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European Child & Adolescent Psychiatry Jun 2024The use of antidepressants has been on the rise among adolescents and young adults, populations also increasingly at risk for type 2 diabetes. However, the relationship...
BACKGROUND
The use of antidepressants has been on the rise among adolescents and young adults, populations also increasingly at risk for type 2 diabetes. However, the relationship between antidepressant uses and diabetes incidence in these age groups remains poorly understood.
METHODS
Adhering to PRISMA guidelines and the Cochrane Handbook, we conducted a comprehensive search in PubMed, Scopus, Embase, and Web of Science up to 21 February 2024, registering our protocol on PROSPERO (CRD42024516272).
RESULTS
Six studies, ranging from 16, 470 to 1, 582, 914 participants and spanning 2010 to 2023 across North America, Europe, and Asia, were included. The meta-analysis revealed a significant association between antidepressant use and diabetes onset, with 10 cases per 1, 000 observations (p < 0.01; I = 100%). Adolescents using high doses of antidepressants showed a 62% increased risk of developing diabetes compared to non-users or those on low doses (Risk ratio = 1.67; 95% CI 1.19-2.35; I = 87%; p < 0.01). The overall quality of the studies was high, with an average Newcastle-Ottawa Scale score of 7.66. Sensitivity analysis highlighted the robustness of these findings, except when removing specific studies, indicating potential sources of heterogeneity.
CONCLUSION
Antidepressant use in adolescents is associated with a significantly increased risk of diabetes onset, particularly at higher doses. This finding underscores the necessity for vigilant monitoring of glucose levels in this population and warrants further investigation into the underlying mechanisms and long-term outcomes.
PubMed: 38914830
DOI: 10.1007/s00787-024-02502-x -
JAMA Pediatrics Jun 2024In response to widespread concerns about social media's influence on adolescent mental health, most research has studied adolescents from the general population,...
IMPORTANCE
In response to widespread concerns about social media's influence on adolescent mental health, most research has studied adolescents from the general population, overlooking clinical groups.
OBJECTIVE
To synthesize, quantify, and compare evidence on the association between social media use and internalizing symptoms in adolescent clinical and community samples.
DATA SOURCES
Peer-reviewed publications from MEDLINE, Web of Science, PsycInfo, and Scopus (initially reviewed in May 2022 and updated in October 2023) and preprints from Europe PubMed Central (February 2023) published in English between 2007 and 2023.
STUDY SELECTION
Two blinded reviewers initially identified 14 211 cross-sectional and longitudinal studies quantifying the association between social media use and internalizing symptoms, excluding experimental studies and randomized clinical trials.
DATA EXTRACTION AND SYNTHESIS
PRISMA and MOOSE guidelines were followed, pooling data using a random-effects model and robust variance estimation. The quality of evidence was assessed using the Quality of Survey Studies in Psychology Checklist.
MAIN OUTCOMES AND MEASURES
Articles were included if they reported at least 1 quantitative measure of social media use (time spent, active vs passive use, activity, content, user perception, and other) and internalizing symptoms (anxiety, depression, or both).
RESULTS
The 143 studies reviewed included 1 094 890 adolescents and 886 effect sizes, 11% of which examined clinical samples. In these samples, a positive and significant meta-correlation was found between social media use and internalizing symptoms, both for time spent (n = 2893; r, 0.08; 95% CI, 0.01 to 0.15; P = .03; I2, 57.83) and user engagement (n = 859; r, 0.12; 95% CI, 0.09 to 0.15; P = .002; I2, 82.67). These associations mirrored those in community samples.
CONCLUSIONS AND RELEVANCE
The findings in this study highlight a lack of research on clinical populations, a critical gap considering public concerns about the increase in adolescent mental health symptoms at clinical levels. This paucity of evidence not only restricts the generalizability of existing research but also hinders our ability to evaluate and compare the link between social media use and mental health in clinical vs nonclinical populations.
PubMed: 38913335
DOI: 10.1001/jamapediatrics.2024.2078 -
Journal of Breast Imaging Jun 2024High mammographic density increases breast cancer risk and reduces mammographic sensitivity. We reviewed evidence on accuracy of supplemental MRI for women with dense...
BACKGROUND
High mammographic density increases breast cancer risk and reduces mammographic sensitivity. We reviewed evidence on accuracy of supplemental MRI for women with dense breasts at average or increased risk.
METHODS
PubMed and Embase were searched 1995-2022. Articles were included if women received breast MRI following 2D or tomosynthesis mammography. Risk of bias was assessed using QUADAS-2. Analysis used independent studies from the articles. Fixed-effect meta-analytic summaries were estimated for predefined groups (PROSPERO: 230277).
