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Infectious Diseases of Poverty Nov 2021To date, coronavirus disease 2019 (COVID-19) becomes increasingly fierce due to the emergence of variants. Rapid herd immunity through vaccination is needed to block the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To date, coronavirus disease 2019 (COVID-19) becomes increasingly fierce due to the emergence of variants. Rapid herd immunity through vaccination is needed to block the mutation and prevent the emergence of variants that can completely escape the immune surveillance. We aimed to systematically evaluate the effectiveness and safety of COVID-19 vaccines in the real world and to establish a reliable evidence-based basis for the actual protective effect of the COVID-19 vaccines, especially in the ensuing waves of infections dominated by variants.
METHODS
We searched PubMed, Embase and Web of Science from inception to July 22, 2021. Observational studies that examined the effectiveness and safety of SARS-CoV-2 vaccines among people vaccinated were included. Random-effects or fixed-effects models were used to estimate the pooled vaccine effectiveness (VE) and incidence rate of adverse events after vaccination, and their 95% confidence intervals (CI).
RESULTS
A total of 58 studies (32 studies for vaccine effectiveness and 26 studies for vaccine safety) were included. A single dose of vaccines was 41% (95% CI: 28-54%) effective at preventing SARS-CoV-2 infections, 52% (31-73%) for symptomatic COVID-19, 66% (50-81%) for hospitalization, 45% (42-49%) for Intensive Care Unit (ICU) admissions, and 53% (15-91%) for COVID-19-related death; and two doses were 85% (81-89%) effective at preventing SARS-CoV-2 infections, 97% (97-98%) for symptomatic COVID-19, 93% (89-96%) for hospitalization, 96% (93-98%) for ICU admissions, and 95% (92-98%) effective for COVID-19-related death, respectively. The pooled VE was 85% (80-91%) for the prevention of Alpha variant of SARS-CoV-2 infections, 75% (71-79%) for the Beta variant, 54% (35-74%) for the Gamma variant, and 74% (62-85%) for the Delta variant. The overall pooled incidence rate was 1.5% (1.4-1.6%) for adverse events, 0.4 (0.2-0.5) per 10 000 for severe adverse events, and 0.1 (0.1-0.2) per 10 000 for death after vaccination.
CONCLUSIONS
SARS-CoV-2 vaccines have reassuring safety and could effectively reduce the death, severe cases, symptomatic cases, and infections resulting from SARS-CoV-2 across the world. In the context of global pandemic and the continuous emergence of SARS-CoV-2 variants, accelerating vaccination and improving vaccination coverage is still the most important and urgent matter, and it is also the final means to end the pandemic.
Topics: COVID-19; COVID-19 Vaccines; Disease Outbreaks; Hospitalization; Humans; SARS-CoV-2
PubMed: 34776011
DOI: 10.1186/s40249-021-00915-3 -
Parkinsonism & Related Disorders Jan 2016Although Deep Brain Stimulation (DBS) is an established treatment for Parkinson's disease (PD), there are still limitations in terms of effectivity, side-effects and... (Review)
Review
Although Deep Brain Stimulation (DBS) is an established treatment for Parkinson's disease (PD), there are still limitations in terms of effectivity, side-effects and battery consumption. One of the reasons for this may be that not only pathological but also physiological neural activity can be suppressed whilst stimulating. For this reason, adaptive DBS (aDBS), where stimulation is applied according to the level of pathological activity, might be advantageous. Initial studies of aDBS demonstrate effectiveness in PD, but there are still many questions to be answered before aDBS can be applied clinically. Here we discuss the feedback signals and stimulation algorithms involved in adaptive stimulation in PD and sketch a potential road-map towards clinical application.
