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Life (Basel, Switzerland) Jan 2023Background and objective: Obstructive sleep apnea (OSA) can be related to changes in the levels of adipokines and neuropeptides, which in turn may affect the energy... (Review)
Review
Background and objective: Obstructive sleep apnea (OSA) can be related to changes in the levels of adipokines and neuropeptides, which in turn may affect the energy balance components of neuronal cells. Herein, a systematic review and meta-analysis checked the changes in serum/plasma levels of omentin-1 (OM-1: an adipokine) and orexin-A (OXA: a neuropeptide) in adults (age > 18 years old) with OSA (aOSA) compared to controls. Materials and methods: Four databases (Cochrane Library, PubMed, Web of Science, and Scopus) were systematically searched until 14 November 2022, without any restrictions. The Joanna Briggs Institute (JBI) critical appraisal checklist adapted for case−control studies was used to assess the quality of the papers. The effect sizes were extracted using the Review Manager 5.3 software for the blood levels of OM-1 and OXA in aOSA compared with controls. Results: Thirteen articles, with six studies for OM-1 levels and eight for OXA levels, were included. The pooled standardized mean differences were −0.85 (95% confidence interval (CI): −2.19, 0.48; p = 0.21; I2 = 98%) and −0.20 (95%CI: −1.16, 0.76; p = 0.68; I2 = 96%) for OM-1 and OXA levels, respectively. Among the studies reporting OM-1, five were high and one was moderate quality. Among the studies reporting OXA, six were moderate, one was high, and one was low quality. Based on the trial sequential analysis, more participants are needed to confirm the pooled results of the analyses of blood levels of OM-1 and OXA. In addition, the radial plot showed outliers as significant factors for high heterogeneity. Conclusions: The main findings indicated a lack of association between the blood levels of OM-1 and OXA and OSA risk. Therefore, OM-1 and OXA did not appear to be suitable biomarkers for the diagnosis and development of OSA.
PubMed: 36676194
DOI: 10.3390/life13010245 -
Journal of Neuroengineering and... Jun 2021Approximately two thirds of stroke survivors maintain upper limb (UL) impairments and few among them attain complete UL recovery 6 months after stroke. Technological... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Approximately two thirds of stroke survivors maintain upper limb (UL) impairments and few among them attain complete UL recovery 6 months after stroke. Technological progress and gamification of interventions aim for better outcomes and constitute opportunities in self- and tele-rehabilitation.
OBJECTIVES
Our objective was to assess the efficacy of serious games, implemented on diverse technological systems, targeting UL recovery after stroke. In addition, we investigated whether adherence to neurorehabilitation principles influenced efficacy of games specifically designed for rehabilitation, regardless of the device used.
METHOD
This systematic review was conducted according to PRISMA guidelines (PROSPERO registration number: 156589). Two independent reviewers searched PubMed, EMBASE, SCOPUS and Cochrane Central Register of Controlled Trials for eligible randomized controlled trials (PEDro score ≥ 5). Meta-analysis, using a random effects model, was performed to compare effects of interventions using serious games, to conventional treatment, for UL rehabilitation in adult stroke patients. In addition, we conducted subgroup analysis, according to adherence of included studies to a consolidated set of 11 neurorehabilitation principles.
RESULTS
Meta-analysis of 42 trials, including 1760 participants, showed better improvements in favor of interventions using serious games when compared to conventional therapies, regarding UL function (SMD = 0.47; 95% CI = 0.24 to 0.70; P < 0.0001), activity (SMD = 0.25; 95% CI = 0.05 to 0.46; P = 0.02) and participation (SMD = 0.66; 95% CI = 0.29 to 1.03; P = 0.0005). Additionally, long term effect retention was observed for UL function (SMD = 0.42; 95% CI = 0.05 to 0.79; P = 0.03). Interventions using serious games that complied with at least 8 neurorehabilitation principles showed better overall effects. Although heterogeneity levels remained moderate, results were little affected by changes in methods or outliers indicating robustness.
CONCLUSION
This meta-analysis showed that rehabilitation through serious games, targeting UL recovery after stroke, leads to better improvements, compared to conventional treatment, in three ICF-WHO components. Irrespective of the technological device used, higher adherence to a consolidated set of neurorehabilitation principles enhances efficacy of serious games. Future development of stroke-specific rehabilitation interventions should further take into consideration the consolidated set of neurorehabilitation principles.
