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Journal of Medical Internet Research Nov 2018Until now, the use of technology in health care was driven mostly by the assumptions about the benefits of electronic health (eHealth) rather than its evidence. It is...
BACKGROUND
Until now, the use of technology in health care was driven mostly by the assumptions about the benefits of electronic health (eHealth) rather than its evidence. It is noticeable that the magnitude of evidence of effectiveness and efficiency of eHealth is not proportionate to the number of interventions that are regularly conducted. Reliable evidence generated through comprehensive evaluation of eHealth interventions may accelerate the growth of eHealth for long-term successful implementation and help to experience eHealth benefits in an enhanced way.
OBJECTIVE
This study aimed to understand how the evidence of effectiveness and efficiency of eHealth can be generated through evaluation. Hence, we aim to discern (1) how evaluation is conducted in distinct eHealth intervention phases, (2) the aspects of effectiveness and efficiency that are typically evaluated during eHealth interventions, and (3) how eHealth interventions are evaluated in practice.
METHODS
A systematic literature review was conducted to explore the evaluation methods for eHealth interventions. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. We searched Google Scholar and Scopus for the published papers that addressed the evaluation of eHealth or described an eHealth intervention study. A qualitative analysis of the selected papers was conducted in several steps.
RESULTS
We intended to see how the process of evaluation unfolds in distinct phases of an eHealth intervention. We revealed that in practice and in several conceptual papers, evaluation is performed at the end of the intervention. There are some studies that discuss the importance of conducting evaluation throughout the intervention; however, in practice, we found no case study that followed this. For our second research question, we discovered aspects of efficiency and effectiveness that are proposed to be assessed during interventions. The aspects that were recurrent in the conceptual papers include clinical, human and social, organizational, technological, cost, ethical and legal, and transferability. However, the case studies reviewed only evaluate the clinical and human and social aspects. At the end of the paper, we discussed a novel approach to look into the evaluation. Our intention was to stir up a discussion around this approach with the hope that it might be able to gather evidence in a comprehensive and credible way.
CONCLUSIONS
The importance of evidence in eHealth has not been discussed as rigorously as have the diverse evaluation approaches and evaluation frameworks. Further research directed toward evidence-based evaluation can not only improve the quality of intervention studies but also facilitate successful long-term implementation of eHealth in general. We conclude that the development of more robust and comprehensive evaluation of eHealth studies or an improved validation of evaluation methods could ease the transferability of results among similar studies. Thus, the resources can be used for supplementary research in eHealth.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Quality of Health Care; Retrospective Studies; Telemedicine; Young Adult
PubMed: 30470678
DOI: 10.2196/10971 -
Sports Medicine (Auckland, N.Z.) Mar 2024Does younger involvement in talent promotion programs (TPPs) facilitate the attainment of higher performance levels? This question is the subject of the present... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Does younger involvement in talent promotion programs (TPPs) facilitate the attainment of higher performance levels? This question is the subject of the present meta-analysis. Many national sport systems have established TPPs such as federations' junior squads (including under-age selection teams) and youth sport academies, and many are making expanding investments in TPPs. TPPs seek to select the most advanced youth high performers at young ages, around puberty or younger, and then strive to further accelerate their performance development. However, studies show 25-55% annual athlete turnover within TPPs. In this context, accelerated biological maturation (puberty, growth spurt), high relative age within one's birth year, and intensified sport-specific childhood/adolescent practice may boost rapid junior performance, but the effects diminish or are reversed by adulthood. Moreover, expanded opportunity costs and risks (time demands, injury, burnout) imposed on young TPP participants may impair their long-term development and even prematurely terminate their career.
OBJECTIVE
We aimed to provide robust and generalizable evidence on the effects of early talent promotion on junior and senior performance through a systematic review and meta-analysis.
METHODS
A systematic literature search was conducted 18/03-03/04/2023 in SPORTDiscus, ProQuest, PsycINFO, PubMed, Scopus, WorldCat, and Google Scholar. We searched for original studies that compared athletes across defined higher and lower performance levels within defined types of sports, age categories, and sexes, regarding their age at commencement of TPP involvement and reported effect sizes or data needed to compute effects sizes. Mean meta-analytic Cohen's was computed separately for junior and senior athletes. Quality of evidence was evaluated using the mixed-methods appraisal tool.
