WorldWideScience

Sample records for systematic analysis comparison

  1. Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Peek, Jesse; Smeeing, Diederik P J; Hietbrink, Falco; Houwert, Roderick M; Marsman, Marije; de Jong, Mirjam B

    2018-02-06

    Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks. PubMed, EMBASE and CENTRAL databases were searched to identify comparative studies investigating epidural, intravenous, paravertebral and intercostal interventions for traumatic rib fractures, without restriction for study type. The search strategy included keywords and MeSH or Emtree terms relating blunt chest trauma (including rib fractures), analgesic interventions, pain management and complications. A total of 19 papers met our inclusion criteria and were finally included in this systematic review. Significant differences were found in favor of epidural analgesia for the reduction of pain. No significant differences were observed between epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks, for the secondary outcomes. Results of this study show that epidural analgesia provides better pain relief than the other modalities. No differences were observed for secondary endpoints like length of ICU stay, length of mechanical ventilation or pulmonary complications. However, the quality of the available evidence is low, and therefore, preclude strong recommendations.

  2. A critical comparison of systematic calibration protocols for activated sludge models: a SWOT analysis.

    Science.gov (United States)

    Sin, Gürkan; Van Hulle, Stijn W H; De Pauw, Dirk J W; van Griensven, Ann; Vanrolleghem, Peter A

    2005-07-01

    Modelling activated sludge systems has gained an increasing momentum after the introduction of activated sludge models (ASMs) in 1987. Application of dynamic models for full-scale systems requires essentially a calibration of the chosen ASM to the case under study. Numerous full-scale model applications have been performed so far which were mostly based on ad hoc approaches and expert knowledge. Further, each modelling study has followed a different calibration approach: e.g. different influent wastewater characterization methods, different kinetic parameter estimation methods, different selection of parameters to be calibrated, different priorities within the calibration steps, etc. In short, there was no standard approach in performing the calibration study, which makes it difficult, if not impossible, to (1) compare different calibrations of ASMs with each other and (2) perform internal quality checks for each calibration study. To address these concerns, systematic calibration protocols have recently been proposed to bring guidance to the modeling of activated sludge systems and in particular to the calibration of full-scale models. In this contribution four existing calibration approaches (BIOMATH, HSG, STOWA and WERF) will be critically discussed using a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis. It will also be assessed in what way these approaches can be further developed in view of further improving the quality of ASM calibration. In this respect, the potential of automating some steps of the calibration procedure by use of mathematical algorithms is highlighted.

  3. Comparison of Ultrasonography and Radiography in Detection of Thoracic Bone Fractures; a Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Yousefifard, Mahmoud; Baikpour, Masoud; Ghelichkhani, Parisa; Asady, Hadi; Darafarin, Abolfazl; Amini Esfahani, Mohammad Reza; Hosseini, Mostafa; Yaseri, Mehdi; Safari, Saeed

    2016-01-01

    The potential benefit of ultrasonography for detection of thoracic bone fractures has been proven in various surveys but no comprehensive conclusion has been drawn yet; therefore, the present study aimed to conduct a thorough meta-analytic systematic review on this subject. Two reviewers independently carried out a comprehensive systematic search in Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest databases. Data were summarized as true positive, false positive, true negative and false negative and were analyzed via STATA 11.0 software using a mixed-effects binary regression model. Sources of heterogeneity were further assessed through subgroup analysis. Data on 1667 patients (807 subjects with and 860 cases without thoracic fractures), whose age ranged from 0 to 92 years, were extracted from 17 surveys. Pooled sensitivity and specificity of ultrasonography in detection of thoracic bone fractures were 0.97 (95% CI: 0.90-0.99; I2= 88.88, prib fractures, compared to fractures of sternum or clavicle (97% vs. 91%). Moreover, the sensitivity was found to be higher when the procedure was carried out by a radiologist in comparison to an emergency medicine specialist (96% vs. 90%). Base on the findings of the present meta-analysis, screening performance characteristic of ultrasonography in detection of thoracic bone fractures was found to be higher than radiography. However, these characteristics were more prominent in detection of rib fractures and in cases where was performed by a radiologist.

  4. Comparison the effects of poor health and low income on early retirement: a systematic review and meta-analysis.

    Science.gov (United States)

    Homaie Rad, Enayatollah; Rashidian, Arash; Arab, Mohamad; Souri, Ali

    2017-08-08

    The main aim of this study was to estimate the effects of poor health and low income on early retirement. For this purpose systematic review and meta-analysis were conducted. Web of Science, PUBMED and Scopus databases were searched systematically. Finally 17 surveys were added in meta-analysis. These studies were conducted in 13 countries. At the end a Meta regression was done to show the effects of welfare system type on effect sizes of poor health and low income. The results of this study showed that poor health had effect on the risk of early retirement. (Poor health pooled effect sizes: 1.279 CI: (1.15 1.41), low income pooled effect sizes: 1.042 CI: (0.92 1.17), (poor health pooled marginal effects: 0.046 CI: (-0.03 0.12), low income pooled marginal effects: -0.002 CI: (-0.003 0.000). The results of this study showed that association between poor health and early retirement was stronger in comparison with low income and early retirement.

  5. A Comparison of Regorafenib and TAS-102 for Metastatic Colorectal Cancer: A Systematic Review and Network Meta-analysis.

    Science.gov (United States)

    Abrahao, Ana B K; Ko, Yoo-Joung; Berry, Scott; Chan, Kelvin K W

    2017-11-21

    Regorafenib and TAS-102 have shown to be superior to placebo in refractory metastatic colorectal cancer. However, no studies have directly compared both drugs. Giving the lack of standard options in this scenario, a systematic review to compare the efficacy and safety of regorafenib and TAS-102 was performed. A systematic review using the PubMed, Medline, Embase, Scopus, and Cochrane databases to identify published and unpublished studies up to November 2015 for randomized controlled trials for patients with metastatic colorectal cancer, involving regorafenib or TAS-102, was performed. Data including overall survival, progression-free survival, and toxicity were extracted. Pairwise direct meta-analyses (regorafenib vs. placebo and TAS-102 vs. placebo) and indirect comparison (regorafenib vs. TAS-102) using network meta-analyses methods to preserve randomization were performed using random effects. Three randomized controlled trials fulfilled eligibility criteria (regorafenib monotherapy for previously treated metastatic colorectal cancer [CORRECT]: an international, multicentre, randomised, pacebo-controlled, phase 3 trial, regorafenib plus best supportive care versus placebo plus best supportive care in Asian patients with previously treated metastatic colorectal cancer [CONCUR]: a randomised, double-blind, placebo-controlled, phase 3 trial, and randomized trial of TAS-102 for refractory metastatic colorectal cancer [RECOURSE] trials) involving 1764 patients (regorafenib, 641; TAS-102, 534; placebo, 589). Subgroups of patients (1659) who had not received prior regorafenib or TAS-102 were used to perform meta-analyses for efficacy. In the indirect comparison, no statistically significant differences were observed between regorafenib and TAS-102 in overall survival (hazard ratio, 0.96; 95% confidence interval [CI], 0.57-1.66; P = .91) or progression-free survival (hazard ratio, 0.85; 95% CI, 0.40-1.81; P = .67). However, regorafenib has statistically more all

  6. Systematic Analysis and Comparison of Nucleotide-Binding Site Disease Resistance Genes in a Diploid Cotton Gossypium raimondii

    Science.gov (United States)

    Wei, Hengling; Li, Wei; Sun, Xiwei; Zhu, Shuijin; Zhu, Jun

    2013-01-01

    Plant disease resistance genes are a key component of defending plants from a range of pathogens. The majority of these resistance genes belong to the super-family that harbors a Nucleotide-binding site (NBS). A number of studies have focused on NBS-encoding genes in disease resistant breeding programs for diverse plants. However, little information has been reported with an emphasis on systematic analysis and comparison of NBS-encoding genes in cotton. To fill this gap of knowledge, in this study, we identified and investigated the NBS-encoding resistance genes in cotton using the whole genome sequence information of Gossypium raimondii. Totally, 355 NBS-encoding resistance genes were identified. Analyses of the conserved motifs and structural diversity showed that the most two distinct features for these genes are the high proportion of non-regular NBS genes and the high diversity of N-termini domains. Analyses of the physical locations and duplications of NBS-encoding genes showed that gene duplication of disease resistance genes could play an important role in cotton by leading to an increase in the functional diversity of the cotton NBS-encoding genes. Analyses of phylogenetic comparisons indicated that, in cotton, the NBS-encoding genes with TIR domain not only have their own evolution pattern different from those of genes without TIR domain, but also have their own species-specific pattern that differs from those of TIR genes in other plants. Analyses of the correlation between disease resistance QTL and NBS-encoding resistance genes showed that there could be more than half of the disease resistance QTL associated to the NBS-encoding genes in cotton, which agrees with previous studies establishing that more than half of plant resistance genes are NBS-encoding genes. PMID:23936305

  7. Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis.

    Science.gov (United States)

    Lemos, Cleidiel Aparecido Araujo; Verri, Fellippo Ramos; Bonfante, Estevam Augusto; Santiago Júnior, Joel Ferreira; Pellizzer, Eduardo Piza

    2018-03-01

    The systematic review and meta-analysis aimed to answer the PICO question: "Do patients that received external connection implants show similar marginal bone loss, implant survival and complication rates as internal connection implants?". Meta-analyses of marginal bone loss, survival rates of implants and complications rates were performed for the included studies. Study eligibility criteria included (1) randomized controlled trials (RCTs) and/or prospective, (2) studies with at least 10 patients, (3) direct comparison between connection types and (4) publications in English language. The Cochrane risk of bias tool was used to assess the quality and risk of bias in RCTs, while Newcastle-Ottawa scale was used for non-RCTs. A comprehensive search strategy was designed to identify published studies on PubMed/MEDLINE, Scopus, and The Cochrane Library databases up to October 2017. The search identified 661 references. Eleven studies (seven RCTs and four prospective studies) were included, with a total of 530 patients (mean age, 53.93 years), who had received a total of 1089 implants (461 external-connection and 628 internal-connection implants). The internal-connection implants exhibited lower marginal bone loss than external-connection implants (PInternal connections had lower marginal bone loss when compared to external connections. However, the implant-abutment connection had no influence on the implant's survival and complication rates. Based on the GRADE approach the evidence was classified as very low to moderate due to the study design, inconsistency, and publication bias. Thus, future research is highly encouraged. Internal connection implants should be preferred over external connection implants, especially when different risk factors that may contribute to increased marginal bone loss are present. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Descriptive analysis of cochrane child-relevant systematic reviews: an update and comparison between 2009 and 2013.

    Science.gov (United States)

    Crick, Katelynn; Thomson, Denise; Fernandes, Ricardo M; Nuspl, Megan; Eurich, Dean T; Rowe, Brian H; Hartling, Lisa

    2017-07-11

    used in 204 (35%) reviews to assess the overall quality of the evidence, which was often moderate (35.6%) or low (37.8%) for primary outcomes. Ninety percent of reviews that were assessed as up to date used the Cochrane Risk of Bias tool, or a modified version, to assess methodological quality. Most reviews conducted one or more meta-analyses (73%). Among the 25 leading causes of death globally, the Review Groups associated with the largest number of causes were: 1) Infectious Diseases, 2) Anaesthesia, Critical, and Emergency Care, 3) Injuries, 4) Pregnancy and Childbirth (PC), and 5) Neonatal. There were large discrepancies between the number of causes of mortality that each Review Group was associated with and the total amount of evidence each Review Group contributed to the CHFRR. Ninety-eight percent of the causes of mortality in 2013 were from developing nations, but only 224 (17.3%) reviews had corresponding authors from developing countries. The content and methodological characteristics of child-relevant systematic reviews in the Cochrane CHFRR have been described in detail. There were modest advances in methods between 2009 and 2013. Systematic reviews contained in the CDSR offer an important resource for researcher's, clinicians and policy makers by synthesizing an extensive body of primary research. Further content analysis will allow the identification of clinical topics of greatest priority for future systematic reviews in child health.

  9. Comparison of Nerve-Sparing Radical Hysterectomy and Radical Hysterectomy: a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Zhuowei Xue

    2016-05-01

    Full Text Available Background/Aims: Radical hysterectomy (RH for the treatment of cervical cancer frequently caused pelvic organ dysfunctions. This study aimed to compare the results of pelvic organ function and recurrence rate after Nerve sparing radical hysterectomy (NSRH and RH treatment through systematic review and meta-analysis. Methods: PubMed, Web of Science and China Knowledge Resource Integrated Database were searched from inception to 25 February 2015. Studies of cervical cancer which reported radical hysterectomy or nerve sparing radical hysterectomy were included. The quality of included studies was evaluated using the guidelines of Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis was performed using Review Manager 5.3 software (Cochrane Collaboration. Results: A total of 20 studies were finally included. Meta-analysis demonstrated that NSRH was associated with less bladder and anorectal dysfunction than RH. The time to bladder and anorectal function recovery after NSRH was shorter than RH. Patients undergoing NSRH also scored higher than patients undergoing RH at Female Sexual Function Index (FSFI. On the other hand, the local recurrence and overall recurrence rate were similar between NSRH and RH. Conclusion: NSRH may be an effective technique for lowering pelvic organ dysfunction and improving the function recovery without increasing the recurrence rate of cervical cancer.

  10. Operative and nonoperative management for renal trauma: comparison of outcomes. A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Mingoli A

    2017-08-01

    Full Text Available Andrea Mingoli,1,2 Marco La Torre,1,2 Emanuele Migliori,1,2 Bruno Cirillo,1,2 Martina Zambon,1,2 Paolo Sapienza,1,2 Gioia Brachini1,2 1Emergency Department, 2Department of Surgery P Valdoni, Policlinico Umberto I, Sapienza University, Rome, Italy Introduction: Preservation of kidney and renal function is the goal of nonoperative management (NOM of renal trauma (RT. The advantages of NOM for minor blunt RT have already been clearly described, but its value for major blunt and penetrating RT is still under debate. We present a systematic review and meta-analysis on NOM for RT, which was compared with the operative management (OM with respect to mortality, morbidity, and length of hospital stay (LOS. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed for this study. A systematic search was performed on Embase, Medline, Cochrane, and PubMed for studies published up to December 2015, without language restrictions, which compared NOM versus OM for renal injuries. Results: Twenty nonrandomized retrospective cohort studies comprising 13,824 patients with blunt (2,998 or penetrating (10,826 RT were identified. When all RT were considered (American Association for the Surgery of Trauma grades 1–5, NOM was associated with lower mortality and morbidity rates compared to OM (8.3% vs 17.1%, odds ratio [OR] 0.471; 95% confidence interval [CI] 0.404–0.548; P<0.001 and 2% vs 53.3%, OR 0.0484; 95% CI 0.0279–0.0839, P<0.001. Likewise, NOM represented the gold standard treatment resulting in a lower mortality rate compared to OM even when only high-grade RT was considered (9.1% vs 17.9%, OR 0.332; 95% CI 0.155–0.708; P=0.004, be they blunt (4.1% vs 8.1%, OR 0.275; 95% CI 0.0957–0.788; P=0.016 or penetrating (9.1% vs 18.1%, OR 0.468; 95% CI 0.398–0.0552; P<0.001. Conclusion: Our meta-analysis demonstrated that NOM for RT is the treatment of choice not only for AAST grades 1 and 2, but also for higher

  11. Typical and Atypical Dementia Family Caregivers: Systematic and Objective Comparisons

    Science.gov (United States)

    Nichols, Linda O.; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J.; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1,476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II)…

  12. Comparison of silodosin to tamsulosin for medical expulsive treatment of ureteral stones: a systematic review and meta-analysis.

    Science.gov (United States)

    Özsoy, Mehmet; Liatsikos, Evangelos; Scheffbuch, Nicolas; Kallidonis, Panagiotis

    2016-11-01

    This study aimed at comparing the success rates of silodosin to the most commonly used for medical expulsive therapy (MET) tamsulosin for the management of ureteral stones. A systematic review using the search string: "silodosin AND (ston* OR calcu* OR expul*)" was conducted on Pubmed, SCOPUS, Web of Science, Cochrane Central Register. The Primary endpoint was the stone expulsion rate. Secondary endpoint was the time to stone expulsion. Two authors independently screened the studies depending on inclusion and exclusion criteria. Meta-analysis and forest-plot figures were calculated with the software Review Manager (RevMan 5.3.5). Variations were evaluated with the χ 2 statistical method and heterogeneity with I 2 index. After screening of 39 publications obtained by the initial search, three randomized controlled trials were eligible to be included in the meta-analysis. 407 patients were pooled. Favorable results were observed for silodosin in terms of stone expulsion rates with a risk ratio of 1.33 (95 % CI 1.17-1.50) (I 2  = 0 %). Similarly, faster stone expulsion times were observed with silodosin when compared with tamsulosin. Mean difference -2.49 (95 % CI -3.40 to 1.58) (I 2  = 89 %). This meta-analysis showed significantly higher stone expulsion rates and faster expulsion times in favor of silodosin when compared to tamsulosin.

  13. Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Tan HaiBo

    Full Text Available To compare the efficacy and safety of Ahmed glaucoma valve implantation (AGV with trabeculectomy in the management of glaucoma patients.A comprehensive literature search (PubMed, Embase, Google, and the Cochrane library was performed, including a systematic review with meta-analysis of controlled clinical trials comparing AGV versus trabeculectomy. Efficacy estimates were the weighted mean differences (WMDs for the percentage intraocular pressure reduction (IOPR % from baseline to end-point, the reduction in glaucoma medications, and the odds ratios (ORs for complete and qualified success rates. Safety estimates were the relative risks (RRs for adverse events. All outcomes were reported with a 95% confidence interval (CI. Statistical analysis was performed using the RevMan 5.0 software.Six controlled clinical trials were included in this meta-analysis. There was no significant difference between the AGV and trabeculectomy in the IOPR% (WMD = -3.04, 95% CI: -8.36- 2.26; P = 0.26. The pooled ORs comparing AGV with trabeculectomy were 0.46 (0.22, 0.99 for the complete success rate (P = 0.05 and 0.97 (0.78-1.20 for the quantified success rate (P = 0.76. No significant difference in the reduction in glaucoma medicines was observed (WMD = 0.24; 95% CI: -0.27-0.76; P = 0.35. AGV was found to be associated with a significantly lower frequency of all adverse events (RR = 0.71; 95%CI: 1.14-0.97; p = 0.001 than trabeculectomy, while the most common complications did not differ significantly (all p> 0.05.AGV was equivalent to trabeculectomy in reducing the IOP, the number of glaucoma medications, success rates, and rates of the most common complications. However, AGV was associated with a significantly lower frequency of overall adverse events.

  14. Comparison of Ahmed glaucoma valve implantation and trabeculectomy for glaucoma: a systematic review and meta-analysis.

    Science.gov (United States)

    HaiBo, Tan; Xin, Kang; ShiHeng, Lu; Lin, Liu

    2015-01-01

    To compare the efficacy and safety of Ahmed glaucoma valve implantation (AGV) with trabeculectomy in the management of glaucoma patients. A comprehensive literature search (PubMed, Embase, Google, and the Cochrane library) was performed, including a systematic review with meta-analysis of controlled clinical trials comparing AGV versus trabeculectomy. Efficacy estimates were the weighted mean differences (WMDs) for the percentage intraocular pressure reduction (IOPR %) from baseline to end-point, the reduction in glaucoma medications, and the odds ratios (ORs) for complete and qualified success rates. Safety estimates were the relative risks (RRs) for adverse events. All outcomes were reported with a 95% confidence interval (CI). Statistical analysis was performed using the RevMan 5.0 software. Six controlled clinical trials were included in this meta-analysis. There was no significant difference between the AGV and trabeculectomy in the IOPR% (WMD = -3.04, 95% CI: -8.36- 2.26; P = 0.26). The pooled ORs comparing AGV with trabeculectomy were 0.46 (0.22, 0.99) for the complete success rate (P = 0.05) and 0.97 (0.78-1.20) for the quantified success rate (P = 0.76). No significant difference in the reduction in glaucoma medicines was observed (WMD = 0.24; 95% CI: -0.27-0.76; P = 0.35). AGV was found to be associated with a significantly lower frequency of all adverse events (RR = 0.71; 95%CI: 1.14-0.97; p = 0.001) than trabeculectomy, while the most common complications did not differ significantly (all p> 0.05). AGV was equivalent to trabeculectomy in reducing the IOP, the number of glaucoma medications, success rates, and rates of the most common complications. However, AGV was associated with a significantly lower frequency of overall adverse events.

  15. Comparison of digital tomosynthesis and chest radiography for the detection of pulmonary nodules: systematic review and meta-analysis.

    Science.gov (United States)

    Kim, Jun H; Lee, Kyung H; Kim, Kyoung-Tae; Kim, Hyun J; Ahn, Hyeong S; Kim, Yeo J; Lee, Ha Y; Jeon, Yong S

    2016-12-01

    To compare the diagnostic accuracy of digital tomosynthesis (DTS) with that of chest radiography for the detection of pulmonary nodules by meta-analysis. A systematic literature search was performed to identify relevant original studies from 1 January 1 1976 to 31 August 31 2016. The quality of included studies was assessed by quality assessment of diagnostic accuracy studies-2. Per-patient data were used to calculate the sensitivity and specificity and per-lesion data were used to calculate the detection rate. Summary receiver-operating characteristic curves were drawn for pulmonary nodule detection. 16 studies met the inclusion criteria. 1017 patients on a per-patient basis and 2159 lesions on a per-lesion basis from 16 eligible studies were evaluated. The pooled patient-based sensitivity of DTS was 0.85 [95% confidence interval (CI) 0.83-0.88] and the specificity was 0.95 (0.93-0.96). The pooled sensitivity and specificity of chest radiography were 0.47 (0.44-0.51) and 0.37 (0.34-0.40), respectively. The per-lesion detection rate was 2.90 (95% CI 2.63-3.19). DTS has higher diagnostic accuracy than chest radiography for detection of pulmonary nodules. Chest radiography has low sensitivity but similar specificity, comparable with that of DTS. Advances in knowledge: DTS has higher diagnostic accuracy than chest radiography for the detection of pulmonary nodules.

  16. Comparison of immediate implant placement in infected and non-infected extraction sockets: a systematic review and meta-analysis.

    Science.gov (United States)

    Lee, Jungwon; Park, Dueun; Koo, Ki-Tae; Seol, Yang-Jo; Lee, Yong-Moo

    2018-04-03

    This review aimed to investigate the feasibility of immediate implant placement in infected extraction sockets. We performed electronic and manual searches up to March 2017 to obtain data from randomized controlled trials (RCTs) and nonrandomized controlled clinical trials (CCTs). Using a fixed-effects model to assess the difference in survival rate (primary outcome), we evaluated the risk difference for immediate implant placement in infected and non-infected sites. We estimated the weighted mean differences (WMDs) of the change in marginal bone loss (MBL), probing depth (PD), modified bleeding index (mBI), marginal gingival level (MGL) and width of keratinized gingiva (WKG) at baseline and latest follow-up. In total, five studies (0 RCT, five CCTs) were included in the systematic review and three studies were included in the meta-analysis. The risk difference for immediate implant placement in an infected extraction socket compared with that in a non-infected socket was -0.02. WMDs for MBL, PD, mBI, MGL and WKG between the two groups were 0.32, 0.12, 0.07, -0.06, 0.20 and 0.51, respectively. No statistical differences were observed between the two groups, except for the change in WKG. Implants can be placed in infected extraction sockets after thorough socket debridement. For aesthetics, WKG should be considered when performing immediate implant placement in infected sites.

  17. An efficacy and safety comparison between different stentriever designs in acute ischaemic stroke: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Grech, R.; Pullicino, R.; Thornton, J.; Downer, J.

    2016-01-01

    Aim: To assess the recanalisation rates and long-term functional outcomes of the Solitaire and Trevo devices; to compare these results to those from the Solitaire With the Intention For Thrombectomy (SWIFT) trial and TREVO 2 studies; and to assess for statistical differences in the outcomes between the two devices. Materials and methods: A systematic review and meta-analysis of studies that utilised stentrievers in the treatment of acute ischaemic stroke was conducted. The results were compared to those of the SWIFT and TREVO 2 trials and outcome differences between Trevo (Stryker, Kalamazoo, Michigan, USA) and Solitaire (ev3/Covidien, Irvine, California, USA) were analysed statistically. Results: Solitaire had a lower mortality rate compared to Trevo (16.2% [95% confidence interval {CI}: 13.1%, 19.8%] versus 22.2% [95% CI: 10.8%, 40.2%]) and achieved a higher rate of functional independence (52.1% [95% CI: 46.3%, 57.8%] versus 47.6% [95% CI: 36.7%, 58.8%]). Statistical tests, however, failed to demonstrate significant differences in either functional outcomes or 3-month mortality rates. No significant differences were noted in weighted mean recanalisation rates between the Solitaire and Trevo groups. Conclusion: Stentrievers achieve a high rate of recanalisation and functional independence in acute ischaemic stroke and have a relatively good safety profile. No significant differences in functional outcomes, mortality, and symptomatic intra-cranial haemorrhage could be demonstrated between two popular stentrievers designs, namely Trevo and Solitaire. - Highlights: • We conducted a meta-analysis of stentrievers in acute ischaemic stroke. • We assessed recanalization rates and functional outcomes of stentrievers. • We also explored any differences between different stentriever designs. • We failed to demonstrate significant differences between Trevo and Solitaire.

  18. Comparison of sputum collection methods for tuberculosis diagnosis: a systematic review and pairwise and network meta-analysis.

    Science.gov (United States)

    Datta, Sumona; Shah, Lena; Gilman, Robert H; Evans, Carlton A

    2017-08-01

    The performance of laboratory tests to diagnose pulmonary tuberculosis is dependent on the quality of the sputum sample tested. The relative merits of sputum collection methods to improve tuberculosis diagnosis are poorly characterised. We therefore aimed to investigate the effects of sputum collection methods on tuberculosis diagnosis. We did a systematic review and meta-analysis to investigate whether non-invasive sputum collection methods in people aged at least 12 years improve the diagnostic performance of laboratory testing for pulmonary tuberculosis. We searched PubMed, Google Scholar, ProQuest, Web of Science, CINAHL, and Embase up to April 14, 2017, to identify relevant experimental, case-control, or cohort studies. We analysed data by pairwise meta-analyses with a random-effects model and by network meta-analysis. All diagnostic performance data were calculated at the sputum-sample level, except where authors only reported data at the individual patient-level. Heterogeneity was assessed, with potential causes identified by logistic meta-regression. We identified 23 eligible studies published between 1959 and 2017, involving 8967 participants who provided 19 252 sputum samples. Brief, on-demand spot sputum collection was the main reference standard. Pooled sputum collection increased tuberculosis diagnosis by microscopy (odds ratio [OR] 1·6, 95% CI 1·3-1·9, pmeta-analysis confirmed these findings, and revealed that both pooled and instructed spot sputum collections were similarly effective techniques for increasing the diagnostic performance of microscopy. Tuberculosis diagnoses were substantially increased by either pooled collection or by providing instruction on how to produce a sputum sample taken at any time of the day. Both interventions had a similar effect to that reported for the introduction of new, expensive laboratory tests, and therefore warrant further exploration in the drive to end the global tuberculosis epidemic. Wellcome Trust

  19. Comparison between SGLT2 inhibitors and DPP4 inhibitors added to insulin therapy in type 2 diabetes: a systematic review with indirect comparison meta-analysis.

    Science.gov (United States)

    Min, Se Hee; Yoon, Jeong-Hwa; Hahn, Seokyung; Cho, Young Min

    2017-01-01

    Both sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors can be used to treat patients with type 2 diabetes mellitus (T2DM) that is inadequately controlled with insulin therapy, and yet there has been no direct comparison of these two inhibitors. We searched MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov through June 2015. Randomized controlled trials published in English that compare SGLT2 inhibitor plus insulin (SGLT2i/INS) with placebo plus insulin or DPP4 inhibitor plus insulin (DPP4i/INS) with placebo plus insulin in patients with T2DM were selected. Data on the study characteristics, efficacy and safety outcomes were extracted. We compared the efficacy and safety between SGLT2i/INS and DPP4i/INS indirectly with covariates adjustment. Risk of potential bias was assessed. Fourteen eligible randomized controlled trials comprising 6980 patients were included (five SGLT2 inhibitor studies and nine DPP4 inhibitor studies). Covariate-adjusted indirect comparison using meta-regression analyses revealed that SGLT2i/INS achieved greater reduction in HbA 1c [weighted mean difference (WMD) -0.24%, 95% confidence interval (CI) -0.43 to -0.05%], fasting plasma glucose (WMD -18.0 mg/dL, 95% CI -28.5 to -7.6 mg/dL) and body weight (WMD -2.38 kg, 95% CI -3.18 to -1.58 kg) from baseline than DPP4i/INS without increasing the risk of hypoglycaemia (relative risks 1.19, 95% CI 0.78 to 1.82). Sodium glucose cotransporter 2 inhibitors achieved better glycaemic control and greater weight reduction than DPP4 inhibitors without increasing the risk of hypoglycaemia in patients with T2DM that is inadequately controlled with insulin. There has been no direct comparison of SGLT2 inhibitors and DPP4 inhibitors in patients with T2DM inadequately controlled with insulin therapy. In this study, we performed indirect meta-analysis comparing SGLT2 inhibitors and DPP4 inhibitors added to insulin

  20. Comparison of High, Intermediate, and Low Frequency Shock Wave Lithotripsy for Urinary Tract Stone Disease: Systematic Review and Network Meta-Analysis.

    Science.gov (United States)

    Kang, Dong Hyuk; Cho, Kang Su; Ham, Won Sik; Lee, Hyungmin; Kwon, Jong Kyou; Choi, Young Deuk; Lee, Joo Yong

    2016-01-01

    To perform a systematic review and network meta-analysis of randomized controlled trials (RCTs) to determine the optimal shock wave lithotripsy (SWL) frequency range for treating urinary stones, i.e., high-frequency (100-120 waves/minute), intermediate-frequency (80-90 waves/minute), and low-frequency (60-70 waves/minute) lithotripsy. Relevant RCTs were identified from electronic databases for meta-analysis of SWL success and complication rates. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Outcome variables are provided as odds ratios (ORs) with 95% confidence intervals (CIs). Thirteen articles were included in the qualitative and quantitative synthesis using pairwise and network meta-analyses. On pairwise meta-analyses, comparable inter-study heterogeneity was observed for the success rate. On network meta-analyses, the success rates of low- (OR 2.2; 95% CI 1.5-2.6) and intermediate-frequency SWL (OR 2.5; 95% CI 1.3-4.6) were higher than high-frequency SWL. Forest plots from the network meta-analysis showed no significant differences in the success rate between low-frequency SWL versus intermediate-frequency SWL (OR 0.87; 95% CI 0.51-1.7). There were no differences in complication rate across different SWL frequency ranges. By rank-probability testing, intermediate-frequency SWL was ranked highest for success rate, followed by low-frequency and high-frequency SWL. Low-frequency SWL was also ranked highest for low complication rate, with high- and intermediate-frequency SWL ranked lower. Intermediate- and low-frequency SWL have better treatment outcomes than high-frequency SWL when considering both efficacy and complication.

  1. Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Liqing; Sun, Yuefeng; Li, Ge

    2018-06-14

    Optimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. PubMed, OVID, Embase, ScienceDirect, and Web of Science were searched up to December 2017 for comparative RCTs involving infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Primary outcomes were blood loss, visual analog scale (VAS) score, range of motion, Lysholm knee scores, and fluoroscopy times. Secondary outcomes were length of hospital stay and postoperative complications. We assessed statistical heterogeneity for each outcome with the use of a standard χ 2 test and the I 2 statistic. The meta-analysis was undertaken using Stata 14.0. Four RCTs involving 293 participants were included in our study. The present meta-analysis indicated that there were significant differences between infrapatellar and suprapatellar intramedullary nail regarding the total blood loss, VAS scores, Lysholm knee scores, and fluoroscopy times. Suprapatellar intramedullary nailing could significantly reduce total blood loss, postoperative knee pain, and fluoroscopy times compared to infrapatellar approach. Additionally, it was associated with an improved Lysholm knee scores. High-quality RCTs were still required for further investigation.

  2. Thermal sensation models: a systematic comparison.

    Science.gov (United States)

    Koelblen, B; Psikuta, A; Bogdan, A; Annaheim, S; Rossi, R M

    2017-05-01

    Thermal sensation models, capable of predicting human's perception of thermal surroundings, are commonly used to assess given indoor conditions. These models differ in many aspects, such as the number and type of input conditions, the range of conditions in which the models can be applied, and the complexity of equations. Moreover, the models are associated with various thermal sensation scales. In this study, a systematic comparison of seven existing thermal sensation models has been performed with regard to exposures including various air temperatures, clothing thermal insulation, and metabolic rate values after a careful investigation of the models' range of applicability. Thermo-physiological data needed as input for some of the models were obtained from a mathematical model for human physiological responses. The comparison showed differences between models' predictions for the analyzed conditions, mostly higher than typical intersubject differences in votes. Therefore, it can be concluded that the choice of model strongly influences the assessment of indoor spaces. The issue of comparing different thermal sensation scales has also been discussed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. A Systematic Review and Meta-Analysis on Economic Comparison Between Endovascular Coiling Versus Neurosurgical Clipping for Ruptured Intracranial Aneurysms.

    Science.gov (United States)

    Zhang, Xiaoxi; Li, Li; Hong, Bo; Xu, Yi; Liu, Yuan; Huang, Qinghai; Liu, Jianmin

    2018-05-01

    Healthcare expenditures and cost reduction have been under critical surveillance in all countries and are critical for policymakers. This review aims at qualitatively and quantitatively analyzing the difference of hospital costs and length of stay between endovascular coiling versus neurosurgical clipping in ruptured intracranial aneurysms (RAs). MEDLINE, the Cochrane database, Embase, and the Web of Science database were searched and evaluated independently by 2 authors according to the Newcastle-Ottawa Scale for cohort studies describing economic hospital cost or length of stay in patients with RAs. A total of 8 studies were included, describing 24,219 RAs treated with neurosurgical clipping and 24,962 RAs with endovascular coiling. Meta-analysis revealed that the total hospital costs (THCs) were similar between coiling versus clipping in RAs (standard mean difference [SMD], -0.05; 95% confidence interval [CI], -0.12 to 0.22; I 2  = 99%; P = 0.50). Subgroup analysis showed that THCs of clipping and coiling were similar in ruptured aneurysms in the United States. However, in South Korea, the THCs of coiling were significantly higher than clipping. In the long run, 1-year medical costs of endovascular treatment were significantly lower than that of clipping in RAs (SMD, 0.15; 95% CI, 0.05-0.25; I 2  = 66%; P = 0.005). In addition, the length of stay of coiled patients was significantly shorter than clipped patients (SMD, 0.29; 95% CI, 0.13-0.45; I 2  = 96%; P China, coiling was more expensive. The length of stay was much shorter in coiled patients in all countries. Copyright © 2018. Published by Elsevier Inc.

  4. Comparison of utility of blood cultures from intravascular catheters and peripheral veins: a systematic review and decision analysis.

    Science.gov (United States)

    Falagas, Matthew E; Kazantzi, Maria S; Bliziotis, Ioannis A

    2008-01-01

    Blood cultures are sometimes obtained from intravascular catheters for convenience. However, there is controversy regarding this practice. The authors compared the diagnostic test characteristics of blood cultures obtained from intravascular catheters and peripheral veins. Relevant studies for inclusion in this review were identified through PubMed (January 1970-October 2005) and the Cochrane Central Register of Controlled Trials. Studies that reported clear definitions of true bacteraemia were included in the analysis. Two reviewers independently extracted the data. Six studies were included in the analysis, providing data for 2677 pairs of blood cultures obtained from an intravascular catheter and a peripheral venipuncture. A culture obtained from an intravascular catheter was found to be a diagnostic test for bacteraemia with better sensitivity (OR 1.85, 95 % CI 1.14-2.99, fixed effects model) and better negative predictive value (almost with statistical significance) (OR 1.55, 95 % CI 0.999-2.39, fixed effects model) but with less specificity (OR 0.33, 95 % CI 0.18-0.59, random effects model) and lower positive predictive value (OR 0.41, 95 % CI 0.23-0.76, random effects model) compared to a culture taken by peripheral venipuncture. In a group of 1000 patients, eight additional patients with true bacteraemia would be identified and 59 falsely diagnosed as having bacteraemia by a blood culture obtained from an intravascular catheter compared to results of the peripheral blood culture. Given the consequences of undertreating patients with bacteraemia, the authors believe that, based on the available evidence, at least one blood culture should be obtained from the intravascular catheter.

  5. A comparison among four tract dilation methods of percutaneous nephrolithotomy: a systematic review and meta-analysis.

