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Journal of Cardiovascular Medicine... Aug 2024To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure. (Meta-Analysis)
Meta-Analysis
AIMS
To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure.
METHODS
The literature search was conducted in PubMed, Web of Science, the Cochrane Library databases, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database and China Scientific Journal Database (VIP). The retrieval period was from the establishment of the database to May 2023. The included studies were trials to explore the effectiveness of mHealth interventions on medication adherence in patients with heart failure. Cochrane collaboration's tool was used for assessing risk of bias in randomized controlled trials. Stata 17.0 software was used to conduct data analysis. Continuous data were expressed as standard mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals (CIs).
RESULTS
A total of 13 studies and 2534 participants were included. One study was rated as Grade A, and the other 12 studies were Grade B. The results of meta-analysis indicate that mHealth interventions are effective in improving medication adherence [relative risk (RR) = 1.26, 95% CI 1.10-1.44, P < 0.05 and standard mean difference = 0.80, 95% CI 0.44-1.15, P < 0.05], and reducing readmission rates (RR = 0.63, 95% CI 0.53-0.76, P < 0.05) and mortality (RR = 0.63, 95% CI 0.43-0.94, P < 0.05) of patients with heart failure.
CONCLUSION
mHealth interventions are beneficial to improve medication adherence in patients with heart failure, and could effectively reduce the readmission rates and mortality of patients in the studies. There is a need to continuously improve the professional abilities of intervention personnel, carry out teamwork, and extend intervention and follow-up time. Convenient, fast and low-cost mobile medical devices should be adopted to reduce the cost of medical treatment. Scientific and reasonable intervention content will be formulated according to evidence-based guidelines and theoretical basis to enhance patients' ability at self-management and understanding of heart failure knowledge.
Topics: Humans; Heart Failure; Telemedicine; Medication Adherence; Female; Male; Middle Aged; Aged; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38949146
DOI: 10.2459/JCM.0000000000001631 -
Journal of Cardiovascular Medicine... Jun 2024To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure.
AIMS
To systematically evaluate the effectiveness of mobile health (mHealth) interventions on medication adherence in patients with heart failure.
METHODS
The literature search was conducted in PubMed, Web of Science, the Cochrane Library databases, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database and China Scientific Journal Database (VIP). The retrieval period was from the establishment of the database to May 2023. The included studies were trials to explore the effectiveness of mHealth interventions on medication adherence in patients with heart failure. Cochrane collaboration's tool was used for assessing risk of bias in randomized controlled trials. Stata 17.0 software was used to conduct data analysis. Continuous data were expressed as standard mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals (CIs).
RESULTS
A total of 13 studies and 2534 participants were included. One study was rated as Grade A, and the other 12 studies were Grade B. The results of meta-analysis indicate that mHealth interventions are effective in improving medication adherence [relative risk (RR) = 1.26, 95% CI 1.10-1.44, P < 0.05 and standard mean difference = 0.80, 95% CI 0.44-1.15, P < 0.05], and reducing readmission rates (RR = 0.63, 95% CI 0.53-0.76, P < 0.05) and mortality (RR = 0.63, 95% CI 0.43-0.94, P < 0.05) of patients with heart failure.
CONCLUSION
mHealth interventions are beneficial to improve medication adherence in patients with heart failure, and could effectively reduce the readmission rates and mortality of patients in the studies. There is a need to continuously improve the professional abilities of intervention personnel, carry out teamwork, and extend intervention and follow-up time. Convenient, fast and low-cost mobile medical devices should be adopted to reduce the cost of medical treatment. Scientific and reasonable intervention content will be formulated according to evidence-based guidelines and theoretical basis to enhance patients' ability at self-management and understanding of heart failure knowledge.
