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2022 ◽  
Author(s):  
Danny Radford ◽  
Oscar Hou In Chou ◽  
George Bazoukis ◽  
Konstantinos Letsas ◽  
Tong Liu ◽  
...  

Abstract Background: Early repolarization syndrome (ERS) and Brugada syndrome (BrS) are both J-wave syndromes. Both can involve mutations in the SCN5A gene but may exhibit distinct electrocardiographic (ECG) differences. The aim of this systematic review and meta-analysis is to investigate possible differences in ECG markers between SCN5A positive patients with ERS and BrS. Methods: PubMed and Embase, were searched from their inception to October 20th, 2021 for human studies containing the search terms “SCN5A” and “variant” and “early reporlarization” or “Brugada”, with no language restrictions. Results: A total of 328 studies were identified. After full text screening, 12 studies met our inclusion criteria and were included in this present study. 104 ERS patients (mean age: 30.86 ±14.45) and 2000 BrS patients (mean age: 36.17 ±11.39) were studied. Our meta-analysis found that ERS patients had a significantly lower heart rate (standardized mean difference [SMD]a= 14.69, 95% confidence interval [CI] = 21.43, 7.94, P = 0.0001), shorter QRS duration (SMD = 13.90, 95% CI = 17.16, 10.65, P = 0.0001) and shorter QTc [corrected QT interval] (SDM = 21.52, 95% CI = 33.77, 9.26, P = 0.0006) than BrS patients. Conclusion: BrS patients with positive SCN5A mutations exhibited prolonged QRS, indicating conduction abnormalities, whereas ERS patients with positive SCN5A mutations showed normal QRS. By contrast, whilst QTc intervals were longer in BrS than in ERS SCN5A positive patients, they were within normal limits. Further studies are needed to examine the implications of these findings for arrhythmic risk stratification.


2022 ◽  
pp. 019459982110677
Author(s):  
Firas Sbeih ◽  
Malek H. Bouzaher ◽  
Swathi Appachi ◽  
Seth Schwartz ◽  
Michael S. Cohen ◽  
...  

Objective To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger. Data Source Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021. Review Methods Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias. Results The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies. Conclusion The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.


Author(s):  
Andja Cirkovic ◽  
Dejana Stanisavljevic ◽  
Jelena Milin-Lazovic ◽  
Nina Rajovic ◽  
Vedrana Pavlovic ◽  
...  

Introduction: Preeclampsia (PE) is a pregnancy-associated, multi-organ, life-threatening disease that appears after the 20th week of gestation. The aim of this study was to perform a systematic review and meta-analysis to determine whether women with PE have disrupted miRNA expression compared to women who do not have PE.Methods: We conducted a systematic review and meta-analysis of studies that reported miRNAs expression levels in placenta or peripheral blood of pregnant women with vs. without PE. Studies published before October 29, 2021 were identified through PubMed, EMBASE and Web of Science. Two reviewers used predefined forms and protocols to evaluate independently the eligibility of studies based on titles and abstracts and to perform full-text screening, data abstraction and quality assessment. Standardized mean difference (SMD) was used as a measure of effect size.Results: 229 publications were included in the systematic review and 53 in the meta-analysis. The expression levels in placenta were significantly higher in women with PE compared to women without PE for miRNA-16 (SMD = 1.51,95%CI = 0.55–2.46), miRNA-20b (SMD = 0.89, 95%CI = 0.33–1.45), miRNA-23a (SMD = 2.02, 95%CI = 1.25–2.78), miRNA-29b (SMD = 1.37, 95%CI = 0.36–2.37), miRNA-155 (SMD = 2.99, 95%CI = 0.83–5.14) and miRNA-210 (SMD = 1.63, 95%CI = 0.69–2.58), and significantly lower for miRNA-376c (SMD = –4.86, 95%CI = –9.51 to –0.20). An increased level of miRNK-155 expression was found in peripheral blood of women with PE (SMD = 2.06, 95%CI = 0.35–3.76), while the expression level of miRNA-16 was significantly lower in peripheral blood of PE women (SMD = –0.47, 95%CI = –0.91 to –0.03). The functional roles of the presented miRNAs include control of trophoblast proliferation, migration, invasion, apoptosis, differentiation, cellular metabolism and angiogenesis.Conclusion: miRNAs play an important role in the pathophysiology of PE. The identification of differentially expressed miRNAs in maternal blood creates an opportunity to define an easily accessible biomarker of PE.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Timothy Makrides ◽  
Linda Ross ◽  
Cameron Gosling ◽  
Joseph Acker ◽  
Peter O'Meara

PurposeThis study aims to map and examine the existing evidence to provide an overview of what is known about the structure and characteristics of the Anglo-American paramedic system in developed countries.Design/methodology/approachThe review includes results examining the structure and characteristics of the Anglo-American paramedic system in English-speaking developed countries. Databases, including Embase, MEDLINE, Web of Science, EBSCOhost, CINAHL, Google Scholar and Epistemonikos, were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forward and backward searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Finally, data extraction was performed using a customised instrument. Included studies were summarised using narrative synthesis structured around broad themes exploring the structure and characteristics of the Anglo-American paramedic system.Findings The synthesis of information shows that varying models (or subsystems) exist within the Anglo-American paramedic system. The use of metaphorical models based on philosophical underpinnings are used to describe two novel subsystems within the Anglo-American paramedic system. These are the professionally autonomous and directive paramedic systems, with the directive model being further categorised into the rescue and hospital-managed submodels.Originality/valueThis study is the first of its kind to explore the modern subcategorisation of the Anglo-American paramedic system using a realist lens as the basis for its approach.


