scholarly journals LDL-Cholesterol Lowering of Plant Sterols and Stanols—Which Factors Influence Their Efficacy?

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1262 ◽  
Author(s):  
Elke Trautwein ◽  
Mario Vermeer ◽  
Harry Hiemstra ◽  
Rouyanne Ras
Keyword(s):  
Ldl Cholesterol ◽  
Critical Factor ◽  
Time Of Day ◽  
Plant Sterols ◽  
Food Supplements ◽  
Lowering Effect ◽  
Daily Intakes ◽  
Meta Analyses ◽  
Main Meal ◽  
The Impact

The LDL-cholesterol (LDL-C) lowering effect of plant sterols/stanols (PSS) is summarized in several meta-analyses showing a dose-response relationship with intakes of 1.5 to 3 g/day lowering LDL-C by 7.5% to 12%. This review summarizes evidence for the impact of various factors potentially influencing the LDL-C-lowering efficacy of PSS. PSS are efficacious in all food formats and in food supplements. Some factors related to food format, e.g., solid vs. liquid foods, seem to impact efficacy, while there is no difference between free PSS and esters. Compared to multiple daily intakes, once-a-day intake of PSS, especially in the morning with light breakfast, leads to a sub-optimal LDL-C lowering. However, intake frequency seems influenced by intake occasion, i.e., with or without a meal, and time of day. Meal intake is a critical factor for an optimal LDL-C lowering efficacy of PSS. While age has no impact, gender is suggested to influence the LDL-C lowering effect of PSS with greater reductions reported for men than women; but overall evidence is inconclusive and larger studies show no gender by treatment interaction. In conclusion, PSS are efficacious in all foods and food supplements; for optimal efficacy they should be consumed with a (main) meal and twice daily.

scholarly journals LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies

2014 ◽  
Vol 112 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Rouyanne T. Ras ◽  
Johanna M. Geleijnse ◽  
Elke A. Trautwein
Keyword(s):  
Dose Response ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Plant Sterols ◽  
Cholesterol Lowering ◽  
Random Effects Models ◽  
Advantages And Disadvantages ◽  
Lowering Effect ◽  
Wide Range ◽  
Cholesterol Lowering Effect

Phytosterols (PS, comprising plant sterols and plant stanols) have been proven to lower LDL-cholesterol concentrations. The dose–response relationship for this effect has been evaluated in several meta-analyses by calculating averages for different dose ranges or by applying continuous dose–response functions. Both approaches have advantages and disadvantages. So far, the calculation of averages for different dose ranges has not been done for plant sterols and stanols separately. The objective of the present meta-analysis was to investigate the combined and separate effects of plant sterols and stanols when classified into different dose ranges. Studies were searched and selected based on predefined criteria. Relevant data were extracted. Average LDL-cholesterol effects were calculated when studies were categorised by dose, according to random-effects models while using the variance as weighing factor. This was done for plant sterols and stanols combined and separately. In total, 124 studies (201 strata) were included. Plant sterols and stanols were administered in 129 and fifty-nine strata, respectively; the remaining used a mix of both. The average PS dose was 2·1 (range 0·2–9·0) g/d. PS intakes of 0·6–3·3 g/d were found to gradually reduce LDL-cholesterol concentrations by, on average, 6–12 %. When plant sterols and stanols were analysed separately, clear and comparable dose–response relationships were observed. Studies carried out with PS doses exceeding 4 g/d were not pooled, as these were scarce and scattered across a wide range of doses. In conclusion, the LDL-cholesterol-lowering effect of both plant sterols and stanols continues to increase up to intakes of approximately 3 g/d to an average effect of 12 %.

scholarly journals Patient preferences for use of virtual consultations in an orthopaedic rehabilitation setting: Results from a discrete choice experiment

2021 ◽  
pp. 135581962110354
Author(s):  
Anthony W Gilbert ◽  
Emmanouil Mentzakis ◽  
Carl R May ◽  
Maria Stokes ◽  
Jeremy Jones
Keyword(s):  
Conceptual Model ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Best Practice ◽  
Time Of Day ◽  
Problem Area ◽  
Fractional Factorial ◽  
The Impact

