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Frontiers in Pediatrics 2024In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and...
In 2019, 80% of the 7.4 million global child deaths occurred in low- and middle-income countries (LMICs). Global and regional estimates of cause of hospital death and admission in LMIC children are needed to guide global and local priority setting and resource allocation but are currently lacking. The study objective was to estimate global and regional prevalence for common causes of pediatric hospital mortality and admission in LMICs. We performed a systematic review and meta-analysis to identify LMIC observational studies published January 1, 2005-February 26, 2021. Eligible studies included: a general pediatric admission population, a cause of admission or death, and total admissions. We excluded studies with data before 2,000 or without a full text. Two authors independently screened and extracted data. We performed methodological assessment using domains adapted from the Quality in Prognosis Studies tool. Data were pooled using random-effects models where possible. We reported prevalence as a proportion of cause of death or admission per 1,000 admissions with 95% confidence intervals (95% CI). Our search identified 29,637 texts. After duplicate removal and screening, we analyzed 253 studies representing 21.8 million pediatric hospitalizations in 59 LMICs. All-cause pediatric hospital mortality was 4.1% [95% CI 3.4%-4.7%]. The most common causes of mortality (deaths/1,000 admissions) were infectious [12 (95% CI 9-14)]; respiratory [9 (95% CI 5-13)]; and gastrointestinal [9 (95% CI 6-11)]. Common causes of admission (cases/1,000 admissions) were respiratory [255 (95% CI 231-280)]; infectious [214 (95% CI 193-234)]; and gastrointestinal [166 (95% CI 143-190)]. We observed regional variation in estimates. Pediatric hospital mortality remains high in LMICs. Global child health efforts must include measures to reduce hospital mortality including basic emergency and critical care services tailored to the local disease burden. Resources are urgently needed to promote equity in child health research, support researchers, and collect high-quality data in LMICs to further guide priority setting and resource allocation.
PubMed: 38910960
DOI: 10.3389/fped.2024.1397232 -
Cureus May 2024Diagnosing endometrial carcinoma correctly is essential for appropriate treatment, as it is a major health risk. As machine learning (ML) and artificial intelligence... (Review)
Review
Diagnosing endometrial carcinoma correctly is essential for appropriate treatment, as it is a major health risk. As machine learning (ML) and artificial intelligence (AI) have grown in popularity, so has interest in their potential to improve cancer diagnosis accuracy. In the context of endometrial cancer, this study attempts to examine the efficacy as well as the accuracy of AI-assisted diagnostic approaches. Additionally, it aims to methodically evaluate the contribution of AI and ML techniques to the improvement of endometrial cancer diagnosis. Following PRISMA guidelines, we performed a thorough search of numerous databases, including Medline via Ovid, PubMed, Scopus, Web of Science, and Google Scholar. Ten years were searched, encompassing both basic and advanced research. Peer-reviewed papers and original research studies that explicitly looked at the application of AI/ML in endometrial cancer diagnosis were the main targets of the well-defined selection criteria. Using the Critical Appraisal Skills Programme (CASP) methodology, two independent researchers conducted a thorough screening process and quality assessment of included studies. The review found a notable inclination towards the effective use of AI in endometrial carcinoma diagnostics, namely in the identification and categorization of endometrial cancer. Artificial intelligence models, particularly Convolutional Neural Networks (CNNs) and deep learning algorithms have shown remarkable precision in detecting endometrial cancer. They frequently achieve or even exceed the diagnostic proficiency of human specialists. The use of artificial intelligence in medical diagnostics signifies revolutionary progress in the field of oncology. AI-assisted diagnostic tools have demonstrated the potential to improve the precision and effectiveness of cancer diagnosis, namely in cases of endometrial carcinoma. This innovation not only enhances the quality of patient care but also indicates a transition towards more individualized and efficient treatment approaches in the field of oncology. The advancement of AI technology is expected to play a crucial role in medical diagnostics, particularly in the field of cancer detection and treatment, perhaps leading to a significant transformation in the approach to these areas.
