Search Results (45)

Background: Nucleotide-binding oligomerization domain-containing protein 2, encoded by NOD2, can trigger chronic gut inflammation that leads to colorectal cancer (CRC). However, studies that have investigated the association of NOD2 polymorphisms and CRC susceptibility have produced inconsistent findings. To clarify this relationship, a meta-analysis was conducted to integrate data from previous studies to achieve a more precise evaluation of the risk association. Methods: PubMed, Scopus, and Web of Science databases were systematically searched to identify relevant studies on the association of NOD2 polymorphisms with CRC risk. Genetic risk association was quantitatively assessed under five genetic models: homozygous, heterozygous, dominant, recessive, and allele. Thirteen studies, comprising 5,013 cases and 4,463 controls, were included in this study. Four NOD2 polymorphisms were investigated in these studies, namely rs2066842, rs2066844, rs2066845, and rs2066847. Results: Of these, only rs2066845 and rs2066847 were found to be significantly associated with increased CRC risk (rs2066845, heterozygous OR = 1.544, 95% CI = 1.014–2.349, P = 0.043; dominant OR = 1.561, 95% CI = 1.035–2.354, P = 0.034; allele OR = 1.572, 95% CI = 1.040–2.375, P = 0.032; rs2066847, heterozygous OR = 1.321, 95% CI = 1.060–1.647, P = 0.013; dominant OR = 1.402, 95% CI = 1.147–1.713, P = 0.001; allele OR = 1.345, 95% CI = 1.088–1.663, P = 0.006). Conclusions: In conclusion, the NOD2 rs2066845 and rs2066847 polymorphisms are associated with an increased risk of CRC and may potentially serve as predisposition biomarkers for the cancer. Full article

Background: Critical thinking is fundamental for registered nurses (RNs) when making clinical decisions, which impact patient outcomes. This review aimed to identify studies on critical thinking and clinical decision making among nurses in clinical practice and synthesize their findings based on the regional area, observed findings, and predictive factors, and to assess the measurement tools used. Methods: A comprehensive search of the PubMed, Web of Science, CINAHL, and SCOPUS databases up to December 2024 was conducted in accordance with the PRISMA guidelines. The Newcastle–Ottawa Scale was used to assess the quality of included studies. Studies with similarly themed components were grouped for narrative synthesis. A meta-analysis of random-effects model calculations was performed. Results: This review included forty studies (twenty-four on CT, twelve on CDM, four on both) from various WHO regions, revealing diverse findings on observed skills. Ten CT and four CDM measurement tools were identified. Many studies also explored individual and group-level predictive factors for these skills. Meta-analyses of four common tools (CCTDI, NCT4P, CDMNS, and NDMI) showed significant heterogeneity, with statistically significant pooled mean scores. Conclusions: The synthesis highlights the global research on nurses’ critical thinking and clinical decision making, including the exploration of various predictive factors. However, the significant heterogeneity in the findings from meta-analyses of commonly used measurement tools underscores a need for more standardized measurement and analytical approaches, such as multilevel modeling, to better account for the hierarchical nature of potential predictive factors (individual and group levels), which would allow for more reliable comparisons and stronger conclusions in this field. Full article

We present a machine learning driven system to monitor joint flexion angles during dynamic motion, using a wearable loop-based sensor. Our approach uses wearable loops to collect transmission coefficient data and an Artificial Neural Network (ANN) with fine-tuned parameters to increase accuracy of the measured angles. We train and validate the ANN for sagittal plane flexion of a leg phantom emulating slow motion, walking, brisk walking, and jogging. We fabricate the loops on conductive threads and evaluate the effect of fabric drift via measurements in the absence and presence of fabric. In the absence of fabric, our model produced a root mean square error (RMSE) of 5.90°, 6.11°, 5.90°, and 5.44° during slow motion, walking, brisk walking, and jogging. The presence of fabric degraded the RMSE to 8.97°, 7.21°, 9.41°, and 7.79°, respectively. Without the proposed ANN method, errors exceeded 35.07° for all scenarios. Proof-of-concept results on three human subjects further validate this performance. Our approach empowers feasibility of wearable loop sensors for motion capture in dynamic, real-world environments. Increasing speed of motion and the presence of fabric degrade sensor performance due to added noise. Nevertheless, the proposed framework is generalizable and can be expanded upon in the future to improve upon the reported angular resolution. Full article

