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Psychoneuroendocrinology Sep 2017Changes in levels of the stress-sensitive hormone cortisol from morning to evening are referred to as diurnal cortisol slopes. Flatter diurnal cortisol slopes have been... (Meta-Analysis)
Meta-Analysis Review
Changes in levels of the stress-sensitive hormone cortisol from morning to evening are referred to as diurnal cortisol slopes. Flatter diurnal cortisol slopes have been proposed as a mediator between chronic psychosocial stress and poor mental and physical health outcomes in past theory and research. Surprisingly, neither a systematic nor a meta-analytic review of associations between diurnal cortisol slopes and health has been conducted to date, despite extensive literature on the topic. The current systematic review and meta-analysis examined associations between diurnal cortisol slopes and physical and mental health outcomes. Analyses were based on 179 associations from 80 studies for the time period up to January 31, 2015. Results indicated a significant association between flatter diurnal cortisol slopes and poorer health across all studies (average effect size, r=0.147). Further, flatter diurnal cortisol slopes were associated with poorer health in 10 out of 12 subtypes of emotional and physical health outcomes examined. Among these subtypes, the effect size was largest for immune/inflammation outcomes (r=0.288). Potential moderators of the associations between diurnal cortisol slopes and health outcomes were examined, including type of slope measure and study quality indices. The possible roles of flatter slopes as either a marker or a mechanism for disease etiology are discussed. We argue that flatter diurnal cortisol slopes may both reflect and contribute to stress-related dysregulation of central and peripheral circadian mechanisms, with corresponding downstream effects on multiple aspects of biology, behavior, and health.
Topics: Circadian Rhythm; Emotions; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Male; Mental Health; Pituitary-Adrenal System; Saliva; Stress, Psychological
PubMed: 28578301
DOI: 10.1016/j.psyneuen.2017.05.018 -
Arthritis & Rheumatology (Hoboken, N.J.) Oct 2015Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available....
OBJECTIVE
Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout.
METHODS
An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multicriterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set.
RESULTS
The entry criterion for the new classification criteria requires the occurrence of at least 1 episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (i.e., synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy computed tomography, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively).
CONCLUSION
The new classification criteria, developed using a data-driven and decision analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout.
Topics: Arthralgia; Europe; Gout; Humans; Synovial Fluid; United States; Uric Acid
PubMed: 26352873
DOI: 10.1002/art.39254 -
Ageing Research Reviews Sep 2022The current evidence on the association of leukocyte telomere length (LTL) with age-related structural and cognitive changes in the brain is mixed. Herein conforming to... (Meta-Analysis)
Meta-Analysis Review
The current evidence on the association of leukocyte telomere length (LTL) with age-related structural and cognitive changes in the brain is mixed. Herein conforming to PRISMA 2020 guidelines, we performed a systematic review and meta-analysis using data from 27 observational studies in non-demented individuals. We used effect size and p-value based meta-analysis methods considering marked heterogeneity among studies. We found that the longer LTL was associated with higher brain volume (β = 0.43, 95%CI: 0.36-0.50%, p = 0.008, N = 1102) and with higher global cognition (β = 0.01; 95%CI: 0.00-0.02, p = 0.03, N = 19609) by effect size based meta-analysis and with brain volume, hippocampal volume, global cognition, cognitive domains of attention/speed as well as executive functions by p-value based meta-analysis. No significant association of LTL with brain white matter hyperintensities was detected. Furthermore, the evidence strongly suggests a subgroup-specific canonical effect of telomeres, notably in older individuals and females. In conclusion, we provide meta-analytic evidence on the beneficial effect of telomeres on brain structure as well as cognition and advocate for a beneficial subgroup-specific effect that warrants further attention.
Topics: Aged; Aging; Brain; Cognition; Female; Humans; Leukocytes; Telomere; Telomere Shortening
PubMed: 35777725
DOI: 10.1016/j.arr.2022.101679 -
Journal of Hypertension Jun 2023Stress is widely considered to be a risk factor for high blood pressure (BP), but evidence on the associations between biomarkers of chronic stress and BP is... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Stress is widely considered to be a risk factor for high blood pressure (BP), but evidence on the associations between biomarkers of chronic stress and BP is inconsistent. This systematic review and meta-analysis assessed the current state of the science on relationships between measures of cortisol concentration reflecting chronic stress exposure [hair cortisol concentration (HCC), nail cortisol concentration)] and BP.
