Physical activity in pregnancy prevents gestational diabetes: A meta-analysis

AimsThe effectiveness of physical activity (PA) programs for prevention of gestational diabetes (GDM) lacks conclusive evidence. The aim of this study was to generate clear evidence regarding the effectiveness of physical activity programs in GDM prevention to guide clinical practice. MethodsPubMed/Medline, ISI Web of Science, Scopus, and EMBASE were searched to identify the randomized trials (RCTs) published until June 2019. Randomised controlled trials enrolling women at high risk before the 20th week of gestation comparing the effect of PA interventions with usual care for prevention of GDM were retrieved. Data obtained were synthesised using a bias-adjusted model of meta-analysis. ResultsA total of 1467 adult women in 11 eligible trials were included. The risk of GDM was significantly lower with PA, but only when it was delivered in the healthcare facility (RR 0.53; 95% CI 0.38–0.74). The number needed to treat with PA in pregnancy (compared to usual care) to prevent one GDM event was 18 (95% CI 14 – 29). The overall effect of PA interventions regardless of location of the intervention was RR 0.69 (95% CI 0.51 – 0.94). ConclusionsThis study provides evidence that in-facility physical activity programs started before the 20th week of gestation can significantly decrease the incidence of GDM among women at high risk

Prediction of pH Change in Processed Acidified Turnips

The acetic acid uptake by turnips was studied during an acidification process in containers. The process was successfully described by a Fickian diffusion, using a correlation for the buffer effect. Diffusion coefficients (0.629 to 3.99 × 10-9 m2/sec) and partition coefficients (0.8 to 1.1) were obtained by optimization of the fit between experimental and theoretical values, using the simplex method. The partition coefficient did not show an evident dependence on temperature, while diffusivity followed an Arrhenius type behavior. The relationship between acid concentration and pH was described using a cubic model with parameters independent of temperature. Results showed that the combination of these models describing the acid diffusion into the food and the buffering effects of the food allowed accurate prediction of pH evolution in the acidification process

A meta-review of meta-analyses and an updated meta-analysis on the efficacy of chloroquine and hydroxychloroquine in treating COVID19 infection

Objective: To synthesize the findings presented in systematic reviews and meta-analyses as well as to update the evidence using a meta-analysis in evaluating the efficacy and safety of CQ and HCQ with or without Azithromycin for the treatment of COVID19 infection.Methods: The design of this meta-review followed the Preferred Reporting Items for Overviews of Systematic Reviews including harms checklist (PRIO-harms). A comprehensive search included several electronic databases in identifying all systematic reviews and metaanalyses as well as experimental studies which investigated the efficacy and safety of CQ, HCQ with or without antibiotics as COVID19 treatment. Findings from the systematic reviews and meta-analyses were reported using a structured summary including tables and forest plots. The updated meta-analysis of experimental studies was carried out using the distributional assumption-free quality effects model. Risk of bias was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool for reviews and the MethodologicAl STandard for Epidemiological Research (MASTER) scale for the experimental studies. The main outcome for both the meta-review and the updated meta-analysis was mortality. Secondary outcomes included transfer to the intensive care unit (ICU) or mechanical ventilation, worsening of illness, viral clearance and the occurrence of adverse events. Results: A total of 13 reviews with 40 primary studies comprising 113,000 participants were included. Most of the primary studies were observational (n=27) and the rest were experimental studies. Two meta-analyses reported a high risk of mortality with similar ORs of 2.5 for HCQ with Azithromycin. However, four other meta-analyses reported contradictory results with two reporting a high risk of mortality and the other two reporting no significant association between HCQ with mortality. Most reviews reported that HCQ with or without Azithromycin had no significant effect on virological cure, disease exacerbation or the risk of transfer to the ICU, need for intubation or mechanical ventilation. After exclusion of studies that did not meet the eligibility criteria, the updated meta-analysis contained eight experimental studies (7 RCTs and 1 quasiexperimental trial), with a total of 5279 participants of whom 1856 were on either CQ/HCQ or combined with Azithromycin. CQ/HCQ with or without Azithromycin was significantly associated with a higher risk of adverse events. HCQ was not effective in reducing mortality transfer to the ICU, intubation or need for mechanical ventilation virological cure (RR 1.0, 95%CI 0.9-1.2, I2 =55%, n=5 studies) nor disease exacerbation (RR 1.2, 95%CI 0.3-5.0, I2 =29%, n=3 studies). Conclusion: There is conclusive evidence that CQ and HCQ, with or without Azithromycin are not effective in treating COVID-19 or its exacerbation

