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Sensors (Basel, Switzerland) Jun 2022Complex energy monitoring and control systems have been widely studied as the related topics include different approaches, advanced sensors, and technologies applied to... (Review)
Review
Complex energy monitoring and control systems have been widely studied as the related topics include different approaches, advanced sensors, and technologies applied to a strongly varying amount of application fields. This paper is a systematic review of what has been done regarding energy metering system issues about (i) sensors, (ii) the choice of their technology and their characterization depending on the application fields, (iii) advanced measurement approaches and methodologies, and (iv) the setup of energy Key Performance Indicators (KPIs). The paper provides models about KPI estimation, by highlighting design criteria of complex energy networks. The proposed study is carried out to give useful elements to build models and to simulate in detail energy systems for performance prediction purposes. Some examples of energy complex KPIs based on the integration of the Artificial Intelligence (AI) concept and on basic KPIs or variables are provided in order to define innovative formulation criteria depending on the application field. The proposed examples highlight how modeling a complex KPI as a function of basic variables or KPIs is possible, by means of graph models of architectures.
Topics: Artificial Intelligence; Quality Indicators, Health Care; Technology
PubMed: 35808429
DOI: 10.3390/s22134929 -
The Cochrane Database of Systematic... Jun 2022Respiratory disease is the main cause of morbidity and mortality in cystic fibrosis (CF), and many different therapies are used by people with CF in the management of... (Review)
Review
BACKGROUND
Respiratory disease is the main cause of morbidity and mortality in cystic fibrosis (CF), and many different therapies are used by people with CF in the management of respiratory problems. Bronchodilator therapy is used to relieve symptoms of shortness of breath and to open the airways to allow clearance of mucus. Despite the widespread use of inhaled bronchodilators in CF, there is little objective evidence of their efficacy. A Cochrane Review looking at both short- and long-acting inhaled bronchodilators for CF was withdrawn from the Cochrane Library in 2016. That review has been replaced by two separate Cochrane Reviews: one on long-acting inhaled bronchodilators for CF, and this review on short-acting inhaled bronchodilators for CF. For this review 'inhaled' includes the use of pressurised metered dose inhalers (MDIs), with or without a spacer, dry powder devices and nebulisers.
OBJECTIVES
To evaluate short-acting inhaled bronchodilators in children and adults with CF in terms of clinical outcomes and safety.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books on 28 March 2022 and searched trial registries for any new or ongoing trials on 12 April 2022. We also searched the reference lists of relevant articles and reviews.
SELECTION CRITERIA
We searched for randomised controlled trials (RCTs) or quasi-RCTs that looked at the effect of any short-acting inhaled bronchodilator delivered by any device, at any dose, at any frequency and for any duration compared to either placebo or another short-acting inhaled bronchodilator in people with CF. We screened references as per standard Cochrane methodology.
DATA COLLECTION AND ANALYSIS
Two review authors extracted data and assessed risk of bias using the Cochrane RoB 1 tool. Where we were not able to enter data into our analyses we reported results directly from the papers. We assessed the certainty of evidence using GRADE.