METHODS
PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane Library, and Embase were searched. Random effects models were used to assess the pooled effect size. Exploratory moderation analysis was performed.
RESULTS
Out of 34 014 identified, 16 articles met eligibility criteria and were included in the review, while 14 were included in the meta-analysis. No articles were reported on the association between nail cortisol concentration and BP. Small, positive associations were observed between HCC and SBP [ r = 0.19 (95% confidence interval (CI): 0.08-0.29)] and HCC and DBP [ r = 0.13 (95% CI: 0.04-0.22)]. Cortisol analysis method was identified as a significant moderator of the association between HCC and DBP. HCC was largely, positively associated with hypertension status [odds ratio = 3.23 (95% CI: 2.55-4.09), P < 0.001].
CONCLUSIONS
Current evidence suggests that higher HCC may be associated with elevated BP and a potential risk factor for hypertension. However, results should be interpreted with caution because HCC can be affected by hair color, hair care products, and analytic methods. Given the limitations of studies included in this review, further research is needed.
Topics: Humans; Blood Pressure; Hydrocortisone; Hypertension; Risk Factors; Hair
PubMed: 37016924
DOI: 10.1097/HJH.0000000000003412 -
Critical Reviews in Food Science and... 2024Neural network (i.e. deep learning, NN)-based data analysis techniques have been listed as a pivotal opportunity to protect the integrity and safety of the global food... (Review)
Review
Neural network (i.e. deep learning, NN)-based data analysis techniques have been listed as a pivotal opportunity to protect the integrity and safety of the global food supply chain and forecast $11.2 billion in agriculture markets. As a general-purpose data analytic tool, NN has been applied in several areas of food science, such as food recognition, food supply chain security and omics analysis, and so on. Therefore, given the rapid emergence of NN applications in food safety, this review aims to provide a comprehensive overview of the NN application in food analysis for the first time, focusing on domain-specific applications in food analysis by introducing fundamental methodology, reviewing recent and notable progress, and discussing challenges and potential pitfalls. NN demonstrated that it has a bright future through effective collaboration between food specialist and the broader community in the food field, for example, superiority in food recognition, sensory evaluation, pattern recognition of spectroscopy and chromatography. However, major challenges impeded NN extension including void in the food scientist-friendly interface software package, incomprehensible model behavior, multi-source heterogeneous data, and so on. The breakthrough from other fields proved NN has the potential to offer a revolution in the immediate future.
Topics: Neural Networks, Computer; Humans; Food Analysis; Food Safety; Food Technology; Food Supply; Deep Learning
PubMed: 36322538
DOI: 10.1080/10408398.2022.2139217 -
Sleep Medicine Sep 2017To investigate the association between daytime napping and prevalent/incident diabetes mellitus (DM) based on systematic review and meta-analytic data. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the association between daytime napping and prevalent/incident diabetes mellitus (DM) based on systematic review and meta-analytic data.
METHODS
The electronic databases of Embase, Medline, Pubmed and Web of Science were searched. Relevant studies were extracted by two reviewers independently. The associations between daytime napping (irrespective of duration), long nap (≥1 h/day) and short nap (<1 h/day), and risk of DM were assessed according to study types. Overall estimates were pooled using either fixed- or random-effect with inverse variance meta-analysis. Heterogeneity of included studies was assessed using the I test and possible cause of the heterogeneity was examined by meta-regression analyses.
RESULTS
Ten studies (four cross-sectional and six longitudinal cohort) comprising a total of 304,885 individuals and 20,857 cases of DM were included in the systematic review, with an average napping prevalence of 47%. Nappers were found to have increased risk of DM in both cross-sectional and cohort studies. However, significant heterogeneity was present. Long nap (≥1 h/day) was associated with both prevalent and incident DM; in particular, those with a daily nap over 1 h had a 31% increased risk of developing DM during follow-up (95% confidence interval: 2-67%). Conversely, no such association was found in individuals with short naps (<1 h/day) in cohort studies.
