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Alternative Therapies in Health and... Nov 2023Leukemia is the most prevalent cancer among children and adolescents. This study investigated the potential association between exposure to magnetic fields and the risk... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Leukemia is the most prevalent cancer among children and adolescents. This study investigated the potential association between exposure to magnetic fields and the risk of pediatric leukemia.
METHODS
We conducted a comprehensive search of electronic databases, including Scopus, EMBASE, Cochrane, Web of Science, and Medline, up to December 15, 2022, to identify relevant studies examining the link between childhood leukemia and magnetic field exposure.
RESULTS
The first meta-analysis revealed a statistically significant inverse association between pediatric leukemia and magnetic field strengths ranging from 0.4 μT to 0.2 μT, suggesting a reduced risk associated with this range. The second meta-analysis focused on wiring configuration codes and observed a potential link between residential magnetic field exposure and childhood leukemia. Pooled relative risk estimates were 1.52 (95% CI = 1.05-2.04, P = .021) and 1.58 (95% CI = 1.15-2.23, P = .006) for exposure to 24-hour magnetic field measurements, suggesting a possible causal relationship. In the third meta-analysis, the odds ratios for the exposure groups of 0.1 to 0.2 μT, 0.2 to 0.3 μT, 0.3 to 0.4 μT, and 0.4 μT above 0.2 μT were 1.09 (95% confidence interval = 0.82 to 1.43 μT), 1.14 (95% confidence interval = 0.68 to 1.92 μT), and 1.45 (95% confidence interval = 0.87 to 2.37 μT), respectively. In contrast to the findings of the three meta-analyses, there was no evidence of a statistically significant connection between exposure to 0.2 μT and the risk of juvenile leukemia. A further result showed no discernible difference between the two groups of children who lived less than 100 meters from the source of magnetic fields and those who lived closer (OR = 1.33; 95% CI = 0.98-1.73 μT).
CONCLUSIONS
The collective results of three meta-analyses, encompassing magnetic field strengths ranging from 0.1 μT to 2.38 μT, underscore a statistically significant association between the intensity of magnetic fields and the occurrence of childhood leukemia. However, one specific analysis concluded that no apparent relationship exists between exposure to 0.1 μT and an elevated risk of leukemia development in children.
Topics: Adolescent; Child; Humans; Electromagnetic Fields; Leukemia; Magnetic Fields; Neoplasms; Electromagnetic Radiation; Environmental Exposure; Case-Control Studies
PubMed: 37678874
DOI: No ID Found -
Supportive Care in Cancer : Official... Oct 2023High-intensity interval training (HIIT) is an appropriate training modality to improve endurance and therefore contributes to physical performance. This review... (Meta-Analysis)
Meta-Analysis Review
Effects of high-intensity interval training on functional performance and maximal oxygen uptake in comparison with moderate intensity continuous training in cancer patients: a systematic review and meta-analysis.
INTRODUCTION
High-intensity interval training (HIIT) is an appropriate training modality to improve endurance and therefore contributes to physical performance. This review investigates the effect of HIIT on functional performance in cancer patients. We reviewed the relative peak oxygen uptake (relV̇O) and meta-analytical compared HIIT with moderate intensity continuous training (MICT). Furthermore, we took various training parameters under consideration.
METHODS
A systematic literature search was conducted in Scopus, PubMed, and Cochrane Library databases. For the review, we included randomized controlled trials containing HIIT with cancer patients. From this, we filtered interventions with additional MICT for the meta-analysis. Outcomes of interest were various functional performance assessments and V̇O.
RESULTS
The research yielded 584 records which fit the inclusion criteria, of which 31 studies with n=1555 patients (57.4±8.6 years) could be included in the overall review and 8 studies in the meta-analysis (n=268, 59.11±5.11 years) regarding relV̇O. Different functional outcomes were found, of which walking distance (+8.63±6.91% meters in 6-min walk test) and mobility (+2.7cm in sit and reach test) improved significantly due to HIIT. In terms of relV̇O, the performance of cancer patients was improved by HIIT (10.68±6.48%) and MICT (7.4±4.29%). HIIT can be favored to increase relV̇O (SMD 0.37; 95% CI 0.09-0.65; I=0%; p=0.009). Effect sizes for relV̇O improvements correlate moderately with total training volume (Spearman's ρ=0.49; p=0.03), whereas percentage increases do not (Spearman's ρ=0.24; p=0.14).
