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Journal of Personalized Medicine Oct 2022Predicting tooth loss is a persistent clinical challenge in the 21st century. While an emerging field in dentistry, computational solutions that employ machine learning... (Review)
Review
Predicting tooth loss is a persistent clinical challenge in the 21st century. While an emerging field in dentistry, computational solutions that employ machine learning are promising for enhancing clinical outcomes, including the chairside prognostication of tooth loss. We aimed to evaluate the risk of bias in prognostic prediction models of tooth loss that use machine learning. To do this, literature was searched in two electronic databases (MEDLINE via PubMed; Google Scholar) for studies that reported the accuracy or area under the curve (AUC) of prediction models. AUC measures the entire two-dimensional area underneath the entire receiver operating characteristic (ROC) curves. AUC provides an aggregate measure of performance across all possible classification thresholds. Although both development and validation were included in this review, studies that did not assess the accuracy or validation of boosting models (AdaBoosting, Gradient-boosting decision tree, XGBoost, LightGBM, CatBoost) were excluded. Five studies met criteria for inclusion and revealed high accuracy; however, models displayed a high risk of bias. Importantly, patient-level assessments combined with socioeconomic predictors performed better than clinical predictors alone. While there are current limitations, machine-learning-assisted models for tooth loss may enhance prognostication accuracy in combination with clinical and patient metadata in the future.
PubMed: 36294820
DOI: 10.3390/jpm12101682 -
Plants (Basel, Switzerland) Apr 2021The early life-history stages of plants, such as germination and seedling establishment, depend on favorable environmental conditions. Changes in the environment at high... (Review)
Review
The early life-history stages of plants, such as germination and seedling establishment, depend on favorable environmental conditions. Changes in the environment at high altitude and high latitude regions, as a consequence of climate change, will significantly affect these life stages and may have profound effects on species recruitment and survival. Here, we synthesize the current knowledge of climate change effects on treeline, tundra, and alpine plants' early life-history stages. We systematically searched the available literature on this subject up until February 2020 and recovered 835 potential articles that matched our search terms. From these, we found 39 studies that matched our selection criteria. We characterized the studies within our review and performed a qualitative and quantitative analysis of the extracted meta-data regarding the climatic effects likely to change in these regions, including projected warming, early snowmelt, changes in precipitation, nutrient availability and their effects on seed maturation, seed dormancy, germination, seedling emergence and seedling establishment. Although the studies showed high variability in their methods and studied species, the qualitative and quantitative analysis of the extracted data allowed us to detect existing patterns and knowledge gaps. For example, warming temperatures seemed to favor all studied life stages except seedling establishment, a decrease in precipitation had a strong negative effect on seed stages and, surprisingly, early snowmelt had a neutral effect on seed dormancy and germination but a positive effect on seedling establishment. For some of the studied life stages, data within the literature were too limited to identify a precise effect. There is still a need for investigations that increase our understanding of the climate change impacts on high altitude and high latitude plants' reproductive processes, as this is crucial for plant conservation and evidence-based management of these environments. Finally, we make recommendations for further research based on the identified knowledge gaps.
PubMed: 33919792
DOI: 10.3390/plants10040768 -
Scandinavian Journal of Surgery : SJS :... 2022Patients presenting with synchronous colorectal liver metastases are increasingly being considered for a curative treatment, and the liver-first approach is gaining... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patients presenting with synchronous colorectal liver metastases are increasingly being considered for a curative treatment, and the liver-first approach is gaining popularity in this context. However, little is known about the completion rates of the liver-first approach and its effects on survival.
METHODS
A systematic review and meta-analysis of liver-first strategy for colorectal liver metastasis. The primary outcome was an assessment of the completion rates of the liver-first approach. Secondary outcomes included overall survival, causes of non-completion, and clinicopathologic data.
RESULTS
Seventeen articles were amenable for inclusion and the total study population was 1041. The median completion rate for the total population was 80% (range 20-100). The median overall survival for the completion and non-completion groups was 45 (range 12-69) months and 13 (range 10.5-25) months, respectively. Metadata showed a significant survival benefit for the completion group, with a univariate hazard ratio of 12.0 (95% confidence interval, range 5.7-24.4). The major cause of non-completion (76%) was liver disease progression before resection of the primary tumor. Pearson tests showed significant negative correlation between median number of lesions and median size of the largest metastasis and completion rate.
