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Nutrients Oct 2023Flavonoids, known for their antioxidant properties, can prevent reactive oxygen species (ROS) and influence athletic performance through various physiological and... (Meta-Analysis)
Meta-Analysis Review
Flavonoids, known for their antioxidant properties, can prevent reactive oxygen species (ROS) and influence athletic performance through various physiological and metabolic mechanisms. However, there are conflicting results after summarizing and analyzing the relevant literature. Hence, it is warranted to evaluate the overall impact of flavonoids on athletic performance in healthy adults based on a comprehensive and systematic review and meta-analysis. After searching four databases for literature published since their respective establishments until February 2023 and conducting publication bias and quality assessments, a total of 22 studies were ultimately included. The names and doses of flavonoids, various outcome measurements, as well as types of training, were extracted from included studies. The athletic performance outcomes from the included studies were categorized into 'performance tests' and 'exercise tolerance,' depending on the type of training undertaken. Several statistical results, such as pooled effect size (ES), among others, were implemented by meta-analysis using the random effects model. The results of meta-analysis suggest that there is currently sufficient evidence (ES = -0.28; 95% confidence interval (CI): [-0.50, -0.07]; = 0.01 and ES = 0.23; 95% CI: [0.07, 0.39]; = 0.005) to support the notion that flavonoid supplementation enhanced athletic performance in performance tests and exercise tolerance. In addition, among the subgroups, nonsignificant results were observed for athletes ( = 0.28) and acute supplementation ( = 0.41) in performance tests, as well as athletes ( = 0.57) and acute supplementation ( = 0.44) in exercise tolerance. Meanwhile, significant results were found for non-athletes ( = 0.04) and long-term supplementation ( = 0.02) in performance tests, as well as non-athletes ( = 0.005) in performance tests and long-term supplementation ( = 0.006) in exercise tolerance. The nonsignificant results were likely due to the limitation in the number of related papers, sample sizes, optimal dosage, duration, type of flavonoids, and other factors. Therefore, future research should focus on further investigating these relationships with larger sample sizes, optimal dosage, duration, and type of flavonoids to provide more robust conclusions.
Topics: Humans; Adult; Flavonoids; Athletic Performance; Exercise Tolerance; Athletes; Dietary Supplements
PubMed: 37960199
DOI: 10.3390/nu15214547 -
Gynecological Endocrinology : the... Jun 2015The objective of this systematic review was to assesses whether the orally acting progestagen, dydrogesterone lowers the incidence of subsequent miscarriage in women... (Meta-Analysis)
Meta-Analysis Review
The objective of this systematic review was to assesses whether the orally acting progestagen, dydrogesterone lowers the incidence of subsequent miscarriage in women with recurrent miscarriage. A computerized search was performed in Medline, Embase and Ovid Medline for original reports with the product name "Duphaston" or "dydrogesterone" and limited to clinical human data. Thirteen reports of dydrogesterone treatment were identified. Two randomized trials and one non-randomized comparative trial were identified, including 509 women who fulfilled the criteria for meta-analysis. The number of subsequent miscarriages or continuing pregnancies per woman was compared in women receiving dydrogesterone compared to standard bed rest or placebo intervention. There was a 10.5% (29/275) miscarriage rate after dydrogesterone administration compared to 23.5% in control women (odds ratio for miscarriage 0.29 [confidence interval 0.13-0.65] and 13% absolute reduction in the miscarriage rate). The adverse and side effects were summarised in all 13 reports, and seemed to be minimal. Although all the predictive and confounding factors could not be controlled for, the results of this systematic review show a significant reduction of 29% in the odds for miscarriage when dydrogesterone is compared to standard care indicating a real treatment effect.
Topics: Abortion, Habitual; Adult; Dydrogesterone; Female; Humans; Progestins; Treatment Outcome
PubMed: 25765519
DOI: 10.3109/09513590.2015.1006618 -
Clinical Journal of the American... Sep 2022Gender-affirming hormone therapy modifies body composition and lean muscle mass in transgender persons. We sought to characterize the change in serum creatinine, other... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Gender-affirming hormone therapy modifies body composition and lean muscle mass in transgender persons. We sought to characterize the change in serum creatinine, other kidney function biomarkers, and GFR in transgender persons initiating masculinizing and feminizing gender-affirming hormone therapy.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
We searched PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov from inception to September 16, 2020 for randomized controlled trials, observational studies, and case series that evaluated the change in serum creatinine, other kidney function biomarkers, and GFR before and after the initiation of gender-affirming hormone therapy in adult transgender persons. Two reviewers independently screened and abstracted data, and disagreements were resolved by a third reviewer. A random effects meta-analysis was performed to determine the change in outcomes over follow-up of 3, 6, and 12 months.
