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Journal of Sport and Health Science Jul 2023There is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.
METHODS
A systematic literature search of PubMed, Embase, and Web of Science was performed. Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs, and the comparator was in standard care or other types of exercise. The primary outcome was QoL, including general health, physical health, mental health, and role function. Secondary outcomes included cancer-related symptoms such as fatigue, insomnia, depression, anxiety, and duration of hospital stay. The network meta-analyses were performed using a random-effect model.
RESULTS
The analysis included 32 eligible articles and a total of 2558 participants. Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health (standardized mean difference (SMD) = 0.66, 95% credible intervals (CrIs): 0.05 to 1.30), and also contributed to a better mental health (SMD = 0.38, 95%CrI: -0.05 to 0.81) and role function (SMD = 0.48, 95%CrI: -0.27 to 1.20). Although without significant changes, short-term resistance exercise tended to increase the physical health of patients with DSCs (SMD = 0.69, 95%CrI: -0.07 to 1.50) and effective in alleviating fatigue (SMD = -0.77, 95%CrI: -1.50 to 0.01). Short-term aerobic exercise was related to a lower score of insomnia (SMD = -1.20, 95%CrI: -2.40 to 0.06), depression (SMD = -0.51, 95%CrI: -1.50 to 0.45), and anxiety (SMD = -0.45, 95%CrI: -1.30 to 0.34). All types of exercise related to a trend of declined hospital stays (-0.87 to -5.00 day). Long-term resistance exercise, however, was negatively associated with general health (SMD = -0.33, 95%CrI: -1.70 to 1.00), physical health (SMD = -0.18, 95%CrI: -1.30 to 0.90), and role function (SMD = -1.20, 95%CrI: -2.50 to 0.11).
CONCLUSION
This study suggests that short-term aerobic exercise, with or without resistance exercise programs, enhances QoL (especially for general health) as well as relieves cancer-related symptoms for DSC survivors, while long-term resistance exercise may have negative effects, and thus should be adopted cautiously. These results provide important evidence for the management of DSCs.
Topics: Adult; Humans; Quality of Life; Network Meta-Analysis; Sleep Initiation and Maintenance Disorders; Exercise; Digestive System Neoplasms; Fatigue; Randomized Controlled Trials as Topic
PubMed: 36528289
DOI: 10.1016/j.jshs.2022.12.008 -
Medicine Sep 2020Unintended pregnancy is popular all over the world, accounting for 40% to 50% of all pregnancies. The condition not only exerts pressure on the relationship of couples... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Unintended pregnancy is popular all over the world, accounting for 40% to 50% of all pregnancies. The condition not only exerts pressure on the relationship of couples and severely impacts the quality of life, but also imposes a heavy burden on the health of women and child. Recently, more than 220 million couples have chosen to be sterilized to obtain contraception, 47.3% of married couples select sterilization, of which vasectomy accounts for 17.1%. Vasectomy is currently the most convenient and effective method of male contraception. We will perform the systematic review and meta-analysis to assess the correlation between vasectomy and male sex dysfunction and provide evidence-based evidence for the couple METHODS:: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry, and Cochrane Library will be retrieved before November 20, 2021. We will search English literature and Chinese literature with proper Medical Subject Heading or text key words. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement.
CONCLUSION AND DISSEMINATION
The aim of this study was to evaluate the effect of vasectomy on the sexual function of patients after operation. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions.
REGISTRATION INFORMATION
INPLASY202080014.
Topics: Double-Blind Method; Humans; Male; Mental Health; Postoperative Complications; Randomized Controlled Trials as Topic; Research Design; Sexual Dysfunctions, Psychological; Vasectomy
PubMed: 32925772
DOI: 10.1097/MD.0000000000022149 -
EBioMedicine Dec 2023Diabetic foot ulcers (DFUs) are a common complication of diabetes, associated with important morbidity. Appropriate animal models of DFUs may improve drug development,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diabetic foot ulcers (DFUs) are a common complication of diabetes, associated with important morbidity. Appropriate animal models of DFUs may improve drug development, and subsequently the success rate of clinical trials. However, while many models have been proposed, they are extremely heterogeneous, and no standard has emerged. We thus propose a systematic review with a network meta-analysis (NMA) to gather direct and indirect evidence, and compare the different mouse models of diabetes-related ulcers.