CONCLUSIONS
The liver-first approach offers a complete resection to most patients enrolled, with an overall survival benefit when completion can be assured. One-fifth fails to return to intended oncologic therapy and the major cause is interim metastatic progression, most often in the liver. Risk of non-completion is related to a higher number of lesions and large metastases. The majority of studies stem from primary rectal cancers, which may influence on the return to intended oncologic therapy as well. 170459.
Topics: Abdomen; Colorectal Neoplasms; Hepatectomy; Humans; Liver Neoplasms; Retrospective Studies; Treatment Outcome
PubMed: 34605325
DOI: 10.1177/14574969211030131 -
Journal of Neurosurgery. Spine Apr 2022Lumbar stenosis treatment has evolved with the introduction of minimally invasive surgery (MIS) techniques. Endoscopic methods take the concepts applied to MIS a step... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Lumbar stenosis treatment has evolved with the introduction of minimally invasive surgery (MIS) techniques. Endoscopic methods take the concepts applied to MIS a step further, with multiple studies showing that endoscopic techniques have outcomes that are similar to those of more traditional approaches. The aim of this study was to perform an updated meta-analysis and systematic review of studies comparing the outcomes between endoscopic (uni- and biportal) and microscopic techniques for the treatment of lumbar stenosis.
METHODS
Following PRISMA guidelines, a systematic search was performed using the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Ovid Embase, and PubMed databases from their dates of inception to December 14, 2020. All identified articles were then systematically screened against the following inclusion criteria: 1) studies comparing endoscopic (either uniportal or biportal) with minimally invasive approaches, 2) patient age ≥ 18 years, and 3) diagnosis of lumbar spinal stenosis. Bias was assessed using quality assessment criteria and funnel plots. Meta-analysis using a random-effects model was used to synthesize the metadata.
RESULTS
From a total of 470 studies, 14 underwent full-text assessment. Of these 14 studies, 13 comparative studies were included for quantitative analysis, totaling 1406 procedures satisfying all criteria for selection. Regarding postoperative back pain, 9 studies showed that endoscopic methods resulted in significantly lower pain scores compared with MIS (mean difference [MD] -1.0, 95% CI -1.6 to -0.4, p < 0.01). The length of stay data were reported by 7 studies, with endoscopic methods associated with a significantly shorter length of stay versus the MIS technique (MD -2.1 days, 95% CI -2.7 to -1.4, p < 0.01). There was no significant difference with respect to leg visual analog scale scores, Oswestry Disability Index scores, blood loss, surgical time, and complications, and there were not any significant quality or bias concerns.
CONCLUSIONS
Both endoscopic and MIS techniques are safe and effective methods for treating patients with symptomatic lumbar stenosis. Patients who undergo endoscopic surgery seem to report less postoperative low-back pain and significantly reduced hospital stay with a trend toward less perioperative blood loss. Future large prospective randomized trials are needed to confirm the findings in this study.
Topics: Adolescent; Decompression, Surgical; Humans; Lumbar Vertebrae; Minimally Invasive Surgical Procedures; Prospective Studies; Spinal Fusion; Spinal Stenosis; Treatment Outcome
PubMed: 34767533
DOI: 10.3171/2021.8.SPINE21890 -
Virulence Dec 2021is an emerging zoonotic pathogen. Over 100 putative virulence factors have been described, but it is unclear to what extent these virulence factors could contribute to... (Meta-Analysis)
Meta-Analysis
is an emerging zoonotic pathogen. Over 100 putative virulence factors have been described, but it is unclear to what extent these virulence factors could contribute to zoonotic potential of . We identified all virulence factors studied in experimental models of human origin in a systematic review and assessed their contribution to zoonotic potential in a subsequent genomic meta-analysis. PubMed and Scopus were searched for English-language articles that studied virulence published until 31 March 2021. Articles that analyzed a virulence factor by knockout mutation, purified protein, and/or recombinant protein in a model of human origin, were included. Data on virulence factor, strain characteristics, used human models and experimental outcomes were extracted. All publicly available genomes with available metadata on host, disease status and country of origin, were included in a genomic meta-analysis. We calculated the ratio of the prevalence of each virulence factor in human and pig isolates. We included 130 articles and 1703 genomes in the analysis. We identified 53 putative virulence factors that were encoded by genes which are part of the core genome and 26 factors that were at least twice as prevalent in human isolates as in pig isolates. Hhly3 and NisK/R were particularly enriched in human isolates, after stratification by genetic lineage and country of isolation. This systematic review and genomic meta-analysis have identified virulence factors that are likely to contribute to the zoonotic potential of .