    Science.gov (United States)

    Dehong, Cao; Liangren, Liu; Huawei, Liu; Qiang, Wei

    2013-11-01

    The purpose of this study was to evaluate the efficacy and safety of the Amplatz dilation (AD), metal telescopic dilation (MTD), balloon dilation (BD), and one-shot dilation (OSD) methods for tract dilation during percutaneous nephrolithotomy (PCNL). Relevant eligible studies were identified using three electronic databases (Medline, EMBASE, and Cochrane CENTRAL). Database acquisition and quality evaluation were independently performed by two reviewers. Efficacy (stone-free rate, surgical duration, and tract dilatation fluoroscopy time) and safety (transfusion rate and hemoglobin decrease) were evaluated using Review Manager 5.2. Four randomized controlled trials and eight clinical controlled trials involving 6,820 patients met the inclusion criteria. The pooled result from a meta-analysis showed statistically significant differences in tract dilatation fluoroscopy time and hemoglobin decrease between the OSD and MTD groups, which showed comparable stone-free and transfusion rates. Significant differences in transfusion rate were found between the BD and MTD groups. Among patients without previous open renal surgery, those who underwent BD exhibited a lower blood transfusion rate and a shorter surgical duration compared with those who underwent AD. The OSD technique is safer and more efficient than the MTD technique for tract dilation during PCNL, particularly in patients with previous open renal surgery, resulting in a shorter tract dilatation fluoroscopy time and a lesser decrease in hemoglobin. The efficacy and safety of BD are better than AD in patients without previous open renal surgery. The OSD technique should be considered for most patients who undergo PCNL therapy.

  6. Comparison of the hypoglycemic effect of acarbose monotherapy in patients with type 2 diabetes mellitus consuming an Eastern or Western diet: a systematic meta-analysis.

    Science.gov (United States)

    Zhu, Qibo; Tong, Yuzhen; Wu, Taixiang; Li, Jieqing; Tong, Nanwei

    2013-06-01

    Because of its mechanism of action, the starch content of a diet might alter the hypoglycemic effect of acarbose. We aimed to determine whether differences in this hypoglycemic effect existed between individuals consuming Eastern and Western diets with significantly different starch contents, a systematic meta-analysis of studies comparing acarbose with placebo or other hypoglycemic agents in patients with type 2 diabetes mellitus (T2DM) was performed. Records were retrieved from the Cochrane clinical controlled trials, MEDLINE, EMBASE, Wanfang, Chinese Technical Periodicals, and ongoing trials databases, and full texts and reference lists were screened. Because no study has directly compared patients consuming different types of diet, fixed- and random-effect models were used to indirectly compare the hypoglycemic effect of acarbose monotherapy with that of placebo and/or comparator drugs in patients with T2DM consuming an Eastern (Eastern Asia) or Western (including Europe and North America) diet. A total of 46 studies were included in the meta-analysis. The results revealed that, compared with placebo, hemoglobin A1c (HbA1c) levels were reduced to a significantly greater extent (1.02%) in the Eastern diet (mean [SD], 1.54% [2.00%]) than in the Western diet (mean [SD], 0.52% [1.20%]) P Eastern (P = 0.20) and Western (P = 0.10) diet groups was similar to that of sulfonylureas, and HbA1c levels were reduced significantly more (0.39%; P Eastern than in the Western diet group. The ability of acarbose to reduce HbA1c levels was similar to those of metformin and nateglinide/repaglinide, but a comparison of its efficacy with different diets was difficult because of the inclusion of few studies in these categories. Analysis of all included studies revealed that acarbose achieved a greater absolute reduction of HbA1c levels in the Eastern diet (mean [SD], 1.26% [1.20%]) than in the Western diet (mean [SD], 0.62% [1.28%]; P Eastern diet trials may have affected the

  7. Capturing public opinion on public health topics: a comparison of experiences from a systematic review, focus group study, and analysis of online, user-generated content

    Directory of Open Access Journals (Sweden)

    Emma Louise Giles

    2015-08-01

    Full Text Available BackgroundCapturing public opinion towards public health topics is important to ensure that services, policy and research are aligned with the beliefs and priorities of the general public. A number of approaches can be used to capture public opinion. MethodsWe are conducting a programme of work on the effectiveness and acceptability of health promoting financial incentive interventions. We have captured public opinion on financial incentive interventions using three methods: a systematic review, focus group study, and analysis of online user-generated comments to news media reports. In this short, editorial-style, piece we compare and contrast our experiences with these three methods.ResultsEach of these methods had their advantages and disadvantages. Advantages include tailoring of the research question for systematic reviews, probing of answers during focus groups, and the ability to aggregate a large data set using online user-generated content. However, disadvantages include needing to update systematic reviews, participants conforming to a dominant perspective in focus groups, and being unable to collect respondent characteristics during analysis of user-generated online content. That said, analysis of user-generated online content offers additional time and resource advantages, and we found it elicited similar findings to those obtained via more traditional methods, such as systematic reviews and focus groups. ConclusionsA number of methods for capturing public opinions on public health topics are available. Public health researchers, policy makers and practitioners should choose methods appropriate to their aims. Analysis user-generated online content, especially in the context of news media reports, may be a quicker and cheaper alternative to more traditional methods, without compromising on the breadth of opinions captured.

  8. Capturing Public Opinion on Public Health Topics: A Comparison of Experiences from a Systematic Review, Focus Group Study, and Analysis of Online, User-Generated Content.

    Science.gov (United States)

    Giles, Emma Louise; Adams, Jean M

    2015-01-01

    Capturing public opinion toward public health topics is important to ensure that services, policy, and research are aligned with the beliefs and priorities of the general public. A number of approaches can be used to capture public opinion. We are conducting a program of work on the effectiveness and acceptability of health promoting financial incentive interventions. We have captured public opinion on financial incentive interventions using three methods: a systematic review, focus group study, and analysis of online user-generated comments to news media reports. In this short editorial-style piece, we compare and contrast our experiences with these three methods. Each of these methods had their advantages and disadvantages. Advantages include tailoring of the research question for systematic reviews, probing of answers during focus groups, and the ability to aggregate a large data set using online user-generated content. However, disadvantages include needing to update systematic reviews, participants conforming to a dominant perspective in focus groups, and being unable to collect respondent characteristics during analysis of user-generated online content. That said, analysis of user-generated online content offers additional time and resource advantages, and we found it elicited similar findings to those obtained via more traditional methods, such as systematic reviews and focus groups. A number of methods for capturing public opinions on public health topics are available. Public health researchers, policy makers, and practitioners should choose methods appropriate to their aims. Analysis of user-generated online content, especially in the context of news media reports, may be a quicker and cheaper alternative to more traditional methods, without compromising on the breadth of opinions captured.

  9. A comparison of blood pressure in community pharmacies with ambulatory, home and general practitioner office readings: systematic review and meta-analysis

    Science.gov (United States)

    Albasri, Ali; O'Sullivan, Jack W.; Roberts, Nia W.; Prinjha, Suman; McManus, Richard J.; Sheppard, James P.

    2017-01-01

    Background: Blood pressure (BP) readings are traditionally taken in a clinic setting, with treatment recommendations based on these measurements. The clinical interpretation of BP readings taken in community pharmacies is currently unclear. This study aimed to systematically review all literature comparing community pharmacy BP (CPBP) readings with ambulatory BP monitoring (ABPM), home BP monitoring and general practitioner clinic readings. Method: Studies were included if they compared CPBP with at least one other measurement modality used for the diagnosis or management of hypertension. Mean CPBP readings were compared with other measurement modalities and summarized using random-effects meta-analyses. The primary outcome was to compare CPBP with gold standard ABPM readings. Results: Searches generated 3815 studies of which eight were included in the meta-analyses. The mean systolic CPBP-daytime ABPM difference was small [+1.6 mmHg (95% confidence interval −1.2 to 4.3) three studies, n = 319]. CPBP was significantly higher than 24-h ABPM [+7.8 mmHg (95% confidence interval 1.5–14.1) three studies n = 429]. Comparisons with general practitioner clinic readings (six studies, n = 2100) were inconclusive with significant heterogeneity between studies. CPBP and home BP monitoring readings (five studies, n = 1848) were nonsignificantly different. Diastolic comparisons mirrored systolic comparisons in all but the CPBP-daytime ABPM comparison, where CPBP was significantly higher. Conclusion: Current evidence around the clinical interpretation of CPBP is inconclusive. Although this review suggests that adopting the 135/85 mmHg threshold for hypertension might be reasonable and potentially result in a higher sensitivity for detecting patients with truly raised BP in pharmacies, the impact of this lower threshold on increased referrals to general practice clinics must be considered. PMID:28594707

  10. Digital Games, Design, and Learning: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Clark, Douglas B.; Tanner-Smith, Emily E.; Killingsworth, Stephen S.

    2016-01-01

    In this meta-analysis, we systematically reviewed research on digital games and learning for K-16 students. We synthesized comparisons of game versus nongame conditions (i.e., media comparisons) and comparisons of augmented games versus standard game designs (i.e., value-added comparisons). We used random-effects meta-regression models with robust…

  11. Comparison of EGFR and KRAS Status between Primary Non-small Cell Lung Cancer and Corresponding Metastases: A Systematic Review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Chengbo HAN

    2010-09-01

    Full Text Available Background and objective Epidermal growth factor receptor (EGFR and KRAS status were particularly critical for the choice of first-line targeted therapy of non-small cell lung cancer (NSCLC, while the primary tumor and metastases might be different in the EGFR and KRAS gene status. The aim of this pooled analysis is to compare EGFR and KRAS status in matching primary NSCLC and metastases and further to guide clinical practice. Methods Systematic computerized searches of the Pubmed and Medline databases (up to May 10, 2010 meeting specified search criteria were performed, followed by a further screening according to inclusive and exclusive criteria. Results Fourteen articles were selected into the final meta-analysis with paired primary and metastatic cases of 598. Expression level of EGFR protein and mutation frequency of KRAS gene in primary tumors were higher than that in metastases, relative risk (RR=1.13 (95%CI: 0.98-1.31, P=0.09 and RR=1.39 (95%CI: 0.95-2.03, P=0.09, respectively. EGFR gene copy number in metastases was higher than that in primary tumor, RR=0.74 (95%CI: 0.53-1.02, P=0.06. There was no statistically significant difference of EGFR mutation frequency in primary tumors and metastases (P=0.31. The discordant rate in primary and metastases was 17.09% for EGFR mutation, 27.07% for EGFR amplification, 27.84% for EGFR protein expression and 25.91% for KRAS mutation. Conclusion The systematic analysis showed that the EGFR mutation status in primary lung cancer and corresponding metastases was more stable than KRAS gene. KRAS mutation in primary lung cancerous foci seems to better reflect systemically cancerous genetic characteristics of KRAS gene. Determination of KRAS gene status based merely on metastatic foci might lead to more resistant selections of EGFR tyrosine kinase inhibitor (TKI therapy. Combined detection of EGFR and KRAS mutation from primary NSCLC foci might serve as a better predictive biomarker for anti-EGFR targeted

  12. Systematic comparison of model polymer nanocomposite mechanics.

    Science.gov (United States)

    Xiao, Senbo; Peter, Christine; Kremer, Kurt

    2016-09-13

    Polymer nanocomposites render a range of outstanding materials from natural products such as silk, sea shells and bones, to synthesized nanoclay or carbon nanotube reinforced polymer systems. In contrast to the fast expanding interest in this type of material, the fundamental mechanisms of their mixing, phase behavior and reinforcement, especially for higher nanoparticle content as relevant for bio-inorganic composites, are still not fully understood. Although polymer nanocomposites exhibit diverse morphologies, qualitatively their mechanical properties are believed to be governed by a few parameters, namely their internal polymer network topology, nanoparticle volume fraction, particle surface properties and so on. Relating material mechanics to such elementary parameters is the purpose of this work. By taking a coarse-grained molecular modeling approach, we study an range of different polymer nanocomposites. We vary polymer nanoparticle connectivity, surface geometry and volume fraction to systematically study rheological/mechanical properties. Our models cover different materials, and reproduce key characteristics of real nanocomposites, such as phase separation, mechanical reinforcement. The results shed light on establishing elementary structure, property and function relationship of polymer nanocomposites.

  13. Comparison of peri-articular liposomal bupivacaine and standard bupivacaine for postsurgical analgesia in total knee arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Xi; Xiao, Lin; Wang, Zhiyuan; Zhao, Guanghui; Ma, Jianbing

    2017-03-01

    This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty. A systematic search was performed in Medline (1966-2016.9), PubMed (1966-2016.9), Embase (1980-2016.9), ScienceDirect (1985-2016.9) and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software. Three randomized controlled trials (RCTs) and two non-randomized controlled trials (Non-RCTs), including 1214 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analogue scale (VAS) score at 24 h (SMD = -0.241, 95% CI: -0.374 to -0.108, P = 0.000), VAS score at 48 h (SMD = -0.124, 95% CI: -0.256 to 0.009, P = 0.0068), morphine equivalent consumption on POD 1 (SMD = -0.275, 95% CI: -0.398 to -0.153, P = 0.000) and incidence of nausea (RD = 0.038, 95% CI: 0.001 to 0.074, P = 0.042) and vomiting (RD = 0.38, 95% CI: 0.003 to 0.072, P = 0.032). Compared to standard bupivacaine, intraoperative peri-articular liposomal bupivacaine infiltration promotes superior pain relief and less morphine consumption after total knee arthroplasty. In addition, there were fewer side effects associated with liposomal bupivacaine infiltration. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Head-To-Head Comparison Between High- and Standard-b-Value DWI for Detecting Prostate Cancer: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Woo, Sungmin; Suh, Chong Hyun; Kim, Sang Youn; Cho, Jeong Yeon; Kim, Seung Hyup

    2018-01-01

    The purpose of this study was to perform a head-to-head comparison between high-b-value (> 1000 s/mm 2 ) and standard-b-value (800-1000 s/mm 2 ) DWI regarding diagnostic performance in the detection of prostate cancer. The MEDLINE and EMBASE databases were searched up to April 1, 2017. The analysis included diagnostic accuracy studies in which high- and standard-b-value DWI were used for prostate cancer detection with histopathologic examination as the reference standard. Methodologic quality was assessed with the revised Quality Assessment of Diagnostic Accuracy Studies tool. Sensitivity and specificity of all studies were calculated and were pooled and plotted in a hierarchic summary ROC plot. Meta-regression and multiple-subgroup analyses were performed to compare the diagnostic performances of high- and standard-b-value DWI. Eleven studies (789 patients) were included. High-b-value DWI had greater pooled sensitivity (0.80 [95% CI, 0.70-0.87]) (p = 0.03) and specificity (0.92 [95% CI, 0.87-0.95]) (p = 0.01) than standard-b-value DWI (sensitivity, 0.78 [95% CI, 0.66-0.86]); specificity, 0.87 [95% CI, 0.77-0.93] (p value DWI (p ≤ 0.05). Sensitivity was significantly higher for high- than for standard-b-value DWI only in the following subgroups: peripheral zone only, transition zone only, multiparametric protocol (DWI and T2-weighted imaging), visual assessment of DW images, and per-lesion analysis (p ≤ 0.04). In a head-to-head comparison, high-b-value DWI had significantly better sensitivity and specificity for detection of prostate cancer than did standard-b-value DWI. Multiple-subgroup analyses showed that specificity was consistently superior for high-b-value DWI.

  15. Glucagon for hypoglycemic episodes in insulin-treated diabetic patients: a systematic review and meta-analysis with a comparison of glucagon with dextrose and of different glucagon formulations.

    Science.gov (United States)

    Boido, Augusto; Ceriani, Valerio; Pontiroli, Antonio E

    2015-04-01

    Glucagon is used as an emergency drug in hypoglycemia, mainly when the patient is unconscious. A few studies report on ineffectiveness of glucagon in relieving hypoglycemia. The present systematic review and meta-analysis evaluate the effectiveness of glucagon alone and in comparison with dextrose and the effectiveness of intranasal glucagon in comparison with injected glucagon. Studies were grouped into three groups: (1) reports on glucagon ineffectiveness; (2) comparison of glucagon and dextrose; (3) comparison of intranasal glucagon and injected glucagon. In groups 2 and 3, only controlled studies were included in the analysis, whether randomized or non-randomized studies. Appropriate methodology (PRISMA statement) was adhered to, and publication bias was formally assessed. Sixteen studies, published in any language as full papers, were analysed to identify predictors of ineffectiveness, and they were included in a meta-analysis (random effects model) to study the effect of different strategies. Intervention effect (number of failures) was expressed as odds ratio (OR), with 95 % confidence intervals. Failure rate ranged from 0.0 to 2.31 %, to 7.6 %, to 14.4 %, and to 59 %. Comparing glucagon and dextrose, the OR was 0.53 (0.20-1.42); comparing intranasal and intramuscular glucagon, the OR was 1.40 (0.18-10.93). Heterogeneity was low and not statistically significant. Publication bias was absent. These data indicate that ineffectiveness of glucagon is unfrequent, not different from dextrose; in addition, intranasal and injected glucagon are similarly effective. In the case of failure, a second dose can be administered.

  16. A comparison of discontinuation rates of tofacitinib and biologic disease-modifying anti-rheumatic drugs in rheumatoid arthritis: a systematic review and Bayesian network meta-analysis.

    Science.gov (United States)

    Park, Sun-Kyeong; Lee, Min-Young; Jang, Eun-Jin; Kim, Hye-Lin; Ha, Dong-Mun; Lee, Eui-Kyung

    2017-01-01

    The purpose of this study was to compare the discontinuation rates of tofacitinib and biologics (tumour necrosis factor inhibitors (TNFi), abatacept, rituximab, and tocilizumab) in rheumatoid arthritis (RA) patients considering inadequate responses (IRs) to previous treatment(s). Randomised controlled trials of tofacitinib and biologics - reporting at least one total discontinuation, discontinuation due to lack of efficacy (LOE), and discontinuation due to adverse events (AEs) - were identified through systematic review. The analyses were conducted for patients with IRs to conventional synthetic disease-modifying anti-rheumatic drugs (cDMARDs) and for patients with biologics-IR, separately. Bayesian network meta-analysis was used to estimate rate ratio (RR) of a biologic relative to tofacitinib with 95% credible interval (CrI), and probability of RR being tofacitinib and biologics in the cDMARDs-IR group. In the biologics-IR group, however, TNFi (RR 0.17, 95% CrI 0.01-3.61, P[RRtofacitinib did. Despite the difference, discontinuation cases owing to LOE and AEs revealed that tofacitinib was comparable to the biologics. The comparability of discontinuation rate between tofacitinib and biologics was different based on previous treatments and discontinuation reasons: LOE, AEs, and total (due to other reasons). Therefore, those factors need to be considered to decide the optimal treatment strategy.

  17. Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis.

    Science.gov (United States)

    Luque-Martinez, Issis; Reis, Alessandra; Schroeder, Marcos; Muñoz, Miguel Angel; Loguercio, Alessandro D; Masterson, Danielle; Maia, Lucianne C

    2016-09-01

    The aim of the study was to compare the color change produced by tray-delivered carbamide peroxide [CP] versus hydrogen peroxide products [HP] for at-home bleaching through a systematic review and meta-analysis. MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), and Cochrane Library and Grey literature were searched without restrictions. The abstracts of the International Association for Dental Research (IADR) and unpublished and ongoing trial registries were also searched. Dissertations and theses were explored using the ProQuest Dissertations and Periodicos Capes Theses databases. We included randomized clinical trials that compared tray-delivered CP versus HP for at-home dental bleaching. The color change in shade guide units (SGU) and ΔE were the primary outcomes, and tooth sensitivity and gingival irritation were the secondary outcomes. The risk of bias tool of the Cochrane Collaboration was used for quality assessment. After duplicate removal, 1379 articles were identified. However, only eight studies were considered to be at "low" risk of bias in the key domains of the risk bias tool and they were included in the analysis. For ΔE, the standardized mean difference was -0.45 (95 % CI -0.69 to -0.21), which favored tray-delivered CP products (p whitening efficacy than HP-based products in terms of ΔE, but they were similar in terms of ΔSGU. Both whitening systems demonstrated equal level of gingival irritation and tooth sensitivity. Tray-delivered CP gels have a slightly better whitening efficacy than HP-based products in terms of ΔE. This should be interpreted with caution as the data of ΔSGU did not show statistical difference between the products.

  18. Accuracy of dental development for estimating the pubertal growth spurt in comparison to skeletal development: a systematic review and meta-analysis.

    Science.gov (United States)

    Bittencourt, MarcosAlan Vieira; Cericato, GrazielaOro; Franco, Ademir; Girão, RafaelaSilva; Lima, Anderson Paulo Barbosa; Paranhos, LuizRenato

    2018-05-01

    This study aimed to search for scientific evidence concerning the accuracy of dental development for estimating the pubertal growth spurt. It was conducted according to the statements of PRISMA. An electronic search was performed in six databases, including the grey literature. The PICOS strategy was used to define the eligibility criteria and only observational studies were selected. Out of 1,416 identified citations, 10 articles fulfilled the criteria and were included in this systematic review. The association between dental development and skeletal maturity was considered strong in seven studies, and moderate in two, although the association with the pubertal growth spurt had been verified in only four articles. According to half of the studies, the tooth that provided the greater association with the ossification centres was the lower canine. The meta-analysis performed also indicated a positive association, being stronger in females [0.725 (0.649-0.808)]. However, when the method used for dental evaluation was considered, it was possible to verify greater correlation coefficients for Nolla [0.736 (0.666-0.814)] than for Demirjian [0.631 (0.450-0.884)], at the boys sample. The heterogeneity test reached high values (Q = 51.00), suggesting a potential bias within the studies. Most of individual studies suggested a strong correlation between dental development and skeletal maturation, although the association with the peakof pubertal growth spurtwas clearly cited only in some of them. However, due to the high heterogeneity found among the studies included in this meta-analysis, a pragmatic recommendation about the use of dental stages is not possible.

  19. Comparison of the effectiveness and safety of formoterol versus salmeterol in the treatment of patients with asthma: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ashraf Velayati

    2015-01-01

    Full Text Available Background: Formoterol and salmeterol are two long-acting β2-agonists given by inhalation, with bronchodilating effects lasting for at least 12 h after a single administration. Formoterol has a faster onset of action compared with salmeterol. The aim of this study was to perform a systematic review and meta-analysis on the data published from previous review in order to calculate pooled estimates of effectiveness and safety assessment of formoterol and salmeterol in treatment of patients with asthma. Materials and Methods: In this study, we conducted an electronic search for medical citation databases including Cochrane, PubMed, Scopus, PsycInfo, and IranMedex. Besides manual search of the databases that record randomized clinical trials, conference proceedings, and journals related to asthma were included. Studies were evaluated by two independent people based on inclusion and exclusion criteria, and the common outcomes of studies were entered into the RevMan 5.0.1 software, after evaluation of studies and extraction of data from them; and in cases where there were homogeneous studies, meta-analysis was performed, and for heterogeneous studies, the results were reported qualitatively. Results: Of the 1539 studies initially found, 13 were included in the study. According to the meta-analysis conducted, no significant difference was found between the inhalation of formoterol 12 μg and salmeterol 50 μg in the two outcomes of mean forced expiratory volume 1 s (FEV1, 12 h after inhalation of medication and Borg score (A frequently used scale for quantifying breathlessness after inhalation of medication. In addition, salmeterol was more effective than formoterol in the two outcomes of percent decrease in FEV1 after inhalation of methacholine and the number of days without an attack. Since the two outcomes of FEV1 30-60 min after inhalation of medication and morning peak expiratory flow after inhalation of medication were heterogeneous, they had no

  20. Comparison of ultrasonic scalpel versus conventional techniques in open gastrectomy for gastric carcinoma patients: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xiao-Long Chen

    Full Text Available To compare surgical efficacy and postoperative recovery of ultrasonic scalpel (USS with conventional techniques for the resection of gastric carcinoma.A systematic search of major medical databases (PubMed, Embase, CCRT and CNKI was conducted. Both randomized and non-randomized controlled trials (RCTs and nRCTs were considered eligible. Operation time (OT, intraoperative blood loss (BL and postoperative complications (POC rates as well as postoperative hospitalization days, number of dissected lymph nodes, abdominal drainage volume and time for recovery of gastrointestinal functions were synthesized and compared.Nineteen studies were included (7 RCTs and 12 nRCTs, in which 1930 patients were enrolled totally (946 in the USS group and 984 in the conventional group. Monopolar electrocautery and ligation were used as the conventional methods. Comparative meta-analysis showed perioperative outcomes were significantly improved using USS compared with conventional surgical instrumentation. OT was reduced from a weighted mean of 185.3 min in the conventional group to 151.0 min in the USS group (MD = -33.30, 95% CI [-41.75, -24.86], p<0.001 and intraoperative BL was decreased from a weighted mean of 217.9 ml in the conventional group to 111.6 ml in the USS group (MD = -113.42, 95% CI [-142.05, -84.79], p<0.001. Results from RCTs subgroup were consistent with those from nRCTs subgroup. The weighted cumulative risk of POC accounted for 8.9% (0%-25% and 12.9% (5.5%-45% in the USS and conventional groups, respectively. Pooled estimated results from nRCTs (OR = 0.54, 95% CI [0.27, 1.06], p = 0.07 and RCTs (RR = 0.75, 95% CI [0.44, 1.26], p = 0.27 showed no significant difference between the USS and control groups. Analysis of secondary outcomes showed the improvements of the USS group over control group regarding the number of dissected lymph nodes, postoperative hospitalization days, abdominal drainage volume and time for recovery of

  1. TAxonomy of Self-reported Sedentary behaviour Tools (TASST) framework for development, comparison and evaluation of self-report tools: content analysis and systematic review.

    Science.gov (United States)

    Dall, P M; Coulter, E H; Fitzsimons, C F; Skelton, D A; Chastin, Sfm

    2017-04-08

    Sedentary behaviour (SB) has distinct deleterious health outcomes, yet there is no consensus on best practice for measurement. This study aimed to identify the optimal self-report tool for population surveillance of SB, using a systematic framework. A framework, TAxonomy of Self-reported Sedentary behaviour Tools (TASST), consisting of four domains (type of assessment, recall period, temporal unit and assessment period), was developed based on a systematic inventory of existing tools. The inventory was achieved through a systematic review of studies reporting SB and tracing back to the original description. A systematic review of the accuracy and sensitivity to change of these tools was then mapped against TASST domains. Systematic searches were conducted via EBSCO, reference lists and expert opinion. The inventory included tools measuring SB in adults that could be self-completed at one sitting, and excluded tools measuring SB in specific populations or contexts. The systematic review included studies reporting on the accuracy against an objective measure of SB and/or sensitivity to change of a tool in the inventory. The systematic review initially identified 32 distinct tools (141 questions), which were used to develop the TASST framework. Twenty-two studies evaluated accuracy and/or sensitivity to change representing only eight taxa. Assessing SB as a sum of behaviours and using a previous day recall were the most promising features of existing tools. Accuracy was poor for all existing tools, with underestimation and overestimation of SB. There was a lack of evidence about sensitivity to change. Despite the limited evidence, mapping existing SB tools onto the TASST framework has enabled informed recommendations to be made about the most promising features for a surveillance tool, identified aspects on which future research and development of SB surveillance tools should focus. International prospective register of systematic reviews (PROPSPERO)/CRD42014009851

  2. Comparison of transverse island flap onlay and tubularized incised-plate urethroplasties for primary proximal hypospadias: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Dongdong Xiao

    Full Text Available PURPOSE: This meta-analysis was conducted to compare postoperative outcomes between transverse island flap (TVIF onlay and tubularized incised-plate (TIP urethroplasties for primary proximal hypospadias. MATERIALS AND METHODS: A comprehensive literature search updated to 21st May 2014 was carried out for relevant studies. After literature identification and data extraction, odds ratio (OR with 95% confidential interval (CI was calculated to compare postoperative complication rate between TVIF onlay and TIP. Meta-regression and subgroup analyses were applied to find potential affective factors. RESULTS: A total of 6 studies including 309 patients receiving TVIF onlay and 262 individuals subjected to TIP met inclusion criteria. The synthetic data suggested that TVIF onlay and TIP were comparable in terms of total complication rate (OR 0.85, 95% CI 0.56-1.30, p = 0.461, fistula (OR 0.68, 95% CI 0.38-1.21, p = 0.194, recurrent curvature (OR 1.16, 95% CI 0.43-3.12, p = 0.766, dehiscence (OR 0.95, 95% CI 0.33-2.74, p = 0.920, diverticulum (OR 1.90, 95% CI 0.53-6.78, p = 0.321, meatal stenosis (OR 0.74, 95% CI 0.20-2.77, p = 0.651 and urethral stricture (OR 1.49, 95% CI 0.41-5.50, p = 0.545, without significant heterogeneity for each comparison group. Meta-regression and subgroup analyses revealed no significant findings. One-way sensitivity analysis indicated that the results were stable. No publication bias was detected using both funnel plot and Egger's test. Also, there were no obvious differences observed in cosmetic and functional outcomes. CONCLUSIONS: This meta-analysis suggests that TVIF onlay and TIP urethroplasties are clinically equivalent. Given the inherent limitations of included studies, this conclusion should be interpreted with caution and wait to be confirmed by more well-designed randomized controlled trials with high quality in the future.

  3. Billionaire Entrepreneurs: A Systematic Analysis

    OpenAIRE

    Henrekson, Magnus; Sanandaji, Tino

    2013-01-01

    The overwhelming majority of self-employed individuals are not entrepreneurial in the Schumpeterian sense. In order to unmistakably identify Schumpeterian entrepreneurs we focus on self-made billionaires (in USD) on Forbes Magazine’s list who became wealthy by founding new firms. In this way we identify 996 billionaire entrepreneurs in over fifty countries in the 1996–2010 period. To our knowledge this is the first systematic cross-country study of billionaire entrepreneurs, an economically i...

  4. Impact of serum SP-A and SP-D levels on comparison and prognosis of idiopathic pulmonary fibrosis: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Kai; Ju, Qing; Cao, Jing; Tang, Wenze; Zhang, Jian

    2017-06-01

    Idiopathic pulmonary fibrosis (IPF) has a poor prognosis in general; however, it is heterogeneous to detect relative biomarkers for predicting the disease progression. Serum biomarkers can be conveniently collected to detect and help to differentially diagnose IPF and predict IPF prognosis. This meta-analysis aimed to evaluate the use of serum surfactant proteins A and D (SP-A and SP-D) for differential diagnosis and prognosis of IPF. Relevant articles were searched in PubMed, Embase, and Chinese National Knowledge Infrastructure databases and reviewed by 2 independent readers. Standard mean difference (SMD) and 95% confidence interval (CI) were calculated to assess the difference in serum levels of SP-A/D among patients with IPF, when compared to patients with non-IPF interstitial lung disease (ILD), pulmonary infection, and healthy control. Hazard ratio (HR) and 95% CI were used to compare the relative risk of mortality. Twenty-one articles (totalling 1289 IPF patients) were included in final meta-analysis. Serum SP-A levels were significantly higher in patients with IPF than in patients with non-IPF ILD (SMD: 1.108 [0.584, 1.632], P infection (SMD: 1.320 [0.999, 1.640], P SMD: 2.802 [1.901, 3.702], P SMD: 0.459 [-0.000, 0.919], P = .050). Serum SP-D levels were significantly higher in patients with IPF than in patients with pulmonary infection (SMD: 1.308 [0.813, 1.803], P SMD: 2.235 [1.739, 2.731], P < .001). Risk of death in patients with IPF and elevated serum SP-A was increased 39% compared to patients with low SP-A groups. Elevated SP-D increased risk by 111% when compared to low SP-D. In acute exacerbation of IPF, serum SP-A/D were higher than those in stable stage. The comparisons and prognosis might be different in Asian and Caucasian patients. Serum SP-A/D detection might be useful for differential diagnosis and prediction of survival in patients with IPF.

  5. Matched-pair comparisons of stereotactic body radiotherapy (SBRT) versus surgery for the treatment of early stage non-small cell lung cancer: A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Zhang, Binglan; Zhu, Fuping; Ma, Xuelei; Tian, Ye; Cao, Dan; Luo, Songe; Xuan, Yu; Liu, Lei; Wei, Yuquan

    2014-01-01

    Purpose: A population-based matched-pair comparison was performed to compare the efficacy of stereotactic body radiotherapy (SBRT) versus surgery for early-stage non-small cell lung cancer (NSCLC). Methods: All the eligible studies were searched by PubMed, Medline, Embase, and the Cochrane Library. The meta-analysis was performed to compare odds ratios (OR) for overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), local control (LC), and distant control (DC). Results: Six studies containing 864 matched patients were included in the meta-analysis. The surgery was associated with a better long-term OS in patients with early-stage NSCLC. The pooled OR and 95% confidence interval (CI) for 1-year, 3-year OS were 1.31 [0.90, 1.91] and 1.82 [1.38, 2.40], respectively. However, the difference in 1-year and 3-year CSS, DFS, LC and DC was not significant. Conclusions: This systematic review found a superior 3-year OS after surgery compared with SBRT, which supports the need to compare both treatments in large prospective, randomized, controlled clinical trials

  6. The Effect of Glucagon-Like Peptide 1 Receptor Agonists on Weight Loss in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jessica E Potts

    Full Text Available To determine the effects of glucagon-like peptide-1 receptor agonists compared with placebo and other anti-diabetic agents on weight loss in overweight or obese patients with type 2 diabetes mellitus.Electronic searches were conducted for randomised controlled trials that compared a glucagon-like peptide-1 receptor agonist therapy at a clinically relevant dose with a comparator treatment (other type 2 diabetes treatment or placebo in adults with type 2 diabetes and a mean body mass index ≥ 25 kg/m2. Pair-wise meta-analyses and mixed treatment comparisons were conducted to examine the difference in weight change at six months between the glucagon-like peptide-1 receptor agonists and each comparator.In the mixed treatment comparison (27 trials, the glucagon-like peptide-1 receptor agonists were the most successful in terms of weight loss; exenatide 2 mg/week: -1.62 kg (95% CrI: -2.95 kg, -0.30 kg, exenatide 20 μg: -1.37 kg (95% CI: -222 kg, -0.52 kg, liraglutide 1.2 mg: -1.01 kg (95%CrI: -2.41 kg, 0.38 kg and liraglutide 1.8 mg: -1.51 kg (95% CI: -2.67 kg, -0.37 kg compared with placebo. There were no differences between the GLP-1 receptor agonists in terms of weight loss.This review provides evidence that glucagon-like peptide-1 receptor agonist therapies are associated with weight loss in overweight or obese patients with type 2 diabetes with no difference in weight loss seen between the different types of GLP-1 receptor agonists assessed.

  7. Systematic analysis and comparison of the PHD-Finger gene family in Chinese pear (Pyrus bretschneideri) and its role in fruit development.

    Science.gov (United States)

    Cao, Yunpeng; Han, Yahui; Meng, Dandan; Abdullah, Muhammad; Li, Dahui; Jin, Qing; Lin, Yi; Cai, Yongping

    2018-04-20

    PHD-finger proteins, which belongs to the type of zinc finger family, and that play an important role in the regulation of both transcription and the chromatin state in eukaryotes. Currently, PHD-finger proteins have been well studied in animals, while few studies have been carried out on their function in plants. In the present study, 129 non-redundant PHD-finger genes were identified from 5 Rosaceae species (pear, apple, strawberry, mei, and peach); among them, 31 genes were identified in pear. Subsequently, we carried out a bioinformatics analysis of the PHD-finger genes. Thirty-one PbPHD genes were divided into 7 subfamilies based on the phylogenetic analysis, which are consistent with the intron-exon and conserved motif analyses. In addition, we identified five segmental duplication events, implying that the segmental duplications might be a crucial role in the expansion of the PHD-finger gene family in pear. The microsynteny analysis of five Rosaceae species showed that there were independent duplication events in addition to the genome-wide duplication of the pear genome. Subsequently, ten expressed PHD-finger genes of pear fruit were identified using qRT-PCR, and one of these genes, PbPHD10, was identified as an important candidate gene for the regulation of lignin synthesis. Our research provides useful information for the further analysis of the function of PHD-finger gene family in pear.

  8. Comparison of the success rate between self-drilling and self-tapping miniscrews: a systematic review and meta-analysis.

