-
Archives of Orthopaedic and Trauma... Nov 2022In this review paper, graft failure rates of different graft types (hamstring tendon autografts, bone-patellar tendon-bone autografts, quadriceps tendon autografts and... (Review)
Review
INTRODUCTION
In this review paper, graft failure rates of different graft types (hamstring tendon autografts, bone-patellar tendon-bone autografts, quadriceps tendon autografts and diverse allografts) that are used for surgical reconstruction of the anterior cruciate ligament are compared and statistically analysed.
METHODS
Literature search was conducted in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria. A total of 194 studies, which reported graft failure rates of at least one of the anterior cruciate ligament reconstruction methods mentioned above, were included in this systematic review. To be able to compare studies with different follow-up periods, a yearly graft failure rate for each reconstruction group was calculated and then investigated for significant differences by using the Kruskal-Wallis test.
RESULTS
Overall, a total of 152,548 patients treated with an anterior cruciate ligament reconstruction were included in the calculations. Comparison of graft types showed that hamstring tendon autografts had a yearly graft failure rate of 1.70%, whereas the bone-patellar tendon-bone autograft group had 1.16%, the quadriceps tendon autograft group 0.72%, and the allografts 1.76%.
CONCLUSION
The findings of this meta-data study indicate that reconstructing the anterior cruciate ligament using quadriceps tendon autografts, hamstring tendon autografts, patellar tendon autografts or allografts does not show significant differences in terms of graft failure rates.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Autografts; Bone-Patellar Tendon-Bone Grafting; Hamstring Tendons; Humans; Transplantation, Autologous
PubMed: 34536121
DOI: 10.1007/s00402-021-04147-w -
Journal of Neuro-oncology May 2020Carbon ion radiotherapy (CIRT) is an emerging radiation therapy to treat skull base chordomas and chondrosarcomas. To date, its use is limited to a few centers around... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Carbon ion radiotherapy (CIRT) is an emerging radiation therapy to treat skull base chordomas and chondrosarcomas. To date, its use is limited to a few centers around the world, and there has been no attempt to systematically evaluate survival and toxicity outcomes reported in the literature. Correspondingly, the aim of this study was to qualitatively and quantitatively assess these outcomes.
METHODS
A systematic search of seven electronic databases from inception to November 2019 was conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. Outcomes were then pooled by random-effects meta-analyses of proportions.
RESULTS
A total of nine studies provided unique metadata for assessment, with six originating from Heidelberg, Germany. The surveyed cohort size was 632 patients, with 389 (62%) chordomas and 243 (38%) chondrosarcomas of the skull base. Across all studies, median cohort age at therapy and female proportion were 46 years and 51% respectively. Estimates of local control incidence at 1-, 5-, and 10-years in chordoma-only studies were 99%, 80%, and 56%, and in chondrosarcoma-only studies were 99%, 89%, and 88%. Estimates of overall survival probability at 1-, 5-, and 10-years in chordoma-only studies were 100%, 94%, and 78%, and in chondrosarcoma-only studies were 99%, 95%, and 79%. The incidence of early and late toxicity (Grade ≥ 3) ranged from 0 to 4% across all study groups.
CONCLUSIONS
The emerging use of CIRT to treat skull base chordomas and chondrosarcomas appear promising with regard to tumor control, overall survival, and risk profile of early and late toxicity. The current literature suffers from the fact only a few centers in the world currently employ this technology.
Topics: Chondrosarcoma; Chordoma; Heavy Ion Radiotherapy; Humans; Skull Base Neoplasms; Survival Analysis; Treatment Outcome
PubMed: 32206977
DOI: 10.1007/s11060-020-03464-1 -
Systematic Reviews Aug 2016Meta-research studies investigating methods, systems, and processes designed to improve the efficiency of systematic review workflows can contribute to building an... (Review)
Review
BACKGROUND
Meta-research studies investigating methods, systems, and processes designed to improve the efficiency of systematic review workflows can contribute to building an evidence base that can help to increase value and reduce waste in research. This study demonstrates the use of an economic evaluation framework to compare the costs and effects of four variant approaches to identifying eligible studies for consideration in systematic reviews.