Objective Virtual Consultations may reduce the need for face-to-face outpatient appointments, thereby potentially reducing the cost and time involved in delivering health care. This study reports a discrete choice experiment (DCE) that identifies factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting. Methods Previous research from the CONNECT (Care in Orthopaedics, burdeN of treatmeNt and the Effect of Communication Technology) Project and best practice guidance informed the development of our DCE. An efficient fractional factorial design with 16 choice scenarios was created that identified all main effects and partial two-way interactions. The design was divided into two blocks of eight scenarios each, to reduce the impact of cognitive fatigue. Data analysis were conducted using binary logit regression models. Results Sixty-one paired response sets (122 subjects) were available for analysis. DCE factors (whether the therapist is known to the patient, duration of appointment, time of day) and demographic factors (patient qualifications, access to equipment, difficulty with activities, multiple health issues, travel costs) were significant predictors of preference. We estimate that a patient is less than 1% likely to prefer a virtual consultation if the patient has a degree, is without access to the equipment and software to undertake a virtual consultation, does not have difficulties with day-to-day activities, is undergoing rehabilitation for one problem area, has to pay less than £5 to travel, is having a consultation with a therapist not known to them, in 1 weeks’ time, lasting 60 minutes, at 2 pm. We have developed a simple conceptual model to explain how these factors interact to inform preference, including patients’ access to resources, context for the consultation and the requirements of the consultation. Conclusions This conceptual model provides the framework to focus attention towards factors that might influence patient preference for virtual consultations. Our model can inform the development of future technologies, trials, and qualitative work to further explore the mechanisms that influence preference.

scholarly journals Efficacy and safety of aliskiren combination therapy: a protocol for an umbrella review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043807
Author(s):  
Jiantong Shen ◽  
Wenming Feng ◽  
Yike Wang ◽  
Qiyuan Zhao ◽  
Billong Laura Flavorta ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Systematic Reviews ◽  
Cochrane Library ◽  
Umbrella Review ◽  
Quality Of Reporting ◽  
Ethical Approval ◽  
Registration Number ◽  
Third Person ◽  
Meta Analyses ◽  
The Impact

IntroductionEfficacy of aliskiren combination therapy with other antihypertensive has been evaluated in the treatment of patients with hypertension in recent systematic reviews. However, most previous reviews only focused on one single health outcome or one setting, none of them made a full summary that assessed the impact of aliskiren combination treatment comprehensively. As such, this umbrella review based on systematic reviews and meta-analyses is aimed to synthesise the evidences on efficacy, safety and tolerability of aliskiren-based therapy for hypertension and related comorbid patients.Methods and analysisA comprehensive search of PubMed, EMBASE, Cochrane Library, CNKI published from inception to August 2020 will be conducted. The selected articles are systematic reviews which evaluated efficacy, safety and tolerability of aliskiren combination therapy. Two reviewers will screen eligible articles, extract data and evaluate quality independently. Any disputes will be resolved by discussion or the arbitration of a third person. The quality of reporting evidence will be assessed using the Assessment of Multiple Systematic Reviews V.2 tool tool. We will take a mixed-methods approach to synthesising the review literatures, reporting summary of findings tables and iteratively mapping the results.Ethics and disseminationEthical approval is not required for the study, as we would only collect data from available published materials. This umbrella review will be also submitted to a peer-reviewed journal for publication after completion.PROSPERO registration numberCRD42020192131.

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

2021 ◽  
Vol 13 (4) ◽  
pp. 2247 ◽  
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.

scholarly journals Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Micaele Maria Lopes Castro ◽  
Maria Karolina Martins Ferreira ◽  
Iasmin Encaua Essashika Prazeres ◽  
Paula Beatriz de Oliveira Nunes ◽  
Marcela Baraúna Magno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Analysis ◽  
Periodontal Diseases ◽  
Hormonal Contraceptive ◽  
Cochrane Library ◽  
Hormonal Contraceptives ◽  
Clinical Parameters ◽  
Significant Difference ◽  
Meta Analyses ◽  
The Impact

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

scholarly journals Effects of Sport-Based Interventions on Children’s Executive Function: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 755
Author(s):  
Falonn Contreras-Osorio ◽  
Christian Campos-Jara ◽  
Cristian Martínez-Salazar ◽  
Luis Chirosa-Ríos ◽  
Darío Martínez-García
Keyword(s):  
Systematic Review ◽  
Working Memory ◽  
Executive Function ◽  
Inhibitory Control ◽  
Cognitive Flexibility ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Healthy Children ◽  
Meta Analyses ◽  
The Impact