    Science.gov (United States)

    Yi, Jianru; Ge, Mengke; Li, Meile; Li, Chunjie; Li, Yu; Li, Xiaobing; Zhao, Zhihe

    2017-06-01

    Both the self-drilling and self-tapping miniscrews have been commonly used as anchorage reinforcement devices in orthodontic treatment. The aim of this study was to compare the success rates of self-drilling and self-tapping miniscrews in orthodontic practice. Literature searches were performed by electronic search in database including PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure and SIGLE, and manual search of relevant journals and reference lists of included studies. Randomized controlled trials, clinical controlled trials and cohort studies comparing the success rates of self-drilling and self-tapping miniscrews as orthodontic anchorage. The data of success rates and root contact rates were extracted by two investigators independently. After evaluating the risk of bias, the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Subgroup analysis was performed on the basis of study design, follow-ups, participant ages and immediate/delayed loading. Sensitivity analysis was performed to test the stability of the results in meta-analysis. Six studies assessed as high quality were included in the meta-analysis. The meta-analysis results showed no difference between the two types of screws in the success rates. The root contact rates of the two screws were similar, while self-drilling miniscrews displayed higher risk of failure when contacting with a tooth root. Currently available clinical evidence suggests that the success rates of self-tapping and self-drilling miniscrews are similar. Determination of the position and direction of placement should be more precise when self-drilling miniscrews are used in sites with narrow root proximity. None. None. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  9. Comparison of oral versus intravenous application of tranexamic acid in total knee and hip arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Lu-Kai; Ma, Jian-Xiong; Kuang, Ming-Jie; Zhao, Jie; Wang, Ying; Lu, Bin; Sun, Lei; Ma, Xin-Long

    2017-09-01

    Tranexamic acid (TXA) is regarded as one of the most important drugs in reducing blood loss and hemoglobin (Hb) drop after total knee arthroplasty (TKA) or total hip arthroplasty (THA). Treatment with tranexamic acid (TXA) by intravenous application has been discussed extensively. Recently, several studies have reported that oral administration has an effect on blood sparing. Therefore, we performed a meta-analysis to investigate the efficacy and safety between oral TXA and intravenous TXA (IV-TXA) for blood sparing in total knee and hip arthroplasty. Randomized controlled trials (RCTs) or retrospective cohort studies (RCSs) about relevant research were searched for by using PubMed (1996-April 2017), Embase (1980-April 2017), and the Cochrane Library (CENTRAL, April 2017). Five studies that compared oral with IV administration of TXA were included in our meta-analysis. Meta-analysis results were collected and analyzed by the software Review Manager 5.3 (Copenhagen: The Nordic Cochrane Center, The Collaboration, 2014). Five studies containing 3474 patients met the inclusion criteria. Our pooled data analysis indicated that oral TXA was as effective as the IV-TXA in terms of the average Hb drop (P = 0.88), total Hb loss (P = 0.57), total blood loss (P = 0.42), transfusion rate (P = 0.16), complications (P = 0.61), and length of hospital stay (P = 1.00). Compared with the IV-TXA method, oral TXA shows similar blood-sparing efficacy for preventing hemoglobin drop, total hemoglobin loss, and total blood loss following TKA or THA. In addition, no significant differences of transfusion rate, complications, or length of hospital stay were found between the 2 groups. However, because of the limited number of included studies, more studies of high quality are needed to further identify the optimal administration time for oral TXA. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Comparison of full-mouth disinfection and quadrant-wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Fang, H; Han, M; Li, Q-L; Cao, C Y; Xia, R; Zhang, Z-H

    2016-08-01

    Scaling and root planing are widely considered as effective methods for treating chronic periodontitis. A meta-analysis published in 2008 showed no statistically significant differences between full-mouth disinfection (FMD) or full-mouth scaling and root planing (FMS) and quadrant scaling and root planing (Q-SRP). The FMD approach only resulted in modest additional improvements in several indices. Whether differences exist between these two approaches requires further validation. Accordingly, a study was conducted to further validate whether FMD with antiseptics or FMS without the use of antiseptics within 24 h provides greater clinical improvement than Q-SRP in patients with chronic periodontitis. Medline (via OVID), EMBASE (via OVID), PubMed and CENTRAL databases were searched up to 27 January 2015. Randomized controlled trials comparing FMD or FMS with Q-SRP after at least 3 mo were included. Meta-analysis was performed to obtain the weighted mean difference (WMD), together with the corresponding 95% confidence intervals. Thirteen articles were included in the meta-analysis. The WMD of probing pocket depth reduction was 0.25 mm (p chronic periodontitis, and they do not lead to any obvious discomfort among patients. Moreover, FMD had modest additional clinical benefits over Q-SRP, so we prefer to recommend FMD as the first choice for the treatment of adult chronic periodontitis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Comparison Between Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lan, Tao; Hu, Shi-Yu; Zhang, Yuan-Tao; Zheng, Yu-Chen; Zhang, Rui; Shen, Zhe; Yang, Xin-Jian

    2018-04-01

    To compare the efficacy and safety in the management of lumbar diseases performed by either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). Interbody fusion is considered the "gold standard" in the treatment of lumbar degenerative diseases. Both PLIF and TLIF have been advocated, and it remains controversial as to the best operative technique. The electronic databases including Embase, PubMed, and Cochrane library were searched to identify relevant studies up to September 2017. The primary outcomes were fusion rate, complications, and clinical satisfaction. The secondary outcomes were length of hospitalization, operation time, blood loss, postoperative visual analog scale, Oswestry Disability Index, and Japanese Orthopaedic Association Score. Data analysis was conducted with RevMan 5.3 software. A total of 16 studies involving 1502 patients (805 patients in PLIF group and 697 in TLIF group) were included in the meta-analysis. The pooled analysis showed that there was no significant difference in terms of fusion rate (P > 0.05) and clinical satisfaction (P > 0.05) between the 2 groups. TLIF was superior to PLIF with significantly lower incidence of nerve root injury (P 0.05) and graft malposition (P > 0.05). PLIF required significant longer operation time (P degenerative lumbar diseases. However, TLIF was superior to PLIF with shorter operation time, less blood loss, and lower incidence of nerve root injury and dural tear. There is no significant difference between both groups regarding wound infection and graft malposition. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Systematic review with meta-analysis

    DEFF Research Database (Denmark)

    Roda, G; Narula, N; Pinotti, R

    2017-01-01

    and meta-analysis of epidemiological studies reporting on extension of ulcerative colitis to determine frequency of disease extension in patients with limited ulcerative colitis at diagnosis. METHODS: We performed a systematic literature search to identify studies on disease extension of ulcerative colitis...... (UC) and predictors of disease progression. RESULTS: Overall, 41 studies were eligible for systematic review but only 30 for meta-analysis. The overall pooled frequency of UC extension was 22.8% with colonic extension being 17.8% at 5 years and 31% at 10 years. Extension was 17.8% (95% CI 11...... in patients from North America (37.8%) than from Europe (19.6%) (Pmeta-analysis, approximately one quarter of patients with limited UC extend over time with most extension occurring during the first 10 years. Rate of extension depends on age at diagnosis and geographic origin...

  13. Human rights protections and HIV prevalence among MSM who sell sex: Cross-country comparisons from a systematic review and meta-analysis.

    Science.gov (United States)

    Oldenburg, Catherine E; Perez-Brumer, Amaya G; Reisner, Sari L; Mayer, Kenneth H; Mimiaga, Matthew J; Hatzenbuehler, Mark L; Bärnighausen, Till

    2018-04-01

    Laws and policies can affect the HIV risk of key populations through a number of direct and indirect pathways. We investigated the association between HIV prevalence among men who engage in transactional sex and language in the penal code protecting sexual minorities, including men who have sex with men (MSM), and sex workers. HIV prevalence among men who engage in transactional sex was assessed through meta-analysis of published literature and country surveillance reports. Meta-regression was used to determine the association between HIV prevalence and protective laws for sexual minorities and sex workers. Sixty-six reports representing 28 countries and 31,924 individuals were included in the meta-analysis. Controlling for multiple study- and country-level variables, legal protection for sexual minorities was associated with a 10.9% (95% CI: 3.8-18.0%) and sex workers associated with a 7.0% (95% CI: 1.3-12.8%) decrease in country-level HIV prevalence among men who engage in transactional sex. Laws that seek to actively protect sex workers and MSM may be necessary to decrease HIV risk for this key population.

  14. Comparisons of Adherence to Antiretroviral Therapy in a High-Risk Population in China: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Zhou Huan

    Full Text Available Reports on antiretroviral therapy (ART adherence are scare in China; we performed this meta-analysis to estimate ART adherence rates in different populations at high risk for HIV transmission in China.We searched PubMed, Chinese Biomedical Literature Database (Chinese, China National Knowledge Infrastructure (Chinese, and Wanfang (Chinese to identify studies published from January 1985 to May 2015. We used random-effects meta-analysis to calculate weighted mean estimates across studies and 95% CIs. Data were pooled with proportions transformed prior to pooling using the Freeman-Tukey double arcsine transformation and then back transformed to the original scale. We calculated the I2 (and its 95% confidence intervals and tau2 to assess between-study heterogeneity.We identified 36 eligible articles, including 6885 HIV-positive individuals, reporting ART adherence. Pooled analysis produced an estimate of 77.61% (95% CI = 71.63-83.08 of patients with HIV with adequate adherence; however, high heterogeneity was observed between studies (I2 = 96.60%, 95%CI = 96.00%-97.20%; tau2 = 0.16. Three studies, which included 149 old HIV-infected patients, reported the highest ART adequate adherence rate (89.39%, 95% CI = 72.01-99.26 with high heterogeneity between the studies (I2 = 86.20%, 95%CI = 60.00-95.20%; tau2 = 0.13. While, only two studies, which included 143 heterosexual transmission group (HTG patients, reported the lowest ART adequate adherence rate (51.55%, 95% CI = 41.33-61.71 with low heterogeneity between the studies (I2 = 31.3%, tau2 = 0.007. In the multivariable meta-regression model, high-risk populations was the main factor explaining heterogeneity (variance explained 28.14%.ART adherence in some high-risk populations (e.g., heterosexual transmission group is below the recommended levels for maintaining virologic suppression. It is crucial to develop comprehensive intervention strategies to promote ART adherence in high-risk populations and

  15. Comparison of the Fertility Outcome of Salpingotomy and Salpingectomy in Women with Tubal Pregnancy: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Xiaolin Cheng

    Full Text Available To compare the natural fertility outcomes of salpingotomy and salpingectomy among women treated for tubal pregnancy.An online database search including PubMed, Embase, CENTRAL and Web of Science was performed to identify studies comparing salpingotomy and salpingectomy to treat women with tubal pregnancy. The search included papers published after the databases were established until May 2015. Two reviewers independently screened literature according to the inclusion and exclusion criteria and then extracted data and assessed the methodological quality of all of the included studies. The meta-analysis was conducted using RevMan 5.3 software. The registration number is CRD42015017545 in PROSPERO.Two randomized controlled trials (RCTs and eight cohort studies, including a total of 1,229 patients, were znalyzed. The meta-analysis of the RCT subgroup indicated that there was no statistically significant difference in IUP rates (RR = 1.04, 95% CI = 0.89-1.21, P = 0.61 nor the repeat ectopic pregnancy (REP rate (RR = 1.30, 95% CI = 0.72-2.38, P = 0.39 between the salpingotomy and salpingectomy group. In contrast, the cohort study subgroup analysis revealed that the IUP rate was higher in the salpingotomy group compared with the salpingectomy group (RR = 1.24, 95% CI = 1.08-1.42, P = 0.002; Salpingotomy also increased the risk of REP rate (RR = 2.27, 95% CI = 1.12-4.58, P = 0.02. The persistent ectopic pregnancy (PEP occurred more frequently in the salpingotomy group than the salpingectomy group (RR = 11.61, 95% CI = 3.17-42.46, P = 0.0002. An IUP would be more likely to occur after salpingotomy than salpingectomy when the follow-up time was more than 36 months (RR = 1.16, 95% CI = 1.02-1.32, P = 0.03. The IUP rate (RR = 1.13, 95% CI = 1.01-1.26, P = 0.03, and the REP rate (RR = 1.62, 95% CI = 1.02-2.56, P = 0.04 was higher after salpingotomy than salpingectomy among patients from Europe compared with those from America.Based on the available evidence

  16. Systematic meta-analysis of childhood social withdrawal in schizophrenia, and comparison with data from at-risk children aged 9-14 years.

    Science.gov (United States)

    Matheson, Sandra L; Vijayan, Hena; Dickson, Hannah; Shepherd, Alana M; Carr, Vaughan J; Laurens, Kristin R

    2013-08-01

    Social withdrawal is a robust childhood risk factor for later schizophrenia. The aims of this paper were to assess the evidence for childhood social withdrawal among adults with schizophrenia and, comparatively, in children aged 9-14 years who are putatively at-risk of developing schizophrenia. We conducted a meta-analysis, including cohort and case-control studies reporting social withdrawal measured by the Child Behavior Checklist (CBCL) in adults with schizophrenia vs. controls. Further, an experimental study compared CBCL withdrawal scores from typically-developing children with scores from two groups of putatively at-risk children: (i) children displaying a triad of replicated antecedents for schizophrenia, and (ii) children with at least one first- or second-degree relative with schizophrenia or schizoaffective disorder. Six studies met inclusion criteria for the meta-analysis (N = 3828), which demonstrated a large effect of increased childhood social withdrawal in adults with schizophrenia (standardized mean difference [SMD] score = 1.035, 95% CI = 0.304-1.766, p = 0.006), with no indication of publication bias, but considerable heterogeneity (I(2) = 91%). Results from the experimental study also indicated a large effect of increased social withdrawal in children displaying the antecedent triad (SMD = 0.743, p = 0.001), and a weaker effect in children with a family history of schizophrenia (SMD = 0.442, p = 0.051). Childhood social withdrawal may constitute a vulnerability marker for schizophrenia in the presence of other antecedents and/or genetic risk factors for schizophrenia. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Xu Chen; Hu, Xu Hua; Wang, Xiao Ran; Zhou, Chao Xi; Wang, Fei Fei; Yang, Shan; Wang, Gui Ying

    2018-03-16

    Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM). It is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method. Articles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library. Preset outcomes were abstracted and pooled to find out the potential advantages in CNB or VAB. Seven studies were identified and entered final meta-analysis from initially found 138 studies. The rate of ductal carcinoma in situ (DCIS) underestimation was significantly lower in VAB than CNB group [risk ratio (RR) = 1.83, 95% confidence interval (CI) 1.40 to 2.40, p < 0.001]. The microcalcification retrieval rate was significantly higher in VAB than CNB group (RR = 0.89, 95% CI 0.81 to 0.98, p = 0.02), while CNB owned a significantly lower complication rate than VAB (RR = 0.18, 95% CI 0.03 to 0.93, p = 0.04). The atypical ductal hyperplasia (ADH) underestimation rates were not compared for the limited number of studies reporting this outcome. Compared with CNB, VAB shows better diagnostic performance in DCIS underestimation rate and microcalcification retrieval rate. However, CNB shows a significantly lower complication rate. More studies are needed to verify these findings.

  18. Comparison of prophylactic effect of UGIB and effects on platelet function between PPIs and H2RAs combined with DAPT: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yi Z

    2017-03-01

    Full Text Available Zhan-Miao Yi,1 Ting-Ting Qiu,1,2 Yuan Zhang,3 Zhi-Yan Liu,1 Suo-Di Zhai1 1Department of Pharmacy, Peking University Third Hospital, Beijing, 2Department of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China; 3Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada Objective: We compared prophylactic effects of proton pump inhibitors (PPIs and histamine-2 receptor antagonists (H2RAs on upper gastrointestinal bleeding (UGIB associated with dual antiplatelet therapy (DAPT and explored this influence on platelet function. Methods: Randomized controlled trials and cohort studies comparing PPIs with H2RAs in adults receiving DAPT were collected from PubMed, EMBASE and Cochrane databases. Dichotomous data were pooled to obtain risk ratios (RRs for UGIB, major adverse cardiovascular events (MACEs, poor responders to clopidogrel and rehospitalization, and continuous data were pooled to obtain mean differences (MDs for P2Y12 reaction units (PRUs, with 95% confidence intervals (CIs. Results: Twelve clinical trials (n=3,301 met the inclusion criteria. Compared to H2RAs, PPIs lessened UGIB (RR =0.16, 95% CI: 0.03–0.70, and there was no significant difference in the incidence of PRUs (MD =18.21 PRUs, 95% CI: -4.11–40.54, poor responders to clopidogrel (RR =1.21, 95% CI: 0.92–1.61, incidence of MACEs (RR =0.89, 95% CI: 0.45–1.75 or rehospitalization (RR =1.76, 95% CI: 0.79–3.92. Subgroup analysis confirmed fewer PRUs in the H2RAs group compared to the omeprazole group (2 studies, n=189, MD =31.80 PRUs, 95% CI: 11.65–51.96. However, poor responder data for clopidogrel and MACEs might be unreliable because few studies of this kind were included. Conclusion: Limited evidence indicates that PPIs were better than H2RAs for prophylaxis of UGIB associated with DAPT and had no effect on platelet function. Further study is needed to confirm these observations. Keywords: proton pump

  19. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  20. Comparison of the accuracy of Hybrid Capture II and polymerase chain reaction in detecting clinically important cervical dysplasia: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Luu, Hung N; Dahlstrom, Kristina R; Mullen, Patricia Dolan; VonVille, Helena M; Scheurer, Michael E

    2013-01-01

    The effectiveness of screening programs for cervical cancer has benefited from the inclusion of Human papillomavirus (HPV) DNA assays; which assay to choose, however, is not clear based on previous reviews. Our review addressed test accuracy of Hybrid Capture II (HCII) and polymerase chain reaction (PCR) assays based on studies with stronger designs and with more clinically relevant outcomes. We searched OvidMedline, PubMed, and the Cochrane Library for English language studies comparing both tests, published 1985–2012, with cervical dysplasia defined by the Bethesda classification. Meta-analysis provided pooled sensitivity, specificity, and 95% confidence intervals (CIs); meta-regression identified sources of heterogeneity. From 29 reports, we found that the pooled sensitivity and specificity to detect high-grade squamous intraepithelial lesion (HSIL) was higher for HCII than PCR (0.89 [CI: 0.89–0.90] and 0.85 [CI: 0.84–0.86] vs. 0.73 [CI: 0.73–0.74] and 0.62 [CI: 0.62–0.64]). Both assays had higher accuracy to detect cervical dysplasia in Europe than in Asia-Pacific or North America (diagnostic odd ratio – dOR = 4.08 [CI: 1.39–11.91] and 4.56 [CI: 1.86–11.17] for HCII vs. 2.66 [CI: 1.16–6.53] and 3.78 [CI: 1.50–9.51] for PCR) and accuracy to detect HSIL than atypical squamous cells of undetermined significance (ASCUS)/ low-grade squamous intraepithelial lesion (LSIL) (HCII-dOR = 9.04 [CI: 4.12–19.86] and PCR-dOR = 5.60 [CI: 2.87–10.94]). For HCII, using histology as a gold standard results in higher accuracy than using cytology (dOR = 2.87 [CI: 1.31–6.29]). Based on higher test accuracy, our results support the use of HCII in cervical cancer screening programs. The role of HPV type distribution should be explored to determine the worldwide comparability of HPV test accuracy

  1. Trial Sequential Analysis in systematic reviews with meta-analysis

    DEFF Research Database (Denmark)

    Wetterslev, Jørn; Jakobsen, Janus Christian; Gluud, Christian

    2017-01-01

    BACKGROUND: Most meta-analyses in systematic reviews, including Cochrane ones, do not have sufficient statistical power to detect or refute even large intervention effects. This is why a meta-analysis ought to be regarded as an interim analysis on its way towards a required information size...... from traditional meta-analyses using unadjusted naïve 95% confidence intervals and 5% thresholds for statistical significance. Spurious conclusions in systematic reviews with traditional meta-analyses can be reduced using Trial Sequential Analysis. Several empirical studies have demonstrated...

  2. Match Analysis in Volleyball: a systematic review

    Directory of Open Access Journals (Sweden)

    Miguel Silva

    2016-03-01

    Full Text Available The present article aims to review the available literature on match analysis in adult male Volleyball. Specific key words "performance analysis", "match analysis", "game analysis", "notational analysis", "tactical analysis", "technical analysis", "outcome" and "skills" were used to search relevant databases (PubMed, Web of Science, SportDiscus, Academic Search Complete and the International Journal of Performance Analysis in Sport. The research was conducted according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta analyses guidelines. Of 3407 studies initially identified, only 34 were fully reviewed, and their outcome measures extracted and analyzed. Studies that fit all inclusion criteria were organized into two levels of analysis, according to their research design (comparative or predictive and depending on the type of variables analyzed (skills and their relationship with success, play position and match phase. Results show that from a methodological point of view, comparative studies where currently complemented with some predictive studies. This predictive approach emerged with the aim to identify the relationship between variables, considering their possible interactions and consequently its effect on team performance, contributing to a better understanding of Volleyball game performance through match analysis. Taking into account the limitations of the reviewed studies, future research should provide comprehensive operational definitions for the studied variables, using more recent samples, and consider integrating the player positions and match phase contexts into the analysis of Volleyball.

  3. Systematic comparison of mechanical and thermal sludge disintegration technologies.

    Science.gov (United States)

    Wett, B; Phothilangka, P; Eladawy, A

    2010-06-01

    This study presents a systematic comparison and evaluation of sewage sludge pre-treatment by mechanical and thermal techniques. Waste activated sludge (WAS) was pre-treated by separate full scale Thermo-Pressure-Hydrolysis (TDH) and ball milling facilities. Then the sludge was processed in pilot-scale digestion experiments. The results indicated that a significant increase in soluble organic matter could be achieved. TDH and ball milling pre-treatment could offer a feasible treatment method to efficiently disintegrate sludge and enhance biogas yield of digestion. The TDH increased biogas production by ca. 75% whereas ball milling allowed for an approximately 41% increase. The mechanisms of pre-treatment were investigated by numerical modeling based on Anaerobic Digestion Model No. 1 (ADM1) in the MatLab/SIMBA environment. TDH process induced advanced COD-solubilisation (COD(soluble)/COD(total)=43%) and specifically complete destruction of cell mass which is hardly degradable in conventional digestion. While the ball mill technique achieved a lower solubilisation rate (COD(soluble)/COD(total)=28%) and only a partial destruction of microbial decay products. From a whole-plant prospective relevant release of ammonia and formation of soluble inerts have been observed especially from thermal hydrolysis. Copyright 2009 Elsevier Ltd. All rights reserved.

  4. Systematic review with meta-analysis

    DEFF Research Database (Denmark)

    Kimer, N; Krag, A; Møller, Søren

    2014-01-01

    BACKGROUND: Rifaximin is recommended for prevention of hepatic encephalopathy (HE). The effects of rifaximin on overt and minimal HE are debated. AIM: To perform a systematic review and meta-analysis of randomised controlled trials (RCTs) on rifaximin for HE. METHODS: We performed electronic...... and manual searches, gathered information from the U.S. Food and Drug Administration Home Page, and obtained unpublished information on trial design and outcome measures from authors and pharmaceutical companies. Meta-analyses were performed and results presented as risk ratios (RR) with 95% confidence...

  5. International comparison of cost of falls in older adults living in the community: a systematic review.

    Science.gov (United States)

    Davis, J C; Robertson, M C; Ashe, M C; Liu-Ambrose, T; Khan, K M; Marra, C A

    2010-08-01

    Our objective was to determine international estimates of the economic burden of falls in older people living in the community. Our systematic review emphasized the need for a consensus on methodology for cost of falls studies to enable more accurate comparisons and subgroup-specific estimates among different countries. The purpose of this study was to determine international estimates of the economic burden of falls in older people living in the community. This is a systematic review of peer-reviewed journal articles reporting estimates for the cost of falls in people aged > or =60 years living in the community. We searched for papers published between 1945 and December 2008 in MEDLINE, PUBMED, EMBASE, CINAHL, Cochrane Collaboration, and NHS EED databases that identified cost of falls in older adults. We extracted the cost of falls in the reported currency and converted them to US dollars at 2008 prices, cost items measured, perspective, time horizon, and sensitivity analysis. We assessed the quality of the studies using a selection of questions from Drummond's checklist. Seventeen studies met our inclusion criteria. Studies varied with respect to viewpoint of the analysis, definition of falls, identification of important and relevant cost items, and time horizon. Only two studies reported a sensitivity analysis and only four studies identified the viewpoint of their economic analysis. In the USA, non-fatal and fatal falls cost US $23.3 billion (2008 prices) annually and US $1.6 billion in the UK. The economic cost of falls is likely greater than policy makers appreciate. The mean cost of falls was dependent on the denominator used and ranged from US $3,476 per faller to US $10,749 per injurious fall and US $26,483 per fall requiring hospitalization. A consensus on methodology for cost of falls studies would enable more accurate comparisons and subgroup-specific estimates among different countries.

  6. Systematic text condensation: a strategy for qualitative analysis.

    Science.gov (United States)

    Malterud, Kirsti

    2012-12-01

    To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies. Giorgi's psychological phenomenological analysis is the point of departure and inspiration for systematic text condensation. The basic elements of Giorgi's method and the elaboration of these in systematic text condensation are presented, followed by a detailed description of procedures for analysis according to systematic text condensation. Finally, similarities and differences compared with other frequently applied methods for qualitative analysis are identified, as the foundation of a discussion of strengths and limitations of systematic text condensation. Systematic text condensation is a descriptive and explorative method for thematic cross-case analysis of different types of qualitative data, such as interview studies, observational studies, and analysis of written texts. The method represents a pragmatic approach, although inspired by phenomenological ideas, and various theoretical frameworks can be applied. The procedure consists of the following steps: 1) total impression - from chaos to themes; 2) identifying and sorting meaning units - from themes to codes; 3) condensation - from code to meaning; 4) synthesizing - from condensation to descriptions and concepts. Similarities and differences comparing systematic text condensation with other frequently applied qualitative methods regarding thematic analysis, theoretical methodological framework, analysis procedures, and taxonomy are discussed. Systematic text condensation is a strategy for analysis developed from traditions shared by most of the methods for analysis of qualitative data. The method offers the novice researcher a process of intersubjectivity, reflexivity, and feasibility, while maintaining a responsible level of methodological rigour.

  7. A systematic review of comparisons between protocols or registrations and full reports in primary biomedical research

    Directory of Open Access Journals (Sweden)

    Guowei Li

    2018-01-01

    Full Text Available Abstract Background Prospective study protocols and registrations can play a significant role in reducing incomplete or selective reporting of primary biomedical research, because they are pre-specified blueprints which are available for the evaluation of, and comparison with, full reports. However, inconsistencies between protocols or registrations and full reports have been frequently documented. In this systematic review, which forms part of our series on the state of reporting of primary biomedical, we aimed to survey the existing evidence of inconsistencies between protocols or registrations (i.e., what was planned to be done and/or what was actually done and full reports (i.e., what was reported in the literature; this was based on findings from systematic reviews and surveys in the literature. Methods Electronic databases, including CINAHL, MEDLINE, Web of Science, and EMBASE, were searched to identify eligible surveys and systematic reviews. Our primary outcome was the level of inconsistency (expressed as a percentage, with higher percentages indicating greater inconsistency between protocols or registration and full reports. We summarized the findings from the included systematic reviews and surveys qualitatively. Results There were 37 studies (33 surveys and 4 systematic reviews included in our analyses. Most studies (n = 36 compared protocols or registrations with full reports in clinical trials, while a single survey focused on primary studies of clinical trials and observational research. High inconsistency levels were found in outcome reporting (ranging from 14% to 100%, subgroup reporting (from 12% to 100%, statistical analyses (from 9% to 47%, and other measure comparisons. Some factors, such as outcomes with significant results, sponsorship, type of outcome and disease speciality were reported to be significantly related to inconsistent reporting. Conclusions We found that inconsistent reporting between protocols or

  8. Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Snedecor SJ

    2013-07-01

    Full Text Available Sonya J Snedecor,1 Lavanya Sudharshan,1 Joseph C Cappelleri,2 Alesia Sadosky,3 Pooja Desai,4 Yash J Jalundhwala,5 Marc Botteman1 1Pharmerit International, Bethesda, MD, USA; 2Global Research and Development, Pfizer, Groton, CT, USA; 3Biostatistics, Pfizer, New York, NY, USA; 4College of Pharmacy, University of Texas at Austin, Austin, TX, USA; 5Pharmacy Administration, University of Illinois at Chicago, Chicago, IL, USA Background: Management of neuropathic pain (NeP associated with spinal cord injury (SCI is difficult. This report presents a systematic literature review and comparison of the efficacy and safety of pharmacologic therapies for treating SCI-associated NeP. Methods: Medline, Embase, Cochrane, and Database of Abstracts of Reviews of Effects were searched through December 2011 for randomized, blinded, and controlled clinical trials of SCI-associated NeP meeting predefined inclusion criteria. Efficacy outcomes of interest were pain reduction on the 11-point numeric rating scale (NRS or 100 mm visual analog scale and proportion of patients achieving ≥30% or ≥50% pain reduction. Discontinuations and adverse events (AEs were also assessed, for which Bayesian meta-analytic indirect comparisons were performed. Results: Of the nine studies included in the analysis, samples were <100 patients, except for one pregabalin study (n = 136. Standard errors for the NRS outcome were often not reported, precluding quantitative comparisons across treatments. Estimated 11-point NRS pain reduction relative to placebo was –1.72 for pregabalin, –1.65 for amitriptyline, –1.0 for duloxetine, –1 (median for levetiracetam, –0.27 for gabapentin, 1 (median for lamotrigine, and 2 for dronabinol. Risk ratios relative to placebo for 30% improvement were 0.71 for levetiracetam and 2.56 for pregabalin, and 0.94 and 2.91, respectively, for 50% improvement. Meta-analytic comparisons showed significantly more AEs with pregabalin and tramadol compared with

  9. Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews.

    Science.gov (United States)

    Golder, Su; Loke, Yoon K; Zorzela, Liliane

    2014-06-01

    Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. To compare search methods in systematic reviews of adverse effects with other reviews. The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials (RCTs). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE. However, reviews of adverse effects are more likely to include a range of study designs (not just RCTs) and search beyond MEDLINE. © 2014 Crown Copyright.

  10. Systematic reviews with meta-analysis: Why, when, and how?

    NARCIS (Netherlands)

    Crocetti, E.

    2016-01-01

    Systematic reviews with meta-analysis represent the gold standard for conducting reliable and transparent reviews of the literature. The purpose of this article is threefold: (a) to address why and when it is worthwhile to conduct a systematic review with meta-analysis, covering advantages of this

  11. Trial Sequential Analysis in systematic reviews with meta-analysis

    Directory of Open Access Journals (Sweden)

    Jørn Wetterslev

    2017-03-01

    Full Text Available Abstract Background Most meta-analyses in systematic reviews, including Cochrane ones, do not have sufficient statistical power to detect or refute even large intervention effects. This is why a meta-analysis ought to be regarded as an interim analysis on its way towards a required information size. The results of the meta-analyses should relate the total number of randomised participants to the estimated required meta-analytic information size accounting for statistical diversity. When the number of participants and the corresponding number of trials in a meta-analysis are insufficient, the use of the traditional 95% confidence interval or the 5% statistical significance threshold will lead to too many false positive conclusions (type I errors and too many false negative conclusions (type II errors. Methods We developed a methodology for interpreting meta-analysis results, using generally accepted, valid evidence on how to adjust thresholds for significance in randomised clinical trials when the required sample size has not been reached. Results The Lan-DeMets trial sequential monitoring boundaries in Trial Sequential Analysis offer adjusted confidence intervals and restricted thresholds for statistical significance when the diversity-adjusted required information size and the corresponding number of required trials for the meta-analysis have not been reached. Trial Sequential Analysis provides a frequentistic approach to control both type I and type II errors. We define the required information size and the corresponding number of required trials in a meta-analysis and the diversity (D2 measure of heterogeneity. We explain the reasons for using Trial Sequential Analysis of meta-analysis when the actual information size fails to reach the required information size. We present examples drawn from traditional meta-analyses using unadjusted naïve 95% confidence intervals and 5% thresholds for statistical significance. Spurious conclusions in

  12. Bimodality in heavy ions collisions: systematic and comparisons

    International Nuclear Information System (INIS)

    Mercier, D.

    2008-11-01

    During the last few years, bi-modality in heavy ions collisions has been observed for different systems, on large energy scale (from 35 MeV/u up to 1 GeV/u). In this thesis, the bimodal behaviour of the largest fragment distribution (Zmax) is studied for different INDRA data sets. For peripheral collisions (Au+Au from 60 to 150 MeV/u, Xe+Sn 80-100 MeV/u), the influence of sorting and selections on bi-modality is tested. Then, two different approaches based on models are considered. In the first one (ELIE), bi-modality would reflect mainly the collision geometry and the Fermi motion of the nucleon. In the second one (SMM), bi-modality would reflect a phase transition of nuclear matter. The data are in favour of the second model. Zmax can then be considered as an order parameter of the transition. A re-weighting procedure producing a flat excitation energy distribution is used to achieve comparisons between various bombarding energies and theoretical predictions based on a canonical approach. A latent heat of the transition is extracted. For central collisions (Ni+Ni from 32 to 74 MeV/u and Xe+Sn from 25 to 50 MeV/u) single source events are isolated by a Discriminant Factor Analysis. Bi-modality is then looked for, in cumulating the different incident energies and in applying the re-weighting procedure of the corresponding excitation energy as done for peripheral collisions. The bi-modality behaviour is less manifest for central collisions than for peripheral ones. The possible reasons of this difference are discussed. (author)

  13. Automatic adventitious respiratory sound analysis: A systematic review.

    Science.gov (United States)

    Pramono, Renard Xaviero Adhi; Bowyer, Stuart; Rodriguez-Villegas, Esther

    2017-01-01

    Automatic detection or classification of adventitious sounds is useful to assist physicians in diagnosing or monitoring diseases such as asthma, Chronic Obstructive Pulmonary Disease (COPD), and pneumonia. While computerised respiratory sound analysis, specifically for the detection or classification of adventitious sounds, has recently been the focus of an increasing number of studies, a standardised approach and comparison has not been well established. To provide a review of existing algorithms for the detection or classification of adventitious respiratory sounds. This systematic review provides a complete summary of methods used in the literature to give a baseline for future works. A systematic review of English articles published between 1938 and 2016, searched using the Scopus (1938-2016) and IEEExplore (1984-2016) databases. Additional articles were further obtained by references listed in the articles found. Search terms included adventitious sound detection, adventitious sound classification, abnormal respiratory sound detection, abnormal respiratory sound classification, wheeze detection, wheeze classification, crackle detection, crackle classification, rhonchi detection, rhonchi classification, stridor detection, stridor classification, pleural rub detection, pleural rub classification, squawk detection, and squawk classification. Only articles were included that focused on adventitious sound detection or classification, based on respiratory sounds, with performance reported and sufficient information provided to be approximately repeated. Investigators extracted data about the adventitious sound type analysed, approach and level of analysis, instrumentation or data source, location of sensor, amount of data obtained, data management, features, methods, and performance achieved. A total of 77 reports from the literature were included in this review. 55 (71.43%) of the studies focused on wheeze, 40 (51.95%) on crackle, 9 (11.69%) on stridor, 9 (11

  14. Why home hemodialysis? A systematic "marketing" analysis.

    Science.gov (United States)

    Piccoli, Giorgina Barbara; Ferraresi, Martina; Consiglio, Valentina; Scognamiglio, Stefania; Deagostini, Maria Chiara; Randone, Olga; Vigotti, Federica Neve; Calderale, Pasquale Mario

    2012-01-01

    Home hemodialysis (HHD) has met with alternating fortunes. The present revival of interest is due to lower costs and more frequent/efficient treatments. HHD is underdeveloped, and a marketing approach may help in defining development strategies. The aim of this study was to systematically review the recent literature (2000-2010) according to a marketing approach, defining the potential of HHD according to the classical marketing items: market size, growth rate, profitability, trends, keys for success, needs for structures and distribution channels. A Medline search was conducted for 2000-2010. The analysis took into account the recent trends in publication as a measure of interest, size and trends, while survival and costs were analyzed as keys for success. The issues of structures and distribution channels were arbitrarily considered as equivalent to the overall hemodialysis market. Interest in HHD is growing, as shown by the increasing number of published papers (9 in 2000, 52 in 2010); yet, clinical studies accounted for less than half of the papers. In the 138 clinical studies, quality of life (33 papers) and metabolism (16 papers) were the most studied topics. Survival and cost analyses were highly heterogeneous (the broad inclusion of nocturnal or quotidian dialysis has to be mentioned). Overall, survival was equal to, or better than, that for other modalities, including transplantation and peritoneal dialysis; costs compared favorably with hospital dialysis and were equivalent to those of peritoneal dialysis. The small "market" of HHD is increasing, with potential for further growth, the keys for success being equivalence or superiority of survival at equivalent or lower costs.

  15. [Development of an Excel spreadsheet for meta-analysis of indirect and mixed treatment comparisons].

    Science.gov (United States)

    Tobías, Aurelio; Catalá-López, Ferrán; Roqué, Marta

    2014-01-01

    Meta-analyses in clinical research usually aimed to evaluate treatment efficacy and safety in direct comparison with a unique comparator. Indirect comparisons, using the Bucher's method, can summarize primary data when information from direct comparisons is limited or nonexistent. Mixed comparisons allow combining estimates from direct and indirect comparisons, increasing statistical power. There is a need for simple applications for meta-analysis of indirect and mixed comparisons. These can easily be conducted using a Microsoft Office Excel spreadsheet. We developed a spreadsheet for indirect and mixed effects comparisons of friendly use for clinical researchers interested in systematic reviews, but non-familiarized with the use of more advanced statistical packages. The use of the proposed Excel spreadsheet for indirect and mixed comparisons can be of great use in clinical epidemiology to extend the knowledge provided by traditional meta-analysis when evidence from direct comparisons is limited or nonexistent.

