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The American Journal of Clinical... Nov 2019Although available data suggest that some dietary flavan-3-ol sources reduce cardiometabolic risk, to our knowledge no review has systematically synthesized their... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although available data suggest that some dietary flavan-3-ol sources reduce cardiometabolic risk, to our knowledge no review has systematically synthesized their specific contribution.
OBJECTIVE
We aimed to examine, for the first time, if there is consistent evidence that higher flavan-3-ol intake, irrespective of dietary source, reduces cardiometabolic risk.
METHODS
MEDLINE, Cochrane Central, and Commonwealth Agricultural Bureau abstracts were searched for prospective cohorts and randomized controlled trials (RCTs) published from 1946 to March 2019 on flavan-3-ol intake and cardiovascular disease (CVD) risk. Random-effects models meta-analysis was used. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach assessed the strength of evidence.
RESULTS
Of 15 prospective cohorts (23 publications), 4 found highest compared with lowest habitual intakes of flavan-3-ols were associated with a 13% reduction in risk of CVD mortality and 2 found a 19% reduction in risk of chronic heart disease (CHD) incidence. Highest compared with lowest habitual intakes of monomers were associated with a reduction in risk of type 2 diabetes mellitus (T2DM) (n = 5) and stroke (n = 4) (10% and 18%, respectively). No association was found for hypertension. Of 156 RCTs, flavan-3-ol intervention resulted in significant improvements in acute/chronic flow-mediated dilation (FMD), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), LDL and HDL cholesterol, triglycerides (TGs), hemoglobin A1c (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR). All analyses, except HbA1c, were associated with moderate/high heterogeneity. When analyses were limited to good methodological quality studies, improvements in TC, HDL cholesterol, SBP, DBP, HOMA-IR, and acute/chronic FMD remained significant. In GRADE evaluations, there was moderate evidence in cohort studies that flavan-3-ol and monomer intakes were associated with reduced risk of CVD mortality, CHD, stroke, and T2DM, whereas RCTs reported improved TC, HDL cholesterol, SBP, and HOMA-IR.
CONCLUSIONS
Available evidence supports a beneficial effect of flavan-3-ol intake on cardiometabolic outcomes, but there was considerable heterogeneity in the meta-analysis. Future research should focus on an integrated intake/biomarker approach in cohorts and high-quality dose-response RCTs. This review was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42018035782.
Topics: Cardiovascular Diseases; Diabetes Mellitus, Type 2; Endothelium, Vascular; Flavonoids; Glucose; Humans; Insulin Resistance; Lipids; Prospective Studies; Randomized Controlled Trials as Topic
PubMed: 31504087
DOI: 10.1093/ajcn/nqz178 -
The Cochrane Database of Systematic... Aug 2017Gestational diabetes mellitus (GDM) is carbohydrate intolerance resulting in hyperglycaemia with onset or first recognition during pregnancy. If untreated, perinatal... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Gestational diabetes mellitus (GDM) is carbohydrate intolerance resulting in hyperglycaemia with onset or first recognition during pregnancy. If untreated, perinatal morbidity and mortality may be increased. Accurate diagnosis allows appropriate treatment. Use of different tests and different criteria will influence which women are diagnosed with GDM. This is an update of a review published in 2011 and 2015.
OBJECTIVES
To evaluate and compare different testing strategies for diagnosis of gestational diabetes mellitus to improve maternal and infant health while assessing their impact on healthcare service costs.
SEARCH METHODS
We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP) (9 January 2017) and reference lists of retrieved studies.
SELECTION CRITERIA
We included randomised trials if they evaluated tests carried out to diagnose GDM. We excluded studies that used a quasi-random model, cluster-randomised or cross-over trials.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach.
