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69,947 result(s) for "Systematic Reviews and Meta‐analyses"
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Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration
Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis is to establish the relation of baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials. We obtained data on all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available. We then used meta-analytic techniques to assess linear and quadratic effects of initial severity on improvement scores for drug and placebo groups and on drug-placebo difference scores. Drug-placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of initial depression to a relatively small difference for patients with very severe depression, reaching conventional criteria for clinical significance only for patients at the upper end of the very severely depressed category. Meta-regression analyses indicated that the relation of baseline severity and improvement was curvilinear in drug groups and showed a strong, negative linear component in placebo groups. Drug-placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.
Wound Repair and Regeneration
The skin is the biggest organ of the human being and has many functions. Therefore, the healing of a skin wound displays an extraordinary mechanism of cascading cellular functions which is unique in nature. As healing and regeneration processes take place in all parts of the human body, this review focuses on the healing processes of the skin and highlights the classical wound healing phases. While regeneration describes the specific substitution of the tissue, i.e. the superficial epidermis, mucosa or fetal skin, skin repair displays an unspecific form of healing in which the wound heals by fibrosis and scar formation. The first stage of acute wound healing is dedicated to hemostasis and the formation of a provisional wound matrix, which occurs immediately after injury and is completed after some hours. Furthermore, this phase initiates the inflammatory process. The inflammatory phase of the wound healing cascade gets activated during the coagulation phase and can roughly be divided into an early phase with neutrophil recruitment and a late phase with the appearance and transformation of monocytes. In the phase of proliferation the main focus of the healing process lies in the recovering of the wound surface, the formation of granulation tissue and the restoration of the vascular network. Therefore, next to the immigration of local fibroblasts along the fibrin network and the beginning of reepithelialization from the wound edges, neovascularization and angiogenesis get activated by capillary sprouting. The formation of granulation tissue stops through apoptosis of the cells, characterizing a mature wound as avascular as well as acellular. During the maturation of the wound the components of the extracellular matrix undergo certain changes. The physiological endpoint of mammalian wound repair displays the formation of a scar, which is directly linked to the extent of the inflammatory process throughout wound healing.
Orthosiphon stamineus Benth. (Lamiaceae): a bibliometric analysis of its antidiabetic properties
The use of medicinal plants for the management of diabetes is gaining rapid attention. There are several reports on the antidiabetic properties of Orthosiphon stamineus Benth. There has been no previous bibliometric analysis review conducted on O. stamineus as an antidiabetic agent to date. Therefore, this review is centred on gathering information about the potential sources of antidiabetic properties from O. stamineus. A bibliometric analysis on the antidiabetic properties of O. stamineus was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific publications in the SCOPUS database were retrieved using the search strings ‘Orthosiphon stamineus’ OR ‘Orthosiphon aristatus’ OR ‘Kumis Kucing’ OR ‘Misai Kucing’ OR ‘Java tea’ AND ‘diabetes’ OR ‘diabetes mellitus’ OR ‘dm’ OR ‘antidiabetic’ OR ‘hypoglycemic’ OR ‘diabetic complications’ OR ‘insulin’ OR ‘glucose’. 76 articles related to O. stamineus and diabetes were included after the exclusion criteria. The bibliometric analysis spanning from 1991 and 2023 sheds light on the dynamic and collaborative research landscape surrounding O.stamineus. It highlights several aspects of the plant's multifaceted exploration for potential antidiabetic properties, including a surge in activity in 2006 and 2012, international contributions, a diverse distribution across journals, and a broad spectrum of keyword concepts.
Vascularization in Tissue Engineering: Angiogenesis versus Inosculation
Background/Purpose: The key challenge in tissue engineering is the establishment of an efficient vascularization for tissue constructs guaranteeing long-term survival and function. Vascularization may be achieved by the stimulation of angiogenesis or the inosculation of preformed microvascular networks within the implants to the host microvasculature. The present review provides an overview of these two concepts applied in tissue engineering. Methods: A literature search was performed in PubMed for publications focusing on vascularization, angiogenesis and inosculation in tissue engineering. Results: Several strategies have been proposed to stimulate the ingrowth of new blood vessels into tissue constructs. These include the modification of the chemical composition and architecture of scaffolds, their bioactivation by incorporation of growth factor delivery systems or by cell seeding as well as the stimulation of stem cell recruitment. However, because angiogenesis is a time-consuming process, all of these approaches cannot prevent ischemic cell death within larger 3-dimensional tissue constructs during the initial phase after implantation. To overcome this problem, in vitro or in situ prevascularization has emerged as a novel concept in tissue engineering. This bears the advantage that preformed microvascular networks within tissue constructs simply have to inosculate with the host microvasculature at the implantation site to get completely blood-perfused within a short period of time. Conclusions: During the last years, considerable progress has been made in the development of promising vascularization strategies in tissue engineering. Particularly the inosculation of preformed microvascular networks has the great potential to markedly improve the survival of tissue constructs after implantation. The optimization of this vascularization strategy may pave the way for a broad clinical use of tissue engineering applications in the future.