RESULTS
Eighteen primary research articles (24 studies) were identified in women aged 19-87 years. Breast density was heterogeneously or extremely dense (BI-RADS C/D) in 15/18 articles and extremely dense (BI-RADS D) in 3/18 articles. Twelve of 18 articles reported on increased-risk populations. Following 21 440 negative mammographic examinations, 288/320 cancers were detected by MRI. Substantial variation was observed between studies in MRI cancer detection rate, partly associated with prevalent vs incident MRI exams (prevalent: 16.6/1000 exams, 12 studies; incident: 6.8/1000 exams, 7 studies). MRI had high sensitivity for mammographically occult cancer (20 studies with at least 1-year follow-up). In 5/18 articles with sufficient data to estimate relative MRI detection rate, approximately 2 in 3 cancers were detected by MRI (66.3%, 95% CI, 56.3%-75.5%) but not mammography. Positive predictive value was higher for more recent studies. Risk of bias was low in most studies.
CONCLUSION
Supplemental breast MRI following negative mammography in women with dense breasts has breast cancer detection rates of ~16.6/1000 at prevalent and ~6.8/1000 at incident MRI exams, considering both high and average risk settings.
PubMed: 38912622
DOI: 10.1093/jbi/wbae019 -
Perspectives of the ASHA Special... Jun 2024One manifestation of systemic inequities in communication sciences and disorders (CSD) is the chronic underreporting and underrepresentation of sex, gender, race, and...
Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of American Speech-Language-Hearing Association Publications in 2020.
PURPOSE
One manifestation of systemic inequities in communication sciences and disorders (CSD) is the chronic underreporting and underrepresentation of sex, gender, race, and ethnicity in research. The present study characterized recent demographic reporting practices and representation of participants across CSD research.
METHODS
We systematically reviewed and extracted key reporting and participant data from empirical studies conducted in the United States (US) with human participants published in the year 2020 in journals by the American Speech-Language-Hearing Association (ASHA; = 407 articles comprising a total = 80,058 research participants, search completed November 2021). Sex, gender, race, and ethnicity were operationalized per National Institutes of Health guidelines (National Institutes of Health, 2015a, 2015b).
RESULTS
Sex or gender was reported in 85.5% of included studies; race was reported in 33.7%; and ethnicity was reported in 13.8%. Sex and gender were clearly differentiated in 3.4% of relevant studies. Where reported, median proportions for race and ethnicity were significantly different from the US population, with underrepresentation noted for all non-White racial groups and Hispanic participants. Moreover, 64.7% of studies that reported sex or gender and 67.2% of studies that reported race or ethnicity did not consider these respective variables in analyses or discussion.
CONCLUSION
At present, research published in ASHA journals frequently fails to report key demographic data summarizing the characteristics of participants. Moreover, apparent gaps in representation of minoritized racial and ethnic groups threaten the external validity of CSD research and broader health care equity endeavors in the US. Although our study is limited to a single year and publisher, our results point to several steps for readers that may bring greater accountability, consistency, and diversity to the discipline.
PubMed: 38912383
DOI: 10.1044/2024_PERSP-23-00204 -
Journal of Maxillofacial and Oral... Jun 2024Facial anthropometric data vary significantly within the Indian population due to the racial, ethnic and geographic diversity. The anthropometric data of a given ethnic... (Review)
Review
OBJECTIVE
Facial anthropometric data vary significantly within the Indian population due to the racial, ethnic and geographic diversity. The anthropometric data of a given ethnic community may not match the other due to diverse ethnic variations, and hence, this study is intended to review the facial anthropometric data pertaining to the diverse Indian populace through a systematic literature survey.
MATERIALS AND METHOD
An electronic search done on Medline, Embase and Central databases was utilized to conduct a systematic review of literature. The available data were analyzed based on the various esthetic subunits of the face. The following inclusion criteria were considered: (1) studies depicting the anthropometric data of any ethnic group identified as belonging to India, (2) studies originating from Indian subcontinent, (3) studies which included data of male and female subjects separately and (4) articles in English language only. The following exclusion criteria were considered: (1) atudies conducted on participants with severe malocclusion, developmental craniofacial anomalies, post-traumatic facial deformities or with a history of previous craniofacial or cosmetic surgery, (2) studies which did not specify the anthropometric landmarks used to obtain the measurements, (3) studies in which the statistical analysis was not provided, or if data were grouped across genders and (4) editorials, commentaries, case reports, systematic reviews, meta-analyses and articles not available in English language.