METHODS
The systematic search was performed in Pubmed and Embase. The main outcomes were wound size measurement at days 3, 7, 11 and 15 (±1 day). The risk of bias and methodological quality of all included studies was assessed by using the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) risk of bias tool. Meta-regressions were done on prespecified variables, including mouse strain, type of ulcer, sex, age, and use of a splint.
FINDINGS
We included 295 studies. Among all models, only db/db, ob/ob, streptozotocin (STZ), and STZ + high fat diet mice showed a significantly delayed wound healing, compared with controls, at each time point. Age, sex and ulcer type had influence on wound healing, although not at all time points.
INTERPRETATION
In conclusion, the db/db model is associated with the largest delay in wound healing The STZ model also exhibits significantly decreased wound healing. STZ + high fat diet and ob/ob mice may also be relevant models of diabetes-related ulcers, although the results rely on a more limited number of studies.
FUNDING
This work was funded by the Agence Nationale de la Recherche (grant ANR-18-CE17-0017).
Topics: Animals; Mice; Network Meta-Analysis; Disease Models, Animal; Diabetic Foot; Animal Experimentation; Diet, High-Fat; Streptozocin; Diabetes Mellitus
PubMed: 38251464
DOI: 10.1016/j.ebiom.2023.104856 -
Journal of Tissue Viability May 2023The aim of this network meta-analysis is to analyze the difference in therapeutic effects between moist dressings and traditional dressings in the treatment of pressure... (Meta-Analysis)
Meta-Analysis Review
AIMS
The aim of this network meta-analysis is to analyze the difference in therapeutic effects between moist dressings and traditional dressings in the treatment of pressure injury (PI), explore the healing, healing time, direct cost, and number of dressing changes of different moist dressings for the management of pressure injuries.
BACKGROUND
The incidence of pressure injury is high and the burden of disease is high, but there is no consensus on how to choose moist dressing treatment.
DESIGN
A systematic review with network meta-analysis was performed.
DATA SOURCES
We searched the Chinese Biomedicine Literature Database and China National Knowledge Infrastructure, Wanfang Database, VIP database, PubMed, Web of Science, EMBASE.com, CENTRAL (Cochrane Central Register of Controlled Trials) and CINAHL to obtain randomized controlled trials (RCTs) on the treatment of PI with moist dressings.
REVIEW METHODS
R studio software and Stata 16.0 software were used to compare different moist dressings and traditional dressings.
RESULTS
41 RCTs of moist dressings in the treatment of PI were included. A total of seven kinds of moist dressings, Vaseline gauze and traditional gauze dressing were involved. All RCTs were at a medium to high risk of bias. Overall, moist dressings had more advantages than traditional dressings in terms of various outcome indicators.
CONCLUSION
The effect of moist dressings in treating PI is more advantageous than traditional dressings. However, in terms of direct cost and the number of dressings changes, more research is needed to improve the credibility of the network meta-analysis. The results of the network meta-analysis show that the silver ion dressing and alginate dressing are the best choices in the treatment of PI.
NO PATIENT OR PUBLIC CONTRIBUTION
This study is a network meta-analysis, which does not require the participation of patients and the public.
Topics: Humans; Pressure Ulcer; Network Meta-Analysis; Bandages; Wound Healing; Surgical Wound Infection
PubMed: 37012120
DOI: 10.1016/j.jtv.2023.03.003 -
Frontiers in Public Health 2023Manual therapy has been used as an alternative approach to treat knee osteoarthritis (KOA) for many years. Numerous systematic reviews (SRs) or meta-analyses (MAs) were... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Manual therapy has been used as an alternative approach to treat knee osteoarthritis (KOA) for many years. Numerous systematic reviews (SRs) or meta-analyses (MAs) were published to evaluate its effectiveness and safety. Nevertheless, the conclusions of SRs/MAs are inconsistent, and the uneven quality needs to be critically appraised.