CONCLUSION
Functional and physical outcomes were positively altered by different HIIT protocols and forms of implementation, whereas a tendency toward more effectiveness of HIIT vs. MICT was found for relV̇O. Future studies should include functional parameters more often, to finally allow a comparison between both training protocols in this regard.
Topics: Humans; High-Intensity Interval Training; Oxygen Consumption; Nutritional Status; Physical Functional Performance; Oxygen; Neoplasms
PubMed: 37851104
DOI: 10.1007/s00520-023-08103-9 -
Experimental Gerontology Oct 2023To analyze the internal consistency, reliability and measurement error of assessment measures for body structure and function (postural balance, muscle strength,... (Review)
Review
Are assessment measures for components of the International Classification of Functioning, Disability and Health reproducible for use on pre-frail and frail older adults? A systematic review.
OBJECTIVE
To analyze the internal consistency, reliability and measurement error of assessment measures for body structure and function (postural balance, muscle strength, cardiorespiratory function and physical fitness), activity (walking and mobility) and participation (quality of life and social reintegration) outcomes for use on pre-frail and frail older adults.
METHODS
Searches were performed in six databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library and Lilacs) and reproducibility studies were included. Cronbach's alpha and the classification proposed by Terwee et al. (2007) were used for the interpretation of internal consistency. The intraclass correlation coefficient (ICC) and the Munro classification were used for the determination of reliability. The standard error of measurement (SEM), minimal detectable change (MDC) as well as percentages of error (SEM%) and change (MDC%) were calculated. Methodological quality of the studies was appraised using Boxes 4, 6 and 7 of the COSMIN Risk of Bias checklist.
RESULTS
Six studies were included in the present systematic review, with a total of 835 (82.4 years; 582 women and 253 men) pre-frail and frail older adults analyzed. Seven measures were identified for the assessment of body structure and function, activity and participation outcomes (Hierarchical Assessment of Balance and Mobility, Self-Assessment of Physical Fitness, Sarcopenia Quality of Life, Reintegration to Normal Living Index, Two-Minute Walking test, Six-Minute Walking test and Ten-Meter Walking test). The following measurement properties were identified: internal consistency = 0.84 (mean Cronbach's alpha); reliability = 0.87 (mean ICC); SEM range = 0.06 to 10.10; MDC range = 0.13 to 28.10; SEM% range = 5.2 % to 9.5 %; and MDC% range = 10.7 % to 28.5 %.
CONCLUSION
The present systematic review found adequate internal consistency, high reliability and an acceptable measurement error for assessment measures of body structure and function, activity and participation outcomes for use on pre-frail and frail older adults.
PubMed: 37769825
DOI: 10.1016/j.exger.2023.112300 -
Sensors (Basel, Switzerland) Aug 2023Cybersecurity is a significant concern for businesses worldwide, as cybercriminals target business data and system resources. Cyber threat intelligence (CTI) enhances... (Review)
Review
Cybersecurity is a significant concern for businesses worldwide, as cybercriminals target business data and system resources. Cyber threat intelligence (CTI) enhances organizational cybersecurity resilience by obtaining, processing, evaluating, and disseminating information about potential risks and opportunities inside the cyber domain. This research investigates how companies can employ CTI to improve their precautionary measures against security breaches. The study follows a systematic review methodology, including selecting primary studies based on specific criteria and quality valuation of the selected papers. As a result, a comprehensive framework is proposed for implementing CTI in organizations. The proposed framework is comprised of a knowledge base, detection models, and visualization dashboards. The detection model layer consists of behavior-based, signature-based, and anomaly-based detection. In contrast, the knowledge base layer contains information resources on possible threats, vulnerabilities, and dangers to key assets. The visualization dashboard layer provides an overview of key metrics related to cyber threats, such as an organizational risk meter, the number of attacks detected, types of attacks, and their severity level. This relevant systematic study also provides insight for future studies, such as how organizations can tailor their approach to their needs and resources to facilitate more effective collaboration between stakeholders while navigating legal/regulatory constraints related to information sharing.