Topics: Activities of Daily Living; Adult; Humans; Recovery of Function; Stroke; Stroke Rehabilitation; Upper Extremity
PubMed: 34130713
DOI: 10.1186/s12984-021-00889-1 -
Brain, Behavior, and Immunity Aug 2020Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in salivary inflammatory markers in response to acute stress.
METHOD
The review included 1558 participants (42 unique samples, 33 studies) obtained through electronic databases (PubMed, PsycINFO, Embase), reference treeing, and articles identified by a 2015 review on a similar topic. To be eligible, articles had to be quantitative and assess change in at least one biomarker of salivary inflammation in response to acute stress in adults. The primary outcome was magnitude of change in inflammatory biomarkers (Cohen's d for repeated measures [d]).
RESULTS
Measures of salivary inflammation included: C-reactive protein (CRP), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. Cytokines IL-6 (k = 26, d = 0.27), IL-10 (k = 11, d = 0.34), TNF-α (k = 10, d = 0.57), and IFN-γ (k = 6, d = 0.28) significantly increased in response to stress. Post hoc sensitivity analyses revealed that IL-1β (k = 19, d = 0.16) and IL-8 (k = 7, d = 0.30) also increased from pre- to post-stress, but findings with IFN-γ did not hold after removing one outlier study. Examination of moderators suggested that study methodology and sample demographics moderated some associations.
CONCLUSIONS
This meta-analysis revealed that certain salivary inflammatory cytokines increase in response to acute stress. Significant heterogeneity in results and moderator analyses suggest need for standardization of research protocols. Directions for future research are discussed.
Topics: Adult; Biomarkers; Cytokines; Humans; Inflammation; Interleukin-12; Interleukin-13; Tumor Necrosis Factor-alpha
PubMed: 32371089
DOI: 10.1016/j.bbi.2020.04.078 -
Vaccines May 2023Post-marketing vaccine safety surveillance aims to monitor and quantify adverse events following immunization in a population, but little is known about their... (Review)
Review
BACKGROUND
Post-marketing vaccine safety surveillance aims to monitor and quantify adverse events following immunization in a population, but little is known about their implementation in low- and middle-income countries (LMICs). We aimed to synthesize methodological approaches used to assess adverse events following COVID-19 vaccination in LMICs.
METHODS
For this systematic review, we searched articles published from 1 December 2019 to 18 February 2022 in main databases, including MEDLINE and Embase. We included all peer-reviewed observational COVID-19 vaccine safety monitoring studies. We excluded randomized controlled trials and case reports. We extracted data using a standardized extraction form. Two authors assessed study quality using the modified Newcastle-Ottawa Quality Assessment Scale. All findings were summarized narratively using frequency tables and figures.
RESULTS
Our search found 4254 studies, of which 58 were eligible for analysis. Many of the studies included in this review were conducted in middle-income countries, with 26 studies (45%) in lower-middle-income and 28 (48%) in upper-middle-income countries. More specifically, 14 studies were conducted in the Middle East region, 16 in South Asia, 8 in Latin America, 8 in Europe and Central Asia, and 4 in Africa. Only 3% scored 7-8 points (good quality) on the Newcastle-Ottawa Scale methodological quality assessment, while 10% got 5-6 points (medium). About 15 studies (25.9%) used a cohort study design and the rest were cross-sectional. In half of them (50%), vaccination data were gathered from the participants' self-reporting methods. Seventeen studies (29.3%) used multivariable binary logistic regression and three (5.2%) used survival analyses. Only 12 studies (20.7%) performed model diagnostics and validity checks (e.g., the goodness of fit, identification of outliers, and co-linearity).
CONCLUSIONS
Published studies on COVID-19 vaccine safety surveillance in LMICs are limited in number and the methods used do not often address potential confounders. Active surveillance of vaccines in LMICs are needed to advocate vaccination programs. Implementing training programs in pharmacoepidemiology in LMICs is essential.
PubMed: 37376424
DOI: 10.3390/vaccines11061035 -
BMC Public Health Dec 2023Despite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Despite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term health issues were reported in children who have history of anemia including decreased work productivity in adult hood period. Although analyzing data on burden and risk factors of anemia are the recommended action areas of World Health Organization framework for accelerating anemia reduction, the aggregated national burden and contributors of anemia in Ethiopia has not been determined so far. There for, this systematic and meta-analysis study is aimed to assess the pooled prevalence and associated factors of anemia among children aged 6-23 months in Ethiopia.