CONCLUSIONS
Long daytime napping over 1 h per day was associated with increased risk of both prevalent and incident DM. Further studies are needed to confirm the findings.
Topics: Diabetes Mellitus; Habits; Humans; Observational Studies as Topic; Photoperiod; Risk Factors; Sleep; Time Factors
PubMed: 28899519
DOI: 10.1016/j.sleep.2017.01.018 -
Biological Trace Element Research Jun 2014Breast cancer is the most common cancer type. In several studies, hints have been provided that there is a correlation between selenium deficiency and the incidence of... (Meta-Analysis)
Meta-Analysis Review
Breast cancer is the most common cancer type. In several studies, hints have been provided that there is a correlation between selenium deficiency and the incidence of breast cancer. Findings of these published reports are, however, inconsistent. This study serves as a pioneering study aiming at combining the results of studies using a meta-analytic method. A total of 16 articles published between 1980 and 2012 worldwide were selected through searching PubMed, Scopus, and Google scholar databases, and the information were analyzed using a meta-analytic method [random effects model]. I (2) statistics were used to examine heterogeneity. The information was then analyzed by STATA version 12. In this study, due to the non-uniform methods used to measure selenium concentrations, selenium levels were measured in the various subgroups in both case and control groups. There were significant correlations between selenium concentration and breast cancer [P<0.05]. Hence, the mean risk differentiating criteria were estimated to be 0.63 [95% confidence interval [95% CI] 0.93 to 0.32] in serum and toenails. Subgroup analysis showed that the value in toenails was -0.07 [95% CI -0.16 to 0.03] and in serum -1.04 [95% CI 1.71 to -0.38]. In studies in which selenium concentrations were measured in serum, a significant correlation was observed between selenium concentration and breast cancer. In contrast, in studies in which selenium concentration was measured in toenails, the correlation was not significant. Therefore, the selenium concentration can be used as one predictor for breast cancer.
Topics: Breast Neoplasms; Confidence Intervals; Female; Humans; Nails; Selenium
PubMed: 24859854
DOI: 10.1007/s12011-014-9998-3 -
Journal of the Neurological Sciences Mar 2011Early and more recent systematic reviews of placebo controlled trials disagree about the relative efficacy of the commercially available INF-ß treatments in studies of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Early and more recent systematic reviews of placebo controlled trials disagree about the relative efficacy of the commercially available INF-ß treatments in studies of adults with RRMS. A limitation of these reviews is that they have derived their findings almost entirely from the pivotal trials and placebo controlled studies.
OBJECTIVE
To provide the first meta-analytic study of head-to-head and comparative trials of INF-ß agents in RRMS treatment.
METHODS
OVID Medline and Cochrane Library electronic databases were searched using keywords "multiple sclerosis", "interferon beta-1a", and "interferon beta-1b". Using a standardized abstraction form, three reviewers independently abstracted MRI, relapse rate, and disability (EDSS) data. RevMan5 software was used to calculate relative risk (RR) and absolute risk differences (RD) based on event rates.
RESULTS
High dose treatment demonstrated superior relapse reduction and MRI stability compared to low dose treatment. There was also a trend observed in the aggregate analyses of disability progression (EDSS) favoring high dose treatment.
CONCLUSIONS
High dose INF-ß treatment demonstrated superior relapse control and MRI stability compared to low dose treatment in a systematic review of comparative studies. These results contradict those of earlier systematic reviews and support the conclusions of more recent systematic reviews of the placebo controlled trials.
Topics: Adult; Chemistry, Pharmaceutical; Databases, Factual; Disease Progression; Endpoint Determination; Humans; Interferon Type I; Interferon-beta; Interferons; Magnetic Resonance Imaging; Multiple Sclerosis, Relapsing-Remitting; Recombinant Proteins; Risk Assessment; Treatment Outcome
PubMed: 21167504
DOI: 10.1016/j.jns.2010.11.003 -
Human Molecular Genetics Jun 2015Polymorphisms rs6232 and rs6234/rs6235 in PCSK1 have been associated with extreme obesity [e.g. body mass index (BMI) ≥ 40 kg/m(2)], but their contribution to common... (Meta-Analysis)
Meta-Analysis Review
Contribution of common non-synonymous variants in PCSK1 to body mass index variation and risk of obesity: a systematic review and meta-analysis with evidence from up to 331 175 individuals.
