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Sports Medicine (Auckland, N.Z.) Oct 2021If interplanetary travel is to be successful over the coming decades, it is essential that countermeasures to minimize deterioration of the musculoskeletal system are as... (Meta-Analysis)
Meta-Analysis
BACKGROUND
If interplanetary travel is to be successful over the coming decades, it is essential that countermeasures to minimize deterioration of the musculoskeletal system are as effective as possible, given the increased duration of spaceflight associated with such missions. The aim of this review, therefore, is to determine the magnitude of deconditioning of the musculoskeletal system during prolonged spaceflight and recommend possible methods to enhance the existing countermeasures.
METHODS
A literature search was conducted using PubMed, Ovid and Scopus databases. 5541 studies were identified prior to the removal of duplicates and the application of the following inclusion criteria: (1) group means and standard deviations for pre- and post-spaceflight for measures of strength, muscle mass or bone density were reported (or provided by the corresponding author when requested via e-mail), (2) exercise-based countermeasures were included, (3) the population of the studies were human, (4) muscle function was assessed and (5) spaceflight rather than simulated spaceflight was used. The methodological quality of the included studies was evaluated using a modified Physiotherapy Evidence Database (PEDro) scale for quality, with publication bias assessed using a failsafe N (Rosenthal method), and consistency of studies analysed using I as a test of heterogeneity. Secondary analysis of studies included Hedges' g effect sizes, and between-study differences were estimated using a random-effects model.
RESULTS
A total of 11 studies were included in the meta-analyses. Heterogeneity of the completed meta-analyses was conducted revealing homogeneity for bone mineral density (BMD) and spinal muscle size (Tau < 0.001; I = 0.00%, p > 0.05), although a high level of heterogeneity was noted for lower body force production (Tau = 1.546; I = 76.03%, p < 0.001) and lower body muscle mass (Tau = 1.386; I = 74.38%, p < 0.001). The estimated variance (≤ -0.306) for each of the meta-analyses was significant (p ≤ 0.033), for BMD (- 0.48 to - 0.53, p < 0.001), lower body force production (- 1.75, p < 0.001) and lower body muscle size (- 1.98, p < 0.001). Spaceflight results in small reductions in BMD of the femur (Hedges g = - 0.49 [- 0.69 to - 0.28]), trochanter (Hedges g = - 0.53 [- 0.77 to - 0.29]), and lumbo-pelvic region (Hedges g = - 0.48 [- 0.73 to - 0.23]), but large decreases in lower limb force production (Hedges g = - 1.75 [- 2.50 to - 0.99]) and lower limb muscle size (Hedges g = - 1.98 [- 2.72 to - 1.23]).
CONCLUSIONS
Current exercise countermeasures result in small reductions in BMD during long-duration spaceflight. In contrast, such exercise protocols do not alleviate the reductions in muscle function or muscle size, which may be attributable to the low to moderate loads reported by crewmembers and the interference effect associated with concurrent training. It is recommended that higher-load resistance exercise and the use of high-intensity interval training should be investigated, to determine if such modifications to the reported training practices result in more effective countermeasures to the deleterious effect of long-duration spaceflight on the muscular system.
Topics: Bone Density; Exercise; Humans; Muscle Strength; Space Flight; Time Factors
PubMed: 34115344
DOI: 10.1007/s40279-021-01496-9 -
Indian Journal of Pharmacology 2021Registration of study protocols brings about transparency and traceability and the amount of publication bias can be estimated. In this study, we have collected and... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Registration of study protocols brings about transparency and traceability and the amount of publication bias can be estimated. In this study, we have collected and presented data regarding clinical study registries, preclinical, in vitro and in silico study registries across the globe.
MATERIALS AND METHODS
We searched via Google Search Engine with appropriate keywords e.g. name of country (n = 198), name of continent (n = 7), registry, study registry, animal, in silico, virtual, simulation, preclinical, animal, clinical trial. The overall pooled prevalence of clinical study registries and WHO primary registries in per continent was calculated using Medcalc software.
RESULTS
The overall pooled prevalence of clinical study registries were 13% in each continent. The prevalence of WHO primary study registries were 8.9% of the countries per continent. Overall, there are 17 primary registries associated with WHO ICTRP as primary registries, 2 partner registries and 6 registries are affiliated to ICMJE. However, the amount of preclinical animal study registry was quite less (n = 4). Regarding in vitro studies, only country specific in vitro fertilization registries were available, however, in other research domains, registries were absent. Only one simulation study registry was available.