PubMed: 37631808
DOI: 10.3390/s23167273 -
Enfermeria Intensiva 2024The clinical guideline for the management of sepsis, recommends using arterial blood samples for glycaemic control. A multicentre study in 86 Spanish intensive care... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The clinical guideline for the management of sepsis, recommends using arterial blood samples for glycaemic control. A multicentre study in 86 Spanish intensive care units (ICU) revealed that 85.4% of ICUs used capillary puncture.
OBJECTIVE
To analyse the reliability of glycaemia by comparing different blood samples (arterial, venous, capillary) and instruments (glucometers, gasometers, central laboratory). Secondarily, to estimate the effect of confounding variables and the performance of measuring instruments as determined by different quality standards.
METHODOLOGY
Systematic review and meta-analysis with search in PubMed, CINAHL and Embase databases in September-2021 and September-2022, with no time or language limits. Grey literature sources: DART-Europe, OpenGrey and Google Scholar. Results summarised by qualitative (description of results, study characteristics) and quantitative (meta-analysis to assess standardised mean difference) synthesis. Methodological quality of articles assessed with Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).
PROTOCOL
https://osf.io/ DOI 10.17605/OSF.IO/T8KYP.
RESULTS
A total of 32 articles and 5451 patients were included. No discrepancies were obtained between arterial glucometer vs laboratory samples [bias (95%CI): 0.01 (-0.12 to 0.14) mg/dL]. In contrast, arterial samples with a gasometer did significantly overestimate [bias (95%CI): 0.12 (0.01 to 0.24) mg/dL]. The same trend is seen in capillaries with a glucometer, although not significantly [bias (95%CI): 0.07 (--0.02 to 0.15) mg/dL]. There is discrepancy between studies on the effect of haematocrit and acid-base balance. The greatest consensus is on the poor agreement of glucometer with capillary vs laboratory samples in the presence of shock and vasopressor support, renal failure or during vitamin C treatment.
CONCLUSIONS
The evidence to date recommends the use of arterial blood with a blood glucose meter for better reliability of glycaemic analysis and less effect of possible confounding variables, frequently present in the critically ill adult patient.
Topics: Adult; Humans; Blood Glucose Self-Monitoring; Blood Glucose; Critical Illness; Reproducibility of Results; Acid-Base Equilibrium; Multicenter Studies as Topic
PubMed: 37474427
DOI: 10.1016/j.enfie.2023.02.002 -
Journal of Neuromuscular Diseases 2024The objective of this study was to describe predictors of loss of ambulation in Duchenne muscular dystrophy (DMD). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The objective of this study was to describe predictors of loss of ambulation in Duchenne muscular dystrophy (DMD).
METHODS
This systematic review and meta-analysis included searches of MEDLINE ALL, Embase, and the Cochrane Database of Systematic Reviews from January 1, 2000, to December 31, 2022, for predictors of loss of ambulation in DMD. Search terms included "Duchenne muscular dystrophy" as a Medical Subject Heading or free text term, in combination with variations of the term "predictor". Risk of bias was assessed using the Newcastle-Ottawa Scale. We performed meta-analysis pooling of hazard ratios of the effects of glucocorticoids (vs. no glucocorticoid therapy) by fitting a common-effect inverse-variance model.
RESULTS
The bibliographic searches resulted in the inclusion of 45 studies of children and adults with DMD from 17 countries across Europe, Asia, and North America. Glucocorticoid therapy was associated with delayed loss of ambulation (overall meta-analysis HR deflazacort/prednisone/prednisolone: 0.44 [95% CI: 0.40-0.48]) (n = 25 studies). Earlier onset of first signs or symptoms, earlier loss of developmental milestones, lower baseline 6MWT (i.e.,<350 vs. ≥350 metres and <330 vs. ≥330 metres), and lower baseline NSAA were associated with earlier loss of ambulation (n = 5 studies). Deletion of exons 3-7, proximal mutations (upstream intron 44), single exon 45 deletions, and mutations amenable of skipping exon 8, exon 44, and exon 53, were associated with prolonged ambulation; distal mutations (intron 44 and downstream), deletion of exons 49-50, and mutations amenable of skipping exon 45, and exon 51 were associated with earlier loss of ambulation (n = 13 studies). Specific single-nucleotide polymorphisms in CD40 gene rs1883832, LTBP4 gene rs10880, SPP1 gene rs2835709 and rs11730582, and TCTEX1D1 gene rs1060575 (n = 7 studies), as well as race/ethnicity and level of family/patient deprivation (n = 3 studies), were associated with loss of ambulation. Treatment with ataluren (n = 2 studies) and eteplirsen (n = 3 studies) were associated with prolonged ambulation. Magnetic resonance biomarkers (MRI and MRS) were identified as significant predictors of loss of ambulation (n = 6 studies). In total, 33% of studies exhibited some risk of bias.