OBJECTIVES
To conduct a comprehensive overview of the effectiveness and safety of manual therapy for KOA and the quality of relevant SRs/MAs, thus providing critical evidence and valuable direction for future researchers to promote the generation of advanced evidence.
METHODS
The pre-defined search strategies were applied to eight electronic databases from inception to September 2022. Suitable SRs/MAs were included in accordance with the inclusion and exclusion criteria. The methodological quality, risk of bias, reporting quality, and evidence quality were assessed by two independent reviewers who used respectively the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Version (PRISMA 2020), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) based on the method of narrative synthesis. We excluded the overlapping randomized controlled trials (RCTs) and performed a re-meta-analysis of the total effective rate.
RESULTS
A total of eleven relevant SRs/MAs were included: nine SRs/MAs were rated critically low quality, and two were rated low quality by AMSTAR-2. According to ROBIS, all SRs/MAs were rated low risk in Phase 1 (assessing relevance) and Domain 1 (study eligibility criteria) of Phase 2. Three SRs/MAs (27.27%) were rated low risk in Domain 2 (identification and selection of studies). Ten SRs/MAs (90.91%) were rated low risk in Domain 3 (data collection and study appraisal). Five SRs/MAs (45.45%) were rated low risk in Domain 4 (synthesis and findings). And five SRs/MAs (45.45%) were rated low risk in Phase 3 (risk of bias in the review). By PRISMA 2020, there were some reporting deficiencies in the aspects of abstract (2/11, 18.18%), search strategy (0/11, 0%), preprocessing of merging data (0/11, 0%), heterogeneity exploration (6/11, 54.55%), sensitivity analysis (4/11, 36.36%), publication bias (5/11, 45.45%), evidence quality (3/11, 27.27%), the list of excluded references (3/11, 27.27%), protocol and registration (1/11, 9.09%), funding (1/11, 9.09%), conflict of interest (3/11, 27.27%), and approach to relevant information (0/11, 0%). In GRADE, the evidence quality was defined as moderate quality (8 items, 21.05%), low quality (16 items, 42.11%), and critically low quality (14 items, 36.84%). Among the downgraded factors, risk of bias, inconsistency, imprecision, and publication bias were the main factors. A re-meta-analysis revealed that manual therapy can increase the total effective rate in KOA patients (risk ratio = 1.15, 95% confidence interval [1.12, 1.18], < 0.00001; I = 0, = 0.84). There are four reviews that narratively report adverse effects, and no severe adverse reactions occurred in the manual therapy group.
CONCLUSIONS
Manual therapy may be clinically effective and safe for patients with KOA. However, this conclusion must be interpreted with caution because of the generally unsatisfactory study quality and inconsistent conclusions of the included SRs/MAs. Further rigorous and normative SRs/MAs are expected to be carried out to provide robust evidence for definitive conclusions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier: CRD42022364672.
Topics: Humans; Osteoarthritis, Knee; Research Design; Research Report; Bias
PubMed: 36908468
DOI: 10.3389/fpubh.2023.1081238 -
International Journal of Environmental... Mar 2023With the advancement of spatial analysis approaches, methodological research addressing the technical and statistical issues related to joint spatial and spatiotemporal... (Review)
Review
With the advancement of spatial analysis approaches, methodological research addressing the technical and statistical issues related to joint spatial and spatiotemporal models has increased. Despite the benefits of spatial modelling of several interrelated outcomes simultaneously, there has been no published systematic review on this topic, specifically when such models would be useful. This systematic review therefore aimed at reviewing health research published using joint spatial and spatiotemporal models. A systematic search of published studies that applied joint spatial and spatiotemporal models was performed using six electronic databases without geographic restriction. A search with the developed search terms yielded 4077 studies, from which 43 studies were included for the systematic review, including 15 studies focused on infectious diseases and 11 on cancer. Most of the studies (81.40%) were performed based on the Bayesian framework. Different joint spatial and spatiotemporal models were applied based on the nature of the data, population size, the incidence of outcomes, and assumptions. This review found that when the outcome is rare or the population is small, joint spatial and spatiotemporal models provide better performance by borrowing strength from related health outcomes which have a higher prevalence. A framework for the design, analysis, and reporting of such studies is also needed.
