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BMC Pediatrics Dec 2023The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association...
BACKGROUNDS
The Autism spectrum disorder (ASD) prevalence has increased significantly over the past two decades. This review summarizes the current knowledge of the association between the early life growth of head circumference (HC), weight, and height with ASD in infants.
METHODS
PubMed, Scopus, Science Direct, and Google Scholar databases were searched up to November 2021 using relevant keywords. All original articles are written in English evaluating the early life growth of HC, weight, and height in infants with ASD were eligible for the present review.
RESULTS
Totally, 23 articles involving 4959 infants were included in this review. Of 13 studies that evaluated HC of infants at birth, 10 studies (83.33%) showed that the HC at the birth of autistic children was similar to that of the average found in the control group. Among 21 studies that evaluated the HC and weight status in infants, 19 studies (90.47%) showed that autistic children had larger HC and weight than the control group or abnormal acceleration of head growth during infancy. Height growth of infants was investigated in 13 studies, of which 10 cases (76.92%) reported that infants with ASD were significantly longer than control groups. Most of he included studies had a good quality.
CONCLUSIONS
The findings suggest that in infants with ASD, without the contribution of birth growth factors and sex of the child, the growth of HC, weight, and height probably was faster than in infants with normal development, in early life. Therefore, these measurements might be useful as initial predictive biomarkers for the risk of developing ASD.
Topics: Infant; Child; Infant, Newborn; Humans; Autism Spectrum Disorder; Head; Cephalometry; Biomarkers; Prevalence
PubMed: 38066466
DOI: 10.1186/s12887-023-04445-9 -
BMC Public Health Dec 2023Despite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Despite several strategies exist for anemia prevention and control, it has been the major public health important problem in the world. Numerous immediate and long-term health issues were reported in children who have history of anemia including decreased work productivity in adult hood period. Although analyzing data on burden and risk factors of anemia are the recommended action areas of World Health Organization framework for accelerating anemia reduction, the aggregated national burden and contributors of anemia in Ethiopia has not been determined so far. There for, this systematic and meta-analysis study is aimed to assess the pooled prevalence and associated factors of anemia among children aged 6-23 months in Ethiopia.
METHODS
The electronic databases including PubMed, Scopus, EMBASE, Web of Science, Science Direct, Google scholar and institutional repositories were searched using search terms. The studies that reported the prevalence and/or risk factors of anemia in children 6-23 months of age were included. The JBI quality assessment tool was used to evaluate the quality of each study. The data was extracted with Microsoft Excel, 2019 and analyzed with STATA 17.0 statistical software. A random effect model was used to estimate the pooled prevalence of anemia and its associated factors. The Cochrane Q-test statistics and I test were used to measure heterogeneity between the included studies. Furthermore, publication bias was examined using the funnel plot graph and statistical tests (Egger's and begg tests). Outliers also visualized using Galbraith plot. When necessary, sensitivity analysis was also employed to detect small study effect.
RESULT
Ten studies with a total population of 14, 733 were included for analysis. The pooled prevalence of anemia among children aged 6-23 months of age in Ethiopia was found to be 57.76% (95%CI; 51.61-63.91; I = 97.192%; p < 0.001). Having history of diarrhea AOR = 2.44 (95%CI: 1.03-3.85), being stunted AOR = 2.00 (95%CI: 1.38-2.61), living in food insecure house hold AOR = 2.08 (95%CI: 1.10-3.07), consuming less diversified food AOR = 2.73 (95%CI: 2.06-3.39) and being 6-11 months of age AOR = 1.59 (95%CI: 1.23-1.95) were associated with anemia.
CONCLUSION AND RECOMMENDATION
The prevalence of anemia is in the range of severe public health problem among children aged 6-23 months in Ethiopia. Diarrhea, stunting, house hold food insecurity, dietary diversity, and age were the predictors of anemia. Further, prospective cohort and random controlled trial studies are recommended. Further, random controlled trial especially effectiveness of nutritional education interventions trial is important. To reduce prevalence of anemia, strengthening diarrhea reduction program, securing household food insecurity, preventing stunting, giving special attention for infants age 6-11 months and encouraging food diversification are important.