One of the most studied aspects of children’s cognitive development is that of the development of the executive function, and research has shown that physical activity has been demonstrated as a key factor in its enhancement. This meta-analysis aims to assess the impact of specific sports interventions on the executive function of children and teenagers. A systematic review was carried out on 1 November 2020 to search for published scientific evidence that analysed different sports programs that possibly affected executive function in students. Longitudinal studies, which assessed the effects of sports interventions on subjects between 6 and 18 years old, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of eight studies, with 424 subjects overall, met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibitory control, and cognitive flexibility. The random-effects model for meta-analyses was performed with RevMan version 5.3 to facilitate the analysis of the studies. Large effect sizes were found in all categories: working memory (ES −1.25; 95% CI −1.70; −0.79; p < 0.0001); inhibitory control (ES −1.30; 95% CI −1.98; −0.63; p < 0.00001); and cognitive flexibility (ES −1.52; 95% CI −2.20; −0.83; p < 0.00001). Our analysis concluded that healthy children and teenagers should be encouraged to practice sports in order to improve their executive function at every stage of their development.

scholarly journals 82 The impact of feeding treats containing cannabidiol (CBD) on the daily activity level of dogs

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 60-61
Author(s):  
Elizabeth M Morris ◽  
Susanna E Kitts-Morgan ◽  
Dawn M Spangler ◽  
Kyle R McLeod ◽  
David L Harmon
Keyword(s):  
Daily Activity ◽  
Block Design ◽  
Companion Animals ◽  
Total Activity ◽  
Time Of Day ◽  
Activity Level ◽  
Activity Levels ◽  
Quiet Time ◽  
Activity Duration ◽  
The Impact

Abstract Growing public interest in and use of Cannabidiol (CBD) in companion animals has amplified the need to elucidate potential impacts. The purpose of this investigation was to determine the impact of CBD on daily activity of adult dogs. Twenty-four dogs (18.0 ± 3.4 kg) were utilized in a randomized complete block design with treatments consisting of control, 2 mg CBD/kg BW/d, and 4 mg CBD/kg BW/d split between two treats administered after twice-daily exercise (7:00-9:00 and 17:00-19:00). Four hours each day (10:00-12:00, AM and 13:30-15:30, PM), were designated as time when no persons entered the kennels, with 2 h designated as Quiet Time and the other 2 h as Music Time, where calming music played over speakers. Quiet and Music sessions were randomly allotted to daily AM or PM times. Activity monitors were fitted to dogs’ collars for continuous collection of activity parameters. Data were collected over a 2-wk baseline period to block dogs by activity level (high or low) before randomly assigning dogs within each block to treatments. After 1 wk of treatment adaptation, activity parameters were collected for 2 wk. Data were tested for normality using the UNIVARIATE procedure in SAS before examining differences using the MIXED procedure in SAS, including effects of treatment, day, session (Quiet or Music), time of day (AM or PM), and accompanying interactions. CBD did not alter total activity points (P = 0.9971) or activity duration (P = 0.8776). CBD tended (P = 0.0692) to reduce scratching compared to control. Irrespective of treatment, dogs were more active in PM than AM (P &lt; 0.0001). Regardless of session, dogs receiving 4 mg/kg/d tended (P = 0.0914) to be less active in the PM than control. CBD did not affect activity duration during exercise periods (P = 0.1425), but dogs receiving CBD ran more than control (P = 0.0339). These results indicate that when supplemented up to 4 mg/kg/d, CBD does not negatively impact daily activity levels of dogs.

Tourism research for the GCC region: Current status and future research directions

2021 ◽  
pp. 135481662199996
Author(s):  
Ali Salman Saleh ◽  
Charbel Bassil ◽  
Arsalan Safari
Keyword(s):  
United Arab Emirates ◽  
Current Status ◽  
Future Research ◽  
Research Directions ◽  
Regional Tourism ◽  
Research Theme ◽  
Tourism Sector ◽  
Future Research Directions ◽  
Meta Analyses ◽  
The Impact