Topics: Animals; Genomics; Streptococcal Infections; Streptococcus suis; Swine; Swine Diseases; Virulence; Virulence Factors
PubMed: 34666617
DOI: 10.1080/21505594.2021.1985760 -
PloS One 2023The use of cannabis for medicinal purposes has increased globally over the past decade since patient access to medicinal cannabis has been legislated across...
The use of cannabis for medicinal purposes has increased globally over the past decade since patient access to medicinal cannabis has been legislated across jurisdictions in Europe, the United Kingdom, the United States, Canada, and Australia. Yet, evidence relating to the effect of medical cannabis on the management of symptoms for a suite of conditions is only just emerging. Although there is considerable engagement from many stakeholders to add to the evidence base through randomized controlled trials, many gaps in the literature remain. Data from real-world and patient reported sources can provide opportunities to address this evidence deficit. This real-world data can be captured from a variety of sources such as found in routinely collected health care and health services records that include but are not limited to patient generated data from medical, administrative and claims data, patient reported data from surveys, wearable trackers, patient registries, and social media. In this systematic scoping review, we seek to understand the utility of online user generated text into the use of cannabis as a medicine. In this scoping review, we aimed to systematically search published literature to examine the extent, range, and nature of research that utilises user-generated content to examine to cannabis as a medicine. The objective of this methodological review is to synthesise primary research that uses social media discourse and internet search engine queries to answer the following questions: (i) In what way, is online user-generated text used as a data source in the investigation of cannabis as a medicine? (ii) What are the aims, data sources, methods, and research themes of studies using online user-generated text to discuss the medicinal use of cannabis. We conducted a manual search of primary research studies which used online user-generated text as a data source using the MEDLINE, Embase, Web of Science, and Scopus databases in October 2022. Editorials, letters, commentaries, surveys, protocols, and book chapters were excluded from the review. Forty-two studies were included in this review, twenty-two studies used manually labelled data, four studies used existing meta-data (Google trends/geo-location data), two studies used data that was manually coded using crowdsourcing services, and two used automated coding supplied by a social media analytics company, fifteen used computational methods for annotating data. Our review reflects a growing interest in the use of user-generated content for public health surveillance. It also demonstrates the need for the development of a systematic approach for evaluating the quality of social media studies and highlights the utility of automatic processing and computational methods (machine learning technologies) for large social media datasets. This systematic scoping review has shown that user-generated content as a data source for studying cannabis as a medicine provides another means to understand how cannabis is perceived and used in the community. As such, it provides another potential 'tool' with which to engage in pharmacovigilance of, not only cannabis as a medicine, but also other novel therapeutics as they enter the market.
Topics: Humans; Social Media; Cannabis; Medicine; Delivery of Health Care; United Kingdom
PubMed: 36662832
DOI: 10.1371/journal.pone.0269143 -
PeerJ. Computer Science 2022Microservices is an emerging paradigm for developing distributed systems. With their widespread adoption, more and more work investigated the relation between...
Microservices is an emerging paradigm for developing distributed systems. With their widespread adoption, more and more work investigated the relation between microservices and security. Alas, the literature on this subject does not form a well-defined : it is spread over many venues and composed of contributions mainly addressing specific scenarios or needs. In this work, we conduct a systematic review of the field, gathering 290 relevant publications-at the time of writing, the largest curated dataset on the topic. We analyse our dataset along two lines: (a) quantitatively, through publication metadata, which allows us to chart publication outlets, communities, approaches, and tackled issues; (b) qualitatively, through 20 research questions used to provide an aggregated overview of the literature and to spot gaps left open. We summarise our analyses in the conclusion in the form of a call for action to address the main open challenges.
