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Endocrine Feb 2024The global prevalence of thyroid cancer is on the rise. About one-third of newly diagnosed thyroid cancer cases comprise low-risk papillary thyroid cancer (1.5 cm or... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The global prevalence of thyroid cancer is on the rise. About one-third of newly diagnosed thyroid cancer cases comprise low-risk papillary thyroid cancer (1.5 cm or more minor). While surgical removal remains the prevailing approach for managing low-risk papillary thyroid cancer (LPTC) in patients, other options such as active surveillance (AS), radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) are also being considered as viable alternatives. This study evaluated and compared surgical thyroid resection (TSR) versus non-surgical (NS) methods for treating patients with LPTC.
METHODS
The study encompassed an analysis of comparisons between surgical thyroid resection (TSR) and alternative approaches, including active surveillance (AS), radiofrequency ablation (RFA), microwave ablation (MWA), or laser ablation (LA). The focus was on patients with biopsy-confirmed low-risk papillary thyroid cancer (LPTC) of less than 1.5 cm without preoperative indications of local or distant metastasis. The primary outcomes assessed were recurrence rates, disease-specific mortality, and quality of life (QoL). Data were collected from prominent databases, including Cochrane Database, Embase, MEDLINE, and Scopus, from inception to June 3rd, 2020. The CLARITY tool was utilized to evaluate bias risk. The analysis involved odds ratios (OR) with 95% confidence intervals (CI) for dichotomous outcomes, as well as mean differences (MD) and standardized mean differences (SMD) for continuous outcomes. The study is registered on PROSPERO under the identifier CRD42021235657.
RESULTS
The study incorporated 13 retrospective cohort studies involving 4034 patients. Surgical thyroid resection (TSR), active surveillance (AS), and minimally invasive techniques like radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) were performed in varying proportions of cases. The analysis indicated that specific disease mortality rates were comparable among AS, MWA, and TSR groups. The risk of recurrence, evaluated over different follow-up periods, showed no significant differences when comparing AS, RFA, MWA, or LA against TSR. Patients undergoing AS demonstrated better physical health-related quality of life (QoL) than those undergoing TSR. However, no substantial differences were observed in the overall mental health domain of QoL when comparing AS or RFA with TSR. The risk of bias was moderate in nine studies and high in four.
CONCLUSION
Low-quality evidence indicates comparable recurrence and disease-specific mortality risks among patients with LPTC who underwent ablation techniques or active surveillance (AS) compared to surgery. Nevertheless, individuals who opted for AS exhibited enhanced physical quality of life (QoL). Subsequent investigations are warranted to validate these findings.
Topics: Humans; Quality of Life; Catheter Ablation; Thyroid Cancer, Papillary; Retrospective Studies; Watchful Waiting; Ablation Techniques; Thyroid Neoplasms; Treatment Outcome
PubMed: 37658978
DOI: 10.1007/s12020-023-03502-8 -
Neuroscience and Biobehavioral Reviews Jun 2024Changes in sleep and dreams are often observed during pregnancy. Dreaming may represent privileged access to the inner world of individuals, providing relevant... (Review)
Review
Changes in sleep and dreams are often observed during pregnancy. Dreaming may represent privileged access to the inner world of individuals, providing relevant information about their well-being. For this reason, a growing but heterogeneous literature has investigated dream experiences of pregnant women. The present paper aimed to systematically review the available evidence on the relationship between pregnancy and oneric activity, focusing on dream and nightmare frequency, dream contents, and emotional features. Moreover, dream changes between pre-partum and post-partum periods and the impact of previous pregnancy-related adverse events on dreaming have been summarized. Overall, 17 studies have been examined. The reviewed evidence suggests that women tend to have an abundant production of dreams and nightmares during pregnancy, and some results support the view that a high rate of dream recall is associated with poor sleep quality. Most studies have shown a high presence of pregnancy-related dream content, likely reflecting waking experiences and concerns. Additionally, dreaming may promote psychological preparation and activation of functional coping strategies to face life changes after childbirth.
PubMed: 38852848
DOI: 10.1016/j.neubiorev.2024.105763 -
PloS One 2019Child maltreatment can have serious effects on development and physical, social and emotional wellbeing. Any long-lasting relational effects can impede the capacity to... (Meta-Analysis)
Meta-Analysis
Healing The Past By Nurturing The Future: A qualitative systematic review and meta-synthesis of pregnancy, birth and early postpartum experiences and views of parents with a history of childhood maltreatment.