  16. Systematic comparison of ORC configurations by means of comprehensive performance indexes

    International Nuclear Information System (INIS)

    Branchini, Lisa; De Pascale, Andrea; Peretto, Antonio

    2013-01-01

    The Organic Rankine Cycle (ORC) is considered as an emerging technology for power generation through heat recovering from different thermal sources, based on the use of organic fluids as working medium. This paper presents a numerical study to assess the relevance: i) of the thermodynamic cycle, ii) of the main design parameters and iii) of the working fluid, on the achievable performance. The ORC performance is here calculated in terms of six different thermodynamic indexes, offering comprehensive information, namely: cycle efficiency, specific work, recovery efficiency, turbine volumetric expansion ratio, ORC fluid-to-hot source mass flow ratio and heat exchangers size parameter. In the framework of a systematic investigation approach, various possible modifications to the simple ORC plant layout are here analyzed and compared, in order to improve the ORC recovery performance; arrangements such as recuperation, superheated cycle, supercritical conditions, regenerative cycle and their combinations are taken into account. The investigation is carried out by means of an in-house developed calculation tool, based on a thermodynamic property database of the considered fluids, including aromatics, siloxanes, refrigerants and hydrocarbons. A comprehensive parametric analysis of these cycles at different hot source temperature and different evaporation pressure values is carried out. The objectives of this investigation are to provide useful guidelines to select the ORC configuration, the most appropriate fluid and to define the operating parameters, depending on the specific application. Thermodynamic results are also related with sizing of ORC components and thus can be used for economic assessment of the different ORC design alternatives. -- Highlights: • Systematic comparison of ORC thermodynamic arrangements is performed. • Performance is calculated introducing six comprehensive energy and size/economic indexes. • An in-house-developed calculation tool is used

  17. Systematic analysis of aircraft separation requirements

    Science.gov (United States)

    Ennis, Rachelle Lea

    2005-12-01

    Minimum separation standards are necessary for safety in the air traffic control system. At the same time, minimum separation standards constrain the flow of air traffic and cause delays that translate to millions of dollars in fuel costs. Two necessary separation standards are defined. Then, practical methods for calculating the minimum required size of these separation standards are presented. First, the protected zone is considered. The protected zone represents a region around a given aircraft that no other aircraft should penetrate for the safety of both aircraft. It defines minimum separation requirements. Three major components of the protected zone and their interplays are identified: a vortex region, a safety buffer region, and a state-uncertainty region. A systematic procedure is devised for the analysis of the state-uncertainty region. In particular, models of trajectory controls are developed that can be used to represent different modes of pilot and/or autopilot controls, such as path feedback and non-path feedback. Composite protected zones under various conditions are estimated, and effective ways to reduce sizes of protected zones for advanced air traffic management are examined. In order to maintain minimum separation standards between two aircraft, proper avoidance maneuvers must be initiated before their relative separation reaches the minimum separation due to aircraft dynamics, controller and pilot response delays, etc. The concept of the required action threshold is presented. It is defined as the advanced time for which the conflict resolution process must begin in order to maintain minimum separation requirements. Five main segments in the process of conflict resolution are identified, discussed, and modeled: state information acquisition, comprehension and decision, communication, pilot response, and aircraft maneuver. Each of the five segments is modeled via a time constant. Time estimates for the first four segments are obtained from

  18. Systematic review and a meta-analysis

    African Journals Online (AJOL)

    We systematically reviewed the available literature and meta-analyzed the data which was specialized in Down syndrome (DS) diagnosis with proteomic techniques. Pubmed, EBSCOhost and ScienceDirect searches for relevant articles published from inception until July 2010 were obtained and ten articles were selected.

  19. VAGINAL PROGESTERONE VERSUS CERVICAL CERCLAGE FOR THE PREVENTION OF PRETERM BIRTH IN WOMEN WITH A SONOGRAPHIC SHORT CERVIX, SINGLETON GESTATION, AND PREVIOUS PRETERM BIRTH: A SYSTEMATIC REVIEW AND INDIRECT COMPARISON META-ANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustin; ROMERO, Roberto; NICOLAIDES, Kypros; CHAIWORAPONGSA, Tinnakorn; O'BRIEN, John M.; CETINGOZ, Elcin; DA FONSECA, Eduardo; CREASY, George; SOMA-PILLAY, Priya; FUSEY, Shalini; CAM, Cetin; ALFIREVIC, Zarko; HASSAN, Sonia S.

    2012-01-01

    OBJECTIVE No randomized controlled trial has directly compared vaginal progesterone and cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous spontaneous preterm birth. We performed an indirect comparison of vaginal progesterone versus cerclage, using placebo/no cerclage as the common comparator. STUDY DESIGN Adjusted indirect meta-analysis of randomized controlled trials. RESULTS Four studies evaluating vaginal progesterone versus placebo (158 patients) and five evaluating cerclage versus no cerclage (504 patients) were included. Both interventions were associated with a statistically significant reduction in the risk of preterm birth <32 weeks of gestation and composite perinatal morbidity and mortality compared with placebo/no cerclage. Adjusted indirect meta-analyses did not show statistically significant differences between vaginal progesterone and cerclage in reducing preterm birth or adverse perinatal outcomes. CONCLUSION Based on state-of-the-art methodology for indirect comparisons, either vaginal progesterone or cerclage are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous preterm birth. The selection of the optimal treatment may depend upon adverse events, cost and patient/clinician preferences. PMID:23157855

  20. A Self-Control Versus a Counterconditioning Paradigm for Systematic Desensitization: An Experimental Comparison

    Science.gov (United States)

    Spiegler, Michael D.; And Others

    1976-01-01

    A comparison was made between the traditional counterconditioning paradigm and a self-control paradigm of systematic desensitization. College students reporting high test anxiety and indicating interest in receiving treatment were assigned to counterconditioning, self-control, or wait-list control conditions. As predicted, self-control procedures…

  1. A practice-driven systematic review of dependency analysis solutions

    NARCIS (Netherlands)

    Callo Arias, Trosky B.; Spek, Pieter van der; Avgeriou, Paris

    2011-01-01

    When following architecture-driven strategies to develop large software-intensive systems, the analysis of the dependencies is not an easy task. In this paper, we report a systematic literature review on dependency analysis solutions. Dependency analysis concerns making dependencies due to

  2. A systematic review of breath analysis and detection of volatile organic compounds in COPD

    DEFF Research Database (Denmark)

    Christiansen, Anders; Davidsen, Jesper Rømhild; Titlestad, Ingrid

    2016-01-01

    research area is breath analysis, with several published attempts to find exhaled compounds as diagnostic markers. The field is broad and no review of published COPD breath analysis studies exists yet. We have conducted a systematic review examining the state of art and identified 12 suitable papers, which...... in breath sampling technologies, the selection of appropriate control groups, and a lack of sophisticated (and standardized) statistical data analysis methods. No cross-hospital/study comparisons have been published yet. We conclude that future efforts should (also) concentrate on making breath data...... analysis more comparable through standardization of sampling, data processing, and reporting....

  3. IPAD: the Integrated Pathway Analysis Database for Systematic Enrichment Analysis.

    Science.gov (United States)

    Zhang, Fan; Drabier, Renee

    2012-01-01

    Next-Generation Sequencing (NGS) technologies and Genome-Wide Association Studies (GWAS) generate millions of reads and hundreds of datasets, and there is an urgent need for a better way to accurately interpret and distill such large amounts of data. Extensive pathway and network analysis allow for the discovery of highly significant pathways from a set of disease vs. healthy samples in the NGS and GWAS. Knowledge of activation of these processes will lead to elucidation of the complex biological pathways affected by drug treatment, to patient stratification studies of new and existing drug treatments, and to understanding the underlying anti-cancer drug effects. There are approximately 141 biological human pathway resources as of Jan 2012 according to the Pathguide database. However, most currently available resources do not contain disease, drug or organ specificity information such as disease-pathway, drug-pathway, and organ-pathway associations. Systematically integrating pathway, disease, drug and organ specificity together becomes increasingly crucial for understanding the interrelationships between signaling, metabolic and regulatory pathway, drug action, disease susceptibility, and organ specificity from high-throughput omics data (genomics, transcriptomics, proteomics and metabolomics). We designed the Integrated Pathway Analysis Database for Systematic Enrichment Analysis (IPAD, http://bioinfo.hsc.unt.edu/ipad), defining inter-association between pathway, disease, drug and organ specificity, based on six criteria: 1) comprehensive pathway coverage; 2) gene/protein to pathway/disease/drug/organ association; 3) inter-association between pathway, disease, drug, and organ; 4) multiple and quantitative measurement of enrichment and inter-association; 5) assessment of enrichment and inter-association analysis with the context of the existing biological knowledge and a "gold standard" constructed from reputable and reliable sources; and 6) cross-linking of

  4. A systematic comparison of recurrent event models for application to composite endpoints.

    Science.gov (United States)

    Ozga, Ann-Kathrin; Kieser, Meinhard; Rauch, Geraldine

    2018-01-04

    Many clinical trials focus on the comparison of the treatment effect between two or more groups concerning a rarely occurring event. In this situation, showing a relevant effect with an acceptable power requires the observation of a large number of patients over a long period of time. For feasibility issues, it is therefore often considered to include several event types of interest, non-fatal or fatal, and to combine them within a composite endpoint. Commonly, a composite endpoint is analyzed with standard survival analysis techniques by assessing the time to the first occurring event. This approach neglects that an individual may experience more than one event which leads to a loss of information. As an alternative, composite endpoints could be analyzed by models for recurrent events. There exists a number of such models, e.g. regression models based on count data or Cox-based models such as the approaches of Andersen and Gill, Prentice, Williams and Peterson or, Wei, Lin and Weissfeld. Although some of the methods were already compared within the literature there exists no systematic investigation for the special requirements regarding composite endpoints. Within this work a simulation-based comparison of recurrent event models applied to composite endpoints is provided for different realistic clinical trial scenarios. We demonstrate that the Andersen-Gill model and the Prentice- Williams-Petersen models show similar results under various data scenarios whereas the Wei-Lin-Weissfeld model delivers effect estimators which can considerably deviate under commonly met data scenarios. Based on the conducted simulation study, this paper helps to understand the pros and cons of the investigated methods in the context of composite endpoints and provides therefore recommendations for an adequate statistical analysis strategy and a meaningful interpretation of results.

  5. Methodology Series Module 6: Systematic Reviews and Meta-analysis.

    Science.gov (United States)

    Setia, Maninder Singh

    2016-01-01

    Systematic reviews and meta-analysis have become an important of biomedical literature, and they provide the "highest level of evidence" for various clinical questions. There are a lot of studies - sometimes with contradictory conclusions - on a particular topic in literature. Hence, as a clinician, which results will you believe? What will you tell your patient? Which drug is better? A systematic review or a meta-analysis may help us answer these questions. In addition, it may also help us understand the quality of the articles in literature or the type of studies that have been conducted and published (example, randomized trials or observational studies). The first step it to identify a research question for systematic review or meta-analysis. The next step is to identify the articles that will be included in the study. This will be done by searching various databases; it is important that the researcher should search for articles in more than one database. It will also be useful to form a group of researchers and statisticians that have expertise in conducting systematic reviews and meta-analysis before initiating them. We strongly encourage the readers to register their proposed review/meta-analysis with PROSPERO. Finally, these studies should be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist.

  6. Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Schwingshackl, Lukas; Hoffmann, Georg

    2013-12-01

    Dietary fat plays an important role in the primary prevention of cardiovascular disease, but long-term (≥12 months) effects of different percentages of fat in the diet on blood lipid levels remain to be established. Our systematic review and meta-analysis focused on randomized controlled trials assessing the long-term effects of low-fat diets compared with diets with high amounts of fat on blood lipid levels. Relevant randomized controlled trials were identified searching MEDLINE, EMBASE, and the Cochrane Trial Register until March 2013. Thirty-two studies were included in the meta-analysis. Decreases in total cholesterol (weighted mean difference -4.55 mg/dL [-0.12 mmol/L], 95% CI -8.03 to -1.07; P=0.01) and low-density lipoprotein (LDL) cholesterol (weighted mean difference -3.11 mg/dL [-0.08 mmol/L], 95% CI -4.51 to -1.71; Plow-fat diets, whereas rise in high-density lipoprotein (HDL) cholesterol (weighted mean difference 2.35 mg/dL [0.06 mmol/L], 95% CI 1.29 to 3.42; Pfat diet groups. Including only hypocaloric diets, the effects of low-fat vs high-fat diets on total cholesterol and LDL cholesterol levels were abolished. Meta-regression revealed that lower total cholesterol level was associated with lower intakes of saturated fat and higher intakes of polyunsaturated fat, and increases in HDL cholesterol levels were related to higher amounts of total fat largely derived from monounsaturated fat (of either plant or animal origin) in high-fat diets (composition of which was ~17% of total energy content in the form of monounsaturated fatty acids, ~8% of total energy content in the form of polyunsaturated fatty acids), whereas increases in triglyceride levels were associated with higher intakes of carbohydrates. In addition, lower LDL cholesterol level was marginally associated with lower saturated fat intake. The results of our meta-analysis do not allow for an unequivocal recommendation of either low-fat or high-fat diets in the primary prevention of

  7. Effects of different lower-limb sensory stimulation strategies on postural regulation?A systematic review and meta-analysis

    OpenAIRE

    Woo, Mei Teng; Davids, Keith; Liukkonen, Jarmo; Orth, Dominic; Chow, Jia Yi; Jaakkola, Timo

    2017-01-01

    Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges’ g) standardized mean differences ...

  8. Comparison between paricalcitol and active non-selective vitamin D receptor activator for secondary hyperparathyroidism in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Cai, Panpan; Tang, Xiaohong; Qin, Wei; Ji, Ling; Li, Zi

    2016-04-01

    The goal of this systematic review is to evaluate the efficacy and safety of paricalcitol versus active non-selective vitamin D receptor activators (VDRAs) for secondary hyperparathyroidism (SHPT) management in chronic kidney disease (CKD) patients. PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), clinicaltrials.gov (inception to September 2015), and ASN Web site were searched for relevant studies. A meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs that assessed the effects and adverse events of paricalcitol and active non-selective VDRA in adult CKD patients with SHPT was performed using Review Manager 5.2. A total of 10 trials involving 734 patients were identified for this review. The quality of included trials was limited, and very few trials reported all-cause mortality or cardiovascular calcification without any differences between two groups. Compared with active non-selective VDRAs, paricalcitol showed no significant difference in both PTH reduction (MD -7.78, 95% CI -28.59-13.03, P = 0.46) and the proportion of patients who achieved the target reduction of PTH (OR 1.27, 95% CI 0.87-1.85, P = 0.22). In addition, no statistical differences were found in terms of serum calcium, episodes of hypercalcemia, serum phosphorus, calcium × phosphorus products, and bone metabolism index. Current evidence is insufficient, showing paricalcitol is superior to active non-selective VDRAs in lowering PTH or reducing the burden of mineral loading. Further trials are required to prove the tissue-selective effect of paricalcitol and to overcome the limitation of current research.

  9. Automatic adventitious respiratory sound analysis: A systematic review.

    Directory of Open Access Journals (Sweden)

    Renard Xaviero Adhi Pramono

    Full Text Available Automatic detection or classification of adventitious sounds is useful to assist physicians in diagnosing or monitoring diseases such as asthma, Chronic Obstructive Pulmonary Disease (COPD, and pneumonia. While computerised respiratory sound analysis, specifically for the detection or classification of adventitious sounds, has recently been the focus of an increasing number of studies, a standardised approach and comparison has not been well established.To provide a review of existing algorithms for the detection or classification of adventitious respiratory sounds. This systematic review provides a complete summary of methods used in the literature to give a baseline for future works.A systematic review of English articles published between 1938 and 2016, searched using the Scopus (1938-2016 and IEEExplore (1984-2016 databases. Additional articles were further obtained by references listed in the articles found. Search terms included adventitious sound detection, adventitious sound classification, abnormal respiratory sound detection, abnormal respiratory sound classification, wheeze detection, wheeze classification, crackle detection, crackle classification, rhonchi detection, rhonchi classification, stridor detection, stridor classification, pleural rub detection, pleural rub classification, squawk detection, and squawk classification.Only articles were included that focused on adventitious sound detection or classification, based on respiratory sounds, with performance reported and sufficient information provided to be approximately repeated.Investigators extracted data about the adventitious sound type analysed, approach and level of analysis, instrumentation or data source, location of sensor, amount of data obtained, data management, features, methods, and performance achieved.A total of 77 reports from the literature were included in this review. 55 (71.43% of the studies focused on wheeze, 40 (51.95% on crackle, 9 (11.69% on stridor, 9

  10. Solid-phase extraction procedures in systematic toxicological analysis

    NARCIS (Netherlands)

    Franke, J.P.; de Zeeuw, R.A

    1998-01-01

    In systematic toxicological analysis (STA) the substance(s) present is (are) not known at the start of the analysis. in such an undirected search the extraction procedure cannot be directed to a given substance but must be a general procedure where a compromise must be reached in that the substances

  11. Systematic comparison of static and dynamic headspace sampling techniques for gas chromatography.

    Science.gov (United States)

    Kremser, Andreas; Jochmann, Maik A; Schmidt, Torsten C

    2016-09-01

    Six automated, headspace-based sample preparation techniques were used to extract volatile analytes from water with the goal of establishing a systematic comparison between commonly available instrumental alternatives. To that end, these six techniques were used in conjunction with the same gas chromatography instrument for analysis of a common set of volatile organic carbon (VOC) analytes. The methods were thereby divided into three classes: static sampling (by syringe or loop), static enrichment (SPME and PAL SPME Arrow), and dynamic enrichment (ITEX and trap sampling). For PAL SPME Arrow, different sorption phase materials were also included in the evaluation. To enable an effective comparison, method detection limits (MDLs), relative standard deviations (RSDs), and extraction yields were determined and are discussed for all techniques. While static sampling techniques exhibited sufficient extraction yields (approx. 10-20 %) to be reliably used down to approx. 100 ng L(-1), enrichment techniques displayed extraction yields of up to 80 %, resulting in MDLs down to the picogram per liter range. RSDs for all techniques were below 27 %. The choice on one of the different instrumental modes of operation (aforementioned classes) was thereby the most influential parameter in terms of extraction yields and MDLs. Individual methods inside each class showed smaller deviations, and the least influences were observed when evaluating different sorption phase materials for the individual enrichment techniques. The option of selecting specialized sorption phase materials may, however, be more important when analyzing analytes with different properties such as high polarity or the capability of specific molecular interactions. Graphical Abstract PAL SPME Arrow during the extraction of volatile analytes from the headspace of an aqueous sample.

  12. Clustering Scientific Publications Based on Citation Relations: A Systematic Comparison of Different Methods.

    Science.gov (United States)

    Šubelj, Lovro; van Eck, Nees Jan; Waltman, Ludo

    2016-01-01

    Clustering methods are applied regularly in the bibliometric literature to identify research areas or scientific fields. These methods are for instance used to group publications into clusters based on their relations in a citation network. In the network science literature, many clustering methods, often referred to as graph partitioning or community detection techniques, have been developed. Focusing on the problem of clustering the publications in a citation network, we present a systematic comparison of the performance of a large number of these clustering methods. Using a number of different citation networks, some of them relatively small and others very large, we extensively study the statistical properties of the results provided by different methods. In addition, we also carry out an expert-based assessment of the results produced by different methods. The expert-based assessment focuses on publications in the field of scientometrics. Our findings seem to indicate that there is a trade-off between different properties that may be considered desirable for a good clustering of publications. Overall, map equation methods appear to perform best in our analysis, suggesting that these methods deserve more attention from the bibliometric community.

  13. Clustering Scientific Publications Based on Citation Relations: A Systematic Comparison of Different Methods

    Science.gov (United States)

    Šubelj, Lovro; van Eck, Nees Jan; Waltman, Ludo

    2016-01-01

    Clustering methods are applied regularly in the bibliometric literature to identify research areas or scientific fields. These methods are for instance used to group publications into clusters based on their relations in a citation network. In the network science literature, many clustering methods, often referred to as graph partitioning or community detection techniques, have been developed. Focusing on the problem of clustering the publications in a citation network, we present a systematic comparison of the performance of a large number of these clustering methods. Using a number of different citation networks, some of them relatively small and others very large, we extensively study the statistical properties of the results provided by different methods. In addition, we also carry out an expert-based assessment of the results produced by different methods. The expert-based assessment focuses on publications in the field of scientometrics. Our findings seem to indicate that there is a trade-off between different properties that may be considered desirable for a good clustering of publications. Overall, map equation methods appear to perform best in our analysis, suggesting that these methods deserve more attention from the bibliometric community. PMID:27124610

  14. A systematic review and mixed treatment comparison of monotherapy in early Parkinson's disease: implications for Latin America.

    Science.gov (United States)

    Márquez-Cruz, Maribel; Díaz-Martínez, Juan Pablo; Soto-Molina, Herman; De Saráchaga, Adib Jorge; Cervantes-Arriaga, Amin; Llorens-Arenas, Rodrigo; Rodríguez-Violante, Mayela

    2016-01-01

    Parkinson's disease (PD) is the second most common neurodegenerative disease. There are no clinical trials comparing all available pharmacological therapies for the treatment of early PD. The objective of this review is to indirectly analyze the efficacy of antiparkinson drugs currently available in Latin America. A systematic review was performed exploring only placebo-controlled randomized trials comparing antiparkinson monotherapy (levodopa, pramipexole, rasagiline, or selegiline) in patients with PD on Hoehn and Yahr stages I through III published from January 1994 to May 2014. The primary outcome was the mean change in the Unified PD Rating Scale (UPDRS) I, II and III. A mixed treatment comparison analysis (indirect comparisons) through a random-effects model was performed. Levodopa demonstrated the highest effects in terms of UPDRS score improvement both from baseline and when compared to other treatments. Levodopa showed a 60.1% probability of granting the greatest reduction in UPDRS I, II and III.

  15. ACCURACY COMPARISON OF VHR SYSTEMATIC-ORTHO SATELLITE IMAGERIES AGAINST VHR ORTHORECTIFIED IMAGERIES USING GCP

    Directory of Open Access Journals (Sweden)

    E. Widyaningrum

    2016-06-01

    Full Text Available The Very High Resolution (VHR satellite imageries such us Pleiades, WorldView-2, GeoEye-1 used for precise mapping purpose must be corrected from any distortion to achieve the expected accuracy. Orthorectification is performed to eliminate geometric errors of the VHR satellite imageries. Orthorectification requires main input data such as Digital Elevation Model (DEM and Ground Control Point (GCP. The VHR systematic-ortho imageries were generated using SRTM 30m DEM without using any GCP data. The accuracy value differences of VHR systematic-ortho imageries and VHR orthorectified imageries using GCP currently is not exactly defined. This study aimed to identified the accuracy comparison of VHR systematic-ortho imageries against orthorectified imageries using GCP. Orthorectified imageries using GCP created by using Rigorous model. Accuracy evaluation is calculated by using several independent check points.

  16. a systematic review and meta-analysis

    African Journals Online (AJOL)

    analysis. ... Journal Home > Vol 27, No 2 (2017) > ... selected studies for inclusion, extracted data and assessed the risk of bias in the included studies. ... maternal height, residential area and socio- economic status were significant risk factors ...

  17. Mixing alcohol with energy drink (AMED) and total alcohol consumption : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Verster, Joris C|info:eu-repo/dai/nl/241442702; Benson, Sarah; Johnson, Sean J; Scholey, Andrew; Alford, Chris

    It has been suggested that consuming alcohol mixed with energy drink (AMED) may increase total alcohol consumption. Aims of this systematic review and meta-analysis were (i) to compare alcohol consumption of AMED consumers with alcohol only (AO) consumers (between-group comparisons), and (ii) to

  18. Comparison Groups in Yoga Research: A Systematic Review and Critical Evaluation of the Literature

    Science.gov (United States)

    Groessl, Erik; Maiya, Meghan; Sarkin, Andrew; Eisen, Susan V.; Riley, Kristen; Elwy, A. Rani

    2014-01-01

    Objectives Comparison groups are essential for accurate testing and interpretation of yoga intervention trials. However, selecting proper comparison groups is difficult because yoga comprises a very heterogeneous set of practices and its mechanisms of effect have not been conclusively established. Methods We conducted a systematic review of the control and comparison groups used in published randomized controlled trials (RCTs) of yoga. Results We located 128 RCTs that met our inclusion criteria; of these, 65 included only a passive control and 63 included at least one active comparison group. Primary comparison groups were physical exercise (43%), relaxation/meditation (20%), and education (16%). Studies rarely provided a strong rationale for choice of comparison. Considering year of publication, the use of active controls in yoga research appears to be slowly increasing over time. Conclusions Given that yoga has been established as a potentially powerful intervention, future research should use active control groups. Further, care is needed to select comparison conditions that help to isolate the specific mechanisms of yoga’s effects. PMID:25440384

  19. Systematic Analysis Of Ocean Colour Uncertainties

    Science.gov (United States)

    Lavender, Samantha

    2013-12-01

    This paper reviews current research into the estimation of uncertainties as a pixel-based measure to aid non- specialist users of remote sensing products. An example MERIS image, captured on the 28 March 2012, was processed with above-water atmospheric correction code. This was initially based on both the Antoine & Morel Standard Atmospheric Correction, with Bright Pixel correction component, and Doerffer Neural Network coastal water's approach. It's showed that analysis of the atmospheric by-products yield important information about the separation of the atmospheric and in-water signals, helping to sign-post possible uncertainties in the atmospheric correction results. Further analysis has concentrated on implementing a ‘simplistic' atmospheric correction so that the impact of changing the input auxiliary data can be analysed; the influence of changing surface pressure is demonstrated. Future work will focus on automating the analysis, so that the methodology can be implemented within an operational system.

  20. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison.

    Directory of Open Access Journals (Sweden)

    Gláucia F Cota

    Full Text Available We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL therapy among HIV infected individuals.The outcomes of interest were clinical and parasitological cure, mortality, and adverse events.PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available.Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3-25%, indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9-9.4%. It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sb(v. The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was

  1. Acoustic Analysis of Voice in Singers: A Systematic Review

    Science.gov (United States)

    Gunjawate, Dhanshree R.; Ravi, Rohit; Bellur, Rajashekhar

    2018-01-01

    Purpose: Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers. Method: A…

  2. Systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Lo, B; Prosberg, M V; Gluud, L L

    2018-01-01

    BACKGROUND: The Inflammatory Bowel Disease Disability Index (IBD-DI) has recently been developed for patients with Crohn's disease (CD) and ulcerative colitis (UC). AIM: To assess the severity of disability and associated factors using the IBD-DI, and review the validity of the IBD-DI as a tool. ...... review and meta-analysis found a significant association between disease activity, treatment received and disability; although significant heterogeneity was found. The IBD-DI is reliable and valid, but further studies are needed to measure its interpretability....

  3. [The concept of nursing. A systematic analysis].

    Science.gov (United States)

    Camaño, R; Piqué, J

    1999-01-01

    Nursing is a field which employs numerous people whose formation and professional roles are regulated by a wide set of rules and norms, and one which benefits innumerable patients. A paradox exists when, upon consulting various dictionaries, one of these the Royal Academy Dictionary (Diccionario de la Real Academia), the term nursing is defined as a physical space/set of nurses without any reference whatsoever to nurses' role in the health and educational systems. The definition we find in a dictionary should correspond to the concept the general public holds and reflect the true meaning of the profession. During a three year period, academic years 1994-96, on the first day of class, we asked each student to define or describe what he/she understood nursing to be. We consider that their responses, in a large sense, should correspond to the idea which the general public holds about nursing. An analysis of the content of these definitions allowed us to establish that there is a clear confrontation between what dictionaries state and what students, as a sample of society as a whole, think. Our results permit us to offer a definition for nursing which may be incorporated into new dictionary editions for the purpose of completing the already existing ones.

  4. A Systematic Review and Meta-Analysis of Baseline Ohip-Edent Scores.

    Science.gov (United States)

    Duale, J M J; Patel, Y A; Wu, J; Hyde, T P

    2018-03-01

    OHIP-EDENT is widely used in the literature to assess Oral-Health-Related-Quality-of-Life (OHRQoL) for edentulous patients. However the normal variance and mean of the baseline OHIP scores has not been reported. It would facilitate critical appraisal of studies if we had knowledge of the normal variation and mean of baseline OHIP-EDENT scores. An established figure for baseline OHIP-EDENT, obtained from a meta-analysis, would simplify comparisons of studies and quantify variations in initial OHRQoL of the trial participants. The aim of this study is to quantify a normal baseline value for pre-operative OHIP-EDENT scores by a systematic review and meta-analysis of the available literature. A systematic literature review was carried. 83 papers were identified that included OHIP-EDENT values. After screening and eligibility assessment, 7 papers were selected and included in the meta-analysis. A meta-analysis for the 7 papers by a random-effect model yielded a mean baseline OHIP-EDENT score of 28.63 with a 95% Confidence intervals from 21.93 to 35.34. A pre-operative baseline OHIP-EDENT has been established by meta-analysis of published papers. This will facilitate the comparison of the initial OHRQoL of one study population to that found elsewhere in the published literature. Copyright© 2018 Dennis Barber Ltd.

  5. Comparison between whole-body MRI and Fluorine-18-Fluorodeoxyglucose PET or PET/CT in oncology: a systematic review

    International Nuclear Information System (INIS)

    Ciliberto, Mario; Maggi, Fabio; Treglia, Giorgio; Padovano, Federico; Calandriello, Lucio; Giordano, Alessandro; Bonomo, Lorenzo

    2013-01-01

    The aim of the article is to systematically review published data about the comparison between positron emission tomography (PET) or PET/computed tomography (PET/CT) using Fluorine-18-Fluorodeoxyglucose (FDG) and whole-body magnetic resonance imaging (WB-MRI) in patients with different tumours. A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through April 2012 and regarding the comparison between FDG-PET or PET/CT and WB-MRI in patients with various tumours was carried out. Forty-four articles comprising 2287 patients were retrieved in full-text version, included and discussed in this systematic review. Several articles evaluated mixed tumours with both diagnostic methods. Concerning the specific tumour types, more evidence exists for lymphomas, bone tumours, head and neck tumours and lung tumours, whereas there is less evidence for other tumour types. Overall, based on the literature findings, WB-MRI seems to be a valid alternative method compared to PET/CT in oncology. Further larger prospective studies and in particular cost-effectiveness analysis comparing these two whole-body imaging techniques are needed to better assess the role of WB-MRI compared to FDG-PET or PET/CT in specific tumour types

  6. Comparison of three radiotherapy modalities on biochemical control and overall survival for the treatment of prostate cancer: A systematic review

    International Nuclear Information System (INIS)

    Pieters, Bradley R.; Back, Djuna Z. de; Koning, Caro C.E.; Zwinderman, Aeilko H.

    2009-01-01

    Background and Purpose: For the radiation treatment of prostate cancer high dose should be delivered for optimal biochemical control. Treatment can be given by dose-escalated external beam radiotherapy (EBRT) or external beam radiotherapy combined with a radioactive seed implantation (EBSeeds) or high-dose rate (HDR) brachytherapy (EBTI). Differences in outcome between the modalities were assessed by a systematic review. Materials and methods: A systematic search was performed resulting in 40 articles to be used. Data were extracted on biochemical control and overall survival at 3, 5, and 8 years and other time points mentioned in the articles. Also known prognostic parameters were noted. Comparison of the modalities was done by a Weibull survival analysis and estimation of Hazard Ratio's (HR) was done with 95% confidence intervals (95% CIs). Results: The HR for biochemical recurrence was 1.40 (95% CI 1.31-1.51) for EBRT relative to EBTI, and was 1.37 (95% CI 1.26-1.49) for EBSeeds relative to EBTI. The HR for overall survival was 1.50 (95% CI 1.29-1.73) for EBRT relative to EBTI, and was 2.33 (95% CI 2.04-2.66) for EBSeeds relative to EBTI. Conclusion: The combination of external beam radiotherapy and HDR brachytherapy results in a superior biochemical control and overall survival found in a systematic review on radiotherapy for prostate cancer.

  7. Markov modeling and discrete event simulation in health care: a systematic comparison.

    Science.gov (United States)

    Standfield, Lachlan; Comans, Tracy; Scuffham, Paul

    2014-04-01

    The aim of this study was to assess if the use of Markov modeling (MM) or discrete event simulation (DES) for cost-effectiveness analysis (CEA) may alter healthcare resource allocation decisions. A systematic literature search and review of empirical and non-empirical studies comparing MM and DES techniques used in the CEA of healthcare technologies was conducted. Twenty-two pertinent publications were identified. Two publications compared MM and DES models empirically, one presented a conceptual DES and MM, two described a DES consensus guideline, and seventeen drew comparisons between MM and DES through the authors' experience. The primary advantages described for DES over MM were the ability to model queuing for limited resources, capture individual patient histories, accommodate complexity and uncertainty, represent time flexibly, model competing risks, and accommodate multiple events simultaneously. The disadvantages of DES over MM were the potential for model overspecification, increased data requirements, specialized expensive software, and increased model development, validation, and computational time. Where individual patient history is an important driver of future events an individual patient simulation technique like DES may be preferred over MM. Where supply shortages, subsequent queuing, and diversion of patients through other pathways in the healthcare system are likely to be drivers of cost-effectiveness, DES modeling methods may provide decision makers with more accurate information on which to base resource allocation decisions. Where these are not major features of the cost-effectiveness question, MM remains an efficient, easily validated, parsimonious, and accurate method of determining the cost-effectiveness of new healthcare interventions.

  8. Hospitality and Tourism Online Review Research: A Systematic Analysis and Heuristic-Systematic Model

    Directory of Open Access Journals (Sweden)

    Sunyoung Hlee

    2018-04-01

    Full Text Available With tremendous growth and potential of online consumer reviews, online reviews of hospitality and tourism are now playing a significant role in consumer attitude and buying behaviors. This study reviewed and analyzed hospitality and tourism related articles published in academic journals. The systematic approach was used to analyze 55 research articles between January 2008 and December 2017. This study presented a brief synthesis of research by investigating content-related characteristics of hospitality and tourism online reviews (HTORs in different market segments. Two research questions were addressed. Building upon our literature analysis, we used the heuristic-systematic model (HSM to summarize and classify the characteristics affecting consumer perception in previous HTOR studies. We believe that the framework helps researchers to identify the research topic in extended HTORs literature and to point out possible direction for future studies.

  9. Digital Games, Design, and Learning: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Clark, Douglas B; Tanner-Smith, Emily E; Killingsworth, Stephen S

    2016-03-01

    In this meta-analysis, we systematically reviewed research on digital games and learning for K-16 students. We synthesized comparisons of game versus nongame conditions (i.e., media comparisons) and comparisons of augmented games versus standard game designs (i.e., value-added comparisons). We used random-effects meta-regression models with robust variance estimates to summarize overall effects and explore potential moderator effects. Results from media comparisons indicated that digital games significantly enhanced student learning relative to nongame conditions ([Formula: see text] = 0.33, 95% confidence interval [0.19, 0.48], k = 57, n = 209). Results from value-added comparisons indicated significant learning benefits associated with augmented game designs ([Formula: see text] = 0.34, 95% confidence interval [0.17, 0.51], k = 20, n = 40). Moderator analyses demonstrated that effects varied across various game mechanics characteristics, visual and narrative characteristics, and research quality characteristics. Taken together, the results highlight the affordances of games for learning as well as the key role of design beyond medium.

  10. Comparison of multislice computed tomography with intravascular ultrasound for detection and characterization of coronary artery plaques: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Springer, Ivonne [Department of Radiology, Charite, Medical School, Humboldt-Universitaet zu Berlin (Germany); Dewey, Marc [Department of Radiology, Charite, Medical School, Humboldt-Universitaet zu Berlin (Germany)], E-mail: marc.dewey@charite.de

    2009-08-15

    Purpose: Multislice computed tomography (MSCT) is a novel non-invasive test for detection and analysis of coronary artery plaques. A systematic review was conducted of the literature to compare MSCT with IVUS as the reference standard for assessing coronary artery plaques. Materials and methods: We performed a literature search in the online database MEDLINE, which was accessed at (http://www.pubmed.gov) on 9th April 2008. Results: The search identified 14 studies with 340 patients (mean age 59 {+-} 5 years). The systematic review revealed a sensitivity of MSCT on the lesion level (n = 1779 coronary plaques) on the order of 90% (range from 87 to 92%) in comparison to IVUS. Per-segment analysis (n = 356) yielded a lower sensitivity of 81-86%. In the per-vessel analysis (n = 90), MSCT had a better sensitivity and specificity for the RCA (83-89% and 92-100%) and the LAD (83-87% and 93%) than for the LCX (71-85% and 77-89%), and on the vessel level and the cross-section analysis MSCT was more sensitive for calcified plaques than for non-calcified plaque. It is noteworthy that most studies provide only incomplete data on technical and methodological parameters such as radiation exposure and patient characteristics. Conclusion: MSCT is an accurate and reliable test for detection of coronary artery plaques in comparison to IVUS with limitations in regards to the LCX and non-calcified plaques. Studies published thus far are limited by the sample sizes and methodological quality issues.