MAIN RESULTS
We included 11 trials from our systematic search, with 191 participants meeting our inclusion criteria; three of these trials had three treatment arms. Eight trials compared short-acting inhaled beta-2 agonists to placebo and four trials compared short-acting inhaled muscarinic antagonists to placebo. Three trials compared short-acting inhaled beta-2 agonists to short-acting inhaled muscarinic antagonists. All were cross-over trials with only small numbers of participants. We were only able to enter data into the analysis from three trials comparing short-acting inhaled beta-2 agonists to placebo. Short-acting inhaled beta-2 agonists versus placebo All eight trials (six single-dose trials and two longer-term trials) reporting on this comparison reported on forced expiratory volume in 1 second (FEV), either as per cent predicted (% predicted) or L. We were able to combine the data from two trials in a meta-analysis which showed a greater per cent change from baseline in FEV L after beta-2 agonists compared to placebo (mean difference (MD) 6.95%, 95% confidence interval (CI) 1.88 to 12.02; 2 trials, 82 participants). Only one of the longer-term trials reported on exacerbations, as measured by hospitalisations and courses of antibiotics. Only the second longer-term trial presented results for participant-reported outcomes. Three trials narratively reported adverse events, and these were all mild. Three single-dose trials and the two longer trials reported on forced vital capacity (FVC), and five trials reported on peak expiratory flow, i.e. forced expiratory flow between 25% and 75% (FEF). One trial reported on airway clearance in terms of sputum weight. We judged the certainty of evidence for each of these outcomes to be very low, meaning we are very uncertain about the effect of short-acting inhaled beta-2 agonists on any of the outcomes we assessed. Short-acting inhaled muscarinic antagonists versus placebo All four trials reporting on this comparison looked at the effects of ipratropium bromide, but in different doses and via different delivery methods. One trial reported FEV % predicted; three trials measured this in L. Two trials reported adverse events, but these were few and mild. One trial reported FVC and three trials reported FEF. None of the trials reported on quality of life, exacerbations or airway clearance. We judged the certainty of evidence for each of these outcomes to be very low, meaning we are very uncertain about the effect of short-acting inhaled muscarinic antagonists on any of the outcomes we assessed. Short-acting inhaled beta-2 agonists versus short-acting inhaled muscarinic antagonists None of the three single-dose trials reporting on this comparison provided data we could analyse. The original papers from three trials report that both treatments lead to an improvement in FEV L. Only one trial reported on adverse events; but none were experienced by any participant. No trial reported on any of our other outcomes. We judged the certainty of evidence to be very low, meaning we are very uncertain about the effect of short-acting inhaled beta-2 agonists compared to short-acting inhaled muscarinic antagonists on any of the outcomes we assessed.
AUTHORS' CONCLUSIONS
All included trials in this review are small and of a cross-over design. Most trials looked at very short-term effects of inhaled bronchodilators, and therefore did not measure longer-term outcomes. The certainty of evidence across all outcomes was very low, and therefore we have been unable to describe any effects with certainty.
Topics: Administration, Inhalation; Adult; Bronchodilator Agents; Child; Cystic Fibrosis; Forced Expiratory Volume; Humans; Muscarinic Antagonists
PubMed: 35749226
DOI: 10.1002/14651858.CD013666.pub2 -
Life (Basel, Switzerland) Jun 2022The present study aims to determine the potential benefits of PNF on balance and gait function in patients with chronic stroke by using a systematic review and... (Review)
Review
Proprioceptive Neuromuscular Facilitation-Based Physical Therapy on the Improvement of Balance and Gait in Patients with Chronic Stroke: A Systematic Review and Meta-Analysis.
The present study aims to determine the potential benefits of PNF on balance and gait function in patients with chronic stroke by using a systematic review and meta-analysis. Systematic review in the following databases: MEDLINE/PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library and Google Scholar. Studies up to September 2020 are included. A systematic database search was conducted for randomized control trials (RCTs) that investigated the effects of PNF intervention in patients with chronic stroke using balance and gait parameters as outcome measures. The primary outcomes of interest were Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG) and 10-Meter Walking Test (10MWT). Nineteen studies with 532 participants were included, of which twelve studies with 327 participants were included for meta-analysis. When the data were pooled, PNF made statistically significant improvements in balance with BBS, FRT and TUG (p < 0.05) or gait velocity with 10MWT (p < 0.001) when compared to the control. This review indicates that PNF is a potential treatment strategy in chronic stroke rehabilitation on balance and gait speed. Further high-quality research is required for concluding a consensus of intervention and research on PNF.