PubMed: 38910646
DOI: 10.7759/cureus.60973 -
JBI Evidence Synthesis Jun 2024The objective of this review was to assess and synthesize evidence on the effectiveness and safety of self-management interventions for improving glycemic control and...
Effectiveness and safety of self-management interventions for improving glycemic control and health-related quality-of-life among adults with type 2 diabetes mellitus in sub-Saharan Africa: a systematic review and meta-analysis.
OBJECTIVE
The objective of this review was to assess and synthesize evidence on the effectiveness and safety of self-management interventions for improving glycemic control and health-related quality of life (HRQoL) among adults with type 2 diabetes mellitus (T2DM) in sub-Saharan Africa.
INTRODUCTION
There has been a rapid increase in the prevalence of T2DM in sub-Saharan Africa. Lifestyle-related risk factors require self-management strategies, and these must be tailored to the context. Several randomized controlled trials (RCTs) evaluating T2DM self-management interventions in sub-Saharan Africa have been conducted.
INCLUSION CRITERIA
This systematic review included RCTs assessing the effectiveness and safety of self-management interventions among adults with T2DM in sub-Saharan Africa, where the self-management intervention matched at least 1 category of the Practical Reviews in Self-Management Support (PRISMS) for long-term conditions taxonomy.
METHODS
The following databases were searched from inception until January 14, 2023: MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Directory of Open Access Journals, EthOS, and ProQuest Dissertations and Theses (ProQuest). Global Health (EBSCOhost) was searched from inception until June 8, 2021. OpenGrey was searched from inception until its archive date of December 1, 2020. Two independent reviewers conducted title and abstract screening, full-text screening, data extraction, and critical appraisal. Disagreements were resolved through discussion or with a third reviewer. Data synthesis was conducted narratively, followed by meta-analysis where feasible. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach for assessing the certainty of evidence was applied.
RESULTS
From 2699 records identified, 18 RCTs were included in the systematic review and 14 in the meta-analysis. Interventions included broad self-management education programs, peer support, exercise interventions with education, nutrition education, educational text messaging, and blood glucose self-monitoring support. Only 4 studies were assigned a "yes" result for more than half of the criteria in the standardized JBI critical appraisal tool for RCTs. Compared to the control, self-management interventions did not significantly reduce glycated hemoglobin (HbA1c) at 3 months (302 participants, mean difference [MD] -6.0 mmol/mol, 95% CI -17.5, 5.4; very low certainty on GRADE assessment) or 12 months (1504 participants, MD -3.7 mmol/mol, 95% CI -8.2, 0.7; moderate certainty on GRADE assessment). HbA1c was significantly reduced at 6 months (671 participants, MD -8.1 mmol/mol, 95% CI -10.7, -5.4; low certainty on GRADE assessment). Four studies assessed HRQoL, but only 1 demonstrated an improvement (2205 participants). Three studies reported no adverse events in relation to the trial interventions (1217 participants), and it was not reported in the remainder. There did not appear to be clinically significant effects on body mass index, lipid profile, and systolic or diastolic blood pressure. The evidence was mixed for weight and waist circumference.
CONCLUSIONS
Self-management interventions for adults living with T2DM in sub-Saharan Africa may produce a clinically significant improvement in glycemic control at 6 months, but this may wane in the longer-term. There was not convincing evidence to indicate a benefit of these interventions on HRQoL, but reporting on this outcome measure was limited. There were insufficient data on adverse events to be able to draw conclusions.
REVIEW REGISTRATION
PROSPERO CRD42021237506.
PubMed: 38910533
DOI: 10.11124/JBIES-23-00273 -
Immunohematology Jun 2024This review aims to provide a better understanding of when and why red blood cell (RBC) genotyping is applicable in transfusion medicine. Articles published within the...