METHODS
The electronic databases including PubMed, Scopus, EMBASE, Web of Science, Science Direct, Google scholar and institutional repositories were searched using search terms. The studies that reported the prevalence and/or risk factors of anemia in children 6-23 months of age were included. The JBI quality assessment tool was used to evaluate the quality of each study. The data was extracted with Microsoft Excel, 2019 and analyzed with STATA 17.0 statistical software. A random effect model was used to estimate the pooled prevalence of anemia and its associated factors. The Cochrane Q-test statistics and I test were used to measure heterogeneity between the included studies. Furthermore, publication bias was examined using the funnel plot graph and statistical tests (Egger's and begg tests). Outliers also visualized using Galbraith plot. When necessary, sensitivity analysis was also employed to detect small study effect.
RESULT
Ten studies with a total population of 14, 733 were included for analysis. The pooled prevalence of anemia among children aged 6-23 months of age in Ethiopia was found to be 57.76% (95%CI; 51.61-63.91; I = 97.192%; p < 0.001). Having history of diarrhea AOR = 2.44 (95%CI: 1.03-3.85), being stunted AOR = 2.00 (95%CI: 1.38-2.61), living in food insecure house hold AOR = 2.08 (95%CI: 1.10-3.07), consuming less diversified food AOR = 2.73 (95%CI: 2.06-3.39) and being 6-11 months of age AOR = 1.59 (95%CI: 1.23-1.95) were associated with anemia.
CONCLUSION AND RECOMMENDATION
The prevalence of anemia is in the range of severe public health problem among children aged 6-23 months in Ethiopia. Diarrhea, stunting, house hold food insecurity, dietary diversity, and age were the predictors of anemia. Further, prospective cohort and random controlled trial studies are recommended. Further, random controlled trial especially effectiveness of nutritional education interventions trial is important. To reduce prevalence of anemia, strengthening diarrhea reduction program, securing household food insecurity, preventing stunting, giving special attention for infants age 6-11 months and encouraging food diversification are important.
Topics: Infant; Humans; Child; Ethiopia; Prevalence; Prospective Studies; Anemia; Diarrhea; Growth Disorders
PubMed: 38042804
DOI: 10.1186/s12889-023-17330-y -
PloS One 2022Increased prevalence of myopia is a major public health challenge worldwide, including in Africa. While previous studies have shown an increasing prevalence in Africa,... (Meta-Analysis)
Meta-Analysis
PURPOSE
Increased prevalence of myopia is a major public health challenge worldwide, including in Africa. While previous studies have shown an increasing prevalence in Africa, there is no collective review of evidence on the magnitude of myopia in African school children. Hence, this study reviews the evidence and provides a meta-analysis of the prevalence of myopia in African school children.
METHODS
This review was conducted using the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five computerized bibliographic databases, PUBMED, Scopus, Web of Science, ProQuest, and Africa Index Medicus were searched for published studies on the prevalence of myopia in Africa from 1 January 2000 to 18 August 2021. Studies were assessed for methodological quality. Data were gathered by gender, age and refraction technique and standardized to the definition of myopia as refractive error ≥ 0.50 diopter. A meta-analysis was conducted to estimate the prevalence. Significant heterogeneity was detected among the various studies (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed to examine the effects of outliers.
RESULTS
We included data from 24 quality assessed studies, covering 36,395 African children. The overall crude prevalence of myopia over the last two decades is 4.7% (95% CI, 3.9-5.7) in African children. Although the prevalence of myopia was slightly higher in females (5.3%, 95%CI: 4.1, 6.5) than in males (3.7%, 95% CI, 2.6-4.7; p = 0.297) and higher in older [12-18 years 5.1% (95% CI, 3.8-6.3) than younger children (aged 5-11 years, 3.4%, 95% CI, 2.5-4.4; p = 0.091), the differences were not significant. There was a significantly lower prevalence of myopia with cycloplegic compared with non-cycloplegic refraction [4.2%, 95%CI: 3.3, 5.1 versus 6.4%, 95%CI: 4.4, 8.4; p = 0.046].
