Summary Of Review Research Articles

Effects of a gluten-reduced or gluten-free diet for the primary prevention of cardiovascular disease: Summary of a Cochrane review

Effects of a gluten-reduced or gluten-free diet for the primary prevention of cardiovascular disease: Summary of a Cochrane review

Is Exercise Beneficial in Patients with Low Back Pain? - A Cochrane Review Summary with Commentary.

The aim of this commentary is to discuss from a rehabilitation perspective the Cochrane Review "Exercise therapy for chronic low back pain" (1) by Hayden JA, Ellis J, Ogilvie R, Malmivaara A and van Tulder MW [1] published by Cochrane Musculoskeletal Group. This Cochrane Corner is produced in agreement with Journal of Rehabilitation Medicine by Cochrane Rehabilitation with views* of the review summary authors in the "implications for practice" section. This summary is based on a Cochrane Review previously published in the Cochrane Database of Systematic Reviews 2021, Issue 9, Art. No.:CD009790, DOI: 10.1002/14651858.CD009790.pub2 (see www.cochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review. * The views expressed in the summary with commentary are those of the Cochrane Corner author (different than the original Cochrane Review authors) and do not represent the Cochrane Library or Journal of Rehabilitation Medicine.

Does Exercise-Based Cardiac Rehabilitation Reduce Mortality and Hospitalization Rates After Heart Valve Surgery?: A Cochrane Review Summary With Commentary.

Does Exercise-Based Cardiac Rehabilitation Reduce Mortality and Hospitalization Rates After Heart Valve Surgery?: A Cochrane Review Summary With Commentary.

Taxation of novel and emerging nicotine and tobacco products (HTPs, ENDS, and ENNDS) globally and in Latin America

ABSTRACTThis article provides a snapshot of the market structure and regulatory approaches around novel and emerging tobacco and nicotine products, both globally and in Latin America, with a focus on excise taxation. Using data from leading market research companies, the WHO Report on the Global Tobacco Epidemic 2021, and country laws and decrees, the article analyses the evolution and market structure of heated tobacco products (HTPs), electronic nicotine delivery systems (ENDS), and electronic non-nicotine delivery systems (ENNDS). This is followed by a summary review of regulatory approaches adopted by countries toward these products, with a particular focus on excise tax policies currently implemented. Based on the well-established knowledge about tobacco taxation best practices and on WHO’s recent recommendations on the taxation of novel and emerging tobacco and nicotine products, the authors then discuss possible elements of a good tax policy approach for countries to consider.

The use of special approval medicines among pediatric patients in a tertiary care hospital: A reality check

BackgroundSpecial approval medicines (SAMs) are medicines used with approval from the Director General of Health Malaysia when the therapeutic options within regulatory and formulary boundaries appear unsuitable or ineffective to treat the patients. ObjectivesTo examine and characterize the use of SAMs among children in a Malaysian tertiary care hospital. MethodsThe named-patient basis SAM application forms, cover letter, pharmacist review summary and patient monitoring forms available at the Pharmacy Department between 1st January 2019 and 31st December 2020 were reviewed. Unprocessed, unapproved and stock-basis applications were excluded. The outcome measures were categories, scope, off-label use and cost of SAM. Per-patient data were analyzed descriptively. ResultsOverall, 1010 patients (mean age of 8.7 ± 5.6 years) were involved in 328 SAMs applications. The most common SAMs pharmacological groups were nervous system (n = 371, 36.7%) and antineoplastic and immunomodulating agents (n = 332, 32.9%). Top three SAMs were melatonin (11.5%), scopolamine (7.6%) and cholecalciferol (7.1%). A total of 837 (82.9%) and 513 (50.8%) patients were involved in the SAMs applications for non-formulary and unregistered medicines, respectively. Unregistered, non-formulary medicines were applied for 47.3% (n = 478) of the patients. The majority of the scope for SAMs (64.7%) were to substitute the available alternatives in the national formulary which were ineffective or sub-optimal for the patients. Among the 262 patients with repeat applications, 93.8% reported disease or symptom improvement while 1.9% experienced side effects. Up to 17% of SAMs analyzed in this study were used for off-label indications. The total cost of the SAMs was RM8,748,358.38 (USD 2,090,418.86). ConclusionThe use of SAMs among children in this hospital involved unregistered, non-formulary medicines used to substitute the available alternatives in the formulary. A concerted effort is warranted in exploring supplementary mechanisms to enhance the medicine registration process and formulary system towards facilitating enhanced provision of treatment for children.