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Shriya Vinjimoor ◽  
Alex Meltzer ◽  
Eneida Mendonca

Background: Asthma is the most common chronic illness among the pediatric patient population. While several studies have investigated the biological and environmental factors associated with asthma exacerbations, research on the relationship between asthma and social determinants of health is limited. This scoping review addresses this gap in knowledge by exploring social factors that are associated with the risk of asthma exacerbations among pediatric patients and mapping identified variables onto the SAVI database. Methods: The OVID Medline, Embase, and PsycInfo databases were systematically searched for studies published as of July 2, 2021. No restrictions on study design or publication type were made but search was limited to English manuscripts. Resulting studies were screened based on phased eligibility criteria on Covidence. In Phase 1, duplicates were removed. In Phase 2, studies unrelated to asthma and those with participants outside of 2-18 years of age were excluded based on title and abstract screening. In Phase 3, studies that investigated asthma exacerbations as well as its association with social factors were retained while studies solely looking at non-social factors or abstract-only studies were excluded based on the full text screening. In Phase 4, data on frequency of both inpatient and outpatient physician visits for asthma were extracted along with information on study characteristics and social factors. Results: Following the initial database search, 3312 studies were retrieved for the scoping review. 772 duplicates were removed during Phase 1. 1628 studies were excluded during the abstract and title screening in Phase 2. Upon resolving 384 conflicts, the remaining 912 studies proceeded to full text screening in Phase 3. Conclusion: The initial literature screening suggests an association between social risk factors and pediatric asthma exacerbations. Incorporating large scale change of these social factors with individual pharmacological treatment could help improve pediatric asthma outcomes.


2021 ◽  
Author(s):  
Mats de Lange ◽  
Ana Sofia Carvalho ◽  
Oscar Brito Fernandes ◽  
Hester Lingsma ◽  
Niek Klazinga ◽  
...  

Aim: To assess the impact of the COVID-19 pandemic on hospital care for cardiac patients. Methods and results: Scoping review, including studies with empirical data on changes in the use of health services measured by performance indicators during January - June 2020. Database searches yielded 6277 articles, of which 838 articles met the inclusion criteria during initial screening. After full-text screening, 94 articles were considered for data extraction. In total, 1637 indicators were retrieved, showing large variation in the indicators and their definitions. Most of the indicators that provided information on changes in number of admissions (n=118, 88%) signalled a decrease in admissions; 88% (n=15) of the indicators showed patients delayed presentation and 40% (n=54) showed patients in a worse clinical condition. A reduction in diagnostic and treatment procedures was signalled by 95% (n=18) and 81% (n=64) of the indicators reporting on cardiac procedures, respectively. Length of stay decreased in 58% (n=21) of the indicators and acute coronary syndromes treatment times increased in 61% (n=65) of the indicators. Outpatient activity decreased in 94% (n=17) of the indicators related with outpatient care, whereas telehealth utilization increased in 100% (n=6). Outcomes worsened in 40% (n=35) of the indicators, and mortality rates increased in 52% (n=31). Conclusion: All phases of the hospital cardiac care pathway were affected. This information could support the planning of care during the ongoing pandemic and in future events. Furthermore, to ensure continuity of care during crises, fostering the use of standardised indicators is paramount.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 173-173
Author(s):  
Afeez Hazzan ◽  
Pamela Haibach-Beach ◽  
Lauren Lieberman ◽  
Jamia Williams

Abstract Unpaid family caregivers play a critical role in the care of older adults with visual impairments (VI). Caring for older adults with VI requires much time and energy, often resulting in psychological stress and reduced quality of life (QoL). However, there is a paucity of data on the impact of caregiving on QoL and related outcomes among these caregivers. The purpose of this study was to conduct a scoping review examining issues of QoL, health, stress, burden, and barriers among unpaid caregivers of older adults (i.e. aged 60 years or more) with VI. The study aimed to summarize interventions for addressing these issues. This study followed the Arksey and O’Malley (2005) five stage approach for scoping reviews. We performed a search of published peer-reviewed articles available in PubMed, CINAHL Complete, and PsycINFO to identify relevant studies. Two reviewers conducted the screening of titles, abstracts, and full-texts. Of the 452 records identified, 24 were eligible for full-text screening and five articles met the final inclusion criteria. The following four themes were identified: (1) prevalence of QoL-related barriers among unpaid caregivers of older adults with VI; (2) adverse events among unpaid caregivers of older adults with VI; (3) interventions for unpaid caregivers of older adults with VI; and (4) potential impacts of intervention on unpaid caregivers of older adults with VI. These findings reveal a lack of interventions for unpaid caregivers of older adults with VI, despite the prevalence of QoL-related barriers and adverse events. Research addressing these issues are urgently needed.