  11. Systematic evaluation of a 171Yb optical clock by synchronous comparison between two lattice systems.

    Science.gov (United States)

    Gao, Qi; Zhou, Min; Han, Chengyin; Li, Shangyan; Zhang, Shuang; Yao, Yuan; Li, Bo; Qiao, Hao; Ai, Di; Lou, Ge; Zhang, Mengya; Jiang, Yanyi; Bi, Zhiyi; Ma, Longsheng; Xu, Xinye

    2018-05-22

    Optical clocks are the most precise measurement devices. Here we experimentally characterize one such clock based on the 1 S 0 - 3 P 0 transition of neutral 171 Yb atoms confined in an optical lattice. Given that the systematic evaluation using an interleaved stabilization scheme is unable to avoid noise from the clock laser, synchronous comparisons against a second 171 Yb lattice system were implemented to accelerate the evaluation. The fractional instability of one clock falls below 4 × 10 -17 after an averaging over a time of 5,000 seconds. The systematic frequency shifts were corrected with a total uncertainty of 1.7 × 10 -16 . The lattice polarizability shift currently contributes the largest source. This work paves the way to measuring the absolute clock transition frequency relative to the primary Cs standard or against the International System of Units (SI) second.

  12. CrossFit Overview: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Claudino, João Gustavo; Gabbett, Tim J; Bourgeois, Frank; Souza, Helton de Sá; Miranda, Rafael Chagas; Mezêncio, Bruno; Soncin, Rafael; Cardoso Filho, Carlos Alberto; Bottaro, Martim; Hernandez, Arnaldo Jose; Amadio, Alberto Carlos; Serrão, Julio Cerca

    2018-02-26

    CrossFit is recognized as one of the fastest growing high-intensity functional training modes in the world. However, scientific data regarding the practice of CrossFit is sparse. Therefore, the objective of this study is to analyze the findings of scientific literature related to CrossFit via systematic review and meta-analysis. Systematic searches of the PubMed, Web of Science, Scopus, Bireme/MedLine, and SciELO online databases were conducted for articles reporting the effects of CrossFit training. The systematic review followed the PRISMA guidelines. The Oxford Levels of Evidence was used for all included articles, and only studies that investigated the effects of CrossFit as a training program were included in the meta-analysis. For the meta-analysis, effect sizes (ESs) with 95% confidence interval (CI) were calculated and heterogeneity was assessed using a random-effects model. Thirty-one articles were included in the systematic review and four were included in the meta-analysis. However, only two studies had a high level of evidence at low risk of bias. Scientific literature related to CrossFit has reported on body composition, psycho-physiological parameters, musculoskeletal injury risk, life and health aspects, and psycho-social behavior. In the meta-analysis, significant results were not found for any variables. The current scientific literature related to CrossFit has few studies with high level of evidence at low risk of bias. However, preliminary data has suggested that CrossFit practice is associated with higher levels of sense of community, satisfaction, and motivation.

  13. Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Zongshi Qin

    2015-01-01

    Full Text Available This is a systematic review and meta-analysis, which aimed to assess the current evidence on the effects and safety of acupuncture for treating sciatica. In this review, a total of 11 randomized controlled trials were included. As a result, we found that the use of acupuncture may be more effective than drugs and may enhance the effect of drugs for patients with sciatica, but because of the insufficient number of relevant and rigorous studies, the evidence is limited. Future trials using rigorous methodology, appropriate comparisons, and clinically relevant outcomes should be conducted.

  14. Analysis Preservation and Systematic Reinterpretation within the ATLAS Experiment

    CERN Document Server

    Heinrich, Lukas; The ATLAS collaboration

    2017-01-01

    The LHC data analysis software used in order to derive and publish experimental results is an important asset that is necessary to preserve in order to fully exploit the scientific potential of a given measurement. Among others, important use cases of analysis preservation are the reproducibility of the original results and the reusability of the analysis procedure in the context of new scientific studies. A prominent use-case for the latter is the systematic reinterpretation of searches for new Physics in terms of signal models that not studied in the original publication (RECAST). This paper presents the usage of the graph-based workflow description language yadage to drive the reinterpretation of preserved HEP analyses. The analysis software for individual states in the analysis is preserved using Docker containers, while the workflow structure is preserved using plain JSON documents. This allows the re-execution of complex analysis workflows on industry standard container-based distributed computing clust...

  15. Simulation-based training for nurses: Systematic review and meta-analysis.

    Science.gov (United States)

    Hegland, Pål A; Aarlie, Hege; Strømme, Hilde; Jamtvedt, Gro

    2017-07-01

    Simulation-based training is a widespread strategy to improve health-care quality. However, its effect on registered nurses has previously not been established in systematic reviews. The aim of this systematic review is to evaluate effect of simulation-based training on nurses' skills and knowledge. We searched CDSR, DARE, HTA, CENTRAL, CINAHL, MEDLINE, Embase, ERIC, and SveMed+ for randomised controlled trials (RCT) evaluating effect of simulation-based training among nurses. Searches were completed in December 2016. Two reviewers independently screened abstracts and full-text, extracted data, and assessed risk of bias. We compared simulation-based training to other learning strategies, high-fidelity simulation to other simulation strategies, and different organisation of simulation training. Data were analysed through meta-analysis and narrative syntheses. GRADE was used to assess the quality of evidence. Fifteen RCTs met the inclusion criteria. For the comparison of simulation-based training to other learning strategies on nurses' skills, six studies in the meta-analysis showed a significant, but small effect in favour of simulation (SMD -1.09, CI -1.72 to -0.47). There was large heterogeneity (I 2 85%). For the other comparisons, there was large between-study variation in results. The quality of evidence for all comparisons was graded as low. The effect of simulation-based training varies substantially between studies. Our meta-analysis showed a significant effect of simulation training compared to other learning strategies, but the quality of evidence was low indicating uncertainty. Other comparisons showed inconsistency in results. Based on our findings simulation training appears to be an effective strategy to improve nurses' skills, but further good-quality RCTs with adequate sample sizes are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The incidence of kidney cancer in Iran: a systematic review and meta-analysis.

    Science.gov (United States)

    Hassanipour, Soheil; Namvar, Gholamreza; Fathalipour, Mohammad; Salehiniya, Hamid

    2018-06-01

    The incidence of kidney cancer from different areas of Iran was reported. Nevertheless, there is no available systematic reviews in this regard. Therefore, the present systematic review carried out to estimate the incidence rate of kidney cancer among Iranian people. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in September 2017. A search was concluded using Medline/ PubMed, Scopus, ScienceDirect, and Google scholar for international papers and four national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) for Persian papers. The incidence rate of kidney cancer was calculated using random effect model. An aggregate of 159 papers were retrieved in the primary search of the databases. Further screening and advanced refinement of the retrieved studies produced 15 studies totally. The age-standardized rate (ASR) of kidney cancer was 1.94, 95% CI (1.62-2.55) and 1.36, 95 % CI (1.09-1.62) in males and females, respectively. In comparison to other parts of the world, the incidence of kidney cancer was lower in Iran. Afterwards, further studies are necessary to outline the exact incidence rate and the trend of kidney cancer in Iran. © Author(s) 2018. This article is published with open access by China Medical University.

  17. Comparison exercise of probabilistic precursor analysis

    International Nuclear Information System (INIS)

    Fauchille, V.; Babst, S.

    2004-01-01

    From 2000 up to 2003, a comparison exercise concerning accident precursor programs was performed by IRSN, GRS, and NUPEC (Japan). The objective of this exercise was to compare the methodologies used to quantify conditional core damage probability related to incidents which can be considered as accident precursors. This exercise provided interesting results concerning the interpretation of such events. Generally, the participants identified similar scenarios of potential degradation. However, for several dominant sequences, differences in the results were noticed. The differences can be attributed to variations in the plant design, the strategy of management and in the methodological approach. For many reasons, comparison of human reliability analysis was difficult and perhaps another exercise in the future could provide more information about this subject. On the other hand, interesting outcomes have been obtained from the quantification of both common cause failures and potential common cause failures. (orig.)

  18. Analysis Preservation and Systematic Reinterpretation within the ATLAS experiment

    CERN Document Server

    Heinrich, Lukas; The ATLAS collaboration

    2017-01-01

    The LHC data analysis software used in order to derive and publish experimental results is an important asset that is necessary to preserve in order to fully exploit the scientific potential of a given measurement. An important use-case is the re-usability of the analysis procedure in the context of new scientific studies such as the reinterpretation of searches for new Physics in terms of signal models that not studied in the original publication (RECAST). We present the usage of the graph-based workflow description language yadage to drive the reinterpretation of preserved HEP analyses. The analysis software is preserved using Docker containers, while the workflow structure is preserved using plain JSON documents. This allows the re-execution of complex analysis workflows on modern distributed container orchestration systems and enables a systematic reinterpretation service based on such preserved analysis.

  19. A Systematic Approach for Engagement Analysis Under Multitasking Environments

    Science.gov (United States)

    Zhang, Guangfan; Leddo, John; Xu, Roger; Richey, Carl; Schnell, Tom; McKenzie, Frederick; Li, Jiang

    2011-01-01

    An overload condition can lead to high stress for an operator and further cause substantial drops in performance. On the other extreme, in automated systems, an operator may become underloaded; in which case, it is difficult for the operator to maintain sustained attention. When an unexpected event occurs, either internal or external to the automated system, a disengaged operation may neglect, misunderstand, or respond slowly/inappropriately to the situation. In this paper, we discuss a systematic approach monitor for extremes of cognitive workload and engagement in multitasking environments. Inferences of cognitive workload ar engagement are based on subjective evaluations, objective performance measures, physiological signals, and task analysis results. The systematic approach developed In this paper aggregates these types of information collected under the multitasking environment and can provide a real-time assessment or engagement.

  20. Adult Craniopharyngioma: Case Series, Systematic Review, and Meta-Analysis.

    Science.gov (United States)

    Dandurand, Charlotte; Sepehry, Amir Ali; Asadi Lari, Mohammad Hossein; Akagami, Ryojo; Gooderham, Peter

    2017-12-18

    The optimal therapeutic approach for adult craniopharyngioma remains controversial. Some advocate for gross total resection (GTR), while others advocate for subtotal resection followed by adjuvant radiotherapy (STR + XRT). To conduct a systematic review and meta-analysis assessing the rate of recurrence in the follow-up of 3 yr in adult craniopharyngioma stratified by extent of resection and presence of adjuvant radiotherapy. MEDLINE (1946-July 1, 2016) and EMBASE (1980-June 30, 2016) were systematically reviewed. From1975 to 2013, 33 patients were treated with initial surgical resection for adult onset craniopharyngioma at our center and were reviewed for inclusion in this study. Data from 22 patients were available for inclusion as a case series in the systematic review. Eligible studies (n = 21) were identified from the literature in addition to a case series of our institutional experience. Three groups were available for analysis: GTR, STR + XRT, and STR. The rates of recurrence were 17%, 27%, and 45%, respectively. The risk of developing recurrence was significant for GTR vs STR (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.15-0.38) and STR + XRT vs STR (OR: 0.20, 95% CI: 0.10-0.41). Risk of recurrence after GTR vs STR + XRT did not reach significance (OR: 0.63, 95% CI: 0.33-1.24, P = .18). This is the first and largest systematic review focusing on the rate of recurrence in adult craniopharyngioma. Although the rates of recurrence are favoring GTR, difference in risk of recurrence did not reach significance. This study provides guidance to clinicians and directions for future research with the need to stratify outcomes per treatment modalities. Copyright © 2017 by the Congress of Neurological Surgeons

  1. Systematic analysis of trimazolin hydrochloride as adrenergic vasoconstrictor

    Directory of Open Access Journals (Sweden)

    Nikolić Goran

    2008-01-01

    Full Text Available Trimazolin-hydrochloride, which is used as a pharmaceutically active component (adrenergic vasoconstrictor for the production of decongestive preparations, was investigated in this paper by performing systematic analysis. In domestic and foreign pharmacopoeias, as well as in scientific and patent literature, there are no data on trimazolin and the methods of its investigation. Systematic analysis involves two investigation phases. A complete physicochemical characterization of the synthesized substance was done by previous investigation. In the second phase, a chemical structure of the synthesized pharmacologically active substance was confirmed to a certain degree of certainty by using the absorption spectroscopic methods (FTIR, UV-VIS, 1H-NMR. The spectroscopic methods used proved to be successful at identifying and investigating the purity of trimazolin hydrochloride. Liquid (RP-HPLC chromatography was used for the analysis of trimazolin hydrochloride in the nasal preparation (Adrianol. The method of titrimetric analysis was developed with the aim of quantitative determination of trimazolin hydrochloride in decongestive preparations.

  2. Comparison of anterior decompression and fusion versus laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu W

    2016-04-01

    Full Text Available Weijun Liu,1,* Ling Hu,2,* Po-Hsin Chou,3 Ming Liu,1 Wusheng Kan,1 Junwen Wang1 1Department of Orthopedics, Pu Ai Hospital, Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Anesthesiology, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, People’s Republic of China; 3Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC *These authors contributed equally to this work Purpose: A meta-analysis was conducted to evaluate the clinical outcomes, complications, reoperation rates, and late neurological deterioration between anterior decompression and fusion (ADF and laminoplasty (LAMP in the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL. Methods: All related studies published up to August 2015 were acquired by searching PubMed and EMBASE. Exclusion criteria were case reports, revision surgeries, combined anterior and posterior surgeries, the other posterior approaches including laminectomy or laminectomy and instrumented fusion, non-English studies, and studies with quality assessment scores of <7. The main end points including Japanese Orthopedic Association (JOA score, recovery rate of JOA, cervical lordosis, complication rate, reoperation rate, and late neurological deterioration were analyzed. All available data was analyzed using RevMan 5.2.0 and Stata 12.0. Results: A total of seven studies were included in the meta-analysis. The mean surgical level of ADF was 3.1, and the mean preoperative occupation ratios of ADF and LAMP group were 55.9% and 51.9%, respectively. No statistical difference was observed with regard to preoperative occupation ratio and preoperative JOA score. Although LAMP group had a higher preoperative cervical lordosis than ADF group (P<0.05, weighted mean difference [WMD

  3. Comparison of breast-conserving surgery with mastectomy in locally advanced breast cancer after good response to neoadjuvant chemotherapy: A PRISMA-compliant systematic review and meta-analysis.

    Science.gov (United States)

    Sun, Yixuan; Liao, Mingjuan; He, Liu; Zhu, Chenfang

    2017-10-01

    The application of breast-conserving surgery (BCS) on patients with locally advanced breast cancer (LABC) with good response to neoadjuvant chemotherapy (NACT) still remains controversial. The objective in this study is to analyze the safety of BCS in the management of LABC in patients with good response to NACT. We searched the electronic databases of Medline (Pubmed) and Cochrane Library for reports on local recurrence (LR), regional recurrence (RR), distant recurrence (DR), 5-year disease-free survival (DFS) or 5-year overall survival (OS) in patients with LABC receiving BCS or mastectomy (MT) and with good response to NACT. Based on the research results, we conducted a meta-analysis using Review Manager 5.3. Our study showed that 16 studies with a combined total of 3531 patients, of whom 1465 patients underwent BCS, whereas 2066 patients underwent MT. There was no significant heterogeneity among these studies (Q statistic: P = .88; I = 0%). Patients with good response to NACT showed no significant difference in LR and RR [odd ratio (OR) = 0.83; 95% confidence interval (CI): 0.60-1.15; P = .26; OR = 0.56; 95% CI: 0.33-0.93; P = .03], while we figured out a lower DR (OR = 0.51; 95% CI: 0.42-0.63; P < .01), a higher DFS (OR = 2.35; 95% CI: 1.84 to 3.01, P < .01) and a higher OS (OR = 2.12; 95% CI: 1.51 to 2.98, P < .01) in BCS compared with MT. This meta-analysis concluded that BCS was a safe surgery for patients with LABC and had good response to NACT.

  4. Topic Modeling in Sentiment Analysis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Toqir Ahmad Rana

    2016-06-01

    Full Text Available With the expansion and acceptance of Word Wide Web, sentiment analysis has become progressively popular research area in information retrieval and web data analysis. Due to the huge amount of user-generated contents over blogs, forums, social media, etc., sentiment analysis has attracted researchers both in academia and industry, since it deals with the extraction of opinions and sentiments. In this paper, we have presented a review of topic modeling, especially LDA-based techniques, in sentiment analysis. We have presented a detailed analysis of diverse approaches and techniques, and compared the accuracy of different systems among them. The results of different approaches have been summarized, analyzed and presented in a sophisticated fashion. This is the really effort to explore different topic modeling techniques in the capacity of sentiment analysis and imparting a comprehensive comparison among them.

  5. Geographical variation in dementia: systematic review with meta-analysis

    Science.gov (United States)

    Russ, Tom C; Batty, G David; Hearnshaw, Gena F; Fenton, Candida; Starr, John M

    2012-01-01

    Background Geographical variation in dementia prevalence and incidence may indicate important socio-environmental contributions to dementia aetiology. However, previous comparisons have been hampered by combining studies with different methodologies. This review systematically collates and synthesizes studies examining geographical variation in the prevalence and incidence of dementia based on comparisons of studies using identical methodologies. Methods Papers were identified by a comprehensive electronic search of relevant databases, scrutinising the reference sections of identified publications, contacting experts in the field and re-examining papers already known to us. Identified articles were independently reviewed against inclusion/exclusion criteria and considered according to geographical scale. Rural/urban comparisons were meta-analysed. Results Twelve thousand five hundred and eighty records were reviewed and 51 articles were included. Dementia prevalence and incidence varies at a number of scales from the national down to small areas, including some evidence of an effect of rural living [prevalence odds ratio (OR) = 1.11, 90% confidence interval (CI) 0.79–1.57; incidence OR = 1.20, 90% CI 0.84–1.71]. However, this association of rurality was stronger for Alzheimer disease, particularly when early life rural living was captured (prevalence OR = 2.22, 90% CI 1.19–4.16; incidence OR = 1.64, 90% CI 1.08–2.50). Conclusions There is evidence of geographical variation in rates of dementia in affluent countries at a variety of geographical scales. Rural living is associated with an increased risk of Alzheimer disease, and there is a suggestion that early life rural living further increases this risk. However, the fact that few studies have been conducted in resource-poor countries limits conclusions. PMID:22798662

  6. Code comparison for accelerator design and analysis

    International Nuclear Information System (INIS)

    Parsa, Z.

    1988-01-01

    We present a comparison between results obtained from standard accelerator physics codes used for the design and analysis of synchrotrons and storage rings, with programs SYNCH, MAD, HARMON, PATRICIA, PATPET, BETA, DIMAD, MARYLIE and RACE-TRACK. In our analysis we have considered 5 (various size) lattices with large and small angles including AGS Booster (10/degree/ bend), RHIC (2.24/degree/), SXLS, XLS (XUV ring with 45/degree/ bend) and X-RAY rings. The differences in the integration methods used and the treatment of the fringe fields in these codes could lead to different results. The inclusion of nonlinear (e.g., dipole) terms may be necessary in these calculations specially for a small ring. 12 refs., 6 figs., 10 tabs

  7. Comparison of methodological quality rating of systematic reviews on neuropathic pain using AMSTAR and R-AMSTAR.

    Science.gov (United States)

    Dosenovic, Svjetlana; Jelicic Kadic, Antonia; Vucic, Katarina; Markovina, Nikolina; Pieper, Dawid; Puljak, Livia

    2018-05-08

    Systematic reviews (SRs) in the field of neuropathic pain (NeuP) are increasingly important for decision-making. However, methodological flaws in SRs can reduce the validity of conclusions. Hence, it is important to assess the methodological quality of NeuP SRs critically. Additionally, it remains unclear which assessment tool should be used. We studied the methodological quality of SRs published in the field of NeuP and compared two assessment tools. We systematically searched 5 electronic databases to identify SRs of randomized controlled trials of interventions for NeuP available up to March 2015. Two independent reviewers assessed the methodological quality of the studies using the Assessment of Multiple Systematic Reviews (AMSTAR) and the revised AMSTAR (R-AMSTAR) tools. The scores were converted to percentiles and ranked into 4 grades to allow comparison between the two checklists. Gwet's AC1 coefficient was used for interrater reliability assessment. The 97 included SRs had a wide range of methodological quality scores (AMSTAR median (IQR): 6 (5-8) vs. R-AMSTAR median (IQR): 30 (26-35)). The overall agreement score between the 2 raters was 0.62 (95% CI 0.39-0.86) for AMSTAR and 0.62 (95% CI 0.53-0.70) for R-AMSTAR. The 31 Cochrane systematic reviews (CSRs) were consistently ranked higher than the 66 non-Cochrane systematic reviews (NCSRs). The analysis of individual domains showed the best compliance in a comprehensive literature search (item 3) on both checklists. The results for the domain that was the least compliant differed: conflict of interest (item 11) was the item most poorly reported on AMSTAR vs. publication bias assessment (item 10) on R-AMSTAR. A high positive correlation between the total AMSTAR and R-AMSTAR scores for all SRs, as well as for CSRs and NCSRs, was observed. The methodological quality of analyzed SRs in the field of NeuP was not optimal, and CSRs had a higher quality than NCSRs. Both AMSTAR and R-AMSTAR tools produced comparable

  8. Rate of familial amyotrophic lateral sclerosis: a systematic review and meta-analysis.

    LENUS (Irish Health Repository)

    Byrne, Susan

    2012-02-01

    BACKGROUND: The population rate of familial amyotrophic lateral sclerosis (FALS) is frequently reported as 10%. However, a systematic review and meta-analysis of the true population based frequency of FALS has never been performed. METHOD: A Medline literature review identified all original articles reporting a rate of FALS. Studies were grouped according to the type of data presented and examined for sources of case ascertainment. A systematic review and meta-analysis of reported rates of FALS was then conducted to facilitate comparison between studies and calculate a pooled rate of FALS. RESULTS: 38 papers reported a rate of FALS. Thirty-three papers were included in analysis and the rate of FALS for all studies was 4.6% (95% CI 3.9% to 5.5%). Restricting the analysis to prospective population based registry data revealed a rate of 5.1% (95% CI 4.1% to 6.1%). The incidence of FALS was lower in southern Europe. There was no correlation between rate of FALS and reported SOD1 mutation rates. CONCLUSION: The rate of FALS among prospective population based registries is 5.1% (CI 4.1 to 6.1%), and not 10% as is often stated. Further detailed prospective population based studies of familial ALS are required to confirm this rate.

  9. Rate of familial amyotrophic lateral sclerosis: a systematic review and meta-analysis.

    LENUS (Irish Health Repository)

    Byrne, Susan

    2010-11-03

    Background The population rate of familial amyotrophic lateral sclerosis (FALS) is frequently reported as 10%. However, a systematic review and meta-analysis of the true population based frequency of FALS has never been performed. Method A Medline literature review identified all original articles reporting a rate of FALS. Studies were grouped according to the type of data presented and examined for sources of case ascertainment. A systematic review and meta-analysis of reported rates of FALS was then conducted to facilitate comparison between studies and calculate a pooled rate of FALS. Results 38 papers reported a rate of FALS. Thirty-three papers were included in analysis and the rate of FALS for all studies was 4.6% (95% CI 3.9% to 5.5%). Restricting the analysis to prospective population based registry data revealed a rate of 5.1% (95% CI 4.1% to 6.1%). The incidence of FALS was lower in southern Europe. There was no correlation between rate of FALS and reported SOD1 mutation rates. Conclusion The rate of FALS among prospective population based registries is 5.1% (CI 4.1 to 6.1%), and not 10% as is often stated. Further detailed prospective population based studies of familial ALS are required to confirm this rate.

  10. Psoriasis and suicidality: A systematic review and meta-analysis.

    Science.gov (United States)

    Singh, Sanminder; Taylor, Catherine; Kornmehl, Heather; Armstrong, April W

    2017-09-01

    Psoriasis is associated with psychiatric comorbidities; however, the relationship between psoriasis and suicidality is not well understood. To perform a systematic review and meta-analysis that elucidates the relationship between psoriasis and suicidality. Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched the PubMed, EMBASE, PsycINFO, and Cochrane databases. We searched literature published between 1946 and 2017. We identified 18 studies with a total of 1,767,583 participants, of whom 330,207 had psoriasis. On the basis of random effects modeling, the pooled odds ratio (OR) for suicidal ideation among patients with psoriasis was 2.05 (95% confidence interval [CI], 1.54-2.74). Patients with psoriasis were more likely to exhibit suicidal behaviors (combined attempted and completed suicides) with a pooled OR of 1.26 (95% CI, 1.13-1.40). Subgroup analysis showed that patients with psoriasis were more likely to attempt suicides (OR, 1.32; 95% CI, 1.14-1.54) and complete suicide (OR, 1.20; 95% CI, 1.04-1.39) than those without psoriasis. More severe psoriasis and younger age were associated with greater likelihood of suicidality. There are few studies examining suicidality in conjunction with psoriasis severity. Patients with psoriasis have a significantly higher likelihood of suicidal ideation, suicide attempts, and completed suicides. Among patients with psoriasis, those who are younger and whose psoriasis is more severe are at particular risk for suicidality. Copyright © 2017. Published by Elsevier Inc.

  11. Systematic Comparison of the MINOS Near and Far Detector Readout Systems

    Energy Technology Data Exchange (ETDEWEB)

    Cabrera, Anatael [Univ. of Oxford (United Kingdom). Queen' s College

    2005-06-22

    The MINOS experiment is a neutrino oscillation baseline experiment intending to use high resolution L/E neutrinos to measure the atmospheric neutrino oscillations parameters to unprecedented precision. Two detectors have been built to realize the measurements, a Near detector, located about 1km downstream from the beam target at the Fermi Laboratory, and a Far detector, located at 736km, at the Soudan Laboratory. The technique relies on the Near detector to measure the un-oscillated neutrino spectrum, while the Far detector measures the neutrino spectrum once oscillated. The comparison between the two measurements is expected to allow MINOS to measure Δm2 beyond 10% precision level. The Near and Far detectors have been built similarly to minimize possible systematic effects. Both detectors have been endowed with different readout systems, as the beam event rates are very different. The MINOS calibration detector (CalDet), installed at CERN, was instrumented with both readout systems such that they can simultaneously measure and characterize the energy deposition (response and event topology) of incident known particle from test-beams. This thesis presents the investigations to quantify the impact of the performance of both readout systems on the MINOS results using the measurements obtained with CalDet. The relative comparison of the responses of both readout systems have been measured to be consistent with being identical within a systematic uncertainty of 0.6%. The event topologies have been found to be negligibly affected. In addition, the performance of the detector simulations have been thoroughly investigated and validated to be in agreement with data within similar level of uncertainties.

  12. Reliability analysis - systematic approach based on limited data

    International Nuclear Information System (INIS)

    Bourne, A.J.

    1975-11-01

    The initial approaches required for reliability analysis are outlined. These approaches highlight the system boundaries, examine the conditions under which the system is required to operate, and define the overall performance requirements. The discussion is illustrated by a simple example of an automatic protective system for a nuclear reactor. It is then shown how the initial approach leads to a method of defining the system, establishing performance parameters of interest and determining the general form of reliability models to be used. The overall system model and the availability of reliability data at the system level are next examined. An iterative process is then described whereby the reliability model and data requirements are systematically refined at progressively lower hierarchic levels of the system. At each stage, the approach is illustrated with examples from the protective system previously described. The main advantages of the approach put forward are the systematic process of analysis, the concentration of assessment effort in the critical areas and the maximum use of limited reliability data. (author)

  13. A systematic review protocol: social network analysis of tobacco use.

    Science.gov (United States)

    Maddox, Raglan; Davey, Rachel; Lovett, Ray; van der Sterren, Anke; Corbett, Joan; Cochrane, Tom

    2014-08-08

    Tobacco use is the single most preventable cause of death in the world. Evidence indicates that behaviours such as tobacco use can influence social networks, and that social network structures can influence behaviours. Social network analysis provides a set of analytic tools to undertake methodical analysis of social networks. We will undertake a systematic review to provide a comprehensive synthesis of the literature regarding social network analysis and tobacco use. The review will answer the following research questions: among participants who use tobacco, does social network structure/position influence tobacco use? Does tobacco use influence peer selection? Does peer selection influence tobacco use? We will follow the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines and search the following databases for relevant articles: CINAHL (Cumulative Index to Nursing and Allied Health Literature); Informit Health Collection; PsycINFO; PubMed/MEDLINE; Scopus/Embase; Web of Science; and the Wiley Online Library. Keywords include tobacco; smoking; smokeless; cigarettes; cigar and 'social network' and reference lists of included articles will be hand searched. Studies will be included that provide descriptions of social network analysis of tobacco use.Qualitative, quantitative and mixed method data that meets the inclusion criteria for the review, including methodological rigour, credibility and quality standards, will be synthesized using narrative synthesis. Results will be presented using outcome statistics that address each of the research questions. This systematic review will provide a timely evidence base on the role of social network analysis of tobacco use, forming a basis for future research, policy and practice in this area. This systematic review will synthesise the evidence, supporting the hypothesis that social network structures can influence tobacco use. This will also include exploring the relationship between social

  14. Glucocorticosteroids for sepsis : systematic review with meta-analysis and trial sequential analysis

    NARCIS (Netherlands)

    Volbeda, M.; Wetterslev, J.; Gluud, C.; Zijlstra, J. G.; van der Horst, I. C. C.; Keus, F.

    Glucocorticosteroids (steroids) are widely used for sepsis patients. However, the potential benefits and harms of both high and low dose steroids remain unclear. A systematic review of randomised clinical trials with meta-analysis and trial sequential analysis (TSA) might shed light on this

  15. Systematic Evaluation of Uncertainty in Material Flow Analysis

    DEFF Research Database (Denmark)

    Laner, David; Rechberger, Helmut; Astrup, Thomas Fruergaard

    2014-01-01

    Material flow analysis (MFA) is a tool to investigate material flows and stocks in defined systems as a basis for resource management or environmental pollution control. Because of the diverse nature of sources and the varying quality and availability of data, MFA results are inherently uncertain....... Uncertainty analyses have received increasing attention in recent MFA studies, but systematic approaches for selection of appropriate uncertainty tools are missing. This article reviews existing literature related to handling of uncertainty in MFA studies and evaluates current practice of uncertainty analysis......) and exploratory MFA (identification of critical parameters and system behavior). Whereas mathematically simpler concepts focusing on data uncertainty characterization are appropriate for descriptive MFAs, statistical approaches enabling more-rigorous evaluation of uncertainty and model sensitivity are needed...

  16. Different materials for direct pulp capping: systematic review and meta-analysis and trial sequential analysis.

    Science.gov (United States)

    Schwendicke, Falk; Brouwer, Fredrik; Schwendicke, Anja; Paris, Sebastian

    2016-07-01

    We systematically assessed randomized controlled trials comparing direct pulp capping materials. Trials comparing materials for direct capping and evaluating clinically and/or radiographically determined success after minimum 3 months were included. Two reviewers independently screened electronic databases (Medline, Central, Embase) and performed hand searches. Risk of bias was assessed and meta-analyses were performed, separated for dentition. Trial sequential analysis was used to assess risk of random errors. Strength of evidence was graded using the GRADE approach. From a total of 453 identified studies, 11 (all with high risk of bias) investigating 1094 teeth (922 patients) were included. Six studies were on primary teeth (all with carious exposures) and five on permanent teeth (carious and artificial exposures). Mean follow-up was 14 months (range 3-24). Most studies used calcium hydroxide as control, comparing it to mineral trioxide aggregate (MTA) (three studies), bonding without prior etching/conditioning (two), or bonding with prior etching/conditioning, enamel matrix proteins, resin-modified glass ionomer cement, calcium sulfate, zinc oxide eugenol, corticosteroids, antibiotics, or formocresol (each in only one study). One study compared MTA and calcium-enriched cement. In permanent teeth, risk of failure was significantly decreased if MTA instead of calcium hydroxide was used (risk ratio (RR) [95 % confidence intervals (CI)] 0.59 [0.39/0.90]); no difference was found for primary teeth. Other comparisons did not find significant differences or were supported by only one study. No firm evidence was reached according to trial sequential analysis. There is insufficient data to recommend or refute the use of a specific material. More long-term practice-based studies with real-life exposures are required. To reduce risk of failure, dentists might consider using MTA instead of calcium hydroxide (CH) for direct capping. Current evidence is insufficient for

  17. Systematic comparison of crystal and NMR protein structures deposited in the protein data bank.

    Science.gov (United States)

    Sikic, Kresimir; Tomic, Sanja; Carugo, Oliviero

    2010-09-03

    Nearly all the macromolecular three-dimensional structures deposited in Protein Data Bank were determined by either crystallographic (X-ray) or Nuclear Magnetic Resonance (NMR) spectroscopic methods. This paper reports a systematic comparison of the crystallographic and NMR results deposited in the files of the Protein Data Bank, in order to find out to which extent these information can be aggregated in bioinformatics. A non-redundant data set containing 109 NMR - X-ray structure pairs of nearly identical proteins was derived from the Protein Data Bank. A series of comparisons were performed by focusing the attention towards both global features and local details. It was observed that: (1) the RMDS values between NMR and crystal structures range from about 1.5 Å to about 2.5 Å; (2) the correlation between conformational deviations and residue type reveals that hydrophobic amino acids are more similar in crystal and NMR structures than hydrophilic amino acids; (3) the correlation between solvent accessibility of the residues and their conformational variability in solid state and in solution is relatively modest (correlation coefficient = 0.462); (4) beta strands on average match better between NMR and crystal structures than helices and loops; (5) conformational differences between loops are independent of crystal packing interactions in the solid state; (6) very seldom, side chains buried in the protein interior are observed to adopt different orientations in the solid state and in solution.

  18. Evaluation of Open and Minimally Invasive Adrenalectomy: A Systematic Review and Network Meta-analysis.

    Science.gov (United States)

    Heger, Patrick; Probst, Pascal; Hüttner, Felix J; Gooßen, Käthe; Proctor, Tanja; Müller-Stich, Beat P; Strobel, Oliver; Büchler, Markus W; Diener, Markus K

    2017-11-01

    Adrenalectomy can be performed via open and various minimally invasive approaches. The aim of this systematic review was to summarize the current evidence on surgical techniques of adrenalectomy. Systematic literature searches (MEDLINE, EMBASE, Web of Science, Cochrane Library) were conducted to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing at least two surgical procedures for adrenalectomy. Statistical analyses were performed, and meta-analyses were conducted. Furthermore, an indirect comparison of RCTs and a network meta-analysis of CCTs were carried out for each outcome. Twenty-six trials (1710 patients) were included. Postoperative complication rates did not show differences for open and minimally invasive techniques. Operation time was significantly shorter for open adrenalectomy than for the robotic approach (p meta-analysis showed open adrenalectomy to be the fastest technique. Blood loss was significantly reduced in the robotic arm compared with open and laparoscopic adrenalectomy (p = 0.01). Length of hospital stay (LOS) was significantly lower after conventional laparoscopy than open adrenalectomy in CCTs (p meta-analysis revealed the lowest LOS after retroperitoneoscopic adrenalectomy. Minimally invasive adrenalectomy is safe and should be preferred over open adrenalectomy due to shorter LOS, lower blood loss, and equivalent complication rates. The retroperitoneoscopic access features the shortest LOS and operating time. Further high-quality RCTs are warranted, especially to compare the posterior retroperitoneoscopic and the transperitoneal robotic approach.

  19. Professional burnout among medical students: Systematic literature review and meta-analysis.

    Science.gov (United States)

    Erschens, Rebecca; Keifenheim, Katharina Eva; Herrmann-Werner, Anne; Loda, Teresa; Schwille-Kiuntke, Juliane; Bugaj, Till Johannes; Nikendei, Christoph; Huhn, Daniel; Zipfel, Stephan; Junne, Florian

    2018-04-14

    This systematic review and meta-analysis aim to summarize the available evidence on the prevalence of professional burnout among medical students. The review was performed according to the PRISMA guidelines. Databases were systematically searched for peer-reviewed articles, reporting burnout among medical students published between 2000 and 2017. The meta-analysis was conducted on the available data on burnout rates in medical students measured with the Maslach Burnout Inventory (MBI-HSS). Fifty-eight out of 3006 studies were found eligible for inclusion. Twelve of these studies met the criteria for meta-analysis. Weighted mean values for the three sub-dimensions of the MBI-HSS were M = 22.93 (SD = 10.25) for Emotional Exhaustion, M = 8.88 (SD = 5.64) for Depersonalization, and M = 35.11 (SD = 8.03) for Personal Accomplishment. Prevalence rates for professional burnout ranged from 7.0% to 75.2%, depending on country-specific factors, applied instruments, cutoff-criteria for burnout symptomatology. This review underlines the burden of burnout among medical students. Future research should explicitly focus on specific context factors and student group under investigation. Such efforts are necessary to control for context-dependent confounders in research on medical students' mental health impairment to enable more meaningful comparisons and adequate prevention strategies.

  20. Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Hugo Souza Bittencourt

    Full Text Available Abstract Non-invasive ventilation (NIV may perfect respiratory and cardiac performance in patients with heart failure (HF. The objective of the study to establish, through systematic review and meta-analysis, NIV influence on functional capacity of HF patients. A systematic review with meta-analysis of randomized studies was carried out through research of databases of Cochrane Library, SciELO, Pubmed and PEDro, using the key-words: heart failure, non-invasive ventilation, exercise tolerance; and the free terms: bi-level positive airway pressure (BIPAP, continuous positive airway pressure (CPAP, and functional capacity (terms were searched for in English and Portuguese using the Boolean operators AND and OR. Methodological quality was ensured through PEDro scale. Weighted averages and a 95% confidence interval (CI were calculated. The meta-analysis was done thorugh the software Review Manager, version 5.3 (Cochrane Collaboration. Four randomized clinical trials were included. Individual studies suggest NIV improved functional capacity. NIV resulted in improvement in the distance of the six-minute walk test (6MWT (68.7m 95%CI: 52.6 to 84.9 in comparison to the control group. We conclude that the NIV is an intervention that promotes important effects in the improvement of functional capacity of HF patients. However, there is a gap in literature on which are the most adequate parameters for the application of this technique.

