-
Frontiers in Neuroscience 2023The aim of this study is to evaluate the efficacy of non-invasive brain stimulation (NIBS) in patients with disorders of consciousness (DoC) and compare differences in...
OBJECTIVE
The aim of this study is to evaluate the efficacy of non-invasive brain stimulation (NIBS) in patients with disorders of consciousness (DoC) and compare differences in efficacy between different stimulation modalities.
METHODS
We searched the PubMed, Cochrane Library, Web of Science, and EMBASE databases for all studies published in English from inception to April 2023. Literature screening and quality assessment were performed independently by two investigators. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to evaluate the therapeutic effects of NIBS. The Cochrane Q test and I statistic were used to evaluate heterogeneity between studies. Subgroup analysis was performed to identify the source of heterogeneity, and differences in efficacy between different stimulation modalities were compared by Bayesian analysis.
RESULTS
A total of 17 studies with 377 DoC patients were included. NIBS significantly improved the state of consciousness in DoC patients when compared to sham stimulation (WMD: 0.81; 95% CI: 0.46, 1.17; I = 78.2%, = 0.000). When divided into subgroups according to stimulation modalities, the heterogeneity of each subgroup was significantly lower than before (I: 0.00-30.4%, >0.05); different stimulation modalities may be the main source of such heterogeneity. Bayesian analysis, based on different stimulation modalities, indicated that a patient's state of consciousness improved most significantly after repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC). Diagnosis-based subgroup analysis showed that NIBS significantly improved the state of consciousness in patients with a minimal consciousness state (WMD: 1.11; 95% CI: 0.37, 1.86) but not in patients with unresponsive wakefulness syndrome or a vegetative state (WMD: 0.31; 95% CI: -0.09, 0.71). Subgroup analysis based on observation time showed that single treatment did not improve the state of consciousness in DoC patients (WMD: 0.28; 95% CI: -0.27, 0.82) while multiple treatments could (WMD: 1.05; 95% CI: 0.49, 1.61). Furthermore, NIBS had long-term effects on DoC patients (WMD: 0.79; 95% CI: 0.08-1.49).
CONCLUSION
Available evidence suggests that the use of NIBS on patients with DoC is more effective than sham stimulation, and that rTMS of the left DLPFC may be the most prominent stimulation modality.
PubMed: 37496734
DOI: 10.3389/fnins.2023.1219043 -
PloS One 2024Postpartum sexual health is indicated by a resumption of sexual activity as well as arousal, desire, orgasm, and sexual satisfaction. The issue of resuming sexual... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Postpartum sexual health is indicated by a resumption of sexual activity as well as arousal, desire, orgasm, and sexual satisfaction. The issue of resuming sexual intercourse after childbirth has received limited attention because healthcare professionals rarely provide adequate care to postnatal women. The present study aimed to ascertain the overall prevalence of early resumption of sexual intercourse among most women.
METHODS
Searches were conducted in PubMed, Web of Science, Science Direct, Google Scholar, African Journals Online, and the Cochrane Library. Data were extracted using Microsoft Excel, and STATA version 14 was used for analysis. Publication bias was checked by funnel plot, Egger, and Begg regression tests. A p-value of 0.05 was regarded to indicate potential publication bias. Using I2 statistics, the heterogeneity of the studies was evaluated. By country, a subgroup analysis was conducted. A sensitivity analysis was carried out to determine the effect of each study's findings on the overall estimate. The random effects model was used to assess the overall effect of the study and then measured using prevalence rates and odds ratio with 95% CI.
RESULTS
Twenty-one studies with 4,482 postpartum women participants were included in the study. The pooled prevalence of early resumption sexual intercourse among post-partum women was 57.26% (95% CI 50.14, 64.39) with significant heterogeneity between studies (I2 = 99.2%; P-value ≤ 0.000) observed. Current contraceptive use (AOR = 1.48, 95%CI = 1.03, 6.21), primipara (AOR = 2.88, 95%CI = 1.41, 5.89), and no history of severe genital injury on the last delivery (AOR = 2.27, 95%CI = 1.05, 4.93) were significantly associated with early resumption of sexual intercourse.
CONCLUSION
This study found that more than half of women resumed sexual intercourse early after giving birth. This suggests that a significant number of women may be at higher risk of unwanted pregnancies, short birth intervals, and postpartum sepsis. Thus, stakeholders should improve the integration of postpartum sexual education with maternal health services to reduce the resumption of postpartum sexual intercourse.