RESULTS
Of the 4758 eligible studies, 26 met the inclusion criteria, including nine studies that recruited 488 transgender men and 593 women in which data were meta-analyzed. There was heterogeneity in study design, populations, gender-affirming hormone therapy routes, and dosing. At 12 months after initiating gender-affirming hormone therapy, serum creatinine increased by 0.15 mg/dl (95% confidence interval, 0.00 to 0.29) in 370 transgender men and decreased by -0.05 mg/dl (95% confidence interval, -0.16 to 0.05) in 361 transgender women. No study reported the effect of gender-affirming hormone therapy on albuminuria, proteinuria, cystatin C, or measured GFR.
CONCLUSIONS
Gender-affirming hormone therapy increases serum creatinine in transgender men and does not affect serum creatinine in transgender women. The effect on gender-affirming hormone therapy on other kidney function biomarkers and measured GFR is unknown.
CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER
Change in Kidney Function Biomarkers in Transgender Persons on Gender Affirmation Hormone Therapy-A Systematic Review and Meta-Analysis, CRD42020214248.
Topics: Male; Adult; Humans; Female; Creatinine; Transsexualism; Biomarkers; Hormones; Kidney
PubMed: 35973728
DOI: 10.2215/CJN.01890222 -
The Journal of Pediatrics Apr 2018To conduct a systematic review of the evidence concerning whether and how adolescents search for online health information and the extent to which they appraise the...
OBJECTIVE
To conduct a systematic review of the evidence concerning whether and how adolescents search for online health information and the extent to which they appraise the credibility of information they retrieve.
STUDY DESIGN
A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, ERIC) was performed. Reference lists of included papers were searched manually for additional articles. Included were studies on whether and how adolescents searched for and appraised online health information, where adolescent participants were aged 13-18 years. Thematic analysis was used to synthesize the findings.
RESULTS
Thirty-four studies met the inclusion criteria. In line with the research questions, 2 key concepts were identified within the papers: whether and how adolescents search for online health information, and the extent to which adolescents appraise online health information. Four themes were identified regarding whether and how adolescents search for online health information: use of search engines, difficulties in selecting appropriate search strings, barriers to searching, and absence of searching. Four themes emerged concerning the extent to which adolescents appraise the credibility of online health information: evaluation based on Web site name and reputation, evaluation based on first impression of Web site, evaluation of Web site content, and absence of a sophisticated appraisal strategy.
CONCLUSIONS
Adolescents are aware of the varying quality of online health information. Strategies used by individuals for searching and appraising online health information differ in their sophistication. It is important to develop resources to enhance search and appraisal skills and to collaborate with adolescents to ensure that such resources are appropriate for them.
Topics: Adolescent; Adolescent Behavior; Consumer Health Information; Humans; Internet; Judgment; Psychology, Adolescent
PubMed: 29398062
DOI: 10.1016/j.jpeds.2017.11.031 -
Journal of Psychopharmacology (Oxford,... Apr 2017Schizotypal personality disorder (SPD) is characterised by thought disorders, experiences of illusions, obsessive ruminations, bizarre or eccentric behaviour, cognitive... (Review)
Review
Schizotypal personality disorder (SPD) is characterised by thought disorders, experiences of illusions, obsessive ruminations, bizarre or eccentric behaviour, cognitive problems and deficits in social functioning - symptoms that SPD shares with schizophrenia. Efforts have been undertaken to investigate the relationship between these conditions regarding genetics, pathophysiology, and phenomenology. However, treatment of SPD with antipsychotics has received less scientific attention. Embase and PubMed databases were searched using all known generic names of antipsychotics as search terms in combination with the following diagnostic terms: latent schizophrenia, schizotypal disorder, latent type schizophrenia, or SPD. Studies were categorised according to evidence level on the basis of their methodology from A, being the best, to E, being the worst. Five hundred and nine studies were retrieved and scrutinised. Sixteen studies, from the period 1972 to 2012, on antipsychotic treatment of SPD were extracted. Four studies were categorised as evidence level A, two as level B, six as level C and three as level D, with one study level E. Only four randomised, double-blind, placebo-controlled trials, on subjects with well-defined diagnoses, exists. Only amisulpride, risperidone and thiothixene have been studied according to evidence level A. This result warrants further high quality studies of the effects of antipsychotic treatment of SPD.
Topics: Antipsychotic Agents; Double-Blind Method; Humans; Randomized Controlled Trials as Topic; Schizotypal Personality Disorder
PubMed: 28347257
DOI: 10.1177/0269881117695879 -
Multiple Sclerosis and Related Disorders May 2020There is an unapprehended diversity in the epidemiology of multiple sclerosis (MS) in different geographical regions. In this study, for the first time, we... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There is an unapprehended diversity in the epidemiology of multiple sclerosis (MS) in different geographical regions. In this study, for the first time, we systematically review the studies estimating the incidence and/or prevalence of MS in the Persian Gulf area. The goal is to obtain the overall incidence and prevalence of MS and elucidate the reasons for the geographical variation.