Topics: Bayes Theorem; Incidence; Research Design; Databases, Factual
PubMed: 37047911
DOI: 10.3390/ijerph20075295 -
International Journal of Environmental... Feb 2021Given the drastic changes in our lifestyles and ecosystems worldwide, the potential health effects of natural environments have grown into a highly pervasive topic.... (Review)
Review
Given the drastic changes in our lifestyles and ecosystems worldwide, the potential health effects of natural environments have grown into a highly pervasive topic. Recent scientific findings suggest beneficial effects from nature exposure on human immune responses. This review aims at providing a comprehensive overview of literature published on immunomodulatory effects of nature exposure by inhalation of natural substances. A systematic database search was performed in SCOPUS and PubMed. The quality and potential bias of included studies (n = 33) were assessed by applying the EPHPP (Effective Public Health Practice Project) tool for human studies and the ARRIVE (Animal Research: Reporting of In Vivo Experiments) and SYRCLE (Systematic Review Centre for Laboratory Animal Experimentation) tools for animal studies. The synthesis of reviewed studies points to positive effects of nature exposure on immunological health parameters; such as anti-inflammatory, anti-allergic, anti-asthmatic effects or increased NK (natural killer) cell activity. Decreased expression of pro-inflammatory molecules, infiltration of leukocytes and release of cytotoxic mediators are outcomes that may serve as a baseline for further studies. However, partially weak study designs evoked uncertainties about outcome reproducibility and key questions remain open concerning effect sizes, duration of exposure and contributions of specific vegetation or ecosystem types.
Topics: Animals; Ecosystem; Humans; Immune System; Reproducibility of Results; Research Design
PubMed: 33546397
DOI: 10.3390/ijerph18041416 -
Orthopaedic Surgery Aug 2023This network meta-analysis aims to evaluate the comparative effectiveness and safety of suture anchors (SA), tendon grafts (TG), hook plates (HP), Tight-Rope (TR), and... (Meta-Analysis)
Meta-Analysis Review
Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta-Analysis.
This network meta-analysis aims to evaluate the comparative effectiveness and safety of suture anchors (SA), tendon grafts (TG), hook plates (HP), Tight-Rope (TR), and EndoButton (EB) in the treatment of acute acromioclavicular joint (ACJ) dislocation. The Embase, PubMed, and Web of Science databases were searched from their inception date to June 3, 2022. Studies included all eligible randomized controlled trials (RCTs) and cohort studies with the comparison of five different fixation systems among SA, TG, HP, TR, and EB were identified. All studies were reviewed, performed data extraction, and assessed the risk of bias independently by two reviewers. The primary outcomes are Constant-Murley score (CMS) improvement for assessing clinical efficacy, and complications. The second outcomes are visual analog scale (VAS) for assessing pain relief and the coracoclavicular distance (CCD) for assessing postoperative joint reduction. Version 2 of the revised Cochrane risk of bias tool for randomized trials (RoB 2) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) were used to assess the RCTs and non-randomized trials, respectively. The continuous outcomes were presented as mean differences (MD), and risk ratios (OR) were used for dichotomous outcomes, both with 95% confidence intervals (CI). Surface under the cumulative ranking curves (SUCRA) results were calculated to offer a ranking of each intervention. We identified 31 eligible trials, including 1687 patients in total. HP showed less CMS improvement than TR and EB in both the Network Meta-analysis (NMA) and pairwise meta-analysis. HP also showed less CMS improvement than SA in NMA. For pain relief, HP performed worse than TR both in pairwise meta-analysis and NMA. No significant differences were found for the measured value of CCD. Both TR and EB showed a lower incidence of complications than HP in pairwise meta-analysis. The rank of SUCRA for CMS improvement was as follows: SA, TR, EB, TG, and HP; for pain relief: TR, EB, TG, SA, and HP; for CCD: HP, TR, SA, EB, and TG. For complications, HP showed the highest rank, followed by TG, EB, TR, and SA. SA shows better clinical effectiveness and reliable safety in the treatment of acute ACJ dislocation. Although HP is the most widely used surgical option currently, it should be carefully taken into consideration for its high incidence of complications.