PubMed: 38949124
DOI: 10.2459/JCM.0000000000001631 -
Influenza and Other Respiratory Viruses Jul 2024Understanding the clinical spectrum of SARS-CoV-2 infection, including the asymptomatic fraction, is important as asymptomatic individuals are still able to infect other... (Meta-Analysis)
Meta-Analysis Review
Understanding the clinical spectrum of SARS-CoV-2 infection, including the asymptomatic fraction, is important as asymptomatic individuals are still able to infect other individuals and contribute to ongoing transmission. The WHO Unity Household transmission investigation (HHTI) protocol provides a platform for the prospective and systematic collection of high-quality clinical, epidemiological, serological and virological data from SARS-CoV-2 confirmed cases and their household contacts. These data can be used to understand key severity and transmissibility parameters-including the asymptomatic proportion-in relation to local epidemic context and help inform public health response. We aimed to estimate the asymptomatic proportion of SARS-CoV-2 Omicron variant infections in Unity-aligned HHTIs. We conducted a systematic review and meta-analysis in alignment with the PRISMA 2020 guidelines and registered our systematic review on PROSPERO (CRD42022378648). We searched EMBASE, Web of Science, MEDLINE and bioRxiv and medRxiv from 1 November 2021 to 22 August 2023. We identified 8368 records, of which 98 underwent full text review. We identified only three studies for data extraction, with substantial variation in study design and corresponding estimates of the asymptomatic proportion. As a result, we did not generate a pooled estimate or I metric. The limited number of quality studies that we identified highlights the need for improved preparedness and response capabilities to facilitate robust HHTI implementation, analysis and reporting, to better inform national, regional and global risk assessments and policymaking.
Topics: Humans; COVID-19; SARS-CoV-2; Family Characteristics; Asymptomatic Infections
PubMed: 38949103
DOI: 10.1111/irv.13348 -
International Endodontic Journal Jul 2024Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal... (Review)
Review
BACKGROUND
Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal treatment.
OBJECTIVES
To investigate (i) the survival of root-filled posterior teeth and (ii) the tooth-related factors that may affect their survival.
METHODS
Randomized controlled trials, comparative studies and observational studies assessing survival rates of root-filled posterior teeth with a minimum 4-year follow-up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre-defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta-analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth-related factors was conducted.
RESULTS
Of the 72 studies identified, data from 20 studies were included in the survival meta-analysis, and data from 13 of these studies were included in the descriptive analysis of tooth-related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4-7 years and 8-20 years of root-filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth-related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown-to-root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks.
CONCLUSIONS
The meta-analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area.
REGISTRATION
PROSPERO Registration: CRD42021227213.
PubMed: 38949036
DOI: 10.1111/iej.14116 -
Frontiers in Neuroscience 2024Previous neuroimaging studies have revealed structural and functional brain abnormalities in patients with cervical spondylosis (CS). However, the results are divergent...
BACKGROUND
Previous neuroimaging studies have revealed structural and functional brain abnormalities in patients with cervical spondylosis (CS). However, the results are divergent and inconsistent. Therefore, the present study conducted a multi-modal meta-analysis to investigate the consistent structural and functional brain alterations in CS patients.
METHODS
A comprehensive literature search was conducted in five databases to retrieve relevant resting-state functional magnetic resonance imaging (rs-fMRI), structural MRI and diffusion tensor imaging (DTI) studies that measured brain functional and structural differences between CS patients and healthy controls (HCs). Separate and multimodal meta-analyses were implemented, respectively, by employing Anisotropic Effect-size Signed Differential Mapping software.
RESULTS
13 rs-fMRI studies that used regional homogeneity, amplitude of low-frequency fluctuations (ALFF) and fractional ALFF, seven voxel-based morphometry (VBM) studies and one DTI study were finally included in the present research. However, no studies on surface-based morphometry (SBM) analysis were included in this research. Due to the insufficient number of SBM and DTI studies, only rs-fMRI and VBM meta-analyses were conducted. The results of rs-fMRI meta-analysis showed that compared to HCs, CS patients demonstrated decreased regional spontaneous brain activities in the right lingual gyrus, right middle temporal gyrus (MTG), left inferior parietal gyrus and right postcentral gyrus (PoCG), while increased activities in the right medial superior frontal gyrus, bilateral middle frontal gyrus and right precuneus. VBM meta-analysis detected increased GMV in the right superior temporal gyrus (STG) and right paracentral lobule (PCL), while decreased GMV in the left supplementary motor area and left MTG in CS patients. The multi-modal meta-analysis revealed increased GMV together with decreased regional spontaneous brain activity in the left PoCG, right STG and PCL among CS patients.