The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials
Oats are a rich source of β-glucan, a viscous, soluble fibre recognised for its cholesterol-lowering properties, and are associated with reduced risk of CVD. Our objective was to conduct a systematic review and meta-analysis of randomised-controlled trials (RCT) investigating the cholesterol-lowering potential of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for the risk reduction of CVD. MEDLINE, Embase, CINAHL and Cochrane CENTRAL were searched. We included RCT of ≥3 weeks of follow-up, assessing the effect of diets enriched with oat β-glucan compared with controlled diets on LDL-cholesterol, non-HDL-cholesterol or apoB. Two independent reviewers extracted data and assessed study quality and risk of bias. Data were pooled using the generic inverse-variance method with random effects models and expressed as mean differences with 95 % CI. Heterogeneity was assessed by the Cochran’s Q statistic and quantified by the I 2-statistic. In total, fifty-eight trials (n 3974) were included. A median dose of 3·5 g/d of oat β-glucan significantly lowered LDL-cholesterol (−0·19; 95 % CI −0·23, −0·14 mmol/l, P<0·00001), non-HDL-cholesterol (−0·20; 95 % CI −0·26, −0·15 mmol/l, P<0·00001) and apoB (−0·03; 95 % CI −0·05, −0·02 g/l, P<0·0001) compared with control interventions. There was evidence for considerable unexplained heterogeneity in the analysis of LDL-cholesterol (I 2=79 %) and non-HDL-cholesterol (I 2=99 %). Pooled analyses showed that oat β-glucan has a lowering effect on LDL-cholesterol, non-HDL-cholesterol and apoB. Inclusion of oat-containing foods may be a strategy for achieving targets in CVD reduction.
Impact of employee digital competence on the relationship between digital autonomy and innovative work behavior: a systematic review
With the advent of the COVID-19 pandemic, the level of concern regarding employee digital competence has increased significantly. Several studies provide different surveys, but they cannot describe the relationship between digital autonomy and innovative work behaviour concerning the impact of employee digital competence. Hence, it is necessary to conduct a survey that provides a deeper understanding of these concerns and suggests a suitable study for other researchers. Using scientific publication databases and adhering to the PRISMA statement, this systematic literature review aims to offer a current overview of employee digital competence impact on the relationship between digital autonomy and innovative work behaviour from 2015 to 2022, covering definitions, research purposes, methodologies, outcomes, and limitations. When reviewing the selected articles, 18 articles were examined under relationship topics, and 12 articles reported on impact topics under different tasks. The main findings highlight the significance of digital competence and autonomy in promoting employee creativity, learning, and sharing knowledge. According to the review findings, employees with greater digital autonomy are more likely to engage in innovative work, leading to improved job performance and empowerment. Therefore, the development of digital autonomy prioritizes organizations by providing access to digital tools, training, and a supportive work environment. Overall, the current review indicates a strong positive correlation between digital autonomy, innovative work behaviour, and employee impact. This underscores the importance for organizations to not only participate in digital competence and skills, but also to create a culture that values autonomy, creativity, and innovation among its employees.
Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies
Several studies have suggested that diabetes mellitus (DM) increases the risk of active tuberculosis (TB). The rising prevalence of DM in TB-endemic areas may adversely affect TB control. We conducted a systematic review and a meta-analysis of observational studies assessing the association of DM and TB in order to summarize the existing evidence and to assess methodological quality of the studies. We searched the PubMed and EMBASE databases to identify observational studies that had reported an age-adjusted quantitative estimate of the association between DM and active TB disease. The search yielded 13 observational studies (n = 1,786,212 participants) with 17,698 TB cases. Random effects meta-analysis of cohort studies showed that DM was associated with an increased risk of TB (relative risk = 3.11, 95% CI 2.27-4.26). Case-control studies were heterogeneous and odds ratios ranged from 1.16 to 7.83. Subgroup analyses showed that effect estimates were higher in non-North American studies. DM was associated with an increased risk of TB regardless of study design and population. People with DM may be important targets for interventions such as active case finding and treatment of latent TB and efforts to diagnose, detect, and treat DM may have a beneficial impact on TB control.