Topics: Humans; Network Meta-Analysis; Acromioclavicular Joint; Shoulder Dislocation; Treatment Outcome; Pain; Joint Dislocations; Bone Plates
PubMed: 37105917
DOI: 10.1111/os.13731 -
European Journal of Pharmaceutical... Jul 2022Dissolving microneedles (MN) with enhanced physiochemical properties are generating considerable interest as antibacterial delivery devices, which minimize hazardous... (Review)
Review
Dissolving microneedles (MN) with enhanced physiochemical properties are generating considerable interest as antibacterial delivery devices, which minimize hazardous sharp wastes, injuries, and transmission of blood-borne pathogens. This systematic review demonstrates and analyzes the current state of dissolvable antibacterial MN to establish their efficacy, and the effect of biomaterials selection on their final properties. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three electronic databases Pubmed, Google scholar, and Scopus were explored for peer-reviewed articles. A total of 551 results with 176 citations and 915 references of resulted articles were reviewed and analyzed. No publication date restrictions were imposed. Last search was placed on 9th of June, 2021. The literature search in electronic databases according to the inclusion criteria was funneled down to 20 papers that were related to antibacterial effects of dissolving microneedles. In conclusion, all included dissolving MN studies presented an enhanced or at least an equal antibacterial activity against common bacterial species when compared to conventional treatments. In addition, composition modifications can enhance their activity and performance. Other factors such as the size and geometry of the produced MN can be tailored to conform to the infected site's characteristics.
Topics: Anti-Bacterial Agents; Research Design
PubMed: 35526676
DOI: 10.1016/j.ejps.2022.106202 -
Journal of Cachexia, Sarcopenia and... Oct 2023In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function...
In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function endpoints may be needed alongside other measures. However, it is not clear which physical function endpoints should be used. The aim of this systematic review was to assess the frequency and diversity of physical function endpoints in cancer cachexia trials. Following a comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990-2021), records were retrieved. Eligible trials met the following criteria: adults (≥18 years), controlled design, more than 40 participants, use of a cachexia intervention for more than 14 days and use of a physical function endpoint. Physical function measures were classified as an objective measure (hand grip strength [HGS], stair climb power [SCP], timed up and go [TUG] test, 6-min walking test [6MWT] and short physical performance battery [SPPB]), clinician assessment of function (Karnofsky Performance Status [KPS] or Eastern Cooperative Oncology Group-Performance Status [ECOG-PS]) or patient-reported outcomes (physical function subscale of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaires [EORTC QLQ-C30 or C15]). Data extraction was performed using Covidence and followed PRISMA guidance (PROSPERO registration: CRD42022276710). A total of 5975 potential studies were examined and 71 were eligible. Pharmacological interventions were assessed in 38 trials (54%). Of these, 11 (29%, n = 1184) examined megestrol and 5 (13%, n = 1928) examined anamorelin; nutritional interventions were assessed in 21 trials (30%); and exercise-based interventions were assessed in 6 trials (8%). The remaining six trials (8%) assessed multimodal interventions. Among the objective measures of physical function (assessed as primary or secondary endpoints), HGS was most commonly examined (33 trials, n = 5081) and demonstrated a statistically significant finding in 12 (36%) trials (n = 2091). The 6MWT was assessed in 12 trials (n = 1074) and was statistically significant in 4 (33%) trials (n = 403), whereas SCP, TUG and SPPB were each assessed in 3 trials. KPS was more commonly assessed than the newer ECOG-PS (16 vs. 9 trials), and patient-reported EORTC QLQ-C30 physical function was reported in 25 trials. HGS is the most commonly used physical function endpoint in cancer cachexia clinical trials. However, heterogeneity in study design, populations, intervention and endpoint selection make it difficult to comment on the optimal endpoint and how to measure this. We offer several recommendations/considerations to improve the design of future clinical trials in cancer cachexia.
Topics: Humans; Cachexia; Hand Strength; Neoplasms; Quality of Life; Research Design
PubMed: 37671529
DOI: 10.1002/jcsm.13321