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BMJ Open Sep 2022Intake of white rice has been associated with elevated risk for type 2 diabetes (T2D), while studies on brown rice are conflicting. To inform dietary guidance, we... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Intake of white rice has been associated with elevated risk for type 2 diabetes (T2D), while studies on brown rice are conflicting. To inform dietary guidance, we synthesised the evidence on white rice and brown rice with T2D risk.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, EMBASE and Cochrane databases were searched through November 2021.
ELIGIBILITY CRITERIA
Prospective cohort studies of white and brown rice intake on T2D risk (≥1 year), and randomised controlled trials (RCTs) comparing brown rice with white rice on cardiometabolic risk factors (≥2 weeks).
DATA EXTRACTION AND SYNTHESIS
Data were extracted by the primary reviewer and two additional reviewers. Meta-analyses were conducted using random-effects models and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using the Newcastle Ottawa Scale for prospective cohort studies and the Cochrane Risk of Bias Tool for RCTs. Strength of the meta-evidence was assessed using NutriGrade.
RESULTS
Nineteen articles were included: 8 cohort studies providing 18 estimates (white rice: 15 estimates, 25 956 cases, n=5 77 426; brown rice: 3 estimates, 10 507 cases, n=1 97 228) and 11 RCTs (n=1034). In cohort studies, white rice was associated with higher risk of T2D (pooled RR, 1.16; 95% CI: 1.02 to 1.32) comparing extreme categories. At intakes above ~300 g/day, a dose-response was observed (each 158 g/day serving was associated with 13% (11%-15%) higher risk of T2D). Intake of brown rice was associated with lower risk of T2D (pooled RR, 0.89; 95% CI: 0.81 to 0.97) comparing extreme categories. Each 50 g/day serving of brown rice was associated with 13% (6%-20%) lower risk of T2D. Cohort studies were considered to be of good or fair quality. RCTs showed an increase in high-density lipoprotein-cholesterol (0.06 mmol/L; 0.00 to 0.11 mmol/L) in the brown compared with white rice group. No other significant differences in risk factors were observed. The majority of RCTs were found to have some concern for risk of bias. Overall strength of the meta-evidence was moderate for cohort studies and moderate and low for RCTs.
CONCLUSION
Intake of white rice was associated with higher risk of T2D, while intake of brown rice was associated with lower risk. Findings from substitution trials on cardiometabolic risk factors were inconsistent.
PROSPERO REGISTRATION NUMBER
CRD42020158466.
Topics: Cholesterol; Cohort Studies; Diabetes Mellitus, Type 2; Humans; Lipoproteins, HDL; Oryza
PubMed: 36167362
DOI: 10.1136/bmjopen-2022-065426 -
International Journal of Environmental... Dec 2021A significant amount of emotional labor takes place during teaching. Teaching is a multitasking profession that consists of both cognitive and emotional components, with... (Review)
Review
A significant amount of emotional labor takes place during teaching. Teaching is a multitasking profession that consists of both cognitive and emotional components, with teachers engaging in emotional labor on a daily basis as an instrumental part of achieving teaching goals and positive learning outcomes. The purpose of the present review was to explore the relationship between emotional labor and burnout in school settings. The review focused specifically on teachers from elementary and high schools, between January 2006 and August 2021, and 21 studies fit the inclusion criteria. Overall, the review of the literature supports the significant associations between burnout and emotional labor with the majority of results pointing to the consistent relationship between surface acting and burnout. However, the results regarding the association of deep acting and naturally felt emotions with burnout were mixed. There is considerable scope for improvement in our study of emotional labor in terms of the study designs we employ, the variables we study and our appreciation of the historical and cultural factors that moderate and mediate the relationship between emotional labor and burnout.
Topics: Burnout, Professional; Educational Personnel; Emotions; Faculty; Humans; Occupations; School Teachers; Surveys and Questionnaires
PubMed: 34886485
DOI: 10.3390/ijerph182312760 -
Neuroscience and Biobehavioral Reviews May 2022Early life exposure to air pollution has been associated with neurodevelopmental disorders. Emerging evidence are highlighting a possible impact of air pollution on... (Review)
Review
Early life exposure to air pollution has been associated with neurodevelopmental disorders. Emerging evidence are highlighting a possible impact of air pollution on typically developing children. Thirty papers were included in this review to systematically evaluate the association between air pollutants exposure in prenatal and/or postnatal periods and specific neurodevelopmental skills (i.e. intellective functioning, memory and learning, attention and executive functions, verbal language, numeric ability and motor and/or sensorimotor functions) in preschool- and school-age children. Detrimental effects of air pollutants on children's neurodevelopmental skills were observed, although they do not show clinically relevant performance deficits. The most affected domains were global intellective functioning and attention/executive functions. The pollutants that seem to represent the greatest risk are PM2.5, NO₂ and PAHs. Prenatal exposure is primarily associated with child neurodevelopment at pre-school and school ages. Early exposure to air pollutants is related to adverse neurodevelopmental outcomes in the general population of children. Further research is needed to support stronger conclusions.