METHODS
A comprehensive literature search was carried out using MEDLINE and EMBASE through articles published between January 1985 and December 2018 on MS epidemiology in Persian Gulf countries including Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Search terms included 'Multiple sclerosis', 'Incidence', 'Prevalence', 'Epidemiology', 'Persian Gulf', 'Arabian Gulf' and name of each country. Only full-text articles published in English were included. All abstracts were considered and two trained reviewers evaluated the study quality using an assessment tool specifically designed for this study.
RESULTS
39 studies met the inclusion criteria. The mean age at disease onset varied in each country and the pooled mean age of onset was 23.11. The overall pooled MS incidence was 5.03/100,000 person-years (95% CI: 0.04 - 10.02). Prevalence was 39.31/100,000 (95% CI: 29.12 - 49.50) and the result of the meta-regression method showed that prevalence increased by 2.3% per year between 1985-2018 (p = 0.04). Quality scores ranged from 4/7 to 8/8.
CONCLUSION
The prevalence and incidence of MS in the Persian Gulf region has gone through significant changes during the past decades. This study highlights the need for future studies of MS prevalence and incidence, which will further elucidate the possible etiologies leading to periodical and geographical variations in MS incidence.
Topics: Humans; Incidence; Indian Ocean; Middle East; Multiple Sclerosis; Prevalence
PubMed: 31991397
DOI: 10.1016/j.msard.2020.101959 -
Journal of Geriatric Oncology Jun 2023The number of older patients with cancer is expected to continue to increase owing to the aging population. Recently, the usefulness of geriatric assessment (GA)... (Review)
Review
Significance of the comprehensive geriatric assessment in the administration of chemotherapy to older adults with cancer: Recommendations by the Japanese Geriatric Oncology Guideline Committee.
INTRODUCTION
The number of older patients with cancer is expected to continue to increase owing to the aging population. Recently, the usefulness of geriatric assessment (GA) conducted by multiple staff members from different medical backgrounds has been reported; however, a consensus on the effectiveness of GA has not yet been achieved.
MATERIALS AND METHODS
We, as the Japanese Geriatric Oncology Guideline Committee for elderly patients with cancer, conducted a literature search of randomized controlled trials published before August 2021 that used GA or comprehensive GA (CGA) as an intervention for patients with cancer undergoing chemotherapy. As the key outcomes for answering the clinical question, we focused on survival benefit, adverse events, and quality of life (QOL). After a systematic review of these studies, the expert panel member developed recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
RESULTS
For older patients with cancer, GA or CGA is suggested during or before chemotherapy (weakly recommended). Chemotherapy-induced adverse events were significantly reduced by GA/CGA interventions without any adverse effects on survival. Health-related QOL tended to improve with the GA/CGA interventions.
DISCUSSION
Although, in our opinion, GA/CGA does require time and resources, it poses no harm patients. Therefore, we suggest expanding the human resources and educating skills of medical providers for clinical implementation of GA/CGA.
Topics: Aged; Humans; Aging; East Asian People; Geriatric Assessment; Neoplasms; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 37062639
DOI: 10.1016/j.jgo.2023.101485 -
Heliyon May 2023The prediabetes population is large and easily overlooked because of the lack of obvious symptoms, which can progress to diabetes. Early screening and targeted... (Review)
Review
BACKGROUNDS
The prediabetes population is large and easily overlooked because of the lack of obvious symptoms, which can progress to diabetes. Early screening and targeted interventions can substantially reduce the rate of conversion of prediabetes to diabetes. Therefore, this study systematically reviewed prediabetes risk prediction models, performed a summary and quality evaluation, and aimed to recommend the optimal model.
METHODS
We systematically searched five databases (Cochrane, PubMed, Embase, Web Of Science, and CNKI) for published literature related to prediabetes risk prediction models and excluded preprints, duplicate publications, reviews, editorials, and other studies, with a search time frame of March 01, 2023. Data were categorized and summarized using a standardized data extraction form that extracted data including author; publication date; study design; country; demographic characteristics; assessment tool name; sample size; study type; and model-related indicators. The PROBAST tool was used to assess the risk of bias profile of included studies.
FINDINGS
14 studies with a total of 15 models were eventually included in the systematic review. We found that the most common predictors of models were age, family history of diabetes, gender, history of hypertension, and BMI. Most of the studies (83.3%) had a high risk of bias, mainly related to under-reporting of outcome information and poor methodological design during the development and validation of models. Due to the low quality of included studies, the evidence for predictive validity of the available models is unclear.