CONCLUSION
This meta-analysis revealed that compared to HCs, CS patients had significant alterations in GMV and regional spontaneous brain activity. The altered brain regions mainly included the primary visual cortex, the default mode network and the sensorimotor area, which may be associated with CS patients' symptoms of sensory deficits, blurred vision, cognitive impairment and motor dysfunction. The findings may contribute to understanding the underlying pathophysiology of brain dysfunction and provide references for early diagnosis and treatment of CS.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/, CRD42022370967.
PubMed: 38948928
DOI: 10.3389/fnins.2024.1415411 -
The Journal of Innovations in Cardiac... Jun 2024Atrial fibrillation (AF) is a prevalent cardiac arrhythmia marked by irregular and frequent tachycardic rhythms in the atria, affecting 1%-2% of the general population.... (Review)
Review
Comparative Profiles of the WATCHMAN™ and Amplatzer™ Cardiac Plug/Amplatzer™ Amulet™ Devices for Left Atrial Appendage Closure in Non-valvular Atrial Fibrillation: A Comprehensive Systematic Review and Meta-analysis.
Atrial fibrillation (AF) is a prevalent cardiac arrhythmia marked by irregular and frequent tachycardic rhythms in the atria, affecting 1%-2% of the general population. The WATCHMAN™ device from Boston Scientific (Marlborough, MA, USA) and the Amplatzer™ Amulet™ device from Abbott (Chicago, IL, USA) are two devices used globally for left atrial appendage closure (LAAC) in non-valvular AF. A systematic search was conducted in PubMed, the Cochrane Library, and Elsevier's ScienceDirect literature databases to identify studies comparing the WATCHMAN™ procedure with Amulet™ device implantation for LAAC in patients with AF. The analyses were conducted using the random-effects model. A total of 20 studies were identified, with 18 falling into the category of observational studies and 2 being randomized controlled trials. A total of 6310 participants were included in this meta-analysis, with 3198 individuals (50.68%) assigned to the WATCHMAN™ procedure group and 3112 individuals (49.32%) allocated to the Amplatzer™ Cardiac Plug (ACP) group. The analysis revealed a higher risk of stroke associated with the WATCHMAN™ technique (relative risk [RR], 1.14), albeit without statistical significance. Conversely, the WATCHMAN™ approach led to a significantly lower risk of cardiac death (RR, 0.44; = .04). Notably, the risks of all-cause mortality (RR, 0.89; 95% confidence interval [CI], 0.73-1.08; = 0%; = .25) and major bleeding (RR, 0.93; 95% CI, 0.65-1.33; = 31%; = .70) were clinically reduced with the WATCHMAN™ procedure, although statistical significance was not achieved. Compared to Amulet™ device implantation, WATCHMAN™ device implantation decreased the risk of cardiac mortality, while the risks of stroke, systemic embolism, all-cause mortality, and major bleeding were not statistically significant.
PubMed: 38948665
DOI: 10.19102/icrm.2024.15061 -
Frontiers in Endocrinology 2024The relationship between adiposity and sepsis has received increasing attention. This study aims to explore the causal relationship between life course adiposity and the... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The relationship between adiposity and sepsis has received increasing attention. This study aims to explore the causal relationship between life course adiposity and the sepsis incidence.
METHODS
Mendelian randomization (MR) method was employed in this study. Instrumental variants were obtained from genome-wide association studies for life course adiposity, including birth weight, childhood body mass index (BMI), childhood obesity, adult BMI, waist circumference, visceral adiposity, and body fat percentage. A meta-analysis of genome-wide association studies for sepsis including 10,154 cases and 454,764 controls was used in this study. MR analyses were performed using inverse variance weighted, MR Egger regression, weighted median, weighted mode, and simple mode. Instrumental variables were identified as significant single nucleotide polymorphisms at the genome-wide significance level ( < 5×10). The sensitivity analysis was conducted to assess the reliability of the MR estimates.