Topics: Female; Humans; Pregnancy; Coitus; Family Planning Services; Postpartum Period; Sexual Behavior
PubMed: 38232099
DOI: 10.1371/journal.pone.0288536 -
BMC Psychology Apr 2024Previous research has presented varying perspectives on the potential effect of screen media use among preschoolers. In this study, we systematically reviewed...
BACKGROUND
Previous research has presented varying perspectives on the potential effect of screen media use among preschoolers. In this study, we systematically reviewed experimental studies that investigated how pacing and fantasy features of TV programs affect children's attention and executive functions (EFs).
METHODS
A systematic search was conducted across eight online databases to identify pertinent studies published until August 2023. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines.
RESULTS
Fifteen papers involving 1855 participants aged 2-7 years fulfilled all the inclusion criteria for this review and were entered into the narrative synthesis. Despite the challenge of reaching general conclusions and encountering conflicting outcomes, a nuanced analysis reveals distinct patterns within various subgroups. The impact of pacing on attention is discernible, particularly in bottom-up attention processes, although the nature of this effect remains contradictory. Conversely, consistent findings emerge regarding top-down attention, suggesting any impact. Moreover, a subgroup analysis of different EF components yields valuable insights, highlighting the negative effect of fantasy on inhibitory control within the EF framework.
CONCLUSION
The complexity of these outcomes highlights the need for further research, considering factors such as content, child-specific characteristics, environmental factors, and methodological approaches. These findings collectively emphasize the necessity of conducting more comprehensive and detailed research, especially in terms of the underlying mechanisms and their impact on brain function.
Topics: Child, Preschool; Humans; Attention; Executive Function; Fantasy; Television
PubMed: 38659021
DOI: 10.1186/s40359-024-01738-1 -
Heliyon Apr 2024At present, the diagnosis of post-traumatic stress disorder(PTSD) mainly relies on clinical symptoms and psychological scales, and finding objective indicators that...
BACKGROUND
At present, the diagnosis of post-traumatic stress disorder(PTSD) mainly relies on clinical symptoms and psychological scales, and finding objective indicators that are helpful for diagnosis has always been a challenge in clinical practice and academic research. Neuroimaging is a useful and powerful tool for discovering the biomarkers of PTSD,especially functional MRI (fMRI), structural MRI (sMRI) and Diffusion Weighted Imaging(DTI)are the most commonly used technologies, which can provide multiple perspectives on brain function, structure and its connectivity. Machine learning (ML) is an emerging and potentially powerful method, which has aroused people's interest because it is used together with neuroimaging data to define brain structural and functional abnormalities related to diseases, and identify phenotypes, such as helping physicians make early diagnosis.
OBJECTIVES
According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) declaration, a systematic review was conducted to assess its accuracy in distinguishing between PTSD patients, TEHC(Trauma-Exposed Healthy Controls), and HC(healthy controls).
METHODS
We searched PubMed, Embase, and Web of Science using common words for ML methods and PTSD until June 2023, with no language or time limits. This review includes 13 studies, with sensitivity, specificity, and accuracy taken from each publication or acquired directly from the authors.
RESULTS
All ML techniques have an diagnostic accuracy rate above 70%,and support vector machine(SVM) are the most commonly used techniques. This series of studies has revealed significant neurobiological differences in key brain regions among individuals with PTSD, TEHC, and HC. The connectivity patterns of regions such as the Insula and Amygdala hold particular significance in distinguishing these groups. TEHC exhibits more normal connectivity patterns compared to PTSD, providing valuable insights for the application of machine learning in PTSD diagnosis.
CONCLUSION
In contrast to any currently available assessment and clinical diagnosis, ML techniques can be used as an effective and non-invasive support for early identification and detection of patients as well as for early screening of high-risk populations.
PubMed: 38571633
DOI: 10.1016/j.heliyon.2024.e28559 -
Neurosurgery Aug 2023Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to...
BACKGROUND
Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC.
OBJECTIVE
To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa.
METHODS
We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Review guidelines across 3 databases (PubMed, Scopus, and Web of Science). English articles investigating AC in Africa were included.
RESULTS
Nineteen studies consisting of 396 patients were included. Egypt was the most represented country with 8 studies (42.1%), followed by Nigeria with 6 records (31.6%). Glioma was the most common lesion type, corresponding to 120 of 396 patients (30.3%), followed by epilepsy in 71 patients (17.9%). Awake-awake-awake was the most common protocol used in 7 studies (36.8%). Sixteen studies (84.2%) contained adult patients. The youngest reported AC patient was 11 years old, whereas the oldest one was 92. Nine studies (47.4%) reported infrastructure limitations for performing AC, including the lack of funding, intraoperative monitoring equipment, imaging, medications, and limited human resources.
