Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades.
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ABSTRACT:
SUBMITTER: Zhao W
PROVIDER: S-EPMC8019694 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo evaluate the change of the risk of bias (RoB) of acupuncture randomized controlled trials (RCTs) in the past five decades.MethodsMultiple databases were searched. We included RCTs identified from systematic reviews (SRs) on acupuncture. General characteristics and RoB judgment for each domain were extracted. The proportions of RCTs at high and unclear RoB were calculated and the changes were examined by the Mann-Kendall test.ResultsWe included 368 SRs including 4 715 RCTs. The rates of RCTs at unclear RoB were the highest in allocation concealment (63%), and at the lowest in incomplete outcome data (35%); in the last five decades, statistically significant reductions were found for random sequence generation (P < 0.001) and selective reporting (P = 0.01), and increases for blinding of participants and personnel (P < 0.001), blinding of outcome assessment (P < 0.001) and incomplete outcome data (P = 0.04). For the proportions of RCTs at high RoB, blinding of participants and personnel (47%) and blinding of outcome assessment (35%) were the poorest domains; there were no significant differences in changes for all domains.ConclusionsAlthough improvements concerning unclear risk were observed for random sequence generation and selective reporting, major issues remain for allocation concealment and blinding. It is imperative to use valid randomization, specify how it is conducted, and try to test for selection bias and the success of masking by using the Berger Exner test.
| S-EPMC7286517 | biostudies-literature
Project description:ObjectiveAs the number of female medical students and surgical residents increases, the increasing number of female academic surgeons has been disproportionate. The purpose of this brief report is to evaluate the AAMC data from 1969 to 2018 to compare the level of female academic faculty representation for surgical specialties over the past four decades.DesignThe number of women as a percentage of the total surgeons per year were recorded for each year from 1969-2018, the most recent year available. Descriptive statistics were performed. Poisson regression examined the percentage of women in each field as the outcome of interest with the year and specialty (using general surgery as a reference) as two predictor variables.SettingData from the American Association of Medical Colleges (AAMC).ParticipantsAll full-time academic faculty physicians in the specialties of obstetrics and gynecology (OB/GYN), general surgery, ophthalmology, otolaryngology (ENT), plastic surgery, plastic surgery, urology, neurosurgery, orthopaedic surgery and cardiothoracic surgery as per AAMC records.ResultsThe percentage of women in surgery for all specialties evaluated increased from 1969 to 2018 (OR 1.04, p<0.001). Compared with general surgery, the rate of yearly percentage change increased more slowly in neurosurgery (OR 0.84; P = .004), orthopaedic surgery (OR 0.82; P = .002), urology (OR 0.59; P < .001), and cardiothoracic surgery (OR 0.38; P < .001). There was no significant difference in the rate of yearly percentage change for plastic surgery (OR 1.01; P = .840). The rate of yearly percentage change increased more rapidly in OB/GYN (OR 2.86; P < .001), ophthalmology (OR 1.79; P < .001) and ENT (OR 1.70; P < .001).ConclusionsRepresentation of women in academic surgery is increasing overall but is increasing more slowly in orthopaedic surgery, neurosurgery, cardiothoracic surgery and urology compared with that in general surgery. These data may be used to inform and further the discussion of how mentorship and sponsorship of female students and trainees interested in surgical careers may improve gender equity in the future.
| S-EPMC7743929 | biostudies-literature
Project description:INTRODUCTION: Treatment-related death (TRD) remains a serious problem in small-cell lung cancer (SCLC), despite recent improvements in supportive care. However, few studies have formally assessed time trends in the proportion of TRD over the past two decades. The aim of this study was to determine the frequency and pattern of TRD over time. METHODS: We examined phase 3 trials conducted between 1990 and 2010 to address the role of systemic treatment for SCLC. The time trend was assessed using linear regression analysis. RESULTS: In total, 97 trials including nearly 25,000 enrolled patients were analyzed. The overall TRD proportion was 2.95%. Regarding the time trend, while it was not statistically significant, it tended to decrease, with a 0.138% decrease per year and 2.76% decrease per two decades. The most common cause of death was febrile neutropenia without any significant time trend in its incidence over the years examined (p = 0.139). However, deaths due to febrile neutropenia as well as all causes in patients treated with non-platinum chemotherapy increased significantly (p = 0.033). CONCLUSIONS: The overall TRD rate has been low, but not negligible, in phase III trials for SCLC over the past two decades.