  1. Toxocariasis and epilepsy: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Graziella Quattrocchi

    Full Text Available OBJECTIVE: Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara canis (T. canis and less frequently Toxocara cati (T. cati. A relationship between toxocariasis and epilepsy has been hypothesized. We conducted a systematic review and a meta-analysis of available data to evaluate the strength of association between epilepsy and Toxocara spp. seropositivity and to propose some guidelines for future surveys. DATA SOURCES: Electronic databases, the database from the Institute of Neuroepidemiology and Tropical Neurology of the University of Limoges (http://www-ient.unilim.fr/ and the reference lists of all relevant papers and books were screened up to October 2011. METHODS: We performed a systematic review of literature on toxocariasis (the exposure and epilepsy (the outcome. Two authors independently assessed eligibility and study quality and extracted data. A common odds ratio (OR was estimated using a random-effects meta-analysis model of aggregated published data. RESULTS: Seven case-control studies met the inclusion criteria, for a total of 1867 participants (850 cases and 1017 controls. The percentage of seropositivity (presence of anti-Toxocara spp. antibodies was higher among people with epilepsy (PWE in all the included studies even if the association between epilepsy and Toxocara spp. seropositivity was statistically significant in only 4 studies, with crude ORs ranging 2.04-2.85. Another study bordered statistical significance, while in 2 of the included studies no significant association was found. A significant (p < 0.001 common OR of 1.92 [95% confidence interval (CI 1.50-2.44] was estimated. Similar results were found when meta-analysis was restricted to the studies considering an exclusively juvenile population and to surveys using Western Blot as confirmatory or diagnostic serological assay. CONCLUSION: Our results support the existence of a positive association between Toxocara spp. seropositivity and

  2. Toxoplasmosis and epilepsy--systematic review and meta analysis.

    Science.gov (United States)

    Ngoungou, Edgard B; Bhalla, Devender; Nzoghe, Amandine; Dardé, Marie-Laure; Preux, Pierre-Marie

    2015-02-01

    Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis. A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%. Six studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27-3.9), p = 0.005. Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy.

  3. Systematic approaches to data analysis from the Critical Decision Method

    Directory of Open Access Journals (Sweden)

    Martin Sedlár

    2015-01-01

    Full Text Available The aim of the present paper is to introduce how to analyse the qualitative data from the Critical Decision Method. At first, characterizing the method provides the meaningful introduction into the issue. This method used in naturalistic decision making research is one of the cognitive task analysis methods, it is based on the retrospective semistructured interview about critical incident from the work and it may be applied in various domains such as emergency services, military, transport, sport or industry. Researchers can make two types of methodological adaptation. Within-method adaptations modify the way of conducting the interviews and cross-method adaptations combine this method with other related methods. There are many decsriptions of conducting the interview, but the descriptions how the data should be analysed are rare. Some researchers use conventional approaches like content analysis, grounded theory or individual procedures with reference to the objectives of research project. Wong (2004 describes two approaches to data analysis proposed for this method of data collection, which are described and reviewed in the details. They enable systematic work with a large amount of data. The structured approach organizes the data according to an a priori analysis framework and it is suitable for clearly defined object of research. Each incident is studied separately. At first, the decision chart showing the main decision points and then the incident summary are made. These decision points are used to identify the relevant statements from the transcript, which are analysed in terms of the Recognition-Primed Decision Model. Finally, the results from all the analysed incidents are integrated. The limitation of the structured approach is it may not reveal some interesting concepts. The emergent themes approach helps to identify these concepts while maintaining a systematic framework for analysis and it is used for exploratory research design. It

  4. Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Garcez, Anderson; Leite, Heloísa Marquardt; Weiderpass, Elisabete; Paniz, Vera Maria Vieira; Watte, Guilherme; Canuto, Raquel; Olinto, Maria Teresa Anselmo

    2018-05-17

    To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I 2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I 2  = 83.1%;p meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality. This systematic review

  5. Measurement Properties of the Functional Rating Index: A systematic Review and Meta-analysis.

    Science.gov (United States)

    Bai, Zhongfei; Shu, Tian; Lu, Jiani; Niu, Wenxin

    2018-04-13

    A systematic review and meta-analysis. To assess the measurement properties of the Functional Rating Index (FRI) and determine whether its measurement properties are comparable with other region-specific questionnaires. In addition to low back pain (LBP) and neck pain (NP), multi-region spinal pain (SP) is a common problem with a considerable prevalence in the general population. The FRI was built to assess physical functioning in patients with SP. However, a systematic review assessing evidence of its measurement properties in separated populations and a comparison with other questionnaires regarding each measurement property is lacking. Articles concerning the FRI's measurement properties or head-to-head comparison with other questionnaires on measurement properties were obtained from MEDLINE, Embase, CINAHL, and PsycINFO. Two reviewers independently reviewed the articles, extracted data, and conducted the methodological quality assessment. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the methodological quality of the included studies. A total of 18 studies evaluating the FRI's measurement properties, including seven that carried out head-to-head comparisons in at least one measurement property with other questionnaires, were included in the current review. Our findings show strong positive evidence for structural validity and internal consistency in patients with SP and LBP. Evidence for most of the FRI's measurement properties is limited, conflicting, or even unknown. The current evidence shows that the FRI is comparable with both the ODI and the NDI in responsiveness. However, relevant information about the majority of the other measurement properties is lacking. Our finding suggests that clinicians and researchers should use the FRI with caution until there are more studies with high methodological quality that support the view that it is positive in all measurement properties

  6. Budget impact analysis of medicines: updated systematic review and implications.

    Science.gov (United States)

    Faleiros, Daniel Resende; Álvares, Juliana; Almeida, Alessandra Maciel; de Araújo, Vânia Eloisa; Andrade, Eli Iola Gurgel; Godman, Brian B; Acurcio, Francisco A; Guerra Júnior, Augusto A

    2016-01-01

    This evaluation determines whether published studies to date meet the key characteristics identified for budget impact analyses (BIA) for medicines, accomplished through a systematic review and assessment against identified key characteristics. Studies from 2001-2015 on 'budget impact analysis' with 'drug' interventions were assessed, selected based on their titles/abstracts and full texts, and their characteristics checked according to key criteria. Out of 1,984 studies, 92 were subsequently identified for review. Of these, 95% were published in Europe and the USA. 2012 saw the largest number of publications (16%) with a decline thereafter. 48% met up to 7 out of the 9 key characteristics. Only 22% stated no conflict of interest. The results indicate low adherence to the key characteristics that should be considered for BIAs and strong conflict of interest. This is an issue since BIAs can be of fundamental importance in managing the entry of new medicines including reimbursement decisions.

  7. [The quality of the German health-care system in an international comparison - a systematic review].

    Science.gov (United States)

    Lauerer, M; Emmert, M; Schöffski, O

    2013-08-01

    Studies assessing the quality of the German health-care system in an international comparison come to different results. Therefore, this review aims to investigate how the German health-care system is evaluated in comparison to other health-care systems by reviewing international publications. Results show starting points for ways to improve the German health-care system, to maintain and expand its strengths as well as to derive strategies for solving identified problems. A systematic review searching different databases [library catalogues, WorldCat (including MEDLINE and OAIster-search), German National Library, Google Scholar and others]. Search requests were addressed to English or German language publications for the time period 2000-2010 (an informal search was conducted in October 2011 for an update). Results of the identified studies were aggregated and main statements derived. In total, 13 publications assessing the German health-care system in an international comparison were identified. These comparisons are based on 377 measures. After aggregation, 244 substantially different indicators remained, which were dedicated to 14 categories. It became apparent that the German health-care system can be characterised by a high level of expenses, a well-developed health-care infrastructure as well as a high availability of personal and material resources. Outcome measures demonstrate heterogeneous results. It can be stated that, particularly in this field, there is potential for further improvement. The utilisation of health-care services is high, the access is mostly not regulated and out of pocket payments can pose a barrier for patients. Waiting times are not regarded as a major weakness. Although civic satisfaction seems to be acceptable, a large portion of the citizens calls for elementary modifications. Especially, more patient-centred health-care delivery should be addressed as well as management of information and the adoption of meaningful electronic

  8. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis.

    Science.gov (United States)

    Adil, Areej; Godwin, Marshall

    2017-07-01

    Androgenetic alopecia, or male pattern hair loss, is a hair loss disorder mediated by dihydrotestosterone, the potent form of testosterone. Currently, minoxidil and finasteride are Food and Drug Administration (FDA)-approved, and HairMax LaserComb, which is FDA-cleared, are the only treatments recognized by the FDA as treatments of androgenetic alopecia. This systematic review and meta-analysis assesses the efficacy of nonsurgical treatments of androgenetic alopecia in comparison to placebo for improving hair density, thickness, growth (defined by an increased anagen:telogen ratio), or subjective global assessments done by patients and investigators. A systematic review of randomized controlled trials was conducted. PubMed, Embase, and Cochrane were searched up to December 2016, with no lower limit on the year. We included only randomized controlled trials of good or fair quality based on the US Preventive Services Task Force quality assessment process. A meta-analysis was conducted separately for 5 groups of studies that tested the following hair loss treatments: low-level laser light therapy in men, 5% minoxidil in men, 2% minoxidil in men, 1 mg finasteride in men, and 2% minoxidil in women. All treatments were superior to placebo (P laser light therapy are effective for promoting hair growth in men with androgenetic alopecia and that minoxidil is effective in women with androgenetic alopecia. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Systematic analysis of transcription start sites in avian development.

    Directory of Open Access Journals (Sweden)

    Marina Lizio

    2017-09-01

    Full Text Available Cap Analysis of Gene Expression (CAGE in combination with single-molecule sequencing technology allows precision mapping of transcription start sites (TSSs and genome-wide capture of promoter activities in differentiated and steady state cell populations. Much less is known about whether TSS profiling can characterize diverse and non-steady state cell populations, such as the approximately 400 transitory and heterogeneous cell types that arise during ontogeny of vertebrate animals. To gain such insight, we used the chick model and performed CAGE-based TSS analysis on embryonic samples covering the full 3-week developmental period. In total, 31,863 robust TSS peaks (>1 tag per million [TPM] were mapped to the latest chicken genome assembly, of which 34% to 46% were active in any given developmental stage. ZENBU, a web-based, open-source platform, was used for interactive data exploration. TSSs of genes critical for lineage differentiation could be precisely mapped and their activities tracked throughout development, suggesting that non-steady state and heterogeneous cell populations are amenable to CAGE-based transcriptional analysis. Our study also uncovered a large set of extremely stable housekeeping TSSs and many novel stage-specific ones. We furthermore demonstrated that TSS mapping could expedite motif-based promoter analysis for regulatory modules associated with stage-specific and housekeeping genes. Finally, using Brachyury as an example, we provide evidence that precise TSS mapping in combination with Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR-on technology enables us, for the first time, to efficiently target endogenous avian genes for transcriptional activation. Taken together, our results represent the first report of genome-wide TSS mapping in birds and the first systematic developmental TSS analysis in any amniote species (birds and mammals. By facilitating promoter-based molecular analysis and genetic

  10. Wearable inertial sensors in swimming motion analysis: a systematic review.

    Science.gov (United States)

    de Magalhaes, Fabricio Anicio; Vannozzi, Giuseppe; Gatta, Giorgio; Fantozzi, Silvia

    2015-01-01

    The use of contemporary technology is widely recognised as a key tool for enhancing competitive performance in swimming. Video analysis is traditionally used by coaches to acquire reliable biomechanical data about swimming performance; however, this approach requires a huge computational effort, thus introducing a delay in providing quantitative information. Inertial and magnetic sensors, including accelerometers, gyroscopes and magnetometers, have been recently introduced to assess the biomechanics of swimming performance. Research in this field has attracted a great deal of interest in the last decade due to the gradual improvement of the performance of sensors and the decreasing cost of miniaturised wearable devices. With the aim of describing the state of the art of current developments in this area, a systematic review of the existing methods was performed using the following databases: PubMed, ISI Web of Knowledge, IEEE Xplore, Google Scholar, Scopus and Science Direct. Twenty-seven articles published in indexed journals and conference proceedings, focusing on the biomechanical analysis of swimming by means of inertial sensors were reviewed. The articles were categorised according to sensor's specification, anatomical sites where the sensors were attached, experimental design and applications for the analysis of swimming performance. Results indicate that inertial sensors are reliable tools for swimming biomechanical analyses.

  11. Scientific publications on systematic review and meta-analysis from Chinese authors: a 10-year survey of the English literature.

    Science.gov (United States)

    Yang, Zhiping; Wu, Qiong; Wu, Kaichun; Fan, Daiming

    2012-03-01

    Systematic reviews and meta-analyses are playing an increasingly important role in clinical research and practice. This study aimed to measure the scientific production of systematic review and meta-analysis from the three major regions of China: the Mainland (ML), Hong Kong (HK), and Taiwan (TW). English articles on systematic review and meta-analysis from ML, HK, and TW from 2001 to 2010 were retrieved from the PubMed database. The total number of articles, impact factors (IF), and articles published in high-impact journals were conducted for quantity and quality comparisons among the three regions. There were 1 587 published articles from ML (1 292), HK (203), and TW (92) during the past ten years. The annual total numbers of articles in the three regions increased significantly from 2001 to 2010 (from 13 to 677). The number of articles from ML has exceeded that from TW since 2001, and surpassed that from HK in 2003. The accumulated IF of articles from ML (3 488.24) was higher than those from HK (493.16) and TW (216.39). HK had the highest average IF of 3.31, followed by ML of 2.90 and TW of 2.85. Researchers from HK published a larger proportion of papers in high-impact journals than those from ML and TW. The Cochrane Database of Systematic Reviews was the most popular journal in China. Chinese authors have been very active to enhance the systematic review and meta-analysis research over the past ten years, especially in ML. The gap between ML and the other two regions has been narrowed. But there is still considerable room for Chinese authors to improve their studies on systematic review and meta-analysis.

  12. A systematic comparison of motion artifact correction techniques for functional near-infrared spectroscopy.

    Science.gov (United States)

    Cooper, Robert J; Selb, Juliette; Gagnon, Louis; Phillip, Dorte; Schytz, Henrik W; Iversen, Helle K; Ashina, Messoud; Boas, David A

    2012-01-01

    Near-infrared spectroscopy (NIRS) is susceptible to signal artifacts caused by relative motion between NIRS optical fibers and the scalp. These artifacts can be very damaging to the utility of functional NIRS, particularly in challenging subject groups where motion can be unavoidable. A number of approaches to the removal of motion artifacts from NIRS data have been suggested. In this paper we systematically compare the utility of a variety of published NIRS motion correction techniques using a simulated functional activation signal added to 20 real NIRS datasets which contain motion artifacts. Principle component analysis, spline interpolation, wavelet analysis, and Kalman filtering approaches are compared to one another and to standard approaches using the accuracy of the recovered, simulated hemodynamic response function (HRF). Each of the four motion correction techniques we tested yields a significant reduction in the mean-squared error (MSE) and significant increase in the contrast-to-noise ratio (CNR) of the recovered HRF when compared to no correction and compared to a process of rejecting motion-contaminated trials. Spline interpolation produces the largest average reduction in MSE (55%) while wavelet analysis produces the highest average increase in CNR (39%). On the basis of this analysis, we recommend the routine application of motion correction techniques (particularly spline interpolation or wavelet analysis) to minimize the impact of motion artifacts on functional NIRS data.

  13. Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Nalinee Poolsup

    Full Text Available OBJECTIVE: To assess the efficacy and safety of treating pregnant women with gestational diabetes mellitus in comparison to usual antenatal care. METHODS: A systematic review and meta-analysis was conducted by including randomized controlled trials comparing any form of therapeutic intervention in comparison to usual antenatal care. A literature search was conducted using electronic databases together with a hand search of relevant journals and conference proceedings. RESULTS: Ten studies involving 3,881 patients contributed to meta-analysis. Our results indicated that gestational diabetes mellitus treatment significantly reduced the risk for macrosomia (RR, 0.47; 95% CI, 0.38-0.57, large for gestational age births (RR, 0.55; 95% CI, 0.45-0.67, shoulder dystocia (RR, 0.42; 95% CI, 0.23-0.77 and gestational hypertension (RR, 0.68; 95% CI, 0.53-0.87 without causing any significant increase in the risk for small for gestational age babies. However, no significant difference was observed between the two groups regarding perinatal/neonatal mortality, neonatal hypoglycemia, birth trauma, preterm births, pre-eclampsia, caesarean section and labor induction. CONCLUSION: Treating GDM reduces risk for many important adverse pregnancy outcomes and its association with any harm seems unlikely.

  14. Systematic comparison between line integrated densities measured with interferometry and polarimetry at JET

    International Nuclear Information System (INIS)

    Brombin, M.; Zilli, E.; Giudicotti, L.; Boboc, A.; Murari, A.

    2009-01-01

    A systematic comparison between the line integrated electron density derived from interferometry and polarimetry at JET has been carried out. For the first time the reliability of the measurements of the Cotton-Mouton effect has been analyzed for a wide range of main plasma parameters and the possibility to evaluate the electron density directly from polarimetric data has been studied. The purpose of this work is to recover the interferometric data with the density derived from the measured Cotton-Mouton effect, when the fringe jump phenomena occur. The results show that the difference between the line integrated electron density from interferometry and polarimetry is with one fringe (1.143x10 19 m -2 ) for more than 90% of the cases. It is possible to consider polarimetry as a satisfactory alternative method to interferometry to measure the electron density and it could be used to recover interferometric signal when a fringe jumps occurs, preventing difficulties for the real-time control of many experiments at the JET machine.

  15. Comparison of Dabigatran vs. Warfarin in Acute Vnous Thromboemboly: Systematic Review.

    Science.gov (United States)

    Ganji, Reza; Ala, Shahram; Aarabi, Mohsen; Baghery, Babak; Salehifar, Ebrahim

    2016-01-01

    Acute Venous Thromboembolism (VTE) is a common disease associated with the significant morbidity and mortality. We reviewed clinical outcomes systematically with Dabigatran as a direct oral anticoagulants (DOAC) for treatment of acute VTE. We used Ovide, PubMed, Cochrane (CENTRAL), EMBASE, Scopus, Science Direct, LILAC(for article written not English) and also Iranian database; Magiran, Isc, Iran Medex, Iran DOC, Doaj up to May 2014 to identify randomized clinical trials of Dabigatran compared with conventional treatment for VTE. Two investigators extracted data independently. Number of 5107 patients including two trails were selected. The risk of recurrent VTE was similar with the Dabigatran and standard treatment (Hazard Ratio, 95% confidence interval 1.09 (0.76-1.57). Dabigatran reduced the risk of minor bleeding in comparison with standard treatment; Warfarin (0.62) (0.50-0.76). Finally-in minor bleeding-the Dabigatran seemed as effective as, and probably safer than standard treatment of acute VTE. But in some aspects such as adherence to treatment, pregnant patient, impact on quality of life, new researches are needed to be clarified.

  16. Systematic comparison of position and time dependent macroparticle simulations in beam dynamics studies

    Directory of Open Access Journals (Sweden)

    Ji Qiang

    2002-06-01

    Full Text Available Macroparticle simulation plays an important role in modern accelerator design and operation. Most linear rf accelerators have been designed based on macroparticle simulations using longitudinal position as the independent variable. In this paper, we have done a systematic comparison between using longitudinal position as the independent variable and using time as the independent variable in macroparticle simulations. We have found that, for an rms-matched beam, the maximum relative moment difference for second, fourth moments and beam maximum amplitudes between these two types of simulations is 0.25% in a 10 m reference transport system with physical parameters similar to the Spallation Neutron Source linac design. The maximum z-to- t transform error in the space-charge force calculation of the position dependent simulation is about 0.1% in such a system. This might cause a several percent error in a complete simulation of a linac with a length of hundreds of meters. Furthermore, the error may be several times larger in simulations of mismatched beams. However, if such errors are acceptable to the linac designer, then one is justified in using position dependent macroparticle simulations in this type of linac design application.

  17. Onset Detection in Surface Electromyographic Signals: A Systematic Comparison of Methods

    Directory of Open Access Journals (Sweden)

    Claus Flachenecker

    2001-06-01

    Full Text Available Various methods to determine the onset of the electromyographic activity which occurs in response to a stimulus have been discussed in the literature over the last decade. Due to the stochastic characteristic of the surface electromyogram (SEMG, onset detection is a challenging task, especially in weak SEMG responses. The performance of the onset detection methods were tested, mostly by comparing their automated onset estimations to the manually determined onsets found by well-trained SEMG examiners. But a systematic comparison between methods, which reveals the benefits and the drawbacks of each method compared to the other ones and shows the specific dependence of the detection accuracy on signal parameters, is still lacking. In this paper, several classical threshold-based approaches as well as some statistically optimized algorithms were tested on large samples of simulated SEMG data with well-known signal parameters. Rating between methods is performed by comparing their performance to that of a statistically optimal maximum likelihood estimator which serves as reference method. In addition, performance was evaluated on real SEMG data obtained in a reaction time experiment. Results indicate that detection behavior strongly depends on SEMG parameters, such as onset rise time, signal-to-noise ratio or background activity level. It is shown that some of the threshold-based signal-power-estimation procedures are very sensitive to signal parameters, whereas statistically optimized algorithms are generally more robust.

  18. A systematic comparison of different approaches of density functional theory for the study of electrical double layers

    International Nuclear Information System (INIS)

    Yang, Guomin; Liu, Longcheng

    2015-01-01

    Based on the best available knowledge of density functional theory (DFT), the reference-fluid perturbation method is here extended to yield different approaches that well account for the cross correlations between the Columbic interaction and the hard-sphere exclusion in an inhomogeneous ionic hard-sphere fluid. In order to quantitatively evaluate the advantage and disadvantage of different approaches in describing the interfacial properties of electrical double layers, this study makes a systematic comparison against Monte Carlo simulations over a wide range of conditions. The results suggest that the accuracy of the DFT approaches is well correlated to a coupling parameter that describes the coupling strength of electrical double layers by accounting for the steric effect and that can be used to classify the systems into two regimes. In the weak-coupling regime, the approaches based on the bulk-fluid perturbation method are shown to be more accurate than the counterparts based on the reference-fluid perturbation method, whereas they exhibit the opposite behavior in the strong-coupling regime. More importantly, the analysis indicates that, with a suitable choice of the reference fluid, the weighted correlation approximation (WCA) to DFT gives the best account of the coupling effect of the electrostatic-excluded volume correlations. As a result, a piecewise WCA approach can be developed that is robust enough to describe the structural and thermodynamic properties of electrical double layers over both weak- and strong-coupling regimes

  19. Comparison of Three Methods of Reducing Test Anxiety: Systematic Desensitization, Implosive Therapy, and Study Counseling

    Science.gov (United States)

    Cornish, Richard D.; Dilley, Josiah S.

    1973-01-01

    Systematic desensitization, implosive therapy, and study counseling have all been effective in reducing test anxiety. In addition, systematic desensitization has been compared to study counseling for effectiveness. This study compares all three methods and suggests that systematic desentization is more effective than the others, and that implosive…

  20. A Systematic Approach for the Design and Analysis of Reaction-Separation Systems with Recycle

    DEFF Research Database (Denmark)

    Gani, Rafiqul; Jimenez, Edgar Ramirez

    2004-01-01

    This paper presents a methodology for a systematic model-based analysis and the results obtained from it for an integrated design and analysis of reaction-separation systems with recycle. The methodology (systematic approach) consists of three stages where stage 1 identifies the limiting values...

  1. Bibliometric analysis of systematics production in Latin America

    International Nuclear Information System (INIS)

    Michan Aguirre, Layla

    2011-01-01

    I compare six bibliographic databases with information on Latin American systematics: Biosis, CAB, periodica, SCI, scopus and Zoological record. the databases are characterized and compared considering their content, temporal, typological, geographical, thematical coverage, kind of access and new taxon description, to identify which and how many should be used to be more representative. Of the 1363 journals analyzed, 36.5% are found in more than one database and 63.46% are recorded in a single one. zoological record contains 63421 documents, Biosis 19079, CAB 14363, periodica 11185, SCI 3257 and scopus 916. CAB and ZR are the oldest databases, the average number of articles published per year was 6417 for Biosis, 433 for ZR, 361 for periodica, 145 for CAB, 91 for SCI and 30 for Scopus. According to the network analysis, there are stronger relations between SCI and Biosis, which share at least 16% of titles, CAB and Biosis share 15%, Biosis and ZR 14%, and CAB and ZR 11%. Based on the cladogram obtained from a parsimony analysis on the shared journals, the strongest relation is between Biosis and SCI; periodica has the largest number of exclusive journals with 285. ZR has 72.9% of published articles with descriptions of new taxa and an average of 322 a year, CAB 54.6% with 82, and periodica 24.6% with 90. None of databases meets the characteristics to be used as a single source of information, therefore it would be appropriate to use different combinations according to the aim of the analysis. biosis has the most comprehensive information on any current taxon, zoological record and CAB have a broader temporal coverage and include mainly animals or plants, respectively. SCI has the largest number of documents in mainstream journals, with references, citations and bibliometric indicators. periodica has the largest number of documents and temporal coverage published in the area. The cladogram proved to be an optimal visualization tool to represent the main features of

  2. Occurrence of Phlebitis: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Chang, Wen P; Peng, Yu X

    Peripheral venous catheters (PVCs) are commonly used in clinical practice. However, varying degrees of phlebitis often occur in patients receiving intravenous injections. The relevant literature suggests that phlebitis occurrence is highly associated with the catheter gauge, insertion site, and catheterization duration. Nevertheless, no meta-analysis has been performed on the influence of these three factors on the occurrence of phlebitis. The objective of this study was to determine whether any significant differences exist in the occurrence of phlebitis between catheters of 20 gauge or smaller and those larger than 20 gauge, between catheters inserted in the antecubital fossa and those inserted in other locations on the upper limbs, or between catheters inserted for more than 96 hours and those inserted for 96 hours or less. Using a systematic approach, we searched for literature published between 2006 and 2017 in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest, and Cochrane Library databases. We used Comprehensive Meta-analysis Version 2 to perform our meta-analysis. After the screening and review processes, we identified 17 studies that met our selection conditions. Among these studies, 14 contained complete data for meta-analysis. These studies involved 4,343 patients and 5,846 PVCs. Regarding the overall effect size in the meta-analysis, the results of the forest plot comparing catheters of 20 gauge or smaller and those larger than 20 gauge presented a risk ratio (RR) of 0.88 (95% confidence interval [0.67, 1.17], p = .380), indicating no statistically significant difference in the occurrence of phlebitis between catheters of the aforementioned gauges. The results of the forest plot comparing catheters inserted in the antecubital fossa and those inserted in other locations on the upper limbs presented an RR of 1.05 (95% confidence interval [0.82, 1.34], p = .696), indicating no statistically significant difference in

  3. A bibliometric analysis of systematic reviews on vaccines and immunisation.

    Science.gov (United States)

    Fernandes, Silke; Jit, Mark; Bozzani, Fiammetta; Griffiths, Ulla K; Scott, J Anthony G; Burchett, Helen E D

    2018-04-19

    SYSVAC is an online bibliographic database of systematic reviews and systematic review protocols on vaccines and immunisation compiled by the London School of Hygiene & Tropical Medicine and hosted by the World Health Organization (WHO) through their National Immunization Technical Advisory Groups (NITAG) resource centre (www.nitag-resource.org). Here the development of the database and a bibliometric review of its content is presented, describing trends in the publication of policy-relevant systematic reviews on vaccines and immunisation from 2008 to 2016. Searches were conducted in seven scientific databases according to a standardized search protocol, initially in 2014 with the most recent update in January 2017. Abstracts and titles were screened according to specific inclusion criteria. All included publications were coded into relevant categories based on a standardized protocol and subsequently analysed to look at trends in time, topic, area of focus, population and geographic location. After screening for inclusion criteria, 1285 systematic reviews were included in the database. While in 2008 there were only 34 systematic reviews on a vaccine-related topic, this increased to 322 in 2016. The most frequent pathogens/diseases studied were influenza, human papillomavirus and pneumococcus. There were several areas of duplication and overlap. As more systematic reviews are published it becomes increasingly time-consuming for decision-makers to identify relevant information among the ever-increasing volume available. The risk of duplication also increases, particularly given the current lack of coordination of systematic reviews on vaccine-related questions, both in terms of their commissioning and their execution. The SYSVAC database offers an accessible catalogue of vaccine-relevant systematic reviews with, where possible access or a link to the full-text. SYSVAC provides a freely searchable platform to identify existing vaccine-policy-relevant systematic

  4. Comparison of systematic mediastinal lymph node dissection versus systematic sampling for lung cancer staging and completeness of surgery.

    Science.gov (United States)

    Wu, Nan; Yan, Shi; Lv, Chao; Feng, Yuan; Wang, Yuzhao; Zhang, Lijian; Yang, Yue

    2011-12-01

    This self-controlled prospective study was designed to investigate the efficacy of systematic sampling (SS), compared with systematic mediastinal lymph node dissection (SMLD), for pathologic staging and completeness of surgery. Over a period of 11 mo, 110 patients with lung cancer were enlisted and treated by pulmonary resection. Surgeons systematically sampled mediastinal lymph nodes prior to pulmonary resection, and after pulmonary resection SMLD was performed to each patient using Mountain's procedure [1]. After SMLD, pN status was classified as N0 in 57 cases, N1 in 27, and N2 in 26. SS detected 38.3% of pooled nodes and 37.6% of pooled positive nodes collected from SMLD. Pathologic diagnosis after SS was understaged in nine cases (8.2%) compared with staging after SMLD. However, surgery was incomplete in 24 cases (21.8%) if SMLD was not performed after sampling. Negative predictive value for SS was 86.8% on the right side, and 95.0% on the left. Three categories were generated according to pN status: negative nodes in SS and additional negative nodes from SMLD [S(-)D(-)], negative nodes in SS but additional positive nodes from SMLD [S(-)D(+)], and positive nodes in SS [S(+)D(+)]. cN2 (P=0.000) and CEA level (P=0.001) were correlated with pN status. There was significant overall survival difference between non-N2 group and N2 group (P=0.002). SMLD may harvest about three times of mediastinal lymph nodes compared with SS. SS is more likely to affect the completeness of surgery instead of underrating pathologic stage. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. A methodological comparison of customer service analysis techniques

    Science.gov (United States)

    James Absher; Alan Graefe; Robert Burns

    2003-01-01

    Techniques used to analyze customer service data need to be studied. Two primary analysis protocols, importance-performance analysis (IP) and gap score analysis (GA), are compared in a side-by-side comparison using data from two major customer service research projects. A central concern is what, if any, conclusion might be different due solely to the analysis...

  6. Systematic analysis of research underfunding in maternal and perinatal health.

    Science.gov (United States)

    Fisk, N M; Atun, R

    2009-02-01

    Little published evidence supports the widely held contention that research in pregnancy is underfunded compared with other disease areas. To assess absolute and relative government and charitable funding for maternal and perinatal research in the UK and internationally. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Major research funding bodies and alliances were identified from an Internet search and discussions with opinion leaders/senior investigators. Websites and annual reports were reviewed for details of strategy, research spend, grants awarded, and allocation to maternal and/or perinatal disease using generic and disease-specific search terms. Within the imprecision in the data sets, global philanthropy concentrated on service provision rather than research. Although research expenditure has been deemed as appropriate for 'reproductive health' disease burden in the UK, there are no data on the equity of maternal/perinatal research spend against disease burden, which globally may justify a manyfold increase. This systematic review of research expenditure and priorities from national and international funding bodies suggests relative underinvestment in maternal/perinatal health. Contributing factors include the low political priority given to women's health, the challenging nature of clinical research in pregnancy, and research capacity dearth as a consequence of chronic underinvestment.

  7. Systematic analysis of γ-ray families, 1

    International Nuclear Information System (INIS)

    Semba, Hiroshi

    1984-01-01

    Atmospheric nuclear interactions caused by cosmic rays are observed in the Chacaltaya emulsion chamber experiment. A systematic analysis is made on 106 events (γ-ray families) with visible energy in the range of 100 - 300 TeV. A new method called 'decascading' is introduced to pick up a cluster of γ-rays and electrons in a family, so that the cluster is an air cascade from one parent γ-ray. The application of 'decascading' method to the family data gives information on original γ-rays produced at the atmospheric interactions. The results are compared with data from the traget interactions at lower energy range ΣEsub(γ)=20 - 100 TeV). The conclusion is that the characteristics of nuclear interactions at the concerned family energy range (E deg approximately equal to 1,000 TeV) are in accordance with those at the target interaction range (E deg approximately equal to 100 TeV), with increased ratio of frequencies of a heavy fire-ball (SH-quantum) to a small and usual fire-ball (H-quantum). (author)

  8. C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Giovanni Leuzzi

    2017-02-01

    Full Text Available The prognostic role of baseline C-reactive protein (CRP in chronic obstructive pulmonary disease (COPD is controversial. In order to clarify this issue, we performed a systematic review and meta-analysis to assess the predictive effect of baseline CRP level in COPD patients. 15 eligible articles focusing on late mortality in COPD were included in our study. We performed a random-effects meta-analysis, and assessed heterogeneity and publication bias. We pooled hazard ratio (HR estimates and their 95% confidence intervals on mortality for the comparison between the study-specific highest category of CRP level versus the lowest category. In overall analysis, elevated baseline CRP levels were significantly associated with higher mortality (HR 1.53, 95% CI 1.32–1.77, I2=68.7%, p<0.001. Similar results were observed across subgroups. However, higher mortality risk was reported in studies using a cut-off value of 3 mg·L−1 (HR 1.61, 95% CI 1.12–2.30 and in those enrolling an Asiatic population (HR 3.51, 95% CI 1.69–7.31. Our analysis indicates that baseline high CRP level is significantly associated with higher late mortality in patients with COPD. Further prospective controlled studies are needed to confirm these data.

  9. Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Collins, Peter F; Stratton, Rebecca J; Elia, Marinos

    2012-06-01

    The efficacy of nutritional support in the management of malnutrition in chronic obstructive pulmonary disease (COPD) is controversial. Previous meta-analyses, based on only cross-sectional analysis at the end of intervention trials, found no evidence of improved outcomes. The objective was to conduct a meta-analysis of randomized controlled trials (RCTs) to clarify the efficacy of nutritional support in improving intake, anthropometric measures, and grip strength in stable COPD. Literature databases were searched to identify RCTs comparing nutritional support with controls in stable COPD. Thirteen RCTs (n = 439) of nutritional support [dietary advice (1 RCT), oral nutritional supplements (ONS; 11 RCTs), and enteral tube feeding (1 RCT)] with a control comparison were identified. An analysis of the changes induced by nutritional support and those obtained only at the end of the intervention showed significantly greater increases in mean total protein and energy intakes with nutritional support of 14.8 g and 236 kcal daily. Meta-analyses also showed greater mean (±SE) improvements in favor of nutritional support for body weight (1.94 ± 0.26 kg, P groups. This systematic review and meta-analysis showed that nutritional support, mainly in the form of ONS, improves total intake, anthropometric measures, and grip strength in COPD. These results contrast with the results of previous analyses that were based on only cross-sectional measures at the end of intervention trials.

  10. Association between matrix metalloproteinases polymorphisms and ovarian cancer risk: A meta-analysis and systematic review.

