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BMC Musculoskeletal Disorders May 2023Interventions provided after hip fracture surgery have been shown to reduce mortality and improve functional outcomes. While some systematic studies have evaluated the...
BACKGROUND
Interventions provided after hip fracture surgery have been shown to reduce mortality and improve functional outcomes. While some systematic studies have evaluated the efficacy of post-surgery interventions, there lacks a systematically rigorous examination of all the post-surgery interventions which allows healthcare providers to easily identify post-operative interventions most pertinent to patient's recovery.
OBJECTIVES
We aim to provide an overview of the available evidence on post-surgery interventions provided in the acute, subacute and community settings to improve outcomes for patients with hip fractures.
METHODS
We performed a systematic literature review guided by the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). We included articles that were (1) randomized controlled trials (RCTs), (2) involved post-surgery interventions that were conducted in the acute, subacute or community settings and (3) conducted among older patients above 65 years old with any type of non-pathological hip fracture that was surgically treated, and who were able to walk without assistance prior to the fracture. We excluded (1) non-English language articles, (2) abstract-only publications, (3) articles with only surgical interventions, (4) articles with interventions that commenced pre-surgery or immediately upon completion of surgery or blood transfusion, (5) animal studies. Due to the large number of RCTs identified, we only included "good quality" RCTs with Jadad score ≥ 3 for data extraction and synthesis.
RESULTS
Our literature search has identified 109 good quality RCTs on post-surgery interventions for patients with fragility hip fractures. Among the 109 RCTs, 63% of the identified RCTs (n = 69) were related to rehabilitation or medication/nutrition supplementation, with the remaining RCTs focusing on osteoporosis management, optimization of clinical management, prevention of venous thromboembolism, fall prevention, multidisciplinary approaches, discharge support, management of post-operative anemia as well as group learning and motivational interviewing. For the interventions conducted in inpatient and outpatient settings investigating medication/nutrition supplementation, all reported improvement in outcomes (ranging from reduced postoperative complications, reduced length of hospital stay, improved functional recovery, reduced mortality rate, improved bone mineral density and reduced falls), except for a study investigating anabolic steroids. RCTs involving post-discharge osteoporosis care management generally reported improved osteoporosis management except for a RCT investigating multidisciplinary post-fracture clinic led by geriatrician with physiotherapist and occupational therapist. The trials investigating group learning and motivational interviewing also reported positive outcome respectively. The other interventions yielded mixed results. The interventions in this review had minor or no side effects reported.
CONCLUSIONS
The identified RCTs regarding post-surgery interventions were heterogeneous in terms of type of interventions, settings and outcome measures. Combining interventions across inpatient and outpatient settings may be able to achieve better outcomes such as improved physical function recovery and improved nutritional status recovery. For example, nutritional supplementation could be made available for patients who have undergone hip fracture surgery in the inpatient settings, followed by post-discharge outpatient osteoporosis care management. The findings from this review can aid in clinical practice by allowing formulation of thematic program with combination of interventions as part of bundled care to improve outcome for patients who have undergone hip fracture surgery.
Topics: Humans; Bone Density; Hip Fractures; Osteoporosis; Postoperative Care; Randomized Controlled Trials as Topic
PubMed: 37231406
DOI: 10.1186/s12891-023-06512-9 -
Sensors (Basel, Switzerland) Apr 2023Digital technologies have recently become more advanced, allowing for the development of social networking sites and applications. Despite these advancements, phone... (Review)
Review
A Systematic Review of Mobile Phone Data in Crime Applications: A Coherent Taxonomy Based on Data Types and Analysis Perspectives, Challenges, and Future Research Directions.