Primary antiphospholipid syndrome (PAPS) is a systemic autoimmune disorder, characterised by consistently high levels of antiphospholipid antibodies, thrombosis, and/or pregnancy morbidity. Due to various suspected causes, deficient or insufficient levels of vitamin D in the serum have been reported in patients with PAPS; however, the reports have been sporadic and inconclusive. This systematic review and meta-analysis aimed to comprehensively evaluate the serum vitamin D levels in patients with PAPS compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42019132128) and a systematic literature search was conducted through Google Scholar, PubMed, Web of Science, Scopus, and ScienceDirect databases without restricting language and year. Pooled prevalence, mean difference (MD), and odds ratio (OR) along with 95% confidence intervals (CI) were determined by using a random effects model. Study quality was assessed by the Joana Brigg’s Institute (JBI) protocol and publication bias was evaluated by a trim and fill funnel plot, Begg’s, and Egger’s tests. The pooled prevalence of vitamin D deficiency and insufficiency was found to be 32.2% [95% CI: 16.3–48.2] and 61.5% [95% CI: 40.2–82.8], respectively. Serum levels of vitamin D were considerably lower in the PAPS patients compared to controls (MD: −5.75, 95% CI: −9.73 to −1.77; p = 0.005). Multiple sensitivity analyses showed that the results remained statistically significant, demonstrating the robustness of this meta-analysis. No significant publication bias was detected in determining the MD of serum vitamin D levels in PAPS and controls. In conclusion, PAPS patients had greater rates of vitamin D deficiency or insufficiency, higher frequency of thrombosis, and lower serum vitamin D levels than healthy individuals. Full article

Zika virus (ZIKV) and chikungunya virus (CHIKV) are arthropod-borne viruses with significant pathogenicity, posing a substantial health and economic burden on a global scale. Moreover, ZIKV-CHIKV coinfection imposes additional therapeutic challenges as there is no specific treatment for ZIKV or CHIKV infection. While a growing number of studies have documented the ZIKV-CHIKV coinfection, there is currently a lack of conclusive reports on this coinfection. Therefore, we performed a systematic review and meta-analysis to determine the true statistics of ZIKV-CHIKV coinfection in the global human population. Relevant studies were searched for in PubMed, Scopus, and Google Scholar without limitation in terms of language or publication date. A total of 33 studies containing 41,460 participants were included in this meta-analysis. The study protocol was registered with PROSPERO under the registration number CRD42020176409. The pooled prevalence and confidence intervals of ZIKV-CHIKV coinfection were computed using a random-effects model. The study estimated a combined global prevalence rate of 1.0% [95% CI: 0.7–1.2] for the occurrence of ZIKV-CHIKV coinfection. The region of North America (Mexico, Haiti, and Nicaragua) and the country of Haiti demonstrated maximum prevalence rates of 2.8% [95% CI: 1.5–4.1] and 3.5% [95% CI: 0.2–6.8], respectively. Moreover, the prevalence of coinfection was found to be higher in the paediatric group (2.1% [95% CI: 0.0–4.2]) in comparison with the adult group (0.7% [95% CI: 0.2–1.1]). These findings suggest that the occurrence of ZIKV-CHIKV coinfection varies geographically and by age group. The results of this meta-analysis will guide future investigations seeking to understand the underlying reasons for these variations and the causes of coinfection and to develop targeted prevention and control strategies. Full article

The dysregulation of non-coding RNAs (ncRNAs), specifically microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), leads to the development and advancement of multiple myeloma (MM). miRNAs, in particular, are paramount in post-transcriptional gene regulation, promoting mRNA degradation and translational inhibition. As a result, miRNAs can serve as oncogenes or tumor suppressors depending on the target genes. In MM, miRNA disruption could result in abnormal gene expression responsible for cell growth, apoptosis, and other biological processes pertinent to cancer development. The dysregulated miRNAs inhibit the activity of tumor suppressor genes, contributing to disease progression. Nonetheless, several miRNAs are downregulated in MM and have been identified as gene regulators implicated in extracellular matrix remodeling and cell adhesion. miRNA depletion potentially facilitates the tumor advancement and resistance of therapeutic drugs. Additionally, lncRNAs are key regulators of numerous cellular processes, such as gene expression, chromatin remodeling, protein trafficking, and recently linked MM development. The lncRNAs are uniquely expressed and influence gene expression that supports MM growth, in addition to facilitating cellular proliferation and viability via multiple molecular pathways. miRNA and lncRNA alterations potentially result in anomalous gene expression and interfere with the regular functioning of MM. Thus, this review aims to highlight the dysregulation of these ncRNAs, which engender novel therapeutic modalities for the treatment of MM. Full article