RESULTS
Analysis using the MR analysis of inverse variance weighted method revealed that genetic predisposition to increased childhood BMI ( = 1.29, = 0.003), childhood obesity ( = 1.07, = 0.034), adult BMI ( = 1.38, < 0.001), adult waist circumference ( = 1.01, = 0.028), and adult visceral adiposity ( = 1.53, < 0.001) predicted a higher risk of sepsis. Sensitivity analysis did not identify any bias in the MR results.
CONCLUSION
The results demonstrated that adiposity in childhood and adults had causal effects on sepsis incidence. However, more well-designed studies are still needed to validate their association.
Topics: Humans; Mendelian Randomization Analysis; Adiposity; Sepsis; Genome-Wide Association Study; Body Mass Index; Polymorphism, Single Nucleotide; Genetic Predisposition to Disease; Pediatric Obesity; Adult; Waist Circumference; Child; Male; Female
PubMed: 38948521
DOI: 10.3389/fendo.2024.1413690 -
Frontiers in Pharmacology 2024Inflammatory bowel disease (IBD) is a chronic condition that can be managed with treatment, but it is challenging to get IBD cured. Resveratrol, a non-flavonoid...
Inflammatory bowel disease (IBD) is a chronic condition that can be managed with treatment, but it is challenging to get IBD cured. Resveratrol, a non-flavonoid polyphenolic organic compound derived from various plants, has a potential effect on IBD. The current research was set out to investigate the therapeutic effects of resveratrol on animal models of IBD. A comprehensive search of PubMed, Embase, Web of Science, and Chinese databases was performed. The literature search process was completed independently by two people and reviewed by a third person. The risk of bias in the included literature was assessed using the Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Stroke (CAMARADES) 10-point quality checklist. The meta-analysis utilized Review Manager 5.4 software to evaluate the efficacy of resveratrol, with histopathological index as the primary outcome measure. Subgroup analysis was conducted based on this indicator. Additionally, meta-analyses were carried out on different outcomes reported in the literature, including final disease activity index, final body weight change, colon length, splenic index, and inflammatory factors. After conducting a thorough literature search and selection process, a total of 28 studies were ultimately included in the analysis. It was found that over half of the selected studies had more than five items with low risk of bias in the bias risk assessment. Relevant datas from included literature indicated that the histopathological index of the resveratrol group was significantly lower than that of the control group (WMD = -2.58 [-3.29, -1.87]). Subgroup analysis revealed that higher doses of resveratrol (>80 mg/kg) had a better efficacy (WMD = -3.47 [-4.97, -1.98]). Furthermore, The data summary and quantitative analysis results of SI and colon length also showed that resveratrol was effective in alleviating intestinal mucosal pathological injury of IBD. In terms of biochemical indicators, the summary analysis revealed that resveratrol affected interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), interferon-γ (IFN-γ), malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), and prostaglandin E2 (PGE2) significantly. These effects may be attributed to the mechanism of resveratrol in regulating immune response and inhibiting oxidative stress. This review suggests that resveratrol demonstrated a notable therapeutic impact in preclinical models of IBD, particularly at doses exceeding 80 mg/kg. This efficacy is attributed to the protective mechanisms targeting the intestinal mucosa involved in the pathogenesis of IBD through various pathways. As a result, resveratrol holds promising prospects for potential clinical use in the future.