METHODS
A cost-effectiveness analysis was conducted using a basic decision-analytic model, to compare the relative efficiency of 'safety first', 'double screening', 'single screening' and 'single screening with text mining' approaches in the title-abstract screening stage of a 'case study' systematic review about undergraduate medical education in UK general practice settings. Incremental cost-effectiveness ratios (ICERs) were calculated as the 'incremental cost per citation 'saved' from inappropriate exclusion' from the review. Resource use and effect parameters were estimated based on retrospective analysis of 'review process' meta-data curated alongside the 'case study' review, in conjunction with retrospective simulation studies to model the integrated use of text mining. Unit cost parameters were estimated based on the 'case study' review's project budget. A base case analysis was conducted, with deterministic sensitivity analyses to investigate the impact of variations in values of key parameters.
RESULTS
Use of 'single screening with text mining' would have resulted in title-abstract screening workload reductions (base case analysis) of >60 % compared with other approaches. Across modelled scenarios, the 'safety first' approach was, consistently, equally effective and less costly than conventional 'double screening'. Compared with 'single screening with text mining', estimated ICERs for the two non-dominated approaches (base case analyses) ranged from £1975 ('single screening' without a 'provisionally included' code) to £4427 ('safety first' with a 'provisionally included' code) per citation 'saved'. Patterns of results were consistent between base case and sensitivity analyses.
CONCLUSIONS
Alternatives to the conventional 'double screening' approach, integrating text mining, warrant further consideration as potentially more efficient approaches to identifying eligible studies for systematic reviews. Comparable economic evaluations conducted using other systematic review datasets are needed to determine the generalisability of these findings and to build an evidence base to inform guidance for review authors.
Topics: Cost-Benefit Analysis; Data Mining; Humans; Patient Safety; Research Design
PubMed: 27535658
DOI: 10.1186/s13643-016-0315-4 -
Frontiers in Cellular and Infection... 2022Cryptosporidiosis is a zoonotic disease caused by Cryptosporidium infection with the main symptom of diarrhea. The present study performed a metaanalysis to determine... (Meta-Analysis)
Meta-Analysis
INTODUCTION
Cryptosporidiosis is a zoonotic disease caused by Cryptosporidium infection with the main symptom of diarrhea. The present study performed a metaanalysis to determine the global prevalence of Cryptosporidium in Equus animals.
METHODS
Data collection was carried out using Chinese National Knowledge Infrastructure (CNKI), VIP Chinese journal database (VIP), WanFang Data, PubMed, and ScienceDirect databases, with 35 articles published before 2021 being included in this systematic analysis. This study analyzed the research data through subgroup analysis and univariate regression analysis to reveal the factors leading to high prevalence. We applied a random effects model (REM) to the metadata.
RESULTS
The total prevalence rate of Cryptosporidium in Equus was estimated to be 7.59% from the selected articles. The prevalence of Cryptosporidium in female Equus was 2.60%. The prevalence of Cryptosporidium in Equus under 1-year-old was 11.06%, which was higher than that of Equus over 1-year-old (2.52%). In the experimental method groups, the positive rate detected by microscopy was the highest (10.52%). The highest Cryptosporidium prevalence was found in scale breeding Equus (7.86%). The horses had the lowest Cryptosporidium prevalence (7.32%) among host groups. C. muris was the most frequently detected genotype in the samples (53.55%). In the groups of geographical factors, the prevalence rate of Cryptosporidium in Equus was higher in regions with low altitude (6.88%), rainy (15.63%), humid (22.69%), and tropical climates (16.46%).
DISCUSSION
The search strategy use of five databases might have caused the omission of some researches. This metaanalysis systematically presented the global prevalence and potential risk factors of Cryptosporidium infection in Equus. The farmers should strengthen the management of young and female Equus animals, improve water filtration systems, reduce stocking densities, and harmless treatment of livestock manure.
Topics: Female; Animals; Horses; Cryptosporidiosis; Cryptosporidium; Prevalence; Risk Factors; Zoonoses
PubMed: 36506009
DOI: 10.3389/fcimb.2022.1072385 -
International Journal of Medical... Sep 2019Passive data refers to data generated without the active participation of the subject. This includes data from global positioning systems and accelerometers or metadata...
