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Current Neuropharmacology 2023Traditional medicine and biomedical sciences are reaching a turning point because of the constantly growing impact and volume of Big Data. Machine Learning (ML)...
Traditional medicine and biomedical sciences are reaching a turning point because of the constantly growing impact and volume of Big Data. Machine Learning (ML) techniques and related algorithms play a central role as diagnostic, prognostic, and decision-making tools in this field. Another promising area becoming part of everyday clinical practice is personalized therapy and pharmacogenomics. Applying ML to pharmacogenomics opens new frontiers to tailored therapeutical strategies to help clinicians choose drugs with the best response and fewer side effects, operating with genetic information and combining it with the clinical profile. This systematic review aims to draw up the state-of-the-art ML applied to pharmacogenomics in psychiatry. Our research yielded fourteen papers; most were published in the last three years. The sample comprises 9,180 patients diagnosed with mood disorders, psychoses, or autism spectrum disorders. Prediction of drug response and prediction of side effects are the most frequently considered domains with the supervised ML technique, which first requires training and then testing. The random forest is the most used algorithm; it comprises several decision trees, reduces the training set's overfitting, and makes precise predictions. ML proved effective and reliable, especially when genetic and biodemographic information were integrated into the algorithm. Even though ML and pharmacogenomics are not part of everyday clinical practice yet, they will gain a unique role in the next future in improving personalized treatments in psychiatry.
Topics: Humans; Pharmacogenetics; Precision Medicine; Machine Learning; Mental Disorders; Psychiatry
PubMed: 37559539
DOI: 10.2174/1570159X21666230808170123 -
Journal of Orthopaedics and... Jun 2023Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy. Menopausal status and/or estrogen level may play a role in CTS. The evidence regarding the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy. Menopausal status and/or estrogen level may play a role in CTS. The evidence regarding the association between hormone replacement therapy (HRT) in postmenopausal women and CTS is still conflicting. This meta-analysis aimed to investigate the association between carpal tunnel syndrome (CTS) and women using hormone replacement therapy (HRT).
METHODS
A search was conducted in the PubMed/Medline, Scopus, Embase, and Cochrane databases, from their inception through July 2022. Studies which reported on the association between any type of HRT use and the risk of developing CTS in postmenopausal women compared to a control group were included. Studies which did not include a control group were excluded. Of the 1573 articles extracted from database searches, seven studies involving 270,764 women were included of which 10,746 had CTS. The association between CTS and HRT use was evaluated using the pooled odds ratio (OR) with a 95% confidence interval (CI) under random-effects modelling. Risk of bias in each study was assessed using the Newcastle-Ottawa Scale (NOS) and version 2 of the Cochrane tool for assessing risk of bias in randomized trials (RoB 2).
RESULTS
HRT use showed no statistically significant association with a higher risk of CTS with pooled odds ratio (OR) 1.49, 95% confidence interval (CI) 0.99-2.23, and p = 0.06, although high heterogeneity among the studies was observed (I 97.0%, Q-test p-value < 0.001). Subgroup analysis of groups in non-randomized controlled studies showed a significantly increased risk of CTS, while groups in randomized controlled studies showed a decreased risk of CTS (pooled OR 1.87, 95% CI 1.24-2.83 versus pooled OR 0.79, 95% CI 0.69-0.92, respectively) with the p-value of group difference < 0.001. The risk of bias in most of the included studies was estimated to be low.
CONCLUSIONS
This meta-analysis supports the safety of using HRT in postmenopausal women with potential risk factors for CTS.
LEVEL OF EVIDENCE
I, Prognosis.
REGISTRATION
INPLASY (202280018).
Topics: Humans; Female; Carpal Tunnel Syndrome; Databases, Factual; Hormone Replacement Therapy; Research Design; Risk Factors
PubMed: 37308714
DOI: 10.1186/s10195-023-00707-5 -
International Journal of Biological... 2021The transient receptor potential cation channel subfamily V member 1 (TRPV1) is a transmembrane protein that can be activated by various physical and chemical stimuli...
The transient receptor potential cation channel subfamily V member 1 (TRPV1) is a transmembrane protein that can be activated by various physical and chemical stimuli and is associated with pain transduction. In recent years, TRPV1 was discovered to play essential roles in cancer tumorigenesis and development, as TRPV1 expression levels are altered in numerous cancer cell types. Several investigations have discovered direct associations between TRPV1 and cancer cell proliferation, cell death, and metastasis. Furthermore, about two dozen TRPV1 agonists/antagonists are under clinical trial, as TRPV1 is a potential drug target for treating various diseases. Hence, more researchers are focusing on the effects of TRPV1 agonists or antagonists on cancer tumorigenesis and development. However, both agonists and antagonists may reveal anti-cancer effects, and the effect may function via or be independent of TRPV1. In this review, we provide an overview of the impact of TRPV1 on cancer cell proliferation, cell death, and metastasis, as well as on cancer therapy and the tumor microenvironment, and consider the implications of using TRPV1 agonists and antagonists for future research and potential therapeutic approaches.
