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Medicine Jan 2015To perform a meta-analysis and examine the use of D-dimer levels for diagnosing acute aortic dissection (AAD). Medline, Cochrane, EMBASE, and Google Scholar were... (Meta-Analysis)
Meta-Analysis Review
To perform a meta-analysis and examine the use of D-dimer levels for diagnosing acute aortic dissection (AAD). Medline, Cochrane, EMBASE, and Google Scholar were searched until April 23, 2014, using the following search terms: biomarker, acute aortic dissection, diagnosis, and D-dimer. Inclusion criteria were diagnosis of acute aortic dissection, D-dimer levels obtained, 2-armed study. Outcome measures were the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of D-dimer level for the diagnosis of AAD. Sensitivity analysis was performed using the leave-one-out approach. Of 34 articles identified, 5 met the inclusion criteria and were included in the analysis. The age of participants was similar between treatments within studies. The number of AAD patients ranged from 16 to 107 (total = 274), and the number of control group patients ranged from 32 to 206 (total = 469). The pooled sensitivity of D-dimer levels in AAD patients was 94.5% (95% confidence interval [CI] 78.1%-98.8%, P < 0.001), and the specificity was 69.1% (95% CI 43.7%-86.5%, P = 0.136). The pooled area under the receiver-operating characteristic curve for D-dimer levels in AAD patients was 0.916 (95% CI 0.863-0.970, P < 0.001). The direction and magnitude of the combined estimates did not change markedly with the exclusion of individual studies, indicating the meta-analysis had good reliability. D-dimer levels are best used for ruling out AAD in patients with low likelihood of the disease.
Topics: Aortic Dissection; Aortic Aneurysm; Biomarkers; Fibrin Fibrinogen Degradation Products; Humans; Predictive Value of Tests; Sensitivity and Specificity
PubMed: 25634194
DOI: 10.1097/MD.0000000000000471 -
Diabetic Medicine : a Journal of the... Feb 2023The aim of this systematic review and meta-analysis was to assess how running and cycling influence the magnitude of blood glucose (BG) excursions in individuals with... (Meta-Analysis)
Meta-Analysis Review
AIMS
The aim of this systematic review and meta-analysis was to assess how running and cycling influence the magnitude of blood glucose (BG) excursions in individuals with type 1 diabetes.
METHODS
A systematic literature search was conducted in EMBASE, PubMed, Cochrane Central Register of Controlled Trials, and ISI Web of Knowledge for publications from January 1950 until February 2021. Parameters included for analysis were population (adults and adolescents), exercise type, intensity, duration and insulin preparation. The meta-analysis was performed to estimate the pooled mean with a 95% confidence interval (CI) of delta BG levels. In addition, sub-group and meta-regression analyses were performed to assess the influence of these parameters on delta BG.
RESULTS
The database search identified 3192 articles of which 69 articles were included in the meta-analysis. Due to crossover designs within articles, 151 different results were included for analysis. Data from 1901 exercise tests of individuals with type 1 diabetes with a mean age of 29 ± 4 years were included. Overall, exercise tests BG decreased by -3.1 mmol/L [-3.4; -2.8] within a mean duration of 46 ± 21 min. The pooled mean decrease in BG for running was -4.1 mmol/L [-4.7; -2.4], whilst the pooled mean decrease in BG for cycling was -2.7 mmol/L [-3.0; -2.4] (p < 0.0001). Overall results can be found in Table S2.
CONCLUSIONS
Running led to a larger decrease in BG in comparison to cycling. Active individuals with type 1 diabetes should be aware that current recommendations for glycaemic management need to be more specific to the mode of exercise.