CONCLUSION
Despite many constraints, AC is being safely performed in low-resource settings. International collaborations among centers are a move forward, but adequate resources and management are essential to make AC an accessible procedure in many more African neurosurgical centers.
Topics: Adult; Child; Humans; Africa; Brain Neoplasms; Craniotomy; Glioma; Wakefulness; Aged, 80 and over
PubMed: 36961213
DOI: 10.1227/neu.0000000000002453 -
Sleep Medicine Reviews Apr 2024This literature review examines all treatments for behavioral insomnia in children under 6 years of age to determine which treatments have empirically demonstrated... (Review)
Review
This literature review examines all treatments for behavioral insomnia in children under 6 years of age to determine which treatments have empirically demonstrated efficacy. Following PRISMA guidelines, three databases were investigated (Pubmed, Cochrane and Psychinfo) to select randomized controlled trials (RCTs) which assess treatments for behavioral insomnia in children under 6 years of age, all with neurotypical development. A total of 908 articles met the search criteria. 21 articles were selected and analyzed in their entirety for a total of 2363 children (ranging from 2 months to 6 years of age). Based on these studies, treatment of behavioral insomnia in young children under 6 years of age is primarily based on behavioral therapy. There is no evidence that pharmacological treatments are effective in the long term for neurotypical children. This review highlights the lack of RCTs in this field: new RCTs should be carried out among young children to refine and optimize the therapeutic approach and to address the risk of therapeutic abuse through the use of non-scientifically validated methods.
Topics: Humans; Child; Child, Preschool; Cognitive Behavioral Therapy; Sleep Initiation and Maintenance Disorders; Behavior Therapy
PubMed: 38394890
DOI: 10.1016/j.smrv.2024.101909 -
Gynecological Endocrinology : the... Dec 2024To synthesize the primary evidence on the efficacy and safety of visnadine on symptoms of sexual dysfunction (SD) in heterosexual women.
OBJECTIVE
To synthesize the primary evidence on the efficacy and safety of visnadine on symptoms of sexual dysfunction (SD) in heterosexual women.
METHODS
We conducted a systematic review of randomized clinical trials (RCTs) with a primary search without language restriction in PubMed/Medline, Scopus, Embase, Web of Science, Cochrane Library, and international clinical trial registries. Trials reporting the use of visnadine by any route in women with SD were eligible. We performed screening, data extraction, and risk of bias assessment in a double-blind approach. The primary outcomes were the Female Sexual Function Index (FSFI) and its domains. Secondary outcomes were safety, arousal, lubrication, pleasure, orgasm, negative sensations, duration, and overall satisfaction.
RESULTS
Initially, 242 records were retrieved. We selected nine papers for full-text reading and finally included two RCTs: one with a parallel design and one with a crossover design with a total of 96 patients. One study compared visnadine aerosol with a placebo, while the other compared different frequencies of visnadine aerosol use. Visnadine use showed a statistically significant improvement ( < 0.05) in overall FSFI scores, regardless of the frequency of use. A meta-analysis was not possible due to the high clinical and methodological heterogeneity between available studies.
CONCLUSION
RCTs regarding the use of visnadine for the Female SD are scarce and methodologically limited. This preliminary evidence shows visnadine as a potentially effective and safe option to alleviate some of the clinical symptoms of SD in heterosexual women. However, future better-designed randomized studies with larger sample numbers are required.
Topics: Female; Humans; Heterosexuality; Randomized Controlled Trials as Topic; Sexual Dysfunction, Physiological; Aerosols; Chromans
PubMed: 38528806
DOI: 10.1080/09513590.2024.2328619 -
Internal and Emergency Medicine Jan 2024The role of awake prone positioning (aPP) in patients with acute hypoxemic respiratory failure is debated. We performed a systematic review and meta-analysis to evaluate... (Meta-Analysis)
Meta-Analysis
The role of awake prone positioning (aPP) in patients with acute hypoxemic respiratory failure is debated. We performed a systematic review and meta-analysis to evaluate the role of aPP in acute respiratory failure related to COronaVIrus Disease-19 (COVID-19). Studies reporting on the clinical course of patients with acute respiratory failure related to COVID-19 treated or not treated by aPP were included in the systematic review and meta-analysis (ProsperoID: CRD42022333211). The primary study outcome was the composite of in-hospital death or orotracheal intubation; the individual components of the primary outcome were secondary study outcomes. The composite of in-hospital death or orotracheal intubation was available for 6 studies (1884 patients), five randomized and one prospective; a significant reduction in the risk of this outcome was observed in patients treated vs. not treated by aPP (33.5% vs. 39.8%; OR 0.73, 95% CI 0.60-0.89; I 0%). In-hospital death was reported in 34 studies (6808 patients) and occurred in 17.4% vs. 23.5% of patients treated or not treated with aPP (random effect OR 0.60, 95% CI 0.46-0.79; I 59%); orotracheal intubation was observed in 25.8% vs. 32.7% of patients treated or not treated with aPP (27 studies, 5369 patients; random effect OR 0.85, 95% CI 0.56-1.27; I 84%). aPP reduces the risk for death or orotracheal intubation in patients with acute respiratory failure related to COVID-19. Further studies should be conducted to confirm the clinical benefit of aPP outside the ICU.Registration Prospero ID: CRD42022333211.