PubMed: 35743913
DOI: 10.3390/life12060882 -
Translational Psychiatry May 2022Neuroscience research presents contradictory evidence in support of both the protective and destructive effects of cannabinoids in depression. Therefore, this systematic... (Meta-Analysis)
Meta-Analysis
Neuroscience research presents contradictory evidence in support of both the protective and destructive effects of cannabinoids in depression. Therefore, this systematic review and meta-analysis summarizes the existing preclinical literature on the effects of cannabinoid administration in the chronic unpredictable stress model of depression in order to evaluate the effects of cannabinoids and identify gaps in the literature. After protocol registration (PROSPERO #CRD42020219986), we systematically searched Scopus, Embase, Psychology & Behavioral Sciences Collection, APA PsychINFO, PubMed, CINAHL Complete, and ProQuest Dissertations & Theses Global from the earliest record of the databases, February 1964, to November 2020 for articles that met inclusion criteria (e.g., rodent subjects and administration of a cannabinoid. A total of 26 articles were included representing a sample size estimate of 1132 rodents with the majority of articles administering daily intraperitoneal injections during chronic unpredictable stress. These articles were evaluated using a modified SYRCLE's risk-of-bias tool. For each continuous behavioral measure, the standardized mean difference was calculated between cannabinoid and vehicle groups in rodents subjected to chronic unpredictable stress. The effects of cannabinoids on depressive-like behavior was evaluated using a multilevel mixed-effects model with effect size weights nested within control groups. Cannabinoid administration moderately improved the pooled negative effects of chronic unpredictable stress on anhedonia, learned helplessness, novelty suppressed feeding, time in the anxiogenic context, and entries into the anxiogenic context. Although the interpretations are limited, these findings suggest that with further investigation, cannabinoids may be a viable long-term treatment for stress-related psychopathologies such as depression.
Topics: Anti-Anxiety Agents; Antidepressive Agents; Cannabinoids; Humans
PubMed: 35641487
DOI: 10.1038/s41398-022-01967-1 -
Biology Apr 2022The use of normobaric hypoxia can bring benefits to sports performance because it improves haematological parameters and/or physical activity tests. Our objective was to... (Review)
Review
BACKGROUND
The use of normobaric hypoxia can bring benefits to sports performance because it improves haematological parameters and/or physical activity tests. Our objective was to conduct a systematic review so as to analyse the methods used in hypoxia and to detect its effects on middle- and/or long-distance runners.
METHODS
Research was conducted using five electronic databases (PubMed, SportDiscus, Cochrane Library, Scopus and PEDro) until December 2021. The methodological quality of the included studies was assessed using the PEDro scale.
RESULTS
Having analysed 158 studies, 12 were chosen for the qualitative and quantitative synthesis. A significant improvement on time until exhaustion was detected, and oxygen saturation decreased after the intervention. There were no significant changes in the 3000-metre time trial or in the haematocrit percentage. The changes in percentage of reticulocytes, heart rate, maximal heart rate, lactate concentration and erythropoietin were heterogeneous between the different research studies.
CONCLUSION
short exposure (less than 3 h to normobaric hypoxia significantly increases the time to exhaustion). However, longer exposure times are necessary to increase haemoglobin. Altitude and exposure time are highly heterogeneous in the included studies.
PubMed: 35625417
DOI: 10.3390/biology11050689 -
The Cochrane Database of Systematic... May 2022Surgery is the cornerstone in curative treatment of colorectal cancer. Unfortunately, surgery itself can adversely affect patient health. 'Enhanced Recovery After... (Review)
Review
BACKGROUND
Surgery is the cornerstone in curative treatment of colorectal cancer. Unfortunately, surgery itself can adversely affect patient health. 'Enhanced Recovery After Surgery' programmes, which include multimodal interventions, have improved patient outcomes substantially. However, these are mainly applied peri- and postoperatively. Multimodal prehabilitation includes multiple preoperative interventions to prepare patients for surgery with the aim of increasing resilience, thereby improving postoperative outcomes.
OBJECTIVES
To determine the effects of multimodal prehabilitation programmes on functional capacity, postoperative complications, and quality of life in adult patients undergoing surgery for colorectal cancer.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase and PsycINFO in January 2021. We also searched trial registries up to March 2021.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) in adult patients with non-metastatic colorectal cancer, scheduled for surgery, comparing multimodal prehabilitation programmes (defined as comprising at least two preoperative interventions) with no prehabilitation. We focused on the following outcomes: functional capacity (i.e. 6-minute walk test, VOpeak, handgrip strength), postoperative outcomes (i.e. complications, mortality, length of hospital stay, emergency department visits, re-admissions), health-related quality of life, compliance, safety of prehabilitation, and return to normal activities.
