Fish intake, n-3 fatty acid body status, and risk of cognitive decline: a systematic review and a dose–response meta-analysis of observational and experimental studies

Abstract Context Randomized controlled trials (RCTs) testing supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids have failed to provide evidence supporting a suggested inverse association between fish intake and dementia risk. Objective Dose–response analyses were conducted to evaluate associations between fish intake, all-cause dementia or Alzheimer’s Disease (AD), and the effect of EPA/DHA supplementation on cognitive performance. Data Sources PubMed, Scopus and Web of Science databases were searched for original research evaluating either associations between fish intake and dementia or AD, or the impact of EPA and/or DHA supplementation on the risk of cognitive decline. Data Extraction Data were collected on study characteristics and methods; number of cases/deaths (for observational studies); categories of exposure; model covariates; risk estimates from the most-adjusted model; type and dosage of supplementation (from RCTs); fatty acid levels in blood; and differences in cognition test results before and after supplementation. Risk of bias was assessed through the ROBINS-E and RoB2.0 tools for observational and experimental studies, respectively. Data Analysis Weighted mixed-effects models were applied, allowing for the inclusion of studies with 2 levels of exposure. Based on findings with low/moderate risk of bias, fish intake of up to 2 portions (250 g) per week was associated with a 10% reduction (95% confidence interval [CI]: 0.79, 1.02, Ν = 5) in all-cause dementia and a 30% reduction (95% CI: 0.54, 0.89, Ν = 3) in AD risk. Changes in EPA and DHA body status had a positive impact on participants’ executive functions, but not on their overall cognitive performance. Conclusion The protection offered by fish intake against cognitive decline levels off at intakes higher than 2 portions/week and likely relates to the impact of EPA and DHA on the individual’s executive functions, although there remain questions about the mechanisms linking the short- and long-term effects. Systematic Review Registration PROSPERO registration no. CRD42019139528.

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The Impact of Environmental Stress on Cognitive Performance: A Systematic Review

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720819839817 ◽

2019 ◽

Vol 61 (8) ◽

pp. 1205-1246 ◽

Cited By ~ 14

Author(s):

Kristy Martin ◽

Emily McLeod ◽

Julien Périard ◽

Ben Rattray ◽

Richard Keegan ◽

...

Keyword(s):

Systematic Review ◽

Environmental Stress ◽

Task Performance ◽

Sea Level ◽

Cognitive Performance ◽

Cognitive Task ◽

Individual Characteristics ◽

Eligibility Criteria ◽

Healthy Human ◽

The Impact

Objective: In this review, we detail the impact of environmental stress on cognitive and military task performance and highlight any individual characteristics or interventions which may mitigate any negative effect. Background: Military personnel are often deployed in regions markedly different from their own, experiencing hot days, cold nights, and trips both above and below sea level. In spite of these stressors, high-level cognitive and operational performance must be maintained. Method: A systematic review of the electronic databases Medline (PubMed), EMBASE (Scopus), PsycINFO, and Web of Science was conducted from inception up to September 2018. Eligibility criteria included a healthy human cohort, an outcome of cognition or military task performance and assessment of an environmental condition. Results: The search returned 113,850 records, of which 124 were included in the systematic review. Thirty-one studies examined the impact of heat stress on cognition; 20 of cold stress; 59 of altitude exposure; and 18 of being below sea level. Conclusion: The severity and duration of exposure to the environmental stressor affects the degree to which cognitive performance can be impaired, as does the complexity of the cognitive task and the skill or familiarity of the individual performing the task. Application: Strategies to improve cognitive performance in extreme environmental conditions should focus on reducing the magnitude of the physiological and perceptual disturbance caused by the stressor. Strategies may include acclimatization and habituation, being well skilled on the task, and reducing sensations of thermal stress with approaches such as head and neck cooling.

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Effectiveness of Nutritional Education for Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

Innovation in Aging ◽

10.1093/geroni/igaa057.1291 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 401-401

Author(s):

Yue-Heng Yin ◽

Liu Yat Justina

Keyword(s):

Systematic Review ◽

Physical Function ◽

Meta Analysis ◽

Experimental Studies ◽

Well Being ◽

Risk Of Bias ◽

Cochrane Library ◽

Nutritional Education ◽

Hand Search ◽

Education Interventions

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.