RESULTS
Twenty-one articles met the inclusion criteria. Majority of the Indians, particularly men, seem to have a mesoproscopic facial phenotype. The vertical and horizontal facial dimensions of the Indian male are comparably larger than the Indian female. There is sexual dimorphism among the Indian population with regard to the upper and lower thirds of the face, with little or no gender difference as regards the middle third of the face. It was observed that the nasal dimensions of the Indian race were not compatible with that of the occidental, oriental or the western race. The overall facial structure and the upper half of the face were critical in determining facial attractiveness in Indian males while the lower half of the face and the mandibular contour were critical in determining facial attractiveness in females.
CONCLUSION
It is observed that there is a paucity of facial anthropometric data for the Indian population considering the ethnic, racial and geographic diversity. Since the prevalence of craniofacial anomalies and dentofacial deformities in India is high and thus the scope for corrective surgery, it is important to compile baseline facial anthropometric data based on the ethnic diversity of the Indian population.
PubMed: 38911415
DOI: 10.1007/s12663-024-02185-6 -
Cureus May 2024The Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative was established in 2016 to assess the... (Review)
Review
The Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data (SISAQOL) initiative was established in 2016 to assess the quality and standardization of patient-reported outcomes (PRO) data analysis in randomized controlled trials (RCTs) on advanced breast cancer. The initiative identified deficiencies in PRO data reporting, including nonstandardized methods for handling missing data. This study evaluated the reporting of health-related quality of life (HRQOL) in Japanese cancer RCTs to provide insights into the state of PRO reporting in Japan. The study reviewed PubMed articles published from 2010 to 2018. Eligible studies included Japanese cancer RCTs with ≥50 adult patients (≥50% were Japanese) with solid tumors receiving anticancer treatments. The evaluation criteria included clarity of the HRQOL hypotheses, multiplicity testing, primary analysis methods, and reporting of clinically meaningful differences. Twenty-seven HRQOL trials were identified. Only 15% provided a clear HRQOL hypothesis, and 63% examined multiple HRQOL domains without adjusting for multiplicity. Model-based methods were the most common statistical methods for the primary HRQOL analysis. Only 22% of the trials explicitly reported clinically meaningful differences in HRQOL. Baseline assessments were reported in most trials, but only 26% reported comparisons between the treatment groups. HRQOL analysis was based on the intention-to-treat population in 19% of the trials, and 74% reported compliance at follow-up; however, 41% did not specify how missing values were handled. Although the rates of reporting clinical hypotheses and clinically meaningful differences were relatively low, the current state of HRQOL evaluation in the Japanese cancer RCT appears comparable to that of previous studies.
PubMed: 38910767
DOI: 10.7759/cureus.60804 -
Cureus May 2024There have been suggestions that vitamin D has anti-inflammatory effects; however, the variabilities of vitamin D levels among specific groups of patients and its... (Review)
Review
There have been suggestions that vitamin D has anti-inflammatory effects; however, the variabilities of vitamin D levels among specific groups of patients and its association with these inflammatory events have not been demonstrated. This study aims to study the association between vitamin D levels and vitamin D deficiency and inflammatory events among the elderly population. PubMed, Web of Science, Scopus, Science Direct, and ClinicalKey were systematically searched in December 2023 to include the relevant data. Comprehensive Meta-Analysis (version 3.0, Biostat, Inc., Englewood, NJ) was the software used for data analyses. A total of 12 studies were included in this analysis with 14,717 elderly patients. There was an overall significant decrease in vitamin D levels in elderly patients with high inflammatory markers compared to controls (Hedges' g = -0.221, 95% CI: -0.268, -0.173, P < 0.001), and event of vitamin D deficiency was found to be 0.321 (95% CI: 0.305, 0.337, P < 0.001). There is a significant decrease in vitamin D levels among the elderly with different inflammatory conditions. Future longitudinal studies and well-designed, large, randomized controlled trials are required to study the association between vitamin D deficiency and the incidence of inflammatory events in this specific group of patients.