DATA COLLECTION AND ANALYSIS
Two authors independently selected studies, extracted data, assessed risk of bias and used GRADE to assess the certainty of the evidence. Any disagreements were solved with discussion and consensus. We pooled data to perform meta-analyses, where possible.
MAIN RESULTS
We included three RCTs that enrolled 250 participants with non-metastatic colorectal cancer, scheduled for elective (mainly laparoscopic) surgery. Included trials were conducted in tertiary care centres and recruited patients during periods ranging from 17 months to 45 months. A total of 130 participants enrolled in a preoperative four-week trimodal prehabilitation programme consisting of exercise, nutritional intervention, and anxiety reduction techniques. Outcomes of these participants were compared to those of 120 participants who started an identical but postoperative programme. Postoperatively, prehabilitation may improve functional capacity, determined with the 6-minute walk test at four and eight weeks (mean difference (MD) 26.02, 95% confidence interval (CI) -13.81 to 65.85; 2 studies; n = 131; and MD 26.58, 95% CI -8.88 to 62.04; 2 studies; n = 140); however, the certainty of evidence is low and very low, respectively, due to serious risk of bias, imprecision, and inconsistency. After prehabilitation, the functional capacity before surgery improved, with a clinically relevant mean difference of 24.91 metres (95% CI 11.24 to 38.57; 3 studies; n = 225). The certainty of evidence was moderate due to downgrading for serious risk of bias. Prehabilitation may also result in fewer complications (RR 0.95, 95% CI 0.70 to 1.29; 3 studies; n = 250) and fewer emergency department visits (RR 0.72, 95% CI 0.39 to 1.32; 3 studies; n = 250). The certainty of evidence was low due to downgrading for serious risk of bias and imprecision. On the other hand, prehabilitation may also result in a higher re-admission rate (RR 1.20, 95% CI 0.54 to 2.65; 3 studies; n = 250). The certainty of evidence was again low due to downgrading for risk of bias and imprecision. The effect on VOpeak, handgrip strength, length of hospital stay, mortality rate, health-related quality of life, return to normal activities, safety of the programme, and compliance rate could not be analysed quantitatively due to missing or insufficient data. The included studies did not report a difference between groups for health-related quality of life and length of hospital stay. Data on remaining outcomes were not reported or were reported inadequately in the included studies.
AUTHORS' CONCLUSIONS
Prehabilitation may result in an improved functional capacity, determined with the 6-minute walk test both preoperatively and postoperatively. Complication rates and the number of emergency department visits postoperatively may also diminish due to a prehabilitation programme, while the number of re-admissions may be higher in the prehabilitation group. The certainty of evidence ranges from moderate to very low, due to downgrading for serious risk of bias, imprecision and inconsistency. In addition, only three heterogeneous studies were included in this review. Therefore, the findings of this review should be interpreted with caution. Numerous relevant RCTs are ongoing and will be included in a future update of this review.
Topics: Colorectal Neoplasms; Humans; Length of Stay; Postoperative Complications; Preoperative Exercise; Quality of Life
PubMed: 35588252
DOI: 10.1002/14651858.CD013259.pub2 -
Clinical Rehabilitation Sep 2022To systemically review the effects of low-intensity pulsed ultrasound (LIPUS) on pain relief and functional recovery in patients with knee osteoarthritis (KOA). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systemically review the effects of low-intensity pulsed ultrasound (LIPUS) on pain relief and functional recovery in patients with knee osteoarthritis (KOA).
DATA SOURCES
PubMed, Web of Science, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were used from inception to 18 March 2022.
REVIEW METHODS
Meta-analysis was performed to evaluate pain and function recovery between control and LIPUS groups. Standardized mean difference (SMD) or mean difference (MD) and 95% confidence interval (CI) were calculated, and data were combined using the fixed or random-effect model.