Topics: Adult; Humans; Adolescent; Blood Glucose; Diabetes Mellitus, Type 1; Glucose; Insulin; Running
PubMed: 36259159
DOI: 10.1111/dme.14981 -
The Science of the Total Environment Sep 2023Heavy metals are defined by their long biological half-life and non-biodegradability in the environment and the human body. Thus, they can accumulate in considerable... (Meta-Analysis)
Meta-Analysis Review
Heavy metals are defined by their long biological half-life and non-biodegradability in the environment and the human body. Thus, they can accumulate in considerable amounts within soil-plant-food chains, presenting a potential health risk to humans. This systematic review and meta-analysis aimed to investigate the prevalence and mean levels of heavy metals (As, Cd, Hg, and Pb) in red meat globally. Studies describing the heavy metal contamination of meat were retrieved by searching international general and specific databases between 2000 and 2021. According to the findings, there is a low level of contamination of meat with arsenic (As) and mercury (Hg). In contrast, the lead (Pb) and cadmium (Cd) levels exceed the Codex permissible levels. There was also a highly severe heterogeneity in the results, and no subgroup analysis revealed the cause of this heterogeneity. However, different continent subgroups, types of meat, and fat content of meat are universally defined as the primary sources of high toxic heavy metal (THM) concentrations. Also, the results of the subgroup analysis showed the Asia continent 1020.15 μg/kg (95 % CI = 605.13-1435.18), followed by Africa 965.73 μg/kg (95 % CI = 840.64-1094.42), have the highest level of Pb contamination. Similarly, Asia 232.12 μg/kg (95 % CI = 206.45-257.79) and Africa 84.68 μg/kg (95 % CI = 74.69-94.66) have reported high levels of Cd that exceeded the limit of the standards. The risk assessment results also revealed that red meat consumption carries health risks due to excessive heavy metals content particularily for heavy consumers. As a result, it is necessary to implement strict control measures to prevent heavy metal contamination in these critical food products for all consumers worldwide, particularly in Asia and Africa.
Topics: Humans; Cadmium; Lead; Metals, Heavy; Arsenic; Mercury; Red Meat; Risk Assessment; Environmental Monitoring; Soil Pollutants; China
PubMed: 37209751
DOI: 10.1016/j.scitotenv.2023.164100 -
Ecotoxicology and Environmental Safety Sep 2023Fine particulate matter (PM) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an... (Meta-Analysis)
Meta-Analysis Review
Fine particulate matter (PM) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on systolic and diastolic BP; SBP and DBP. We conducted an updated systematic review and meta-analysis of studies using true versus sham mode filtration reporting the effects on BP. Of 214 articles identified up to February 5, 2023, seventeen (from China, USA, Canada, South Korea and Denmark) enrolling approximately 880 participants (484 female) met the inclusion criteria for meta-analyses. Aside from studies conducted in China, research on PACs and BP has been conducted in relatively low pollution settings. Mean indoor PM concentrations during the active and sham mode purification were 15.9 and 41.2 µg/m, respectively. The mean efficiency of PACs against indoor PM was 59.8 % (ranging from 23 % to 82 %). True mode filtration was associated with a pooled mean difference of - 2.35 mmHg (95 % confidence interval [CI]: - 4.5, - 0.2) and - 0.81 mmHg (95 % CI: - 1.86, 0.24) in SBP and DBP, respectively. After removing the studies with high risk of bias, the magnitude of the pooled benefits on SBP and DBP increased to - 3.62 mmHg (95 % CI: - 6.69, - 0.56) and - 1.35 mmHg (95 % CI: - 2.29, - 0.41), respectively. However, there are several barriers to the use of PACs, specifically in low- and middle-income countries (LMICs), such as the initial purchase cost and filter replacements. There may be several avenues to help overcome these economic burdens and improve cost effectiveness, such as implementing government or other subsidized programs to distribute PACs targeting vulnerable and higher-risk individuals. We propose that environmental health researchers and healthcare providers should be better trained to educate the public regarding the use of PACs to reduce the impacts of PM on cardiometabolic diseases globally.
Topics: Humans; Female; Blood Pressure; Air Pollution; Particulate Matter; Filtration; China; Air Pollutants; Environmental Exposure
PubMed: 37421892
DOI: 10.1016/j.ecoenv.2023.115227 -
Environmental Science & Technology Jul 2023Mobile ambient air quality monitoring is rapidly changing the current paradigm of air quality monitoring and growing as an important tool to address air quality and... (Meta-Analysis)
Meta-Analysis Review
Mobile ambient air quality monitoring is rapidly changing the current paradigm of air quality monitoring and growing as an important tool to address air quality and climate data gaps across the globe. This review seeks to provide a systematic understanding of the current landscape of advances and applications in this field. We observe a rapidly growing number of air quality studies employing mobile monitoring, with low-cost sensor usage drastically increasing in recent years. A prominent research gap was revealed, highlighting the double burden of severe air pollution and poor air quality monitoring in low- and middle-income regions. Experiment-design-wise, the advances in low-cost monitoring technology show great potential in bridging this gap while bringing unique opportunities for real-time personal exposure, large-scale deployment, and diversified monitoring strategies. The median value of unique observations at the same location in spatial regression studies is ten, which can be used as a rule-of-thumb for future experiment design. Data-analysis-wise, even though data mining techniques have been extensively employed in air quality analysis and modeling, future research can benefit from exploring air quality information from nontabular data, such as images and natural language.