CONCLUSION
Our synthesis of predictors of loss of ambulation in DMD contributes to the understanding the natural history of disease and informs the design of new trials of novel therapies targeting this heavily burdened patient population.
Topics: Muscular Dystrophy, Duchenne; Humans; Glucocorticoids; Walking; Pregnenediones; Latent TGF-beta Binding Proteins
PubMed: 38669554
DOI: 10.3233/JND-230220 -
Archives of Endocrinology and Metabolism Sep 2023To conduct a systematic review and meta-analysis assessing the cardiorespiratory fitness (CRF) among individuals with and without type 2 diabetes. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To conduct a systematic review and meta-analysis assessing the cardiorespiratory fitness (CRF) among individuals with and without type 2 diabetes.
MATERIALS AND METHODS
The current review was registered in PROSPERO under the number CRD42018082718. MEDLINE, EMBASE, and Cochrane Library databases were searched from inception through February 2022. Eligibility criteria consisted of observational or interventional studies that evaluated CRF through cardiopulmonary exercise testing or six-minute walk test in individuals with type 2 diabetes compared with individuals without type 2 diabetes. For data extraction, we used baseline CRF assessments of randomized clinical trials or follow-up CRF assessments in observational studies. We performed a meta-analysis using maximal oxygen consumption (VO max), and distance walked in the 6MWT as primary outcomes. They were extracted and expressed as mean differences (MDs) and 95% CIs between treatment and comparator groups. The meta-analysis was conducted using Review Manager (RevMan) software.
RESULTS
Out of 8,347 studies retrieved, 77 were included. Compared with individuals without type 2 diabetes, individuals with diabetes achieved a lower VO max (-5.84 mL.kg.min, 95% CI -6.93, -4.76 mL.kg.min, p = <0.0001; I = 91%, p for heterogeneity < 0.0001), and a smaller distance walked in 6MWT (-93.30 meters, 95% CI -141.2, -45.4 meters, p > 0.0001; I: 94%, p for heterogeneity < 0.0001).
CONCLUSION
Type 2 diabetes was associated with lower cardiorespiratory fitness, as observed by lower VO max on maximal tests, and smaller distance walked in 6MWT, however the quality of studies was low.
Topics: Humans; Diabetes Mellitus, Type 2; Cardiorespiratory Fitness; Exercise Test; Oxygen Consumption; Walk Test
PubMed: 37738467
DOI: 10.20945/2359-4292-2023-0040 -
Journal of Neurogastroenterology and... Jan 2024We performed a systematic review and meta-analysis evaluating the symptomatic response rate to antibiotics in patients with small intestinal bacterial overgrowth (SIBO).... (Meta-Analysis)
Meta-Analysis
BACKGROUND/AIMS
We performed a systematic review and meta-analysis evaluating the symptomatic response rate to antibiotics in patients with small intestinal bacterial overgrowth (SIBO). Similarly, we performed a meta-analysis on the symptomatic response to antibiotics in irritable bowel syndrome (IBS) patients with and without SIBO.
METHODS
MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched from inception to March 2021. Randomized controlled trials and prospective studies reporting dichotomous outcomes were included.
RESULTS
There were 6 studies included in the first meta-analysis comparing the efficacy of antibiotics to placebo or no antibiotic. This included 196 patients, of whom 101 received antibiotics and 95 received placebo or no antibiotics. Significantly more patients improved with antibiotics (relative risk [95% CI] = 2.46 [1.33-4.55], = 0.004). There were 4 studies included in the analysis comparing symptomatic response rates in IBS patients with or without SIBO with 266 IBS patients, of whom 172 had SIBO and 94 did not. The pooled response rate for symptomatic response was 51.2% in the SIBO group vs 23.4% in the no SIBO group, respectively. Significantly more IBS patients with SIBO responded to antibiotics compared to those without SIBO (relative risk [95% CI] = 2.07 [1.40-3.08], = 0.0003).