CONCLUSION
At priori study registration is essential to deal with selective reporting. Comparison between study protocol and final report allows us to know the protocol deviations and allows us to evaluate risk of bias and internal validity of the research findings. Although trialists are responsible for the completeness of records, yet the registries must have some measures for their periodic update and quality control of the data.
Topics: Animals; Clinical Protocols; Clinical Trials as Topic; Drug Evaluation, Preclinical; Humans; Registries; World Health Organization
PubMed: 34100401
DOI: 10.4103/ijp.ijp_1090_20 -
Ultrasound in Medicine & Biology Aug 2021The goal of this review was to systematize the evidence on pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with...
The goal of this review was to systematize the evidence on pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with coronavirus disease 2019 (COVID-19). Evidence on the use of PU for diagnosis and monitorization of or as hospital discharge criteria for COVID-19 patients confirmed to have COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) between December 1, 2019 and July 5, 2020 was compared with evidence obtained with thoracic radiography (TR), chest computed tomography (CT) and RT-PCR. The type of study, motives for use of PU, population, type of transducer and protocol, results of PU and quantitative or qualitative correlation with TR and/or chest CT and/or RT-PCR were evaluated. A total of 28 articles comprising 418 patients were involved. The average age was 50 y (standard deviation: 25.1 y), and there were 395 adults and 23 children. One hundred forty-three were women, 13 of whom were pregnant. The most frequent result was diffuse, coalescent and confluent B-lines. The plural line was irregular, interrupted or thickened. The presence of subpleural consolidation was noduliform, lobar or multilobar. There was good qualitative correlation between TR and chest CT and a quantitative correlation with chest CT of r = 0.65 (p < 0.001). Forty-four patients were evaluated only with PU. PU is a useful tool for diagnosis and monitorization and as criteria for hospital discharge for patients with COVID-19.
Topics: COVID-19; COVID-19 Testing; Humans; Lung; SARS-CoV-2; Ultrasonography
PubMed: 34024680
DOI: 10.1016/j.ultrasmedbio.2021.04.011 -
PloS One 2021The recovery of other pathogens in patients with SARS-CoV-2 infection has been reported, either at the time of a SARS-CoV-2 infection diagnosis (co-infection) or... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The recovery of other pathogens in patients with SARS-CoV-2 infection has been reported, either at the time of a SARS-CoV-2 infection diagnosis (co-infection) or subsequently (superinfection). However, data on the prevalence, microbiology, and outcomes of co-infection and superinfection are limited. The purpose of this study was to examine the occurrence of co-infections and superinfections and their outcomes among patients with SARS-CoV-2 infection.
PATIENTS AND METHODS
We searched literature databases for studies published from October 1, 2019, through February 8, 2021. We included studies that reported clinical features and outcomes of co-infection or superinfection of SARS-CoV-2 and other pathogens in hospitalized and non-hospitalized patients. We followed PRISMA guidelines, and we registered the protocol with PROSPERO as: CRD42020189763.
RESULTS
Of 6639 articles screened, 118 were included in the random effects meta-analysis. The pooled prevalence of co-infection was 19% (95% confidence interval [CI]: 14%-25%, I2 = 98%) and that of superinfection was 24% (95% CI: 19%-30%). Pooled prevalence of pathogen type stratified by co- or superinfection were: viral co-infections, 10% (95% CI: 6%-14%); viral superinfections, 4% (95% CI: 0%-10%); bacterial co-infections, 8% (95% CI: 5%-11%); bacterial superinfections, 20% (95% CI: 13%-28%); fungal co-infections, 4% (95% CI: 2%-7%); and fungal superinfections, 8% (95% CI: 4%-13%). Patients with a co-infection or superinfection had higher odds of dying than those who only had SARS-CoV-2 infection (odds ratio = 3.31, 95% CI: 1.82-5.99). Compared to those with co-infections, patients with superinfections had a higher prevalence of mechanical ventilation (45% [95% CI: 33%-58%] vs. 10% [95% CI: 5%-16%]), but patients with co-infections had a greater average length of hospital stay than those with superinfections (mean = 29.0 days, standard deviation [SD] = 6.7 vs. mean = 16 days, SD = 6.2, respectively).
