scholarly journals A systematic review and meta-analysis of indoor bioaerosols in hospitals: The influence of heating, ventilation, and air conditioning

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0259996
Author(s):  
Rongchen Dai ◽  
Shan Liu ◽  
Qiushuang Li ◽  
Hanting Wu ◽  
Li Wu ◽  
...  
Keyword(s):  
Air Quality ◽  
Air Conditioning ◽  
High Efficiency ◽  
Practical Implication ◽  
Meta Analysis ◽  
Hvac Systems ◽  
Cochrane Library ◽  
Airborne Bacteria ◽  
Bacteria And Fungi

Objectives To evaluate (1) the relationship between heating, ventilation, and air conditioning (HVAC) systems and bioaerosol concentrations in hospital rooms, and (2) the effectiveness of laminar air flow (LAF) and high efficiency particulate air (HEPA) according to the indoor bioaerosol concentrations. Methods Databases of Embase, PubMed, Cochrane Library, MEDLINE, and Web of Science were searched from 1st January 2000 to 31st December 2020. Two reviewers independently extracted data and assessed the quality of the studies. The samples obtained from different areas of hospitals were grouped and described statistically. Furthermore, the meta-analysis of LAF and HEPA were performed using random-effects models. The methodological quality of the studies included in the meta-analysis was assessed using the checklist recommended by the Agency for Healthcare Research and Quality. Results The mean CFU/m3 of the conventional HVAC rooms and enhanced HVAC rooms was lower than that of rooms without HVAC systems. Furthermore, the use of the HEPA filter reduced bacteria by 113.13 (95% CI: -197.89, -28.38) CFU/m3 and fungi by 6.53 (95% CI: -10.50, -2.55) CFU/m3. Meanwhile, the indoor bacterial concentration of LAF systems decreased by 40.05 (95% CI: -55.52, -24.58) CFU/m3 compared to that of conventional HVAC systems. Conclusions The HVAC systems in hospitals can effectively remove bioaerosols. Further, the use of HEPA filters is an effective option for areas that are under-ventilated and require additional protection. However, other components of the LAF system other than the HEPA filter are not conducive to removing airborne bacteria and fungi. Limitation of study Although our study analysed the overall trend of indoor bioaerosols, the conclusions cannot be extrapolated to rare, hard-to-culture, and highly pathogenic species, as well as species complexes. These species require specific culture conditions or different sampling requirements. Investigating the effects of HVAC systems on these species via conventional culture counting methods is challenging and further analysis that includes combining molecular identification methods is necessary. Strength of the study Our study was the first meta-analysis to evaluate the effect of HVAC systems on indoor bioaerosols through microbial incubation count. Our study demonstrated that HVAC systems could effectively reduce overall bioaerosol concentrations to maintain better indoor air quality. Moreover, our study provided further evidence that other components of the LAF system other than the HEPA filter are not conducive to removing airborne bacteria and fungi. Practical implication Our research showed that HEPA filters are more effective at removing bioaerosols in HVAC systems than the current LAF system. Therefore, instead of opting for the more costly LAF system, a filter with a higher filtration rate would be a better choice for indoor environments that require higher air quality; this is valuable for operating room construction and maintenance budget allocation.

scholarly journals Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 3991
Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastasis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Vertebral Metastasis ◽  
Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

Assessment of the indoor air quality based on airborne bacteria and fungi measurements in a public school of Istanbul

2020 ◽  
Vol 13 (24) ◽  
Author(s):  
Nuket Sivri ◽  
Ahmet Ozgur Dogru ◽  
Arzu Funda Bagcigil ◽  
Kemal Metiner ◽  
Dursun Zafer Seker
Keyword(s):  
Air Quality ◽  
Public School ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Airborne Bacteria ◽  
Bacteria And Fungi

scholarly journals A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1351
Author(s):  
Mengshu Wang ◽  
Xufei Luo ◽  
Ling Wang ◽  
Janne Estill ◽  
Meng Lv ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Interstitial Pneumonia ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Receiver Operating Curve ◽  
Cochrane Library ◽  
Molecular Tests ◽  
Specificity And Sensitivity