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Between Level Up and Game Over: A Systematic Literature Review of Gamification in Education

Sustainability ◽

10.3390/su13042247 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2247 ◽

Cited By ~ 1

Author(s):

Ana Manzano-León ◽

Pablo Camacho-Lazarraga ◽

Miguel A. Guerrero ◽

Laura Guerrero-Puerta ◽

José M. Aguilar-Parra ◽

...

Keyword(s):

Systematic Review ◽

Academic Performance ◽

Game Design ◽

Learning Strategy ◽

Experimental Studies ◽

Quasi Experimental ◽

Current Lines ◽

Meta Analyses ◽

Game Elements ◽

The Impact

Educational gamification consists of the use of game elements and game design techniques in the educational context. The objective of this study is to examine the existing evidence on the impact of educational gamification on student motivation and academic performance in the last five years in order to analyze its distribution over time, educational level, variables, and most used game elements, and know the advantages of its implementation in the classroom. For this, a systematic review is proposed through the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) methodology in three multidisciplinary databases, through an exhaustive search with inclusion and exclusion criteria on quantitative experimental studies that explore gamification in educational centers, which provide information about the most current lines of research. Fourteen studies were included in this review. These used experimental or quasi-experimental designs. Most of them report gamification as a valid learning strategy. The results support the conclusion that educational gamification has a potential impact on the academic performance, commitment, and motivation of students. Therefore, this study implies the need to expand research on the needs and challenges of students when learning with gamified techniques.

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Cognitive decline in patients with prostate cancer: study protocol of a prospective cohort, NEON-PC

BMJ Open ◽

10.1136/bmjopen-2020-043844 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043844

Author(s):

Natalia Araujo ◽

Samantha Morais ◽

Ana Rute Costa ◽

Raquel Braga ◽

Ana Filipa Carneiro ◽

...

Keyword(s):

Prostate Cancer ◽

Cognitive Decline ◽

Cognitive Performance ◽

Androgen Deprivation Therapy ◽

Survival Rates ◽

Cardiovascular Complications ◽

Androgen Deprivation ◽

High Survival ◽

The Impact

IntroductionProstate cancer is the most prevalent oncological disease among men in industrialised countries. Despite the high survival rates, treatments are often associated with adverse effects, including metabolic and cardiovascular complications, sexual dysfunction and, to a lesser extent, cognitive decline. This study was primarily designed to evaluate the trajectories of cognitive performance in patients with prostate cancer, and to quantify the impact of the disease and its treatments on the occurrence of cognitive decline.MethodsParticipants will be recruited from two main hospitals providing care to approximately half of the patients with prostate cancer in Northern Portugal (Portuguese Institute of Oncology of Porto and São João Hospital Centre), and will comprise a cohort of recently diagnosed patients with prostate cancer proposed for different treatment plans, including: (1) radical prostatectomy; (2) brachytherapy and/or radiotherapy; (3) radiotherapy in combination with androgen deprivation therapy and (4) androgen deprivation therapy (with or without chemotherapy). Recruitment began in February 2018 and is expected to continue until the first semester of 2021. Follow-up evaluations will be conducted at 1, 3, 5, 7 and 10 years. Sociodemographic, behavioural and clinical characteristics, anxiety and depression, health literacy, health status, quality of life, and sleep quality will be assessed. Blood pressure and anthropometrics will be measured, and a fasting blood sample will be collected. Participants’ cognitive performance will be evaluated before treatments and throughout follow-up (Montreal Cognitive Assessment and Cube Test as well as Brain on Track for remote monitoring). All participants suspected of cognitive impairment will undergo neuropsychological tests and clinical observation by a neurologist.Ethics and disseminationThe study was approved by the Ethics Committee of the hospitals involved. All participants will provide written informed consent, and study procedures will be developed to ensure data protection and confidentiality. Results will be disseminated through publication in peer-reviewed journals and presentation in scientific meetings.

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Influence of Coronal Preflaring on the Accuracy of Electronic Working Length Determination: Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10132760 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2760

Author(s):

María León-López ◽

Daniel Cabanillas-Balsera ◽

Victoria Areal-Quecuty ◽

Jenifer Martín-González ◽

María C. Jiménez-Sánchez ◽

...