Topics: Animals; Brain-Computer Interfaces; Deep Brain Stimulation; Humans; Hypokinesia; Parkinson Disease; Subthalamic Nucleus; Tremor
PubMed: 26411502
DOI: 10.1016/j.parkreldis.2015.09.028 -
Clinical Microbiology Reviews Jul 2018Bloodstream infections are associated with considerable morbidity and health care costs. Molecular rapid diagnostic tests (mRDTs) are a promising complement to... (Review)
Review
Bloodstream infections are associated with considerable morbidity and health care costs. Molecular rapid diagnostic tests (mRDTs) are a promising complement to conventional laboratory methods for the diagnosis of bloodstream infections and may reduce the time to effective therapy among patients with bloodstream infections. The concurrent implementation of antimicrobial stewardship programs (ASPs) may reinforce these benefits. The aim of this study was to evaluate the cost-effectivenesses of competing strategies for the diagnosis of bloodstream infection alone or combined with an ASP. To this effect, we constructed a decision-analytic model comparing 12 strategies for the diagnosis of bloodstream infection. The main arms compared the use of mRDT and conventional laboratory methods with or without an ASP. The baseline strategy used as the standard was the use of conventional laboratory methods without an ASP, and our decision-analytic model assessed the cost-effectivenesses of 5 principal strategies: mRDT (with and without an ASP), mRDT with an ASP, mRDT without an ASP, conventional laboratory methods with an ASP, and conventional laboratory methods without an ASP. Furthermore, based on the availability of data in the literature, we assessed the cost-effectivenesses of 7 mRDT subcategories, as follows: PCR with an ASP, matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) analysis with an ASP, peptide nucleic acid fluorescent hybridization (PNA-FISH) with an ASP, a blood culture nanotechnology microarray system for Gram-negative bacteria (BC-GP) with an ASP, a blood culture nanotechnology microarray system for Gram-positive bacteria (BC-GN) with an ASP, PCR without an ASP, and PNA-FISH without an ASP. Our patient population consisted of adult inpatients in U.S. hospitals with suspected bloodstream infection. The time horizon of the model was the projected life expectancy of the patients. In a base-case analysis, cost-effectiveness was determined by calculating the numbers of bloodstream infection deaths averted, the numbers of quality-adjusted life years gained, and incremental cost-effectiveness ratios (ICERs). In a probabilistic analysis, uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. In the base-case analysis, MALDI-TOF analysis with an ASP was the most cost-effective strategy, resulting in savings of $29,205 per quality-adjusted life year and preventing 1 death per 14 patients with suspected bloodstream infection tested compared to conventional laboratory methods without an ASP (ICER, -$29,205/quality-adjusted life year). BC-GN with an ASP (ICER, -$23,587/quality-adjusted life year), PCR with an ASP (ICER, -$19,833/quality-adjusted life year), and PCR without an ASP (ICER, -$21,039/quality-adjusted life year) were other cost-effective options. In the probabilistic analysis, mRDT was dominant and cost-effective in 85.1% of simulations. Importantly, mRDT with an ASP had an 80.0% chance of being cost-effective, while mRDT without an ASP had only a 41.1% chance. In conclusion, our findings suggest that mRDTs are cost-effective for the diagnosis of patients with suspected bloodstream infection and can reduce health care expenditures. Notably, the combination of mRDT and an ASP can result in substantial health care savings.
Topics: Antimicrobial Stewardship; Bacteremia; Computer Simulation; Cost-Benefit Analysis; Diagnostic Tests, Routine; Humans; Models, Theoretical; Time Factors
PubMed: 29848775
DOI: 10.1128/CMR.00095-17 -
Nutrients Sep 2022Attention Deficit/Hyperactivity Disorder is the most prevalent neurodevelopmental disorder worldwide. Choice treatment includes psychostimulants, but parents tend to be... (Clinical Trial)
Clinical Trial
Attention Deficit/Hyperactivity Disorder is the most prevalent neurodevelopmental disorder worldwide. Choice treatment includes psychostimulants, but parents tend to be reluctant to administer them due to side effects, and alternatives are needed. Saffron extract is a natural stimulant that has been proven safe and effective for treating a variety of mental disorders. This study compares the efficacy of saffron and the usual treatment with methylphenidate, using objective and pen-and-paper tests. We performed a non-randomized clinical trial with two groups, methylphenidate ( = 27) and saffron ( = 36), in children and adolescents aged 7 to 17. Results show that the efficacy of saffron is comparable to that of methylphenidate. Saffron is more effective for treating hyperactivity symptoms, while methylphenidate is more effective for inattention symptoms.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Central Nervous System Stimulants; Child; Crocus; Humans; Methylphenidate; Parents
PubMed: 36235697
DOI: 10.3390/nu14194046 -
International Journal of Sports... Nov 2015Self-myofascial release (SMR) is a popular intervention used to enhance a client's myofascial mobility. Common tools include the foam roll and roller massager. Often...