| S-EPMC3412813 | biostudies-literature
Project description:Despite the growing interest in predicting global and regional trends in vegetation productivity in response to a changing climate, changes in water constraint on vegetation productivity (i.e., water limitations on vegetation growth) remain poorly understood. Here we conduct a comprehensive evaluation of changes in water constraint on vegetation growth in the extratropical Northern Hemisphere between 1982 and 2015. We document a significant increase in vegetation water constraint over this period. Remarkably divergent trends were found with vegetation water deficit areas significantly expanding, and water surplus areas significantly shrinking. The increase in water constraints associated with water deficit was also consistent with a decreasing response time to water scarcity, suggesting a stronger susceptibility of vegetation to drought. We also observed shortened water surplus period for water surplus areas, suggesting a shortened exposure to water surplus associated with humid conditions. These observed changes were found to be attributable to trends in temperature, solar radiation, precipitation, and atmospheric CO2. Our findings highlight the need for a more explicit consideration of the influence of water constraints on regional and global vegetation under a warming climate.
| S-EPMC8213694 | biostudies-literature
Project description:BackgroundThe paper presents an overview of air quality in the 27 member countries of the European Union (EU) and the United Kingdom (previous EU-28), from 2000 to 2017. We reviewed the progress made towards meeting the air quality standards established by the EU Ambient Air Quality Directives (European Council Directive 2008/50/EC) and the World Health Organization (WHO) Air Quality Guidelines by estimating the trends (Mann-Kendal test) in national emissions of main air pollutants, urban population exposure to air pollution, and in mortality related to exposure to ambient fine particles (PM2.5) and tropospheric ozone (O3).ResultsDespite significant reductions of emissions (e.g., sulfur oxides: ~ 80%, nitrogen oxides: ~ 46%, non-methane volatile organic compounds: ~ 44%, particulate matters with a diameter lower than 2.5 µm and 10 µm: ~ 30%), the EU-28 urban population was exposed to PM2.5 and O3 levels widely exceeding the WHO limit values for the protection of human health. Between 2000 and 2017, the annual PM2.5-related number of deaths decreased (- 4.85 per 106 inhabitants) in line with a reduction of PM2.5 levels observed at urban air quality monitoring stations. The rising O3 levels became a major public health issue in the EU-28 cities where the annual O3-related number of premature deaths increased (+ 0.55 deaths per 106 inhabitants).ConclusionsTo achieve the objectives of the Ambient Air Quality Directives and mitigate air pollution impacts, actions need to be urgently taken at all governance levels. In this context, greening and re-naturing cities and the implementation of fresh air corridors can help meet air quality standards, but also answer to social needs, as recently highlighted by the COVID-19 lockdowns.
| S-EPMC7937352 | biostudies-literature
Project description:Mortality is a key indicator of forest health, and increasing mortality can serve as bellwether for the impacts of global change on forest ecosystems. Here we analyze trends in forest canopy mortality between 1984 and 2016 over more than 30 Mill. ha of temperate forests in Europe, based on a unique dataset of 24,000 visually interpreted spectral trajectories from the Landsat archive. On average, 0.79% of the forest area was affected by natural or human-induced mortality annually. Canopy mortality increased by +2.40% year-1, doubling the forest area affected by mortality since 1984. Areas experiencing low-severity mortality increased more strongly than areas affected by stand-replacing mortality events. Changes in climate and land-use are likely causes of large-scale forest mortality increase. Our findings reveal profound changes in recent forest dynamics with important implications for carbon storage and biodiversity conservation, highlighting the importance of improved monitoring of forest mortality.
| S-EPMC6255806 | biostudies-literature
Project description:BackgroundAn important goal of chronic obstructive pulmonary disease (COPD) treatment is to reduce the frequency of exacerbations. Some observations suggest a decline in exacerbation rates in clinical trials over time. A more systematic understanding would help to improve the design and interpretation of COPD trials.MethodsWe performed a systematic review and meta-regression of the placebo groups in published randomized controlled trials reporting exacerbations as an outcome. A Bayesian negative binomial model was developed to accommodate results that are reported in different formats; results are reported with credible intervals (CI) and posterior tail probabilities (pB).ResultsOf 1114 studies identified by our search, 55 were ultimately included. Exacerbation rates decreased by 6.7% (95% CI (4.4, 9.0); pB < 0.001) per year, or 50% (95% CI (36, 61)) per decade. Adjusting for available study and baseline characteristics such as forced expiratory volume in 1 s (FEV1) did not alter the observed trend considerably. Two subsets of studies, one using a true placebo group and the other allowing inhaled corticosteroids in the "placebo" group, also yielded consistent results.ConclusionsIn conclusion, this meta-regression indicates that the rate of COPD exacerbations decreased over the past two decades to a clinically relevant extent independent of important prognostic factors. This suggests that care is needed in the design of new trials or when comparing results from older trials with more recent ones. Also a considerable effect of adjunct therapy on COPD exacerbations can be assumed.RegistrationPROSPERO 2018 CRD4218118823.