CONCLUSIONS
Antibiotics appear to be efficacious in treating SIBO, although small sample sizes and poor data quality limit this interpretation. Symptomatic response rates also appear to be higher in IBS patients with SIBO. This may be the first example of precision medicine in IBS as opposed to our current empiric treatment approach. Large-multicenter studies are needed to verify the results.
PubMed: 38173154
DOI: 10.5056/jnm22187 -
Clinical Child and Family Psychology... Mar 2024Health-related Quality of Life (HRQoL) is a multi-faceted construct influenced by a myriad of environmental, demographic, and individual characteristics. Our... (Review)
Review
Health-related Quality of Life (HRQoL) is a multi-faceted construct influenced by a myriad of environmental, demographic, and individual characteristics. Our understanding of these influencers remains highly limited in neurodevelopmental conditions. Existing research in this area is sparse, highly siloed by diagnosis labels, and focused on symptoms. This review synthesized the evidence in this area using a multi-dimensional model of HRQoL and trans-diagnostically across neurodevelopmental conditions. The systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Checklist, was completed in June 2023 using Medline, PsycInfo, Embase, PubMed, and Cochrane Library. Our search revealed 78 studies that examined predictors of HRQoL in neurodevelopmental conditions. The majority of these studies focused on autism and ADHD with a paucity of literature in other conditions. Cross-diagnosis investigations were limited despite the fact that many of the examined predictors transcend diagnostic boundaries. Significant gaps were revealed in domains of biology/physiology, functioning, health perceptions, and environmental factors. Very preliminary evidence suggested potentially shared predictors of HRQoL across conditions including positive associations between HRQoL and adaptive functioning, male sex/gender, positive self-perception, physical activity, resources, and positive family context, and negative associations with diagnostic features and mental health symptoms. Studies of transdiagnostic predictors across neurodevelopmental conditions are critically needed to enable care models that address shared needs of neurodivergent individuals beyond diagnostic boundaries. Further understanding of HRQoL from the perspective of neurodivergent communities is a critical area of future work.
Topics: Child; Humans; Male; Quality of Life
PubMed: 38070100
DOI: 10.1007/s10567-023-00462-3 -
Sensors (Basel, Switzerland) Mar 2024The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb... (Review)
Review
The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb exoskeletons (LLEs) have emerged as a promising solution to enhance physical function in older individuals. This systematic review synthesizes the use of LLEs in alignment with the WHO's healthy aging vision, examining their impact on intrinsic capacities and functional abilities. We conducted a comprehensive literature search in six databases, yielding 36 relevant articles covering older adults (65+) with various health conditions, including sarcopenia, stroke, Parkinson's Disease, osteoarthritis, and more. The interventions, spanning one to forty sessions, utilized a range of LLE technologies such as Ekso, HAL, Stride Management Assist, Honda Walking Assist, Lokomat, Walkbot, Healbot, Keeogo Rehab, EX1, overground wearable exoskeletons, Eksoband, powered ankle-foot orthoses, HAL lumbar type, Human Body Posturizer, Gait Enhancing and Motivation System, soft robotic suits, and active pelvis orthoses. The findings revealed substantial positive outcomes across diverse health conditions. LLE training led to improvements in key performance indicators, such as the 10 Meter Walk Test, Five Times Sit-to-Stand test, Timed Up and Go test, and more. Additionally, enhancements were observed in gait quality, joint mobility, muscle strength, and balance. These improvements were accompanied by reductions in sedentary behavior, pain perception, muscle exertion, and metabolic cost while walking. While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even the instantaneous augmentation of functional abilities can be observed in a single session. In summary, this review demonstrates consistent and significant enhancements in critical parameters across a broad spectrum of health conditions following LLE interventions in older adults. These findings underscore the potential of LLE in promoting healthy aging and enhancing the well-being of older adults.
Topics: Humans; Aged; Exoskeleton Device; Healthy Aging; Postural Balance; Time and Motion Studies; World Health Organization
PubMed: 38610440
DOI: 10.3390/s24072230