BACKGROUND
Self-myofascial release (SMR) is a popular intervention used to enhance a client's myofascial mobility. Common tools include the foam roll and roller massager. Often these tools are used as part of a comprehensive program and are often recommended to the client to purchase and use at home. Currently, there are no systematic reviews that have appraised the effects of these tools on joint range of motion, muscle recovery, and performance.
PURPOSE
The purpose of this review was to critically appraise the current evidence and answer the following questions: (1) Does self-myofascial release with a foam roll or roller-massager improve joint range of motion (ROM) without effecting muscle performance? (2) After an intense bout of exercise, does self-myofascial release with a foam roller or roller-massager enhance post exercise muscle recovery and reduce delayed onset of muscle soreness (DOMS)? (3) Does self-myofascial release with a foam roll or roller-massager prior to activity affect muscle performance?
METHODS
A search strategy was conducted, prior to April 2015, which included electronic databases and known journals. Included studies met the following criteria: 1) Peer reviewed, english language publications 2) Investigations that measured the effects of SMR using a foam roll or roller massager on joint ROM, acute muscle soreness, DOMS, and muscle performance 3) Investigations that compared an intervention program using a foam roll or roller massager to a control group 4) Investigations that compared two intervention programs using a foam roll or roller massager. The quality of manuscripts was assessed using the PEDro scale.
RESULTS
A total of 14 articles met the inclusion criteria. SMR with a foam roll or roller massager appears to have short-term effects on increasing joint ROM without negatively affecting muscle performance and may help attenuate decrements in muscle performance and DOMS after intense exercise. Short bouts of SMR prior to exercise do not appear to effect muscle performance.
CONCLUSION
The current literature measuring the effects of SMR is still emerging. The results of this analysis suggests that foam rolling and roller massage may be effective interventions for enhancing joint ROM and pre and post exercise muscle performance. However, due to the heterogeneity of methods among studies, there currently is no consensus on the optimal SMR program.
LEVEL OF EVIDENCE
2c.
PubMed: 26618062
DOI: No ID Found -
Annals of Medicine 2023Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load training, which is suitable for post-op rehabilitation. We explored the effectiveness and safety of BFR therapy in DRF patients who underwent surgery.
MATERIALS AND METHODS
Thirty-five patients were randomly assigned to either the BFR or the regular training (RT; no BFR therapy) groups. All patients completed the same 4-week postoperative rehabilitation program, including anti-inflammatory treatments, strengthening and range of motion (ROM) training. In the BFR group, the pressure was 120 mmHg in strengthening training course. Pain, circumferences of wrists and forearms, ROM, muscle strength, and D-dimer levels were evaluated at weeks 0, 2, and 4. Radius union scoring system (RUSS) was measured at weeks 4 and 12. Finally, wrist functionality (Cooney modification) was evaluated at week 12.
RESULTS
The BFR group had significantly decreased pain levels compared with the RT group ( < 0.01, effect size= 2.33, -2.44 at weeks 2 and 4). Swelling was effectively relieved in both groups. The wrist swelling was less in the BFR group ( < 0.01, effect size = -2.17 at week 4). The isometric strength of wrist extension ( < 0.01, effect size = 1.5, 3.02 at weeks 2 and 4), flexion ( < 0.01, effect size = 1.33, 2.53 at weeks 2 and 4), and functionality significantly increased in the BFR group ( < 0.01, effect size = 2.80 at week 12). No risk of VT in the BFR group was found. BFR did not threaten bone healing.
CONCLUSIONS
In patients with DRF who underwent corrective surgery, BFR therapy effectively relieved pain and swelling, increased muscle strength and wrist function, and had no additional risks for bone healing and VT.
Topics: Humans; Blood Flow Restriction Therapy; Resistance Training; Wrist Fractures; Muscle Strength; Pain
PubMed: 37505919
DOI: 10.1080/07853890.2023.2240329 -
European Journal of Physical and... Oct 2020Patients with chronic obstructive pulmonary disease (COPD) often suffer from expectoration. To address this problem, active cycle of breathing techniques (ACBT) can be...
INTRODUCTION
Patients with chronic obstructive pulmonary disease (COPD) often suffer from expectoration. To address this problem, active cycle of breathing techniques (ACBT) can be applied. However, the effects of ACBT on COPD patients have shown mixed results. Therefore, we investigated the effectiveness of ACBT in patients with COPD by conducting a systematic review of the literature.