CONCLUSIONS
Our results showed that myopia affects about one in twenty African schoolchildren, and it is overestimated in non-cycloplegic refraction. Clinical interventions to reduce the prevalence of myopia in the region should target females, and school children who are aged 12-18 years.
Topics: Adolescent; Africa; Child; Child, Preschool; Female; Humans; Male; Myopia; Prevalence; Refraction, Ocular; Refractive Errors; Vision Tests
PubMed: 35113922
DOI: 10.1371/journal.pone.0263335 -
BMC Infectious Diseases Jan 2024In the first reported cases of human immunodeficiency virus (HIV) infection, people living with HIV (PLHIV) suffered weight loss, which was an independent predictor of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In the first reported cases of human immunodeficiency virus (HIV) infection, people living with HIV (PLHIV) suffered weight loss, which was an independent predictor of mortality. Highly active antiretroviral therapy (HAART) has changed this scenario for ideal weight, overweight, and even obesity. However, some PLHIV, even on HAART, continue to lose weight. Thus, the guiding question of the study was: do PLHIV hospitalized using HAART with weight loss have higher mortality than hospitalized PLHIV using HAART without weight loss?
METHOD
A systematic review and meta-analysis of prospective cohort studies published in English, Spanish, or Portuguese, searched in the MedLine, Embase, and LILACS databases from March 2020, until October 2023, reported by MOOSE. We analyzed the methodological quality and risk of bias using the Joanna Briggs Institute Critical Appraisal Tool for Cohort Studies; used the risk ratio (RR) to calculate the probability of hospitalized PLWH who lost weight dying, applied the random effect model and created the funnel plot. We used the inverse variance test estimated by the Mantel-Haenszel method, considering a 95% confidence interval (CI), heterogeneity (I), total effect size (Z), and significance value of p < 0.05. We performed a sensitivity analysis with meta-regression and meta-analyses on subgroups to diagnose influence and outliers. The quality of evidence and strength of recommendation were analyzed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE).
RESULTS
We included 10 of the 711 studies identified, totaling 1,637 PLHIV. The studies were from South Africa (1), Canada (1), China (1), Brazil (1), Cameroon (1), Ethiopia (1), Thailand (1), Colombia (1), and Tanzania (2), from 1996 to 2017. The average age of the participants was 33.1 years old, and the male was predominant. The leading causes of hospital admission were related to co-infections, and the average hospitalization time was 20.5 days. The prevalence of death in hospitalized PLHIV using HAART who lost weight was 57.5%, with a 1.5 higher risk of dying (RR: 1.50, 95% CI: 1.03, 2.19, p = 0.04) than hospitalized PLHIV who did not lose weight.
CONCLUSION
We concluded, with a very low confidence level, that that weight loss significantly increased the risk of death in hospitalized PLWH using HAART.
TRIAL REGISTRATION AND FUNDING
PROSPERO International Prospective Register of Systematic Reviews CRD42020191246 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020191246 .
Topics: Adult; Humans; Male; Antiretroviral Therapy, Highly Active; Ethiopia; HIV Infections; Prospective Studies; Weight Loss; Female
PubMed: 38166819
DOI: 10.1186/s12879-023-08889-3 -
Pathogens (Basel, Switzerland) Sep 2022Low glucose-6-phosphate dehydrogenase enzyme (G6PD) activity is a key determinant of drug-induced haemolysis. More than 230 clinically relevant genetic variants have... (Review)
Review
Low glucose-6-phosphate dehydrogenase enzyme (G6PD) activity is a key determinant of drug-induced haemolysis. More than 230 clinically relevant genetic variants have been described. We investigated the variation in G6PD activity within and between different genetic variants. In this systematic review, individual patient data from studies reporting G6PD activity measured by spectrophotometry and corresponding the G6PD genotype were pooled (PROSPERO: CRD42020207448). G6PD activity was converted into percent normal activity applying study-specific definitions of 100%. In total, 4320 individuals from 17 studies across 10 countries were included, where 1738 (40.2%) had one of the 24 confirmed G6PD mutations, and 61 observations (3.5%) were identified as outliers. The median activity of the hemi-/homozygotes with A-(c.202G>A/c.376A>G) was 29.0% (range: 1.7% to 76.6%), 10.2% (range: 0.0% to 32.5%) for Mahidol, 16.9% (range 3.3% to 21.3%) for Mediterranean, 9.0% (range: 2.9% to 23.2%) for Vanua Lava, and 7.5% (range: 0.0% to 18.3%) for Viangchan. The median activity in heterozygotes was 72.1% (range: 16.4% to 127.1%) for A-(c.202G>A/c.376A>G), 54.5% (range: 0.0% to 112.8%) for Mahidol, 37.9% (range: 20.7% to 80.5%) for Mediterranean, 53.8% (range: 10.9% to 82.5%) for Vanua Lava, and 52.3% (range: 4.8% to 78.6%) for Viangchan. A total of 99.5% of hemi/homozygotes with the Mahidol mutation and 100% of those with the Mediterranean, Vanua Lava, and Viangchan mutations had <30% activity. For A-(c.202G>A/c.376A>G), 55% of hemi/homozygotes had <30% activity. The G6PD activity for each variant spanned the current classification thresholds used to define clinically relevant categories of enzymatic deficiency.
