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Cureus Nov 2022Bennett's fracture is a relatively common fracture of the base of the thumb with no consensus on optimum management. Determining the optimal treatment method for... (Review)
Review
Bennett's fracture is a relatively common fracture of the base of the thumb with no consensus on optimum management. Determining the optimal treatment method for Bennett's fractures remain a challenge and has been the subject of much debate. This systematic review aims to investigate present and past literature and determine the optimum treatment intervention for Bennett's fracture-dislocation. The primary outcome measure is post-traumatic arthritis, and the secondary outcome measures are reoperation, pain, infection, and nonunion. As per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the literature was performed to evaluate patient demographics, clinical profile, management, and treatment outcomes. Two authors independently performed electronic searches of the Embase, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Cochrane databases. Studies conducted between 1963 and 2021 with articles reporting Bennett's fracture management were included. The study was registered with PROSPERO (CRD42021295464). In the initial screening, 58 articles were identified, of which 13 articles met the criteria and were included in the final review, evaluating 558 patients. Out of these, 439 were managed by various surgical procedures, and 119 were treated by manipulation and plaster of Paris (POP) immobilization. Of the 13 studies considered, eight have a clear mention of post-traumatic osteoarthritis, with a total of 50 (9%) patients. Secondary outcomes included pain in 76 (13%) patients, infection in four patients, reoperation in 11 (2%) patients, and no nonunion. This review was conducted with the help of retrospective studies as there is no randomized controlled trial on the management of Bennett's fracture. Our primary outcome measure of post-traumatic arthritis in patients being treated by operative and conservative methods was mentioned in these studies. However, due to the sample size being small and the heterogenicity of these studies, the strength of these findings is low. Due to these shortfalls, this review study cannot recommend any single (or) particular treatment for all patients with Bennett's fracture.
PubMed: 36514567
DOI: 10.7759/cureus.31340 -
Environmental Research Apr 2023The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic... (Review)
Review
BACKGROUND
The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic but none of them are specific to cognitive outcomes in the entire age range of children. Moreover, only a few of them have examined the effects of bluespace in addition to greenspace. Also, theses reviews are focused either only on observational studies or experimental studies. Our systematic review focuses on cognitive outcomes in relation to greenspace and bluespace in children and adolescents aged 0-18; it captures both observational and experimental studies. Cognitive outcomes are presented according to an evidence-based taxonomy of human cognitive abilities: the Cattell-Horn-Carroll (CHC) theory.
METHODS
We conducted searches in the PubMed and PsychInfo databases, from their inception dates to 17 December 2021. We used three-text terms related to outcome, exposure, and population as well as MeSH terms for outcome and population. Further, the reference lists and existing reviews were searched ("snowball" search) until 21 April 2022 to detect additional studies. For the results reporting, we followed the updated guidelines of the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). We included observational and experimental studies on greenspace or bluespace exposure in relation to cognitive functioning, published in English, German, or Polish. Two reviewers independently checked study eligibility and extracted data. Two reviewers evaluated the risk of bias according to the Office of Health Assessment and Translation (OHAT) tool. At all stages, discrepancies between the two reviewers were solved via discussion with a third reviewer.
RESULTS
Records identified from PubMed (n = 2030) and PsycINFO (n = 1168) were deduplicated and screened. Twenty one reports were first selected. The "snowball" search revealed 16 additional reports. Altogether, 39 studies (17 experimental and 22 observational) published in 37 reports were qualified. The data extraction showed that the methodology used in the studies was heterogenous and the findings were inconsistent. The majority of the studies investigated attentional functioning, which we subdivided into two categories according to the CHC theory: attentional control and reaction and decision speed (12 studies) and attentional control and processing speed (10 studies). Eleven studies investigated working memory and/or short-term memory that we categorized as CHC working memory capacity. Nine studies investigated intellectual functioning, which we categorized as CHC general ability, fluid reasoning, and comprehension-knowledge. Two studies investigated visual-spatial skills, which we categorized as CHC visual processing and psychomotor speed. One study measured parent-reported attention; two studies examined early childhood/cognitive development; three studies examined decision-making and self-regulation, which can be categorized as several CHC theory abilities.