Evidence (-based medicine) in manual medicine/manual therapy—a summary review

Abstract Objective The aim of this summary review is to analyse the current state of evidence in manual medicine or manual therapy. Methods The literature search focussed on systematic reviews listed in PubMed referring to manual medicine treatment until the beginning of 2022, limited to publications in English or German. The search concentrates on (1) manipulation, (2) mobilization, (3) functional/musculoskeletal and (4) fascia. The CASP Checklist for Systematic Reviews was used to present the included reviews in a clear way. Results A total of 67 publications were included and herewith five categories: low back pain, neck pain, extremities, temporomandibular disorders and additional effects. The results were grouped in accordance with study questions. Conclusion Based on the current systematic reviews, a general evidence-based medicine level III is available, with individual studies reaching level II or Ib. This allows manual medicine treatment or manual therapy to be used in a valid manner.

Bandaging products and topical therapeutics: a summary review

One of the most important aspects of wildlife rehabilitation is successful wound management. Wounds come in a vast diversity of types, including abrasions, lacerations, partial and full thickness wounds, punctures, abscesses, chronicwounds and burns, to name just a few. To properly treat a wound, it is imperative to understand not only the type of wound being treated and the mechanics of how the wound occurred and will hopefully heal, but also the products andsupplies available to facilitate healing.

Accuracy of ICD-10 codes for patients with acute myocarditis: a retrospective study at a large tertiary centre in London, UK

Abstract Background Acute myocarditis (AM) is an inflammatory disease of the myocardium that is associated with heterogenous clinical presentations, which may be non-specific. Furthermore, several cardiac diseases can mimic its clinical phenotype. Research in AM frequently utilises ICD-10 codes from hospital admissions for case identification. We retrospectively confirmed or refuted a diagnosis of AM according to ESC Position Statement criteria in patients with an ICD-10 code for AM. Methods We performed a single-centre retrospective analysis of all unique admissions with ICD-10 codes corresponding to myocarditis or myopericarditis in the first three coding positions at King's College Hospital, London, United Kingdom. The diagnosis was classified as “confirmed” if proven by cardiac magnetic resonance imaging (CMR) or endomyocardial biopsy (EMB) or “suspected” in the absence of CMR or EMB if other ESC Position Statement criteria were met. To identify additional cases, we used an open-source retrieval system for unstructured clinical data (CogStack). We searched hospital and Intensive Care Unit (ICU) discharge summaries for inpatients discharged alive containing the keywords “myocarditis” or “myopericarditis”. We also searched for patients who died during the study period where the keywords “myocarditis” or “myopericarditis” were included on the death notification. Results We identified 308 unique admissions with an ICD-10 code for myocarditis or myopericarditis in this study, presenting between 2008 and 2020 (Figure 1). Overall, 26.0% of patients (n=80/308) could be excluded from a diagnosis of AM on review of the clinical summary. A total of 16.2% of patients (n=50/308) had insufficient evidence of AM, 1.9% (n=6/308) had not had coronary artery disease excluded as a culprit for the presentation, and 10.1% (n=31/308) had an alternative diagnosis. Only 45.8% (n=141/308) of all patients met criteria for suspected or confirmed AM. Of those, 86.5% (n=122/141) of cases were confirmed by CMR. Overall, 39.6% of patients with an ICD-10 code indicating AM had a confirmed diagnosis. An additional 46 suspected and 197 confirmed cases were identified using open-source retrieval from unstructured clinical data. Conclusion AM has heterogenous and sometimes non-specific clinical presentations, which may be compounded by limited access to CMR and EMB. We identified significant misclassification using ICD-10 codes. It is crucial to ensure that studies investigating AM include only patients meeting appropriate diagnostic criteria, thereby ensuring a high-quality evidence base in this disease. Funding Acknowledgement Type of funding sources: None.

Outpatient and peri-operative antibiotic stewardship in solid organ transplantation.

