-
PLoS Neglected Tropical Diseases Jun 2024Chikungunya is a viral disease caused by a mosquito-borne alphavirus. The acute phase of the disease includes symptoms such as fever and arthralgia and lasts 7-10 days.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chikungunya is a viral disease caused by a mosquito-borne alphavirus. The acute phase of the disease includes symptoms such as fever and arthralgia and lasts 7-10 days. However, debilitating symptoms can persist for months or years. Despite the substantial impact of this disease, a comprehensive assessment of its clinical picture is currently lacking.
METHODS
We conducted a systematic literature review on the clinical manifestations of chikungunya, their prevalence and duration, and related hospitalization. Embase and MEDLINE were searched with no time restrictions. Subsequently, meta-analyses were conducted to quantify pooled estimates on clinical outcomes, the symptomatic rate, the mortality rate, and the hospitalization rate. The pooling of effects was conducted using the inverse-variance weighting methods and generalized linear mixed effects models, with measures of heterogeneity reported.
RESULTS
The systematic literature review identified 316 articles. Out of the 28 outcomes of interest, we were able to conduct 11 meta-analyses. The most prevalent symptoms during the acute phase included arthralgia in 90% of cases (95% CI: 83-94%), and fever in 88% of cases (95% CI: 85-90%). Upon employing broader inclusion criteria, the overall symptomatic rate was 75% (95% CI: 63-84%), the chronicity rate was 44% (95% CI: 31-57%), and the mortality rate was 0.3% (95% CI: 0.1-0.7%). The heterogeneity between subpopulations was more than 92% for most outcomes. We were not able to estimate all predefined outcomes, highlighting the existing data gap.
CONCLUSION
Chikungunya is an emerging public health concern. Consequently, a thorough understanding of the clinical burden of this disease is necessary. Our study highlighted the substantial clinical burden of chikungunya in the acute phase and a potentially long-lasting chronic phase. Understanding this enables health authorities and healthcare professionals to effectively recognize and address the associated symptoms and raise awareness in society.
Topics: Chikungunya Fever; Humans; Chikungunya virus; Arthralgia; Hospitalization; Fever; Prevalence
PubMed: 38848443
DOI: 10.1371/journal.pntd.0012254 -
PloS One 2024The study on the adoption of mobile learning in university education reveals a growing interest in mobile technologies to improve the learning process; both the...
The study on the adoption of mobile learning in university education reveals a growing interest in mobile technologies to improve the learning process; both the acceptance and rejection of these tools among students have been analyzed. However, there are gaps in the research that require a deeper exploration of the factors that influence the adoption and use of these technologies. Understanding these aspects is crucial to optimize mobile learning strategies and improve the educational experience in the university setting. The objective is to examine research trends regarding the topic. PRISMA-2020 is used in the Scopus and Web of Science databases. The results show the questionnaires as the main collection instruments; geographical contexts show that it has been researched predominantly in Asia; The studies have focused on university students; the most applied theories are TAM and UTAUT; and latent variables such as behavioral intention and attitude. The conclusions summarize the trends and patterns observed in the reviewed literature, as well as the research gaps identified, providing a solid foundation for future research and highlighting the importance of addressing this issue in the current context of digital education. The systematic review identifies key models and factors in the adoption of mobile learning in university settings, revealing both theoretical and practical implications. Furthermore, this text provides practical guidance for selecting effective data collection tools and making informed educational and policy decisions. However, it acknowledges limitations such as potential publication and language bias in the search process.
Topics: Universities; Humans; Students; Learning; Education, Distance; Surveys and Questionnaires; Mobile Applications
PubMed: 38848384
DOI: 10.1371/journal.pone.0304116 -
JAMA Health Forum Jun 2024The five 1997 Office of Management and Budget races in the US include American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other...