BACKGROUND
Child maltreatment can have serious effects on development and physical, social and emotional wellbeing. Any long-lasting relational effects can impede the capacity to nurture children, potentially leading to 'intergenerational trauma'. Conversely, the transition to parenthood during pregnancy, birth and the early postpartum period offers a unique life-course opportunity for healing. This systematic review aims to understand the pregnancy, birth and early postpartum experiences of parents who reported maltreatment in their own childhood.
METHODS
A protocol, based on the ENTREQ statement, was registered with PROSPERO. We searched Medline, PsycINFO, CINAHL, EMBASE, NHS Evidence and key Web of Science databases from date of inception to June 2018 to identify qualitative studies exploring perinatal experiences of parents who were maltreated in their own childhood. Two reviewers independently screened articles for inclusion and extracted data. Data were synthesised using grounded theory and thematic analysis approaches.
FINDINGS
The search yielded 18329 articles, 568 full text articles were reviewed, and 50 studies (60 articles) met inclusion criteria for this review. Due to the large number of studies across the whole perinatal period (pregnancy to two years postpartum), this paper reports findings for experiences during pregnancy, birth and early postpartum (27 studies). Parents described positive experiences and strategies to help them achieve their hopes and dreams of providing safe, loving and nurturing care for their children. However, many parents experienced serious challenges. Seven core analytic themes encapsulated these diverse and dynamic experiences: New beginnings; Changing roles and identities; Feeling connected; Compassionate care; Empowerment; Creating safety; and Reweaving a future.
CONCLUSIONS
Pregnancy birth and the early postpartum period is a unique life-course healing opportunity for parents with a history of maltreatment. Understanding parent's experiences and views of perinatal care and early parenting is critical for informing the development of acceptable and effective support strategies.
Topics: Adult Survivors of Child Abuse; Female; Humans; Parenting; Parents; Parturition; Postpartum Period; Pregnancy; Pregnant Women
PubMed: 31834894
DOI: 10.1371/journal.pone.0225441 -
Sleep Medicine Reviews Oct 2023The purpose of this narrative review was to describe prevalence rates of nightmares and nightmare disorder in school-aged youth according to sample characteristics and... (Review)
Review
The purpose of this narrative review was to describe prevalence rates of nightmares and nightmare disorder in school-aged youth according to sample characteristics and methods used to assess nightmares. We searched PsychINFO, PubMed, and CINAHL databases to identify empirical peer-reviewed articles and grey literature published between 2001 and 2021. Sixty-nine studies from 23 countries were included. The prevalence of nightmares was between 1% and 11% in the past week and 25% to 35% in the past month in pediatric developmental samples and between 27% and 57% in the past week and 18%-22% in the past month in psychiatric samples. The prevalence of nightmare disorder was approximately between 3% and 6% in pediatric developmental samples and 10%-12% in psychiatric samples. Nightmare prevalence peaks between ages 10 and 14 then decreases with older age. Generally, prevalence was higher in girls than boys, and one study suggested gender divergence started around age 14. Children's self-reports were higher than parent reports, except in samples with comorbid psychiatric problems where there was more parent-child agreement. Inconsistencies in nightmare definitions and measurement were observed across the literature and indicate a need for standardized measurement of nightmares.
Topics: Humans; Dreams; Child; Prevalence; Adolescent; Female; Male
PubMed: 37651893
DOI: 10.1016/j.smrv.2023.101834 -
Frontiers in Public Health 2022Studies conducted on the practice of COVID-19 preventive methods across the world are highly inconsistent and inconclusive. Hence, this study intended to estimate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Studies conducted on the practice of COVID-19 preventive methods across the world are highly inconsistent and inconclusive. Hence, this study intended to estimate the pooled preventive practice and its determinants among the general population.
METHODS
This study was conducted using online databases (PubMed, HINARI, Scopus, EMBASE, Science Direct, and Cochrane library database), African Journals online, Google Scholar, open gray and online repository accessed studies. The quality of the included studies was assessed using Newcastle-Ottawa Quality Assessment Scale (NOS). STATA 14.0 software for analysis. The existence of heterogeneity between studies was checked using Cochran Q test and I2 test statistics and then, the presence of publication bias was detected using both funnel plot and Egger's test.