RESULTS
Thirteen studies involving 807 patients with KOA were included. Patients' outcomes treated by LIPUS were improved significantly, including Visual analog scale (VAS) score (MD = -0.95, 95% CI: -1.43 to -0.48, < 0.001), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score (MD = -4.35, 95% CI: -8.30 to -0.40, = 0.0309), Lysholm score (SMD = 1.59, 95% CI: 1.29 to 1.90, < 0.001), Lequesne index (MD = -1.33, 95% CI: -1.69 to -0.96, < 0.001), Range of motion (ROM) (MD = 2.43, 95% CI: 0.39 to 4.46, = 0.0197) and 50 meter walking time (SMD = 1.48, 95% CI: 0.46 to 2.49, = 0.0044). Subgroup analyses showed monotherapy of LIPUS produced a better effect on reducing VAS score ( = 0.0213), and the shorter therapeutic period (≤4 weeks) produced a more significant effect on raising the WOMAC score ( = 0.0083).
CONCLUSION
LIPUS was beneficial for pain relief and functional knee recovery and maybe as an alternative therapy in KOA rehabilitation.
Topics: Humans; Knee Joint; Osteoarthritis, Knee; Pain; Randomized Controlled Trials as Topic; Ultrasonic Waves
PubMed: 35535403
DOI: 10.1177/02692155221097035 -
Frontiers in Psychology 2022Needle-related pain, fear, and anxiety can be a deterrent to treatments in children and adolescents. Virtual reality (VR) can be used to manage the poor experience of...
BACKGROUND
Needle-related pain, fear, and anxiety can be a deterrent to treatments in children and adolescents. Virtual reality (VR) can be used to manage the poor experience of needle procedures.
OBJECTIVE
This meta-analysis aimed to examine the effects of VR on pain, fear, and anxiety related to needle procedures in children and adolescents.
METHODS
PubMed, EMBASE, and the Cochrane Library were searched for potentially eligible studies published up to June 2021. The outcomes were pain assessed by the Wong-Baker Faces Pain Scale (WBS) or Faces Pain Scale-Revised (FPS-R), and Visual Analog Scale (VAS), fear assessed by Children's Fear Scale (CFS), and anxiety assessed by Children's Anxiety Meter (CAM), VAS, or CFS. Because of expected heterogeneity among studies, all analyses were conducted using the random-effects model.
RESULTS
Ten studies were included (571 children in the VR group and 575 in the control group). Based on the WBS, VR reduced pain, either self-reported (WMD = -2.17, 95%CI: -3.37, -0.97), parent-reported (WMD = -3.52, 95%CI: -4.62, -2.42), nurse-reported (WMD = -3.29, 95%CI: -5.59, -0.99), and physician/investigator-reported (WMD = -3.48, 95%CI: -5.93, -1.04). Using the FPS-R, VR reduced needle-related pain compared with controls (WMD = -0.85, 95%CI: -1.64, -0.06). Similar results were observed for fear (children/adolescents: WMD = -1.52, 95%CI: -2.18, -0.86; parents: WMD = -1.71, 95%CI: -2.30, -1.13; nurses: WMD = -1.55, 95%CI: -2.47, -0.63; physicians/investigators: WMD = -0.59, 95%CI: -1.00, -0.18) and anxiety (self-reported: WMD = -2.79, 95%CI: -4.07, -1.54; parent-reported: WMD = -3.87, 95%CI: -5.58, -2.15; nurse-reported: WMD = -4.64, 95%CI: -6.56, -2.71; physician/investigator-reported: WMD = -2.06, 95%CI: -4.13, -0.00).
CONCLUSION
A VR-based intervention could reduce needle-related pain, fear, and anxiety in children and adolescents.
PubMed: 35519646
DOI: 10.3389/fpsyg.2022.842847 -
Gerontology 2022Aging is often associated with increasing functional decline as measured by deterioration in mobility and activities of daily living. Older adults (OAs) living in...