Digital technologies have recently become more advanced, allowing for the development of social networking sites and applications. Despite these advancements, phone calls and text messages still make up the largest proportion of mobile data usage. It is possible to study human communication behaviors and mobility patterns using the useful information that mobile phone data provide. Specifically, the digital traces left by the large number of mobile devices provide important information that facilitates a deeper understanding of human behavior and mobility configurations for researchers in various fields, such as criminology, urban sensing, transportation planning, and healthcare. Mobile phone data record significant spatiotemporal (i.e., geospatial and time-related data) and communication (i.e., call) information. These can be used to achieve different research objectives and form the basis of various practical applications, including human mobility models based on spatiotemporal interactions, real-time identification of criminal activities, inference of friendship interactions, and density distribution estimation. The present research primarily reviews studies that have employed mobile phone data to investigate, assess, and predict human communication and mobility patterns in the context of crime prevention. These investigations have sought, for example, to detect suspicious activities, identify criminal networks, and predict crime, as well as understand human communication and mobility patterns in urban sensing applications. To achieve this, a systematic literature review was conducted on crime research studies that were published between 2014 and 2022 and listed in eight electronic databases. In this review, we evaluated the most advanced methods and techniques used in recent criminology applications based on mobile phone data and the benefits of using this information to predict crime and detect suspected criminals. The results of this literature review contribute to improving the existing understanding of where and how populations live and socialize and how to classify individuals based on their mobility patterns. The results show extraordinary growth in studies that utilized mobile phone data to study human mobility and movement patterns compared to studies that used the data to infer communication behaviors. This observation can be attributed to privacy concerns related to acquiring call detail records (CDRs). Additionally, most of the studies used census and survey data for data validation. The results show that social network analysis tools and techniques have been widely employed to detect criminal networks and urban communities. In addition, correlation analysis has been used to investigate spatial-temporal patterns of crime, and ambient population measures have a significant impact on crime rates.
Topics: Humans; Cell Phone; Text Messaging; Communication; Transportation; Crime
PubMed: 37177554
DOI: 10.3390/s23094350 -
BMJ Open May 2023Rabies is a neglected zoonotic disease that can infect all mammals, including humans. We aimed to summarise the current knowledge of the incidence, risk factors and...
OBJECTIVE
Rabies is a neglected zoonotic disease that can infect all mammals, including humans. We aimed to summarise the current knowledge of the incidence, risk factors and mortality of rabies in Southeast Asia.
DESIGN
Systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020.
DATA SOURCES
Scopus, Web of Science and PubMed were searched from 1 January 2012 to 21 February 2023.
ELIGIBILITY CRITERIA
Original English language articles published between 2012 and 2023 were included.
DATA EXTRACTION AND SYNTHESIS
Nine independent reviewers extracted data and assessed the risk of bias. The quality appraisal of included articles was carried out using the Mixed Methods Appraisal Tool.
RESULTS
A total of eight articles were included in this analysis. In Vietnam, the incidence of rabies ranged from 1.7 to 117.2 per 100 000 population. The cumulative incidence in Sarawak was estimated at 1.7 per 100 000 population. In Indonesia, 104 human rabies cases were reported from 2008 to 2010, while in Thailand, a total of 46 rabies cases were reported in Thailand from 2010 to 2015. In the Philippines, the incidence of rabies ranged from 0.1 to 0.3 per 100 000 population. An increased risk of rabies virus infection was associated with a high population density, illiteracy, seasonal patterns and dog butchers. The case fatality rate was 100%.
CONCLUSION
This study included research from Southeast Asia, which may not represent rabies infection in other regions or continents. In addition, the role of publication bias should be acknowledged as grey literature was not included. The occurrence of rabies in Southeast Asia is due to the high number of unvaccinated stray and pet dogs, working hazards (dog butchers in Vietnam), the unavailability of the rabies vaccine in rural regions and misinformation about the significance of seeking treatment after dog bites.
PROSPERO REGISTRATION NUMBER
CRD42022311654.