Topics: Infant; Humans; Child; Ethiopia; Prevalence; Prospective Studies; Anemia; Diarrhea; Growth Disorders
PubMed: 38042804
DOI: 10.1186/s12889-023-17330-y -
Journal of Medical Economics 2023Increasing trend for progression-free survival (PFS)-based primary endpoint in oncology has led to lack of mature overall survival (OS) data at the time of approval. To...
Bayesian survival extrapolation for cost-effectiveness analysis: a case study of RELAY for ramucirumab in combination with erlotinib in the treatment of non-small-cell lung cancer.
AIM
Increasing trend for progression-free survival (PFS)-based primary endpoint in oncology has led to lack of mature overall survival (OS) data at the time of approval. To address this evidence gap in economic evaluations, we used a joint Bayesian approach to predict survival outcomes using immature OS data from the RELAY trial.
METHODS
Patient data from RELAY and systematic literature review (SLR) of phase 3 randomized clinical trials with hazard ratio (HR) estimates of mature PFS and immature OS were considered. OS and PFS were analyzed individually using a univariate model; bivariate analysis was performed using a joint model based on modified Bayesian normal induced copula estimation model. First, a Bayesian univariate model incorporated informative priors based on predicted HR and acceleration factor for OS and PFS. Second, a Bayesian-based joint model of RELAY PFS and OS data was based on the correlation between PFS and OS established in trials of similar populations. Marginal distribution of PFS was used to estimate the same for OS.
RESULTS
Publications ( = 122) of first-line treatments in patients with epidermal growth factor receptor ()-mutated non-small cell lung cancer were identified in the SLR, of which 36 trials were linked to RELAY. Twenty-six trials with HR data were used. The univariate model could predict OS with reduced uncertainty compared with the frequentist approach. In the joint model, the marginal OS distribution borrowed strength from the marginal PFS distribution through the established correlation coefficient.
LIMITATIONS
Bayesian approach was successfully used in RELAY analysis but may not be universally applied to oncology trials due to the different associations of OS and PFS and different trial patient populations.
CONCLUSIONS
We demonstrated that both the univariate and joint Bayesian models reduced uncertainty in predicting OS compared to frequentist method. The methodology introduced here will have potential applications in clinical decision-making for other oncology trials.
Topics: Humans; Antineoplastic Combined Chemotherapy Protocols; Bayes Theorem; Carcinoma, Non-Small-Cell Lung; Cost-Benefit Analysis; Erlotinib Hydrochloride; Lung Neoplasms; Ramucirumab; Clinical Trials, Phase III as Topic
PubMed: 38035666
DOI: 10.1080/13696998.2023.2272534 -
The International Journal of Oral &... Nov 2023The clinical use of bioactive substances, such as growth factors, have significantly increased, however, potential regenerative effects derived from the addition of...
Do recombinant, purified or concentrated growth factors enhance the regenerative potential of particulate bone graft substitutes in maxillary sinus floor augmentation? A systematic review and meta-analysis.
BACKGROUND
The clinical use of bioactive substances, such as growth factors, have significantly increased, however, potential regenerative effects derived from the addition of different growth factors to bone substitutes on maxillary sinus floor augmentation (MSA) procedures is still controversial. This systematic review (SR) aimed at answering the following question: "Do recombinant, purified and concentrated growth factors enhance the regenerative potential of particulate bone graft substitutes in maxillary sinus floor augmentation?".
METHODS
Human studies comparing histomorphometric data of the outcomes of interest new bone formation, residual graft material, and fibrous tissue ratio following MSA procedures employing particulate bone grafts/substitutes in combination or not with growth factors were retrieved from PubMed/MEDLINE, Web of Science, Cochrane and Scopus online databases and complemented with a hand search. Controlled studies published in English up to December 2022 and reporting on histomorphometric data expressed as percent volume of the outcomes of interest were considered. Risk of bias was assessed, and a meta-analysis (MA) was performed to investigate the effects of supplementary growth factors on new bone formation, remaining graft particles and fibrous tissue ratio.