MAIN RESULTS
We included a total of seven small trials, with 1420 women. One trial including 726 women was identified by this update and examined the two step versus one step approach. These trials were assessed as having varying risk of bias, with few outcomes reported. We prespecified six outcomes to be assessed for quality using the GRADE approach for one comparison: 75 g oral glucose tolerance test (OGTT) versus 100 g OGTT; data for only one outcome (diagnosis of gestational diabetes) were available for assessment. One trial compared three different methods of delivering glucose: a candy bar (39 women), a 50 g glucose polymer drink (40 women) and a 50 g glucose monomer drink (43 women). We have included the results reported by this trial as separate comparisons. No trial reported on measures of costs of health services.We examined six main comparisons. 75 g OGTT versus 100 g OGTT (1 trial, 248 women): women who received 75 g OGTT had a higher relative risk of being diagnosed with GDM (risk ratio (RR) 2.55, 95% confidence interval (CI) 0.96 to 6.75; very-low quality evidence). No data were reported for the following additional outcomes prespecified for GRADE assessment: caesarean section, macrosomia > 4.5 kg or however defined in the trial, long-term type 2 diabetes maternal, long-term type 2 diabetes infant and economic costs. Candy bar versus 50 g glucose monomer drink (1 trial, 60 women): more women receiving the candy bar, rather than glucose monomer, preferred the taste of the candy bar (RR 0.60, 95% CI 0.42 to 0.86) and 1-hour glucose was less with the candy bar. There were no differences in the other outcomes reported (maternal side effects). No infant outcomes were reported or any review primary outcomes. 50 g glucose polymer drink versus 50 g glucose monomer drink (3 trials, 239 women): mean difference (MD) in gestation at birth was -0.80 weeks (1 trial, 100 women; 95% CI -1.69 to 0.09). Total side effects were less common with the glucose polymer drink (1 trial, 63 women; RR 0.21, 95% CI 0.07 to 0.59), and no clear difference in taste acceptability was reported (1 trial, 63 women; RR 0.99, 95% CI 0.76 to 1.29). Fewer women reported nausea following the 50 g glucose polymer drink compared with the 50 g glucose monomer drink (1 trial, 66 women; RR 0.29, 95% CI 0.11 to 0.78). No other measures of maternal morbidity or outcomes for the infant were reported. 50 g glucose food versus 50 g glucose drink (1 trial, 30 women): women receiving glucose in their food, rather than as a drink, reported fewer side effects (RR 0.08, 95% CI 0.01 to 0.56). No clear difference was noted in the number of women requiring further testing (RR 0.14, 95% CI 0.01 to 2.55). No other measures of maternal morbidity or outcome were reported for the infant or review primary outcomes. 75 g OGTT World Health Organization (WHO) criteria versus 75 g OGTT American Diabetes Association (ADA) criteria (1 trial, 116 women): no clear differences in included outcomes were observed between women who received the 75 g OGTT and were diagnosed using criteria based on WHO (1999) recommendations and women who received the 75 g OGTT and were diagnosed using criteria recommended by the ADA (1979). Outcomes measured included diagnosis of gestational diabetes (RR 1.47, 95% CI 0.66 to 3.25), caesarean section (RR 1.07, 95% CI 0.85 to 1.35), macrosomia defined as > 90th percentile by ultrasound or birthweight equal to or exceeding 4000 g (RR 0.73, 95% CI 0.19 to 2.79), stillbirth (RR 0.49, 95% CI 0.02 to 11.68) and instrumental birth (RR 0.21, 95% CI 0.01 to 3.94). No other secondary outcomes were reported. Two-step approach (50 g oral glucose challenge test followed by selective 100 g OGTT Carpenter and Coustan criteria) versus one-step approach (universal 75 g OGTT ADA criteria) (1 trial, 726 women): women allocated the two-step approach had a lower risk of being diagnosed with GDM at 11 to 14 weeks' gestation compared to women allocated the one-step approach (RR 0.51, 95% CI 0.28 to 0.95). No other primary or secondary outcomes were reported.
AUTHORS' CONCLUSIONS
There is insufficient evidence to suggest which strategy is best for diagnosing GDM. Large randomised trials are required to establish the best strategy for correctly identifying women with GDM.
Topics: Beverages; Candy; Diabetes, Gestational; Female; Glucose; Glucose Tolerance Test; Humans; Infant Welfare; Infant, Newborn; Maternal Welfare; Pregnancy; Prenatal Exposure Delayed Effects; Randomized Controlled Trials as Topic
PubMed: 28832911
DOI: 10.1002/14651858.CD007122.pub4 -
Restorative Dentistry & Endodontics Nov 2021The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current.
OBJECTIVES
The purpose of this systematic review was to collect and discuss the technique of adhesive systems application on dentin substrate under electric current.
MATERIALS AND METHODS
The first search strategy was based on data available at PubMed, LILACS, Scielo, Scopus, and Cochrane Library, using a combination of descriptors such as "dentin bond agents OR adhesive system AND electric current OR electrobond" or "dentin bonding agents OR dentin bonding agent application OR adhesive system AND electric current OR electrobond", with no limit regarding the publication year. The second search strategy was based on the articles' references found previously. An additional search strategy was applied that concerned the proposed theme in the SBU-UNICAMP (Unicamp's Library System Institutional Repository).
RESULTS
Twelve studies published between 2006 and 2020 were found. The analyses of the selected studies showed that the use of electric current during adhesive systems application on dentin, whether conventional or self-conditioning, increases resinous monomer infiltration in the dentin substrate, which improves the hybridization processes and the bond strength of the restorative material to dentin.
CONCLUSIONS
Despite the favorable results related to the use of this technique, there is still no specific protocol for the application of adhesive systems under electric current.
PubMed: 34909419
DOI: 10.5395/rde.2021.46.e55 -
Sheng Wu Gong Cheng Xue Bao = Chinese... Mar 2021Cyanobacteria is one of the promising microbial chassis in synthetic biology, which serves as a typical host for light-driven production. With the gradual depletion of...