Topics: Humans; Animals; Dogs; Rabies; Rabies Vaccines; Incidence; Vietnam; Risk Factors; Mammals
PubMed: 37164462
DOI: 10.1136/bmjopen-2022-066587 -
The Cochrane Database of Systematic... May 2023Osteoporosis is characterized by low bone mass and micro-architectural deterioration of bone tissue leading to increased bone fragility. In people with... (Review)
Review
BACKGROUND
Osteoporosis is characterized by low bone mass and micro-architectural deterioration of bone tissue leading to increased bone fragility. In people with beta-thalassaemia, osteoporosis represents an important cause of morbidity and is due to a number of factors. First, ineffective erythropoiesis causes bone marrow expansion, leading to reduced trabecular bone tissue with cortical thinning. Second, excessive iron loading causes endocrine dysfunction, leading to increased bone turnover. Lastly, disease complications can result in physical inactivity, with a subsequent reduction in optimal bone mineralization. Treatments for osteoporosis in people with beta-thalassaemia include bisphosphonates (e.g. clodronate, pamidronate, alendronate; with or without hormone replacement therapy (HRT)), calcitonin, calcium, zinc supplementation, hydroxyurea, and HRT alone (for preventing hypogonadism). Denosumab, a fully human monoclonal antibody, inhibits bone resorption and increases bone mineral density (BMD). Finally, strontium ranelate simultaneously promotes bone formation and inhibits bone resorption, thus contributing to a net gain in BMD, increased bone strength, and reduced fracture risk. This is an update of a previously published Cochrane Review.
OBJECTIVES
To review the evidence on the efficacy and safety of treatment for osteoporosis in people with beta-thalassaemia.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, which includes references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also searched online trial registries. Date of most recent search: 4 August 2022.
SELECTION CRITERIA
Randomized controlled trials (RCTs) in people with beta-thalassaemia with: a BMD Z score below -2 standard deviations (SDs) for children aged under 15 years, adult males (aged 15 to 50 years) and premenopausal females aged over 15 years; or a BMD T score below -2.5 SDs for postmenopausal females and males aged over 50 years.
DATA COLLECTION AND ANALYSIS
Two review authors assessed the eligibility and risk of bias of the included RCTs, and extracted and analysed data. We assessed the certainty of the evidence using GRADE.
MAIN RESULTS
We included six RCTs (298 participants). Active interventions included bisphosphonates (3 trials, 169 participants), zinc supplementation (1 trial, 42 participants), denosumab (1 trial, 63 participants), and strontium ranelate (1 trial, 24 participants). The certainty of the evidence ranged from moderate to very low and was downgraded mainly due to concerns surrounding imprecision (low participant numbers), but also risk of bias issues related to randomization, allocation concealment, and blinding. Bisphosphonates versus placebo or no treatment Two RCTs compared bisphosphonates to placebo or no treatment. After two years, one trial (25 participants) found that alendronate and clodronate may increase BMD Z score compared to placebo at the femoral neck (mean difference (MD) 0.40, 95% confidence interval (CI) 0.22 to 0.58) and the lumbar spine (MD 0.14, 95% CI 0.05 to 0.23). One trial (118 participants) reported that neridronate compared to no treatment may increase BMD at the lumbar spine and total hip at six and 12 months; for the femoral neck, the study found increased BMD in the neridronate group at 12 months only. All results were of very low-certainty. There were no major adverse effects of treatment. Participants in the neridronate group reported less back pain; we considered this representative of improved quality of life (QoL), though the certainty of the evidence was very low. One participant in the neridronate trial (116 participants) sustained multiple fractures as a result of a traffic accident. No trials reported BMD at the wrist or mobility. Different doses of bisphosphonate compared One 12-month trial (26 participants) assessed different doses of pamidronate (60 mg versus 30 mg) and found a difference in BMD Z score favouring the 60 mg dose at the lumbar spine (MD 0.43, 95% CI 0.10 to 0.76) and forearm (MD 0.87, 95% CI 0.23 to 1.51), but no difference at the femoral neck (very low-certainty evidence). This trial did not report fracture incidence, mobility, QoL, or adverse effects of treatment. Zinc versus placebo One trial (42 participants) showed zinc supplementation probably increased BMD Z score compared to placebo at the lumbar spine after 12 months (MD 0.15, 95% CI 0.10 to 0.20; 37 participants) and 18 months (MD 0.34, 95% CI 0.28 to 0.40; 32 participants); the same was true for BMD at the hip after 12 months (MD 0.15, 95% CI 0.11 to 0.19; 37 participants) and 18 months (MD 0.26, 95% CI 0.21 to 0.31; 32 participants). The evidence for these results was of moderate certainty. The trial did not report BMD at the wrist, fracture incidence, mobility, QoL, or adverse effects of treatment. Denosumab versus placebo Based on one trial (63 participants), we are unsure about the effect of denosumab on BMD Z score at the lumbar spine, femoral neck, and wrist joint after 12 months compared to placebo (low-certainty evidence). This trial did not report fracture incidence, mobility, QoL, or adverse effects of treatment, but the investigators reported a reduction in bone pain measured on a visual analogue scale in the denosumab group after 12 months of treatment compared to placebo (MD -2.40 cm, 95% CI -3.80 to -1.00). Strontium ranelate One trial (24 participants) only narratively reported an increase in BMD Z score at the lumbar spine in the intervention group and no corresponding change in the control group (very low-certainty evidence). This trial also found a reduction in back pain measured on a visual analogue scale after 24 months in the strontium ranelate group compared to the placebo group (MD -0.70 cm (95% CI -1.30 to -0.10); we considered this measure representative of improved quality of life.
