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Nutrients Nov 2023In the pursuit of enhanced athletic prowess in different disciplines, athletes constantly look for strategies to increase their physical performance, encompassing... (Review)
Review
In the pursuit of enhanced athletic prowess in different disciplines, athletes constantly look for strategies to increase their physical performance, encompassing technical skills and dietary components, which inevitably, in most cases, include the incorporation of sports supplements. In recent years, there has been an increase in the number of athletes using ergogenic aids. In this context, scientific evidence must play a prominent role in either endorsing or warning against the use of these products, ensuring the preservation of health while promoting the theoretically established positive benefits. In this vein, beetroot juice (BJ) stands out as a key supplement as an ergogenic aid to improve sports performance, given its demonstrated influence on both aerobic and anaerobic exercise. However, despite widespread global demand, there remains a lack of understanding regarding the potential synergistic effects of combining BJ with other supplements. Consequently, our study aims to determine whether the combination of BJ with another nutritional supplement can enhance its beneficial effects and, therefore, optimize physical performance in humans. A comprehensive literature search was conducted in two major databases-Web of Science and PubMed-from 1 January 2018 to 29 January 2023, using specific keywords. After the exclusion criteria, six articles were selected for analysis. Therefore, our study shows that the effectiveness of combining BJ with another supplement mainly depends on the duration of the chronic intervention, which is where the greatest benefits have been observed.
Topics: Humans; Athletic Performance; Dietary Supplements; Diet
PubMed: 38004231
DOI: 10.3390/nu15224838 -
The International Journal of Behavioral... Nov 2023To determine rates of compliance (i.e., supervised intervention attendance) and adherence (i.e., unsupervised physical activity completion) to high-intensity interval... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To determine rates of compliance (i.e., supervised intervention attendance) and adherence (i.e., unsupervised physical activity completion) to high-intensity interval training (HIIT) among insufficiently active adults and adults with a medical condition, and determine whether compliance and adherence rates were different between HIIT and moderate-intensity continuous training (MICT).
METHODS
Articles on adults in a HIIT intervention and who were either insufficiently active or had a medical condition were included. MEDLINE, EMBASE, PsychINFO, SPORTDiscus, CINAHL, and Web of Science were searched. Article screening and data extraction were completed by two independent reviewers. Risk of bias was assessed using RoB 2.0 or ROBINS-I. Meta-analyses were conducted to discern differences in compliance and adherence between HIIT vs. MICT. Sensitivity analyses, publication bias, sub-group analyses, and quality appraisal were conducted for each meta-analysis.
RESULTS
One hundred eighty-eight unique studies were included (n = 8928 participants). Compliance to HIIT interventions averaged 89.4% (SD:11.8%), while adherence to HIIT averaged 63% (SD: 21.1%). Compliance and adherence to MICT averaged 92.5% (SD:10.6%) and 68.2% (SD:16.2%), respectively. Based on 65 studies included in the meta-analysis, compliance rates were not different between supervised HIIT and MICT interventions [Hedge's g = 0.015 (95%CI: - 0.088-0.118), p = .78]. Results were robust and low risk of publication bias was detected. No differences were detected based on sub-group analyses comparing medical conditions or risk of bias of studies. Quality of the evidence was rated as moderate over concerns in the directness of the evidence. Based on 10 studies, adherence rates were not different between unsupervised HIIT and MICT interventions [Hedge's g = - 0.313 (95%CI: - 0.681-0.056), p = .096]. Sub-group analysis points to differences in adherence rates dependent on the method of outcome measurement. Adherence results should be interpreted with caution due to very low quality of evidence.
CONCLUSIONS
Compliance to HIIT and MICT was high among insufficiently active adults and adults with a medical condition. Adherence to HIIT and MICT was relatively moderate, although there was high heterogeneity and very low quality of evidence. Further research should take into consideration exercise protocols employed, methods of outcome measurement, and measurement timepoints.
REGISTRATION
This review was registered in the PROSPERO database and given the identifier CRD42019103313.