CONCLUSIONS
Our study showed that as many as 19% of patients with COVID-19 have co-infections and 24% have superinfections. The presence of either co-infection or superinfection was associated with poor outcomes, including increased mortality. Our findings support the need for diagnostic testing to identify and treat co-occurring respiratory infections among patients with SARS-CoV-2 infection.
Topics: Bacterial Infections; COVID-19; Coinfection; Hospitalization; Humans; Mycoses; Prevalence; SARS-CoV-2; Superinfection; Treatment Outcome; Virus Diseases
PubMed: 33956882
DOI: 10.1371/journal.pone.0251170 -
Frontiers in Neurology 2021Constraint induced movement therapy (CIMT) is effective at improving upper limb outcomes after stroke. The aim of this study was to carry out a systematic review and...
Constraint induced movement therapy (CIMT) is effective at improving upper limb outcomes after stroke. The aim of this study was to carry out a systematic review and meta-analysis of the effects of lower limb CIMT studies of any design in people with stroke. PubMED, PEDro, OTSeeker, CENTRAL, and Web of Science were searched from their earliest dates to February 2021. Lower limbs CIMT studies that measured outcomes at baseline and post-intervention were selected. Sample size, mean, and standard deviation on the outcomes of interest and the protocols of both the experimental and control groups were extracted. McMaster Critical Review Form was used to assess the methodological quality of the studies. Sixteen studies with different designs were included in this review. The result showed that lower limb CIMT improves functional, physiological and person's reported outcomes including motor function, balance, mobility, gait speed, oxygen uptake, exertion before and after commencement of activities, knee extensor spasticity, weight bearing, lower limb kinematics and quality of life in people with stroke post intervention. However, there were only significant differences in quality of life in favor of CIMT post-intervention [mean difference (MD) = 16.20, 95% CI = 3.30-29.10, = 0.01]; and at follow-up [mean difference (MD) = 14.10, 95% CI = 2.07-26.13, = 0.02] between CIMT and the control group. Even for the quality of life, there was significant heterogeneity in the studies post intervention ( = 84%, = 0.01). Lower limb CIMT improves motor function, balance, functional mobility, gait speed, oxygen uptake, weigh bearing, lower limb kinematics, and quality of life. However, it is only superior to the control at improving quality of life after stroke based on the current literature.
PubMed: 33833730
DOI: 10.3389/fneur.2021.638904 -
Journal of ISAKOS : Joint Disorders &... Jan 2021Operative treatment of gluteal tendon tears is becomingly increasingly more common with varying surgical techniques and rehabilitation protocols.
IMPORTANCE
Operative treatment of gluteal tendon tears is becomingly increasingly more common with varying surgical techniques and rehabilitation protocols.
OBJECTIVE
To perform a systematic review of gluteal tendon repair as it relates to tear characteristics, rehabilitation protocols, patient-reported outcomes, satisfaction, resolution of gait deviation and complication rates.
EVIDENCE REVIEW
A comprehensive literature search of PubMed and Embase/MEDLINE was used to identify all literature pertaining to gluteal tendon repair. A total of 389 articles were identified.
FINDINGS
A total of 22 studies (611 hips) were included in this review. The majority of tears were noted to be partial thickness (77.9% vs 22.1%). Both arthroscopic and open repair demonstrated improvements in functional outcomes. Within studies documenting gait deviation, 54% were noted to have gait deviation preoperatively, of which approximately 70% had resolution following repair. On average, abduction strength increased almost one whole grade (0.84) following repair. Overall complication rate was found to be 5.2% (20 of 388 hips). Endoscopic repair demonstrated a decreased complication rate compared with open (0.7% vs 7.8%). Retear rate was found to be 3.8%, with open repair having a slightly increased rate compared with endoscopic repair (3.4% vs 4.1%).
CONCLUSIONS AND RELEVANCE
The majority of tears tend to be partial thickness with involvement of gluteus medius in almost all cases and concomitant involvement of gluteus minimus in close to half of cases. Both endoscopic and open gluteal tendon repairs resulted in improvements in outcomes and functional improvement. Retear rates were similar between the two repair techniques, while endoscopic repair demonstrated a lower complication rate.
LEVEL OF EVIDENCE
Level IV, systematic review.