AUTHORS' CONCLUSIONS
Bisphosphonates may increase BMD at the femoral neck, lumbar spine, and forearm compared to placebo after two years' therapy. Zinc supplementation probably increases BMD at the lumbar spine and hip after 12 months. Denosumab may make little or no difference to BMD, and we are uncertain about the effect of strontium on BMD. We recommend further long-term RCTs on different bisphosphonates and zinc supplementation therapies in people with beta-thalassaemia-associated osteoporosis.
Topics: Adult; Child; Female; Male; Humans; Middle Aged; beta-Thalassemia; Alendronate; Pamidronate; Clodronic Acid; Denosumab; Osteoporosis; Diphosphonates; Fractures, Bone
PubMed: 37159055
DOI: 10.1002/14651858.CD010429.pub3 -
Antioxidants (Basel, Switzerland) Apr 2023Osteoporosis is characterized by a decline in bone mineral density (BMD) and increased fracture risk. Free radicals and antioxidant systems play a central role in bone... (Review)
Review
Osteoporosis is characterized by a decline in bone mineral density (BMD) and increased fracture risk. Free radicals and antioxidant systems play a central role in bone remodeling. This study was conducted to illustrate the role of oxidative-stress-related genes in BMD and osteoporosis. A systematic review was performed following the PRISMA guidelines. The search was computed in PubMed, Web of Sciences, Scopus, EBSCO, and BVS from inception to November 1st, 2022. The risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist tool. A total of 427 potentially eligible articles exploring this search question were detected. After removing duplicates (n = 112) and excluding irrelevant manuscripts based on screenings of their titles and abstracts (n = 317), 19 articles were selected for full-text review. Finally, 14 original articles were included in this systematic review after we applied the exclusion and inclusion criteria. Data analyzed in this systematic review indicated that oxidative-stress-related genetic polymorphisms are associated with BMD at different skeletal sites in diverse populations, influencing the risk of osteoporosis or osteoporotic fracture. However, it is necessary to look deep into their association with bone metabolism to determine if the findings can be translated into the clinical management of osteoporosis and its progression.
PubMed: 37107290
DOI: 10.3390/antiox12040915 -
Marine Drugs Mar 2023Dyslipidemia is a common chronic disease that increases the risk of cardiovascular disease. Diet plays an important role in the development of dyslipidemia. As people... (Meta-Analysis)
Meta-Analysis Review
Dyslipidemia is a common chronic disease that increases the risk of cardiovascular disease. Diet plays an important role in the development of dyslipidemia. As people pay increased attention to healthy eating habits, brown seaweed consumption is increasing, particularly in East Asian countries. The association between dyslipidemia and brown seaweed consumption has been previously demonstrated. We searched for keywords associated with brown seaweed and dyslipidemia in electronic databases such as PubMed, Embase, and Cochrane. Heterogeneity was estimated using the I statistic. The 95% confidence interval (CI) of the forest plot and heterogeneity were confirmed using meta-ANOVA and meta-regression. Funnel plots and publication bias statistical tests were used to determine publication bias. Statistical significance was set at < 0.05. In this meta-analysis, we found that brown seaweed intake significantly decreased the levels of total cholesterol (mean difference (MD): -3.001; 95% CI: -5.770, -0.232) and low-density lipoprotein (LDL) cholesterol (MD: -6.519; 95% CI: -12.884, -0.154); nevertheless, the statistically significant association of brown seaweed intake with high-density lipoprotein (HDL) cholesterol and triglycerides were not observed in our study (MD: 0.889; 95% CI: -0.558, 2.335 and MD: 8.515; 95% CI: -19.354, 36.383). Our study demonstrated that brown seaweed and its extracts decreased total cholesterol and LDL cholesterol levels. The use of brown seaweeds may be a promising strategy to reduce the risk of dyslipidemia. Future studies involving a larger population are warranted to investigate the dose-response association of brown seaweed consumption with dyslipidemia.