INTRODUCTION
Passive data refers to data generated without the active participation of the subject. This includes data from global positioning systems and accelerometers or metadata on phone call and text activity. Although the potential healthcare applications are far-reaching, passive data raises numerous ethical challenges.
MATERIALS AND METHODS
We performed a systematic review to identify all ethical concerns, normative standpoints, and underlying arguments related to the use of passive data in healthcare.
RESULTS
Among the various challenges discussed in the ethical literature, informational privacy, informed consent, and data security were the primary focus of the current debate. Other topics of discussion were the evaluation and regulation of products, equity in access, vulnerable patient groups, ownership, and secondary use.
CONCLUSION
No clear ethical framework has been established that stimulates passive data-driven innovation while protecting patient integrity. The consensus in the ethical literature, as well as the parallels with similar concerns and solutions in other fields, can lay a foundation for the construction of an ethical framework. The future debate should focus on conflicts between two or more ethical, technical, or clinical values to ensure a safe and effective implementation of passive data in healthcare.
Topics: Consensus; Data Collection; Delivery of Health Care; Informed Consent; Ownership; Privacy
PubMed: 31445262
DOI: 10.1016/j.ijmedinf.2019.06.015 -
The effects of population management on wild ungulates: A systematic map of evidence for UK species.PloS One 2022Over recent decades, the abundance and geographic ranges of wild ungulate species have expanded in many parts of Europe, including the UK. Populations are managed to... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Over recent decades, the abundance and geographic ranges of wild ungulate species have expanded in many parts of Europe, including the UK. Populations are managed to mitigate their ecological impacts using interventions, such as shooting, fencing and administering contraception. Predicting how target species will respond to interventions is critical for developing sustainable, effective and efficient management strategies. However, the quantity and quality of evidence of the effects of interventions on ungulate species is unclear. To address this, we systematically mapped research on the effects of population management on wild ungulate species resident in the UK.
METHODS
We searched four bibliographic databases, Google Scholar and nine organisational websites using search terms tested with a library of 30 relevant articles. Worldwide published peer-reviewed articles were considered, supplemented by 'grey' literature from UK-based sources. Three reviewers identified and screened articles for eligibility at title, abstract and full-text levels, based on predefined criteria. Data and metadata were extracted and summarised in a narrative synthesis supported by structured graphical matrices.
RESULTS
A total of 123 articles were included in the systematic map. Lethal interventions were better represented (85%, n = 105) than non-lethal interventions (25%, n = 25). Outcomes related to demography and behaviour were reported in 95% of articles (n = 117), whereas effects on health, physiology and morphology were studied in only 11% of articles (n = 14). Well-studied species included wild pigs (n = 58), red deer (n = 28) and roe deer (n = 23).
CONCLUSIONS
Evidence for the effects of population management on wild ungulate species is growing but currently limited and unevenly distributed across intervention types, outcomes and species. Priorities for primary research include: species responses to non-lethal interventions, the side-effects of shooting and studies on sika deer and Chinese muntjac. Shooting is the only intervention for which sufficient evidence exists for systematic review or meta-analysis.
Topics: Animals; Deer; Europe; United Kingdom
PubMed: 35687554
DOI: 10.1371/journal.pone.0267385 -
Journal of Ambient Intelligence and... 2023The success of deep learning over the traditional machine learning techniques in handling artificial intelligence application tasks such as image processing, computer...
UNLABELLED
The success of deep learning over the traditional machine learning techniques in handling artificial intelligence application tasks such as image processing, computer vision, object detection, speech recognition, medical imaging and so on, has made deep learning the buzz word that dominates Artificial Intelligence applications. From the last decade, the applications of deep learning in physiological signals such as electrocardiogram (ECG) have attracted a good number of research. However, previous surveys have not been able to provide a systematic comprehensive review including biometric ECG based systems of the applications of deep learning in ECG with respect to domain of applications. To address this gap, we conducted a systematic literature review on the applications of deep learning in ECG including biometric ECG based systems. The study analyzed systematically, 150 primary studies with evidence of the application of deep learning in ECG. The study shows that the applications of deep learning in ECG have been applied in different domains. We presented a new taxonomy of the domains of application of the deep learning in ECG. The paper also presented discussions on biometric ECG based systems and meta-data analysis of the studies based on the domain, area, task, deep learning models, dataset sources and preprocessing methods. Challenges and potential research opportunities were highlighted to enable novel research. We believe that this study will be useful to both new researchers and expert researchers who are seeking to add knowledge to the already existing body of knowledge in ECG signal processing using deep learning algorithm.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12652-022-03868-z.