Author(s):  
Despina Laparidou ◽  
Ffion Curtis ◽  
Joseph Akanuwe ◽  
Khaled Goher ◽  
A. Niroshan Siriwardena ◽  
...  

Abstract Background In recent years, robotic rehabilitation devices have often been used for motor training. However, to date, no systematic reviews of qualitative studies exploring the end-user experiences of robotic devices in motor rehabilitation have been published. The aim of this study was to review end-users’ (patients, carers and healthcare professionals) experiences with robotic devices in motor rehabilitation, by conducting a systematic review and thematic meta-synthesis of qualitative studies concerning the users’ experiences with such robotic devices. Methods Qualitative studies and mixed-methods studies with a qualitative element were eligible for inclusion. Nine electronic databases were searched from inception to August 2020, supplemented with internet searches and forward and backward citation tracking from the included studies and review articles. Data were synthesised thematically following the Thomas and Harden approach. The CASP Qualitative Checklist was used to assess the quality of the included studies of this review. Results The search strategy identified a total of 13,556 citations and after removing duplicates and excluding citations based on title and abstract, and full text screening, 30 studies were included. All studies were considered of acceptable quality. We developed six analytical themes: logistic barriers; technological challenges; appeal and engagement; supportive interactions and relationships; benefits for physical, psychological, and social function(ing); and expanding and sustaining therapeutic options. Conclusions Despite experiencing technological and logistic challenges, participants found robotic devices acceptable, useful and beneficial (physically, psychologically, and socially), as well as fun and interesting. Having supportive relationships with significant others and positive therapeutic relationships with healthcare staff were considered the foundation for successful rehabilitation and recovery.


Mathematics ◽  
2021 ◽  
Vol 9 (23) ◽  
pp. 3036
Author(s):  
Mihael Baketarić ◽  
Marjan Mernik ◽  
Tomaž Kosar

Context: In this study, we report on a Systematic Mapping Study (SMS) for attraction basins in the domain of metaheuristics. Objective: To identify research trends, potential issues, and proposed solutions on attraction basins in the field of metaheuristics. Research goals were inspired by the previous paper, published in 2021, where attraction basins were used to measure exploration and exploitation. Method: We conducted the SMS in the following steps: Defining research questions, conducting the search in the ISI Web of Science and Scopus databases, full-text screening, iterative forward and backward snowballing (with ongoing full-text screening), classifying, and data extraction. Results: Attraction basins within discrete domains are understood far better than those within continuous domains. Attraction basins on dynamic problems have hardly been investigated. Multi-objective problems are investigated poorly in both domains, although slightly more often within a continuous domain. There is a lack of parallel and scalable algorithms to compute attraction basins and a general framework that would unite all different definitions/implementations used for attraction basins. Conclusions: Findings regarding attraction basins in the field of metaheuristics reveal that the concept alone is poorly exploited, as well as identify open issues where researchers may improve their research.


Author(s):  
Arjola Agolli ◽  
Olsi Agolli ◽  
Diana Fiorela Sánchez Velazco ◽  
Md Ripon Ahammed ◽  
Mehrie Patel ◽  
...  

Abstract Background Pregnancy is an immunocompromised state and, for this reason, a pregnant woman is at a higher risk of getting infected as compared with a healthy individual. There is limited data available regarding the impact of COVD-19 on pregnancy; however, the case of miscarriage due to placental infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in second trimester has already been reported. Methods We searched for all published articles in PubMed, Science Direct, Cochrane, Scopus, and Embase. The literature search produced 167 relevant publications; 67 manuscripts were further excluded because they did not satisfy our inclusion criteria. Out of the remaining 100 articles, 78 were excluded after full text screening. Therefore, a total of 22 articles were eligible for review in our study. Results Overall, these 22 studies included a total of 7,034 participants: 2,689 (38.23%) SARS-CoV-2 positive pregnant women, of which 2,578 (95.87%) were laboratory confirmed and 111 (4.13%) were clinically diagnosed. Among the positive patients, there were 174 (6.47%) cases of abortion, of them 168 (96.55%) were spontaneous abortions and 6 (3.45%) were missed. Most patients either reported mild symptoms of fever, cough, fatigue, and anosmia or they presented asymptomatic. Conclusion Additional investigation and rigorous research are warranted to confirm placental pathology mechanisms concerning COVID-19 to protect maternal and fetal health.


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