Topics: Air Pollutants; Environmental Monitoring; Air Pollution; Particulate Matter
PubMed: 37343238
DOI: 10.1021/acs.est.2c06310 -
Environmental Science and Pollution... May 2023Blood lead levels (BLLs) have been decreasing worldwide for decades. However, systematic reviews and quantitative syntheses of BLLs in electronic waste (e-waste)-exposed... (Meta-Analysis)
Meta-Analysis Review
Blood lead levels (BLLs) have been decreasing worldwide for decades. However, systematic reviews and quantitative syntheses of BLLs in electronic waste (e-waste)-exposed children are lacking. To summarize temporal trend of BLLs among children in e-waste-recycling areas. Fifty-one studies met the inclusion criteria and included participants from six countries. Meta-analysis was performed using the random-effects model. Results showed that among e-waste-exposed children, the total geometric mean (GM) BLL was 7.54 μg/dL (95% CI: 6.77, 8.31). Children's BLLs displayed a decreasing temporal trend, from 11.77 μg/dL in phase I (2004-2006) to 4.63 μg/dL in phase V (2016-2018). Almost 95% of eligible studies found that children exposed to e-waste had significantly higher BLLs than reference groups. The difference of children's BLLs between the exposure group and the reference group was from 6.60 μg/dL (95% CI: 6.14, 7.05) in 2004 to 1.99 μg/dL (95% CI: 1.61, 2.36) in 2018. For subgroup analyses, except for Dhaka and Montevideo, the BLLs of children from Guiyu in the same survey year were higher than those of children from other regions. Our findings indicate that the gap between BLLs of children exposed to e-waste and those of reference group children is closing, and we appeal that the critical value for blood lead poisoning in children should be lowered in key e-waste-dismantling areas of developing countries, such as Guiyu.
Topics: Humans; Child; Lead; Electronic Waste; Environmental Exposure; Bangladesh; Lead Poisoning
PubMed: 37097575
DOI: 10.1007/s11356-023-27114-x -
Marine Pollution Bulletin May 2022Anthropogenic pollution of marine ecosystems caused by beach debris has become a serious environmental concern in the last few decades. Regarding the raising production... (Review)
Review
Anthropogenic pollution of marine ecosystems caused by beach debris has become a serious environmental concern in the last few decades. Regarding the raising production of beach debris, the present work aimed to summarize the quantity and quality of beach debris reported from different beach areas of the world. Also, a bibliometric analysis was used to analyze research trends and upgrade knowledge in this research area. Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), the eligible papers reviewed regarding beach debris abundance along with their composition from 2010, which were extracted from the Scopus database. The results of the study showed that plastic items represented the dominant material (61.25%), followed by food (5.88%), wood (5.78%), metals (5.2%), and glass (5%). Further, the beaches studied were classified into three degrees, including highly polluted (31.5 items/m), moderate polluted (3.47 items/m), and low polluted (0.37 items/m), based on the average abundance of debris.
Topics: Bibliometrics; Ecosystem; Environmental Monitoring; Plastics; Waste Products
PubMed: 35397342
DOI: 10.1016/j.marpolbul.2022.113637 -
Presence of heavy metals in drinking water resources of Iran: a systematic review and meta-analysis.Environmental Science and Pollution... Jun 2021Water quality is one of the most important indices for public health especially for drinking water consumptions. This study was conducted to survey the presence of heavy... (Meta-Analysis)
Meta-Analysis Review
Water quality is one of the most important indices for public health especially for drinking water consumptions. This study was conducted to survey the presence of heavy metals in drinking water resources of Iran using a systematic review and meta-analysis. The literature search was conducted in data bases of PubMed, Web of Science, EMBASE, Scopus, Google Scholar, and some Persian databases up to 31 July 2018. Of all the articles reviewed (1151 articles), 61 papers were eligible for systematic review. Results indicated variable heterogeneity between studies for different pollutants (I between 0 and 100). A subgroup analysis was performed for three different types of water resources such as drinking water, groundwater, and surface water to find the possible source of the heterogeneity. The pooled mean concentration level of iron was the highest at 255.8 (95% CI = 79.48-432.13 μg/l) and vanadium the lowest at 3.21 (95% CI = 1.45-4.98 μg/l). The sequence of metal concentration (μg/l) in descending order is as follows: Fe (255.8) > B (159.81) > Al (158.5) > Zn (130.73) > As (85.85) > Mn (51.61) > Cu (47.98) > Se (42.68) > Pb (37.22) > Co (22.76) > Mo (18.92) > Ni (16.79) > Cr (13.47) > Hg (4.49) > Cd (4.19) > V (3.21). The mean pooled concentration level of Al, As, Se, Pb, and Cd was higher than the WHO guideline and Iran Standard, and the rest of the metals had lower mean pooled concentration level. Pb and Cd were the common heavy metals that existed in all subgroups. As a recommendation, the relationship assessment of water parameters and heavy metals could be addressed in future studies of Iran's water resources.