PubMed: 35821879
DOI: 10.1007/s12652-022-03868-z -
JMIR MHealth and UHealth Jun 2020Comprehensive exams such as the Dean-Woodcock Neuropsychological Assessment System, the Global Deterioration Scale, and the Boston Diagnostic Aphasia Examination are the...
BACKGROUND
Comprehensive exams such as the Dean-Woodcock Neuropsychological Assessment System, the Global Deterioration Scale, and the Boston Diagnostic Aphasia Examination are the gold standard for doctors and clinicians in the preliminary assessment and monitoring of neurocognitive function in conditions such as neurodegenerative diseases and acquired brain injuries (ABIs). In recent years, there has been an increased focus on implementing these exams on mobile devices to benefit from their configurable built-in sensors, in addition to scoring, interpretation, and storage capabilities. As smartphones become more accepted in health care among both users and clinicians, the ability to use device information (eg, device position, screen interactions, and app usage) for subject monitoring also increases. Sensor-based assessments (eg, functional gait using a mobile device's accelerometer and/or gyroscope or collection of speech samples using recordings from the device's microphone) include the potential for enhanced information for diagnoses of neurological conditions; mapping the development of these conditions over time; and monitoring efficient, evidence-based rehabilitation programs.
OBJECTIVE
This paper provides an overview of neurocognitive conditions and relevant functions of interest, analysis of recent results using smartphone and/or tablet built-in sensor information for the assessment of these different neurocognitive conditions, and how human-device interactions and the assessment and monitoring of these neurocognitive functions can be enhanced for both the patient and health care provider.
METHODS
This survey presents a review of current mobile technological capabilities to enhance the assessment of various neurocognitive conditions, including both neurodegenerative diseases and ABIs. It explores how device features can be configured for assessments as well as the enhanced capability and data monitoring that will arise due to the addition of these features. It also recognizes the challenges that will be apparent with the transfer of these current assessments to mobile devices.
RESULTS
Built-in sensor information on mobile devices is found to provide information that can enhance neurocognitive assessment and monitoring across all functional categories. Configurations of positional sensors (eg, accelerometer, gyroscope, and GPS), media sensors (eg, microphone and camera), inherent sensors (eg, device timer), and participatory user-device interactions (eg, screen interactions, metadata input, app usage, and device lock and unlock) are all helpful for assessing these functions for the purposes of training, monitoring, diagnosis, or rehabilitation.
CONCLUSIONS
This survey discusses some of the many opportunities and challenges of implementing configured built-in sensors on mobile devices to enhance assessments and monitoring of neurocognitive functions as well as disease progression across neurodegenerative and acquired neurological conditions.
Topics: Computers, Handheld; Delivery of Health Care; Humans; Smartphone; Surveys and Questionnaires
PubMed: 32442150
DOI: 10.2196/15517 -
Stroke Research and Treatment 2021This review aimed at figuring out the risk factors of uncontrolled hypertension in stroke. (Review)
Review
OBJECTIVE
This review aimed at figuring out the risk factors of uncontrolled hypertension in stroke.
METHOD
This study systematically analyzed the hypertension risk factors available in the ProQuest, EBSCO, and PubMed databases published between 2010 and December 2019. The risk factors' pooled odds ratio (POR) included in this research was calculated using both fixed and random-effect models. The meta-data analysis was processed using the Review Manager 5.3 (Rev Man 5.3).