The assurance of safety and effectiveness is a significant focal point in all therapeutic approaches. Although mesenchymal stem cells (MSCs) have been identified as a potential novel therapeutic strategy for multiple sclerosis (MS), existing evidence regarding the effectiveness and safety of this strategy remains inconclusive. Thus, the primary aim of this systematic review and meta-analysis (SRMA) was to comprehensively assess the effectiveness and safety of MSC therapy in individuals diagnosed with MS. A comprehensive search was conducted using appropriate keywords in the PubMed, Scopus, Cochrane, ScienceDirect, and Google Scholar databases to determine the eligible studies. The change in the expanded disability status scale (EDSS) score from baseline to follow-up was used to assess MSC efficacy. The effectiveness of the therapy was assessed using a random-effects model, which calculated the combined prevalence and 95% confidence intervals (CIs) for MS patients who experienced improvement, stability, or worsening of their condition. The protocol was registered in PROSPERO (CRD42020209671). The findings indicate that 40.4% (95% CI: 30.6–50.2) of MS patients exhibited improvements following MSC therapy, 32.8% (95% CI: 25.5–40.1) remained stable, and 18.1% (95% CI: 12.0–24.2) experienced a worsening of their condition. Although no major complications were observed, headaches 57.6 [37.9–77.3] and fever 53.1 [20.7–85.4] were commonly reported as minor adverse events. All of the results reported in this meta-analysis are consistent and credible according to the sensitivity analyses. Regardless of different individual studies, our meta-analysis provides a comprehensive overview showing the potential of MSC therapy as a possible effective treatment strategy for patients with MS. Full article

Background: Multiple myeloma (MM) is a hematological malignancy characterized by the exponential growth of malignant plasma cells. Individuals diagnosed with MM exhibit a deficiency in vitamin D and may suffer fatigue, a loss of muscular strength, persistent musculoskeletal aches, and pain. The objective of this systematic review and meta-analysis is to determine the prevalence of vitamin D insufficiency and deficiency in individuals diagnosed with MM. Methods: We searched five electronic databases using relevant keywords. The quality of the included studies was evaluated using the critical appraisal tool developed by the Joanna Briggs Institute. We employed a random-effects model and presented the findings in the form of percentages accompanied by 95% confidence intervals (CI). This protocol has been officially registered in PROSPERO under the registration number CRD42021248710. Results: The meta-analysis comprised a total of eighteen studies and found that, among patients with MM, the occurrence of serum vitamin D deficiency and insufficiency was 39.4% (95% CI: 25.8 to 52.9, n = 3746) and 34.1% (95% CI: 20.9 to 47.2, n = 3559), respectively. The findings indicate that a greater proportion of newly diagnosed patients exhibited vitamin D deficiency and insufficiency, with rates of 43.0% and 41.6%, respectively, compared to those receiving treatment (rates of 41.6% and 32.3%, respectively). The findings of the sensitivity analyses were consistent, and most of the studies (72.2%) were deemed to be of high quality. The results of Egger’s test indicated the absence of publication bias. Conclusions: Patients diagnosed with MM have been found to exhibit significantly elevated levels of both vitamin D deficiency and insufficiency. Therefore, it is recommended to consider vitamin D testing as an additional parameter in the current criteria for the clinical evaluation of MM. Full article

