/ppc.13068