DISCUSSION
The heterogeneity of the included studies does not permit clear conclusions for our review. In accordance with previous systematic reviews, greenspace and bluespace were not more strongly related to a particular domain of cognitive functioning than other cognitive domains, and no effects of age or type of exposure assessment on the association between nature and cognition were detected. Further research is needed, including state-of-the-art of assessment of cognitive outcomes and diverse exposure assessment methods within both observational and experimental approaches. Expertise will be required in several domains, such as environmental epidemiology, cognitive psychology, and neuropsychology. Systematic review registration number (INPLASY): 202220018.
Topics: Adolescent; Humans; Child; Child, Preschool; Parks, Recreational; Cognition; Memory, Short-Term; Processing Speed
PubMed: 36731600
DOI: 10.1016/j.envres.2023.115340 -
Frontiers in Plant Science 2020Plants dedicate a high amount of energy and resources to the production of ribosomes. Historically, these multi-protein ribosome complexes have been considered static...
Plants dedicate a high amount of energy and resources to the production of ribosomes. Historically, these multi-protein ribosome complexes have been considered static protein synthesis machines that are not subject to extensive regulation but only read mRNA and produce polypeptides accordingly. New and increasing evidence across various model organisms demonstrated the heterogeneous nature of ribosomes. This heterogeneity can constitute specialized ribosomes that regulate mRNA translation and control protein synthesis. A prominent example of ribosome heterogeneity is seen in the model plant, , which, due to genome duplications, has multiple paralogs of each ribosomal protein (RP) gene. We support the notion of plant evolution directing high RP paralog divergence toward functional heterogeneity, underpinned in part by a vast resource of ribosome mutants that suggest specialization extends beyond the pleiotropic effects of single structural RPs or RP paralogs. Thus, Arabidopsis is a highly suitable model to study this phenomenon. Arabidopsis enables reverse genetics approaches that could provide evidence of ribosome specialization. In this review, we critically assess evidence of plant ribosome specialization and highlight steps along ribosome biogenesis in which heterogeneity may arise, filling the knowledge gaps in plant science by providing advanced insights from the human or yeast fields. We propose a data analysis pipeline that infers the heterogeneity of ribosome complexes and deviations from canonical structural compositions linked to stress events. This analysis pipeline can be extrapolated and enhanced by combination with other high-throughput methodologies, such as proteomics. Technologies, such as kinetic mass spectrometry and ribosome profiling, will be necessary to resolve the temporal and spatial aspects of translational regulation while the functional features of ribosomal subpopulations will become clear with the combination of reverse genetics and systems biology approaches.
PubMed: 32670337
DOI: 10.3389/fpls.2020.00948 -
European Journal of Neurology Nov 2023The role of the gut microbiome in the pathogenesis of Parkinson disease (PD) is under intense investigation, and the results presented are still very heterogeneous.... (Review)
Review
BACKGROUND AND PURPOSE
The role of the gut microbiome in the pathogenesis of Parkinson disease (PD) is under intense investigation, and the results presented are still very heterogeneous. These discrepancies arise not only from the highly heterogeneous pathology of PD, but also from widely varying methodologies at all stages of the workflow, from sampling to final statistical analysis. The aim of the present work is to harmonize the workflow across studies to reduce the methodological heterogeneity and to perform a pooled analysis to account for other sources of heterogeneity.
METHODS
We performed a systematic review to identify studies comparing the gut microbiota of PD patients to healthy controls. A workflow was designed to harmonize processing across all studies from bioinformatics processing to final statistical analysis using a Bayesian random-effects meta-analysis based on individual patient-level data.
RESULTS
The results show that harmonizing workflows minimizes differences between statistical methods and reveals only a small set of taxa being associated with the pathogenesis of PD. Increased shares of the genera Akkermansia and Bifidobacterium and decreased shares of the genera Roseburia and Faecalibacterium were most characteristic for PD-associated microbiota.
