Several studies have investigated the potential role of selenium (Se) in the development of type 2 diabetes (T2D) with disparate findings. We conducted a systematic review and meta-analysis to synthesize the evidence of any association between Se and T2D. PubMed, Embase, and Scopus were searched following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Approach (PRISMA). Sixteen studies from 15 papers met inclusion criteria defined for this review. Of the 13 observational studies included, 8 demonstrated a statistically significant positive association between concentrations of Se and odds for T2D, with odds ratios (95% confidence intervals) ranging from 1.52 (1.01–2.28) to 7.64 (3.34–17.46), and a summary odds ratio (OR) (95% confidence interval (CI)) of 2.03 (1.51–2.72). In contrast, among randomized clinical trials (RCTs) of Se, a higher risk of T2D was not observed for those who received Se compared to a placebo (OR = 1.18, 95% CI 0.95–1.47). Taken together, the results for the relationship between Se and T2D differ between observational studies and randomized clinical trials (RCTs). It remains unclear whether these differences are the result of uncontrolled confounding in the observational studies, or whether there is a modest effect of Se on the risk for T2D that may vary by duration of exposure. Further investigations on the effects of Se on glucose metabolism are needed.
Background Birth cohort studies have linked exposure to perfluoroalkyl substances (PFASs) with child anthropometry. Metabolic hormone dysregulation needs to be considered as a potential adverse outcome pathway. We examined the associations between PFAS exposures and concentrations of adipokine hormones from birth to adolescence. Methods We studied 80 mother-child pairs from a Faroese cohort born in 1997 to 2000. Five PFASs were measured in maternal pregnancy serum and in child serum at ages 5, 7, and 13 years. Leptin, adiponectin, and resistin were analyzed in cord serum and child serum at the same ages. We fitted multivariable-adjusted generalized estimating equations to assess the associations of PFASs at each age with repeated adipokine concentrations at concurrent and subsequent ages. Results We observed tendencies of inverse associations between PFASs and adipokine hormones specific to particular ages and sex. Significant associations with all adipokines were observed for maternal and child 5-year serum PFAS concentrations, whereas associations for PFASs measured at ages 7 to 13 years were mostly null. The inverse associations with leptin and adiponectin were seen mainly in females, whereas the inverse PFAS associations with resistin levels were seen mainly in males. Estimates for significant associations (P value <0.05) suggested mean decreases in hormone levels (range) by 38% to 89% for leptin, 16% to 70% for adiponectin, and 33% to 62% for resistin for each twofold increase in serum PFAS concentration. Conclusions These findings suggest adipokine hormone dysregulation in early life as a potential pathway underlying PFAS-related health outcomes and underscore the need to further account for susceptibility windows and sex-dimorphic effects in future investigations.
Education intervention effectiveness to improve bed net care and repair knowledge or practices is unclear. To assess intervention effectiveness, we systematically reviewed eight peerreviewed literature databases and 16 malaria organizations (PROSPERO protocol CRD42019123932) using pre-specified combinations of 'education intervention', 'mosquito net', and 'malaria' search terms. Data were abstracted for 29 of 43 studies meeting inclusion criteria, of which 16 studies included education as amain focus. Of these 16, there was evidence of intervention effectiveness among half of the studies, which reported improvements in knowledge or practices, while four had mixed results, and four had unclear results. Overall there is no clear conclusion regarding the effectiveness of education interventions to improve net care and repair, though some instructional methods suggest more success than others. Interventions used combinations of instructional methods; passive mass education (6), active mass education (12), and interpersonal methods (8). Interventions combining mass and interpersonal methods resulted in positive improvements (four positive, one mixed). We found no evidence that interventions grounded in health behavior theory achieved more positive results than those not grounded in theory, potentially because net care education was typically asecondary objective. Of 289 gray literature results, 286 (99%) were net distribution reports from Against Malaria Foundation describing 136 distributions; eighty of which (58.8%) mentioned no education related to net care and repair. We found lack of involvement of experts in education among included interventions. Involving trained instructors with expertise in education theory and instructional strategies may improve instruction quality to yield more effective interventions.
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