IMPORTANCE
The five 1997 Office of Management and Budget races in the US include American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White, with Hispanic ethnicity. Despite the Affordable Care Act mandating Office of Management and Budget-based collecting and reporting standards, race and ethnicity publishing in medical journals is inconsistent, despite being necessary to achieve health equity.
OBJECTIVE
To quantify race and ethnicity reporting rates and calculate representation quotients (RQs) in published oncology clinical trials.
EVIDENCE REVIEW
In this systematic review, PubMed and Embase were queried for phase 2/3 clinical trials of the 6 most common noncutaneous solid cancers, published between January 1, 2012, and December 31, 2022, in 4 high-impact journals. Trial characteristics were recorded. The RQs for each race and ethnicity were calculated by dividing the percent of representation in each clinical trial publication by the percent of year-matched, site-specific incident cancers in the US, compared with Kruskal-Wallis tests with Bonferroni correction (BC). Reporting was compared between journal publications and ClinicalTrials.gov.
FINDINGS
Among 1202 publications evaluated, 364 met inclusion criteria: 16 JAMA, 241 Journal of Clinical Oncology, 19 Lancet, and 88 New England Journal of Medicine. Publications included 268 209 patients (171 132 women [64%]), with a median of 356 (IQR, 131-800) patients per publication. Reported race and ethnicity included American Indian or Alaska Native in 52 (14%) publications, Asian in 196 (54%), Black or African American in 215 (59%), Hispanic in 67 (18%), Native Hawaiian or Other Pacific Islander in 28 (8%), and White in 254 (70%). Median RQ varied across race (P < .001 BC), with 1.04 (IQR, 0.09-4.77) for Asian, 0.98 (IQR, 0.86-1.06) for White, 0.42 (IQR, 0.12-0.75) for Black or African American, and 0.00 (IQR, 0.00-0.00) for both American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander patients. Sensitivity analyses showed similar findings on subset analysis for US-only clinical trials. There was significantly less race and ethnicity reporting in the clinical trial publications compared with ClinicalTrials.gov documentation for American Indian or Alaska Native (14% vs 45%; P < .001 per McNemar χ2 test with continuity correction [MC]) and Native Hawaiian or Other Pacific Islander (8% vs 43%; P < .001 MC).
CONCLUSIONS AND RELEVANCE
While most phase 2/3 oncology clinical trials published in high-impact journals report race and ethnicity, most did not report American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander racial categories. Our findings support a call to action for consistent journal policies and transparent race and ethnicity reporting, in alignment with Affordable Care Act-concordant race and ethnicity federal reporting requirements.
Topics: Humans; Racial Groups; Clinical Trials, Phase III as Topic; Clinical Trials, Phase II as Topic; United States; Neoplasms; Ethnicity
PubMed: 38848090
DOI: 10.1001/jamahealthforum.2024.1388 -
Journal of Multimorbidity and... 2024This is the first systematic review and meta-analysis of the prevalence of multimorbidity, its risk factors including socioeconomic factors, and the consequences of... (Review)
Review
OBJECTIVES
This is the first systematic review and meta-analysis of the prevalence of multimorbidity, its risk factors including socioeconomic factors, and the consequences of multimorbidity on health systems and broader society in India.
METHODS
A systematic review of both published and grey literature from five databases (Medline, Embase, EBSCO, Scopus, and ProQuest) was conducted including original studies documenting prevalence or patient outcomes associated with multimorbidity among adults in India. We excluded studies that did not explicitly mention multimorbidity. Three independent reviewers did primary screening based on titles and abstracts followed by full-text review for potential eligibility. The risk of bias was independently assessed by two reviewers following the Appraisal Tool for Cross-Sectional Studies. We presented both qualitative and quantitative (through meta-analysis) summaries of the evidence. The protocol for this study was prospectively registered with PROSPERO (CRD42021257281).