    Directory of Open Access Journals (Sweden)

    Xu-Ming Zhu

    Full Text Available Published data on the relationship between matrix metalloproteinases (MMPs polymorphisms and ovarian cancer risk have implicated inconclusive results. To evaluate the role of MMPs polymorphisms in ovarian cancer risk, a meta-analysis and systematic review were performed.MMPs polymorphisms which could be quantitatively synthesized were involved in meta-analysis. Five comparison models (homozygote model, heterozygote model, dominant model, recessive model, additive model were carried out, a subgroup analysis was performed to clarify heterogeneity source. The remaining polymorphisms which could not be quantitatively synthesized were involved in systematic review.10 articles with 20 studies were included in this paper. Among those studies, 8 studies involving MMP1 rs1799750 and MMP3 rs34093618 could be meta-analyzed and 12 studies involving 12 polymorphisms could not. Meta-analysis showed that no associations were found between MMP1 rs1799750 (homozygote model: OR = 0.93, 95%CI = 0.70-1.23, POR = 0.60; heterozygote model: OR = 1.09, 95%CI = 0.78-1.54, POR = 0.61; dominant model: OR = 1.02, 95%CI = 0.83-1.25, POR = 0.84; recessive model: OR = 0.95, 95%CI = 0.75-1.21, POR = 0.67; additive model: OR = 1.00, 95%CI = 0.85-1.17, POR = 0.99, MMP3 rs34093618 (homozygote model: OR = 1.25, 95%CI = 0.70-2.24, POR = 0.46; heterozygote model: OR = 1.08, 95%CI = 0.51-2.31, POR = 0.84; dominant model: OR = 0.97, 95%CI = 0.68-1.38, POR = 0.85; recessive model: OR = 1.12, 95%CI = 0.69-1.80, POR = 0.65; additive model: OR = 1.01, 95%CI = 0.79-1.31, POR = 0.91 and ovarian cancer. Furthermore, similar results were detected in subgroup analysis. The systematic review on 12 polymorphisms suggested that MMP2 C-735T, MMP7 A-181G, MMP8 rs11225395, MMP9 rs6094237, MMP12 rs2276109, MMP20 rs2292730, MMP20 rs12278250, MMP20 rs9787933 might have a potential effect on ovarian cancer risk.In summary, polymorphisms of MMPs might not be associated with ovarian cancer risk. However

  11. Selenium and Lung Cancer: A Systematic Review and Meta Analysis

    Science.gov (United States)

    Fritz, Heidi; Kennedy, Deborah; Fergusson, Dean; Fernandes, Rochelle; Cooley, Kieran; Seely, Andrew; Sagar, Stephen; Wong, Raimond; Seely, Dugald

    2011-01-01

    Background Selenium is a natural health product widely used in the treatment and prevention of lung cancers, but large chemoprevention trials have yielded conflicting results. We conducted a systematic review of selenium for lung cancers, and assessed potential interactions with conventional therapies. Methods and Findings Two independent reviewers searched six databases from inception to March 2009 for evidence pertaining to the safety and efficacy of selenium for lung cancers. Pubmed and EMBASE were searched to October 2009 for evidence on interactions with chemo- or radiation-therapy. In the efficacy analysis there were nine reports of five RCTs and two biomarker-based studies, 29 reports of 26 observational studies, and 41 preclinical studies. Fifteen human studies, one case report, and 36 preclinical studies were included in the interactions analysis. Based on available evidence, there appears to be a different chemopreventive effect dependent on baseline selenium status, such that selenium supplementation may reduce risk of lung cancers in populations with lower baseline selenium status (serumselenium (≥121.6 ng/mL). Pooling data from two trials yielded no impact to odds of lung cancer, OR 0.93 (95% confidence interval 0.61–1.43); other cancers that were the primary endpoints of these trials, OR 1.51 (95%CI 0.70–3.24); and all-cause-death, OR 0.93 (95%CI 0.79–1.10). In the treatment of lung cancers, selenium may reduce cisplatin-induced nephrotoxicity and side effects associated with radiation therapy. Conclusions Selenium may be effective for lung cancer prevention among individuals with lower selenium status, but at present should not be used as a general strategy for lung cancer prevention. Although promising, more evidence on the ability of selenium to reduce cisplatin and radiation therapy toxicity is required to ensure that therapeutic efficacy is maintained before any broad clinical recommendations can be made in this context. PMID:22073154

  12. Sequential analysis in neonatal research-systematic review.

    Science.gov (United States)

    Lava, Sebastiano A G; Elie, Valéry; Ha, Phuong Thi Viet; Jacqz-Aigrain, Evelyne

    2018-05-01

    As more new drugs are discovered, traditional designs come at their limits. Ten years after the adoption of the European Paediatric Regulation, we performed a systematic review on the US National Library of Medicine and Excerpta Medica database of sequential trials involving newborns. Out of 326 identified scientific reports, 21 trials were included. They enrolled 2832 patients, of whom 2099 were analyzed: the median number of neonates included per trial was 48 (IQR 22-87), median gestational age was 28.7 (IQR 27.9-30.9) weeks. Eighteen trials used sequential techniques to determine sample size, while 3 used continual reassessment methods for dose-finding. In 16 studies reporting sufficient data, the sequential design allowed to non-significantly reduce the number of enrolled neonates by a median of 24 (31%) patients (IQR - 4.75 to 136.5, p = 0.0674) with respect to a traditional trial. When the number of neonates finally included in the analysis was considered, the difference became significant: 35 (57%) patients (IQR 10 to 136.5, p = 0.0033). Sequential trial designs have not been frequently used in Neonatology. They might potentially be able to reduce the number of patients in drug trials, although this is not always the case. What is known: • In evaluating rare diseases in fragile populations, traditional designs come at their limits. About 20% of pediatric trials are discontinued, mainly because of recruitment problems. What is new: • Sequential trials involving newborns were infrequently used and only a few (n = 21) are available for analysis. • The sequential design allowed to non-significantly reduce the number of enrolled neonates by a median of 24 (31%) patients (IQR - 4.75 to 136.5, p = 0.0674).

  13. A systematic analysis of the science of sandboxing

    Directory of Open Access Journals (Sweden)

    Michael Maass

    2016-01-01

    Full Text Available Sandboxes are increasingly important building materials for secure software systems. In recognition of their potential to improve the security posture of many systems at various points in the development lifecycle, researchers have spent the last several decades developing, improving, and evaluating sandboxing techniques. What has been done in this space? Where are the barriers to advancement? What are the gaps in these efforts? We systematically analyze a decade of sandbox research from five top-tier security and systems conferences using qualitative content analysis, statistical clustering, and graph-based metrics to answer these questions and more. We find that the term “sandbox” currently has no widely accepted or acceptable definition. We use our broad scope to propose the first concise and comprehensive definition for “sandbox” that consistently encompasses research sandboxes. We learn that the sandboxing landscape covers a range of deployment options and policy enforcement techniques collectively capable of defending diverse sets of components while mitigating a wide range of vulnerabilities. Researchers consistently make security, performance, and applicability claims about their sandboxes and tend to narrowly define the claims to ensure they can be evaluated. Those claims are validated using multi-faceted strategies spanning proof, analytical analysis, benchmark suites, case studies, and argumentation. However, we find two cases for improvement: (1 the arguments researchers present are often ad hoc and (2 sandbox usability is mostly uncharted territory. We propose ways to structure arguments to ensure they fully support their corresponding claims and suggest lightweight means of evaluating sandbox usability.

  14. Systematic review and meta-analysis of music interventions in hypertension treatment: a quest for answers.

    Science.gov (United States)

    Kühlmann, Anne Y R; Etnel, Jonathan R G; Roos-Hesselink, Jolien W; Jeekel, Johannes; Bogers, Ad J J C; Takkenberg, Johanna J M

    2016-04-19

    Adverse effects, treatment resistance and high costs associated with pharmacological treatment of hypertension have led to growing interest in non-pharmacological complementary therapies such as music interventions. This meta-analysis aims to provide an overview of reported evidence on the efficacy of music interventions in the treatment of hypertension. A systematic literature search was conducted for publications on the effect of music interventions on blood pressure in adult hypertensive subjects published between January 1990-June 2014. Randomized controlled trials with a follow-up duration ≥28 days were included. Blood pressure measures were pooled using inverse variance weighting. Of the 1689 abstracts reviewed, 10 randomized controlled trials were included. Random-effects pooling of the music intervention groups showed a trend toward a decrease in mean systolic blood pressure (SBP) from 144 mmHg(95 % CI:137-152) to 134 mmHg(95 % CI:124-144), and in mean diastolic blood pressure (DBP) from 84 mmHg(95 % CI:78-89) to 78 mmHg(95 % CI:73-84). Fixed-effect analysis of a subgroup of 3 trials with valid control groups showed a significant decrease in pooled mean SBP and DBP in both intervention and control groups. A comparison between music intervention groups and control groups was not possible due to unavailable measures of dispersion. This systematic review and meta-analysis revealed a trend towards a decrease in blood pressure in hypertensive patients who received music interventions, but failed to establish a cause-effect relationship between music interventions and blood pressure reduction. Considering the potential value of this safe, low-cost intervention, well-designed, high quality and sufficiently powered randomized studies assessing the efficacy of music interventions in the treatment of hypertension are warranted.

  15. Analysis of Content Shared in Online Cancer Communities: Systematic Review.

    Science.gov (United States)

    van Eenbergen, Mies C; van de Poll-Franse, Lonneke V; Krahmer, Emiel; Verberne, Suzan; Mols, Floortje

    2018-04-03

    The content that cancer patients and their relatives (ie, posters) share in online cancer communities has been researched in various ways. In the past decade, researchers have used automated analysis methods in addition to manual coding methods. Patients, providers, researchers, and health care professionals can learn from experienced patients, provided that their experience is findable. The aim of this study was to systematically review all relevant literature that analyzes user-generated content shared within online cancer communities. We reviewed the quality of available research and the kind of content that posters share with each other on the internet. A computerized literature search was performed via PubMed (MEDLINE), PsycINFO (5 and 4 stars), Cochrane Central Register of Controlled Trials, and ScienceDirect. The last search was conducted in July 2017. Papers were selected if they included the following terms: (cancer patient) and (support group or health communities) and (online or internet). We selected 27 papers and then subjected them to a 14-item quality checklist independently scored by 2 investigators. The methodological quality of the selected studies varied: 16 were of high quality and 11 were of adequate quality. Of those 27 studies, 15 were manually coded, 7 automated, and 5 used a combination of methods. The best results can be seen in the papers that combined both analytical methods. The number of analyzed posts ranged from 200 to 1,500,000; the number of analyzed posters ranged from 75 to 90,000. The studies analyzing large numbers of posts mainly related to breast cancer, whereas those analyzing small numbers were related to other types of cancers. A total of 12 studies involved some or entirely automatic analysis of the user-generated content. All the authors referred to two main content categories: informational support and emotional support. In all, 15 studies reported only on the content, 6 studies explicitly reported on content and social

  16. Comparison of systematic versus targeted screening for detection of risky drinking in primary care.

    Science.gov (United States)

    Reinholdz, Hanna; Fornazar, Robin; Bendtsen, Preben; Spak, Fredrik

    2013-01-01

    To compare two identification methods for risky drinking in primary health care centres (PHCs). Sixteen PHCs from three Swedish counties were randomized into strands: consultation-based early identification (CEI) or systematic screening early identification (SS). Measurements took place at baseline and during two intervention periods. Patients filled in questionnaires including gender, age, if they had the issue of alcohol brought up during the consultation and the AUDIT-C (a three item screening tool). The intervention periods were preceded by training sessions for clinicians. The AUDIT-C was used for categorization of risky drinking with cut-offs for risky drinking set at ≥5 for men and ≥4 for women. In the SS strand, clinicians were supposed to give AUDIT-C to all patients for the identification of risky drinking. In the CEI strands, they were encouraged to use early clinical signs to identify risky drinking. The proportions of patients having the issue of alcohol brought up are higher during the intervention periods than baseline. A higher proportion of all patients and of risk drinkers in SS, than in CEI, had the issue of alcohol brought up. A higher mean score of AUDIT-C was found among patients having the issue of alcohol brought up in CEI than in SS, and this was also true after adjusting for age and gender. More patients are asked about alcohol in the SS strand and thus have the possibility of receiving brief interventions. CEI identifies risk drinkers with higher AUDIT-C scores which might indicate more severe problems. No comparison of the effectiveness of a brief intervention following these alternative identification procedures is reported here.

  17. Estimating HIV incidence among adults in Kenya and Uganda: a systematic comparison of multiple methods.

    Directory of Open Access Journals (Sweden)

    Andrea A Kim

    2011-03-01

    Full Text Available Several approaches have been used for measuring HIV incidence in large areas, yet each presents specific challenges in incidence estimation.We present a comparison of incidence estimates for Kenya and Uganda using multiple methods: 1 Epidemic Projections Package (EPP and Spectrum models fitted to HIV prevalence from antenatal clinics (ANC and national population-based surveys (NPS in Kenya (2003, 2007 and Uganda (2004/2005; 2 a survey-derived model to infer age-specific incidence between two sequential NPS; 3 an assay-derived measurement in NPS using the BED IgG capture enzyme immunoassay, adjusted for misclassification using a locally derived false-recent rate (FRR for the assay; (4 community cohorts in Uganda; (5 prevalence trends in young ANC attendees. EPP/Spectrum-derived and survey-derived modeled estimates were similar: 0.67 [uncertainty range: 0.60, 0.74] and 0.6 [confidence interval: (CI 0.4, 0.9], respectively, for Uganda (2005 and 0.72 [uncertainty range: 0.70, 0.74] and 0.7 [CI 0.3, 1.1], respectively, for Kenya (2007. Using a local FRR, assay-derived incidence estimates were 0.3 [CI 0.0, 0.9] for Uganda (2004/2005 and 0.6 [CI 0, 1.3] for Kenya (2007. Incidence trends were similar for all methods for both Uganda and Kenya.Triangulation of methods is recommended to determine best-supported estimates of incidence to guide programs. Assay-derived incidence estimates are sensitive to the level of the assay's FRR, and uncertainty around high FRRs can significantly impact the validity of the estimate. Systematic evaluations of new and existing incidence assays are needed to the study the level, distribution, and determinants of the FRR to guide whether incidence assays can produce reliable estimates of national HIV incidence.

  18. Association of endothelial nitric oxide synthase gene polymorphisms with coronary artery disease: an updated meta-analysis and systematic review.

    Directory of Open Access Journals (Sweden)

    Himanshu Rai

    Full Text Available Several association studies of endothelial nitric oxide synthase (NOS3 gene polymorphisms with respect to coronary artery disease (CAD have been published in the past two decades. However, their association with the disease, especially among different ethnic subgroups, still remains controversial. This prompted us to conduct a systematic review and an updated structured meta-analysis, which is the largest so far (89 articles, 132 separate studies, and a sample size of 69,235, examining association of three polymorphic forms of the NOS3 gene (i.e. Glu298Asp, T786-C and 27 bp VNTR b/a with CAD. In a subgroup analysis, we tested their association separately among published studies originating predominantly from European, Middle Eastern, Asian, Asian-Indian and African ancestries. The pooled analysis confirmed the association of all the three selected SNP with CAD in three different genetic models transcending all ancestries worldwide. The Glu298Asp polymorphism showed strongest association (OR range = 1.28-1.52, and P<0.00001 for all comparisons, followed by T786-C (OR range = 1.34-1.42, and P<0.00001 for all comparisons and 4b/a, (OR range = 1.19-1.41, and P ≤ 0.002 for all comparisons in our pooled analysis. Subgroup analysis revealed that Glu298Asp (OR range = 1.54-1.87, and P<0.004 for all comparisons and 4b/a (OR range = 1.71-3.02, and P<0.00001 for all comparisons have highest degree of association amongst the Middle Easterners. On the other hand, T786-C and its minor allele seem to carry a highest risk for CAD among subjects of Asian ancestry (OR range = 1.61-1.90, and P ≤ 0.01 for all comparisons.

  19. Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature.

    Science.gov (United States)

    Mathes, Tim; Walgenbach, Maren; Antoine, Sunya-Lee; Pieper, Dawid; Eikermann, Michaela

    2014-10-01

    The quality of systematic reviews of health economic evaluations (SR-HE) is often limited because of methodological shortcomings. One reason for this poor quality is that there are no established standards for the preparation of SR-HE. The objective of this study is to compare existing methods and suggest best practices for the preparation of SR-HE. To identify the relevant methodological literature on SR-HE, a systematic literature search was performed in Embase, Medline, the National Health System Economic Evaluation Database, the Health Technology Assessment Database, and the Cochrane methodology register, and webpages of international health technology assessment agencies were searched. The study selection was performed independently by 2 reviewers. Data were extracted by one reviewer and verified by a second reviewer. On the basis of the overlaps in the recommendations for the methods of SR-HE in the included papers, suggestions for best practices for the preparation of SR-HE were developed. Nineteen relevant publications were identified. The recommendations within them often differed. However, for most process steps there was some overlap between recommendations for the methods of preparation. The overlaps were taken as basis on which to develop suggestions for the following process steps of preparation: defining the research question, developing eligibility criteria, conducting a literature search, selecting studies, assessing the methodological study quality, assessing transferability, and synthesizing data. The differences in the proposed recommendations are not always explainable by the focus on certain evaluation types, target audiences, or integration in the decision process. Currently, there seem to be no standard methods for the preparation of SR-HE. The suggestions presented here can contribute to the harmonization of methods for the preparation of SR-HE. © The Author(s) 2014.

  20. Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? Systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Rodrigo F Ramos

    2011-12-01

    Full Text Available CONTEXT: Although the high incidence of gastroesophageal reflux disease (GERD in the population, there is much controversy in this topic, especially in the surgical treatment. The decision to use of a total or partial fundoplication in the treatment of GERD is still a challenge to many surgeons because the few evidence found in the literature. OBJECTIVE: To bring more clear evidence in the comparison between total and partial fundoplication. DATA SOURCES: A systematic review of the literature and metaanalysis with randomized controlled trials accessed from MEDLINE, LILACS, Cochrane Controlled Trials Database was done. The outcomes remarked were: dysphagia, inability to belch, bloating, recurrence of acid reflux, heartburn and esophagitis. For data analysis the odds ratio was used with corresponding 95% confidence interval. Statistical heterogeneity in the results of the metaanalysis was assessed by calculating a test of heterogeneity. The software Review Manager 5 (Cochrane Collaboration was utilized for the data gathered and the statistical analysis. Sensitive analysis was applied using only trials that included follow-up over 2 years. RESULTS: Ten trials were included with 1003 patients: 502 to total fundoplication group and 501 to partial fundoplication group. The outcomes dysphagia and inability to belch had statistical significant difference (P = 0.00001 in favor of partial fundoplication. There was not statistical difference in outcomes related with treatment failure. There were no heterogeneity in the outcomes dysphagia and recurrence of the acid reflux. CONCLUSION: The partial fundoplication has lower incidence of obstructive side effects.

  1. Systematic review and meta-analysis of the efficacy and safety of amfepramone and mazindol as a monotherapy for the treatment of obese or overweight patients

    OpenAIRE

    Lucchetta, Rosa Camila; Riveros, Bruno Salgado; Pontarolo, Roberto; Radominski, Rosana Bento; Otuki, Michel Fleith; Fernandez-Llimos, Fernando; Correr, Cassyano Januário

    2017-01-01

    The aim of this study was to evaluate efficacy and safety of amfepramone, fenproporex and mazindol as a monotherapy for the treatment of obese or overweight patients. A systematic review of primary studies was conducted, followed by a direct meta-analysis (random effect) and mixed treatment comparison. Medline and other databases were searched. Heterogeneity was explored through I2 associated with a p-value. Of 739 identified publications, 25 were included in the meta-analysis. The global eva...

  2. Systematic review and meta-analysis of Internet interventions for smoking cessation among adults.

    Science.gov (United States)

    Graham, Amanda L; Carpenter, Kelly M; Cha, Sarah; Cole, Sam; Jacobs, Megan A; Raskob, Margaret; Cole-Lewis, Heather

    2016-01-01

    The aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines. This review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of "Internet," "web-based," and "smoking cessation intervention" and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs) for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Forty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15-2.21, I (2)=51.7%; four studies). Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63-1.10, I (2)=0%; two studies), whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25-3.52, I (2)=41.6%; two studies). No significant effects were observed in pooled results of Internet interventions compared to face-to-face counseling (RR 1.35, 95% CI 0.97-1.87, I (2)=0%; four studies) or to telephone counseling (RR 0.95, 95% CI 0.79-1.13, I (2)=0%; two studies). The majority of trials compared different Internet interventions; pooled results from 15 such trials (24 comparisons) found a significant effect in favor of experimental Internet interventions (RR 1.16, 95% CI 1.03-1.31, I (2)=76.7%). Internet interventions are superior to other broad reach

  3. Production and citation of cochrane systematic reviews: a bibliometrics analysis.

    Science.gov (United States)

    Shen, Jiantong; Li, Youping; Clarke, Mike; Du, Liang; Wang, Li; Zhong, Dake

    2014-05-06

    To evaluate the production and utilization of Cochrane systematic reviews(CSRs) and to analyze its influential factors, so as to improve the capacity of translating CSRs into practice. All CSRs and protocols were retrieved from the Cochrane Library ISSUE 2, 2011 and citation data were retrieved from SCI database. Citation analysis was used to analyze the situation of CSRs production and utilization. CSR publication had grown from an annual average of 32 to 718 documents. Only one developing country was among the ten countries with the largest amount of publications. High income countries accounted for 83% of CSR publications and 90.8% of cited counts. 34.7% of CSRs had a cited count of 0, while only 0.9% had been cited more than 50 times. Highly cited CSRs were published in England, Australia, Canada, USA and other high income countries. The countries with a Cochrane center or a Cochrane methodology group had a greater capability of CSRs production and citing than others. The CSRs addressing the topics of diseases were more than those targeted at public health issues. There was a big gap in citations of different interventions even for the same topic. The capability of CSR production and translation grew rapidly, but varied among countries and institutions, which was affected by several factors such as the capability of research, the resourcesand the applicability of the evidence. It is important to improve evidence translation through educating, training and prioritizing the problems based on real demands of end user. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  4. Primary health care research in Bolivia: systematic review and analysis.

    Science.gov (United States)

    Alvarez, Francisco N; Leys, Mart; Mérida, Hugo E Rivera; Guzmán, Giovanni Escalante

    2016-02-01

    Bolivia is currently undergoing a series of healthcare reforms centred around the Unified Family, Community and Intercultural Health System (SAFCI), established in 2008 and Law 475 for Provision of Comprehensive Health Services enacted in 2014 as a first step towards universal health coverage. The SAFCI model aims to establish an intercultural, intersectoral and integrated primary health care (PHC) system, but there has not been a comprehensive analysis of effective strategies towards such an end. In this systematic review, we analyse research into developing PHC in Bolivia utilizing MEDLINE, the Virtual Health Library and grey literature from Pan American Health Organization/World Health Organization's internal database. We find that although progress has been made towards implementation of a healthcare system incorporating principles of PHC, further refining the system and targeting improvements effectively will require increased research and evaluation. Particularly in the 7 years since establishment of SAFCI, there has been a dearth of PHC research that makes evaluation of such key national policies impossible. The quantity and quality of PHC research must be improved, especially quasi-experimental studies with adequate control groups. The infrastructure for such studies must be strengthened through improved financing mechanisms, expanded institutional capacity and setting national research priorities. Important for future progress are improved tracking of health indicators, which in Bolivia are often out-of-date or incomplete, and prioritization of focused national research priorities on relevant policy issues. This study aims to serve as an aid towards PHC development efforts at the national level, as well as provide lessons for countries globally attempting to build effective health systems accommodating of a multi-national population in the midst of development. © The Author 2015. Published by Oxford University Press in association with The London School

  5. Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

    Science.gov (United States)

    Narayan, Anand; Lobner, Katie; Fritz, Jan

    2018-02-01

    The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Meditation for posttraumatic stress: Systematic review and meta-analysis.

    Science.gov (United States)

    Hilton, Lara; Maher, Alicia Ruelaz; Colaiaco, Benjamin; Apaydin, Eric; Sorbero, Melony E; Booth, Marika; Shanman, Roberta M; Hempel, Susanne

    2017-07-01

    We conducted a systematic review and meta-analysis that synthesized evidence from randomized controlled trials of meditation interventions to provide estimates of their efficacy and safety in treating adults diagnosed with posttraumatic stress disorder (PTSD). This review was based on an established protocol (PROSPERO: CRD42015025782) and is reported according to PRISMA guidelines. Outcomes of interest included PTSD symptoms, depression, anxiety, health-related quality of life, functional status, and adverse events. Meta-analyses were conducted using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In total, 10 trials on meditation interventions for PTSD with 643 participants met inclusion criteria. Across interventions, adjunctive meditation interventions of mindfulness-based stress reduction, yoga, and the mantram repetition program improve PTSD and depression symptoms compared with control groups, but the findings are based on low and moderate quality of evidence. Effects were positive but not statistically significant for quality of life and anxiety, and no studies addressed functional status. The variety of meditation intervention types, the short follow-up times, and the quality of studies limited analyses. No adverse events were reported in the included studies; only half of the studies reported on safety. Meditation appears to be effective for PTSD and depression symptoms, but in order to increase confidence in findings, more high-quality studies are needed on meditation as adjunctive treatment with PTSD-diagnosed participant samples large enough to detect statistical differences in outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. A systematic identification and analysis of scientists on Twitter

    Science.gov (United States)

    Ke, Qing; Ahn, Yong-Yeol; Sugimoto, Cassidy R.

    2017-01-01

    Metrics derived from Twitter and other social media—often referred to as altmetrics—are increasingly used to estimate the broader social impacts of scholarship. Such efforts, however, may produce highly misleading results, as the entities that participate in conversations about science on these platforms are largely unknown. For instance, if altmetric activities are generated mainly by scientists, does it really capture broader social impacts of science? Here we present a systematic approach to identifying and analyzing scientists on Twitter. Our method can identify scientists across many disciplines, without relying on external bibliographic data, and be easily adapted to identify other stakeholder groups in science. We investigate the demographics, sharing behaviors, and interconnectivity of the identified scientists. We find that Twitter has been employed by scholars across the disciplinary spectrum, with an over-representation of social and computer and information scientists; under-representation of mathematical, physical, and life scientists; and a better representation of women compared to scholarly publishing. Analysis of the sharing of URLs reveals a distinct imprint of scholarly sites, yet only a small fraction of shared URLs are science-related. We find an assortative mixing with respect to disciplines in the networks between scientists, suggesting the maintenance of disciplinary walls in social media. Our work contributes to the literature both methodologically and conceptually—we provide new methods for disambiguating and identifying particular actors on social media and describing the behaviors of scientists, thus providing foundational information for the construction and use of indicators on the basis of social media metrics. PMID:28399145

  8. Treatment of unicameral bone cyst: systematic review and meta analysis.

    Science.gov (United States)

    Kadhim, Muayad; Thacker, Mihir; Kadhim, Amjed; Holmes, Laurens

    2014-03-01

    Different treatment modalities have been utilized to treat unicameral bone cyst (UBC), but evidence has not been fully described to support one treatment over another and the optimal treatment is controversial. The aim of this quantitative systematic review was to assess the effectiveness of different UBC treatment modalities. We utilized Pubmed to isolate retrospective studies on patients with UBC who received any kind of treatment. The included studies needed to have a minimum sample size of 15 patients, and have provided data on radiographic healing outcome. Sixty-two articles were selected for the meta-analysis from a total of 463 articles. The cumulative sample size was 3,211 patients with 3,217 UBC, and male to female ratio was 2.2:1. The summary or pool estimate of methylprednisolone acetate (MPA) injection resulted in a healing rate of (77.4 %) that was comparable to bone marrow injection (77.9 %). A higher healing rate was observed with MPA injection when inner wall disruption was performed. The pool estimate of bone marrow with demineralized bone matrix injection was high (98.7 %). UBC healing rate after surgical curettage was comparable whether autograft or allograft was utilized (90 %). UBC treatment with flexible intramedullary nails without curettage provided almost 100% healing rate, while continuous decompression with cannulated screws provided 89 % healing rate. Conservative treatment indicated a healing rate of 64.2, 95 % CI (26.7-101.8). Active treatment for UBC provided variable healing rates and the outcomes were favorable relative to conservative treatment. Due to the heterogeneity of the studies and reporting bias, the interpretation of these findings should be handled with caution.

  9. A systematic identification and analysis of scientists on Twitter.

    Directory of Open Access Journals (Sweden)

    Qing Ke

    Full Text Available Metrics derived from Twitter and other social media-often referred to as altmetrics-are increasingly used to estimate the broader social impacts of scholarship. Such efforts, however, may produce highly misleading results, as the entities that participate in conversations about science on these platforms are largely unknown. For instance, if altmetric activities are generated mainly by scientists, does it really capture broader social impacts of science? Here we present a systematic approach to identifying and analyzing scientists on Twitter. Our method can identify scientists across many disciplines, without relying on external bibliographic data, and be easily adapted to identify other stakeholder groups in science. We investigate the demographics, sharing behaviors, and interconnectivity of the identified scientists. We find that Twitter has been employed by scholars across the disciplinary spectrum, with an over-representation of social and computer and information scientists; under-representation of mathematical, physical, and life scientists; and a better representation of women compared to scholarly publishing. Analysis of the sharing of URLs reveals a distinct imprint of scholarly sites, yet only a small fraction of shared URLs are science-related. We find an assortative mixing with respect to disciplines in the networks between scientists, suggesting the maintenance of disciplinary walls in social media. Our work contributes to the literature both methodologically and conceptually-we provide new methods for disambiguating and identifying particular actors on social media and describing the behaviors of scientists, thus providing foundational information for the construction and use of indicators on the basis of social media metrics.

  10. Pediatric cervical spine marrow T2 hyperintensity: a systematic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gefen, Ron [Cooper University Hospital, Department of Diagnostic Radiology, Candem, NJ (United States); Schweitzer, Mark E. [The Ottawa Hospital and University of Ottawa, Department of Diagnostic Imaging, Ottawa (Canada); Shabshin, Nogah [Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel-HaShomer (Israel); Hospital of University of Pennsylvania, Department of Diagnostic Imaging, Philadelphia, PA (United States)

    2011-08-15

    Hyperintense areas of vertebral bone marrow on fluid-sensitive sequences are at times seen on pediatric MRI of the cervical spine in children without suspicious clinical conditions to explain marrow pathology. Although these likely have no clinical significance they may be mistaken for pathology. The purpose of this study is to systematically evaluate the locations and patterns of marrow T2 hyperintensity in the pediatric cervical spine, with respect to age. At 1.5 T, the C2 through T3 vertebrae of 82 children aged 0-17 years without clinically suspicious marrow abnormality were retrospectively reviewed by two musculoskeletal radiologists, who were blinded to patients' age. The frequency, intensity, and location of the foci of marrow T2 hyperintensity were recorded for each vertebra on a 12-point scoring system and were correlated with the patients' age. Foci of marrow hyperintensity were seen in 46/82 (56.1%) patients and in 241/734 (32.8%) vertebrae. Foci were most common in C4 (42% of patients), C5 (45.7%), and C6 (37.8%). The foci of T2 hyperintensity were more common inferiorly (188 foci) and adjacent to the anterior cortex (123). Analysis revealed no significant correlation between age and marrow score (Spearman = -0.147, P = 0.19), but did find a trend towards increased presence of marrow T2 hyperintensity in the ages of most rapid growth, 8-14 years (81.5% of patients). Vertebral body marrow T2 hyperintensity was most common endosteally and in the mid-cervical spine with a slight peak in adolescence. We therefore believe that these pediatric cervical marrow changes may be related to rapid bone growth at the point of maximal kyphotic stress. (orig.)

  11. Virtual reality training in laparoscopic surgery: A systematic review & meta-analysis.

    Science.gov (United States)

    Alaker, Medhat; Wynn, Greg R; Arulampalam, Tan

    2016-05-01

    Laparoscopic surgery requires a different and sometimes more complex skill set than does open surgery. Shortened working hours, less training times, and patient safety issues necessitates that these skills need to be acquired outside the operating room. Virtual reality simulation in laparoscopic surgery is a growing field, and many studies have been published to determine its effectiveness. This systematic review and meta-analysis aims to evaluate virtual reality simulation in laparoscopic abdominal surgery in comparison to other simulation models and to no training. A systematic literature search was carried out until January 2014 in full adherence to PRISMA guidelines. All randomised controlled studies comparing virtual reality training to other models of training or to no training were included. Only studies utilizing objective and validated assessment tools were included. Thirty one randomised controlled trials that compare virtual reality training to other models of training or to no training were included. The results of the meta-analysis showed that virtual reality simulation is significantly more effective than video trainers, and at least as good as box trainers. The use of Proficiency-based VR training, under supervision with prompt instructions and feedback, and the use of haptic feedback, has proven to be the most effective way of delivering the virtual reality training. The incorporation of virtual reality training into surgical training curricula is now necessary. A unified platform of training needs to be established. Further studies to assess the impact on patient outcomes and on hospital costs are necessary. (PROSPERO Registration number: CRD42014010030). Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis

    NARCIS (Netherlands)

    S.A. Steenen (Serge A.); A.J. van Wijk (Arjen); G.J.M.G. Van Der Heijden (Geert J.M.G.); R. van Westrhenen (Roos); J. de Lange (Jan); A. de Jongh (Ad)

    2016-01-01

    textabstractThe effects of propranolol in the treatment of anxiety disorders have not been systematically evaluated previously. The aim was to conduct a systematic review and meta-analysis of randomised controlled trials, addressing the efficacy of oral propranolol versus placebo or other medication

  13. Phantom Behavioral Assimilation Effects : Systematic Biases in Social Comparison Choice Studies

    NARCIS (Netherlands)

    Marsh, Herbert W.; Seaton, Marjorie; Kuyper, Hans; Dumas, Florence; Huguet, Pascal; Regner, Isabelle; Buunk, Abraham P.; Monteil, Jean-Marc; Gibbons, Frederick X.

    Consistent with social comparison theory (SCT), Blanton, Buunk, Gibbons, and Kuyper (1999) and Huguet, Dumas, Monteil, and Genestoux (2001) found that students tended to choose comparison targets who slightly outperformed them (i.e., upward comparison choices), and this had a beneficial effect on

  14. Aircraft noise effects on sleep: a systematic comparison of EEG awakenings and automatically detected cardiac activations

    International Nuclear Information System (INIS)

    Basner, Mathias; Müller, Uwe; Elmenhorst, Eva-Maria; Kluge, Götz; Griefahn, Barbara

    2008-01-01

    Polysomnography is the gold standard for investigating noise effects on sleep, but data collection and analysis are sumptuous and expensive. We recently developed an algorithm for the automatic identification of cardiac activations associated with cortical arousals, which uses heart rate information derived from a single electrocardiogram (ECG) channel. We hypothesized that cardiac activations can be used as estimates for EEG awakenings. Polysomnographic EEG awakenings and automatically detected cardiac activations were systematically compared using laboratory data of 112 subjects (47 male, mean ± SD age 37.9 ± 13 years), 985 nights and 23 855 aircraft noise events (ANEs). The probability of automatically detected cardiac activations increased monotonically with increasing maximum sound pressure levels of ANEs, exceeding the probability of EEG awakenings by up to 18.1%. If spontaneous reactions were taken into account, exposure–response curves were practically identical for EEG awakenings and cardiac activations. Automatically detected cardiac activations may be used as estimates for EEG awakenings. More investigations are needed to further validate the ECG algorithm in the field and to investigate inter-individual differences in its ability to predict EEG awakenings. This inexpensive, objective and non-invasive method facilitates large-scale field studies on the effects of traffic noise on sleep

  15. Seismic interferometry by crosscorrelation and by multidimensional deconvolution: a systematic comparison

    Science.gov (United States)

    Wapenaar, Kees; van der Neut, Joost; Ruigrok, Elmer; Draganov, Deyan; Hunziker, Jürg; Slob, Evert; Thorbecke, Jan; Snieder, Roel

    2011-06-01

    Seismic interferometry, also known as Green's function retrieval by crosscorrelation, has a wide range of applications, ranging from surface-wave tomography using ambient noise, to creating virtual sources for improved reflection seismology. Despite its successful applications, the crosscorrelation approach also has its limitations. The main underlying assumptions are that the medium is lossless and that the wavefield is equipartitioned. These assumptions are in practice often violated: the medium of interest is often illuminated from one side only, the sources may be irregularly distributed, and losses may be significant. These limitations may partly be overcome by reformulating seismic interferometry as a multidimensional deconvolution (MDD) process. We present a systematic analysis of seismic interferometry by crosscorrelation and by MDD. We show that for the non-ideal situations mentioned above, the correlation function is proportional to a Green's function with a blurred source. The source blurring is quantified by a so-called interferometric point-spread function which, like the correlation function, can be derived from the observed data (i.e. without the need to know the sources and the medium). The source of the Green's function obtained by the correlation method can be deblurred by deconvolving the correlation function for the point-spread function. This is the essence of seismic interferometry by MDD. We illustrate the crosscorrelation and MDD methods for controlled-source and passive-data applications with numerical examples and discuss the advantages and limitations of both methods.

  16. Comparison of tiered formularies and reference pricing policies: a systematic review.

    Science.gov (United States)

    Morgan, Steve; Hanley, Gillian; Greyson, Devon

    2009-01-01

    To synthesize methodologically comparable evidence from the published literature regarding the outcomes of tiered formularies and therapeutic reference pricing of prescription drugs. We searched the following electronic databases: ABI/Inform, CINAHL, Clinical Evidence, Digital Dissertations & Theses, Evidence-Based Medicine Reviews (which incorporates ACP Journal Club, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Database of Abstracts of Reviews of Effectiveness, Health Technology Assessments and NHS Economic Evaluation Database), EconLit, EMBASE, International Pharmaceutical Abstracts, MEDLINE, PAIS International and PAIS Archive, and the Web of Science. We also searched the reference lists of relevant articles and several grey literature sources. We sought English-language studies published from 1986 to 2007 that examined the effects of either therapeutic reference pricing or tiered formularies, reported on outcomes relevant to patient care and cost-effectiveness, and employed quantitative study designs that included concurrent or historical comparison groups. We abstracted and assessed potentially appropriate articles using a modified version of the data abstraction form developed by the Cochrane Effective Practice and Organisation of Care Group. From an initial list of 2964 citations, 12 citations (representing 11 studies) were deemed eligible for inclusion in our review: 3 studies (reported in 4 articles) of reference pricing and 8 studies of tiered formularies. The introduction of reference pricing was associated with reduced plan spending, switching to preferred medicines, reduced overall drug utilization and short-term increases in the use of physician services. Reference pricing was not associated with adverse health impacts. The introduction of tiered formularies was associated with reduced plan expenditures, greater patient costs and increased rates of non-compliance with

  17. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

    Science.gov (United States)

    El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

    2014-08-20

    Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary

  18. Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

    Science.gov (United States)

    2014-01-01

    Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews

  19. A comparison of statistical methods for identifying out-of-date systematic reviews.

    Directory of Open Access Journals (Sweden)

    Porjai Pattanittum

    Full Text Available BACKGROUND: Systematic reviews (SRs can provide accurate and reliable evidence, typically about the effectiveness of health interventions. Evidence is dynamic, and if SRs are out-of-date this information may not be useful; it may even be harmful. This study aimed to compare five statistical methods to identify out-of-date SRs. METHODS: A retrospective cohort of SRs registered in the Cochrane Pregnancy and Childbirth Group (CPCG, published between 2008 and 2010, were considered for inclusion. For each eligible CPCG review, data were extracted and "3-years previous" meta-analyses were assessed for the need to update, given the data from the most recent 3 years. Each of the five statistical methods was used, with random effects analyses throughout the study. RESULTS: Eighty reviews were included in this study; most were in the area of induction of labour. The numbers of reviews identified as being out-of-date using the Ottawa, recursive cumulative meta-analysis (CMA, and Barrowman methods were 34, 7, and 7 respectively. No reviews were identified as being out-of-date using the simulation-based power method, or the CMA for sufficiency and stability method. The overall agreement among the three discriminating statistical methods was slight (Kappa = 0.14; 95% CI 0.05 to 0.23. The recursive cumulative meta-analysis, Ottawa, and Barrowman methods were practical according to the study criteria. CONCLUSION: Our study shows that three practical statistical methods could be applied to examine the need to update SRs.