Topics: Antineoplastic Agents; Carcinogenesis; Drug Development; Humans; Neoplasms; TRPV Cation Channels
PubMed: 34131404
DOI: 10.7150/ijbs.59918 -
Paediatrics & Child Health Jul 2023Hospitalized children face pain and anxiety associated with the environment and procedures. (Review)
Review
BACKGROUND
Hospitalized children face pain and anxiety associated with the environment and procedures.
OBJECTIVE
This review aimed to assess the impact of music, play, pet and art therapies on pain and anxiety in hospitalized paediatric patients. RCTs assessing the impact of music, play, pet, and/or art therapies on pain and/or anxiety in hospitalized paediatric patients were eligible.
METHODS
Database searching and citation screening was completed to identify studies. A narrative synthesis was used to summarize study findings and certainty of evidence was assessed using GRADE. Of the 761 documents identified, 29 were included spanning music (n = 15), play (n = 12), and pet (n = 3) therapies.
RESULTS
A high certainty of evidence supported play in reducing pain and moderate certainty for music and pet. A moderate certainty of evidence supported music and play in reducing anxiety.
CONCLUSION
Complementary therapies utilized alongside conventional medical treatment may mitigate pain and anxiety in hospitalized paediatric patients.
PubMed: 37287483
DOI: 10.1093/pch/pxad010 -
Heliyon Dec 2022Recurrent hemarthrosis is one of the major complications affecting joint functions, and causing chronic pain in hemophilia patients. (Review)
Review
BACKGROUND
Recurrent hemarthrosis is one of the major complications affecting joint functions, and causing chronic pain in hemophilia patients.
OBJECTIVE
To summarize the existing evidence of the effects of myofascial therapy (MFT) on joint status, joint pain, and hemarthrosis in hemophilic arthropathy.
METHODS
This systematic review and meta-analysis was done according to PRISMA checklist. Finally, four clinical trials included and were pooled using STATA 13. Standardized mean difference (SMD) considered as the effect size.
RESULTS
All patients in the case group received 3 interventions of MFT over a 3-week period and were evaluated for 1-5 months. Joint pain with and without load was significantly decreased after three weeks in the intervention group compared to controls (SMD: -0.61, 95% CI: -1.02, -0.21 and 0.58, 95% CI: -0.88, -0.28 respectively). Also, joint status significantly improved three weeks later in patients with MFT compared to controls. (SMD: -0.49, 95% CI: -0.79, -0.19) and this improvement remained until the end of the follow-up period (SMD: -0.54, 95% CI: -0.84, -0.24).
CONCLUSION
This meta-analysis showed that MFT can be an effective intervention improving the joint status and decreasing pain perception in patients with hemophilic arthropathy. Consequently, it can play an important role in achieving higher functionality and quality of life in these patients. However, due to the small number of studies and other limitations, further well-designed trials and updated meta-analysis are needed for more accurate results and interpretation.
PubMed: 36590485
DOI: 10.1016/j.heliyon.2022.e12552 -
Journal of Ovarian Research Nov 2023Clinical prediction models play an important role in the field of medicine. These can help predict the probability of an individual suffering from disease,... (Review)
Review
Clinical prediction models play an important role in the field of medicine. These can help predict the probability of an individual suffering from disease, complications, and treatment outcomes by applying specific methodologies. Polycystic ovary syndrome (PCOS) is a common disease with a high incidence rate, huge heterogeneity, short- and long-term complications, and complex treatments. In this systematic review study, we reviewed the progress of clinical prediction models in PCOS patients, including diagnosis and prediction models for PCOS complications and treatment outcomes. We aimed to provide ideas for medical researchers and clues for the management of PCOS. In the future, models with poor accuracy can be greatly improved by adding well-known parameters and validations, which will further expand our understanding of PCOS in terms of precision medicine. By developing a series of predictive models, we can make the definition of PCOS more accurate, which can improve the diagnosis of PCOS and reduce the likelihood of false positives and false negatives. It will also help discover complications earlier and treatment outcomes being known earlier, which can result in better outcomes for women with PCOS.
Topics: Female; Humans; Polycystic Ovary Syndrome; Models, Statistical; Prognosis
PubMed: 38007488
DOI: 10.1186/s13048-023-01310-2 -
Borderline Personality Disorder and... Dec 2021The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT...
BACKGROUND
The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT may be useful in increasing access to care and augmenting in-person DBT. This review examines DBT based apps, with a specific focus on content quality and usability.
METHODS
All apps referring to DBT were identified in Google Play and iOS app stores and were systematically reviewed for app content and quality. The Mobile App Rating Scale (MARS) was used to evaluate app usability and engagement.