The consequences of inappropriate antimicrobial use including resistance are increasingly recognized as a global public health threat and many steps have been taken over the last few decades to advance antimicrobial stewardship initiatives with most organ transplant centers currently part of institutions with active antimicrobial stewardship programs. A review of the literature was conducted and articles were categorized according to the topic and relevance in the judgment of the two authors. A summary review of the currently available literature was created with a focus on periprocedural and outpatient antimicrobial stewardship. Limitations in the data were significant and discussed in the review. The principles of antimicrobial stewardship remain important throughout all phases starting with periprocedural prophylactic antimicrobial selection all the way through to discharge and subsequent healthcare encounters. Despite the broad advances in stewardship initiatives and the rapidly progressing supportive data overall there continue to be significant opportunities for additional research within various special patient populations including recipients of solid organ transplantation (SOT). The recent white paper published in the American Journal of Transplantation called to action the transplant and stewardship communities to have an increased focus and awareness of the issues that antimicrobial overuse can present in the SOT patient population. This is an important step that will hopefully generate more data in this group of patients that arguably faces the greatest vulnerability to the consequences of increased antimicrobial resistance.

How effective and safe are non-drug treatments for spatial neglect following non-progressive brain injury? A Cochrane Review summary with commentary.

Around 30% of stroke survivors experience spatial neglect. Spatial neglect hinders rehabilitation outcomes and increases the risk of injury. Non-pharmacological interventions are available, yet their efficacy is unknown. To evaluate the effectiveness of non-pharmacological interventions for spatial neglect (inattention) following stroke and other non-progressive brain injuries. A summary of the Cochrane Review by Longley et al. 2020, with comments from a rehabilitation perspective. A total of 43 studies were included in meta-analysis and the quality of evidence was very low for all analyses. The benefits or risks associated with each intervention for spatial neglect including visual treatment, prism adaptation training, body awareness, mental function, movement treatment, non-invasive brain stimulation, electrical stimulation, and acupuncture remain unclear. Evidence in support or against the treatments is sparse and more rigorous studies are needed to evaluate their efficacy. Clinicians should continue to follow current guidelines when available to meet patients' rehabilitation goals.

State of the art on vibration signal processing towards data‐driven gear fault diagnosis

Gear fault diagnosis (GFD) based on vibration signals is a popular research topic in industry and academia. This paper provides a comprehensive summary and systematic review of vibration signal-based GFD methods in recent years, thereby providing insights for relevant researchers. The authors first introduce the common gear faults and their vibration signal characteristics. The authors overview and compare the common feature extraction methods, such as adaptive mode decomposition, deconvolution, mathematical morphological filtering, and entropy. For each method, this paper introduces its idea, analyses its advantages and disadvantages, and reviews its application in GFD. Then the authors present machine learning-based methods for gear fault recognition and emphasise deep learning-based methods. Moreover, the authors compare different fault recognition methods. Finally, the authors discuss the challenges and opportunities towards data-driven GFD.

The Third Sector and Climate Change: A Literature Review and Agenda for Future Research and Action

This article presents a summary review of the voluntary sector literature on third sector organizations (TSOs) and climate change. As governments around the world fail to respond adequately to the climate crisis, TSOs are called upon to work with governments, advocate for policy change, and support communities. However, the literature on TSOs and climate change remains limited. We reviewed 68 articles about TSOs and climate change and identified four mechanisms for voluntary action on climate change, which vary on two dimensions—focusing on advocacy or implementation and occurring within or outside government—and include policy advocacy, advocacy for behavior change, participation in governance, and direct interventions. We conclude with five key areas for future research: explaining the relationship between advocacy strategies and context, foregrounding the role of TSOs in climate governance, exploring direct interventions by TSOs, examining community-based TSOs, and linking TSO action and climate outcomes.

Monitoring for atrial fibrillation prior to patent foramen ovale closure after cryptogenic stroke.

Patients who had a cryptogenic stroke (CS) suspected to be causally related to a patent foramen ovale (PFO) are candidates for percutaneous PFO closure. In such patients, it is important to screen for atrial fibrillation (AF). Limited guidance is available regarding AF monitoring strategies in CS patients with PFO addressing optimal monitoring technology and duration. To provide a narrative review of cardiac rhythm monitoring in CS patients considered for PFO closure, including current practices, stroke recurrences after CS, findings from monitoring studies in CS patients, and predictors for AF detection published in the literature. To propose a personalized strategy for cardiac monitoring in CS patients, accounting for aspects predicting AF detection. AF detection in CS patients is predicted by age, left atrial enlargement, prolonged PR interval, frequent premature atrial contractions, interatrial conduction block, diabetes, prior brain infarctions, leukoaraiosis, elevated B-type natriuretic peptide (BNP)/N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and a family history of AF, as well as composed scores (e.g. CHA2DS2-VASc, atrial fibrillation in embolic stroke of undetermined source (AF-ESUS)). The causal role of the PFO may be accounted for by the risk of paradoxical embolism (RoPE) score and/or the PFO-Associated Stroke Causal Likelihood (PASCAL) classification. A personalized approach to AF detection in CS patients is proposed, accounting for the likelihood of AF detection and aimed at obtaining sufficient confidence regarding the absence of AF in patients considered for PFO closure. In addition, the impact of high-risk PFO features on the monitoring strategy is discussed.