RESULTS
The review identified 5442 articles out of which 35 articles were finally included in this study. Twenty-three studies were based on the primary data while 12 used secondary data. Eleven studies were conducted in hospital/primary care setting while 24 were community-based. The pooled prevalence of multimorbidity based on (n=19) studies included for meta-analysis was 20% (95% CI: 19% to 20%). The most frequent outcomes were increased healthcare utilization, reduced health-related quality of life, physical and mental functioning.
CONCLUSION
We identified a wide variance in the magnitude of multimorbidity across age groups and regions with most of the studies from eastern India. Nation-wide studies, studies on vulnerable populations and interventions are warranted.
PubMed: 38846927
DOI: 10.1177/26335565241258851 -
Frontiers in Oral Health 2024Cardiovascular diseases (CVDs) are a significant cause of morbidity and mortality worldwide, resulting in a high socioeconomic burden. Growing evidence has shown a link...
BACKGROUND
Cardiovascular diseases (CVDs) are a significant cause of morbidity and mortality worldwide, resulting in a high socioeconomic burden. Growing evidence has shown a link between oral diseases and several chronic conditions including CVDs. The focus of this review is to investigate and summaries the evidence surrounding oral health interventions and their potential impact on reducing both the risk and/or severity of CVDs.
METHODS
A scoping review was conducted to examine oral health interventions for managing CVD outcomes and risks. The review adhered to the Joanna Briggs Institute (JBI) framework for evidence synthesis and followed the reporting standards outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analysis- extension to Scoping Review (PRISMA-ScR). A systematic search across EBSCOhost, PubMed, and Scopus databases from 2012 to 2024 was utilized to identify relevant studies. Inclusion criteria focused on English language articles with a sample size of at least 50, evaluating the impact of oral health interventions on CVD outcomes.
RESULTS
Out of the initial 2,154 studies identified in the search, 12 studies met the inclusion and exclusion criteria and were included in the final analysis. Overall, the studies revealed that along with surgical and non-surgical periodontal therapy, regular oral hygiene care practices, including toothbrushing, tongue brushing, and flossing, significantly reduced the risk of cardiovascular events and mortality. These interventions in patients with or without CVD baseline have shown a decrease in CVD risk markers as well as a reduction in bacterial colonization. Similarly, consistent oral hygiene routines, combined with regular dental visits, were associated with a lower risk of heart failure and CVD risk mortality.
CONCLUSION
The evidence extracted from this review suggests that periodontal therapy, regular dental cleaning, and re-enforcing of oral health regimes can stabilize oral health conditions and subsequently improve CVD progression/risks. However, limited to no evidence exists regarding the therapeutic effects of oral health promotion in managing CVD markers and its direct impact on disease outcomes, warranting further investigation.
PubMed: 38846319
DOI: 10.3389/froh.2024.1364765 -
Journal of Pharmaceutical Policy and... 2024Advances in targeted therapies have expanded the treatment options for colorectal cancer (CRC), allowing for more tailored and effective approaches to managing the...
BACKGROUND
Advances in targeted therapies have expanded the treatment options for colorectal cancer (CRC), allowing for more tailored and effective approaches to managing the disease. In targeted therapy, Bevacizumab is a commonly prescribed anti-VEGF monoclonal antibody that has a direct anti-vascular impact in cancer patients. Vascular Endothelial Growth Factors (VEGFs), especially VEGF-A, are significant agents in promoting tumour angiogenesis
OBJECTIVE
To assess the impact of adding Bevacizumab to chemotherapy on progression-free survival (PFS) and overall survival (OS) in patients with metastatic colorectal cancer.
METHODOLOGY
Comprehensive searches have been performed on electronic databases such as PubMed, and Google Scholar using the following terms: colorectal cancer, adenocarcinoma, Bevacizumab, chemotherapy, and monoclonal antibody.