Topics: Humans; Cholesterol; Triglycerides; Dyslipidemias; Cholesterol, HDL; Vegetables; Biomarkers
PubMed: 37103359
DOI: 10.3390/md21040220 -
North American Spine Society Journal Jun 2023Novel methods of bone density assessment using computed tomography (CT) and magnetic resonance imaging (MRI) have been increasingly reported in the spine surgery...
BACKGROUND
Novel methods of bone density assessment using computed tomography (CT) and magnetic resonance imaging (MRI) have been increasingly reported in the spine surgery literature. Correlations between these newer measurements and traditional Dual-Energy X-ray Absorptiometry (DEXA) is not well known. The purpose of this study is to perform an updated systematic review of correlations between bone mineral density (BMD) from CT or MRI and DEXA.
METHODS
Articles published between 2011 and 2021 that reported correlations between the CT-HU or MRI measurements to DEXA t-scores or BMD of lumbar spine or hip were included in this systematic review.
RESULTS
A total of 25 studies (15 CT, 10 MRI) met the inclusion criteria with a total number of 2,745 patients. The pooled correlation coefficient of spine CT-HU versus spine DEXA, spine CT-HU versus hip DEXA and spine CT-HU versus lowest t-score were 0.60, 0.50 and 0.60 respectively. Regarding spine DEXA parameters, the pooled r for spine CT-HU versus spine t-score was 0.684 and spine CT-HU versus spine BMD was 0.598. Furthermore, in patients undergoing spine surgery in four studies, the pooled correlation between spine CT and spine DEXA was (r: 0.64). In MRI studies, the pooled r of spine MRI versus spine DEXA and spine MRI versus hip DEXA were -0.41 and -0.44 respectively.
CONCLUSIONS
CT-HU has stronger correlations with DEXA than MRI measurements. Lumbar CT-HU has the highest pooled correlation (r = 0.6) with both spine DEXA and lowest skeletal t-score followed by lumbar CT-HU with hip DEXA (r = 0.5) and lumbar MRI with hip (r = 0.44) and spine (r = 0.41) DEXA. Both imaging modalities achieved only a moderate correlation with DEXA. Few studies in both modalities have investigated the correlation in spine surgery populations and the available data shows that the correlations are worse in the degenerative spine population. A careful interruption of CT HU and MRI measurement when evaluation of BMD as they only moderately correlated with DEXA scores. At this time, it is unclear which modality is a better predictor of mechanical complications and clinical outcomes in spine surgery patients.
PubMed: 37090222
DOI: 10.1016/j.xnsj.2023.100204 -
Frontiers in Public Health 2023Social factors play the main role in the vulnerability of exposed countries to disasters. The COVID-19 pandemic as a disaster is not an exception to this fact. This...
BACKGROUND
Social factors play the main role in the vulnerability of exposed countries to disasters. The COVID-19 pandemic as a disaster is not an exception to this fact. This study aimed to determine the main social vulnerability indicators in the COVID-19 pandemic in Iran.
METHODS
This study was conducted during the period of 2021-2022 in three phases, including a systematic review, a virtual panel expert, and the Analytical Hierarchy Process. First, the draft of social vulnerability indicators in COVID-19 was extracted through a systematic review. Then, the extracted indicators were finalized and prioritized by the expert panel and the AHP, respectively.
RESULTS
Initially, the literature review found five domains and 38 indicators of social vulnerability in COVID-19. The outcome of the expert panel increased the related domains to six but decreased the indicators to 31. The three prioritized social vulnerability indicators that were determined by the AHP were population density, accessibility to healthcare facilities, and relevant services and vulnerable groups.