Topics: Adult; Aged; Aged, 80 and over; Buttocks; Endoscopy; Female; Hip; Humans; Male; Middle Aged; Muscle, Skeletal; Patient Reported Outcome Measures; Patient Satisfaction; Postoperative Complications; Reinjuries; Tendon Injuries; Tendons; Treatment Outcome; Young Adult
PubMed: 33833043
DOI: 10.1136/jisakos-2020-000474 -
PeerJ 2021We explored functional correction training using the Functional Movement Screen (FMS™) tool. We also analyzed the effects of training on the injuries of athletes in a... (Clinical Trial)
Clinical Trial
BACKGROUND
We explored functional correction training using the Functional Movement Screen (FMS™) tool. We also analyzed the effects of training on the injuries of athletes in a systematic review and meta-analysis of non-randomized clinical trials.
METHODOLOGY
We collected twenty-four articles from PubMed, CENTRAL, Scopus, ProQuest, Web of Science, EBSCOhost, SPORTDiscus, Embase, WanFang, and CNKI that were published between January 1997 to September 2020. Articles were selected based on the following inclusion criteria: randomized and non-randomized controlled trials, studies with functional correction training screened by FMS™ as the independent variable, and studies with injury risk to the athlete as the dependent variable. Data conditions included the sample size, mean, standard deviation, total FMS™ scores, number of injuries, and asymmetry movement patterns after interventions in the experimental and control groups. Exclusion criteria included: conference abstracts, cross-sectional studies, articles with retrospective study design.
RESULTS
Twelve non-randomized trials were included in the meta-analysis. The injury risk ratio of athletes after functional correction training was 0.39 RR (95 CI [1.50-1.93]; = 15.53; < 0.0001; = 2.6%), indicating an improvement of athletes functional patterns.
CONCLUSION
Grade B evidence indicates that functional correction training based on FMS™ may improve the functional patterns of athletes and Grade D evidence indicates that it may reduce the risk of sports injury. However, the true effect is likely to be different from the estimate of the effect. Therefore, further studies are needed to explore the influence of functional correction training on the injury risks of athletes. Protocol registration: CRD42019145287.
PubMed: 33828917
DOI: 10.7717/peerj.11089 -
Journal of Integrative Medicine Jul 2021The therapeutic evidence collected from well-designed studies is needed to help manage the global pandemic of the coronavirus disease 2019 (COVID-19). Evaluating the...
BACKGROUND
The therapeutic evidence collected from well-designed studies is needed to help manage the global pandemic of the coronavirus disease 2019 (COVID-19). Evaluating the quality of therapeutic data collected during this most recent pandemic is important for improving future clinical research under similar circumstances.
OBJECTIVE
To assess the methodological quality and variability in implementation of randomized controlled trials (RCTs) for treating COVID-19, and to analyze the support that should be provided to improve data collected during an urgent pandemic situation.
SEARCH STRATEGY
PubMed, Excerpta Medica Database, China National Knowledge Infrastructure, Wanfang, and Chongqing VIP, and the preprint repositories including Social Science Research Network and MedRxiv were systematically searched, up to September 30, 2020, using the keywords "coronavirus disease 2019 (COVID-19)," "2019 novel coronavirus (2019-nCoV)," "severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2)," "novel coronavirus pneumonia (NCP)," "randomized controlled trial (RCT)" and "random."
INCLUSION CRITERIA
RCTs studying the treatment of COVID-19 were eligible for inclusion.
DATA EXTRACTION AND ANALYSIS
Screening of published RCTs for inclusion and data extraction were each conducted by two researchers. Analysis of general information on COVID-19 RCTs was done using descriptive statistics. Methodological quality was assessed using the risk-of-bias tools in the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Variability in implementation was assessed by comparing consistency between RCT reports and registration information.
RESULTS
A total of 5886 COVID-19 RCTs were identified. Eighty-one RCTs were finally included, of which, 45 had registration information. Methodological quality of the RTCs was not optimal due to deficiencies in five main domains: allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, and selective reporting. Comparisons of consistency between published protocols and registration information showed that the 45 RCTs with registration information had common deviations in seven items: inclusion and exclusion criteria, sample size, outcomes, research sites of recruitment, interventions, and blinding.
CONCLUSION
The methodological quality of COVID-19 RCTs conducted in early to mid 2020 was consistently low and variability in implementation was common. More support for implementing high-quality methodology is needed to obtain the quality of therapeutic evidence needed to provide positive guidance for clinical care. We make an urgent appeal for accelerating the construction of a collaborative sharing platform and preparing multidisciplinary talent and professional teams to conduct excellent clinical research when faced with epidemic diseases of the future. Further, variability in RCT implementation should be clearly reported and interpreted to improve the utility of data resulting from those trials.