EVIDENCE ACQUISITION
Seven electronic databases (PubMed, Web of Science, Embase, CINAHL, China National Knowledge Infrastructure [CNKI], Chinese Biomedical Literature [CBM], and Wanfang Database) were carefully searched from August 17 to 19, 2019.
EVIDENCE SYNTHESIS
The search yielded 2224 records, and ultimately only eight articles were selected for analysis. A total of 390 patients were included in the eight studies. The intervention program is a comparison of ACBT with non-ACBT. For COPD patients, ACBT was more effective in sputum production and cough efficiency. Compared with usual care, ACBT may improve lung function, blood gas analysis, and other parameters.
CONCLUSIONS
Our systematic review found that ACBT can effectively improve the sputum production and cough efficiency in patients with COPD. However, there was no definite conclusion on the effectiveness of ACBT on lung function, blood gas analysis and other aspects. More research and quantitative analyses are needed to confirm the effectiveness of ACBT on other aspects of COPD patient.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Respiratory Therapy
PubMed: 32397703
DOI: 10.23736/S1973-9087.20.06144-4 -
American Journal of Pharmaceutical... May 2014Over the past 2 decades, e-learning has evolved as a new pedagogy within pharmacy education. As learners and teachers increasingly seek e-learning opportunities for an... (Review)
Review
Over the past 2 decades, e-learning has evolved as a new pedagogy within pharmacy education. As learners and teachers increasingly seek e-learning opportunities for an array of educational and individual benefits, it is important to evaluate the effectiveness of these programs. This systematic review of the literature examines the quality of e-learning effectiveness studies in pharmacy, describes effectiveness measures, and synthesizes the evidence for each measure. E-learning in pharmacy education effectively increases knowledge and is a highly acceptable instructional format for pharmacists and pharmacy students. However, there is limited evidence that e-learning effectively improves skills or professional practice. There is also no evidence that e-learning is effective at increasing knowledge long term; thus, long-term follow-up studies are required. Translational research is also needed to evaluate the benefits of e-learning at patient and organizational levels.
Topics: Computer-Assisted Instruction; Curriculum; Education, Pharmacy; Educational Measurement; Educational Status; Humans; Internet; Learning; Students, Pharmacy
PubMed: 24850945
DOI: 10.5688/ajpe78483 -
Tobacco Control May 2016To inform international research and policy, we conducted a meta-analysis of the experimental literature on pictorial cigarette pack warnings. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To inform international research and policy, we conducted a meta-analysis of the experimental literature on pictorial cigarette pack warnings.
DATA SOURCES
We systematically searched 7 computerised databases in April 2013 using several search terms. We also searched reference lists of relevant articles.
STUDY SELECTION
We included studies that used an experimental protocol to test cigarette pack warnings and reported data on both pictorial and text-only conditions. 37 studies with data on 48 independent samples (N=33,613) met criteria.
DATA EXTRACTION AND SYNTHESIS
Two independent coders coded all study characteristics. Effect sizes were computed from data extracted from study reports and were combined using random effects meta-analytic procedures.
RESULTS
Pictorial warnings were more effective than text-only warnings for 12 of 17 effectiveness outcomes (all p<0.05). Relative to text-only warnings, pictorial warnings (1) attracted and held attention better; (2) garnered stronger cognitive and emotional reactions; (3) elicited more negative pack attitudes and negative smoking attitudes and (4) more effectively increased intentions to not start smoking and to quit smoking. Participants also perceived pictorial warnings as being more effective than text-only warnings across all 8 perceived effectiveness outcomes.
CONCLUSIONS
The evidence from this international body of literature supports pictorial cigarette pack warnings as more effective than text-only warnings. Gaps in the literature include a lack of assessment of smoking behaviour and a dearth of theory-based research on how warnings exert their effects.
Topics: Attention; Cognition; Health Behavior; Health Education; Health Knowledge, Attitudes, Practice; Humans; Motivation; Photography; Product Labeling; Risk Assessment; Risk Factors; Smoking; Smoking Cessation; Smoking Prevention; Tobacco Products; Visual Perception
PubMed: 25948713
DOI: 10.1136/tobaccocontrol-2014-051978