Topics: Drinking Water; Environmental Monitoring; Iran; Metals, Heavy; Risk Assessment; Water Pollutants, Chemical; Water Resources
PubMed: 33791963
DOI: 10.1007/s11356-021-13293-y -
Aging Clinical and Experimental Research May 2022Systemic chronic inflammation has been proposed as an essential mediating factor in frailty, and several studies tested its relationship with frailty. However, the issue... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Systemic chronic inflammation has been proposed as an essential mediating factor in frailty, and several studies tested its relationship with frailty. However, the issue is still controversial.
OBJECTIVES
We identified observational studies and pooled their results to assess whether abnormal expression of inflammatory biomarkers is present in the blood of older adults with frailty.
METHODS
We conducted a systematic search on the Medline, Embase, and Web of Science database from inception to 1st September 2021. The quality of included studies was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies (JBI-MAStARI). Study heterogeneity was assessed with the Cochran Q test and I statistic. Pooled estimates were obtained through random-effect models. Sensitivity analyses were conducted by excluding one of the studies. Egger's regression test and observation of funnel plots were used to detect small-study effects and publication bias. PROSPERO registration: CRD42020172853.
RESULT
A total of 53 cross-sectional studies corresponding to 56 independent study populations were included in this analysis. There were 31 study populations with three frailty categories (3144 frailty, 14,023 pre-frailty, 10,989 robust) and 25 study populations with two frailty categories (2576 frailty, 8368 non-frailty). This meta-analysis performed pooled analyses for the inflammatory biomarker leukocyte, lymphocytes, CRP, IL-6, IL-10, and TNF-α. Older adults with frailty had lower lymphocytes and higher interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) levels compared with the control group. However, there was no significant difference in leukocyte and IL-10 levels in the two groups.
CONCLUSIONS
These findings suggest that peripheral inflammatory biomarkers lymphocytes, IL-6, CRP, and TNF-α are related to frailty status. Our findings are not conclusive regarding the causal relationship between chronic inflammation and frailty, so the development of further longitudinal and well-designed studies focused on this is necessary.
Topics: Aged; Biomarkers; C-Reactive Protein; Cross-Sectional Studies; Frailty; Humans; Inflammation; Interleukin-10; Interleukin-6; Tumor Necrosis Factor-alpha
PubMed: 34981430
DOI: 10.1007/s40520-021-02022-7 -
Scientific Reports Mar 2016ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship... (Meta-Analysis)
Meta-Analysis Review
ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship between ABO blood group and coronary artery disease (CAD) is still controversial. We here performed an updated meta-analysis of the related studies and tried to elucidate the potential role of ABO blood group as a risk factor for CAD. All detectable case-control and cohort studies comparing the risk of CAD in different ABO blood groups were collected for this analysis through searching PubMed, Embase, and the Cochrane Library. Ultimately, 17 studies covering 225,810 participants were included. The combined results showed that the risk of CAD was significantly higher in blood group A (OR = 1.14, 95% CI = 1.03 to 1.26, p = 0.01) and lower in blood group O (OR = 0.85, 95% CI = 0.78 to 0.94, p = 0.0008). Even when studies merely about myocardial infarction (MI) were removed, the risk of CAD was still significantly higher in blood group A (OR = 1.05, 95% CI = 1.00 to 1.10, p = 0.03) and lower in blood group O (OR = 0.89, 95% CI = 0.85 to 0.93, p < 0.00001). This updated systematic review and meta-analysis indicated that both blood group A and non-O were the risk factors of CAD.
Topics: ABO Blood-Group System; Adult; Aged; Coronary Artery Disease; Disease Susceptibility; Female; Humans; Male; Middle Aged; Risk Factors; Young Adult
PubMed: 26988722
DOI: 10.1038/srep23250