RESULTS
In the meta-analysis, 16 out of the 24 included studies were analysed. In the final analysis, incorporating Bevacizumab with chеmothеrapy demonstrated favourable outcomes for OS with a hazard ratio (HR = 0.689,95%CI: 0.51-0.83, ² = 39%, p <0.01) and for PFS with a hazard ratio (HR = 0.77 95% CI: 0.60-0.96, I² = 54%, < 0.01). The subgroup analysis of PFS, categorised by study dеsign (prospеctivе vs rеtrospеctivе), reveals that the Hazard Ratio (HR = 0.82, 95% CI: 0.62-0.97, ² = 21%, < 0.01) and for OS with a hazard ratio (HR = 0.73, 95% CI: 0.52-0.86, I² = 17%, < 0.01).
CONCLUSION
Our findings indicate that combining Bevacizumab with chemotherapy enhances clinical outcomes and results in a significant increase in PFS and OS in patients with metastatic colorectal cancer. Positive outcomes are demonstrated by a substantial 23% increase in PFS and 31% increase in OS in patients with metastatic colorectal cancer who undergo Bevacizumab in conjunction with chemotherapy
PubMed: 38845624
DOI: 10.1080/20523211.2024.2354300 -
BMC Public Health Jun 2024Non-pharmaceutical interventions (NPIs) have been widely utilised to control the COVID-19 pandemic. However, it is unclear what the optimal strategies are for...
BACKGROUND
Non-pharmaceutical interventions (NPIs) have been widely utilised to control the COVID-19 pandemic. However, it is unclear what the optimal strategies are for implementing NPIs in the context of coronavirus vaccines. This study aims to systematically identify, describe, and evaluate existing ecological studies on the real-world impact of NPIs in containing COVID-19 pandemic following the roll-out of coronavirus vaccines.
METHODS
We conducted a comprehensive search of relevant studies from January 1, 2021, to June 4, 2023 in PubMed, Embase, Web of science and MedRxiv. Two authors independently assessed the eligibility of the studies and extracted the data. A risk of bias assessment tool, derived from a bibliometric review of ecological studies, was applied to evaluate the study design, statistical methodology, and the quality of reporting. Data were collected, synthesised and analysed using qualitative and quantitative methods. The results were presented using summary tables and figures, including information on the target countries and regions of the studies, types of NPIs, and the quality of evidence.
RESULTS
The review included a total of 17 studies that examined the real-world impact of NPIs in containing the COVID-19 pandemic after the vaccine roll-out. These studies used five composite indicators that combined multiple NPIs, and examined 14 individual NPIs. The studies had an average quality assessment score of 13 (range: 10-16), indicating moderately high quality. NPIs had a larger impact than vaccination in mitigating the spread of COVID-19 during the early stage of the vaccination implementation and in the context of the Omicron variant. Testing policies, workplace closures, and restrictions on gatherings were the most effective NPIs in containing the COVID-19 pandemic, following the roll-out of vaccines. The impact of NPIs varied across different time frames, countries and regions.
CONCLUSION
NPIs had a larger contribution to the control of the pandemic as compared to vaccination during the early stage of vaccine implementation and in the context of the omicron variant. The impact of NPIs in containing the COVID-19 pandemic exhibited variability in diverse contexts. Policy- and decision-makers need to focus on the impact of different NPIs in diverse contexts. Further research is needed to understand the policy mechanisms and address potential future challenges.
Topics: Humans; COVID-19; COVID-19 Vaccines; SARS-CoV-2; Pandemics
PubMed: 38844867
DOI: 10.1186/s12889-024-18980-2 -
BMJ Open Jun 2024This study aimed to identify the types of transparency interventions in the health systems of the low-income and middle-income countries and the outcomes of such...
OBJECTIVES
This study aimed to identify the types of transparency interventions in the health systems of the low-income and middle-income countries and the outcomes of such interventions in those systems.
METHOD
We searched major medical databases including PubMed, Embase and Scopus, for any kind of interventional study on transparency in health systems. We also looked for additional sources of information in organisational websites, grey literature and reference checking. Using the PRISMA algorithm for identifying related studies, we included 24 articles.