RESULTS
A total of 21 free to download apps were identified. The majority of apps (71%) included a component of skills training, five apps included a diary card feature. Most (76.19%) apps were designed to function without help from a therapist. The average user "star" rating was 4.39 out of 5. The mean overall MARS score was 3.41, with a range of 2.15 to 4.59, and 71.43% were considered minimally 'acceptable,' as defined by a score of 3 or higher. The average star rating was correlated with the total MARS score (r = .51, p = .02). Estimates of app usage differed substantially between popular and unpopular apps, with the three most popular apps accounting for 89.3% of monthly active users.
CONCLUSIONS
While the present study identified many usable and engaging apps in app stores designed based on DBT, there are limited apps for clinicians. DBT based mobile apps should be carefully developed and clinically evaluated.
PubMed: 34857035
DOI: 10.1186/s40479-021-00167-5 -
Exploration of Targeted Anti-tumor... 2023One in eight fatalities globally are considered cancer-related. The need for cancer therapy is growing. Natural products continue to play a role in drug development, as... (Review)
Review
AIM
One in eight fatalities globally are considered cancer-related. The need for cancer therapy is growing. Natural products continue to play a role in drug development, as up to 50% of authorized drugs in the last 30 years have been isolated from natural sources.
METHODS
Anticancer, antioxidant, antibacterial, antifungal, antiviral, analgesic, anti-inflammatory, and other actions have all been reported in research papers using plants from the genus in the treatment and prevention of disease.
RESULTS
Results from the anticancer test showed that the genus, especially , and had significant promise as an anticancer agent against several cancer cell lines. Numerous factors, including phytochemical composition, increased apoptotic activity, decreased cell proliferation, stopped angiogenesis, and reduced inflammation.
CONCLUSIONS
These results, despite preliminary, show promise for further purification and investigation of bioactive compounds and extracts within the genus for their anticancer properties.
PubMed: 37205310
DOI: 10.37349/etat.2023.00134 -
Cognitive Behaviour Therapy Jul 2023Exposure therapy is effective but widely underused. Numerous studies indicate therapist factors that might explain this pattern of underuse. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
Exposure therapy is effective but widely underused. Numerous studies indicate therapist factors that might explain this pattern of underuse. This systematic review and meta-analysis synthesised those previous research findings, to identify which therapist factors are clearly associated with their intent to use exposure therapy. A systematic review and six random-effects meta-analyses synthesised studies identified in three databases (Scopus, PsychINFO, Web of Science) and through reference lists and citation searches. Most studies relied on a survey design, resulting in weak quality of research. Twenty-six eligible studies were included in the narrative synthesis, (including 5557 participants), while 21 studies yielded sufficient data to enter the meta-analysis. Medium to large pooled effect sizes indicated that therapists with more positive beliefs, a CBT orientation, and training in exposure therapy were significantly more likely to use exposure. Small pooled effect sizes indicated that older and more anxious therapists were less likely to use exposure. Therapist years of experience was not significantly associated with exposure use. There was no evidence of publication bias. Therapist characteristics clearly play a role in the use of exposure therapy, and future clinical and research work is required to address this limitation in the delivery of this effective therapy.
Topics: Humans; Implosive Therapy; Anxiety; Narration
PubMed: 36974519
DOI: 10.1080/16506073.2023.2191824 -
Behavioral Sciences (Basel, Switzerland) Jul 2020Behavioral therapy (BT) and exercise are efficacious treatments for depression and anxiety when employed separately. The combination of BT and exercise (BT+Ex) may... (Review)
Review
Behavioral therapy (BT) and exercise are efficacious treatments for depression and anxiety when employed separately. The combination of BT and exercise (BT+Ex) may augment improvements but the combined effect of these therapies is not fully elucidated. The purpose of this meta-analysis was to determine if BT+Ex yielded a significant reduction in depression and anxiety symptoms compared to BT alone (BT). Randomized controlled studies published prior to September 2019 were searched among several databases (PUBMED, MEDLINE, PsychArticle, and Cochrane Central Register of Clinical Trials). Studies that measured depression and anxiety symptoms following BT+Ex vs. BT were extracted and analyzed. The effect of these therapies on depression and anxiety were analyzed. Subgroup analyses were performed to evaluate the effect of exercise intensity (moderate and high), exercise type (aerobic and combined exercise), and baseline levels of depression. The moderating effects of gender, age, and treatment duration were performed. Data were extracted from 18 studies (1686 participants, mean age = 47 years, 65% female). There was a significant effect of BT+Ex on symptoms of depression. The effect of BT+Ex was significant for moderate intensity exercise and elevated baseline levels of depression. Age moderated the effect for depression. There was a significant effect of BT+Ex on depressive symptoms in humans. Exercise intensity and elevated depressive symptoms may play a role in the effect of exercise.
PubMed: 32674359
DOI: 10.3390/bs10070116