Cyanobacteria is one of the promising microbial chassis in synthetic biology, which serves as a typical host for light-driven production. With the gradual depletion of fossil resources and intensification of global warming, the research on cyanobacterial cell factory using CO2 as carbon resource is ushering in a new wave. For a long time, research focus on cyanobacterial cell factory has mainly been the production of energy products, such as liquid fuels and hydrogen. One of the critical bottlenecks occurring in cyanobacterial cell factory is the poor economic performance, which is mainly caused by the inherent inefficiency of cyanobacteria. The problem is particularly prominent for these extremely cost-sensitive energy products. As an indispensable basis for modern industry, polymer monomers belong to the bulk chemicals with high added value. Therefore, increasing attention has been focused on polymer monomers which are superior in overcoming the economic barrier in commercialization of cyanobacterial cell factories. Here, we systematically review the progress on the production of polymer monomers using cyanobacteria, including the strategies for improving production, and the related technologies for the application of this important microbial cell factory. Finally, we summarize several issues in cyanobacterial synthetic biology and proposed future developing trends in this field.
Topics: Cyanobacteria; Macromolecular Substances; Polymers; Synthetic Biology
PubMed: 33783165
DOI: 10.13345/j.cjb.200637 -
Sheng Wu Gong Cheng Xue Bao = Chinese... Apr 2018Poly (3-hydroxypropionate) (P3HP), a new member of thermoplastic of family polyhydroxyalkanoates (PHAs), has excellent characteristics of biodegradability and...
Poly (3-hydroxypropionate) (P3HP), a new member of thermoplastic of family polyhydroxyalkanoates (PHAs), has excellent characteristics of biodegradability and biocompatibility. By now no reports can be found about wild-type bacteria that naturally synthesize P3HP, so the main way to produce P3HP is chemical and biological methods. Chemical method by adding high cost 3-HP monomers or their structural analogs as precursors, has the drawbacks of toxicity, low effectiveness and high cost. Biological method using engineered strain may utilize inexpensive and renewable carbon source to produce P3HP and has gradually become more and more popular. We systematically review here the biosynthesis of P3HP research progress. The advantages and disadvantages of biosynthesis pathways of glycerol pathway, malonyl-CoA pathway and β-alanine pathway were analyzed.
Topics: Bacteria; Bacterial Proteins; Coenzyme A Ligases; Glycerol; Industrial Microbiology; Metabolic Networks and Pathways; Polyesters; beta-Alanine
PubMed: 29701024
DOI: 10.13345/j.cjb.170267 -
International Journal of Environmental... May 2019(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the...
(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the application of dental resin, they dissolve in the saliva. (2) Methods: The literature search was carried out in Pubmed, Cochrane and Embase databases. Randomized controlled trials, cohort studies and case-control studies that evaluated BPA levels in human urine, saliva and/or blood were included. (3) Results: The initial search had 5111 results. A total of 20 studies were included in the systematic review. Most studies showed an increase of the levels of bisphenol A 1 h after treatments with composite resins and dental sealants. One week after treatments the levels were decreased. (4) Conclusions: Some clinical precautions should be taken to decrease the release of BPA, namely the use of rubber dam, the immediate polishing of all resins used, or the use of glycerin gel to avoid non-polymerization of the last resin layer, and mouthwash after treatment. Another preventive measure in addition to the above-mentioned is the use of the smallest possible number of restorations or sealants, a maximum of four per appointment. These measures are even more important in children, adolescents and pregnant women.
Topics: Animals; Benzhydryl Compounds; Case-Control Studies; Cohort Studies; Humans; Phenols; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Resins, Synthetic
PubMed: 31075949
DOI: 10.3390/ijerph16091627 -
PloS One 2018Polymerization shrinkage of resin composite can compromise the longevity of restorations. To minimize this problem, the monomeric composition of composites have been... (Meta-Analysis)
Meta-Analysis
Polymerization shrinkage of resin composite can compromise the longevity of restorations. To minimize this problem, the monomeric composition of composites have been modified. The objective of this study was to conduct a meta-analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite in comparison with traditional methacrylates-based resin composite. This systematic review was registered at Prospero data system (CRD42015023940). Studies were searched in the electronic databases PubMed, Web of Science, Scopus, Lilacs and EMBASE according to a predefined search strategy. The inclusion criteria were as follow: (1) randomized controlled clinical trials with at least six months of follow-up; (2) studies investigating composites with monomers designed to reduce polymerization shrinkage; (3) studies conducted with class I or II restorations in the permanent dentition; and (4) studies that assessed at least one of the following criteria: marginal integrity/adaptation, marginal discoloration, recurent caries, retention of composite restorations, and postoperative sensitivity. Two independent reviewers analyzed the articles to determine inclusion and risk of bias. The search conducted in the databases resulted in a total of 14,217 studies. After reviewing the references and citations, 21 articles remained. The longest clinical follow-up time was 60 months. The meta-analysis of the data in the included studies demonstrated that only one variable (marginal adaptation after 12 months) showed statistically significant outcomes, in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers. The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane, ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites.
Topics: Composite Resins; Dental Restoration, Permanent; Humans; Methacrylates; Polymerization
PubMed: 29466366
DOI: 10.1371/journal.pone.0191942