RESULTS
51 studies were included and the pooled level of practice toward the preventive measures of COVID-19 was 74.4% (95% CI: 70.2-78.6%, 2 = 99.7%, < 0.001] using a random effects model. Being female [OR = 1.97: 95% CI 1.75, 2.23; 2 = 0.0%, < 0.698], rural residence [OR = 0.53: 95% CI 0.44, 0.65; 2 = 73.5%, < 0.013], attending higher education level [OR = 1.47: 95% CI 1.18, 1.83; 2 = 75.4%, < 0.001], being employed [OR = 2.12: 95% CI 1.44, 3.12; 2 = 91.8%, < 0.001], age < 30 [OR = 0.73: 95% CI 0.60, 0.89; 2 = 73.9%, < 0.001], and knowledgeable [OR = 1.22: 95% CI 1.09, 1.36; 2 = 47.3%, < 0.077] were the independent predictors of adequate practice level.
CONCLUSIONS
nearly three-fourths of the general population has an adequate preventive practice level toward COVID-19. Thus, the global, regional, national, and local governments need to establish policies and strategies to address the identified factors.
Topics: Black People; COVID-19; Databases, Factual; Female; Humans; Local Government; Male; Policy
PubMed: 35784216
DOI: 10.3389/fpubh.2022.844692 -
Malaria Journal Nov 2022Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria.
METHODS
The protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger's and Begg's statistical tests.
RESULTS
Twelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria.
CONCLUSION
More than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission.
Topics: Child; Humans; Insecticides; Ethiopia; Malaria; Risk Factors; Prevalence
PubMed: 36384533
DOI: 10.1186/s12936-022-04370-9 -
The British Journal of Radiology Feb 2020The recent increase in publications on radiomic analysis as means to produce diagnostic and predictive biomarkers in head and neck cancers (HNCC) reveal complicated and...
Radiomic analysis for response assessment in advanced head and neck cancers, a distant dream or an inevitable reality? A systematic review of the current level of evidence.
OBJECTIVE
The recent increase in publications on radiomic analysis as means to produce diagnostic and predictive biomarkers in head and neck cancers (HNCC) reveal complicated and often conflicting results. The objective of this paper is to systematically review the published data, and evaluate the current level of evidence accumulated that would determine clinical application.
METHODS
Articles in the English language available on the Ovid-MEDLINE and Embase databases were used for the literature search. :Studies which evaluated the role of radiomics as a predictive or prognostic tool for response assessment in HNCC were included in this review.Study appraisal and synthesis methods: The authors set-out to perform a meta-analysis, however given the small number of studies retrieved that presented adequate data, combined with excessive methodological heterogeneity, we could only perform a structured descriptive systematic review summarizing the key findings. Independent extraction of articles was performed by two authors using predefined data fields and any disagreement was resolved by consensus.
RESULTS
Though most papers concluded that radiomics is an effective predictive and prognostic biomarker in the management of HNCC, significant heterogeneity exists in the study methodology and statistical modelling; thus precluding accurate mathematical comparison or the ability to make clear recommendations going forwards. Moreover, most studies have not been validated and the reproducibility of their results will be a challenge.
CONCLUSION
Until robust external validation studies on the reproducibility and accuracy of radiomic analysis methods on HNCC are carried out, the current level of evidence remains low, with the authors advising caution against hasty implementation of these tools in the multidisciplinary clinic.
ADVANCES IN KNOWLEDGE
This review is the first attempt to critically analyze the merits and demerits of currently published literature on tumour heterogeneity studies in HNCC, and identifies specific loop holes that need to be addressed by research groups, for a meaningful clinical translation of this potential biomarker.