RESULTS
The search yielded k = 51 effect sizes from N = 6233 athletes from a wide range of countries and sports, 82% male and 18% female, from 2009 to 2022. The central finding is that effects on short-term junior performance versus long-term senior performance are opposite, whereby higher-performing junior athletes began TPP involvement at younger ages than lower-performing junior athletes, = - 0.53. In contrast, higher-performing senior athletes began TPP involvement at older ages than lower-performing senior athletes, = 0.56. The findings are robust across different TPPs (federation's junior squad/selection team, youth academy), individual and team sports, and performance levels compared (international, national, regional). The quality of primary studies was high.
DISCUSSION
The findings are consistent with recent meta-analytic evidence that participation patterns predicting early junior success versus long-term senior success are opposite (starting age, main-sport and other-sports practice amounts, age to reach performance 'milestones'). We discuss theoretical and practical implications of potential selection and 'treatment' effects of TPPs.
CONCLUSIONS
Consistent across different populations, early TPP involvement is positively correlated with short-term junior performance but is negatively correlated with long-term senior performance.
Topics: Adolescent; Humans; Male; Female; Adult; Child; Sports; Athletes; Team Sports; Aptitude; Youth Sports
PubMed: 37921913
DOI: 10.1007/s40279-023-01957-3 -
Respirology (Carlton, Vic.) Oct 2021Despite the growing body of evidence on lung function trajectories over the life course and their risk factors, the literature has not been systematically synthesized.... (Review)
Review
Despite the growing body of evidence on lung function trajectories over the life course and their risk factors, the literature has not been systematically synthesized. Publications related to lung function trajectories were identified from PubMed, EMBASE and CINAHL databases. Two authors independently identified publications for inclusion according to predefined selection criteria. Studies that modelled lung function trajectories and reported associated exposures were included. Meta-analyses could not be conducted due to heterogeneity in the exposures and methods used to model lung function trajectories. Nine publications were eligible for inclusion of which four used group-based trajectory modelling to model lung function trajectories, while five used latent profile analysis. Studies with repeated lung function measurements over the life course identified more trajectories than others. Only one study spanning from childhood to middle age reported catch-up trajectory. The following childhood risk factors for subnormal lung function trajectories were observed in at least across two studies: low birth weight, early wheezing, asthma, allergic sensitization, eczema, allergic rhinitis, lower respiratory tract infections, family history of asthma and second-hand smoke exposure. Adult active asthma and personal cigarette smoking were observed to be associated with accelerated decline lung trajectories. Our review identified 10 risk factors associated with the growth, catch-up, reduced plateau and decline trajectories of lung function. Intervention directed at childhood asthma and infections, and tobacco smoke exposure at all ages would help promote lung health and prevent subnormal lung function trajectories.
Topics: Adult; Asthma; Child; Humans; Lung; Middle Aged; Respiratory Sounds; Rhinitis, Allergic; Risk Factors
PubMed: 34490723
DOI: 10.1111/resp.14142 -
Journal of Clinical and Translational... Apr 2022Adipose-derived mesenchymal stem cells (ADSCs) have been proven effective to prevent distal skin flap necrosis in preclinical models. However, to appropriately translate... (Review)
Review
BACKGROUND AND AIM
Adipose-derived mesenchymal stem cells (ADSCs) have been proven effective to prevent distal skin flap necrosis in preclinical models. However, to appropriately translate these findings to clinical trials, the effect of ADSC of human origin (hADSC) needs to be evaluated. We hypothesize that hADSC treatment is as effective as animal ADSC treatment at preventing distal skin flap necrosis in animal flap models.
METHODS
Three databases were inquired on August 17, 2020, to evaluate the necrotic flap area after using hADSCs in animal models of ischemic flaps. No publication status or dates were considered. Studies were included if they used hADSCs, measured the surviving or necrotic skin area of flaps, used animal models, and were in English. Studies were excluded if they did not use cells of human origin. The flap survival or necrotic area, perfusion, capillary density, vascular endothelial growth factor secretion and HIF-1α expression were extracted.