PubMed: 38948464
DOI: 10.3389/fphar.2024.1411566 -
Indian Journal of Orthopaedics Jul 2024Meniscal injuries frequently require surgical intervention to restore knee joint function and stability. Intraoperative platelet-rich plasma (PRP) injection has emerged... (Review)
Review
BACKGROUND
Meniscal injuries frequently require surgical intervention to restore knee joint function and stability. Intraoperative platelet-rich plasma (PRP) injection has emerged as a potential adjunctive therapy to enhance tissue healing post-meniscal repair. This systematic review and meta-analysis aimed to evaluate the efficacy of PRP in terms of pain relief, functional recovery, and overall success rates in patients undergoing meniscal repair procedures
METHODS
A comprehensive search strategy was employed to identify relevant studies across Scopus, PubMed, Embase, and the Cochrane Library databases. The inclusion criteria encompassed human studies, including randomized controlled trials (RCTs), cohorts, and case-control studies, focusing on intraoperative platelet-rich plasma (PRP) use post-meniscal repair and reporting outcomes related to pain, functionality, and cure rates. Exclusion criteria comprised animal studies, non-English publications, studies lacking relevant outcome measures, and those with insufficient data. Two reviewers independently screened titles and abstracts, resolving disagreements through consensus or consultation with a third reviewer, followed by a full-text assessment for potentially eligible studies. Data extraction was conducted independently by two reviewers using a standardized form. The reliability of observational studies was evaluated using the Newcastle-Ottawa Scale. Subgroup analyses and pooled effect estimates for main outcomes were computed using RevMan 5.3, a meta-analysis tool.
RESULTS
The demographic analysis revealed that the PRP group had an average age of 41.39 years, while the control group had an average age of 42.1 years. In terms of gender distribution, the PRP group consisted of 61 men and 29 women, while the control group had 62 men and 34 women. Pain ratings showed a preference for PRP with a mean difference of 4.83 ( = 0.13). However, there was no significant difference in Lysholm scores (mean difference: - 0.44, p = 0.91) or IKDC scores (mean difference: 2.80, = 0.14) between the PRP and control groups. Similarly, ROM measures did not show a statistically significant difference, with a mean difference of 2.80 ( = 0.18). Additionally, there was no significant distinction in failure rates between the PRP and control groups, as indicated by a weighted mean difference of 0.71 ( = 0.52). These findings suggest that while PRP may offer some benefits in pain relief, its impact on functional recovery, range of motion, and failure rates following meniscal repair procedures is inconclusive.
CONCLUSION
The current evidence regarding the effect of intraoperative platelet-rich plasma (PRP) injection on patients undergoing meniscal repair remains inconclusive. While some studies suggest potential benefits in terms of pain relief and functional recovery, others show no significant differences compared to control groups. The impact of PRP therapy on overall success rates, including rates of re-tear and revision surgery, is also uncertain. Further well-designed randomized controlled trials with larger sample sizes are needed to provide more robust evidence and guide clinical practice in orthopedic surgery.
PubMed: 38948373
DOI: 10.1007/s43465-024-01155-x -
Frontiers in Genetics 2024Wool plays an irreplaceable role in the lives of livestock and the textile industry. The variety of hair quality and shape leads to the diversity of its functions and...
Wool plays an irreplaceable role in the lives of livestock and the textile industry. The variety of hair quality and shape leads to the diversity of its functions and applications, and the finer wool has a higher economic value. In this study, 10 coarse and 10 fine ordos fine wool sheep skin samples were collected for RNA-seq, and coarse and fine skin/hair follicle RNA-seq datasets of other five animal breeds were obtained from NCBI. Weighted gene co-expression network analysis showed that the common genes were clustered into eight modules. Similar gene expression patterns in sheep and rabbits with the same wool types, different gene expression patterns in animal species with different hair types, and brown modules were significantly correlated with species and breeds. GO and KEGG enrichment analyses showed that, most genes in the brown module associated with hair follicle development. Hence, gene expression patterns in skin tissues may determine hair morphology in animal. The analysis of differentially expressed genes revealed that 32 highly expressed candidate genes associated with the wool fineness of Ordos fine wool sheep. Among them, (grey module), (brown module), (brown module), (tan module), and genes have been reported to be involved in the regulation of the hair follicle cycle or hair loss. Additionally, 12 genes, including and are differentially expressed across various animal breeds and species. The above results suggest that different sheep breeds share a similar molecular regulatory basis of wool fineness. Finally, the study provides a theoretical reference for molecular breeding of sheep breeds as well as for the investigation of the origin and evolution of animal hair.
PubMed: 38948362
DOI: 10.3389/fgene.2024.1401369