CONCLUSION
Measuring social vulnerability with the identified indicators is valuable for addressing high COVID-19 incidence among socially vulnerable hotspot areas. Regarding the result of this study, further research should be conducted to validate the identified indicators.
Topics: Humans; COVID-19; Social Vulnerability; Iran; Pandemics; Disasters
PubMed: 37050958
DOI: 10.3389/fpubh.2023.1080137 -
Frontiers in Veterinary Science 2023The overall prevalence of spp., a group of important zoonotic pathogens, in the global dairy herds and the risk of cross-species transmission between humans and dairy...
INTRODUCTION
The overall prevalence of spp., a group of important zoonotic pathogens, in the global dairy herds and the risk of cross-species transmission between humans and dairy cows remain to be clarified. This systematic review aimed to determine the prevalence of spp. in milk samples from dairy cows with mastitis worldwide and to assess the factors influencing the prevalence of these strains.
METHODS
Qualified studies published from 2007 to 2021 were retrieved from ScienceDirect, Web of Science, PubMed, WanFang Database, China National Knowledge Infrastructure (CNKI), and VIP Chinese Journal Database. Calculations of prevalence and their 95% confidence intervals (CIs) were performed for all the studies using the Freeman-Tukey double arcsine transformation (PFT).
RESULTS
A total of 79,852 milk samples from 55 manuscripts were examined in this meta-analysis, and 2,478 samples were found to be positive for spp. The pooled prevalence estimates worldwide were 7.95% (95% CI: 6.07%-10.06%), with significant heterogeneity ( = 98.8%, = 0). The sampling period of 2013-2020 had a higher ( < 0.05) Klebsiella-positive proportion of milk samples (12.16%, 95% CI: 8.08%-16.90%) than that of 2007-2012 (3.85%, 95% CI: 2.67%-5.21%), indicating that bovine mastitis caused by Klebsiella may become increasingly prevalent. The risk factors for the high prevalence of Klebsiella in milk samples mainly included: economic development level (developing countries; 11.76%, 95% CI: 8.25%-15.77%), mastitis type (CM; 11.99%, 95% CI: 8.62%-15.79%), and population density (>500 per sq km; 10.28%, 95% CI: 2.73%-21.58%). Additionally, a bivariate meta-regression analysis revealed that the multidrug-resistance (MDR) rate of the epidemic strains was also closely related to economic development level ( = 78.87%) and population density ( = 87.51%).
DISCUSSION
Due to the potential risk of cross-species transmission between humans and cows, the prevalence of mastitis milk-derived Klebsiella and its high MDR rate need to be monitored, especially in developing countries with high population densities.
PubMed: 37035815
DOI: 10.3389/fvets.2023.1143257 -
Frontiers in Physiology 2023Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled...
Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled effect of exercise interventions following frequency, intensity, time and type prescriptions. This systematic review and meta-analysis aimed to synthesise evidence regarding the effectiveness of exercise interventions on bone health in children and adolescents with cancer during and after oncological treatment. A systematic search was conducted in the MEDLINE ( PubMed), Web of Science and Scopus databases from November 2021 to January 2022. Randomised controlled trials (RCTs) and non-RCTs reporting pre-post changes of the effectiveness of exercise interventions on DXA-measured bone parameters in young population (1-19 years) during or after oncological treatment were included. Pooled (ESs) and 95% confidence intervals (95%CIs) were calculated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A total of eight trials with 341 participants were included. The meta-analyses did not reveal a statistically significant increase in whole body areal bone mineral density (ES = 0.10; 95%CI: -0.14, 0.34), lumbar spine (ES = 0.03; 95%CI: -0.21, 0.26) or femoral neck (ES = 0.10; 95%CI: -0.37, 0.56). Similarly, during the oncological treatment phase the ES was 0.04 (95%CI: -0.17, 0.25) and after the ES was 0.07 (95%CI: -0.20, 0.33). To date, exercise interventions have been inappropriate and therefore, ineffective to illustrate any beneficial effect on bone health in children and adolescents with cancer during and after oncological treatment. : PROSPERO registration number: CRD42022310876.
PubMed: 37035662
DOI: 10.3389/fphys.2023.1088740