INTERPRETATION
We should pay attention to the early screening of prediabetes patients and give timely pharmacological and lifestyle interventions. The predictive performance of the existing model is not satisfactory, and the model building process can be standardized and external validation can be added to improve the accuracy of the model in the future.
PubMed: 37215820
DOI: 10.1016/j.heliyon.2023.e15529 -
Journal of Research in Health Sciences Oct 2021Accuracy, speed, efficiency, and applicability of activities in the workplace are among the most important effective factors on people's productivity, which is in turn...
BACKGROUND
Accuracy, speed, efficiency, and applicability of activities in the workplace are among the most important effective factors on people's productivity, which is in turn affected by environmental factors, such as light. Therefore, the present research aimed to review the studies performed about the effects of light on attention and reaction time.
METHODS
This review study systematically searched articles from 2000-2019 in databases of Google Scholar, ISC, SID, Magiran, Web of Science, Science Direct, PubMed, and Scopus using keywords of light, lighting, attention, and reaction time. The titles and abstracts of articles containing relevant results over the past 20 years were extracted. Thereafter, they were categorized and analyzed according to the title, author name, publication year, study method, study type, and evaluation results.
RESULTS
Based on the results, the light with shorter wavelengths, higher intensity, and higher color temperature led to suppressed melatonin, higher consciousness, less somnolence, increased attention, and faster reaction time. Simultaneous exposure to harmful levels of environmental factors affects cognitive and physiological parameters, acting independently with a separate mechanism or synergistically with a similar mechanism. The best light in the regulation of psychological, biological, and cognitive processes is bright daylight in the morning with a short wavelength, high intensity, and more lasting effects.
CONCLUSION
As evidenced by the obtained results, light is a powerful modulator of non-visual performance in cognitive tasks. The wavelength, color temperature, and light intensity modulate brain responses to cognitive tasks, including attention and reaction time. Therefore, these parameters, along with personal and environmental factors, should be considered in designing and using light.
Topics: Humans; Reaction Time; Attention; Melatonin; Cognition; Workplace
PubMed: 36511225
DOI: 10.34172/jrhs.2021.66 -
The Cochrane Database of Systematic... 2002Synthetic anxiolytic drugs are effective for anxiety, but are often burdened with adverse events. Constraints on resources and time often render treatments such as... (Review)
Review
BACKGROUND
Synthetic anxiolytic drugs are effective for anxiety, but are often burdened with adverse events. Constraints on resources and time often render treatments such as psychological interventions impracticable. Thus, an effective and safe oral medication would be of considerable interest and a welcome addition to the therapeutic repertoire.
OBJECTIVES
To systematically review the evidence from rigorous clinical trials assessing the efficacy and safety of kava extract versus placebo for the treatment of anxiety.
SEARCH STRATEGY
Publications describing randomised controlled trials (RCTs) of kava extract for anxiety were sought through Medline, Embase, Biosis, AMED, CISCOM and the Cochrane Library (all from their respective inception to June 1998). The search terms used were kava, kawa, kavain, Piper methysticum and Rauschpfeffer (German common name for Piper methysticum). Manufacturers of kava preparations and experts on the subject were contacted and asked to contribute published and unpublished material. In addition, our own files were searched and the bibliographies of all of the studies identified were scanned for further trials. There were no restrictions on the language of publication.
SELECTION CRITERIA
Randomized, double-blind trials of oral kava extract mono-preparations for the treatment of anxiety were included. Trials comparing kava with placebo were included. Trials assessing kava as one of several active components in a combination preparation or as a part of a combination treatment were excluded.
DATA COLLECTION AND ANALYSIS
All publications were blinded prior to assessment by a person not involved in the study. Data were extracted systematically. Methodological quality of all trials was evaluated using the standard scoring system developed by Jadad and colleagues. The screening of studies, selection, data extraction and the assessment of methodological quality were performed independently by the two reviewers. Disagreements in the evaluation of individual trials were resolved through discussion.
MAIN RESULTS
Seven trials met the inclusion criteria. All of the reviewed trials suggest superiority of kava extract over placebo. The meta-analysis of three studies using the Hamilton Anxiety Score as a common outcome measure suggests a significant differential treatment effect in favour of kava extract (weighted mean difference: 9.7, 95% confidence interval: 3.5 - 15.8). Adverse events as reported in the reviewed trials were mild, transient and infrequent.
REVIEWER'S CONCLUSIONS
The evidence presented implies that kava extract is superior compared with placebo and relatively safe as a treatment option for anxiety. These findings warrant further and more rigorous investigations into the efficacy and safety of kava extract.
Topics: Anxiety; Humans; Kava; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic
PubMed: 12076477
DOI: 10.1002/14651858.CD003383