BACKGROUND
Aging is often associated with increasing functional decline as measured by deterioration in mobility and activities of daily living. Older adults (OAs) living in residential long-term care (LTC) homes in particular may not engage in regular physical exercise, significantly increasing their risk of further cognitive and functional decline. Exergaming may hold promise for OAs by combining exercise and technology-based gaming systems, but evidence for its use in LTC is unknown.
METHODS
A systematic review was conducted to summarize the effects of exergaming interventions on physical, cognitive, and quality of life (QoL) outcomes for OAs (>65 years of age) living in LTC.
RESULTS
Twenty-one studies involving 657 OAs living in LTC met the inclusion criteria. Most studies were associated with a high risk of bias and many used uncontrolled designs and small samples. Across studies, exergame interventions were associated with preliminary benefits relative to control conditions on standardized measures of physical outcomes (e.g., Timed Up & Go, 5-meter gait speed). No consistent effects were found for cognitive and QoL outcomes.
CONCLUSIONS
Exergames might be a promising intervention to benefit the physical health of OAs (>65 years) living in LTC, but more research is required to determine the effects of exergaming on physical health, as well as cognitive and QoL outcomes. More specifically, larger and more methodologically robust evaluations are needed.
Topics: Activities of Daily Living; Aged; Cognition; Exergaming; Humans; Long-Term Care; Quality of Life
PubMed: 35290983
DOI: 10.1159/000521832 -
JAMA Network Open Mar 2022The prevalence of overweight (body mass index [BMI] = 25-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity (BMI ≥30) is... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
The prevalence of overweight (body mass index [BMI] = 25-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity (BMI ≥30) is increasing among patients with cystic fibrosis (CF). However, it is unclear whether there is a benefit associated with increasing weight compared with the reference range (ie, normal) in CF.
OBJECTIVE
To evaluate the association of altered BMI or body composition and clinical outcomes in patients with CF.
DATA SOURCES
For this systematic review and meta-analysis, the literature search was conducted November 2, 2020, of 3 databases: MEDLINE (via PubMed), Embase, and Cochrane Central Register of Controlled Trials.
STUDY SELECTION
Patients older than 2 years diagnosed with CF with altered body composition or BMI were compared with patients having the measured parameters within the reference ranges. Records were selected by title, abstract, and full text; disagreements were resolved by consensus. Cohort studies and conference abstracts were eligible; articles with no original data and case reports were excluded.
DATA EXTRACTION AND SYNTHESIS
Two authors independently extracted data, which were validated by a third author. Studies containing insufficient poolable numerical data were included in the qualitative analysis. A random-effects model was applied in all analyses.
MAIN OUTCOMES AND MEASURES
Pulmonary function, exocrine pancreatic insufficiency (PI), and CF-related diabetes (CFRD) were investigated as primary outcomes. Odds ratios (ORs) or weighted mean differences (WMDs) with 95% CIs were calculated. The hypothesis was formulated before data collection.
RESULTS
Of 10 524 records identified, 61 met the selection criteria and were included in the qualitative analysis. Of these, 17 studies were included in the quantitative synthesis. Altogether, 9114 patients were included in the systematic review and meta-analysis. Overweight (WMD, -8.36%; 95% CI, -12.74% to -3.97%) and obesity (WMD, -12.06%; 95% CI, -23.91% to -0.22%) were associated with higher forced expiratory volume in the first second of expiration compared with normal weight. The odds for CFRD and PI were more likely in patients of normal weight (OR, 1.49; 95% CI, 1.10 to 2.00) than in those who were overweight (OR, 4.40; 95% CI, 3.00 to 6.45). High heterogeneity was shown in the analysis of pulmonary function (I2 = 46.7%-85.9%).
CONCLUSIONS AND RELEVANCE
The findings of this systematic review and meta-analysis suggest that the currently recommended target BMI in patients with CF should be reconsidered. Studies with long-term follow-up are necessary to assess the possible adverse effects of higher BMI or higher fat mass in patients with CF.
Topics: Body Mass Index; Cystic Fibrosis; Humans; Obesity; Overweight; Prevalence
PubMed: 35254432
DOI: 10.1001/jamanetworkopen.2022.0740