| S-EPMC6697937 | biostudies-literature
Project description:Lactobacillus plantarum is a lactic acid bacterium that produces a racemic mixture of l- and d-lactate from sugar fermentation. The interconversion of lactate isomers is performed by a lactate racemase (Lar) that is transcriptionally controlled by the l-/d-lactate ratio and maximally induced in the presence of l-lactate. We previously reported that the Lar activity depends on the expression of two divergently oriented operons: (i) the larABCDE operon encodes the nickel-dependent lactate racemase (LarA), its maturases (LarBCE), and a lactic acid channel (LarD), and (ii) the larR(MN)QO operon encodes a transcriptional regulator (LarR) and a four-component ABC-type nickel transporter [Lar(MN), in which the M and N components are fused, LarQ, and LarO]. LarR is a novel regulator of the Crp-Fnr family (PrfA group). Here, the role of LarR was further characterized in vivo and in vitro. We show that LarR is a positive regulator that is absolutely required for the expression of Lar activity. Using gel retardation experiments, we demonstrate that LarR binds to a 16-bp palindromic sequence (Lar box motif) that is present in the larR-larA intergenic region. Mutations in the Lar box strongly affect LarR binding and completely abolish transcription from the larA promoter (PlarA). Two half-Lar boxes located between the Lar box and the -35 box of PlarA promote LarR multimerization on DNA, and point mutations within one or both half-Lar boxes inhibit PlarA induction by l-lactate. Gel retardation and footprinting experiments indicate that l-lactate has a positive effect on the binding and multimerization of LarR, while d-lactate antagonizes the positive effect of l-lactate. A possible mechanism of LarR regulation by lactate enantiomers is proposed.
| S-EPMC4288682 | biostudies-literature
Project description:ObjectiveOpioid-related harm has risen in recent decades, but limited research describes the clinical burden of opioid poisoning to Australian EDs. We aimed to investigate hospital presentations with opioid poisoning over three decades.MethodsThis is an observational series of prospectively collected data investigating presentations of opioid poisoning to an ED in Newcastle (1990-2021). Type of opioid, naloxone administration, intubation, intensive care unit (ICU) admission, length of stay and death were extracted from the unit's database.ResultsThere were 4492 presentations in 3574 patients (median age 36, 57.7% female), increasing from an average of 93 presentations annually in the first decade to 199 in the third decade. Deliberate self-poisonings accounted for 3694 presentations (82.2%). Heroin dominated the 1990s, peaking in 1999 before decreasing. Prescription opioids then rose, with codeine (usually in paracetamol combination) predominating until 2018, after which oxycodone presentations exceeded them. Methadone consistently increased from six presentations annually in the first decade to 16 in the last decade. Naloxone was administered in 990 (22.0%) presentations and 266 (5.9%) were intubated, most frequently following methadone and heroin exposures. ICU admissions increased from 5% in 1990 to 16% in 2021. Codeine exposures resulted in less severe effects, whereas methadone had more severe effects overall. The median length of stay was 17 h (interquartile range 9-27 h). There were 28 deaths (0.6%).ConclusionOpioid presentations increased in number and severity over three decades as the type of opioid changed. Oxycodone is currently the main opioid of concern. Methadone poisoning was the most severe.
| S-EPMC10947284 | biostudies-literature
Project description:BackgroundIndia is the second most populated country in the world with 41% of the population (492 million) under 18 years of age. While numerous studies have shown an increasing prevalence of myopia worldwide, there continues to be uncertainty about the magnitude of myopia in Indian school going population.DesignSystematic review and meta-analysis.MethodsWe systematically identified published literature of last four decades from 1980 to March 2020 and assessed them for methodological quality. Data were gathered into 5-year age groups from 5-15, in urban or rural populations, and standardized to definition of myopia as refractive error ≥ -0.50 dioptre. Random effects meta-analysis was done.ResultsWe included data from 59 quality assessed studies, covering nearly 1,66,000 urban and 1,20,000 rural children. The overall crude prevalence of myopia over last four decades is 7.5% (95% CI, 6.5-8.5%) in 5-15-year age group. The prevalence of myopia is 8.5% (95% CI, 7.1-9.9%) in urban and 6.1% (95% CI, 4.5-7.7%) in rural children, with highest prevalence in urban 11-15-year age group [15.0% in last decade]. A significant increment in prevalence is noted in the last decade in rural children from 4.6% to 6.8%, reflecting changing rural environment.ConclusionMyopia is an emerging public health problem in both urban and rural school going adolescents in India requiring urgent efforts.
| S-EPMC7571694 | biostudies-literature