Tourism in the Gulf Cooperation Council (GCC) countries has recently been considered by policymakers as a new avenue for economic diversification. Despite the considerable literature concerning the impact of tourism worldwide, only a limited number of studies have looked at the tourism sector in the GCC region or analyzed its economic, sociocultural, and environmental impacts. This article therefore conducts a systematic review of the state of the literature related to tourism in the GCC region. It provides effective insights about the current status, gaps, and challenges and proposes future research directions in this area for academics, practitioners, and policymakers with an interest in regional tourism development. The preferred reporting items for systematic reviews and meta-analyses approach was used to identify and select the papers. Some 23 papers were identified and analyzed. The majority of these studies focused on the United Arab Emirates, specifically the Dubai emirate. We found the most dominant research theme to be tourism planning.

scholarly journals A protocol for the systematic review and meta-analysis of thigmotactic behaviour in the open field test in rodent models associated with persistent pain

2021 ◽  
Vol 5 (1) ◽  
pp. e100135
Author(s):  
Xue Ying Zhang ◽  
Jan Vollert ◽  
Emily S Sena ◽  
Andrew SC Rice ◽  
Nadia Soliman
Keyword(s):  
Systematic Review ◽  
Outcome Measure ◽  
Meta Analysis ◽  
Persistent Pain ◽  
Effect Sizes ◽  
Bias Assessment ◽  
Animal Pain ◽  
Trim And Fill ◽  
Meta Analyses ◽  
The Impact

ObjectiveThigmotaxis is an innate predator avoidance behaviour of rodents and is enhanced when animals are under stress. It is characterised by the preference of a rodent to seek shelter, rather than expose itself to the aversive open area. The behaviour has been proposed to be a measurable construct that can address the impact of pain on rodent behaviour. This systematic review will assess whether thigmotaxis can be influenced by experimental persistent pain and attenuated by pharmacological interventions in rodents.Search strategyWe will conduct search on three electronic databases to identify studies in which thigmotaxis was used as an outcome measure contextualised to a rodent model associated with persistent pain. All studies published until the date of the search will be considered.Screening and annotationTwo independent reviewers will screen studies based on the order of (1) titles and abstracts, and (2) full texts.Data management and reportingFor meta-analysis, we will extract thigmotactic behavioural data and calculate effect sizes. Effect sizes will be combined using a random-effects model. We will assess heterogeneity and identify sources of heterogeneity. A risk-of-bias assessment will be conducted to evaluate study quality. Publication bias will be assessed using funnel plots, Egger’s regression and trim-and-fill analysis. We will also extract stimulus-evoked limb withdrawal data to assess its correlation with thigmotaxis in the same animals. The evidence obtained will provide a comprehensive understanding of the strengths and limitations of using thigmotactic outcome measure in animal pain research so that future experimental designs can be optimised. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines and disseminate the review findings through publication and conference presentation.

scholarly journals Diversity of Plant Sterols Metabolism: The Impact on Human Health, Sport, and Accumulation of Contaminating Sterols

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1623
Author(s):  
Arthur T. Kopylov ◽  
Kristina A. Malsagova ◽  
Alexander A. Stepanov ◽  
Anna L. Kaysheva
Keyword(s):  
Cardiovascular Disease ◽  
Protective Effect ◽  
Steroid Hormones ◽  
Intestinal Microflora ◽  
Plant Sterols ◽  
Anabolic Effect ◽  
The Past ◽  
The World ◽  
Health Sport ◽  
The Impact

The way of plant sterols transformation and their benefits for humans is still a question under the massive continuing revision. In fact, there are no receptors for binding with sterols in mammalians. However, possible biotransformation to steroids that can be catalyzed by gastro-intestinal microflora, microbial cells in prebiotics or cytochromes system were repeatedly reported. Some products of sterols metabolization are capable to imitate resident human steroids and compete with them for the binding with corresponding receptors, thus affecting endocrine balance and entire physiology condition. There are also tremendous reports about the natural origination of mammalian steroid hormones in plants and corresponding receptors for their binding. Some investigations and reports warn about anabolic effect of sterols, however, there are many researchers who are reluctant to believe in and have strong opposing arguments. We encounter plant sterols everywhere: in food, in pharmacy, in cosmetics, but still know little about their diverse properties and, hence, their exact impact on our life. Most of our knowledge is limited to their cholesterol-lowering influence and protective effect against cardiovascular disease. However, the world of plant sterols is significantly wider if we consider the thousands of publications released over the past 10 years.

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