RESULTS
Data of 613 samples from 477 patients reported in 22 publications were included. MA showed PRP or PRF resulted in 49% more new bone formation than in areas in control groups (P=0.004), and those areas supplemented with growth factors presented 57% less residual graft particles after healing (P<0.0001). A significant (P=0.03) 1.85-fold increase in connective tissue formation was noted in areas treated with rhBMP after healing.
CONCLUSION
The MA provided evidence that selective supplementary growth factors may enhance new bone formation and accelerate particulate graft turnover, while rhBMP may significantly increase connective tissue formation in MSA procedures in humans.
PubMed: 37939238
DOI: 10.11607/jomi.10553 -
The Cochrane Database of Systematic... Nov 2023Many infants are fed infant formulas to promote growth. Some formulas have a high protein content (≥ 2.5 g per 100 kcal) to accelerate weight gain during the first... (Review)
Review
BACKGROUND
Many infants are fed infant formulas to promote growth. Some formulas have a high protein content (≥ 2.5 g per 100 kcal) to accelerate weight gain during the first year of life. The risk-benefit balance of these formulas is unclear.
OBJECTIVES
To evaluate the benefits and harms of higher protein intake versus lower protein intake in healthy, formula-fed term infants.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, OpenGrey, clinical trial registries, and conference proceedings in October 2022.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) of healthy formula-fed infants (those fed only formula and those given formula as a complementary food). We included infants of any sex or ethnicity who were fed infant formula for at least three consecutive months at any time from birth. We excluded quasi-randomized trials, observational studies, and infants with congenital malformations or serious underlying diseases. We defined high protein content as 2.5 g or more per 100 kcal, and low protein content as less than 1.8 g per 100 kcal (for exclusive formula feeding) or less than 1.7 g per 100 kcal (for complementary formula feeding).
DATA COLLECTION AND ANALYSIS
Four review authors independently assessed the risk of bias and extracted data from trials, and a fifth review author resolved discrepancies. We performed random-effects meta-analyses, calculating risk ratios (RRs) or Peto odds ratios (Peto ORs) with 95% confidence intervals (CIs) for dichotomous outcomes, and mean differences (MDs) with 95% CIs for continuous outcomes. We used the GRADE approach to evaluate the certainty of the evidence.
MAIN RESULTS
We included 11 RCTs (1185 infants) conducted in high-income countries. Seven trials (1629 infants) compared high-protein formula against standard-protein formula, and four trials (256 infants) compared standard-protein formula against low-protein formula. The longest follow-up was 11 years. High-protein formula versus standard-protein formula We found very low-certainty evidence that feeding healthy term infants high-protein formula compared to standard-protein formula has little or no effect on underweight (MD in weight-for-age z-score 0.05 SDs, 95% CI -0.09 to 0.19; P = 0.51, I = 61%; 7 studies, 1629 participants), stunting (MD in height-for-age z-score 0.15 SDs, 95% CI -0.05 to 0.35; P = 0.14, I = 73%; 7 studies, 1629 participants), and wasting (MD in weight-for-height z-score -0.12 SDs, 95% CI -0.31 to 0.07; P = 0.20, I = 94%; 7 studies, 1629 participants) in the first year of life. We found very low-certainty evidence that feeding healthy infants high-protein formula compared to standard-protein formula has little or no effect on the occurrence of overweight (RR 1.26, 95% CI 0.63 to 2.51; P = 0.51; 1 study, 1090 participants) or obesity (RR 1.96, 95% CI 0.59 to 6.48; P = 0.27; 1 study, 1090 participants) at five years of follow-up. No studies reported all-cause mortality. Feeding healthy infants high-protein formula compared to standard-protein formula may have little or no effect on the occurrence of adverse events such as diarrhea, vomiting, or milk hypersensitivity (RR 0.93, 95% CI 0.76 to 1.13; P = 0.44, I = 0%; 4 studies, 445 participants; low-certainty evidence) in the first year of life. Standard-protein formula versus low-protein formula We found very low-certainty evidence that feeding healthy infants standard-protein formula compared to low-protein formula has little or no effect on underweight (MD in weight-for-age z-score 0.0, 95% CI -0.43 to 0.43; P = 0.99, I = 81%; 4 studies, 256 participants), stunting (MD in height-for-age z-score -0.01, 95% CI -0.36 to 0.35; P = 0.96, I = 73%; 4 studies, 256 participants), and wasting (MD in weight-for-height z-score 0.13, 95% CI -0.29 to 0.56; P = 0.54, I = 95%; 4 studies, 256 participants) in the first year of life. No studies reported overweight, obesity, or all-cause mortality. Feeding healthy infants standard-protein formula compared to low-protein formula may have little or no effect on the occurrence of adverse events such as diarrhea, vomiting, or milk hypersensitivity (Peto OR 1.55, 95% CI 0.70 to 3.40; P = 0.28, I = 0%; 2 studies, 206 participants; low-certainty evidence) in the first four months of life.