CONCLUSIONS
Our study summarizes evidence that reduced levels of butyrate-producing taxa in combination with possible degradation of the mucus layer by Akkermansia may promote intestinal inflammation and reduced permeability of the gut mucosal layer. This may allow potentially pathogenic metabolites to transit and enter the enteric nervous system.
PubMed: 36593694
DOI: 10.1111/ene.15671 -
Sleep Science (Sao Paulo, Brazil) Jun 2023Shift work can cause circadian cycles disturbances and misaligns the endogenous rhythms. The physiological variables are driven by the circadian system and, its... (Review)
Review
Shift work can cause circadian cycles disturbances and misaligns the endogenous rhythms. The physiological variables are driven by the circadian system and, its misalignment, can impair the metabolic functions. Thus, the main objective of this study was to evaluate the metabolic alterations as a result of shift work and night work reported in articles published in the last 5 years, using the eligibility criteria both gender and indexed articles in English language. In order to execute this work, we perform a systematic review according to PRISMA guidelines and searched about Chronobiology Disorders and Night Work, both related to metabolism, in Medline, Lilacs, ScienceDirect and Cochrane. Cross-sectional, cohort and experimental studies with low risk of bias were included. We found a total of 132 articles, and, after the selection process, 16 articles remained to be analyzed. It was observed that shift work can cause circadian misalignment and, consequently, some metabolic parameters alterations such as an impaired glycemic control and insulin functioning, cortisol phase release, cholesterol fractions imbalance, changes in morphological indexes and melatonin secretion. There are some limitations, such as heterogenicity in used databases and the 5 years restriction period, because the effects of sleep disturbance may have been reported earlier. In conclusion, we suggest that shift work interferes with the sleep-wake cycle and eating patterns, which cause crucial physiological alterations that, together, can lead to metabolic syndrome.
PubMed: 37425967
DOI: 10.1055/s-0043-1770798 -
JAMA Network Open May 2023Despite the expansion of published prediction models for acute kidney injury (AKI), there is little evidence of uptake of these models beyond their local derivation nor... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Despite the expansion of published prediction models for acute kidney injury (AKI), there is little evidence of uptake of these models beyond their local derivation nor data on their association with patient outcomes.
OBJECTIVE
To systematically review published AKI prediction models across all clinical subsettings.
DATA SOURCES
MEDLINE via PubMed (January 1946 to April 2021) and Embase (January 1947 to April 2021) were searched using medical subject headings and text words related to AKI and prediction models.
STUDY SELECTION
All studies that developed a prediction model for AKI, defined as a statistical model with at least 2 predictive variables to estimate future occurrence of AKI, were eligible for inclusion. There was no limitation on study populations or methodological designs.
DATA EXTRACTION AND SYNTHESIS
Two authors independently searched the literature, screened the studies, and extracted and analyzed the data following the Preferred Reporting Items for Systematic Review and Meta-analyses guideline. The data were pooled using a random-effects model, with subgroups defined by 4 clinical settings. Between-study heterogeneity was explored using multiple methods, and funnel plot analysis was used to identify publication bias.
MAIN OUTCOMES AND MEASURES
C statistic was used to measure the discrimination of prediction models.
RESULTS
Of the 6955 studies initially identified through literature searching, 150 studies, with 14.4 million participants, met the inclusion criteria. The study characteristics differed widely in design, population, AKI definition, and model performance assessments. The overall pooled C statistic was 0.80 (95% CI, 0.79-0.81), with pooled C statistics in different clinical subsettings ranging from 0.78 (95% CI, 0.75-0.80) to 0.82 (95% CI, 0.78-0.86). Between-study heterogeneity was high overall and in the different clinical settings (eg, contrast medium-associated AKI: I2 = 99.9%; P < .001), and multiple methods did not identify any clear sources. A high proportion of models had a high risk of bias (126 [84.4%]) according to the Prediction Model Risk Of Bias Assessment Tool.