RESULTS
Ten studies met inclusion criteria. The mean absolute risk reduction (ARR) in necrotic skin area was 22.37% (95% confidence interval [CI] 16.98-27.76%, <0.05) for flaps treated with animal ADSCs and 18.04% (95% CI 2.74-33.33%, P<0.05) for flaps treated with hADSCs. The difference between mean ARRs was not statistically significant (4.33%, 95% CI - 34.47-43.13%, >0.05).
CONCLUSION
Human ADSCs prevent skin flap necrosis to the same degree as animal ADSCs in rodent and rabbit flap models.
RELEVANCE FOR PATIENTS
This review found that adipose-derived stem cells of human origin are equally effective at reducing the risk of surgical flap necrosis in preclinical models of small animals as autologous animal cells. The findings in this review should encourage researchers to use human adipose-derived stem cells in animal models of ischemic flaps to accelerate their translation into clinical trials and, eventually, surgical practice. The low immunogenicity of these cells should be leveraged to gain insight into the effects of the products that will be ultimately administered to patients. Furthermore, human adipose-derived stem cells' pro-angiogenic mechanism of action sets this therapy as a promising preventive measure for flap necrosis.
PubMed: 35382131
DOI: No ID Found -
BMC Pediatrics Dec 2023The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association...
BACKGROUNDS
The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association between the early life growth of head circumference (HC), weight, and height with ASD in infants.
METHODS
PubMed, Scopus, Science Direct, and Google Scholar databases were searched up to November 2021 using relevant keywords. All original articles are written in English evaluating the early life growth of HC, weight, and height in infants with ASD were eligible for the present review.
RESULTS
Totally, 23 articles involving 4959 infants were included in this review. Of 13 studies that evaluated HC of infants at birth, 10 studies (83.33%) showed that the HC at the birth of autistic children was similar to that of the average found in the control group. Among 21 studies that evaluated the HC and weight status in infants, 19 studies (90.47%) showed that autistic children had larger HC and weight than the control group or abnormal acceleration of head growth during infancy. Height growth of infants was investigated in 13 studies, of which 10 cases (76.92%) reported that infants with ASD were significantly longer than control groups. Most of he included studies had a good quality.
CONCLUSIONS
The findings suggest that in infants with ASD, without the contribution of birth growth factors and sex of the child, the growth of HC, weight, and height probably was faster than in infants with normal development, in early life. Therefore, these measurements might be useful as initial predictive biomarkers for the risk of developing ASD.
Topics: Infant; Child; Infant, Newborn; Humans; Autism Spectrum Disorder; Head; Cephalometry; Biomarkers; Prevalence
PubMed: 38066466
DOI: 10.1186/s12887-023-04445-9 -
Environmental Monitoring and Assessment May 2023Faced with the accelerated growth of cities and the consequent increase in the number of motor vehicles, urban noise levels caused by vehicular traffic have increased... (Review)
Review
Faced with the accelerated growth of cities and the consequent increase in the number of motor vehicles, urban noise levels caused by vehicular traffic have increased considerably. To assess noise levels in cities and implement noise control measures or identify the problem's location in different urban areas, it is necessary to obtain the noise levels to which people are exposed. Noise maps are tools that have applications as they are cartographic representations of the noise level distribution in an area and over a period of time. This article aims to identify, select, evaluate, and synthesize information, through a systematic literature review, on using different road noise prediction models, in sound mapping computer programs in countries that do not have a standard noise prediction model. The analysis period was from 2018 to 2022. From a previous analysis of articles, the choice of topic was based on identifying various models for predicting road noise in countries without a standardized sound mapping model. The papers compiled by a systematic literature review showed that studies concentrated in China, Brazil, and Ecuador, the most used traffic noise prediction models, were the RLS-90 and the NMPB, and the most used mapping programs were SoundPLAN and ArcGIS with a grid size of 10 × 10 m. Most measurements were carried out during a 15-min period at a height from the ground level of 1.5 m. In addition, it was observed that research on noise maps in countries that do not have a local model has been increasing over time.