Topics: Humans; COVID-19; Hospital Mortality; Prospective Studies; Wakefulness; Prone Position; Respiratory Insufficiency
PubMed: 37796372
DOI: 10.1007/s11739-023-03434-1 -
Sleep Advances : a Journal of the Sleep... 2024Evidence from studies among non-Indigenous populations has established the association of poor sleep to mental health issues and supported how improving sleep could...
STUDY OBJECTIVES
Evidence from studies among non-Indigenous populations has established the association of poor sleep to mental health issues and supported how improving sleep could reduce the risk of mental ill health. In contrast, for Indigenous people, who experience disproportionate rates of mental ill health, the association between sleep and mental health and the potential of sleep health in reducing the risk and severity of mental health issues have never been fully reviewed. Considering the literature gap, this review assesses the association between sleep and mental health in Indigenous people.
METHODS
Following PRISMA guidelines, a study was submitted to the PROSPERO database for registration (293798) prior to commencing the review. Then academic databases were searched for relevant studies published up till 19 February 2023. Studies with quantitative data on sleep and mental health association in Indigenous people were included and a narrative review/synthesis was conducted.
RESULTS
Seven studies, using carer/self-reports (six cross-sectional, one longitudinal) among three Indigenous groups ( = 3066) met the inclusion criteria. In Indigenous Australian children, arousal problems were associated with aggression, and withdrawn behavior, while early bedtime was associated with a lower risk of behavioral problems. In Native American young people, insomnia symptoms were associated with depressive symptoms in adults, short sleep was associated with affective disorders. Clinical sleep issues, i.e. restless leg and apnea, were associated with depression. In Amerindian/Mestizo adults, restless leg syndrome was associated with depression and anxiety. Overall, findings report the prevalence of poor sleep and mental health issues among Indigenous communities across the globe. Six studies scored "moderate quality" and one study scored "high quality" in quality assessment.
CONCLUSIONS
While there is limited research available, our finding suggests an association between poor sleep and mental health issues in Indigenous people. Further investigation of the potential role of, and investing in, sleep health could help support mental health.
PubMed: 38721053
DOI: 10.1093/sleepadvances/zpae028 -
Endocrine Journal May 2024Acute sleep deprivation has aroused widespread concern and the relationship between acute sleep deprivation and cortisol levels is inconsistent. This study aimed to...
Acute sleep deprivation has aroused widespread concern and the relationship between acute sleep deprivation and cortisol levels is inconsistent. This study aimed to explore additional evidence and details. The PubMed, Web of Science, EMBASE, CLINAHL and Cochrane databases were searched for eligible studies published up to June 7, 2023. All analyses were performed using Review Manager 5.4 and Stata/SE 14.0. A total of 24 studies contributed to this meta-analysis. There was no significant difference in cortisol levels between participants with acute sleep deprivation and normal sleep in 21 crossover-designed studies (SMD = 0.18; 95% CI: -0.11, 0.45; p = 0.208) or 3 RCTs (SMD = 0.26; 95% CI: -0.22, 0.73; p = 0.286). Subgroup analysis revealed that the pooled effects were significant for studies using serum as the sample (SMD = 0.46; 95%CI: 0.11, 0.81; p = 0.011). Studies reporting cortisol levels in the morning, in the afternoon and in the evening did not show significant difference (p > 0.05). The pooled effects were statistically significant for studies with multiple measurements (SMD = 0.28; 95%CI: 0.03, 0.53; p = 0.027) but not for studies with single cortisol assessments (p = 0.777). When the serum was used as the test sample, the cortisol levels of individuals after acute sleep deprivation were higher than those with normal sleep.
PubMed: 38777757
DOI: 10.1507/endocrj.EJ23-0714