RESULTS
Our initial search, from 1980 to August 2021, retrieved 407 articles, 24 of which were narratively analysed. Response to a problem (mostly corruption) was the main reason for the initiation of a transparency intervention. Transparency interventions differed in terms of types, performance methods, collaboration partners and outcomes. They help improve the health system mostly in the short term and in some cases, long term.
CONCLUSION
Although our findings revealed that transparency initiatives could reduce some problems such as counterfeit drugs and corruption, and improve health indicators in a short term, still their sustainability remains a concern. Health systems need robust interventions with clearly defined and measured outcomes, especially sustainable outcomes to tackle corruption fundamentally.
Topics: Humans; Developing Countries; Delivery of Health Care; Quality Improvement
PubMed: 38844391
DOI: 10.1136/bmjopen-2023-081152 -
Frontiers in Public Health 2024Antimicrobial resistance (AMR) is a major public health threat. With the growing emphasis on patient-centred care/ shared decision making, it is important for healthcare...
INTRODUCTION
Antimicrobial resistance (AMR) is a major public health threat. With the growing emphasis on patient-centred care/ shared decision making, it is important for healthcare professionals' (HCPs) who prescribe, dispense, administer and/or monitor antimicrobials to be adequately equipped to facilitate appropriate antimicrobial use. We systematically identified existing interventions which aim to improve HCPs interaction with patients and examined barriers and facilitators of appropriate the use of such interventions and appropriate antimicrobial use among both HCPs and patientsantimicrobial use while using these interventions.
METHODS
We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and internet (via Google search engine). We included primary studies, published in English from 2010 to 2023 [PROSPERO (CRD42023395642)]. The protocol was preregistered with PROSPERO (CRD42023395642). We performed quality assessment using mixed methods appraisal tool. We applied narrative synthesis and used the COM-B (Capability, Opportunity, Motivation -Behaviour) as a theoretical framework for barriers and facilitators at HCP and patient levels.
RESULTS
Of 9,172 citations retrieved from database searches, From 4,979 citations remained after removal of duplicates. We included 59 studies spanning over 13 countries. Interventions often involved multiple components beyond HCPs' interaction with patients. From 24 studies reporting barriers and facilitators, we identified issues relating to capability (such as, knowledge/understanding about AMR, diagnostic uncertainties, awareness of interventions and forgetfulness); opportunity (such as, time constraint and intervention accessibility) and motivation (such as, patient's desire for antibiotics and fear of litigation).
CONCLUSION
The findings of this review should be considered by intervention designers/adopters and policy makers to improve utilisation and effectiveness.
Topics: Humans; Health Personnel; Professional-Patient Relations; Anti-Bacterial Agents; Drug Resistance, Bacterial
PubMed: 38841670
DOI: 10.3389/fpubh.2024.1359790 -
Heliyon Jun 2024The tourism sector is presently facing new challenges resulting from the increasing digitalization of society. Boosted by industry 4.0, new tourism dynamics are...
The tourism sector is presently facing new challenges resulting from the increasing digitalization of society. Boosted by industry 4.0, new tourism dynamics are emerging. Nonetheless, the real significance of this revolutionary trend and its implications still lack further development. Aiming to assess the state-of-the-art about the digital transformation on the tourism sector, triggered by the 4.0 paradigm, the present study followed a systematic literature review approach, adopting the PRISMA protocol guidelines. A total of 44 manuscripts were considered relevant for analysis. The findings illustrate that the 4.0 paradigm is being embraced from three main perspectives: the visitor-technology interaction and its influence on decision-making, the digital competencies in tourism students, and the technology penetration in different sub-sectors of the supply chain. However, studies conceptualizing the 4.0 paradigm in the tourism sector are lacking, beyond empirical research on areas such as digital skills, pros and cons of industry 4.0 technologies, and spatial consequences.
PubMed: 38841503
DOI: 10.1016/j.heliyon.2024.e31590