Topics: Humans; Environmental Monitoring; Noise, Transportation; Motor Vehicles; Cities; China
PubMed: 37233823
DOI: 10.1007/s10661-023-11268-9 -
Nutrients Jun 2018Nutritional supplements can influence outcomes for individuals undergoing major surgery, particularly in older persons whose functional reserve is limited. Accelerating... (Review)
Review
Nutritional supplements can influence outcomes for individuals undergoing major surgery, particularly in older persons whose functional reserve is limited. Accelerating recovery from total hip replacement (THR) and total knee replacement (TKR) may offer significant benefits. Therefore, we explored the role of nutritional supplements in improving recovery following THR and TKR. A systematic review was conducted to source randomized clinical trials that tested nutritional supplements in cohorts of THR or TKR patients. Our search yielded nine relevant trials. Intake of a carbohydrate-containing fluid is reported to improve insulin-like growth factor levels, reduce hunger, nausea, and length of stay, and attenuate the decrease in whole-body insulin sensitivity and endogenous glucose release. Amino acid supplementation is reported to reduce muscle atrophy and accelerate return of functional mobility. One paper reported a suppressive effect of beta-hydroxy beta-methylbutyrate, L-arginine, and L-glutamine supplementation on muscle strength loss following TKR. There is limited evidence for nutritional supplementation in THR and TKR pathways; however, the low risk profile and potential benefits to adjunctive treatment methods, such as exercise programs, suggest nutritional supplements may have a role. Optimizing nutritional status pre-operatively may help manage the surgical stress response, with a particular benefit for undernourished, frail, or elderly individuals.
Topics: Administration, Oral; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Dietary Supplements; Hip Joint; Humans; Knee Joint; Muscle Strength; Nutritional Status; Randomized Controlled Trials as Topic; Recovery of Function; Treatment Outcome
PubMed: 29941852
DOI: 10.3390/nu10070820 -
Brazilian Dental Journal 2019The aim of presented systematic scoping review was to investigate the actual and future clinical possibilities of regenerative therapies and their ability to regenerate...
The aim of presented systematic scoping review was to investigate the actual and future clinical possibilities of regenerative therapies and their ability to regenerate bone, periodontal and pulp with histological confirmation of the nature of formed tissue. Electronic search was conducted using a combination between Keywords and MeSH terms in PubMed, Scopus, ISI-Web of Science and Cochrane library databases up to January 2016. Two reviewers conducted independently the papers judgment. Screened studies were read following the predetermined inclusion criteria. The included studies were evaluated in accordance with Arksey and O'Malley's modified framework. From 1349 papers, 168 completed inclusion criteria. Several characterized and uncharacterized cells used in Cell Therapy have provided bone regeneration, demonstrating bone gain in quantity and quality, even as accelerators for bone and periodontal regeneration. Synthetic and natural scaffolds presented good cell maintenance, however polyglycolid-polylactid presented faster resorption and consequently poor bone gain. The Growth Factor-Mediated Therapy was able to regenerate bone and all features of a periodontal tissue in bone defects. Teeth submitted to Revascularization presented an increase of length and width of root canal. However, formed tissues not seem able to deposit dentin, characterizing a repaired tissue. Both PRP and PRF presented benefits when applied in regenerative therapies as natural scaffolds. Therefore, most studies that applied regenerative therapies have provided promising results being possible to regenerate bone and periodontal tissue with histological confirmation. However, pulp regeneration was not reported. These results should be interpreted with caution due to the short follow-up periods.
Topics: Bone Regeneration; Dental Pulp; Dentin; Periodontium; Root Canal Therapy
PubMed: 30970065
DOI: 10.1590/0103-6440201902053 -
Human Vaccines & Immunotherapeutics Dec 2022With the relatively rapid development of the COVID-19 pandemic, vaccine development has become crucial for limiting disease transmission. The accelerated growth in the...