Topics: Head and Neck Neoplasms; Humans; Magnetic Resonance Imaging; Positron Emission Tomography Computed Tomography; Prognosis; Tomography, X-Ray Computed
PubMed: 31682155
DOI: 10.1259/bjr.20190496 -
Varenicline for smoking cessation in people with schizophrenia: systematic review and meta-analysis.European Archives of Psychiatry and... Apr 2015We performed an updated meta-analysis of randomized double-blind placebo-controlled trials (RCTs) on the effects of varenicline adjuvant therapy for smoking cessation in... (Meta-Analysis)
Meta-Analysis Review
We performed an updated meta-analysis of randomized double-blind placebo-controlled trials (RCTs) on the effects of varenicline adjuvant therapy for smoking cessation in people with schizophrenia, on the basis of a previous meta-analysis (Tsoi in Cochrane Database Syst Rev 2:CD007253, 2013). We searched PubMed, the Cochrane Library databases, and PsycINFO up to August 1, 2014. RCTs comparing varenicline adjuvant therapy with placebo in schizophrenia were included. The risk ratio (RR), number needed to harm (NNH), and standardized mean differences with its 95% confidence interval (CI) were used. Seven studies (total n = 439), including 6 with only schizophrenia (total n = 352), 1 with both schizophrenia (n = 77) and bipolar disorder (n = 10), were included. Varenicline was not superior to placebo in smoking cessation (RR = 0.79, 95% CI 0.58-1.08, p = 0.14, 5 RCTs, n = 322). Varenicline failed to show its superiority to placebo for overall, positive, negative, and depressive symptoms. Moreover, there was no significant difference in the discontinuation rate due to all causes, clinical deterioration, or side effects between varenicline and placebo. Although varenicline caused less abnormal dreams/nightmares than placebo (RR = 0.47, 95% CI 0.22-0.99, p = 0.05, NNH = not significant, 4 RCTs, n = 288), it caused more nausea (RR = 1.79, 95% CI 1.20-2.67, p = 0.004, NNH = 6, p = 0.004, 6 RCTs, n = 417). We detected no significant difference in suicidal ideation and depression between varenicline and placebo. Our results suggest that although varenicline adjuvant therapy is well tolerated, varenicline is not superior to placebo for smoking cessation in people with schizophrenia. Because of the limited sample sizes of the available studies, future studies will require larger samples to ensure that these findings are generalizable.
Topics: Humans; Nicotinic Agonists; Schizophrenia; Smoking; Smoking Cessation; Varenicline
PubMed: 25283510
DOI: 10.1007/s00406-014-0551-3 -
Computational Intelligence and... 2022Cloud computing is a long-standing dream of computing as a utility, where users can store their data remotely in the cloud to enjoy on-demand services and high-quality... (Review)
Review
Cloud computing is a long-standing dream of computing as a utility, where users can store their data remotely in the cloud to enjoy on-demand services and high-quality applications from a shared pool of configurable computing resources. Thus, the privacy and security of data are of utmost importance to all of its users regardless of the nature of the data being stored. In cloud computing environments, it is especially critical because data is stored in various locations, even around the world, and users do not have any physical access to their sensitive data. Therefore, we need certain data protection techniques to protect the sensitive data that is outsourced over the cloud. In this paper, we conduct a systematic literature review (SLR) to illustrate all the data protection techniques that protect sensitive data outsourced over cloud storage. Therefore, the main objective of this research is to synthesize, classify, and identify important studies in the field of study. Accordingly, an evidence-based approach is used in this study. Preliminary results are based on answers to four research questions. Out of 493 research articles, 52 studies were selected. 52 papers use different data protection techniques, which can be divided into two main categories, namely noncryptographic techniques and cryptographic techniques. Noncryptographic techniques consist of data splitting, data anonymization, and steganographic techniques, whereas cryptographic techniques consist of encryption, searchable encryption, homomorphic encryption, and signcryption. In this work, we compare all of these techniques in terms of data protection accuracy, overhead, and operations on masked data. Finally, we discuss the future research challenges facing the implementation of these techniques.
Topics: Cloud Computing; Computer Security; Confidentiality; Delivery of Health Care; Privacy
PubMed: 35712069
DOI: 10.1155/2022/8303504 -
Sleep Medicine Reviews Apr 2019Suicide and self-harm behaviours represent public health concerns, and university students are a particularly high risk group. Identifying modifiable risk factors for...
Suicide and self-harm behaviours represent public health concerns, and university students are a particularly high risk group. Identifying modifiable risk factors for the development and maintenance of suicidal thoughts and behaviours is a research priority, as prevention is crucial. Research examining the relationship between poor sleep and self-harm/suicidality within university students is, for the first time, systematically evaluated, critically appraised, and synthesised. This literature consistently demonstrates that insomnia and nightmares are associated with elevated suicide risk of suicidal thoughts and behaviours within this subpopulation of young adults. However, as findings are predominantly derived from cross-sectional investigations, the directionality of this relationship is not yet clear. While research investigating the psychological processes driving these relationships is in its infancy, preliminary findings suggest that thwarted belongingness, socio-cognitive factors and emotional dysregulation could be partly responsible. Methodological limitations are highlighted and a research agenda suggesting the key directions for future research is proposed. Continued research in this area - employing longitudinal designs, and testing novel theoretically derived hypotheses - will be crucial to the development of suicide prevention and intervention efforts.
Topics: Depression; Dreams; Humans; Risk Factors; Self-Injurious Behavior; Sleep Initiation and Maintenance Disorders; Students; Suicide; Universities; Young Adult
PubMed: 30721844
DOI: 10.1016/j.smrv.2018.12.008