Burkitt lymphoma (BL) is a form of B-cell malignancy that progresses aggressively and is most often seen in children. While Epstein–Barr virus (EBV) is a double-stranded DNA virus that has been linked to a variety of cancers, it can transform B lymphocytes into immortalized cells, as shown in BL. Therefore, the estimated prevalence of EBV in a population may assist in the prediction of whether this population has a high risk of increased BL cases. This systematic review and meta-analysis aimed to estimate the prevalence of Epstein–Barr virus in patients with Burkitt lymphoma. Using the appropriate keywords, four electronic databases were searched. The quality of the included studies was assessed using the Joanna Briggs Institute’s critical appraisal tool. The results were reported as percentages with a 95% confidence interval using a random-effects model (CI). PROSPERO was used to register the protocol (CRD42022372293), and 135 studies were included. The prevalence of Epstein–Barr virus in patients with Burkitt lymphoma was 57.5% (95% CI: 51.5 to 63.4, n = 4837). The sensitivity analyses demonstrated consistent results, and 65.2% of studies were of high quality. Egger’s test revealed that there was a significant publication bias. EBV was found in a significantly high proportion of BL patients (more than 50% of BL patients). This study recommends EBV testing as an alternative for predictions and the assessment of the clinical disease status of BL. Full article

Shigella is the leading global etiological agent of shigellosis, especially in poor and underdeveloped or developing nations with insufficient sanitation such as Bangladesh. Antibiotics are the only treatment option for the shigellosis caused by Shigella spp. as no effective vaccine exists. However, the emergence of antimicrobial resistance (AMR) poses a serious global public health concern. Therefore, a systematic review and meta-analysis were conducted to establish the overall drug resistance pattern against Shigella spp. in Bangladesh. The databases of PubMed, Web of Science, Scopus, and Google Scholar were searched for relevant studies. This investigation comprised 28 studies with 44,519 samples. Forest and funnel plots showed any-drug, mono-drug, and multi-drug resistance. Any fluoroquinolone had a resistance rate of 61.9% (95% CI: 45.7–83.8%), any trimethoprim–sulfamethoxazole—60.8% (95% CI: 52.4–70.5%), any azithromycin—38.8% (95% CI: 19.6–76.9%), any nalidixic acid—36.2% (95% CI: 14.2–92.4%), any ampicillin—34.5% (95% CI: 25.0–47.8%), and any ciprofloxacin—31.1% (95% CI: 11.9–81.3%). Multi-drug-resistant Shigella spp. exhibited a prevalence of 33.4% (95% CI: 17.3–64.5%), compared to 2.6% to 3.8% for mono-drug-resistant strains. Since resistance to commonly used antibiotics and multidrug resistance were higher, a judicious use of antibiotics, the promotion of infection control measures, and the implementation of antimicrobial surveillance and monitoring programs are required to tackle the therapeutic challenges of shigellosis. Full article

Antiphospholipid antibodies are highly prevalent in autoimmune diseases and mainly associated with thromboembolic events, which is one of the major reasons for cancer-related mortality. Confirmed adult cancer patients were included (n = 40) with an equal number of age- and sex-matched healthy controls. The presence and concentration of anticardiolipin antibodies were investigated by the enzyme-linked immunosorbent assay using the venous blood samples. aCL antibodies were detected in 60.0% (n = 24) of the cancer patients compared to none in the healthy controls (p < 0.001). The serum concentration of aCL antibodies was significantly higher in cancer patients than controls (p < 0.001) and ranged from 89.0 U/mL to 133.0 U/mL among the aCL-positive patients. All the lung cancer patients (n = 6) were diagnosed with positive aCL, and a borderline significant association of aCL antibody positivity was observed in colon cancer patients (p = 0.051). About 72.7% of the advanced-stage cancer individuals and 81.8% of the cancer patients who underwent surgery were diagnosed with positive aCL antibodies. A significant association of aCL antibody positivity was observed with cancer patients comorbid with heart diseases (p = 0.005). The prevalence and serum levels of aCL antibodies were significantly higher in cancer patients compared to healthy controls. Cancer patients (i.e., lung, liver, and colon), at advanced-stage, comorbid with heart diseases, who underwent surgery, were more likely to be diagnosed with aCL antibodies. Full article