Topics: Air Pollutants; Air Pollution; Child; Child, Preschool; Environmental Exposure; Female; Humans; Neurodevelopmental Disorders; Particulate Matter; Pregnancy
PubMed: 35331818
DOI: 10.1016/j.neubiorev.2022.104623 -
PloS One 2023Whether food source or energy mediates the effect of fructose-containing sugars on blood pressure (BP) is unclear. We conducted a systematic review and meta-analysis of... (Meta-Analysis)
Meta-Analysis
Whether food source or energy mediates the effect of fructose-containing sugars on blood pressure (BP) is unclear. We conducted a systematic review and meta-analysis of the effect of different food sources of fructose-containing sugars at different levels of energy control on BP. We searched MEDLINE, Embase and the Cochrane Library through June 2021 for controlled trials ≥7-days. We prespecified 4 trial designs: substitution (energy matched substitution of sugars); addition (excess energy from sugars added); subtraction (excess energy from sugars subtracted); and ad libitum (energy from sugars freely replaced). Outcomes were systolic and diastolic BP. Independent reviewers extracted data. GRADE assessed the certainty of evidence. We included 93 reports (147 trial comparisons, N = 5,213) assessing 12 different food sources across 4 energy control levels in adults with and without hypertension or at risk for hypertension. Total fructose-containing sugars had no effect in substitution, subtraction, or ad libitum trials but decreased systolic and diastolic BP in addition trials (P<0.05). There was evidence of interaction/influence by food source: fruit and 100% fruit juice decreased and mixed sources (with sugar-sweetened beverages [SSBs]) increased BP in addition trials and the removal of SSBs (linear dose response gradient) and mixed sources (with SSBs) decreased BP in subtraction trials. The certainty of evidence was generally moderate. Food source and energy control appear to mediate the effect of fructose-containing sugars on BP. The evidence provides a good indication that fruit and 100% fruit juice at low doses (up to or less than the public health threshold of ~10% E) lead to small, but important reductions in BP, while the addition of excess energy of mixed sources (with SSBs) at high doses (up to 23%) leads to moderate increases and their removal or the removal of SSBs alone (up to ~20% E) leads to small, but important decreases in BP in adults with and without hypertension or at risk for hypertension. Trial registration: Clinicaltrials.gov: NCT02716870.
Topics: Adult; Humans; Fructose; Blood Pressure; Fruit; Sugars; Hypertension
PubMed: 37582096
DOI: 10.1371/journal.pone.0264802 -
Journal of Medical Internet Research Nov 2021Skin cancer is the most common cancer type affecting humans. Traditional skin cancer diagnosis methods are costly, require a professional physician, and take time.... (Review)
Review
BACKGROUND
Skin cancer is the most common cancer type affecting humans. Traditional skin cancer diagnosis methods are costly, require a professional physician, and take time. Hence, to aid in diagnosing skin cancer, artificial intelligence (AI) tools are being used, including shallow and deep machine learning-based methodologies that are trained to detect and classify skin cancer using computer algorithms and deep neural networks.
OBJECTIVE
The aim of this study was to identify and group the different types of AI-based technologies used to detect and classify skin cancer. The study also examined the reliability of the selected papers by studying the correlation between the data set size and the number of diagnostic classes with the performance metrics used to evaluate the models.
METHODS
We conducted a systematic search for papers using Institute of Electrical and Electronics Engineers (IEEE) Xplore, Association for Computing Machinery Digital Library (ACM DL), and Ovid MEDLINE databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The studies included in this scoping review had to fulfill several selection criteria: being specifically about skin cancer, detecting or classifying skin cancer, and using AI technologies. Study selection and data extraction were independently conducted by two reviewers. Extracted data were narratively synthesized, where studies were grouped based on the diagnostic AI techniques and their evaluation metrics.
RESULTS
We retrieved 906 papers from the 3 databases, of which 53 were eligible for this review. Shallow AI-based techniques were used in 14 studies, and deep AI-based techniques were used in 39 studies. The studies used up to 11 evaluation metrics to assess the proposed models, where 39 studies used accuracy as the primary evaluation metric. Overall, studies that used smaller data sets reported higher accuracy.
CONCLUSIONS
This paper examined multiple AI-based skin cancer detection models. However, a direct comparison between methods was hindered by the varied use of different evaluation metrics and image types. Performance scores were affected by factors such as data set size, number of diagnostic classes, and techniques. Hence, the reliability of shallow and deep models with higher accuracy scores was questionable since they were trained and tested on relatively small data sets of a few diagnostic classes.
Topics: Algorithms; Artificial Intelligence; Data Management; Humans; Reproducibility of Results; Skin Neoplasms
PubMed: 34821566
DOI: 10.2196/22934 -
Medical Education Oct 2018Research has suggested beneficial effects of self-regulated learning (SRL) for medical students' and residents' workplace-based learning. Ideally, learners go through a... (Review)
Review
OBJECTIVES
Research has suggested beneficial effects of self-regulated learning (SRL) for medical students' and residents' workplace-based learning. Ideally, learners go through a cyclic process of setting learning goals, choosing learning strategies and assessing progress towards goals. A clear overview of medical students' and residents' successful key strategies, influential factors and effective interventions to stimulate SRL in the workplace is missing. This systematic review aims to provide an overview of and a theoretical base for effective SRL strategies of medical students and residents for their learning in the clinical context.
METHODS
This systematic review was conducted according to the guidelines of the Association for Medical Education in Europe. We systematically searched PubMed, EMBASE, Web of Science, PsycINFO, ERIC and the Cochrane Library from January 1992 to July 2016. Qualitative and quantitative studies were included. Two reviewers independently performed the review process and assessed the methodological quality of included studies. A total of 3341 publications were initially identified and 18 were included in the review.
RESULTS
We found diversity in the use of SRL strategies by medical students and residents, which is linked to individual (goal setting), contextual (time pressure, patient care and supervision) and social (supervisors and peers) factors. Three types of intervention were identified (coaching, learning plans and supportive tools). However, all interventions focused on goal setting and monitoring and none on supporting self-evaluation.
CONCLUSIONS
Self-regulated learning in the clinical environment is a complex process that results from an interaction between person and context. Future research should focus on unravelling the process of SRL in the clinical context and specifically on how medical students and residents assess their progress towards goals.
Topics: Clinical Competence; Education, Medical; Europe; Goals; Humans; Internship and Residency; Self-Directed Learning as Topic; Students, Medical
PubMed: 29943415
DOI: 10.1111/medu.13615 -
Neuroepidemiology 2015As adult brain structure is primarily established in early life, genetic and environmental exposures in infancy and childhood influence the risk for Alzheimer disease... (Review)
Review
BACKGROUND
As adult brain structure is primarily established in early life, genetic and environmental exposures in infancy and childhood influence the risk for Alzheimer disease (AD). In this systematic review, we identified several early life risk factors and discussed the evidence and underlying mechanism for each.
SUMMARY
Early risk factors for AD may alter brain anatomy, causing vulnerability to AD-related dementia later in life. In the perinatal period, both genes and learning disabilities have been associated with the development of distinct AD phenotypes. During early childhood, education and intellect, as well as body growth, may predispose to AD through alterations in cognitive and brain reserve, though the specific mediators of neural injury are disputed. Childhood socioeconomic status (SES) may predispose to AD by influencing adult SES and cognition. Association of these risk factors with underlying AD pathology (rather than just clinical diagnosis) has not been sufficiently examined.
KEY MESSAGES
Factors that impede or alter brain growth during early life could render certain brain regions or networks selectively vulnerable to the onset, accumulation or spread of AD-related pathology during later life. Careful life-course epidemiology could provide clues as to why the brain systematically degenerates during AD.
Topics: Alzheimer Disease; Brain; Cognition; Cognitive Reserve; Dementia; Humans; Risk Factors
PubMed: 26501691
DOI: 10.1159/000439568 -
Neuroscience and Biobehavioral Reviews Oct 2021Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for... (Review)
Review
Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.
Topics: Conditioning, Classical; Conditioning, Psychological; Extinction, Psychological; Fear; Humans; Obsessive-Compulsive Disorder
PubMed: 34314751
DOI: 10.1016/j.neubiorev.2021.07.026 -
Journal of Healthcare Engineering 2022Dental caries is one of the major oral health problems and is increasing rapidly among people of every age (children, men, and women). Deep learning, a field of... (Review)
Review
BACKGROUND
Dental caries is one of the major oral health problems and is increasing rapidly among people of every age (children, men, and women). Deep learning, a field of Artificial Intelligence (AI), is a growing field nowadays and is commonly used in dentistry. AI is a reliable platform to make dental care better, smoother, and time-saving for professionals. AI helps the dentistry professionals to fulfil demands of patients and to ensure quality treatment and better oral health care. AI can also help in predicting failures of clinical cases and gives reliable solutions. In this way, it helps in reducing morbidity ratio and increasing quality treatment of dental problem in population.
OBJECTIVES
The main objective of this study is to conduct a systematic review of studies concerning the association between dental caries and machine learning. The objective of this study is to design according to the PICO criteria.
MATERIALS AND METHODS
A systematic search for randomized trials was conducted under the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). In this study, e-search was conducted from four databases including PubMed, IEEE Xplore, Science Direct, and Google Scholar, and it involved studies from year 2008 to 2022.
RESULT
This study fetched a total of 133 articles, from which twelve are selected for this systematic review. We analyzed different types of machine learning algorithms from which deep learning is widely used with dental caries images dataset. Neural Network Backpropagation algorithm, one of the deep learning algorithms, gives a maximum accuracy of 99%.
CONCLUSION
In this systematic review, we concluded how deep learning has been applied to the images of teeth to diagnose the detection of dental caries with its three types (proximal, occlusal, and root caries). Considering our findings, further well-designed studies are needed to demonstrate the diagnosis of further types of dental caries that are based on progression (chronic, acute, and arrested), which tells us about the severity of caries, virginity of lesion, and extent of caries. Apart from dental caries, AI in the future will emerge as supreme technology to detect other diseases of oral region combinedly and comprehensively because AI will easily analyze big datasets that contain multiple records.
Topics: Algorithms; Artificial Intelligence; Child; Dental Caries; Female; Humans; Machine Learning; Neural Networks, Computer
PubMed: 35399834
DOI: 10.1155/2022/5032435 -
The Lancet. Gastroenterology &... Jun 2023Measuring the incidence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is key to track progress towards elimination. We aimed to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Measuring the incidence of HIV and hepatitis C virus (HCV) infection among people who inject drugs (PWID) is key to track progress towards elimination. We aimed to summarise global data on HIV and primary HCV incidence among PWID and associations with age and sex or gender.
METHODS
In this systematic review and meta-analysis, we updated an existing database of HIV and HCV incidence studies among PWID by searching MEDLINE, Embase, and PsycINFO, capturing studies published between Jan 1, 2000, and Dec 12, 2022, with no language or study design restrictions. We contacted authors of identified studies for unpublished or updated data. We included studies that estimated incidence by longitudinally re-testing people at risk of infection or by using assays for recent infection. We pooled incidence and relative risk (RR; young [generally defined as ≤25 years] vs older PWID; women vs men) estimates using random-effects meta-analysis and assessed risk of bias with a modified Newcastle-Ottawa scale. This study is registered with PROSPERO, CRD42020220884.
FINDINGS
Our updated search identified 9493 publications, of which 211 were eligible for full-text review. An additional 377 full-text records from our existing database and five records identified through cross-referencing were assessed. Including 28 unpublished records, 125 records met the inclusion criteria. We identified 64 estimates of HIV incidence (30 from high-income countries [HICs] and 34 from low-income or middle-income countries [LMICs]) and 66 estimates of HCV incidence (52 from HICs and 14 from LMICs). 41 (64%) of 64 HIV and 42 (64%) of 66 HCV estimates were from single cities rather than being multi-city or nationwide. Estimates were measured over 1987-2021 for HIV and 1992-2021 for HCV. Pooled HIV incidence was 1·7 per 100 person-years (95% CI 1·3-2·3; I=98·4%) and pooled HCV incidence was 12·1 per 100 person-years (10·0-14·6; I=97·2%). Young PWID had a greater risk of HIV (RR 1·5, 95% CI 1·2-1·8; I=66·9%) and HCV (1·5, 1·3-1·8; I=70·6%) acquisition than older PWID. Women had a greater risk of HIV (RR 1·4, 95% CI 1·1-1·6; I=55·3%) and HCV (1·2, 1·1-1·3; I=43·3%) acquisition than men. For both HIV and HCV, the median risk-of-bias score was 6 (IQR 6-7), indicating moderate risk.
INTERPRETATION
Although sparse, available HIV and HCV incidence estimates offer insights into global levels of HIV and HCV transmission among PWID. Intensified efforts are needed to keep track of the HIV and HCV epidemics among PWID and to expand access to age-appropriate and gender-appropriate prevention services that serve young PWID and women who inject drugs.
FUNDING
Canadian Institutes of Health Research, Fonds de recherche du Québec-Santé, Canadian Network on Hepatitis C, UK National Institute for Health and Care Research, and WHO.
Topics: Male; Humans; Female; Hepacivirus; Substance Abuse, Intravenous; Drug Users; Incidence; HIV Infections; Canada; Hepatitis C
PubMed: 36996853
DOI: 10.1016/S2468-1253(23)00018-3