Keyword(s):

Systematic Review ◽

Science Studies ◽

Meta Analysis ◽

Experimental Studies ◽

Risk Of Bias ◽

Permanent Teeth ◽

Total Risk ◽

Human Teeth ◽

Working Length ◽

Meta Analyses

Aim. To conduct a systematic review and meta-analysis according to the following PICO question: in extracted human permanent teeth, does preflaring, compared with unflared canals, influence the accuracy of WL determination with EAL? Material and Methods. A systematic review was conducted according to the PRISMA checklist, using the following databases: PubMed, Science Direct, Scopus, and Web of Science. Studies related to WL determination using EAL both in preflared and unflared root canals of extracted human teeth were included. The outcome of interest was the accuracy of the electronic WL determination. A quality assessment of the included studies was performed, determining the risk of bias. The meta-analyses were calculated with the 5.4 RevMan software using the inverse variance method with random effects. PROSPERO registration: CRD42021243412. Results. Ten experimental studies fulfilled the inclusion criteria, and most of them found that preflaring increases the accuracy of the EALs in WL determination. The calculated OR was 1.98 (95% CI = 1.65–2.37; p < 0.00001; I2 = 10%), indicating that the determination of WL by EALs is almost twice as accurate in preflared canals. The accuracy of Root ZX in WL determination increases more than three times (OR = 3.25; p < 0.00001). Preflaring with Protaper files significantly increases the accuracy of EALs (OR = 1.76; p < 0.00001). The total risk of bias of the included studies was low. No obvious publication bias was observed. Conclusions. The results indicate a significant increase in the accuracy of WL determination with EAL after preflaring, doubling the percentage of exact measurements. Preflaring should be recommended as an important step during mechanical enlargement of the root canal, not only because it improves the access of the files to the canal, but also because it allows one to obtain more accurate electronic determinations of WL.

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The Impact of Classroom Chatter Noise on Comprehension: A Systematic Review

Perceptual and Motor Skills ◽

10.1177/00315125211005935 ◽

2021 ◽

pp. 003151252110059

Author(s):

Anne-Sophie Lamotte ◽

Aziz Essadek ◽

Gérard Shadili ◽

Jean-Michel Perez ◽

Julien Raft

Keyword(s):

Systematic Review ◽

Literature Review ◽

Teaching Methods ◽

Classroom Environment ◽

Field Survey ◽

Human Life ◽

Experimental Studies ◽

Noisy Environment ◽

Student Comprehension ◽

The Impact

Communication through discussion and conversations is fundamental to human life; but when such discourse escapes the control of a teacher in the classroom, it becomes little more than chatter. This noise challenges teaching methods and the teaching stance with students. Yet, its impact on comprehension has rarely been studied. The aim of this literature review was to examine the research on the impact of classroom noise generated by chatter on students’ comprehension performance. We adopted the PRISMA (Preferred Reporting Items for Systematic Reviews and Metanalysis) guidelines to examine this literature. This review covered a 10-year period (papers written between 2009 and 2019), with nine experimental studies selected from the 2,954 papers screened. In 89% of these nine studies, there were significant comprehension differences on all tests, revealed when comprehension took place in a noisy environment due to chatter. This review indicated an essential need for a field survey to better understand the impact of chatter on comprehension. Other studies are recommended to highlight any correlation between measured chatter and student comprehension in a real classroom environment.

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The Effect of Plantago major on Wound Healing in Preclinical Studies: A Systematic Review

Wound Management & Prevention ◽

10.25270/wmp.2021.1.2734 ◽

2021 ◽

Vol 67 (1) ◽

pp. 27-34

Author(s):

Fernanda Cardoso ◽

Jéssica Breder ◽

Priscila Apolinário ◽

Henrique Oliveia ◽

Maria Saidel ◽

...

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Meta Analysis ◽

Experimental Studies ◽

Risk Of Bias ◽

Preclinical Studies ◽

Plantago Major ◽

Best Response ◽

Meta Analyses

BACKGROUND: Plantago major is a medicinal plant that has been used for centuries to treat various health conditions including wounds. PURPOSE: To investigate the effectiveness of the topical use of P major in healing skin wounds in animal models. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was conducted. Seven (7) electronic databases (Virtual Health Library, Public/Publisher MEDLINE, Scopus, Web of Science, Embase, Cumulative Index of Nursing and Allied Health Literature, and CAB Direct) were searched for controlled studies published in English from January 2006 to March 2020. The Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies tools guided the evaluation of the studies and determined their quality. The Systematic Review Center for Laboratory Animal Experimentation was used to assess the risk of bias. RESULTS: Of the 176 publications identified, 4 met the inclusion criteria. Studies included 20 to 100 animals and varying concentrations of P major. There were no reports of losses during research. Wound healing was assessed between 17 and 21 days following wounding. The best response in terms of wound contraction rate occurred with 10%, 20%, and 50% concentrations when compared with control groups. One (1) study did not have an animal ethics committee review. All studies had a high risk of bias and a lack of methodological rigor. CONCLUSION: The results of this review did not find evidence about the in vivo effectiveness of P major for wound healing. More rigorous preclinical studies with adequate sample sizes are required to identify the best concentrations and formulations as well as increase understanding about the mechanisms of action of P major in wound healing.