Topics: COVID-19; Humans; Pandemics; Randomized Controlled Trials as Topic; SARS-CoV-2
PubMed: 33789839
DOI: 10.1016/j.joim.2021.03.003 -
Complementary Therapies in Medicine Jun 2021Scientists suggest that soy isoflavones or the combination of soy isoflavones and soy protein may have beneficial effects on inflammation. Thus, the present study aims... (Meta-Analysis)
Meta-Analysis Review
Beneficial effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of C-reactive protein among postmenopausal women: An updated systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Scientists suggest that soy isoflavones or the combination of soy isoflavones and soy protein may have beneficial effects on inflammation. Thus, the present study aims at conducting a systematic review and meta-analysis on randomized controlled trials (RCTs) in which the effect of soy isoflavones and the combination of soy isoflavones and soy protein on serum concentration of C-reactive protein (CRP) among postmenopausal women is assessed.
METHODS AND MATERIALS
A literature searching was done to identify a breadth of related references in PubMed, Scopus, ISI Web of Science, Cochrane Library, and Clinicaltrials.gov up to December 2020. The mean change from baseline in the CRP concentrations and its standard deviation (SD) for both intervention and comparison groups were used to calculate the effect size. The summary of the overall effects and heterogeneity was estimated by using the DerSimonian and Laird random effects model. The protocol was registered in PROSPERO (No. CRD42020166053).
RESULTS
This study considered 23 articles for systematic review and 19 articles for meta-analysis. The overall effect presented a non-significant effect of soy isoflavones on serum CRP concentrations (WMD = 0.08 mg/L, 95 % CI: -0.08, 0.24; p = 0.302) and the overall effect of the combination of soy isoflavones and soy protein indicated non-significant effect in serum levels of CRP (WMD= -0.02 mg/L 95 % CI: -0.12, 0.08; p = 0.715).
CONCLUSION
Published RCTs did not provide strong evidence regarding beneficial effect of soy isoflavones or the combination of soy isoflavones and soy protein on serum CRP concentration among postmenopausal women.
Topics: C-Reactive Protein; Female; Humans; Isoflavones; Postmenopause; Randomized Controlled Trials as Topic; Soybean Proteins
PubMed: 33785457
DOI: 10.1016/j.ctim.2021.102715 -
Journal of Prosthodontic Research Jan 2022To review the current clinical studies regarding the accuracy of implant computer-guided surgery in partially edentulous patients and investigate potential influencing... (Meta-Analysis)
Meta-Analysis
PURPOSE
To review the current clinical studies regarding the accuracy of implant computer-guided surgery in partially edentulous patients and investigate potential influencing factors.
STUDY SELECTION
Electronic searches on the PubMed and Cochrane Central Register of Controlled Trials databases, and subsequent manual searches were performed. Two reviewers selected the studies following our inclusion and exclusion criteria. Qualitative review and meta-analysis of the implant placement accuracy were performed to analyze potential influencing factors. Angular deviation, coronal deviation, apical deviation, and depth deviation were evaluated as the accuracy outcomes.
RESULTS
Eighteen studies were included in this systematic review, including six randomized controlled trials, nine prospective studies, and three retrospective clinical studies. A total of 1317 implants placed in 642 partially edentulous patients were reviewed. Eight studies were evaluated using meta-analysis. Fully guided surgery showed statistically higher accuracy in angular (P <0.001), coronal (P <0.001), and apical deviation (P <0.05) compared with pilot-drill guided surgery. A statistically significant difference (P <0.001) was also observed in coronal deviation between the bounded edentulous (BES) and distal extension spaces (DES). A significantly lower angular deviation (P <0.001) was found in implants placed using computer-aided design/computer-aided manufacturing (CAD/CAM) compared to the conventional surgical guides.
CONCLUSION
The edentulous space type, surgical guide manufacturing procedure, and guided surgery protocol can influence the accuracy of computer-guided surgery in partially edentulous patients. Higher accuracy was found when the implants were placed in BES, with CAD/CAM manufactured surgical guides, using a fully guided surgery protocol.
Topics: Computer-Aided Design; Computers; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Implants; Humans; Prospective Studies; Retrospective Studies; Surgery, Computer-Assisted
PubMed: 33504723
DOI: 10.2186/jpr.JPR_D_20_00184