Topics: Adult; Humans; High-Intensity Interval Training; Exercise
PubMed: 37990239
DOI: 10.1186/s12966-023-01535-w -
World Journal of Hepatology Oct 2023The existing literature suggests that exercise for cirrhotic patients is safe and favours significant improvement to their physical capacity. However, exercise training...
BACKGROUND
The existing literature suggests that exercise for cirrhotic patients is safe and favours significant improvement to their physical capacity. However, exercise training for this population and how to deliver activities, especially in severe stages of the disease and while waiting for a liver transplant (LT), remain undefined.
AIM
To review the existing exercise prescriptions for cirrhotic patients on the waiting list for LT, their results for frailty evolution and their effect on clinical outcomes.
METHODS
A systematic review was performed following the Preferred Reporting Review and Meta-Analysis guidelines and searching the PubMed, MEDLINE, and Scopus databases. The keyword "liver transplant" was used in combination with the free terms "frailty" and "exercise" for the literature review. Clinical studies that evaluated the effect of a regular training program, independent of supervision or the duration or intensity of physical exercise, in cirrhotic patients on the waiting list for LT were reviewed. The data on safe physical activity prescriptions following Frequency, Intensity, Time, and Type recommendations were extracted and summarised.
RESULTS
Nine articles met the inclusion criteria for this review. Various instruments for frailty assessment were used, frequently in combination. Five studies prescribed physical activity for patients, one in-person and four to be performed remotely and unsupervised. The remaining four studies only used a self-report instrument to assess the level of physical activity. None reported adverse events related to exercise training. The exercise frequency mainly varied from daily to a minimum of twice per week. The intensity depended on frailty and included increasing levels of activity. The type of exercise was predominantly a combination of aerobic and resistance training. The duration of exercise varied from 4 to 12 wk. Three articles evaluated the effect of the exercise program on clinical outcomes, reporting a reduction in 90-d readmission rates post-transplant and improved frailty scores, as well as improved survival of cirrhotic patients waiting for LT.
CONCLUSION
Routine frailty assessment is essential for this population. Although more robust evidence is required, the prescription of exercise is safe and can improve patients' functional capacity, improving pre- and post-LT outcomes.
PubMed: 37970618
DOI: 10.4254/wjh.v15.i10.1153 -
Diagnostics (Basel, Switzerland) Oct 2023Ultrasound elastography is gaining attention for its diagnostic potential across various medical fields, and its physical properties make it valuable in modern clinical... (Review)
Review
Ultrasound elastography is gaining attention for its diagnostic potential across various medical fields, and its physical properties make it valuable in modern clinical medicine. However, its specific attributes, especially in the context of recent medical advancements, remain relatively unexplored. This study aimed to identify instrument-specific characteristics and applications of real-time ultrasound elastography, shear wave elastography, and strain elastography, particularly within gastroenterology. Following PRISMA guidelines, the study examined elastography articles on databases like PubMed, resulting in 78 included articles. Data on patient demographics, organ involvement, specificity, sensitivity, accuracy, positive predictive value, and negative predictive value were extracted. Statistical analysis involved SPSS version 21, with significance set at < 0.05. The majority of patients were male (50.50%), with a mean age of 42.73 ± 4.41 years. Shear wave elastography was the most prevalent technique (48.7%), and liver investigations were predominant in gastroenterology (34.6%). Gastrointestinal applications showed higher sensitivity, positive predictive value, and negative predictive values ( < 0.05) but lower specificity ( < 0.05). Real-time ultrasound elastography exhibited increased specificity, accuracy, and predictive values ( < 0.05). Ultrasound elastography appears more accurate and effective in gastroenterological settings. Nonetheless, its performance depends on instrument-specific and operator-dependent factors. While promising, further studies are necessary to ascertain optimal utilization in both gastrointestinal and non-gastrointestinal conditions.