RESULT
Of 1868 articles, seven studies were included in this review searched using specific keywords. Based on the analysis results, there were 7 risk factors of uncontrolled hypertension in stroke: medication nonadherence (POR = 2.23 [95% CI 1.71-2.89], = 0.342; = 6.7%), use of antihypertensive drugs (POR = 1.13 [95% CI 1.19-1.59, = 0.001; = 90.9%), stage of hypertension (POR = 1.14 [95% CI 1.02-1.27], = <0.001; = 97.1%), diabetes mellitus (POR = 0.71 [95% CI 0.52-0.99], = <0.001; = 96.5%), atrial fibrillation (POR = 1.74 [95% CI 1.48-2.04)], = <0.001; = 93.1%), triglycerides (POR = 1.47 [95% CI 1.23-1.75], = 0.879; = 0%), and age (POR = 1.03 [95% CI 0.89-1.18], = <0.001; = 97.5%]. There were no bias publications among studies. Medication nonadherence and triglycerides had homogeneous variations, while the others had heterogeneous variations.
CONCLUSION
Medication nonadherence, triglycerides, stage of hypertension, atrial fibrillation, and use of antihypertensive drugs significantly affect the uncontrolled hypertension in stroke.
PubMed: 33680423
DOI: 10.1155/2021/6683256 -
Journal of Neuro-oncology May 2023Management of hydrocephalus symptoms in the setting of leptomeningeal disease (LMD) includes cerebrospinal fluid (CSF) diversion, which can in the form of... (Meta-Analysis)
Meta-Analysis Review
Postoperative course of cerebrospinal fluid diversion in the setting of leptomeningeal disease: a systematic review, meta-analysis, and meta-regression with an illustrative case.
BACKGROUND
Management of hydrocephalus symptoms in the setting of leptomeningeal disease (LMD) includes cerebrospinal fluid (CSF) diversion, which can in the form of ventriculoperitoneal shunting (VPS) and lumboperitoneal shunting (LPS). However, the quantifiable postoperative course following this intervention is poorly defined. Correspondingly the aim of our study was to quantitatively define and analyze the pooled metadata regarding this topic.
METHODS
Multiple electronic databases from inception to March 2023 were searched following PRISMA guidelines. Respective cohort-level outcomes were then abstracted and pooled by means of meta-analyses and analyzed by means meta-regression, both utilizing random-effects modeling. Post-hoc bias evaluation was then performed for all outcomes.
RESULTS
A total of 12 studies were identified for inclusion, describing 503 LMD patients managed by CSF diversion - 442 (88%) by VPS and 61 (12%) by LPS. Median male percentage and age at diversion were 32% and 58 years respectively, with lung and breast cancer the most common primary diagnoses. Meta-analysis demonstrated pooled incidence of symptom resolution in 79% (95% CI 68-88%) of patients after index shunt surgery, and shunt revision required in 10% (95% CI 6-15%) of cases. Pooled overall survival from index shunt surgery was 3.8 mo (95% CI 2.9-4.6 mo) across all studies. Meta-regression demonstrated that studies published later trended towards significantly shorter overall survival from index shunt surgery (co-efficient=-0.38, P = 0.023), whereas the proportion of VPS to LPS in each study did not impact survival (P = 0.89). When accounting for these biases, overall survival from index shunt surgery was re-estimated to be shorter 3.1 mo (95% CI 1.7-4.4 mo). We present an illustrative case demonstrating the course of symptom improvement, shunt revision and an overall survival of 2 weeks from index CSF diversion.
CONCLUSION
Although CSF diversion in the setting of LMD can improve hydrocephalus symptoms in the majority of patients, there is a non-negligible proportion that will require shunt revision. Postoperatively, the prognosis of LMD remains poor irrespective of shunt type, and despite possible biases within the current literature, the expected median overall survival after index surgery is a matter of months. These findings support CSF diversion as an effective palliative procedure when considering symptoms and quality of life. Further research is required to understand how postoperative expectations can be managed to respect the best wishes of patients, their family, and the treating clinical team.
Topics: Humans; Male; Cerebrospinal Fluid Shunts; Quality of Life; Lipopolysaccharides; Hydrocephalus; Ventriculoperitoneal Shunt; Retrospective Studies
PubMed: 37191912
DOI: 10.1007/s11060-023-04334-2