PubMed: 38910627
DOI: 10.7759/cureus.60892 -
Autism : the International Journal of... Jun 2024Black/African American people in the United States who have a diagnosis of autism often experience service-related disparities, including not having the same access to... (Review)
Review
Black/African American people in the United States who have a diagnosis of autism often experience service-related disparities, including not having the same access to high-quality autism and related care (e.g. behavioral interventions), and are less likely to have sustained treatment engagement across their lifespan. While interventions to support autistic people are typically designed to be universal, there is concern that these interventions not being tailored to the Black/African American population could reduce the overall impact due to a lack of responsiveness to the needs of the Black children or families who receive the intervention. The current systematic review summarized research on interventions developed for the Black autism community, including Black children with autism and their caregivers. After a comprehensive, systematic search, eight peer-reviewed publications were identified that met the study's inclusion criteria. The majority of the interventions were tailored to Black caregivers of children with autism. Autism researchers demonstrate different strategies for engaging Black caregivers in culturally responsive ways; however, more research into these interventions is needed in order to assess their effectiveness. In addition, there are still limited interventions adapted to be culturally responsive to Black/African American autistic people. The Cultural Adaptation Checklist framework is a novel approach with promise to become the standard for adapting interventions to meet the needs of culturally diverse groups. Cultural responsiveness is an important facet in the development of interventions that produce optimal outcomes for the range of diversity in the United States and is an important step to achieving equitable autism research practices.
PubMed: 38910297
DOI: 10.1177/13623613241259910 -
Respiratory Medicine Jun 2024Enhancing lung function can significantly improve daily life functionality for children with cerebral palsy, leading to increased interest in respiratory physiotherapy... (Review)
Review
INTRODUCTION
Enhancing lung function can significantly improve daily life functionality for children with cerebral palsy, leading to increased interest in respiratory physiotherapy training devices in clinical practice. This study aims to evaluate the efficacy of devices (inspiratory muscle training and feedback devices) for improving pulmonary function through various respiratory parameters.
METHODS
A systematic review with meta-analysis of randomized clinical trials was conducted in seven databases up until May 2023. The included studies focused on training inspiratory muscle function using specific devices (inspiratory muscle training and feedback devices) in children with cerebral palsy. The main outcomes were maximum expiratory pressure and maximum inspiratory pressure. Secondary outcomes included forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, and the Tiffenau index. The effects of respiratory treatment were calculated through the estimation of the effect size and its 95% confidence intervals. The risk of bias in the included studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias (RoB2).
RESULTS
Nine studies were included in the systematic review with meta-analysis, involving a total of 321 children aged between 6 and 18 years after secondary analyses were conducted. Feedback devices were found to be more effective in improving maximum expiratory pressure (effect size -0.604; confidence interval -1.368 to 0.161), peak expiratory flow, forced expiratory volume in 1 s, and forced vital capacity. Inspiratory muscle training devices yielded better effectiveness in improving maximum inspiratory pressure (effect size -0.500; confidence interval -1.259 to 0.259), the Tiffeneau index, and quality of life.
CONCLUSION
Both devices showed potential in improving pulmonary function in children with cerebral palsy. Further high-quality clinical trials are needed to determine the optimal dosage and the most beneficial device type for each pulmonary function parameter.
PubMed: 38908411
DOI: 10.1016/j.rmed.2024.107717 -
Archives of Gerontology and Geriatrics Jun 2024To assess the impact of multicomponent exercises on physical functions of frail elderly in communities, evaluating their effect on muscle strength, balance, and... (Review)
Review
OBJECTIVE
To assess the impact of multicomponent exercises on physical functions of frail elderly in communities, evaluating their effect on muscle strength, balance, and endurance, and their influence on quality of life.
METHOD
PubMed, Embase, Cochrane, and Web of Science were searched to collect relevant randomized controlled trials. The search cutoff date was January 24, 2024. Included studies met pre-specified inclusion and exclusion criteria. Data analysis was performed using Revman 5.4 and Stata 15.0 software.
RESULT
This analysis included 19 studies. After 12 weeks, the multicomponent exercises significantly enhanced participants' performance in various physical function assessments. Specifically, in the Timed Up and Go Test, the exercise group showed a significant reduction in time [SMD = -0.86 (95 % CI: -1.40 to -0.33)]. In the Short Physical Performance Battery, interventions shorter than 6 weeks significantly increased scores [SMD = 1.01 (95 % CI: 0.64 to 1.37)], and those longer than 6 weeks showed improvements [SMD = 0.53 (95 % CI: 0.26 to 0.80)]. Muscle strength also improved, with handgrip strength and knee extensor strength enhancements [SMD = 0.93 (95 % CI: 0.27 to 1.59); SMD = 0.72 (95 % CI: 0.24 to 1.20)]. However, there was no statistically significant difference in walking speed between the groups [SMD = 0.04 (95 % CI: -0.33 to 0.40)].
CONCLUSION
Although multicomponent exercises significantly improve muscle strength, balance, and endurance in frail elderly individuals, there is no conclusive evidence of their effect on enhancing quality of life or long-term health outcomes. Further research is needed to explore the specific impacts of different types and intensities of exercises on this population.
PubMed: 38908349
DOI: 10.1016/j.archger.2024.105543