Breast cancer risk factors in Iran: A systematic review & Meta-analysis

Objectives: Breast cancer is known as one of the deadliest forms of cancer, and it is increasing globally. There are a variety of proven and controversial risk factors for this malignancy. Herein, we aimed to undertake a systematic review and meta-analysis focus on the epidemiology of breast cancer risk factors in Iran. Methods: We performed a systematic search via PubMed, Scopus, Web of Science, and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95 confidence intervals (CIs) using a fixed/random-effects models. Results: Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95CI 1.47-2.12), hormonal replacement therapy (HRT) (OR: 5.48, 95CI 0.84-1.74), passive smokers (OR: 1.68, 95CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95CI 1.19-5.63), abortion (OR: 1.84, 95CI 1.35-2.33), sweets consumption (OR: 1.71, 95CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95CI 0.32-0.83), nulliparity (OR: 0.68, 95CI 0.39-0.96), 13-24 months of breastfeeding (OR: 0.68, 95CI 0.46-0.90), daily exercise (OR: 0.59, 95CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95CI 0.10-0.46). Conclusions: This study suggests that factors such as family history, HRT, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development. © 2020 Amir Shamshirian et al., published by De Gruyter

Staffing and Training Aspects of Hospital Management: Some Issues for Research

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68624/2/10.1177_107755878904600205.pd

The Reproductive Revolution

Este texto fue publicado en 2009 por The Sociological Review. Rogamos que, a efectos de divulgación, docencia y cita bibliográfica se acuda a la publicación impresa (u online de la propia revista) y la cita sea esta: MacInnes, J., Pérez Díaz, J. (2009), "The reproductive revolution" The Sociological Review 57 (2): 262-284. Su versión html puede encontrarse en esta dirección:http://www3.interscience.wiley.com/cgi-bin/fulltext/122368561/HTMLSTART Quienes estén interesados en ampliar la información sobre nuestra Teoría de la Revolución Reproductiva pueden visitar la página web siguiente: http://www.ieg.csic.es/jperez/pags/RRweb/RRweb.htm También encontrarán en este mismo repositorio otra publicación con unaexposición en castellano de las mismas ideas y publicada en la REIS bajo el título “La tercera revolución de la modernidad: la reproductiva”.We suggest that a third revolution alongside the better known economic and political ones has been vital to the rise of modernity: the reproductive revolution, comprising a historically unrepeatable shift in the efficiency of human reproduction which for the first time brought demographic security.As well as highlighting the contribution of demographic change to the rise of modernity and addressing the limitations of orthodox theories of the demographic transition, the concept of the reproductive revolution offers a better way to integrate sociology and demography. The former has tended to pay insufficient heed to sexual reproduction, individual mortality and the generational replacement of population, while the latter has undervalued its own distinctive theoretical contribution, portraying demographic change as the effect of causes lying elsewhere. We outline a theory of the reproductive revolution, review some relevant supporting empirical evidence and briefly discuss its implications both for demographic transition theory itself, and for a range of key social changes that we suggest it made possible: the decline of patriarchy and feminisation of the public sphere, the deregulation and privatisation of sexuality, family change, the rise of identity, ‘low’ fertility and ‘population ageing’.Peer reviewe

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding: Bill & Melinda Gates Foundation

Efficacy of hydrophilic polymer reduced with time under greenhouse experiment

The effect of a hydrophilic polymer (Broadleaf P4*: HP) wn growth of cucumber seedlings {Cuettmh sativus I.,! was investigated. Furthermore, the efficiency of HP to absorb water over a period of time was studied. Predetermined amounts of HP (0.0%, 0,! %, 0.2%, 0.3%, and! 0.4% dry-weight basis were mixed with moderately calcareous sandy loam soil in pate. At the end of the first experiment (42 days), the growth of the seedlings was recorded, as well as the maximum soil water-holding capacity t W.MC). The same pots were left for a drying period ranging from 2 lo 5 months and then used for another four successive experiments. Soil VVHC increased significantly with increasing level of HP. but decreased after each experiment. After five experiments, (lie WHC hsid decreased 17.3% and 27.8% where HP was added at the rate of 0.1% and 0.4%. respectively. The hulk density of soils decreased significantly with addition of HI* and had increased after five growing experiments at each HP rate. Cucumber seedling growth was stimulated by addition of the polymer. The greatest vegetative growth, expressed as leaf area and shoot fresh and dry weights, was observed at 0.3% HP in the first and second experiment, but at 0.4% in the third and fourth