Background: Metabolic syndrome (MetS) is considerably higher worldwide. It varies greatly in different populations geographically and based on criteria used to diagnose the disease. This review was conducted to determine the prevalence of MetS among apparently healthy adults of Pakistan. A systematic review was performed on Medline/PubMed, SCOPUS, ScienceDirect, Google Scholar, and Web of Science databases until July 2022. Articles published on Pakistani healthy adult population reporting MetS were included. Pooled prevalence was reported with 95% confidence interval (CI). Of 440 articles, 20 articles met the eligibility. Results: The pooled prevalence of MetS was 28.8% (95% CI: 17.8–39.7). The maximum prevalence was from a sub-urban village of Punjab (68%, 95% CI: 66.6–69.3) and Sindh province (63.7%, 95% CI: 61.1–66.3). International Diabetes Federation guidelines had shown 33.2% (95% CI: 18.5–48.0) whereas National Cholesterol Education Program guidelines showed 23.9% (95% CI: 8.0–39.8) prevalence of MetS. Furthermore, individuals with low high-density lipoprotein (HDL) 48.2% (95% CI: 30.8–65.6), central obesity 37.1% (95% CI: 23.7–50.5), and high triglyceride 35.8% (95% CI: 24.3–47.3) showed higher prevalence. Conclusion: A considerably higher prevalence of MetS was observed among apparently healthy individuals in Pakistan. High triglyceride, low HDL, and central obesity were found as significant risk factors. (Registration # CRD42022335528) Full article

The prevalence of anemia is high among children and adolescents in low- and middle-income countries because of undernutrition resulting from their poor socioeconomic status and lack of knowledge on proper nutrition. We conducted a systematic review and meta-analysis to determine the prevalence of anemia among children and adolescents aged between 6 months and 19 years in Bangladesh. Databases such as PubMed, Scopus, and Google Scholar were searched to identify the studies that reported the prevalence of anemia among children and adolescents. A total of 24 studies, including the data of 14,062 cases, were included in the systematic review and meta-analysis of the time period between 1997 and 2019. The random-effects model was used to calculate the summary estimates. The protocol was registered with PROSPERO (CRD42021246960). The pooled prevalence of anemia, iron deficiency anemia (IDA), and non-severe and severe anemia were 46.8% [95% CI: 36.0–57.6], 13.6% [95% CI: 8.0–19.2], 56.4% [95% CI: 39.6–73.1] and 0.7% [95% CI: 0.1–1.4], respectively. Prevalence of anemia exhibited the highest among the children aged ≤2 years. Briefly, 91.67% of the studies were of high quality. No significant publication bias was found; however, two outlier studies were detected. The prevalence of anemia among children and adolescents was estimated as high in Bangladesh. Full article

Classical BCR-ABL-negative myeloproliferative neoplasms (MPN) include polycythaemia vera, essential thrombocythaemia, and primary myelofibrosis. Unlike monogenic disorders, a more complicated series of genetic mutations are believed to be responsible for MPN with various degrees of thromboembolic and bleeding complications. Thrombosis is one of the early manifestations in patients with MPN. To date, the driver genes responsible for MPN include JAK2, CALR, MPL, TET2, ASXL1, and MTHFR. Affords have been done to elucidate these mutations and the incidence of thromboembolic events. Several lines of evidence indicate that mutations in JAK2, MPL, TET2 and ASXL1 gene and polymorphisms in several clotting factors (GPIa, GPIIa, and GPIIIa) are associated with the occurrence and prevalence of thrombosis in MPN patients. Some polymorphisms within XRCC1, FBG, F2, F5, F7, F12, MMP9, HPA5, MTHFR, SDF-1, FAS, FASL, TERT, ACE, and TLR4 genes may also play a role in MPN manifestation. This review aims to provide an insightful overview on the genetic perspective of thrombotic complications in patients with MPN. Full article

Obtaining the exact position of accumulated calcium on the inner walls of coronary arteries is critical for successful angioplasty procedures. For the first time to our knowledge, in this work, we present a high accuracy imaging of the inner coronary artery using microwaves for precise calcium identification. Specifically, a cylindrical catheter radiating microwave signals is designed. The catheter has multiple dipole-like antennas placed around it to enable a 360° field-of-view around the catheter. In addition, to resolve image ambiguity, a metallic rod is inserted along the axis of the plastic catheter. The reconstructed images using data obtained from simulations show successful detection and 3D localization of the accumulated calcium on the inner walls of the coronary artery in the presence of blood flow. Considering the space and shape limitations, and the highly lossy biological tissue environment, the presented imaging approach is promising and offers a potential solution for accurate localization of coronary atherosclerosis during angioplasty or other related procedures. Full article