PubMed: 36145477
DOI: 10.3390/pathogens11091045 -
Advances in Nutrition (Bethesda, Md.) Dec 2021Mobile dietary record apps have been increasingly validated by studies with various study designs. This review aims to evaluate the overall accuracy of dietary record... (Meta-Analysis)
Meta-Analysis
Mobile dietary record apps have been increasingly validated by studies with various study designs. This review aims to evaluate the overall accuracy of dietary record apps in measuring the intake of energy, macro- and micronutrients, and food groups in real-life settings and the designs of validation studies. We systematically searched mobile dietary record validation studies published during the period from 2013 to 2019. We identified 14 studies for the systematic review, of which 11 studies were suitable for meta-analyses on energy intake and 8 studies on macronutrient intake. Mean differences and SDs of nutrient estimations between the app and the reference method from studies were pooled using a random-effects model. All apps underestimated energy intake when compared with their reference methods, with a pooled effect of -202 kcal/d (95% CI: -319, -85 kcal/d); the heterogeneity of studies was 72%. After stratification, studies that used the same food-composition table for both the app and the reference method had a lower level of heterogeneity (0%) and a pooled effect of -57 kcal/d (95% CI: -116, 2 kcal/d). The heterogeneity of studies in the differences in carbohydrate, fat, and protein intake was 54%, 73%, and 80%, with the pooled effect of -18.8 g/d, -12.7 g/d, and -12.2 g/d, respectively, after excluding outliers. The intakes of micronutrients and food groups were statistically nonsignificantly underestimated by the apps in most cases. In conclusion, dietary record apps underestimated food consumption compared with traditional dietary assessment methods. Moreover, varying study designs have been found across studies. Recommended practices for conducting validation studies were formulated including considering biomarkers as the reference, testing in a larger and more representative study population for a longer period, avoiding the learning effect of each method, and comparing food group or food item consumption in addition to comparing energy and nutrient intakes.
Topics: Diet; Diet Records; Energy Intake; Humans; Mobile Applications; Nutrients
PubMed: 34019624
DOI: 10.1093/advances/nmab058 -
Neuroscience and Biobehavioral Reviews Dec 2022A substantial part of the research on the efficacy of mindfulness-based interventions on mood regulation is conducted in the laboratory. Nevertheless, a systematic... (Meta-Analysis)
Meta-Analysis Review
A substantial part of the research on the efficacy of mindfulness-based interventions on mood regulation is conducted in the laboratory. Nevertheless, a systematic review of the results is lacking. This meta-analysis aimed to investigate the effects of mindfulness as an emotion regulation (ER) strategy when using mood induction procedures. A systematic search of databases was conducted and a total of 43 studies were included in the meta-analysis. We found a small significant overall effect size of mindfulness [g= -0.15 (95% CI [-0.30, -0.01], p = 0.04)], which became non-significant after removing outliers (g=-0.15, p = 0.06). We also found high levels of heterogeneity which was not explained by the moderating variables analyzed. Thus, there is limited meta-analytic evidence of the efficacy of mindfulness strategies in down-regulating or preventing heightened or chronic effects of induced mood states in well-controlled laboratory settings. We propose that this could be partially due to some limitations in laboratory methodologies and suggest some guidelines to overcome them in future primary research.
Topics: Humans; Mindfulness; Self Report; Emotions; Emotional Regulation; Affect
PubMed: 36370843
DOI: 10.1016/j.neubiorev.2022.104957