Web-Based Electronic Health Record Program: A Twelve-Month Evaluation on Pharmacist’s Intervention in Medicare Part D Annual Comprehensive Medication Review

Objective:The objective of this study was to evaluate the impact of pharmacist’s intervention on annual comprehensive medication review (Annual CMR) for Medicare Part D beneficiaries. Background: To develop a new approach to assess Medicare Part D Annual CMR using a technological tool. Methods: One hundred sixty-three (163) eligible Medicare Part D beneficiaries were enrolled. By using an Electronic Health Record (EHR) Program, the pharmacist was able to assess laboratory, pharmacy, diagnosis, and patient information. A post-medication review summary was provided to the medical providers and patients which included a medication action plan. At the end of 3 months, 6 months and 12 months after the medication review, data were collected, assessed and compared. Results: The study showed that pharmacist’s interventions were recommended to seventy-four (74) enrollees which comprised of 45% of the total enrollees. It showed that at 3-month, 6-month, and 12-month intervals after the medication review, the recommended interventions acknowledged and implemented by the medical providers were 20%, 51% and 64% respectively, which showed a significant difference over a 12-month period (P-value <.05). Different types of pharmacist’s interventions that were recommended may include to initiate, to adjust and to discontinue medication. The most common disease states that required interventions were psychiatric disorder, cardiovascular disease, pulmonary disease, gastrointestinal disease, diabetes, dyslipidemia and pain. Conclusion: The finding of this study revealed that such a web-based EHR system was a very meaningful and effective tool in assisting pharmacists to assess the proper and safe use of medication in elderly patients.

Workplace-based Interventions to Increase Mammography Screening in Islamic Countries: A Systematic Review and Narrative SummaryWorkplace-based Interventions to Increase Mammography Screening in Islamic Countries: A Systematic Review and Narrative Summary

Introduction: Breast cancer is a contributing factor to women’s death. Mammography screening uptake is low in Islamic countries compared to non-Islamic countries. In Saudi Arabia, a first step is to develop an appropriate intervention at workplace to increase mammography screening rates, this review was conducted to update current knowledge on the effectiveness of existing workplace interventions to enhance mammography screening uptake in Saudi Arabia. Methods: A systematic review and narrative syntheses was conducted. All studies that assessed the effectiveness of workplace interventions to increase mammography screening uptake among female employees were included. This review was registered on PROSPERO with the number CRD42021281744. Results: Three studies were included. All the studies evaluated a workplace educational intervention aiming to increase mammography screening uptake. It was found that workplace-based interventions increase breast mammography screening uptake while the effectiveness of the existing workplace intervention remains questionable and further research is warranted to improve our understanding of how we can successfully improve mammography screening among women in Islamic countries. Conclusion: This review has demonstrated that the effectiveness of the existing workplace interventions to increase mammography screening uptake remains unclear. It was also found that no studies about workplace interventions in Islamic countries.

From star rating to sentiment rating: using textual content of online reviews to develop more effective reputation systems for peer-to-peer accommodation platforms

ABSTRACT Star ratings on P2P accommodation platforms are highly positive. Such biases have led many users to utilise selective processing strategies to evaluate the textual content of online reviews. However, when many reviews are available for a product or a service, these strategies would be suboptimal at best, posing several challenges to the users of peer-to-peer (P2P) accommodation platforms. To enable the guests to perform more informed evaluations and overcome the challenges that the skewed distribution of star ratings creates for decision-making, we employ content analysis tools to derive an aggregated sentiment score for each listing. Using this score, we define a new measure, called “sentiment rating”, that compares a listing with other similar listings based on their textual reviews. Our choice-based conjoint experiment suggests that unlike users’ initial perception about the function of star rating as the most salient factor in evaluating P2P listings, users actually attribute more importance to sentiment ratings of P2P accommodations. Therefore, a text-based summary of online reviews would indeed help users in evaluating alternatives on a P2P platform and in decision making. We argue that a text-based quantitative summary of user reviews could be a useful supplements to (or substitutes for) star ratings on P2P accommodation platforms and even online retailing websites.