This review aims to provide a better understanding of when and why red blood cell (RBC) genotyping is applicable in transfusion medicine. Articles published within the last 8 years in peer-reviewed journals were reviewed in a systematic manner. RBC genotyping has many applications in transfusion medicine including predicting a patient's antigen profile when serologic methods cannot be used, such as in a recently transfused patient, in the presence of autoantibody, or when serologic reagents are not available. RBC genotyping is used in prenatal care to determine zygosity and guide the administration of Rh immune globulin in pregnant women to prevent hemolytic disease of the fetus and newborn. In donor testing, RBC genotyping is used for resolving ABO/D discrepancies for better donor retention or for identifying donors negative for high-prevalence antigens to increase blood availability and compatibility for patients requiring rare blood. RBC genotyping is helpful to immunohematology reference laboratory staff performing complex antibody workups and is recommended for determining the antigen profiles of patients and prospective donors for accurate matching for C, E, and K in multiply transfused patients. Such testing is also used to determine patients or donors with variant alleles in the Rh blood group system. Information from this testing aides in complex antibody identification as well as sourcing rare allele-matched RBC units. While RBC genotyping is useful in transfusion medicine, there are limitations to its implementation in transfusion services, including test availability, turn-around time, and cost.
Topics: Female; Humans; Pregnancy; Blood Group Antigens; Blood Grouping and Crossmatching; Erythrocytes; Genotype; Genotyping Techniques; Transfusion Medicine
PubMed: 38910442
DOI: 10.2478/immunohematology-2024-009 -
Current Cardiology Reviews Jun 2024Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD...
BACKGROUND
Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD in the DSM-5 has underscored the importance of comprehensively understanding its physiological and psychological effects.
OBJECTIVE
This systematic review aims to analyze and synthesize existing literature on the cardiophysiological and neurophysiological activities of individuals diagnosed with IGD, with a focus on identifying patterns, trends, and implications for clinical practice and future research.
METHODS
A systematic search was conducted in PubMed and Scopus databases to identify relevant studies published up to 2023. The search strategy included terms related to IGD, cardiophysiology, neurophysiology, and relevant measurement techniques. Inclusion criteria encompassed peer-reviewed research articles and clinical trials examining cardiophysiological (e.g., heart rate variability, blood pressure) and neurophysiological (e.g., brain imaging, electroencephalography) parameters in individuals with IGD. Exclusion criteria were applied to ensure methodological rigor and relevance to the research question.
RESULTS
The initial search yielded 1320 papers related to IGD, of which twenty studies met the eligibility criteria and were included in the review. Data extraction and synthesis focused on key cardiophysiological and neurophysiological outcomes observed in individuals with IGD compared to healthy controls. Findings revealed decreased Heart Rate Variability (HRV), increased sympathetic activity, and executive control deficits in IGD individuals based on Electrocardiogram (ECG) recordings and cognitive assessments. Neuroimaging studies demonstrated heightened brain activation in the lateral and prefrontal cortex, altered reward processing, and impulse control mechanisms among IGD subjects. Gender-specific differences were noted, with males exhibiting distinct thalamic activation striatum and decreased Regional Homogeneity (ReHo) in the right Posterior Cingulate (rPCC) compared to females.
DISCUSSION
The synthesized evidence indicates a complex interplay between excessive gaming and cardiophysiological/neurophysiological changes, highlighting the need for multidimensional assessments in diagnosing and managing IGD. Implications for clinical practice include early detection using ECG, EEG, and advanced neuroimaging techniques, as well as personalized interventions tailored to individual characteristics and gender-specific differences.
CONCLUSION
This systematic review provides a comprehensive overview of the cardiophysiological and neurophysiological activities associated with Internet Gaming Disorder. The findings underscore the need for further research to elucidate underlying mechanisms, develop standardized diagnostic protocols, and optimize targeted interventions for individuals with IGD.