With the relatively rapid development of the COVID-19 pandemic, vaccine development has become crucial for limiting disease transmission. The accelerated growth in the approved COVID-19 vaccines has sparked concerns about their efficacies which have been assessed by many studies. This systematic review compares the efficacy and effectiveness of seven COVID-19 vaccines. A comprehensive systematic literature search was performed using several databases to identify studies reporting the effectiveness or the efficacy of the vaccines. Only 42 studies met our inclusion criteria, which revealed that the COVID-19 vaccines have successfully reduced the rates of infections, severity, hospitalization, and mortality among the different populations. The full-dose regimen of the Pfizer/BioNTech vaccine is the most effective against infections with the B.1.1.7 and B.1.351 variants. Despite of the high effectiveness of some of the COVID-19 vaccines, more efforts are required to test their effectiveness against the other newly emerging variants.
Topics: COVID-19; COVID-19 Vaccines; Hospitalization; Humans; Pandemics; SARS-CoV-2
PubMed: 35113777
DOI: 10.1080/21645515.2022.2027160 -
JAMA Network Open Mar 2021Hyperprogressive disease (HPD) is a recognized pattern of rapid tumor progression during immune checkpoint inhibitor (ICI) treatment. Definitions of HPD have not been... (Meta-Analysis)
Meta-Analysis
Definition, Incidence, and Challenges for Assessment of Hyperprogressive Disease During Cancer Treatment With Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis.
IMPORTANCE
Hyperprogressive disease (HPD) is a recognized pattern of rapid tumor progression during immune checkpoint inhibitor (ICI) treatment. Definitions of HPD have not been standardized, posing the risk of capturing different tumoral behaviors.
OBJECTIVES
To provide a systematic summary of definitions and the incidence of HPD in patients undergoing ICI treatment and discuss the challenges of current assessment of HPD.
DATA SOURCES
Articles that evaluated HPD published before March 3, 2020, were identified from MEDLINE and EMBASE.
STUDY SELECTION
Clinical trials and observational studies providing the incidence and definition of HPD from patients with cancer treated with ICIs.
DATA EXTRACTION AND SYNTHESIS
Factors included in the analysis comprised authors, year of publication, cancer type, ICI type, number of previous treatment lines, definition of HPD, time frame used to assess HPD, number of patients with HPD, onset of HPD, and prognosis of patients with HPD. Quantitative and qualitative syntheses for the incidence of HPD were performed.
MAIN OUTCOMES AND MEASURES
Definitions of HPD were categorized and the range of incidence of HPD was evaluated. Subgroup analysis on the incidence of HPD according to the category was performed and the challenges associated with current HPD assessment were evaluated.
RESULTS
Twenty-four studies with 3109 patients were analyzed. The incidence of HPD varied from 5.9% to 43.1%. The definitions were divided into 4 categories based on the calculation of tumor growth acceleration: tumor growth rate ratio (pooled incidence of HPD, 9.4%; 95% CI, 6.9%-12.0%), tumor growth kinetics ratio (pooled incidence, 15.8%; 95% CI, 8.0%-23.7%), early tumor burden increase (pooled incidence, 20.6%; 95% CI, 9.3%-31.8%), and combinations of the above (pooled incidence, 12.4%; 95% CI, 7.3%-17.5%). Hyperprogressive disease could be overestimated or underestimated if the assessment was limited to tumor growth rate or tumor growth kinetics ratio, target lesions, or response evaluation criteria in solid tumors (RECIST)-defined progressors, or if the assessment time frame conformed to RECIST. Study results on clinical outcome were heterogeneous on discriminating patients with HPD from those with natural progressive disease.
CONCLUSIONS AND RELEVANCE
Definitions of HPD appear to be diverse, with the incidence of HPD varying from 5.9% to 43.1% across studies examined in this meta-analysis. Varying incidence and definitions of HPD indicate the need for establishing its uniform and clinically relevant criteria based on currently available evidence.
Topics: Disease Progression; Humans; Immune Checkpoint Inhibitors; Incidence; Neoplasms; Time Factors
PubMed: 33760090
DOI: 10.1001/jamanetworkopen.2021.1136