AUTHORS' CONCLUSIONS
We are unsure if feeding healthy infants high-protein formula compared to standard-protein formula has an effect on undernutrition, overweight, or obesity. There may be little or no difference in the risk of adverse effects between infants fed with high-protein formula versus those fed with standard-protein formula. We are unsure if feeding healthy infants standard-protein formula compared to low-protein formula has any effect on undernutrition. There may be little or no difference in the risk of adverse effects between infants fed with standard-protein formula versus those fed with low-protein formula. The findings of six ongoing studies and two studies awaiting classification studies may change the conclusions of this review.
Topics: Infant; Humans; Milk Hypersensitivity; Overweight; Thinness; Growth Disorders; Obesity; Malnutrition; Diarrhea; Vomiting
PubMed: 37929831
DOI: 10.1002/14651858.CD013758.pub2 -
Sports Medicine (Auckland, N.Z.) Mar 2024Does younger involvement in talent promotion programs (TPPs) facilitate the attainment of higher performance levels? This question is the subject of the present... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Does younger involvement in talent promotion programs (TPPs) facilitate the attainment of higher performance levels? This question is the subject of the present meta-analysis. Many national sport systems have established TPPs such as federations' junior squads (including under-age selection teams) and youth sport academies, and many are making expanding investments in TPPs. TPPs seek to select the most advanced youth high performers at young ages, around puberty or younger, and then strive to further accelerate their performance development. However, studies show 25-55% annual athlete turnover within TPPs. In this context, accelerated biological maturation (puberty, growth spurt), high relative age within one's birth year, and intensified sport-specific childhood/adolescent practice may boost rapid junior performance, but the effects diminish or are reversed by adulthood. Moreover, expanded opportunity costs and risks (time demands, injury, burnout) imposed on young TPP participants may impair their long-term development and even prematurely terminate their career.
OBJECTIVE
We aimed to provide robust and generalizable evidence on the effects of early talent promotion on junior and senior performance through a systematic review and meta-analysis.
METHODS
A systematic literature search was conducted 18/03-03/04/2023 in SPORTDiscus, ProQuest, PsycINFO, PubMed, Scopus, WorldCat, and Google Scholar. We searched for original studies that compared athletes across defined higher and lower performance levels within defined types of sports, age categories, and sexes, regarding their age at commencement of TPP involvement and reported effect sizes or data needed to compute effects sizes. Mean meta-analytic Cohen's was computed separately for junior and senior athletes. Quality of evidence was evaluated using the mixed-methods appraisal tool.
RESULTS
The search yielded k = 51 effect sizes from N = 6233 athletes from a wide range of countries and sports, 82% male and 18% female, from 2009 to 2022. The central finding is that effects on short-term junior performance versus long-term senior performance are opposite, whereby higher-performing junior athletes began TPP involvement at younger ages than lower-performing junior athletes, = - 0.53. In contrast, higher-performing senior athletes began TPP involvement at older ages than lower-performing senior athletes, = 0.56. The findings are robust across different TPPs (federation's junior squad/selection team, youth academy), individual and team sports, and performance levels compared (international, national, regional). The quality of primary studies was high.
DISCUSSION
The findings are consistent with recent meta-analytic evidence that participation patterns predicting early junior success versus long-term senior success are opposite (starting age, main-sport and other-sports practice amounts, age to reach performance 'milestones'). We discuss theoretical and practical implications of potential selection and 'treatment' effects of TPPs.
CONCLUSIONS
Consistent across different populations, early TPP involvement is positively correlated with short-term junior performance but is negatively correlated with long-term senior performance.
Topics: Adolescent; Humans; Male; Female; Adult; Child; Sports; Athletes; Team Sports; Aptitude; Youth Sports
PubMed: 37921913
DOI: 10.1007/s40279-023-01957-3 -
Cureus Sep 2023The information for protein synthesis is given by the genes. These proteins are responsible for controlling functions like cell growth, differentiation, cell... (Review)
Review
The information for protein synthesis is given by the genes. These proteins are responsible for controlling functions like cell growth, differentiation, cell maturation, and cell death. In the case of genetic mutations, the protein functions get disturbed leading to a drastic shift in the normal physiological functions of cell growth, differentiation, and proliferation, making the normal cell cancerous. The Harvey rat sarcoma virus (HRAS) gene is an oncogene that belongs to the rat sarcoma virus (RAS) family. HRAS gene provides the instructions for making the HRAS protein that plays an important role in regulating cell division and when the HRAS gene gets mutated it gets involved in initiating cancer. HRAS mutation has been frequently noted in head and neck cancers; however, the mechanism of HRAS mutation involved in the initiation of oral squamous cell carcinoma (OSCC) still remains unexplored. An elaborate systematic literature search was done in PubMed, Scopus, and Web of Science databases. It was found that the Ras-dependent mutations affect the involved upstream and downstream components of the Ras-Raf-MAPK (rat sarcoma virus-rapidly accelerated fibrosarcoma-mitogen-activated protein kinase) pathway deregulating the signal leading to tumorigenesis. The Ras mutation can affect the Ras-Raf-MAPK pathway at different stages. The disease caused is based on the frequency of the HRAS mutation and it can lead to diverse cellular outcomes as it is mainly associated with cell division, differentiation, growth, survival, and the cell cycle. The crosstalk between the signaling pathways is controlled by the signaling molecules resulting in the creation of molecular networks. The balance of these molecular networks is very important to determine the cellular outcome. This systematic review inspects the molecular network of HRAS and its vital role in carcinogenesis. It is aimed at exploring and summarizing the contributions of the HRAS mutation involved in the pathogenesis of OSCC.
PubMed: 37868370
DOI: 10.7759/cureus.45505 -
International Journal of Molecular... Oct 2023Respiratory diseases have a major impact on global health. The airway epithelium, which acts as a frontline defence, is one of the most common targets for inhaled... (Review)
Review
Respiratory diseases have a major impact on global health. The airway epithelium, which acts as a frontline defence, is one of the most common targets for inhaled allergens, irritants, or micro-organisms to enter the respiratory system. In the tissue engineering field, biomaterials play a crucial role. Due to the continuing high impact of respiratory diseases on society and the emergence of new respiratory viruses, in vitro airway epithelial models with high microphysiological similarities that are also easily adjustable to replicate disease models are urgently needed to better understand those diseases. Thus, the development of biomaterial scaffolds for the airway epithelium is important due to their function as a cell-support device in which cells are seeded in vitro and then are encouraged to lay down a matrix to form the foundations of a tissue for transplantation. Studies conducted in in vitro models are necessary because they accelerate the development of new treatments. Moreover, in comparatively controlled conditions, in vitro models allow for the stimulation of complex interactions between cells, scaffolds, and growth factors. Based on recent studies, the biomaterial scaffolds that have been tested in in vitro models appear to be viable options for repairing the airway epithelium and avoiding any complications. This review discusses the role of biomaterial scaffolds in in vitro airway epithelium models. The effects of scaffold, physicochemical, and mechanical properties in recent studies were also discussed.
Topics: Humans; Biocompatible Materials; Epithelial Cells; Epithelium; Respiratory System; Tissue Engineering; Respiratory Tract Diseases; Tissue Scaffolds
PubMed: 37834382
DOI: 10.3390/ijms241914935 -
Retina (Philadelphia, Pa.) Feb 2024To identify the prevalence of retinal pigment epithelium tear (RPET) after anti-vascular endothelial growth factor (VEGF) therapy and determine the efficacy of continued... (Meta-Analysis)
Meta-Analysis
PURPOSE
To identify the prevalence of retinal pigment epithelium tear (RPET) after anti-vascular endothelial growth factor (VEGF) therapy and determine the efficacy of continued anti-VEGF therapy in patients with RPET.
METHODS
All relevant clinical trials and observational studies in several online databases were screened. The main outcomes were the incidence of RPET after anti-VEGF therapy and changes in visual acuity for patients with RPET treated with continued anti-VEGF.
RESULTS
The pooled incidence of RPET after anti-VEGF therapy from 24 studies with 17,354 patients was 1.9% (95% CI: 1.3-2.7). Most new RPET cases were concentrated in the first month at baseline or after the first injection during anti-VEGF therapy and gradually decreased by the subsequent month or injection. 13 studies with 157 patients reported that for patients who received anti-VEGF therapy after RPET, their pooled best-corrected visual acuity improved, but did not reach a significant level (standardized mean differences 0.34; 95% CI: -0.03 to 0.71).
CONCLUSION
The incidence of RPET after anti-VEGF therapy is low. The intravitreal anti-VEGF injection may accelerate this process. For patients with RPET, maintenance of anti-VEGF therapy ensures visual acuity stability.
Topics: Humans; Ranibizumab; Angiogenesis Inhibitors; Bevacizumab; Vascular Endothelial Growth Factor A; Endothelial Growth Factors; Antibodies, Monoclonal, Humanized; Retinal Pigment Epithelium; Intravitreal Injections
PubMed: 37824816
DOI: 10.1097/IAE.0000000000003922 -
Acta Gastro-enterologica Belgica 2023Dumping syndrome is a frequent and wellknown adverse event after bariatric surgery and covers a dynamic spectrum of early and late dumping. Accelerated gastric emptying... (Review)
Review
BACKGROUND
Dumping syndrome is a frequent and wellknown adverse event after bariatric surgery and covers a dynamic spectrum of early and late dumping. Accelerated gastric emptying is generally considered to be the cause of gastrointestinal and vasomotor complaints. However, there is much uncertainty regarding the exact pathophysiology of dumping. It has been speculated that the syndrome is a desired consequence of bariatric surgery and contributes to more efficient weight loss, but supporting data are scarce.
METHODS
A systematic search was conducted in PubMed in July-August 2021. The prevalence of dumping after the most frequently performed bariatric procedures was analyzed, as well as underlying pathophysiology and its role in weight reduction.
RESULTS
Roux-en-Y gastric bypass (RYGB) is associated with the highest postoperative prevalence of dumping. The fast transit induces neurohumoral changes which contribute to an imbalance between postprandial glucose and insulin levels, resulting in hypoglycemia which is the hallmark of late dumping. Early dumping can, when received in a positive way, become a tool to maintain a strict dietary pattern, but no significant relationship to the degree of weight loss has been shown. However, late dumping is detrimental and promotes overall higher caloric intake.
CONCLUSION
Dumping syndrome is common after bariatric surgery, especially after RYGB. The pathophysiology is complex and ambiguous. Currently available data do not support dumping as a necessary condition to induce weight loss after bariatric surgery.
Topics: Humans; Dumping Syndrome; Obesity, Morbid; Prevalence; Gastrectomy; Gastric Bypass; Bariatric Surgery; Weight Loss
PubMed: 37814558
DOI: 10.51821/86.3.11476