Background Lung ultrasound (LUS) and computed tomography (CT) can both be used for diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID-19), but the agreement between LUS and CT is unknown. Purpose to compare the agreement of LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19. Materials and Methods We searched PubMed, Cochrane library, Embase, Chinese Biomedicine Literature, and WHO COVID-19 databases to identify studies that compared LUS with CT in the diagnosis of interstitial pneumonia caused by COVID-19. We calculated the pooled overall, positive and negative percent agreements, diagnostic odds ratio (DOR) and the area under the standard receiver operating curve (SROC) for LUS in the diagnosis of COVID-19 compared with CT. Results We identified 1896 records, of which nine studies involving 531 patients were finally included. The pooled overall, positive and negative percentage agreements of LUS for the diagnosis of interstitial pneumonia caused by COVID-19 compared with CT were 81% (95% confidence interval [CI] 43–99%), 96% (95% CI, 80–99%, I2 = 92.15%) and 80% (95%CI, 60–92%, I2 = 92.85%), respectively. DOR was 37.41 (95% CI, 9.43–148.49, I2 = 63.9%), and the area under the SROC curve was 0.94 (95% CI, 0.92–0.96). The quality of evidence for both specificity and sensitivity was low because of heterogeneity and risk of bias. Conclusion The level of diagnostic agreement between LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19 is high. LUS can be therefore considered as an equally accurate alternative for CT in situations where molecular tests are not available.

scholarly journals Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5171
Author(s):  
Yusuke Handa ◽  
Kenya Okada ◽  
Hiroshi Takasaki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grade System ◽  
Cochrane Library ◽  
Forward Head Posture ◽  
Quality Of Evidence ◽  
Head Posture ◽  
Head Extension ◽  
The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

scholarly journals Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): a meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yanli Liu ◽  
Yilong Pan ◽  
Yuyao Yin ◽  
Wenhao Chen ◽  
Xiaodong Li
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Risk Of Death ◽  
Potential Association ◽  
Increased Risk ◽  
Language Restriction ◽  
Newcastle Ottawa Scale

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.

scholarly journals Effects of exercise-based pulmonary rehabilitation on adults with asthma: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhenzhen Feng ◽  
Jiajia Wang ◽  
Yang Xie ◽  
Jiansheng Li
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Life Questionnaire ◽  
Asthma Control Questionnaire ◽  
Clinical Trial Registration ◽  
Domain Scores

Abstract Background Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma. Methods The PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results Ten literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: − 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = − 0.25, 95% CI: − 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: − 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: − 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant. Conclusions Exercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required. Clinical trial registration: The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/, and the ID is CRD42019147107).

scholarly journals The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohail Akhtar ◽  
Jamal Abdul Nasir ◽  
Amara Javed ◽  
Mariyam Saleem ◽  
Sundas Sajjad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Population Based ◽  
Included Study ◽  
Cochrane Library ◽  
Or Education ◽  
Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

scholarly journals Traditional Chinese Herb Combined with Surgery versus Surgery for Varicocele Infertility: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Rong-liang Dun ◽  
Min Yao ◽  
Long Yang ◽  
Xue-jun Cui ◽  
Jian-min Mao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Chinese Herb ◽  
Chinese Herbs ◽  
Cochrane Library ◽  
Dichotomous Data ◽  
Surgery Group ◽  
Traditional Chinese Herb ◽  
The Cochrane Library

Objective. The objective of this study was to conduct a systematic review to assess the effectiveness and safety of traditional Chinese herb combined with surgery for male varicocele infertility compared to surgery.Methods. Randomized controlled trials (RCTs) data of traditional Chinese herbs combined with surgery for male varicocele fertility versus surgery were collected by searching the Cochrane Library, Embase, PubMed, and Chinese databases. The risk of bias was assessed using Cochrane Handbook. Study outcomes were presented as risk ratios (RRs) for dichotomous data.Results. Seventeen of 72 potentially relevant trials met the inclusion criteria. The methodological qualities of the RCTs were low. Compared with the surgery group, the traditional Chinese herb combined with surgery group had superiority in pregnancy rate at 3-month (RR=1.76, andP=0.008), 6-month (RR=1.58, andP=0.0005), and 2-year (RR=1.58, andP=0.0005) follow-ups. No RCT was found to describe the side effects.Conclusion. On considering the low methodological quality of RCTs, there was no enough evidence on traditional Chinese herb with surgery for male varicocele infertility, and more high-quality RCTs of large sample sizes are required.

scholarly journals The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Lu Wang ◽  
Mingmin Xu ◽  
Qianhua Zheng ◽  
Wei Zhang ◽  
Ying Li
Keyword(s):  
Quality Of Life ◽  
Meta Analysis ◽  
Safety Evaluation ◽  
Functional Constipation ◽  
Responder Rate ◽  
Current Evidence ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Increased Risk