Social Inequalities in Exposure to Ambient Air Pollution: A Systematic Review in the WHO European Region
Ambient air pollution is a long-standing and significant public health issue. The aim of this review is to systematically examine the peer-reviewed evidence on social inequalities and ambient air pollution in the World Health Organization European Region. Articles published between 2010 and 2017 were analyzed in the review. In total 31 articles were included in the review. There is good evidence from ecological studies that higher deprivation indices and low economic position are usually linked with higher levels of pollutants such as particulate matter (particulate matter under 2.5 and 10 microns in diameter, PM2.5, PM10) and oxides of nitrogen (e.g., NO2, and NOx). There is also evidence that ethnic minorities experience a mixed exposure in comparison to the majority population being sometimes higher and sometimes lower depending on the ethnic minority under consideration. The studies using data at the individual level in this review are mainly focused on pregnant women or new mothers, in these studies deprivation and ethnicity are more likely to be linked to higher exposures of poor air quality. Therefore, there is evidence in this review that the burden of higher pollutants falls disproportionally on different social groups.
Initiatives, Concepts, and Implementation Practices of the Findable, Accessible, Interoperable, and Reusable Data Principles in Health Data Stewardship: Scoping Review
Thorough data stewardship is a key enabler of comprehensive health research. Processes such as data collection, storage, access, sharing, and analytics require researchers to follow elaborate data management strategies properly and consistently. Studies have shown that findable, accessible, interoperable, and reusable (FAIR) data leads to improved data sharing in different scientific domains. This scoping review identifies and discusses concepts, approaches, implementation experiences, and lessons learned in FAIR initiatives in health research data. The Arksey and O'Malley stage-based methodological framework for scoping reviews was applied. PubMed, Web of Science, and Google Scholar were searched to access relevant publications. Articles written in English, published between 2014 and 2020, and addressing FAIR concepts or practices in the health domain were included. The 3 data sources were deduplicated using a reference management software. In total, 2 independent authors reviewed the eligibility of each article based on defined inclusion and exclusion criteria. A charting tool was used to extract information from the full-text papers. The results were reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A total of 2.18% (34/1561) of the screened articles were included in the final review. The authors reported FAIRification approaches, which include interpolation, inclusion of comprehensive data dictionaries, repository design, semantic interoperability, ontologies, data quality, linked data, and requirement gathering for FAIRification tools. Challenges and mitigation strategies associated with FAIRification, such as high setup costs, data politics, technical and administrative issues, privacy concerns, and difficulties encountered in sharing health data despite its sensitive nature were also reported. We found various workflows, tools, and infrastructures designed by different groups worldwide to facilitate the FAIRification of health research data. We also uncovered a wide range of problems and questions that researchers are trying to address by using the different workflows, tools, and infrastructures. Although the concept of FAIR data stewardship in the health research domain is relatively new, almost all continents have been reached by at least one network trying to achieve health data FAIRness. Documented outcomes of FAIRification efforts include peer-reviewed publications, improved data sharing, facilitated data reuse, return on investment, and new treatments. Successful FAIRification of data has informed the management and prognosis of various diseases such as cancer, cardiovascular diseases, and neurological diseases. Efforts to FAIRify data on a wider variety of diseases have been ongoing since the COVID-19 pandemic. This work summarises projects, tools, and workflows for the FAIRification of health research data. The comprehensive review shows that implementing the FAIR concept in health data stewardship carries the promise of improved research data management and transparency in the era of big data and open research publishing. RR2-10.2196/22505.
Comparative peripheral edema for dihydropyridines calcium channel blockers treatment: A systematic review and network meta‐analysis
Dihydropyridine calcium channel blockers (DHPCCBs) are widely used to treat hypertension and chronic coronary artery disease. One common adverse effect of DHPCCBs is peripheral edema, particularly of the lower limbs. The side effect could lead to dose reduction or discontinuation of the medication. The combination of DHPCCBs and renin‐angiotensin system blockers has shown to reduce the risk of DHPCCBs‐associated peripheral edema compared with DHPCCBs monotherapy. We performed the current systematic review and network meta‐analysis of randomized controlled trials (RCTs) to estimate the rate of peripheral edema with DHPCCBs as a class and with individual DHPCCBs and the ranking of the reduction of peripheral edema. The effects of renin‐angiotensin system blockers on DHPCCBs network meta‐analysis were created to analyze the ranking of the reduction of peripheral edema. A total of 3312 publications were identified and 71 studies with 56,283 patients were included. Nifedipine ranked highest in inducing peripheral edema (SUCRA 81.8%) and lacidipine (SUCRA 12.8%) ranked the least. All DHPCCBs except lacidipine resulted in higher relative risk (RR) of peripheral edema compared with placebo. Nifedipine plus angiotensin receptor blocker (SUCRA: 92.3%) did not mitigate peripheral edema and amlodipine plus angiotensin‐converting enzyme inhibitors (SUCRA: 16%) reduced peripheral edema the most. Nifedipine ranked the highest and lacidipine ranked the lowest amongst DHPCCBs for developing peripheral edema when used for cardiovascular indications. The second or higher generation of DHPCCBs combination with ACEIs or ARBs or diuretics lowered the chance of peripheral edema development compared to single DHPCCB treatment.