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The relationship between memory complaints and age in normal aging

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn30200005 ◽

2009 ◽

Vol 3 (2) ◽

pp. 94-100 ◽

Cited By ~ 5

Author(s):

Thaís Bento Lima-Silva ◽

Mônica Sanches Yassuda

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Cognitive Performance ◽

Digit Span ◽

Normal Aging ◽

Screening Tests ◽

Memory Complaint ◽

Memory Complaints ◽

The Impact ◽

The Relationship

Abstract Normal aging can be characterized by a gradual decline in some cognitive functions, such as memory. Memory complaints are common among older adults, and may indicate depression, anxiety, or cognitive decline. Objectives: To investigate the association between memory complaints and age in cognitively unimpaired older adults, and the relationship between memory complaints and memory performance. Methods: Cognitive screening tests as well as memory complaint questionnaires validated for the Brazilian population were used: the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Memory Complaint Questionnaire (MAC-Q), Memory test of 18 pictures, Forward and Backward Digit Span (WAIS-III). Fifty seven regular members of the SESC social club participated (50 women), having a mean age of 71.4 years, and 4 to 8 years of education - 34 from 4 to 7 years and 23 with 8 years of education. Results: Results revealed no significant association between cognitive complaints and age or cognitive performance. Older participants in this sample did not show worse performance or a higher level of complaints. There was no significant association between age and GDS scores. Conclusions: The studied sample constitutes a particular group of older adults whose participation in activities may be protecting them from cognitive decline, thus highlighting the impact of lifestyle on cognitive performance during the aging process.

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Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review

BMJ Open ◽

10.1136/bmjopen-2019-031598 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031598 ◽

Cited By ~ 14

Author(s):

Clare Meernik ◽

Hannah M Baker ◽

Sarah D Kowitt ◽

Leah M Ranney ◽

Adam O Goldstein

Keyword(s):

Systematic Review ◽

Risk Perceptions ◽

Longitudinal Research ◽

Age Groups ◽

Experimental Studies ◽

Final Analysis ◽

Eligibility Criteria ◽

Product Appeal ◽

The Impact

ObjectivesGiven the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults.DesignPubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018.Eligibility criteriaQuantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation.Data extraction and synthesisThree authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure.ResultsThe review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies).ConclusionThis review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.

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The effect of hemodilution on free flap survival: A systematic review of clinical and experimental studies

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-200832 ◽

2020 ◽

Vol 75 (4) ◽

pp. 457-466

Author(s):

Matteo Amoroso ◽

Peter Apelgren ◽

Anna Elander ◽

Karin Säljö ◽

Lars Kölby

Keyword(s):

Systematic Review ◽

Literature Search ◽

Experimental Studies ◽

Free Flaps ◽

Risk Of Bias ◽

Cochrane Library ◽

Level Of Evidence ◽

Grade Scale ◽

Reconstructive Microsurgery ◽

The Cochrane Library

BACKGROUND: Acute normovolemic hemodilution (ANH) has been proposed as a microsurgical technique to improve blood flow in free flaps. OBJECTIVE: Here, we present the first systematic review of clinical and experimental studies on the effect of ANH. METHODS: We performed a systematic literature search of PubMed, Medline, the Cochrane Library, Google Scholar, and ClinicalTrials.gov using search strategies and a review process in agreement with the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions. PICO criteria were defined before bibliometric processing of the retrieved articles, which were analyzed with the SYRCLE RoB tool for risk of bias and the GRADE scale for level of evidence. RESULTS: We retrieved 74 articles from the literature search, and after processing according to PICO criteria, only four articles remained, all of which were experimental. The rating for risk of bias was uncertain according to SYRCLE RoB results, and the level of evidence was low according to GRADE evaluation. CONCLUSIONS: There is no clinical evidence for the effect of ANH on microcirculation in free flaps, and experimental studies provide weak evidence supporting the use of hemodilution in reconstructive microsurgery.

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