PubMed: 38910426
DOI: 10.2174/011573403X295560240530104352 -
Autism : the International Journal of... Jun 2024Black/African American people in the United States who have a diagnosis of autism often experience service-related disparities, including not having the same access to... (Review)
Review
Black/African American people in the United States who have a diagnosis of autism often experience service-related disparities, including not having the same access to high-quality autism and related care (e.g. behavioral interventions), and are less likely to have sustained treatment engagement across their lifespan. While interventions to support autistic people are typically designed to be universal, there is concern that these interventions not being tailored to the Black/African American population could reduce the overall impact due to a lack of responsiveness to the needs of the Black children or families who receive the intervention. The current systematic review summarized research on interventions developed for the Black autism community, including Black children with autism and their caregivers. After a comprehensive, systematic search, eight peer-reviewed publications were identified that met the study's inclusion criteria. The majority of the interventions were tailored to Black caregivers of children with autism. Autism researchers demonstrate different strategies for engaging Black caregivers in culturally responsive ways; however, more research into these interventions is needed in order to assess their effectiveness. In addition, there are still limited interventions adapted to be culturally responsive to Black/African American autistic people. The Cultural Adaptation Checklist framework is a novel approach with promise to become the standard for adapting interventions to meet the needs of culturally diverse groups. Cultural responsiveness is an important facet in the development of interventions that produce optimal outcomes for the range of diversity in the United States and is an important step to achieving equitable autism research practices.
PubMed: 38910297
DOI: 10.1177/13623613241259910 -
Journal of Pain and Symptom Management Jun 2024Co-design is a methodology that includes active collaboration between stakeholders in designing solutions and has been used in the development and implementation of... (Review)
Review
CONTEXT
Co-design is a methodology that includes active collaboration between stakeholders in designing solutions and has been used in the development and implementation of palliative care (PC) interventions.
OBJECTIVES
To synthesize the state of evidence for co-design in the development of PC interventions.
METHODS
We searched PubMed, EMBASE, and CINAHL for peer-reviewed studies published after 1995 that reported evidence of co-designed interventions and outcomes in patients receiving palliative, hospice, or end-of-life care. We screened studies through independent and blinded dual review within Covidence and assessed study quality with the 2018 Mixed Methods Appraisal Tool. We narratively synthesized co-design duration, engagement approach, stakeholders involved, intervention designs, follow-ups, and outcomes, comparing among co-designs reporting meaningful improvement in outcomes. We created a best practice checklist which we used to evaluate co-design use in each study.
RESULTS
1,036 abstracts and 54 full text articles were screened. 28 studies met inclusion criteria and were abstracted. Feedback collection modalities ranged from iterative drafting, pilot testing, advisory panels, workshops, focus groups, and interviews. 13 studies applied pretesting/prototyping through pre-test post-test, focus groups, prototypes, alpha and beta testing, and mock-ups. 11 studies reported improved outcomes, 8 of which utilized iterative co-design. All the studies reporting improved outcomes mentioned meeting with stakeholders at least twice. 2 studies met all criteria in our co-design best practice checklist.
CONCLUSION
Co-designed PC interventions demonstrate high variance in the modality of acquiring feedback and application of co-design. Successful co-design leading to improvement in outcomes is achieved by involving patients, caregivers, and providers in iterating intervention design.
PubMed: 38909694
DOI: 10.1016/j.jpainsymman.2024.06.007 -
Dermatology and Therapy Jun 2024Up to 25% of children and 5.6% of adults in the USA have atopic dermatitis (AD), with substantial impacts on quality of life. Effective control can be challenging... (Review)
Review
INTRODUCTION
Up to 25% of children and 5.6% of adults in the USA have atopic dermatitis (AD), with substantial impacts on quality of life. Effective control can be challenging despite therapy efforts. The emergence of information and communication technologies (ICT) in AD management prompted this study to assess its impact on self-management. We conducted a meta-analysis to assess outcomes from peer-reviewed clinical trials evaluating the effectiveness of teledermatology, mobile health (mHealth) apps, and electronic devices for managing AD.
METHODS
We searched PubMed, Web of Science, Scopus, and Embase for articles written in English and published until May 2023.