CONCLUSIONS AND RELEVANCE
In this study, the discrimination of the published AKI prediction models was good, reflected by high C statistics; however, the wide variation in the clinical settings, populations, and predictive variables likely drives the highly heterogenous findings that limit clinical utility. Standardized procedures for development and validation of prediction models are urgently needed.
Topics: Humans; Bias; Contrast Media; Acute Kidney Injury
PubMed: 37184837
DOI: 10.1001/jamanetworkopen.2023.13359 -
The Science of the Total Environment Mar 2023The prevalence of osteoporosis and osteoporotic fractures is expected to increase with the aging of the population in the coming decades. In this study, we... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The prevalence of osteoporosis and osteoporotic fractures is expected to increase with the aging of the population in the coming decades. In this study, we systematically reviewed the evidence on the association between exposure to air pollution and osteoporosis-related outcomes.
METHODS
We systematically searched evidence according to the PRISMA on PubMed, Scopus, and Web of Science (until August 2022). The risk of bias (RoB) was assessed using the Risk of Bias in the Non-randomized Studies of Exposures (ROBINS-E) tool. Random effects meta-analysis was applied to calculate combined estimates. We evaluated the heterogeneity using Cochran's Q test and quantified it by I and tau statistics. The overall body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) tool.
RESULTS
Out of 5254 retrieved articles, 19 studies (11 cross-sectional, seven cohorts, and one case-control) met our inclusion criteria. Most of the studies had a high probability of RoB (n = 17), and only two had a moderate RoB. Different outcomes including bone mineral density, bone mineral content, osteoporotic fracture, osteoporosis, and osteopenia were reported across the studies. The associations were reported for different air pollutants including PM2.5, PM10, nitrogen oxides, nitrogen dioxide, ozone, black carbon, carbon monoxide, sulfur dioxide, nitrogen oxide, and coarse particulate matter. Evidence was suggestive of the negative role of PM10, PM2.5, and nitrogen dioxide (e.g. bone mineral density pooled estimate: -0.02, 95%CI: -0.03: -0.01). The overall body of evidence for most of the exposure-outcome pairs was low and very low.
CONCLUSIONS
The evidence on the association between air pollution exposure and osteoporosis-related outcomes is heterogenic. However, the evidence suggests an increased risk of osteoporotic fracture and osteoporosis in outdoor air pollutants. Due to the small number of studies in each group, also observed heterogeneity, and publication bias, the results should be interpreted with caution.
Topics: Humans; Osteoporotic Fractures; Bone Density; Nitrogen Dioxide; Cross-Sectional Studies; Environmental Exposure; Air Pollution; Air Pollutants; Particulate Matter; Nitrogen Oxides; Osteoporosis
PubMed: 36586679
DOI: 10.1016/j.scitotenv.2022.161117 -
Journal of Clinical Medicine Sep 2021Liver transplant (LT) recipients are considered a vulnerable population amidst the COVID-19 pandemic. To date, available data have been heterogeneous and scarce.... (Review)
Review
Liver transplant (LT) recipients are considered a vulnerable population amidst the COVID-19 pandemic. To date, available data have been heterogeneous and scarce. Therefore, we conducted a systematic literature review identifying English-language articles published in PubMed between November 2019 and 30 May 2021. We aimed to explore three areas: (1) outcome and clinical course; (2) immunological response after COVID-19 in LT recipients; and (3) vaccination response. After systematic selection, 35, 4, and 5 articles, respectively, were considered suitable for each area of analysis. Despite the heterogeneity of the reports included in this study, we found that gastrointestinal symptoms were common in LT recipients. The outcome of the LT population was not per se worse compared to the general population, although careful management of immunosuppressive therapy is required. While a complete therapy discontinuation is not encouraged, caution needs to be taken with use of mycophenolate mofetil (MMF), favoring tacrolimus (TAC) use. Although data conflicted about acquired immunity after SARS-CoV-2 infection, vaccine immunogenicity appeared to be low, suggesting that the level of surveillance should be kept high in this population.