Polymorphisms rs6232 and rs6234/rs6235 in PCSK1 have been associated with extreme obesity [e.g. body mass index (BMI) ≥ 40 kg/m(2)], but their contribution to common obesity (BMI ≥ 30 kg/m(2)) and BMI variation in a multi-ethnic context is unclear. To fill this gap, we collected phenotypic and genetic data in up to 331 175 individuals from diverse ethnic groups. This process involved a systematic review of the literature in PubMed, Web of Science, Embase and the NIH GWAS catalog complemented by data extraction from pre-existing GWAS or custom-arrays in consortia and single studies. We employed recently developed global meta-analytic random-effects methods to calculate summary odds ratios (OR) and 95% confidence intervals (CIs) or beta estimates and standard errors (SE) for the obesity status and BMI analyses, respectively. Significant associations were found with binary obesity status for rs6232 (OR = 1.15, 95% CI 1.06-1.24, P = 6.08 × 10(-6)) and rs6234/rs6235 (OR = 1.07, 95% CI 1.04-1.10, P = 3.00 × 10(-7)). Similarly, significant associations were found with continuous BMI for rs6232 (β = 0.03, 95% CI 0.00-0.07; P = 0.047) and rs6234/rs6235 (β = 0.02, 95% CI 0.00-0.03; P = 5.57 × 10(-4)). Ethnicity, age and study ascertainment significantly modulated the association of PCSK1 polymorphisms with obesity. In summary, we demonstrate evidence that common gene variation in PCSK1 contributes to BMI variation and susceptibility to common obesity in the largest known meta-analysis published to date in genetic epidemiology.
Topics: Alleles; Body Mass Index; Genetic Predisposition to Disease; Genetic Variation; Humans; Obesity; Odds Ratio; Polymorphism, Single Nucleotide; Proprotein Convertase 1
PubMed: 25784503
DOI: 10.1093/hmg/ddv097 -
Pain Physician Nov 2017Abuse-deterrent formulations (ADFs) represent one novel strategy for curbing the potential of opioid abuse. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Abuse-deterrent formulations (ADFs) represent one novel strategy for curbing the potential of opioid abuse.
OBJECTIVE
We aim to compare and contrast the characteristics and applications of current abuse-deterrent opioid products in clinical practice.
METHODS
Literature searches were conducted in databases (Pubmed Medline, International Pharmaceutical Abstracts, Google Scholar) and official reports. Relevant data were screened and organized into: 1) epidemiology of opioid abuse, 2) mitigation strategies for reducing opioid abuse, 3) development of ADFs, and 4) clinical experience with these formulations.
RESULTS
Increasing trends of opioid abuse and misuse have been reported globally. There are 5 types of abuse-deterrent opioid products: physical chemical barrier, combined agonist/antagonist, sequestered aversive agent, prodrug, and novel delivery system. The advantages and disadvantages of the 5 options are discussed in this review. A total of 9 products with abuse-deterrent labels have been approved by the Food and Drug Administration (FDA). The rates of abuse, diversion, and overdose deaths of these new products are also discussed. A framework for collecting in-time data on the efficacy, benefit and risk ratio, and cost-effectiveness of these new products is suggested to facilitate their optimal use.
LIMITATIONS
The present review did not utilize systematic review standards or meta-analytic techniques, given the large heterogeneity of data and outcomes reviewed.
CONCLUSIONS
ADFs provide an option for inhibiting the abuse or misuse of oral opioid products by hindering extraction of the active ingredient, preventing alternative routes of administration, or causing aversion. Their relatively high costs, uncertain insurance policies, and limited data on pharmacoeconomics warrant collaborative monitoring and assessment by government agencies, pharmaceutical manufacturers, and data analysis services to define their therapeutic role in the future.
KEY WORDS
Opioid abuse, abuse-deterrent formulations, ADF, post-marketing, FDA guidance, cost impact, abuse liking, physician attitude, generic abuse-deterrent formulation, clinical application.
Topics: Analgesics, Opioid; Chemistry, Pharmaceutical; Drug Compounding; Humans; Opioid-Related Disorders; Prescription Drug Misuse
PubMed: 29149148
DOI: No ID Found