PubMed: 35111904
DOI: 10.7717/peerj-cs.779 -
Efficacy of combined antioxidant therapy in male subfertility-A systematic review and meta-analysis.Cellular and Molecular Biology... Jan 2022Antioxidant therapy is a potentially promising approach to improve clinical outcomes for couples undergoing assisted reproduction techniques long-term. The review aims... (Meta-Analysis)
Meta-Analysis
Antioxidant therapy is a potentially promising approach to improve clinical outcomes for couples undergoing assisted reproduction techniques long-term. The review aims to (a) collate evidence for the effectiveness of combined oral antioxidant supplementation, including a head-to-head comparison in the treatment of male subfertility, and (b) investigate whether other intervention features, including duration, specific combinations, or dosage affect clinical outcomes in this population. Randomized controlled trials (RCTs) that examined the effectiveness of combined antioxidants on male subfertility, electronic databases including PubMed, Embase, CINAHL, PSYCHINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. We also searched for unpublished data and references of identified articles. Two reviewers screened eligible studies according to pre-defined criteria and relevant data extracted. The Jadad scale assessed the quality of studies. The study used RevMan version 5.4.1 Meta-analysis software to analyze the effect of combination antioxidants for each outcome measure. Metadata was presented as relative risks for dichotomous outcomes and as standardized mean differences (or mean differences) for continuous outcomes. The systematic review and meta-analysis aimed to report available evidence of whether combination antioxidant is effective and safe in sub-fertile men undergoing assisted reproductive techniques. Also, this review highlighted whether any specific oral antioxidant combinations, dosage, or duration of therapy have a major influence on the clinical outcomes.
Topics: Antioxidants; Female; Humans; Infertility, Male; Live Birth; Male; Pregnancy; Pregnancy Rate
PubMed: 35809282
DOI: 10.14715/cmb/2021.67.4.27 -
International Journal of Medical... Sep 2019Passive data refers to data generated without the active participation of the subject. This includes data from global positioning systems and accelerometers or metadata...
INTRODUCTION
Passive data refers to data generated without the active participation of the subject. This includes data from global positioning systems and accelerometers or metadata on phone call and text activity. Although the potential healthcare applications are far-reaching, passive data raises numerous ethical challenges.
MATERIALS AND METHODS
We performed a systematic review to identify all ethical concerns, normative standpoints, and underlying arguments related to the use of passive data in healthcare.
RESULTS
Among the various challenges discussed in the ethical literature, informational privacy, informed consent, and data security were the primary focus of the current debate. Other topics of discussion were the evaluation and regulation of products, equity in access, vulnerable patient groups, ownership, and secondary use.
CONCLUSION
No clear ethical framework has been established that stimulates passive data-driven innovation while protecting patient integrity. The consensus in the ethical literature, as well as the parallels with similar concerns and solutions in other fields, can lay a foundation for the construction of an ethical framework. The future debate should focus on conflicts between two or more ethical, technical, or clinical values to ensure a safe and effective implementation of passive data in healthcare.
Topics: Consensus; Data Collection; Delivery of Health Care; Informed Consent; Ownership; Privacy
PubMed: 31445262
DOI: 10.1016/j.ijmedinf.2019.06.015 -
Environmental Microbiology Dec 2021Risk assessment is critical for identifying target concentrations of antibiotic resistant pathogens necessary for mitigating potential harmful exposures associated with... (Review)
Review
Risk assessment is critical for identifying target concentrations of antibiotic resistant pathogens necessary for mitigating potential harmful exposures associated with water reuse. However, there is currently limited available data characterizing the concentrations of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in recycled water to support robust efforts at risk assessment. The objective of this systematic review was to identify and synthesize the existing literature documenting the presence and abundance of ARB and ARGs in recycled water. In addition, this review identifies best practices and explores monitoring targets for studying ARB and ARGs in recycled water to guide future work and identifies key research needs aimed at better supporting quantitative microbial risk assessment focused on recycled water and antibiotic resistance. Future efforts to collect data about ARB and ARG prevalence in recycled water should report concentration data per unit volume. Sample metadata should also be provided, including a description of treatment approach, a description of planned water uses (e.g., potable, irrigation), methods for conveyance to the point of use, and available physicochemical water quality data. Additional research is needed aimed at identifying recommended ARB and ARG monitoring targets and for developing approaches to incorporate metagenomic data into risk assessment.
Topics: Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Anti-Bacterial Agents; Genes, Bacterial; Risk Assessment; Wastewater
PubMed: 34632683
DOI: 10.1111/1462-2920.15804