Objective. The purpose of this study was to assess the effectiveness and safety of acupuncture for functional constipation (FC). Methods. A rigorous literature search was performed in English (PubMed, Web of Science, the Cochrane Library, and EMBASE) and Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang database, and China Science and Technology Journal (VIP)) electronic databases from their inception to October 2019. Included randomized controlled trials (RCTs) compared acupuncture therapy with sham acupuncture or pharmacological therapies. The outcome measures were evaluated, including the primary outcome of complete spontaneous bowel movement (CSBM) and secondary outcomes of Bristol Stool Form Scale (BSFS), constipation symptoms scores (CSS), responder rate, the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, and safety evaluation. Meta-analysis was performed by using RevMan5.3. Results. The merged data of 28 RCTs with 3525 participants indicated that acupuncture may be efficient for FC by increasing CSBMs (p<0.00001; MD = 0.84 [95% CI, 0.65 to 1.03]; I2 = 0%) and improving constipation symptoms (p=0.03; SMD = −0.4 [95% CI, −0.78 to −0.03]; I2 = 74%), stool formation (p<0.00001; MD = 0.24 [95% CI, 0.15 to 0.34]; I2 = 0%), quality of life (p<0.00001; N = 1, MD = −0.33 [95% CI, −0.45 to −0.21]), and responder rates (p=0.02; RR = 2.16; [95% CI, 1.1 to 4.24]; I2 = 69%) compared with the effects of sham treatment. No increased risk of adverse events was observed (p=0.44; RR = 1.18; [95% CI, 0.77 to 1.81]; I2 = 0%). With regard to medication comparisons, the pooled data indicated that acupuncture was more effective in increasing CSBMs (p=0.004; MD = 0.53 [95% CI, 0.17 to 0.88]; I2 = 88%) and improving patients’ quality of life (p<0.00001; SMD = −0.73 [95% CI, −1.02 to −0.44]; I2 = 64%), with high heterogeneity. However, there were no significant differences in responder rate (p=0.12; RR = 1.31; [95% CI, 0.94 to 1.82]; I2 = 53%), BSFS (p=0.5; MD = 0.17 [95% CI, −0.33 to 0.68]; I2 = 93%), or CSS (p=0.05; SMD = −0.62 [95% CI, −1.23 to −0.01]; I2 = 89%). Regarding safety evaluation, acupuncture was safer than medications (p<0.0001; RR = 0.3; [95% CI, 0.18 to 0.52]; I2 = 30%). Conclusions. Current evidence suggests that acupuncture is an efficient and safe treatment for FC. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life. However, the evidence quality was relatively low and the relationship between acupuncture and drugs is not clear. More high-quality trials are recommended in the future. PROSPERO registration number: CRD42019143347.

scholarly journals Can Public Spaces Effectively Be Used as Cleaner Indoor Air Shelters during Extreme Smoke Events?

2021 ◽  
Vol 18 (8) ◽  
pp. 4085
Author(s):  
Amanda J. Wheeler ◽  
Ryan W. Allen ◽  
Kerryn Lawrence ◽  
Christopher T. Roulston ◽  
Jennifer Powell ◽  
...  
Keyword(s):  
Air Quality ◽  
Indoor Air ◽  
Air Conditioning ◽  
High Efficiency ◽  
Public Library ◽  
Public Building ◽  
Central Air Conditioning ◽  
The Media ◽  
The Impact ◽  
Pm2.5 Concentration

During extreme air pollution events, such as bushfires, public health agencies often recommend that vulnerable individuals visit a nearby public building with central air conditioning to reduce their exposure to smoke. However, there is limited evidence that these “cleaner indoor air shelters” reduce exposure or health risks. We quantified the impact of a “cleaner indoor air shelter” in a public library in Port Macquarie, NSW, Australia when concentrations of fine particulate matter (PM2.5) were elevated during a local peat fire and nearby bushfires. Specifically, we evaluated the air quality improvements with central air conditioning only and with the use of portable high efficiency particulate air (HEPA) filter air cleaners. We measured PM2.5 from August 2019 until February 2020 by deploying pairs of low-cost PM2.5 sensors (i) inside the main library, (ii) in a smaller media room inside the library, (iii) outside the library, and (iv) co-located with regulatory monitors located in the town. We operated two HEPA cleaners in the media room from August until October 2019. We quantified the infiltration efficiency of outdoor PM2.5 concentrations, defined as the fraction of the outdoor PM2.5 concentration that penetrates indoors and remains suspended, as well as the additional effect of HEPA cleaners on PM2.5 concentrations. The infiltration efficiency of outdoor PM2.5 into the air-conditioned main library was 30%, meaning that compared to the PM2.5 concentration outdoors, the concentrations of outdoor-generated PM2.5 indoors were reduced by 70%. In the media room, when the HEPA cleaners were operating, PM2.5 concentrations were reduced further with a PM2.5 infiltration efficiency of 17%. A carefully selected air-conditioned public building could be used as a cleaner indoor air shelter during episodes of elevated smoke emissions. Further improvements in indoor air quality within the building can be achieved by operating appropriately sized HEPA cleaners.

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