PubMed: 37958199
DOI: 10.3390/diagnostics13213302 -
Journal of Sport and Health Science May 2024Regular physical exercise has been recognized as a potent modulator of immune function, with its effects including enhanced immune surveillance, reduced inflammation,... (Review)
Review
Regular physical exercise has been recognized as a potent modulator of immune function, with its effects including enhanced immune surveillance, reduced inflammation, and improved overall health. While strong evidence exists that physical exercise affects the specific expression and activity of non-coding RNAs (ncRNAs) also involved in immune system regulation, heterogeneity in individual study designs and analyzed exercise protocols exists, and a condensed list of functional, exercise-dependent ncRNAs with known targets in the immune system is missing from the literature. A systematic review and qualitative analysis was used to identify and categorize ncRNAs participating in immune modulation by physical exercise. Two combined approaches were used: (a) a systematic literature search for "ncRNA and exercise immunology", (b) and a database search for microRNAs (miRNAs) (miRTarBase and DIANA-Tarbase v8) aligned with known target genes in the immune system based on the Reactome database, combined with a systematic literature search for "ncRNA and exercise". Literature searches were based on PubMed, Web of Science, and SPORTDiscus; and miRNA databases were filtered for targets validated by in vitro experimental data. Studies were eligible if they reported on exercise-based interventions in healthy humans. After duplicate removal, 95 studies were included reporting on 164 miRNAs, which were used for the qualitative synthesis. Six studies reporting on long-noncoding RNAs (lncRNAs) or circular RNAs were also identified. Results were analyzed using ordering tables that included exercise modality (endurance/resistance exercise), acute or chronic interventions, as well as the consistency in reported change between studies. Evaluation criteria were defined as "validated" with 100% of ≥3 independent studies showing identical direction of regulation, "plausible" (≥80%), or "suggestive" (≥70%). For resistance exercise, upregulation of miR-206 was validated while downregulation of miR-133a appeared plausible. For endurance exercise, 15 miRNAs were categorized as validated, with 12 miRNAs being consistently elevated and 3 miRNAs being downregulated, most of them after acute exercise training. In conclusion, our approach provides evidence that miRNAs play a major role in exercise-induced effects on the innate and adaptive immune system by targeting different pathways affecting immune cell distribution, function, and trafficking as well as production of (anti-)inflammatory cytokines. miRNAs miR-15, miR-29c, miR-30a, miR-142/3, miR-181a, and miR-338 emerged as key players in mediating the immunomodulatory effects of exercise predominantly after acute bouts of endurance exercise.
Topics: Humans; Exercise; MicroRNAs; RNA, Untranslated; Immune System
PubMed: 37925072
DOI: 10.1016/j.jshs.2023.11.001 -
Neuroscience and Biobehavioral Reviews Dec 2023This systematic review estimates the prevalence of co-occurring conditions (CCs) in children and adults with autism. A comprehensive search strategy consulting existing... (Meta-Analysis)
Meta-Analysis Review
This systematic review estimates the prevalence of co-occurring conditions (CCs) in children and adults with autism. A comprehensive search strategy consulting existing guidelines, diagnostic manuals, experts, carers, and autistic people was developed. PubMed and PsycInfo databases from inception to May 2022 were searched. PROSPERO registration: CRD42019132347. Two blind authors screened and extracted the data. Prevalence estimates for different CCs were summarized by using random effects models. Subgroup analyses were performed for age groups (children/adolescents vs adults) and study designs (population/registry-based vs clinical sample-based). Of 19,932 studies, 340 publications with about 590,000 participants were included and meta-analyzed to estimate the prevalence of 38-point prevalence, 27-lifetime, and 3 without distinction between point and lifetime prevalence. Point prevalence of developmental coordination disorder, sleep-wake problem, gastrointestinal problem, ADHD, anxiety disorder, overweight/obesity, feeding and eating disorder, elimination disorder, disruptive behavior, and somatic symptoms and related disorder were the most frequent CCs. Prevalence differed depending on the age group and study design. Knowing specific CCs linked to autism helps professional investigations and interventions for improved outcomes.
Topics: Child; Adolescent; Adult; Humans; Autism Spectrum Disorder; Prevalence; Obesity; Autistic Disorder; Overweight
PubMed: 37913872
DOI: 10.1016/j.neubiorev.2023.105436 -
BMJ Open Oct 2023The economic burden of COVID-19 pandemic is substantial, with both direct and indirect costs playing a significant role.