Are Cannabis and Cannabinoids Effective for Symptomatic Treatment in People With Multiple Sclerosis?: A Cochrane Review Summary With Commentary.

Are Cannabis and Cannabinoids Effective for Symptomatic Treatment in People With Multiple Sclerosis?: A Cochrane Review Summary With Commentary.

Predictors of post-stroke cognitive impairment using acute structural MRI neuroimaging: A systematic review and meta-analysis.

Stroke survivors are at an increased risk of developing post-stroke cognitive impairment and post-stroke dementia; those at risk could be identified by brain imaging routinely performed at stroke onset. This systematic review aimed to identify features which are associated with post-stroke cognitive impairment (including dementia) on magnetic resonance imaging (MRI) performed at stroke diagnosis. We searched the literature from inception to January 2022 and identified 10,284 records. We included studies that performed MRI at the time of stroke (0-30 days after a stroke) and assessed cognitive outcome at least 3 months after stroke. We synthesized findings from 26 papers, comprising 27 stroke-populations (N = 13,114, average age range = 40-80 years, 19-62% female). When data were available, we pooled unadjusted (ORu) and adjusted (ORa) odds ratios.We found associations between cognitive outcomes and presence of cerebral atrophy (three studies, N = 453, ORu = 2.48, 95% CI = 1.15-4.62), presence of microbleeds (two studies, N = 9151, ORa = 1.36, 95% CI = 1.08-1.70), and increasing severity of white matter hyperintensities (three studies, N = 704, ORa = 1.26, 95% CI = 1.06-1.49). Increasing cerebral small vessel disease score was associated with cognitive outcome following unadjusted analysis only (two studies, N = 499, ORu = 1.34, 95%CI = 1.12-1.61; three studies, N = 950, ORa = 1.23, 95% CI = 0.96-1.57). Associations remained after controlling for pre-stroke cognitive impairment. We did not find associations between other stroke features and cognitive outcome, or there were insufficient data. Acute stroke MRI features may enable healthcare professionals to identify patients at risk of post-stroke cognitive problems. However, there is still substantial uncertainty about the prognostic utility of acute MRI for this.

Conclusiveness, linguistic characteristics and readability of Cochrane plain language summaries of intervention reviews: a cross-sectional study

BackgroundOne of the most important formats to disseminate the evidence in health to different populations are Cochrane Plain Language Summaries (PLSs). PLSs should be written in a simplified language, easily understandable and providing clear message for the consumer. The aim of this study was to examine the extent to which PLSs are customized for lay persons, specifically by providing conclusive, comprehensible, and readable messages.MethodsThe study analyzed Cochrane PLSs of interventional studies (N = 4360) in the English language published from 1995 to 2019. We categorized the conclusiveness into one of the following categories: “positive”, “positive inconclusive”, “no evidence”, “no opinion”, “negative”, “negative inconclusive”, “unclear”, “equal”, “equal inconclusive”. Language characteristics were analyzed using Linguistic Inquiry and Word Count (LIWC) software. The level of readability was measured by SMOG (Simple Measure of Gobbledygook) index, indicating the number of years of education required to read the text. For each PLS, we also collected the following data: Cochrane Review Network, year of publication and number of authors.ResultsMost of the PLSs (80%) did not have a conclusive message. In 53% PLSs there was no concluding opinion about the studied intervention or the conclusion was unclear. The most frequent conclusiveness category was “no opinion” (30%), and its frequency increased over time. The conclusiveness categories were similarly dispersed across Cochrane Networks. PLSs were written in an objective style, with high levels of analytical tone and clout above neutral, but a lower relation to authenticity and tone. The median number of years of non-specific education needed to read the PLSs was 14.9 (IQR 13.8 to 16.1), indicating that the person needs almost 15 years of general education to read the content with ease.ConclusionMost of the Cochrane PLSs provided no concluding opinion or unclear conclusion regarding the effects of analyzed intervention. Analysis of readability indicated that they may be difficult to read for the lay population without medical education. Our results indicate that PLSs may not be so plain, and that the writing of Cochrane PLSs requires more effort. Tools used in this study could improve PLSs and make them better suited for lay audiences.

Annals for Educators - September 2022

Annals for Educators - September 2022