  20. Analgesic efficacy of preoperative dexketoprofen trometamol: A systematic review and meta-analysis.

    Science.gov (United States)

    Esparza-Villalpando, Vicente; Pozos-Guillén, Amaury; Masuoka-Ito, David; Gaitán-Fonseca, César; Chavarría-Bolaños, Daniel

    2018-03-01

    Post-Market Research Clinical evidence supports the use of dexketoprofen trometamol (DEX) to manage acute postoperative pain. However, controversies surround the impact of the use of this drug in preoperative analgesic protocols. The aim of the present meta-analysis was to evaluate the effectiveness of the preoperative administration of DEX under postoperative pain conditions. Electronic and manual searches were conducted through diverse electronic databases. A systematic review and meta-analysis to evaluate the analgesic efficacy of the preoperative administration of DEX was performed including Randomized Clinical Trials (RCTs) published between 2002 and 2017. Suitable individual studies were evaluated through a quality system, and the data were extracted and analyzed. Fourteen RTCs were included (12 parallel trials and 2 cross-over trials), published in the English and Turkish languages. Follow-up periods ranged from 4, 6, 8, 24, and 48 hr. All trials measured the outcome result as Acute Pain Level (APL) (VAS, NRS, VRS), time to requiring a second dose of DEX or analgesic emergency and consumption of opioids via patient-controlled analgesia. When the comparators were other drugs - paracetamol, Lornoxicam or placebo during the preoperative time, preoperative administration of DEX was superior. When the comparison comprised preoperative and postoperative DEX, both alternatives exhibited comparable analgesic effects. The analgesic efficacy of the preoperative administration of DEX when compared to placebo, lornoxicam, and paracetamol on postoperative pain was evident. Preoperative administration of DEX compared to its immediate postoperative administration showed a similar analgesic effect. © 2017 Wiley Periodicals, Inc.

  1. Acupuncture for ankle sprain: systematic review and meta-analysis

    Science.gov (United States)

    2013-01-01

    Background Ankle sprain is one of the most frequently encountered musculoskeletal injuries; however, the efficacy of acupuncture in treating ankle sprains remains uncertain. We therefore performed a systematic review to evaluate the evidence regarding acupuncture for ankle sprains. Methods We searched 15 data sources and two trial registries up to February 2012. Randomized controlled trials of acupuncture were included if they involved patients with ankle sprains and reported outcomes of symptom improvement, including pain. A Cochrane risk of bias assessment tool was used. Risk ratio (RR) or mean difference (MD) was calculated with 95% confidence intervals (CIs) in a random effects model. Subgroup analyses were performed based on acupuncture type, grade of sprain, and control type. Sensitivity analyses were also performed with respect to risk of bias, sample size, and outcomes reported. Results Seventeen trials involving 1820 participants were included. Trial quality was generally poor, with just three reporting adequate methods of randomization and only one a method of allocation concealment. Significantly more participants in acupuncture groups reported global symptom improvement compared with no acupuncture groups (RR of symptoms persisting with acupuncture = 0.56, 95% CI 0.42–0.77). However, this is probably an overestimate due to the heterogeneity (I2 = 51%) and high risk of bias of the included studies. Acupuncture as an add-on treatment also improved global symptoms compared with other treatments only, without significant variability (RR 0.61, 95% CI 0.51–0.73, I2 = 1%). The benefit of acupuncture remained significant when the analysis was limited to two studies with a low risk of bias. Acupuncture was more effective than various controls in relieving pain, facilitating return to normal activity, and promoting quality of life, but these analyses were based on only a small number of studies. Acupuncture did not appear to be associated with

  2. Acupuncture for ankle sprain: systematic review and meta-analysis.

    Science.gov (United States)

    Park, Jimin; Hahn, Seokyung; Park, Ji-Yeun; Park, Hi-Joon; Lee, Hyangsook

    2013-03-04

    Ankle sprain is one of the most frequently encountered musculoskeletal injuries; however, the efficacy of acupuncture in treating ankle sprains remains uncertain. We therefore performed a systematic review to evaluate the evidence regarding acupuncture for ankle sprains. We searched 15 data sources and two trial registries up to February 2012. Randomized controlled trials of acupuncture were included if they involved patients with ankle sprains and reported outcomes of symptom improvement, including pain. A Cochrane risk of bias assessment tool was used. Risk ratio (RR) or mean difference (MD) was calculated with 95% confidence intervals (CIs) in a random effects model. Subgroup analyses were performed based on acupuncture type, grade of sprain, and control type. Sensitivity analyses were also performed with respect to risk of bias, sample size, and outcomes reported. Seventeen trials involving 1820 participants were included. Trial quality was generally poor, with just three reporting adequate methods of randomization and only one a method of allocation concealment. Significantly more participants in acupuncture groups reported global symptom improvement compared with no acupuncture groups (RR of symptoms persisting with acupuncture = 0.56, 95% CI 0.42-0.77). However, this is probably an overestimate due to the heterogeneity (I2 = 51%) and high risk of bias of the included studies. Acupuncture as an add-on treatment also improved global symptoms compared with other treatments only, without significant variability (RR 0.61, 95% CI 0.51-0.73, I2 = 1%). The benefit of acupuncture remained significant when the analysis was limited to two studies with a low risk of bias. Acupuncture was more effective than various controls in relieving pain, facilitating return to normal activity, and promoting quality of life, but these analyses were based on only a small number of studies. Acupuncture did not appear to be associated with adverse events. Given

  3. Changes in latent fingerprint examiners' markup between analysis and comparison.

    Science.gov (United States)

    Ulery, Bradford T; Hicklin, R Austin; Roberts, Maria Antonia; Buscaglia, JoAnn

    2015-02-01

    After the initial analysis of a latent print, an examiner will sometimes revise the assessment during comparison with an exemplar. Changes between analysis and comparison may indicate that the initial analysis of the latent was inadequate, or that confirmation bias may have affected the comparison. 170 volunteer latent print examiners, each randomly assigned 22 pairs of prints from a pool of 320 total pairs, provided detailed markup documenting their interpretations of the prints and the bases for their comparison conclusions. We describe changes in value assessments and markup of features and clarity. When examiners individualized, they almost always added or deleted minutiae (90.3% of individualizations); every examiner revised at least some markups. For inconclusive and exclusion determinations, changes were less common, and features were added more frequently when the image pair was mated (same source). Even when individualizations were based on eight or fewer corresponding minutiae, in most cases some of those minutiae had been added during comparison. One erroneous individualization was observed: the markup changes were notably extreme, and almost all of the corresponding minutiae had been added during comparison. Latents assessed to be of value for exclusion only (VEO) during analysis were often individualized when compared to a mated exemplar (26%); in our previous work, where examiners were not required to provide markup of features, VEO individualizations were much less common (1.8%). Published by Elsevier Ireland Ltd.

  4. Systematic mapping review on student's performance analysis using ...

    African Journals Online (AJOL)

    This paper classify the various existing predicting models that are used for monitoring and improving students' performance at schools and higher learning institutions. It analyses all the areas within the educational data mining methodology. Two databases were chosen for this study and a systematic mapping study was ...

  5. Inflammatory mediators in human epilepsy : A systematic review and meta-analysis

    NARCIS (Netherlands)

    de Vries, Evelien E.; van den Munckhof, Bart; Braun, Kees P J; van Royen-Kerkhof, Annet; de Jager, Wilco; Jansen, Floor E.

    Background: Accumulating evidence suggests a role for inflammation in the pathophysiology of epilepsy. Methods: We performed a systematic review and meta-analysis of studies that investigated inflammatory mediators in human epilepsy. Studies reporting on inflammatory mediators in serum,

  6. Effectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis

    NARCIS (Netherlands)

    la Chapelle, C.F.; Veersema, S.; Brölmann, H.A.M.; Jansen, F.W.

    2015-01-01

    Objective To assess whether hysteroscopic sterilization is feasible and effective in preventing pregnancy. Secondarily, to identify risk factors for failure of hysteroscopic sterilization. Design A systematic review and meta-analysis. Setting Not applicable. Patient(s) Women undergoing hysteroscopic

  7. Inadvertent P-hacking among trials and systematic reviews of the effect of progestogens in pregnancy? A systematic review and meta-analysis.

    Science.gov (United States)

    Prior, M; Hibberd, R; Asemota, N; Thornton, J G

    2017-06-01

    Progestogens have been evaluated in numerous trials and meta-analyses, many of which concluded they were effective. However, two large trials PROMISE and OPPTIMUM have recently concluded that progesterone was ineffective. This raises the possibility that earlier studies and reviews had been biased by either selective publication or selective choice of outcomes, so called "P-hacking". To compare the findings all progestogen trials and systematic reviews with those of trials with pre-registered primary outcomes which avoided selective outcome reporting. Search of PubMed, the Cochrane Library and trial registries. Registration PROSPERO CRD42016035303. Systematic reviews of randomised trials comparing progestogen with placebo in pregnancy and the individual trials included in those reviews. The subset of trials reporting a pre-registered primary outcome were compared with the totality of trials and reviews. For reviews all outcomes were included. For individual trials all outcomes reported in the systematic reviews were included. For the comparison group we recorded the registered primary outcome from trials that were either registered before they started, or registered during the recruitment phase and also double blind. Nineteen of twenty-nine meta-analyses concluded that progestogens were effective. Twenty-two trials reported their pre-registered primary outcomes. There was no effect of progesterone on primary registered dichotomous outcome RR 1.00 (95% CI 0.94-1.07). Only one of the 22 showed a nominally statistically significant benefit. When evaluated in registered double-blind trials with analysis restricted to predefined primary outcomes, progestational agents in pregnancy are ineffective. Progestogens to prevent pregnancy loss, an example of P-hacking. © 2017 Royal College of Obstetricians and Gynaecologists.

  8. Interferon alpha adjuvant therapy in patients with high-risk melanoma: a systematic review and meta-analysis.

    Science.gov (United States)

    Mocellin, Simone; Pasquali, Sandro; Rossi, Carlo R; Nitti, Donato

    2010-04-07

    Based on previous meta-analyses of randomized controlled trials (RCTs), the use of interferon alpha (IFN-alpha) in the adjuvant setting improves disease-free survival (DFS) in patients with high-risk cutaneous melanoma. However, RCTs have yielded conflicting data on the effect of IFN-alpha on overall survival (OS). We conducted a systematic review and meta-analysis to examine the effect of IFN-alpha on DFS and OS in patients with high-risk cutaneous melanoma. The systematic review was performed by searching MEDLINE, EMBASE, Cancerlit, Cochrane, ISI Web of Science, and ASCO databases. The meta-analysis was performed using time-to-event data from which hazard ratios (HRs) and 95% confidence intervals (CIs) of DFS and OS were estimated. Subgroup and meta-regression analyses to investigate the effect of dose and treatment duration were also performed. Statistical tests were two-sided. The meta-analysis included 14 RCTs, published between 1990 and 2008, and involved 8122 patients, of which 4362 patients were allocated to the IFN-alpha arm. IFN-alpha alone was compared with observation in 12 of the 14 trials, and 17 comparisons (IFN-alpha vs comparator) were generated in total. IFN-alpha treatment was associated with a statistically significant improvement in DFS in 10 of the 17 comparisons (HR for disease recurrence = 0.82, 95% CI = 0.77 to 0.87; P < .001) and improved OS in four of the 14 comparisons (HR for death = 0.89, 95% CI = 0.83 to 0.96; P = .002). No between-study heterogeneity in either DFS or OS was observed. No optimal IFN-alpha dose and/or treatment duration or a subset of patients more responsive to adjuvant therapy was identified using subgroup analysis and meta-regression. In patients with high-risk cutaneous melanoma, IFN-alpha adjuvant treatment showed statistically significant improvement in both DFS and OS.

  9. Analysis and comparison of transportation security systems

    International Nuclear Information System (INIS)

    Rinne, R.L.

    1976-05-01

    The role of modeling in the analysis of transportation security systems is described. Various modeling approaches are outlined. The conflict model developed in Sandia Laboratories' Transportation Mode Analysis for the NRC Special Safeguards Study is used to demonstrate the capability of models to determine system sensitivities and compare alternatives

  10. Sequence comparison and phylogenetic analysis of core gene of ...

    African Journals Online (AJOL)

    Phylogenetic analysis suggests that our sequences are clustered with sequences reported from Japan. This is the first phylogenetic analysis of HCV core gene from Pakistani population. Our sequences and sequences from Japan are grouped into same cluster in the phylogenetic tree. Sequence comparison and ...

  11. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection

    International Nuclear Information System (INIS)

    Pallwein, Leo; Struve, Peter; Aigner, Friedrich; Gradl, Johann; Schurich, Matthias; Frauscher, Ferdinand; Mitterberger, Michael; Horninger, Wolfgang; Bartsch, Georg; Pedross, Florian

    2007-01-01

    A prospective study was performed to determine the value of sonoelastography (SE) targeted biopsy for prostate cancer (PCa) detection. A series of 230 male screening volunteers was examined. Two independent examiners evaluated each subject. One single investigator performed ≤5 SE targeted biopsies into suspicious regions in the peripheral zone only. The stiffness of the lesion was displayed by SE and color-coded from red (soft) to blue (hard). Hard lesions were considered as malignant and targeted by biopsy. Subsequently, another examiner performed ten systematic biopsies. Cancer detection rates of the two techniques were compared. Cancer was detected in 81 of the 230 patients (35%), including 68 (30%) by SE targeted biopsy and in 58 (25%) by systematic biopsy. Cancer was detected by targeted biopsy alone in 23 patients (10%) and by systematic biopsy alone in 13 patients (6%). The detection rate for SE targeted biopsy cores (12.7% or 135 of 1,109 cores) was significantly better than for systematic biopsy cores (5.6% or 130 of 2,300 cores, P < 0.001). SE targeted biopsy in a patient with cancer was 2.9-fold more likely to detect PCa than systematic biopsy. SE targeted biopsy detected more cases of PCa than systematic biopsy, with fewer than half the number of biopsy cores in this prostate-specific antigen screening population. (orig.)

  12. Psychotherapeutic Treatment for Anorexia Nervosa: A Systematic Review and Network Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Almut Zeeck

    2018-05-01

    Full Text Available Background: The aim of the study was a systematic review of studies evaluating psychotherapeutic treatment approaches in anorexia nervosa and to compare their efficacy. Weight gain was chosen as the primary outcome criterion. We also aimed to compare treatment effects according to service level (inpatient vs. outpatient and age group (adolescents vs. adults.Methods:The data bases PubMed, Cochrane Library, Web of Science, Cinahl, and PsychInfo were used for a systematic literature search (until Feb 2017. Search terms were adapted for data base, combining versions of the search terms anorexia, treat*/therap* and controlled trial. Studies were selected using pre-defined in- and exclusion criteria. Data were extracted by two independent coders using piloted forms. Network-meta-analyses were conducted on all RCTs. For a comparison of service levels and age groups, standard mean change (SMC statistics were used and naturalistic, non-randomized studies included.Results: Eighteen RCTs (trials on adults: 622 participants; trials on adolescents: 625 participants were included in the network meta-analysis. SMC analyses were conducted with 38 studies (1,164 participants. While family-based approaches dominate interventions for adolescents, individual psychotherapy dominates in adults. There was no superiority of a specific approach. Weight gains were more rapid in adolescents and inpatient treatment.Conclusions: Several specialized psychotherapeutic interventions have been developed and can be recommended for AN. However, adult and adolescent patients should be distinguished, as groups differ in terms of treatment approaches considered suitable as well as treatment response. Future trials should replicate previous findings and be multi-center trials with large sample sizes to allow for subgroup analyses. Patient assessment should include variables that can be considered relevant moderators of treatment outcome. It is desirable to explore adaptive treatment

  13. Accommodating error analysis in comparison and clustering of molecular fingerprints.

    OpenAIRE

    Salamon, H.; Segal, M. R.; Ponce de Leon, A.; Small, P. M.

    1998-01-01

    Molecular epidemiologic studies of infectious diseases rely on pathogen genotype comparisons, which usually yield patterns comprising sets of DNA fragments (DNA fingerprints). We use a highly developed genotyping system, IS6110-based restriction fragment length polymorphism analysis of Mycobacterium tuberculosis, to develop a computational method that automates comparison of large numbers of fingerprints. Because error in fragment length measurements is proportional to fragment length and is ...

  14. Effects of different lower-limb sensory stimulation strategies on postural regulation-A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mei Teng Woo

    Full Text Available Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges' g standardized mean differences (SMD = 0.31-0.66 were observed with the addition of noise in a Stochastic Resonance Stimulation Strategy (SRSS, in three populations (i.e., healthy young adults, older adults, and individuals with lower-limb injuries, and under different task constraints (i.e., unipedal, bipedal, and eyes open. A Textured Material Stimulation Strategy (TMSS enhanced postural control in the most challenging condition-eyes-closed on a stable surface (SMD = 0.61, and in older adults (SMD = 0.30. The Wearable Garments Stimulation Strategy (WGSS showed no or adverse effects (SMD = -0.68-0.05 under all task constraints and in all populations, except in individuals with lower-limb injuries (SMD = 0.20. Results of our systematic review and meta-analysis revealed that future research could consider combining two or more stimulation strategies in intervention treatments for postural regulation and balance problems, depending on individual needs.

  15. Effects of different lower-limb sensory stimulation strategies on postural regulation-A systematic review and meta-analysis.

    Science.gov (United States)

    Woo, Mei Teng; Davids, Keith; Liukkonen, Jarmo; Orth, Dominic; Chow, Jia Yi; Jaakkola, Timo

    2017-01-01

    Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges' g) standardized mean differences (SMD) = 0.31-0.66) were observed with the addition of noise in a Stochastic Resonance Stimulation Strategy (SRSS), in three populations (i.e., healthy young adults, older adults, and individuals with lower-limb injuries), and under different task constraints (i.e., unipedal, bipedal, and eyes open). A Textured Material Stimulation Strategy (TMSS) enhanced postural control in the most challenging condition-eyes-closed on a stable surface (SMD = 0.61), and in older adults (SMD = 0.30). The Wearable Garments Stimulation Strategy (WGSS) showed no or adverse effects (SMD = -0.68-0.05) under all task constraints and in all populations, except in individuals with lower-limb injuries (SMD = 0.20). Results of our systematic review and meta-analysis revealed that future research could consider combining two or more stimulation strategies in intervention treatments for postural regulation and balance problems, depending on individual needs.

  16. Comparison between herbal medicine and fluoxetine for depression: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Ren, Yi; Zhu, Chenjun; Wu, Jianjun; Zheng, Ruwen; Cao, Huijaun

    2015-10-01

    To evaluate the effectiveness and safety of Chinese herbal medicine (CHM) versus fluoxetine on depression. A systematic review of randomized controlled trials (RCTs). RCT with two parallel groups that compared CHM and fluoxetine on treatment of depression with reported decreased Hamilton Depression Scale (HAMD) and adverse events during treatment were included after searching through six electric-databases. The methodological quality of RCTs was assessed according to the Cochrane risk of bias tool. Meta-analysis was conducted using RevMan 5.3 software with pooled mean difference (MD) or risk ratio (RR) and their 95% confidence interval (CI) if no significant heterogeneity was detected. A SOF table was generated using GRADEPro software to evaluate the overall quality of the evidence. Twenty-six trials with 3294 participants were included in the review. Most of them had high risk of bias during conducting and reporting. The results achieved weak evidence which showed CHM had similar effect to fluoxetine (20mg/day) on relieving depression according to HAMD assessment (for primary depression: MD=-0.08, 95%CI -0.98-0.82; for secondary depression: MD=-0.36, 95%CI -1.55-0.83), but fewer incidences of adverse events than the drug (for primary depression: RR=0.31, 95%CI 0.17-0.59; for post-stroke depression: RR=0.04, 95%CI 0.00-0.25). No serious adverse event was found in neither CHM nor fluoxetine group. Due to the poor quality of included trials and the potential publication bias of this review, no confirmed conclusion could be draw to evaluate the effectiveness and safety of CHM for depression compared with fluoxetine. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Comparison of pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a protocol for a systematic review incorporating network meta-analyses.

    Science.gov (United States)

    Burry, L D; Hutton, B; Guenette, M; Williamson, D; Mehta, S; Egerod, I; Kanji, S; Adhikari, N K; Moher, D; Martin, C M; Rose, L

    2016-09-08

    Delirium is characterized by acute changes in mental status including inattention, disorganized thinking, and altered level of consciousness, and is highly prevalent in critically ill adults. Delirium has adverse consequences for both patients and the healthcare system; however, at this time, no effective treatment exists. The identification of effective prevention strategies is therefore a clinical and research imperative. An important limitation of previous reviews of delirium prevention is that interventions were considered in isolation and only direct evidence was used. Our systematic review will synthesize all existing data using network meta-analysis, a powerful statistical approach that enables synthesis of both direct and indirect evidence. We will search Ovid MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science from 1980 to March 2016. We will search the PROSPERO registry for protocols and the Cochrane Library for published systematic reviews. We will examine reference lists of pertinent reviews and search grey literature and the International Clinical Trials Registry Platform for unpublished studies and ongoing trials. We will include randomized and quasi-randomized trials of critically ill adults evaluating any pharmacological, non-pharmacological, or multi-component intervention for delirium prevention, administered in or prior to (i.e., peri-operatively) transfer to the ICU. Two authors will independently screen search results and extract data from eligible studies. Risk of bias assessments will be completed on all included studies. To inform our network meta-analysis, we will first conduct conventional pair-wise meta-analyses for primary and secondary outcomes using random-effects models. We will generate our network meta-analysis using a Bayesian framework, assuming a common heterogeneity parameter across all comparisons, and accounting for correlations in multi-arm studies. We will perform analyses using WinBUGS software. This systematic review

  18. Correction of systematic behaviour in topographical surface analysis

    DEFF Research Database (Denmark)

    Quagliotti, Danilo; Baruffi, Federico; Tosello, Guido

    2016-01-01

    Four specimens in the sub-micrometre range and with different polishing were topographically investigated in fiveareas over their respective surfaces. Uncertainties were evaluated with and without correction for systematicbehaviour and successively analysed by a design of experiment (DOE). Result...... showed that the correction forsystematic behaviour allowed for a lower value of the estimated uncertainty when the correction was adequate tocompletely recognise the systematic effects. If not, the correction can produce an overestimation of the uncertainty....

  19. Biomechanical Differences of Foot-Strike Patterns During Running: A Systematic Review With Meta-analysis.

    Science.gov (United States)

    Almeida, Matheus O; Davis, Irene S; Lopes, Alexandre D

    2015-10-01

    Systematic review with meta-analysis. To determine the biomechanical differences between foot-strike patterns used when running. Strike patterns during running have received attention in the recent literature due to their potential mechanical differences and associated injury risks. Electronic databases (MEDLINE, Embase, LILACS, SciELO, and SPORTDiscus) were searched through July 2014. Studies (cross-sectional, case-control, prospective, and retrospective) comparing the biomechanical characteristics of foot-strike patterns during running in distance runners at least 18 years of age were included in this review. Two independent reviewers evaluated the risk of bias. A meta-analysis with a random-effects model was used to combine the data from the included studies. Sixteen studies were included in the final analysis. In the meta-analyses of kinematic variables, significant differences between forefoot and rearfoot strikers were found for foot and knee angle at initial contact and knee flexion range of motion. A forefoot-strike pattern resulted in a plantar-flexed ankle position and a more flexed knee position, compared to a dorsiflexed ankle position and a more extended knee position for the rearfoot strikers, at initial contact with the ground. In the comparison of rearfoot and midfoot strikers, midfoot strikers demonstrated greater ankle dorsiflexion range of motion and decreased knee flexion range of motion compared to rearfoot strikers. For kinetic variables, the meta-analysis revealed that rearfoot strikers had higher vertical loading rates compared to forefoot strikers. There are differences in kinematic and kinetic characteristics between foot-strike patterns when running. Clinicians should be aware of these characteristics to help in the management of running injuries and advice on training.

  20. Prevalence of treponema species detected in endodontic infections: systematic review and meta-regression analysis.

    Science.gov (United States)

    Leite, Fábio R M; Nascimento, Gustavo G; Demarco, Flávio F; Gomes, Brenda P F A; Pucci, Cesar R; Martinho, Frederico C

    2015-05-01

    This systematic review and meta-regression analysis aimed to calculate a combined prevalence estimate and evaluate the prevalence of different Treponema species in primary and secondary endodontic infections, including symptomatic and asymptomatic cases. The MEDLINE/PubMed, Embase, Scielo, Web of Knowledge, and Scopus databases were searched without starting date restriction up to and including March 2014. Only reports in English were included. The selected literature was reviewed by 2 authors and classified as suitable or not to be included in this review. Lists were compared, and, in case of disagreements, decisions were made after a discussion based on inclusion and exclusion criteria. A pooled prevalence of Treponema species in endodontic infections was estimated. Additionally, a meta-regression analysis was performed. Among the 265 articles identified in the initial search, only 51 were included in the final analysis. The studies were classified into 2 different groups according to the type of endodontic infection and whether it was an exclusively primary/secondary study (n = 36) or a primary/secondary comparison (n = 15). The pooled prevalence of Treponema species was 41.5% (95% confidence interval, 35.9-47.0). In the multivariate model of meta-regression analysis, primary endodontic infections (P apical abscess, symptomatic apical periodontitis (P < .001), and concomitant presence of 2 or more species (P = .028) explained the heterogeneity regarding the prevalence rates of Treponema species. Our findings suggest that Treponema species are important pathogens involved in endodontic infections, particularly in cases of primary and acute infections. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  1. A Comparison of Three Methods for the Analysis of Skin Flap Viability: Reliability and Validity.

    Science.gov (United States)

    Tim, Carla Roberta; Martignago, Cintia Cristina Santi; da Silva, Viviane Ribeiro; Dos Santos, Estefany Camila Bonfim; Vieira, Fabiana Nascimento; Parizotto, Nivaldo Antonio; Liebano, Richard Eloin

    2018-05-01

    Objective: Technological advances have provided new alternatives to the analysis of skin flap viability in animal models; however, the interrater validity and reliability of these techniques have yet to be analyzed. The present study aimed to evaluate the interrater validity and reliability of three different methods: weight of paper template (WPT), paper template area (PTA), and photographic analysis. Approach: Sixteen male Wistar rats had their cranially based dorsal skin flap elevated. On the seventh postoperative day, the viable tissue area and the necrotic area of the skin flap were recorded using the paper template method and photo image. The evaluation of the percentage of viable tissue was performed using three methods, simultaneously and independently by two raters. The analysis of interrater reliability and viability was performed using the intraclass correlation coefficient and Bland Altman Plot Analysis was used to visualize the presence or absence of systematic bias in the evaluations of data validity. Results: The results showed that interrater reliability for WPT, measurement of PTA, and photographic analysis were 0.995, 0.990, and 0.982, respectively. For data validity, a correlation >0.90 was observed for all comparisons made between the three methods. In addition, Bland Altman Plot Analysis showed agreement between the comparisons of the methods and the presence of systematic bias was not observed. Innovation: Digital methods are an excellent choice for assessing skin flap viability; moreover, they make data use and storage easier. Conclusion: Independently from the method used, the interrater reliability and validity proved to be excellent for the analysis of skin flaps' viability.

  2. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.

    Science.gov (United States)

    Sherrington, Catherine; Michaleff, Zoe A; Fairhall, Nicola; Paul, Serene S; Tiedemann, Anne; Whitney, Julie; Cumming, Robert G; Herbert, Robert D; Close, Jacqueline C T; Lord, Stephen R

    2017-12-01

    Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects. Update of a systematic review with random effects meta-analysis and meta-regression. Cochrane Library, CINAHL, MEDLINE, EMBASE, PubMed, PEDro and SafetyLit were searched from January 2010 to January 2016. We included randomised controlled trials that compared fall rates in older people randomised to receive exercise as a single intervention with fall rates in those randomised to a control group. 99 comparisons from 88 trials with 19 478 participants were available for meta-analysis. Overall, exercise reduced the rate of falls in community-dwelling older people by 21% (pooled rate ratio 0.79, 95% CI 0.73 to 0.85, pexercise programmes that challenged balance and involved more than 3 hours/week of exercise. These variables explained 76% of the between-trial heterogeneity and in combination led to a 39% reduction in falls (incident rate ratio 0.61, 95% CI 0.53 to 0.72, pExercise also had a fall prevention effect in community-dwelling people with Parkinson's disease (pooled rate ratio 0.47, 95% CI 0.30 to 0.73, p=0.001, I 2 65%, 6 comparisons) or cognitive impairment (pooled rate ratio 0.55, 95% CI 0.37 to 0.83, p=0.004, I 2 21%, 3 comparisons). There was no evidence of a fall prevention effect of exercise in residential care settings or among stroke survivors or people recently discharged from hospital. Exercise as a single intervention can prevent falls in community-dwelling older people. Exercise programmes that challenge balance and are of a higher dose have larger effects. The impact of exercise as a single intervention in clinical groups and aged care facility residents requires further investigation, but promising results are evident for people with Parkinson

  3. Therapeutic Effects of Horseback Riding Interventions: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Stergiou, Alexandra; Tzoufi, Meropi; Ntzani, Evangelia; Varvarousis, Dimitrios; Beris, Alexandros; Ploumis, Avraam

    2017-10-01

    Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life. In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool. Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs. Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.

  4. Salivary gland transfer to prevent radiation-induced xerostomia: a systematic review and meta-analysis.

    Science.gov (United States)

    Sood, Amit J; Fox, Nyssa F; O'Connell, Brendan P; Lovelace, Tiffany L; Nguyen, Shaun A; Sharma, Anand K; Hornig, Joshua D; Day, Terry A

    2014-02-01

    Salivary gland transfer (SGT) has the potential to prevent radiation-induced xerostomia. We attempt to analyze the efficacy of SGT in prevention of xerostomia and maintenance of salivary flow rates after radiation treatment (XRT). Systematic review and meta-analysis. Primary endpoint was efficacy of SGT in prevention of radiation-induced xerostomia. Secondary endpoint was change from baseline of unstimulated and stimulated salivary flow rates after XRT. Seven articles, accruing data from 12 institutions, met inclusion criteria. In a total of 177 patients at mean follow-up of 22.7months, SGT prevented radiation-induced xerostomia in 82.7% (95% CI, 76.6-87.7%) of patients. Twelve months after XRT, unstimulated and stimulated salivary flow rates rose to 88% and 76% of baseline values, respectively. In comparison to control subjects twelve months after XRT, SGT subjects' unstimulated (75% vs. 11%) and stimulated (86% vs. 8%) salivary flow rates were drastically higher in SGT patients. Salivary gland transfer appears to be highly effective in preventing the incidence of xerostomia in patients receiving definitive head and neck radiation therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. HIV/STI prevention interventions: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Globerman Jason

    2017-12-01

    Full Text Available Behavioral interventions can prevent the transmission of HIV and sexually transmitted infections. This systematic review and meta-analysis assesses the effectiveness and quality of available evidence of HIV prevention interventions for people living with HIV in high-income settings. Searches were conducted in MEDLINE, EMBASE, PsycINFO, and CDC Compendium of Effective Interventions. Interventions published between January, 1998 and September, 2015 were included. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE. Forty-six articles and 63 datasets involving 14,096 individuals met inclusion criteria. Included articles were grouped by intervention type, comparison group and outcome. Few of these had high or moderate quality of evidence and statistically significant effects. One intervention type, group-level health education interventions, were effective in reducing HIV/STI incidence when compared to attention controls. A second intervention type, comprehensive risk counseling and services, was effective in reducing sexual risk behaviors when compared to both active and attention controls. All other intervention types showed no statistically significant effect or had low or very low quality of evidence. Given that the majority of interventions produced low or very low quality of evidence, researchers should commit to rigorous evaluation and high quality reporting of HIV intervention studies.

  6. Cognition and objectively measured sleep duration in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Short, Michelle A; Blunden, Sarah; Rigney, Gabrielle; Matricciani, Lisa; Coussens, Scott; M Reynolds, Chelsea; Galland, Barbara

    2018-06-01

    Sleep recommendations are widely used to guide communities on children's sleep needs. Following recent adjustments to guidelines by the National Sleep Foundation and the subsequent consensus statement by the American Academy of Sleep Medicine, we undertook a systematic literature search to evaluate the current evidence regarding relationships between objectively measured sleep duration and cognitive function in children aged 5 to 13 years. Cognitive function included measures of memory, attention, processing speed, and intelligence in children aged 5 to 13 years. Keyword searches of 7 databases to December 2016 found 23 meeting inclusion criteria from 137 full articles reviewed, 19 of which were suitable for meta-analysis. A significant effect (r = .06) was found between sleep duration and cognition, suggesting that longer sleep durations were associated with better cognitive functioning. Analyses of different cognitive domains revealed that full/verbal IQ was significantly associated with sleep loss, but memory, fluid IQ, processing speed and attention were not. Comparison of study sleep durations with current sleep recommendations showed that most children studied had sleep durations that were not within the range of recommended sleep. As such, the true effect of sleep loss on cognitive function may be obscured in these samples, as most children were sleep restricted. Future research using more rigorous experimental methodologies is needed to properly elucidate the relationship between sleep duration and cognition in this age group. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  7. Analysis and comparison of biometric methods

    OpenAIRE

    Zatloukal, Filip

    2011-01-01

    The thesis deals with biometrics and biometric systems and the possibility to use these systems in the enterprise. Aim of this study is an analysis and description of selected types of biometric identification methods and their advantages and shortcomings. The work is divided into two parts. The first part is theoretical, describes the basic concepts of biometrics, biometric identification criteria, currently used identification systems, the ways of biometric systems use, performance measurem...

  8. Peroral endoscopic myotomy for the treatment of esophageal achalasia: systematic review and pooled analysis.

    Science.gov (United States)

    Patel, K; Abbassi-Ghadi, N; Markar, S; Kumar, S; Jethwa, P; Zaninotto, G

    2016-10-01

    Peroral endoscopic myotomy (POEM) is a novel approach to performing esophageal myotomy for the treatment of achalasia. This review aims to assess subjective and objective metrics of achalasia treatment efficacy, perioperative adverse events and the incidence of postoperative gastroesophageal reflux disease in patients treated with POEM. Secondary aims include a pooled analysis comparison of the clinical outcomes and procedural safety of POEM versus laparoscopic Heller's myotomy (LHM). A systematic review of the literature, up to and including January 15, 2015, was conducted for studies reporting POEM outcomes. Studies comparing POEM to LHM were also included for the purpose of pooled analysis. Outcomes from 1122 POEM patients, from 22 studies, are reported in this systematic review. Minor operative adverse events included capno/pneumo-peritoneum (30.6%), capno/pneumo-thorax (11.0%) and subcutaneous emphysema (31.6%). Major operative adverse events included mediastinal leak (0.3%), postoperative bleeding (1.1%) and a single mortality (0.09%). There was an improvement in lower esophageal sphincter pressure and timed barium esophagram column height of 66% and 80% post-POEM, respectively. Symptom improvement was demonstrated with a pre- and post-POEM Eckardt score ± standard deviation of 6.8 ± 1.0 and 1.2 ± 0.6, respectively. Pre- and post-POEM endoscopy showed esophagitis in 0% and 19% of patients, respectively. The median (interquartile range) points scored for study quality was 15 (14-16) out of total of 32. Pooled analysis of three comparative studies between LHM and POEM showed similar results for adverse events, perforation rate, operative time and a nonsignificant trend toward a reduced length of hospital stay in the POEM group. In conclusion, POEM is a safe and effective treatment for achalasia, showing significant improvements in objective metrics and achalasia-related symptoms. Randomized comparative studies of LHM and POEM are required to determine the

  9. