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PloS One 2024The propensity to accept vaccines and factors that affect vaccine acceptance and hesitancy will determine the overall success of the COVID-19 vaccination program....
The propensity to accept vaccines and factors that affect vaccine acceptance and hesitancy will determine the overall success of the COVID-19 vaccination program. Therefore, countries need to understand the factors that influence vaccine acceptance and hesitancy to prevent further future shocks, and it is necessary to have a thorough understanding of these factors. As a result, this study aims to review selected published works in the study's domain and conduct valuable analysis to determine the most influential factors in COVID-19 vaccine acceptance and hesitancy in Ghana. The review also explored the acceptance rate of COVID-19 vaccines in Ghana. We selected published works from 2021 to April 2023 and extracted, analyzed, and summarized the findings based on the key factors that influence COVID-19 vaccine acceptance and hesitancy in Ghana, the acceptance rate in Ghana, the demographic factors that are often examined, and the study approach used to examine these factors. The study found that positive vaccination perception, safety, belief in vaccine efficacy, knowledge of COVID-19, and a good vaccine attitude influence COVID-19 vaccine acceptance in Ghana. The negative side effects of the vaccines, mistrust in the vaccine, lack of confidence in the vaccine's safety, fear, and spiritual and religious beliefs all played significant roles in influencing COVID-19 vaccine hesitancy. For this study, the COVID-19 acceptance rates observed in the reviewed articles ranged from 17.5% to 82.6%. The demographic parameters frequently included in these studies that have a significant impact include educational attainment, gender, religious affiliation, age, and marital status. The positive perceptions of the COVID-19 vaccine and concerns about its negative effects influenced Ghanaians' acceptance and hesitancy.
Topics: Humans; Ghana; COVID-19 Vaccines; COVID-19; Vaccination Hesitancy; Patient Acceptance of Health Care; Vaccination; SARS-CoV-2; Health Knowledge, Attitudes, Practice
PubMed: 38917063
DOI: 10.1371/journal.pone.0305993 -
Nutrition Reviews Jun 2024Vitamin E, a well-known antioxidant with numerous positive effects on human health, encompasses tocotrienol-rich fraction (TRF), a natural variant abundant in palm oil.
CONTEXT
Vitamin E, a well-known antioxidant with numerous positive effects on human health, encompasses tocotrienol-rich fraction (TRF), a natural variant abundant in palm oil.
OBJECTIVE
This systematic review analyzed findings from randomized controlled trials published until 2022 to evaluate the health impacts of palm TRF.
DATA SOURCES
A literature search was performed in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, OVID Medline, SCOPUS, and Web of Science from inception until December 2022. Thirty studies involving 2646 patients, including both healthy individuals and those with underlying conditions, were identified.
RESULTS
This review shows palm TRF to be a promising natural supplement against inflammation and lipid peroxidation and that can significantly enhance overall health. Additionally, the study underscores the necessity for further research to ascertain the optimal dosage, formulation, and duration of supplementation, maximizing the potential health advantages.
CONCLUSION
This systematic review provides evidence supporting the health benefits associated with palm TRF.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42020204070.
PubMed: 38916919
DOI: 10.1093/nutrit/nuae061 -
BMC Medicine Jun 2024To combat coronavirus disease 2019 (COVID-19), booster vaccination strategies are important. However, the optimal administration of booster vaccine platforms remains... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To combat coronavirus disease 2019 (COVID-19), booster vaccination strategies are important. However, the optimal administration of booster vaccine platforms remains unclear. Herein, we aimed to assess the benefits and harms of three or four heterologous versus homologous booster regimens.
METHODS
From November 3 2022 to December 21, 2023, we searched five databases for randomised clinical trials (RCT). Reviewers screened, extracted data, and assessed bias risks independently with the Cochrane risk-of-bias 2 tool. We conducted meta-analyses and trial sequential analyses (TSA) on our primary (all-cause mortality; laboratory confirmed symptomatic and severe COVID-19; serious adverse events [SAE]) and secondary outcomes (quality of life [QoL]; adverse events [AE] considered non-serious). We assessed the evidence with the GRADE approach. Subgroup analyses were stratified for trials before and after 2023, three or four boosters, immunocompromised status, follow-up, risk of bias, heterologous booster vaccine platforms, and valency of booster.
RESULTS
We included 29 RCTs with 43 comparisons (12,538 participants). Heterologous booster regimens may not reduce the relative risk (RR) of all-cause mortality (11 trials; RR 0.86; 95% CI 0.33 to 2.26; I 0%; very low certainty evidence); laboratory-confirmed symptomatic COVID-19 (14 trials; RR 0.95; 95% CI 0.72 to 1.25; I 0%; very low certainty); or severe COVID-19 (10 trials; RR 0.51; 95% CI 0.20 to 1.33; I 0%; very low certainty). For safety outcomes, heterologous booster regimens may have no effect on SAE (27 trials; RR 1.15; 95% CI 0.68 to 1.95; I 0%; very low certainty) but may raise AE considered non-serious (20 trials; RR 1.19; 95% CI 1.08 to 1.32; I 64.4%; very low certainty). No data on QoL was available. Our TSAs showed that the cumulative Z curves did not reach futility for any outcome.
CONCLUSIONS
With our current sample sizes, we were not able to infer differences of effects for any outcomes, but heterologous booster regimens seem to cause more non-serious AE. Furthermore, more robust data are instrumental to update this review.
Topics: Humans; COVID-19 Vaccines; Immunization, Secondary; COVID-19; Randomized Controlled Trials as Topic; SARS-CoV-2; Adult; Quality of Life
PubMed: 38915011
DOI: 10.1186/s12916-024-03471-3 -
American Journal of Cardiovascular... Jun 2024Cardiovascular disease was the leading cause of death worldwide in 2021, with atherosclerotic cardiovascular disease, encompassing hypercholesterolemia, being a major...
BACKGROUND
Cardiovascular disease was the leading cause of death worldwide in 2021, with atherosclerotic cardiovascular disease, encompassing hypercholesterolemia, being a major contributing factor. A range of lipid-lowering medications is used for the management of hyperlipidemia, but the use of statins is considered as standard therapy. Unfortunately, some patients do not respond to this therapy, necessitating novel therapeutic approaches. Tafolecimab is a novel proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody that inhibits the binding of PCSK9 with low-density lipoprotein receptors (LDLRs) and increases LDLR recycling, and thus it indirectly lowers circulating low-density lipoprotein cholesterol (LDL-C) levels by increasing LDL-C uptake. The primary objective of this study is to assess the efficacy of tafolecimab in reducing LDL-C levels.
METHODS
A thorough search was conducted on Medline (PubMed), Cochrane CENTRAL, Scopus, and Google Scholar from inception until December 2023. Review Manager was used for statistical analysis. The random effects model was used to calculate risk ratios (RRs), mean differences (MDs), and 95% confidence intervals (CIs). Heterogeneity was assessed using the Higgins I index. The risk of bias was assessed using Cochrane's RoB 2 tool. This review has been registered with PROSPERO (CRD42023471020).
RESULTS
A total of four Chinese studies matched the inclusion criteria and were included in this review. A total of 726 patients were included in this review, out of which 476 patients were males. Out of four, three studies that studied the efficacy of 450 mg tafolecimab every 4 weeks in patients (n = 462) as compared to placebo (n = 224) were included in the meta-analysis. According to the pooled results, tafolecimab caused a significant decrease in LDL-C levels from baseline to week 12 as compared to placebo (MD = - 63.78, 95% CI - 65.88 to - 61.68, p value < 0.00001, I = 97%). The pooled results showed that more patients achieved ≥ 50% reductions in LDL-C levels (RR = 52.33, 95% CI 18.51-147.95, p value < 0.00001, I = 0%) and LDL-C < 1.8 mmol/L (RR = 17.27, 95% CI 9.59-31.11, p value < 0.00001, I = 0%) at week 12 in the tafolecimab group than the placebo group. Additionally, tafolecimab also caused a robust decrease in non-HDL-C, apolipoprotein B, and lipoprotein(a) levels from baseline to week 12 compared to placebo. The overall risk of bias was low, as determined by the RoB 2 tool.
CONCLUSIONS
Tafolecimab showed promising lipid-lowering efficacy and a well-tolerated safety profile. Our findings suggest its potential as an innovative therapeutic option for individuals with hypercholesterolemia; however, significant heterogeneity was observed in some results, making it difficult to come to a firm conclusion. Therefore, large-scale randomized trials are required to confirm our findings, particularly exploring the most effective dosage regimens across varied populations.
REGISTRATION
PROSPERO identifier number CRD42023471020.
PubMed: 38913274
DOI: 10.1007/s40256-024-00654-4 -
Campbell Systematic Reviews Jun 2024Investment in mobile devices to support primary or elementary education is increasing and must be informed by robust evidence to demonstrate impact. This systematic... (Review)
Review
BACKGROUND
Investment in mobile devices to support primary or elementary education is increasing and must be informed by robust evidence to demonstrate impact. This systematic review of randomised controlled trials sought to identify the overall impact of mobile devices to support literacy and numeracy outcomes in mainstream primary classrooms.
OBJECTIVES
The aim of this systematic review was to understand how mobile devices are used in primary/elementary education around the world, and in particular, determine how activities undertaken using mobile devices in the primary classroom might impact literacy and numeracy attainment for the pupils involved. Within this context, mobile devices are defined as tablets (including iPads and other branded devices), smartphones (usually those with a touchscreen interface and internet connectivity) and handheld games consoles (again usually with touchscreen and internet-enabled). The interventions of interest were those aimed at improving literacy and/or numeracy for children aged 4-12 within the primary/elementary school (or equivalent) classroom.Specifically, the review aimed to answer the following research questions: -What is the effect of mobile device integration in the primary school classroom on children's literacy and numeracy outcomes?-Are there specific devices which are more effective in supporting literacy and numeracy? (Tablets, smartphones, or handheld games consoles)-Are there specific classroom integration activities which moderate effectiveness in supporting literacy and numeracy?-Are there specific groups of children for whom mobile devices are more effective in supporting literacy and numeracy? (Across age group and gender).-Do the benefits of mobile devices for learning last for any time beyond the study?-What is the quality of available evidence on the use of mobile devices in primary/elementary education, and where is further research needed in this regard? An Expert Advisory Group supported the review process at key stages to ensure relevance to current practice.
SEARCH METHODS
The search strategy was designed to retrieve both published and unpublished literature, and incorporated relevant journal and other databases with a focus on education and social sciences. Robust electronic database searches were undertaken (12 databases, including APA PsychInfo, Web of Science, ERIC, British Education Index and others, and relevant government and other websites), as well as a hand-search of relevant journals and conference proceedings. Contact was also made with prominent authors in the field to identify any ongoing or unpublished research. All searches and author contact took place between October and November 2020. The review team acknowledges that new studies will likely have emerged since and are not captured at this time. A further update to the review in the future is important and would build on the evidence reflected here.
SELECTION CRITERIA
The review included children within mainstream primary/elementary/kindergarten education settings in any country (aged 4-12), and interventions or activities initiated within the primary school classroom (or global equivalent) that used mobile devices (including tablets, smartphones, or hand-held gaming devices) to intentionally support literacy or numeracy learning. In terms of study design, only Randomised Controlled Trials were included in the review.
DATA COLLECTION AND ANALYSIS
A total of 668 references were identified through a robust search strategy including published and unpublished literature. Following duplicate screening, 18 relevant studies, including 11,126 participants, 14 unique interventions, and 46 relevant outcome measures were synthesised using Robust Variance Estimation and a random effects meta-analysis model. Risk of Bias assessment was undertaken by three reviewers using the ROB2 tool to assess the quality of studies, with 13 studies rated as having some concerns, and 5 as having high risk of bias. Qualitative data was also extracted and analysed in relation to the types of interventions included to allow a comparison of the key elements of each.
MAIN RESULTS
A positive, statistically significant combined effect was found (Cohen's = 0.24, CI 0.0707 to 0.409, < 0.01), demonstrating that in the studies and interventions included, children undertaking maths or literacy interventions using mobile devices achieved higher numeracy or literacy outcomes than those using an alternative device (e.g., a laptop or desktop computer) or no device (class activities as usual). However these results should be interpreted with caution given the risk of bias assessment noted above (5 studies rated high risk of bias and 13 rated as having some concerns). As the interventions and classroom circumstances differed quite widely, further research is needed to understand any potential impact more fully.Sensitivity analysis aimed to identify moderating factors including age or gender, screen size, frequency/dosage of intervention exposure, and programme implementation features/activities (based on Puentedura's [2009] SAMR model of technology integration). There were too few studies identified to support quantitative analysis of sufficient power to draw robust conclusions on moderating factors, and insufficient data to determine impact beyond immediate post-test period. Sensitivty analysis was also undertaken to exclude the five studies identified as having a high risk of bias, to identify any impact they may have on overall findings.
AUTHORS' CONCLUSIONS
Overall, this review demonstrates that for the specific interventions and studies included, mobile device use in the classroom led to a significant, positive effect on literacy and numeracy outcomes for the children involved, bringing positive implications for their continued use in primary education. However given the concerns on risk of bias assessment reported above, the differing circumstances, interventions and treatment conditions and intensities, the findings must be interpreted with caution. The review also supports the need for further robust research to better understand what works, under what circumstances, and for whom, in the use of mobile devices to support learning.
PubMed: 38911050
DOI: 10.1002/cl2.1417 -
The Journal of Maternal-fetal &... Dec 2024The current study aims to evaluate the correlation between oxytocin augmentation and postpartum hemorrhage. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The current study aims to evaluate the correlation between oxytocin augmentation and postpartum hemorrhage.
METHOD
PubMed, Web of Science, and Scopus has been searched for studies assessing the correlation between oxytocin augmentation and postpartum hemorrhage up to January 24, 2024. The search strategy included relevant keywords related to PPH and oxytocin augmentation. The risk of bias assessment was conducted by two reviewers using the Newcastle-Ottawa Scale (NOS). To pool the effects sized of included studies odds ratios (OR) of interest outcome with their 95% confidence interval (CI) were used.
RESULTS
Eight studies were included in this meta-analysis. The pooled analysis of the included studies showed a statistically significant association between oxytocin augmentation and increased odds of PPH (pooled odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.05-1.53; I2 = 84.94%; = 0.01). Publication bias was assessed using funnel plots, which appeared relatively asymmetrical, indicating significant publication bias. Galbraith plot and trim and fill plot were used for publication bias. Sensitivity analyses were performed by leave one out method.
CONCLUSION
This meta-analysis suggests that using oxytocin for labor augmentation is linked to a significant increase in the risk of PPH. It highlights the need for careful monitoring and consideration when using oxytocin, especially in low and middle-income countries where guidelines and supervision are crucial.
Topics: Humans; Oxytocin; Female; Postpartum Hemorrhage; Pregnancy; Oxytocics
PubMed: 38910114
DOI: 10.1080/14767058.2024.2369210 -
Advances in Nutrition (Bethesda, Md.) Jun 2024Microbiota in early life is closely associated with the health of infants, especially premature ones. Probiotics are important drivers of gut microbiota development in... (Meta-Analysis)
Meta-Analysis Review
Microbiota in early life is closely associated with the health of infants, especially premature ones. Probiotics are important drivers of gut microbiota development in preterm infants; however, there is no consensus regarding the characteristics of specific microbiota in preterm infants receiving probiotics. In this study, we performed a meta-analysis of 5 microbiome data sets (1816 stool samples from 706 preterm infants) to compare the gut microbiota of preterm infants exposed to probiotics with that of preterm infants not exposed to probiotics across populations. Despite study-specific variations, we found consistent differences in gut microbial composition and predicted functional pathways between the control and probiotic groups across different cohorts of preterm infants. The enrichment of Acinetobacter, Bifidobacterium, and Lactobacillus spp and the depletion of the potentially pathogenic bacteria Finegoldia, Veillonella, and Klebsiella spp. were the most consistent changes in the gut microbiota of preterm infants supplemented with probiotics. Probiotics drove microbiome transition into multiple preterm gut community types, and notably, preterm gut community type 3 had the highest α-diversity, with enrichment of Bifidobacterium and Bacteroides spp. At the functional level, the major predicted microbial pathways involved in peptidoglycan biosynthesis consistently increased in preterm infants supplemented with probiotics; in contrast, the crucial pathways associated with heme biosynthesis consistently decreased. Interestingly, Bifidobacterium sp. rather than Lactobacillus sp. gradually became dominant in gut microbiota of preterm infants using mixed probiotics, although both probiotic strains were administered at the same dosage. Taken together, our meta-analysis suggests that probiotics contribute to reshaping the microbial ecosystem of preterm infants at both the taxonomic and functional levels of the bacterial community. More standardized and relevant studies may contribute to better understanding the crosstalk among probiotics, the gut microbiota, and subsequent disease risk, which could help to give timely nutritional feeding guidance to preterm infants. This systematic review and meta-analysis was registered at PROSPERO (https://www.crd.york.ac.uk/PROSPERO/) as CRD42023447901.
Topics: Humans; Gastrointestinal Microbiome; Probiotics; Infant, Premature; Infant, Newborn; Bifidobacterium; Feces; Bacteria; Lactobacillus; Female
PubMed: 38908894
DOI: 10.1016/j.advnut.2024.100233 -
Respiratory Medicine Jun 2024Enhancing lung function can significantly improve daily life functionality for children with cerebral palsy, leading to increased interest in respiratory physiotherapy... (Review)
Review
INTRODUCTION
Enhancing lung function can significantly improve daily life functionality for children with cerebral palsy, leading to increased interest in respiratory physiotherapy training devices in clinical practice. This study aims to evaluate the efficacy of devices (inspiratory muscle training and feedback devices) for improving pulmonary function through various respiratory parameters.
METHODS
A systematic review with meta-analysis of randomized clinical trials was conducted in seven databases up until May 2023. The included studies focused on training inspiratory muscle function using specific devices (inspiratory muscle training and feedback devices) in children with cerebral palsy. The main outcomes were maximum expiratory pressure and maximum inspiratory pressure. Secondary outcomes included forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, and the Tiffenau index. The effects of respiratory treatment were calculated through the estimation of the effect size and its 95% confidence intervals. The risk of bias in the included studies was assessed using the Cochrane Collaboration's tool for assessing the risk of bias (RoB2).
RESULTS
Nine studies were included in the systematic review with meta-analysis, involving a total of 321 children aged between 6 and 18 years after secondary analyses were conducted. Feedback devices were found to be more effective in improving maximum expiratory pressure (effect size -0.604; confidence interval -1.368 to 0.161), peak expiratory flow, forced expiratory volume in 1 s, and forced vital capacity. Inspiratory muscle training devices yielded better effectiveness in improving maximum inspiratory pressure (effect size -0.500; confidence interval -1.259 to 0.259), the Tiffeneau index, and quality of life.
CONCLUSION
Both devices showed potential in improving pulmonary function in children with cerebral palsy. Further high-quality clinical trials are needed to determine the optimal dosage and the most beneficial device type for each pulmonary function parameter.
PubMed: 38908411
DOI: 10.1016/j.rmed.2024.107717 -
BMC Anesthesiology Jun 2024Dexmedetomidine and midazolam are commonly used sedatives in children. We conducted a systematic review and meta-analysis to compare the safety and effectiveness of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dexmedetomidine and midazolam are commonly used sedatives in children. We conducted a systematic review and meta-analysis to compare the safety and effectiveness of sedation provided by dexmedetomidine combined with midazolam versus other sedatives including chloral hydrate, midazolam and other sedatives in pediatric sedation.
METHODS
The Embase, Web of Science, Cochrane Library, and PubMed databases, and Clinicaltrials.gov register of controlled trials were searched from inception to June 2022. All randomized controlled trials used dexmedetomidine-midazolam in pediatric sedation were enrolled. The articles search, data extraction, and quality assessment of included studies were performed independently by two researchers. The success rate of sedation was considered as the primary outcome. The secondary outcomes included onset time of sedation, recovery time of sedation and occurrence of adverse events.
RESULTS
A total of 522 studies were screened and 6 RCTs were identified; 859 patients were analyzed. The administration of dexmedetomidine combined with midazolam was associated with a higher sedation success rate and a lower incidence of nausea and vomiting in computed tomography, magnetic resonance imaging, Auditory Brainstem Response test or fiberoptic bronchoscopy examinations than the other sedatives did (OR = 2.92; 95% CI: 1.39-6.13, P = 0.005, I = 51%; OR = 0.23, 95% CI: 0.07-0.68, P = 0.008, I = 0%, respectively). Two groups did not differ significantly in recovery time and the occurrence of adverse reactions (WMD = - 0.27, 95% CI: - 0.93 to - 0.39, P = 0.42; OR 0.70; 95% CI: 0.48-1.02, P = 0.06, I = 45%. respectively). However, the results of the subgroup analysis of ASA I-II children showed a quicker onset time in dexmedetomidine-midazolam group than the other sedatives (WMD=-3.08; 95% CI: -4.66 to - 1.49, P = 0.0001, I = 30%).
CONCLUSIONS
This meta-analysis showed that compared with the control group, dexmedetomidine combined with midazolam group provided higher sedation success rates and caused a lower incidence of nausea and vomiting in completing examinations, indicating a prospective outpatient clinical application for procedural sedation.
Topics: Dexmedetomidine; Humans; Hypnotics and Sedatives; Midazolam; Child; Drug Therapy, Combination; Randomized Controlled Trials as Topic
PubMed: 38907338
DOI: 10.1186/s12871-024-02570-1 -
Journal of Vascular and Interventional... Jun 2024Transient cortical blindness (TCB) is characterized by a partial or complete loss of perceived vision, normal fundi, normal pupillary reflexes, and unaltered extraocular... (Review)
Review
Transient cortical blindness (TCB) is characterized by a partial or complete loss of perceived vision, normal fundi, normal pupillary reflexes, and unaltered extraocular movements. It is a rare complication of contrast medium use, with no definitive pathophysiology. This systematic review aimed to summarize identified risk factors, the most common clinical presentations, radiological and neurophysiological features and proposed pathophysiological mechanisms of TCB. A total of 115 patients, from 2 retrospective cohort studies, 10 case series, and 52 case reports, were included. The available evidence suggests that TCB can manifest after both invasive and non-invasive angiographic procedures. Higher contrast medium dosage and its injection solely into the posterior circulation are the only risk factors identified in association with TCB.
PubMed: 38906244
DOI: 10.1016/j.jvir.2024.06.007