PubMed: 34501463
DOI: 10.3390/jcm10174015 -
Malaria Journal Jul 2022Interleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Interleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation, data on IL-4 levels in patients with severe and uncomplicated malaria were compiled.
METHODS
The systematic review was registered at PROSPERO (CRD42022323387). Searches for relevant articles on IL-4 levels in patients with severe malaria and studies that examined IL-4 levels in both uncomplicated malaria and healthy controls were performed in PubMed, Embase, and Scopus using the search strategy without limitation to publication years or language. The quality of all included studies was evaluated using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: standards for reporting observational studies. Qualitative and quantitative data syntheses were performed. The random-effects model, which weights each study according to its between- and within-study variance, was used to pool the mean difference (MD) of individual studies. The degree of heterogeneity was determined using Cochran's Q and I statistics. Additionally, meta-regression and subgroup analyses were perfomed to investigate possible sources of heterogeneity. The outliers were identified using the leave-one-out method and assessed publication bias using funnel plots, Egger's test, and a contour-enhanced funnel plot.
RESULTS
A total of 2300 studies were identified through database searches, and 36 were included for analyses. The meta-analysis results showed lower mean IL-4 levels in severe malaria (434 cases) than in uncomplicated malaria (611 cases) (P = 0.01, pooled MD: -3.36 pg/mL, 95% confidence intervals CI -5.55 to -1.16 pg/mL, I: 98.15%, 11 studies). The meta-analysis results showed no difference in mean IL-4 levels between cerebral malaria (96 cases) and noncerebral severe malaria (108 cases) (P = 0.71, pooled MD: 0.86 pg/mL, 95% CI -3.60 to 5.32 pg/mL, I 92.13%, four studies). Finally, no difference was found in mean IL-4 levels between uncomplicated malaria (635 cases) and healthy controls (674 cases) (P = 0.57, pooled MD: 0.79 pg/mL, 95% CI -1.92 to 3.50 pg/mL, I: 99.89%, 11 studies).
CONCLUSION
The meta-analysis revealed lower IL-4 levels in patients with severe malaria than in those with uncomplicated malaria, though a trend toward comparable IL-4 levels between both groups was more likely because several sources of heterogeneities were observed. Based on the limited number of studies included in the meta-analysis, until additional investigations have been conducted, IL-4 consideration as an alternative prognostic factor for malaria severity is not warranted.
Topics: Humans; Interleukin-4; Malaria, Cerebral
PubMed: 35820892
DOI: 10.1186/s12936-022-04237-z -
Neuroscience and Biobehavioral Reviews Mar 2023Pain-induced gamma-band oscillations (GBOs) are one of the most promising biomarkers of the pain experience. Although GBOs reliably encode pain perception across... (Meta-Analysis)
Meta-Analysis Review
Pain-induced gamma-band oscillations (GBOs) are one of the most promising biomarkers of the pain experience. Although GBOs reliably encode pain perception across different individuals and species, considerable heterogeneity could be observed in the characteristics and functions of GBOs. However, such heterogeneity of GBOs and its underlying sources have rarely been detailed previously. Here, we conducted a systematic review and meta-analysis to characterize the temporal, frequential, and spatial characteristics of GBOs and summarize the functional significance of distinct GBOs. We found that GBO heterogeneity was mainly related to pain types, with a higher frequency (∼66 Hz) GBOs at the sensorimotor cortex elicited by phasic pain and a lower frequency (∼55 Hz) GBOs at the prefrontal cortex associated with tonic and chronic pains. Positive correlations between GBO magnitudes and pain intensity were observed in healthy participants. Notably, the characteristics and functions of GBOs seemed to be phylogenetically conserved across humans and rodents. Altogether, we provided a comprehensive description of heterogeneous GBOs in pain and nociception, laying the foundation for clinical applications of GBOs.
Topics: Animals; Humans; Nociception; Rodentia; Electroencephalography; Pain Perception; Chronic Pain
PubMed: 36682424
DOI: 10.1016/j.neubiorev.2023.105062