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International Journal of Molecular... Aug 2023The use of platelet-rich plasma (PRP) has gained increasing interest in recent decades. The platelet secretome contains a multitude of growth factors, cytokines,... (Review)
Review
The use of platelet-rich plasma (PRP) has gained increasing interest in recent decades. The platelet secretome contains a multitude of growth factors, cytokines, chemokines, and other biological biomolecules. In recent years, developments in the field of platelets have led to new insights, and attention has been focused on the platelets' released extracellular vesicles (EVs) and their role in intercellular communication. In this context, the aim of this review was to compile the current evidence on PRP-derived extracellular vesicles to identify the advantages and limitations fortheir use in the upcoming clinical applications. A total of 172 articles were identified during the systematic literature search through two databases (PubMed and Web of Science). Twenty publications met the inclusion criteria and were included in this review. According to the results, the use of PRP-EVs in the clinic is an emerging field of great interest that represents a promising therapeutic option, as their efficacy has been demonstrated in the majority of fields of applications included in this review. However, the lack of standardization along the procedures in both the field of PRP and the EVs makes it extremely challenging to compare results among studies. Establishing standardized conditions to ensure optimized and detailed protocols and define parameters such as the dose or the EV origin is therefore urgent. Further studies to elucidate the real contribution of EVs to PRP in terms of composition and functionality should also be performed. Nevertheless, research on the field provides promising results and a novel basis to deal with the regenerative medicine and drug delivery fields in the future.
Topics: Blood Platelets; Cell Communication; Extracellular Vesicles; Platelet-Rich Plasma; Regenerative Medicine
PubMed: 37685849
DOI: 10.3390/ijms241713043 -
NPJ Primary Care Respiratory Medicine Jul 2023
Meta-Analysis
Topics: Humans; Pulmonary Medicine; Primary Health Care
PubMed: 37438388
DOI: 10.1038/s41533-023-00348-5 -
Bulletin of the World Health... Oct 2023To consolidate recent information on elimination and eradication goals for infectious diseases and clarify the definitions and associated terminology for different goals. (Review)
Review
OBJECTIVE
To consolidate recent information on elimination and eradication goals for infectious diseases and clarify the definitions and associated terminology for different goals.
METHODS
We conducted a systematic search of the World Health Organization's Institutional Repository for Information Sharing (WHO IRIS) and a customized systematic Google advanced search for documents published between 2008 and 2022 on elimination or eradication strategies for infectious conditions authored by WHO or other leading health organizations. We extracted information on names of infectious conditions, the elimination and eradication goals and timelines, definitions of goals, non-standardized terminology, targets and assessment processes.
FINDINGS
We identified nine goals for 27 infectious conditions, ranging from disease control to eradication. In comparison with the hierarchy of disease control, as defined at the Dahlem Workshop in 1997, six goals related to disease control with varying levels of advancement, two related to elimination and one to eradication. Goals progressed along a disease-control continuum, such as end of disease epidemic to pre-elimination to elimination as a public health problem or threat. We identified the use of non-standardized terminology with certain goals, including elimination, of disease epidemics, public health and public health
CONCLUSION
As we approach the 2030 target date to achieve many of the goals related to disease control and for other infections to become candidates for elimination in the future, clarity of definitions and objectives is important for public health professionals and policy-makers to avoid misperceptions and miscommunication.
Topics: Humans; Goals; Disease Eradication; Public Health; Global Health; Communicable Diseases
PubMed: 37772196
DOI: 10.2471/BLT.23.289676 -
Systematic Reviews Jul 2017The use of information technology, including internet- and telephone-based resources, is becoming an alternative and supporting method of providing many forms of... (Review)
Review
BACKGROUND
The use of information technology, including internet- and telephone-based resources, is becoming an alternative and supporting method of providing many forms of services in a healthcare and health management setting. Telephone consultations provide a promising alternative and supporting service for face-to-face general practice care. The aim of this review is to utilize a systematic review to collate evidence on the use of telephone consultation as an alternative to face-to-face general practice visits.
METHODS
A systematic search of MEDLINE, CINAHL, The Cochrane Library, and the International Clinical Trials Registry Platform was performed using the search terms for the intervention (telephone consultation) and the comparator (general practice). Systematic reviews and randomized control trials that examined telephone consultation compared to normal face-to-face consultation in general practice were included in this review. Papers were reviewed, assessed for quality (Cochrane Collaboration's 'Risk of bias' tool) and data extracted and analysed.
RESULTS
Two systematic reviews and one RCT were identified and included in the analysis. The RCT (N = 388) was of patients requesting same-day appointments from two general practices and patients were randomized to a same-day face-to-face appointment or a telephone call back consultation. There was a reduction in the time spent on consultations in the telephone group (1.5 min (0.6 to 2.4)) and patients in the telephone arm had 0.2 (0 to 0.3) more follow-up consultations than the face-to-face group. One systematic review focused on telephone consultation and triage on healthcare use, and included one RCT and one other observational study that examined telephone consultations. The other systematic review focused on patient access and included one RCT and four observational studies that examined telephone consultations. Both systematic reviews provided narrative interpretations of the evidence and concluded that telephone consultations provided an appropriate alternative to telephone consultations and reduced practice work load.
CONCLUSION
There is a lack of high level evidence for telephone consultations in a GP setting; however, current evidence suggests that telephone consultations as an alternative to face-to-face general practice consultations offers an appropriate option in certain settings.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42015025225.
Topics: Delivery of Health Care; General Practice; Humans; Referral and Consultation; Telemedicine; Telephone
PubMed: 28673333
DOI: 10.1186/s13643-017-0529-0 -
International Journal of Environmental... Jul 2021Given the extent of workaholism identified in the literature, it seems essential to consider effective preventive measures. The purpose of this article is to summarize... (Review)
Review
INTRODUCTION
Given the extent of workaholism identified in the literature, it seems essential to consider effective preventive measures. The purpose of this article is to summarize literature data on possible collective and individual preventive measures against workaholism, especially in occupational medicine.
METHOD
We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
155 articles were retrieved in March 2019, but only 15 well-designed studies providing concrete measures to prevent workaholism were included. The various measures were classified using the traditional distinction between three levels of prevention. At the first level of prevention, workaholism can be avoided by implementing a protective organizational culture. The second level of prevention rather focuses on individual training and counselling to address the negative consequences of workaholism. Finally, the third level of prevention combines cognitive and behavioral interventions that enable professional and social reintegration of workaholics.
DISCUSSION
This literature review confirms the multifactorial origin of workaholism and the involvement of organizational factors, supporting the necessary contribution of companies in its prevention. This review also reinforces the growing perception of workaholism as a behavioral addiction. Occupational physicians play a key role in this preventive approach as they can influence both working conditions and individual care. The highlighted preventive measures seem to be not only favorable to workaholics, but also to companies.
CONCLUSION
This review provides field tools that can be used at the various levels of workaholism prevention. Nevertheless, intervention studies are required to confirm the effectiveness of the measures presented.
Topics: Behavior, Addictive; Occupational Medicine; Occupations
PubMed: 34281048
DOI: 10.3390/ijerph18137109 -
Journal of Medical Systems Jul 2023Gait and dynamic balance are two main goals in neurorehabilitation that mHealth systems could address. To analyze the impact of using mHealth systems on gait and dynamic... (Meta-Analysis)
Meta-Analysis Review
Gait and dynamic balance are two main goals in neurorehabilitation that mHealth systems could address. To analyze the impact of using mHealth systems on gait and dynamic balance outcomes in subjects with neurological disorders. Randomized controlled trials (RCT) published in PubMed, Web of Science, Scopus, and PEDro databases were searched up to April 2023. Studies including adults with neurological disorders, analyzing the effectiveness of mHealth systems on gait and dynamic balance compared with conventional therapy and/or not intervention, were included. The PEDro scale and the Cochrane Collaboration's 2.0 tool were used for the methodological quality and risk of bias assessment. The Review Manager 5.4 software was used to obtain meta-analyses. 13 RCT were included in the systematic review and 11 in the meta-analyses, involving 528 subjects. A total of 21 mobile applications were identified for gait and balance training, and to enhance physical activity behaviors. There were significant differences in gait parameters, speed by 0.10 s/m (95% confidence interval (CI)=0.07,0.13;p<0.001), cadence by 8.01 steps/min (95%CI=3.30,12.72;p<0.001), affected step length by 8.89 cm (95%CI=4.88,12.90;p<0.001), non-affected step length by 8.08 cm (5%CI=2.64,13.51;p=0.004), and in dynamic balance, Timed Up and Go by -7.15 s (95%CI=-9.30,-4.99;p<0.001), and mobility subscale of Posture Assessment Scale for Stroke by 1.71 points (95%CI=1.38,2.04;p<0.001). Our findings suggested the use of mHealth systems for improving gait in subjects with neurological disorders, but controversial results on dynamics balance recovery were obtained. However, the quality of evidence is insufficient to strongly recommend them, so further research is needed.
Topics: Adult; Humans; Gait; Stroke; Motor Activity; Neurological Rehabilitation; Telemedicine; Postural Balance; Stroke Rehabilitation
PubMed: 37462759
DOI: 10.1007/s10916-023-01963-y -
JMIR MHealth and UHealth Jul 2021Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients.... (Review)
Review
BACKGROUND
Telemedicine, including video-, web-, and telephone-based interventions, is used in adult and pediatric populations to deliver health care and communicate with patients. In the realm of hematology, telemedicine has recently been used to safely and efficiently monitor treatment side-effects, perform consultations, and broaden the reach of subspecialty care.
OBJECTIVE
We aimed to synthesize and analyze information regarding the feasibility, acceptability, and potential benefits of telemedicine interventions in malignant and nonmalignant hematology, as well as assess the recognized limitations of these interventions.
METHODS
Studies were identified through a comprehensive Medical Subject Headings (MeSH) search on the PubMed MEDLINE, Controlled Register of Clinical Trials (Cochrane CENTRAL from Wiley), Embase, and CINAHL (EBSCO) databases on February 7, 2018. A second search, utilizing the same search strategy, was performed on October 1, 2020. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the reporting of included evidence. Included studies were original articles researching the feasibility, acceptability, and clinical outcomes of telemedicine or telehealth interventions in pediatric or adult populations with malignant or nonmalignant hematological conditions. Data items in the extraction form included first author name, publication year, country, malignant or nonmalignant hematological condition or disease focus of the study, participant age, participant age subgroup (pediatric or adult), study design and setting, telemedicine intervention type and description, study purpose, and main study outcomes.
RESULTS
A total of 32 articles met the preset criteria and were included in this study. Most (25/32) studies were conducted in adults, and the remaining (7/32) were conducted in the pediatric population. Of the 32 studies, 12 studied malignant hematological conditions, 18 studied nonmalignant conditions, and two studied both malignant and nonmalignant conditions. Study types included pilot study (11/32), retrospective study (9/32), randomized controlled trial (6/32), cross-sectional study (2/32), case study (1/32), pre-post study (1/32), noncomparative prospective study (1/32), and prospective cohort study (1/32). The three main types of telemedicine interventions utilized across all studies were video-based (9/32), telephone-based (9/32), and web-based interventions (14/32). Study results showed comparable outcomes between telemedicine and traditional patient encounter groups across both pediatric and adult populations for malignant and nonmalignant hematological conditions.
CONCLUSIONS
Evidence from this review suggests that telemedicine use in nonmalignant and malignant hematology provides similar or improved health care compared to face-to-face encounters in both pediatric and adult populations. Telemedicine interventions utilized in the included studies were well received in both pediatric and adult settings. However, more research is needed to determine the efficacy of implementing more widespread use of telemedicine for hematological conditions.
Topics: Adult; Child; Cross-Sectional Studies; Hematology; Humans; Pilot Projects; Prospective Studies; Retrospective Studies; Telemedicine
PubMed: 34255706
DOI: 10.2196/29619 -
Family Medicine Feb 2015Evidence-based medicine (EBM) is increasingly important in resident education, and reliable and valid tests of competence for family medicine residents are needed. (Review)
Review
BACKGROUND AND OBJECTIVES
Evidence-based medicine (EBM) is increasingly important in resident education, and reliable and valid tests of competence for family medicine residents are needed.
METHODS
MEDLINE, PsycINFO, ERIC, ERC, and the Research & Development Resource Base (University of Toronto) were searched from inception to June 2014 to identify competence tests of family medicine and general practice residents in EBM. Two authors independently assessed all titles, abstracts, and full texts and abstracted data.
RESULTS
Three EBM courses were evaluated by the Fresno test. Seven other authors designed EBM interventions and individual tests to evaluate them. Content validity was assessed by nine studies, construct validity by five, face validity by three, and concurrent validity by one. Internal reliability was reported by seven studies, inter-rater by four, item difficult and item discrimination by two, and intra-rater by one. Eight studies reported that knowledge scores increased significantly after the intervention.
CONCLUSIONS
Content validity and internal reliability were the most frequently assessed measures. The basic EBM activities of identifying Population, Intervention, Comparison, Outcome, and Study Design (PICOS questions) and computing sensitivity, specificity, and number needed to treat (NNT) are unlikely to change. However, guidelines are often used in EBM courses, and they are updated regularly, which will involve new clinical scenarios, PICOS questions, and statistical computations. The Fresno test has been evaluated with three groups of family medicine residents, has the best documentation of validity and reliability, and is the best candidate for future development. Evaluation tools also need to be developed to measure if care received by patients is EBM.
Topics: Canada; Clinical Competence; Evidence-Based Medicine; Family Practice; Humans; Internship and Residency; Reproducibility of Results; United States
PubMed: 25646982
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jul 2023To synthesise research investigating data and code sharing in medicine and health to establish an accurate representation of the prevalence of sharing, how this... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To synthesise research investigating data and code sharing in medicine and health to establish an accurate representation of the prevalence of sharing, how this frequency has changed over time, and what factors influence availability.
DESIGN
Systematic review with meta-analysis of individual participant data.
DATA SOURCES
Ovid Medline, Ovid Embase, and the preprint servers medRxiv, bioRxiv, and MetaArXiv were searched from inception to 1 July 2021. Forward citation searches were also performed on 30 August 2022.
REVIEW METHODS
Meta-research studies that investigated data or code sharing across a sample of scientific articles presenting original medical and health research were identified. Two authors screened records, assessed the risk of bias, and extracted summary data from study reports when individual participant data could not be retrieved. Key outcomes of interest were the prevalence of statements that declared that data or code were publicly or privately available (declared availability) and the success rates of retrieving these products (actual availability). The associations between data and code availability and several factors (eg, journal policy, type of data, trial design, and human participants) were also examined. A two stage approach to meta-analysis of individual participant data was performed, with proportions and risk ratios pooled with the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis.
RESULTS
The review included 105 meta-research studies examining 2 121 580 articles across 31 specialties. Eligible studies examined a median of 195 primary articles (interquartile range 113-475), with a median publication year of 2015 (interquartile range 2012-2018). Only eight studies (8%) were classified as having a low risk of bias. Meta-analyses showed a prevalence of declared and actual public data availability of 8% (95% confidence interval 5% to 11%) and 2% (1% to 3%), respectively, between 2016 and 2021. For public code sharing, both the prevalence of declared and actual availability were estimated to be <0.5% since 2016. Meta-regressions indicated that only declared public data sharing prevalence estimates have increased over time. Compliance with mandatory data sharing policies ranged from 0% to 100% across journals and varied by type of data. In contrast, success in privately obtaining data and code from authors historically ranged between 0% and 37% and 0% and 23%, respectively.
CONCLUSIONS
The review found that public code sharing was persistently low across medical research. Declarations of data sharing were also low, increasing over time, but did not always correspond to actual sharing of data. The effectiveness of mandatory data sharing policies varied substantially by journal and type of data, a finding that might be informative for policy makers when designing policies and allocating resources to audit compliance.
SYSTEMATIC REVIEW REGISTRATION
Open Science Framework doi:10.17605/OSF.IO/7SX8U.
Topics: Humans; Prevalence; Medicine; Administrative Personnel; Biomedical Research; Information Dissemination
PubMed: 37433624
DOI: 10.1136/bmj-2023-075767 -
Journal of Medical Internet Research Mar 2022Mental health disorders are a leading cause of medical disabilities across an individual's lifespan. This burden is particularly substantial in children and adolescents... (Review)
Review
BACKGROUND
Mental health disorders are a leading cause of medical disabilities across an individual's lifespan. This burden is particularly substantial in children and adolescents because of challenges in diagnosis and the lack of precision medicine approaches. However, the widespread adoption of wearable devices (eg, smart watches) that are conducive for artificial intelligence applications to remotely diagnose and manage psychiatric disorders in children and adolescents is promising.
OBJECTIVE
This study aims to conduct a scoping review to study, characterize, and identify areas of innovations with wearable devices that can augment current in-person physician assessments to individualize diagnosis and management of psychiatric disorders in child and adolescent psychiatry.
METHODS
This scoping review used information from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search of several databases from 2011 to June 25, 2021, limited to the English language and excluding animal studies, was conducted. The databases included Ovid MEDLINE and Epub ahead of print, in-process and other nonindexed citations, and daily; Ovid Embase; Ovid Cochrane Central Register of Controlled Trials; Ovid Cochrane Database of Systematic Reviews; Web of Science; and Scopus.
RESULTS
The initial search yielded 344 articles, from which 19 (5.5%) articles were left on the final source list for this scoping review. Articles were divided into three main groups as follows: studies with the main focus on autism spectrum disorder, attention-deficit/hyperactivity disorder, and internalizing disorders such as anxiety disorders. Most of the studies used either cardio-fitness chest straps with electrocardiogram sensors or wrist-worn biosensors, such as watches by Fitbit. Both allowed passive data collection of the physiological signals.
CONCLUSIONS
Our scoping review found a large heterogeneity of methods and findings in artificial intelligence studies in child psychiatry. Overall, the largest gap identified in this scoping review is the lack of randomized controlled trials, as most studies available were pilot studies and feasibility trials.
Topics: Adolescent; Adolescent Psychiatry; Artificial Intelligence; Autism Spectrum Disorder; Child Psychiatry; Humans; Wearable Electronic Devices
PubMed: 35285812
DOI: 10.2196/33560