RESULTS
Twelve trials with 2424 participants were selected from 811 studies. A meta-analysis of 1038 individuals reported a mean difference (MD) of -1.57 [95% confidence interval (CI): -2.24, -0.91] for the Patient Oriented Eczema Measure (POEM). A meta-analysis of 495 individuals reported a Dermatology Life Quality Index (DLQI) MD of -0.59 [95% CI: -0.95, -0.23]. Despite heterogeneity (I = 47% and I = 74%), the impact was significant (P ≤ 0.001). SCORing Atopic Dermatitis (SCORAD) showed an insignificant MD of -0.12 (P = 0.91).
CONCLUSION
mHealth applications and telemonitoring show significant improvement in patients' quality of life (DLQI) and self-management (POEM) but no significant impact on AD severity (SCORAD).
PubMed: 38909171
DOI: 10.1007/s13555-024-01213-0 -
Sleep Medicine Jun 2024Parkinson's disease (PD) is a progressive neurodegenerative disorder, involving motor and non-motor symptoms (NMS). Sleep disturbances (SD) are the second most common... (Review)
Review
Parkinson's disease (PD) is a progressive neurodegenerative disorder, involving motor and non-motor symptoms (NMS). Sleep disturbances (SD) are the second most common NMS in PD and include rapid eye movement (REM) sleep behavior disorder (RBD), excessive daytime sleepiness and insomnia. Freezing of gait (FOG) is a gait impairment frequently reported in people with PD greatly hampering functional independence and quality of life. Presence of FOG has been associated with increased frequency and severity of NMS, including SD. Thus, the aim of this study was to systematically review the literature comparing the number of people with FOG in PD with (PD + SD) and without SD (PD-SD). By systematically searching PubMed and Web of Science databases to identify original peer-reviewed articles, 8 studies including 5251 people with PD (2025 PD + SD and 3226 PD-SD) met eligibility criteria and were included in the review. In 6 studies (4 studies investigating RBD, 2 studies investigating overall sleep quality), the group of PD + SD had higher prevalence of FOG compared with PD-SD. Although a limited number of studies, our findings suggest that PD + SD present more frequently FOG than PD-SD. More studies are required to investigate the possible mechanism underlying this association between FOG and sleep.
PubMed: 38908269
DOI: 10.1016/j.sleep.2024.06.001 -
Medicina Oral, Patologia Oral Y Cirugia... Jun 2024The DNA mismatch repair (MMR) system serves as a sophisticated guardian of the precise functioning of the human genome. Dysregulation within this system is linked to the...
BACKGROUND
The DNA mismatch repair (MMR) system serves as a sophisticated guardian of the precise functioning of the human genome. Dysregulation within this system is linked to the oncogenesis process. Reduced expression of MMR system proteins identified in salivary gland tumors (SGTs) suggests an increased risk of tumoral occurrence. This study aims to analyze the expression of MMR proteins in SGTs and discuss the relevance of this association to the development of these neoplasms.
MATERIAL AND METHODS
This review was conducted following the PRISMA guidelines and was registered in PROSPERO (CRD42023465590). A comprehensive search of the PubMed/MEDLINE, Web of Science, Scopus, Embase, and ProQuest (non-peer reviewed platform) was performed to answer the question "Do DNA MMR system proteins exhibit expression in SGTs?". The methodological quality of the selected studies was assessed using the JBI's Critical Appraisal Tool.
RESULTS
A total of 142 patients with benign SGTs and 84 with malignant SGTs were included in this review. The literature analysis showed a notable reduction in the expression of DNA MMR system proteins (hHMS2, hMLH1, hMSH3 and hMSH6) in the percentage of marked cells.
CONCLUSIONS
The reduction in the expression of the DNA MMR system proteins suggests an interesting correlation with the development of malignant and benign SGTs. Nevertheless, further investigations are warranted to better clarify the precision of measuring biomarker protein expression.
PubMed: 38907641
DOI: 10.4317/medoral.26647