OBJECTIVES
The economic burden of COVID-19 pandemic is substantial, with both direct and indirect costs playing a significant role.
DESIGN
A systematic literature review was conducted to estimate the cost of the COVID-19 pandemic and the cost-effectiveness of pharmaceutical or non-pharmaceutical interventions. All cost data were adjusted to the 2021 Euro, and interventions compared with null.
DATA SOURCES
Ovid MEDLINE and EMBASE were searched from January 2020 through 22 April 2021.
ELIGIBILITY CRITERIA
Studies regarding COVID-19 outbreak or public health preparedness measures or interventions with outcome measures related to the direct and indirect costs for disease and preparedness and/or response in countries of the European Union (EU), the European Economic Area (EEA), the UK and the Organisation for Economic Co-operation and Development (OECD) of all relevant epidemiological designs which estimate cost within the selected time frame were considered eligible.
DATA EXTRACTION AND SYNTHESIS
Studies were searched, screened and coded independently by two reviewers with high measure of inter-rater agreement. Data were extracted to a predefined data extraction sheet. The risk of bias was assessed using the Consensus on Health Economic Criteria checklist.
RESULTS
We included data from 41 economic studies. Ten studies evaluated the cost of the COVID-19 pandemic, while 31 assessed the cost-benefit of public health surveillance, preparedness and response measures. Overall, the economic burden of the COVID-19 pandemic was found to be substantial. Community screening, bed provision policies, investing in personal-protective-equipment and vaccination strategies were cost-effective. Physical distancing measures were associated with health benefits; however, their cost-effectiveness was dependent on the duration, compliance and the phase of the epidemic in which it was implemented.
CONCLUSIONS
COVID-19 pandemic is associated with substantial short-term and long-term economic costs to healthcare systems, payers and societies, while interventions including testing and screening policies, vaccination and physical distancing policies were identified as those presenting cost-effective options to deal with the pandemic, dependent on population vaccination and the R at the stage of the pandemic.
Topics: Humans; COVID-19; Pandemics; Cost-Benefit Analysis; Organisation for Economic Co-Operation and Development; European Union; United Kingdom
PubMed: 37907290
DOI: 10.1136/bmjopen-2023-077602 -
Bioengineering (Basel, Switzerland) Oct 2023Pulmonary auscultation is essential for detecting abnormal lung sounds during physical assessments, but its reliability depends on the operator. Machine learning (ML)... (Review)
Review
Pulmonary auscultation is essential for detecting abnormal lung sounds during physical assessments, but its reliability depends on the operator. Machine learning (ML) models offer an alternative by automatically classifying lung sounds. ML models require substantial data, and public databases aim to address this limitation. This systematic review compares characteristics, diagnostic accuracy, concerns, and data sources of existing models in the literature. Papers published from five major databases between 1990 and 2022 were assessed. Quality assessment was accomplished with a modified QUADAS-2 tool. The review encompassed 62 studies utilizing ML models and public-access databases for lung sound classification. Artificial neural networks (ANN) and support vector machines (SVM) were frequently employed in the ML classifiers. The accuracy ranged from 49.43% to 100% for discriminating abnormal sound types and 69.40% to 99.62% for disease class classification. Seventeen public databases were identified, with the ICBHI 2017 database being the most used (66%). The majority of studies exhibited a high risk of bias and concerns related to patient selection and reference standards. Summarizing, ML models can effectively classify abnormal lung sounds using publicly available data sources. Nevertheless, inconsistent reporting and methodologies pose limitations to advancing the field, and therefore, public databases should adhere to standardized recording and labeling procedures.
PubMed: 37892885
DOI: 10.3390/bioengineering10101155 -
Journal of Personalized Medicine Oct 2023Intraoral orthodontic elastics (IOE), typically referred to as rubber bands, are important tools for correcting malocclusion, and they are classified into latex and... (Review)
Review
Evaluation of the Loss of Strength, Resistance, and Elasticity in the Different Types of Intraoral Orthodontic Elastics (IOE): A Systematic Review of the Literature of In Vitro Studies.
BACKGROUND
Intraoral orthodontic elastics (IOE), typically referred to as rubber bands, are important tools for correcting malocclusion, and they are classified into latex and synthetic (elastomeric-based) elastics. They have different strengths and sizes, depending on their intended use, that provide clinicians with the ability to correct both anteroposterior and vertical discrepancies. Clinical use, together with saliva, alters the physical characteristics of both latex and synthetic elastics, causing declines in strength over time.
AIM
The aim of the study was to assess, through a systematic review of in vitro studies, the properties of intraoral elastics. The primary goal was to evaluate how IOEs behave in terms of tension strength and duration. The secondary goal was to investigate the force loss during the first hours of wear. The tertiary goal was to assess how these forces decayed.
MATERIALS AND METHODS
The following electronic databases were searched from December 2020 to April 2021: Medline Full Text, PubMed, Cochrane Clinical Trials Register, Science Direct, and Literature Review. Out of 8505 initial articles, 10 were selected for the systematic review.
RESULTS
The force-degradation property was found in all types of IOEs. The loss of strength was directly proportional to time, with the highest value during the first 3 h after extension, regardless of the elastic band size and manufacturer. The forces generated by the latex bands were higher than in those of the elastomeric-based elastics, but they did not consistently correspond to the loads specified by the manufacturers. The retention forces in the latex IOEs were significantly higher than those in the nonlatex bands, suggesting that elastomeric-based bands need to be changed more frequently and at regular intervals throughout a 24 h period.
CONCLUSION
This systematic review indicates that intraoral orthodontic elastics have the greatest loss of force during the first 3 h, that latex rubber bands have the highest strength during the first hour, that the forces generated are not always consistent with the manufacturer's specifications, and that nonlatex (elastomeric-based) IOEs need to be changed frequently and regularly during a 24-h cycle.
PubMed: 37888106
DOI: 10.3390/jpm13101495 -
NIHR Open Research 2023Smoking cessation interventions are being introduced into routine secondary care in the United Kingdom (UK), but there are person and setting-related factors that could...
Covariates of success in quitting smoking: a systematic review of studies from 2008 to 2021 conducted to inform the statistical analyses of quitting outcomes of a hospital-based tobacco dependence treatment service in the United Kingdom.
BACKGROUND
Smoking cessation interventions are being introduced into routine secondary care in the United Kingdom (UK), but there are person and setting-related factors that could moderate their success in quitting smoking. This review was conducted as part of an evaluation of the QUIT hospital-based tobacco dependence treatment service ( https://sybics-quit.co.uk). The aim of the review was to identify a comprehensive set of variables associated with quitting success among tobacco smokers contacting secondary healthcare services in the UK who are offered support to quit smoking and subsequently set a quit date. The results would then be used to inform the development of a statistical analysis plan to investigate quitting outcomes.
METHODS
Systematic literature review of five electronic databases. Studies eligible for inclusion investigated quitting success in one of three contexts: (a) the general population in the UK; (b) people with a mental health condition; (c) quit attempts initiated within a secondary care setting. The outcome measures were parameters from statistical analysis showing the effects of covariates on quitting success with a statistically significant (i.e., p-value <0.05) association.
RESULTS
The review identified 29 relevant studies and 14 covariates of quitting success, which we grouped into four categories: demographics (age; sex; ethnicity; socio-economic conditions; relationship status, cohabitation and social network), individual health status and healthcare setting (physical health, mental health), tobacco smoking variables (current tobacco consumption, smoking history, nicotine dependence; motivation to quit; quitting history), and intervention characteristics (reduction in amount smoked prior to quitting, the nature of behavioural support, tobacco dependence treatment duration, pharmacological aids).
CONCLUSIONS
In total, 14 data fields were identified that should be considered for inclusion in datasets and statistical analysis plans for evaluating the quitting outcomes of smoking cessation interventions initiated in secondary care contexts in the UK.
PROSPERO REGISTRATION
CRD42021254551 (13/05/2021).
PubMed: 37881466
DOI: 10.3310/nihropenres.13427.2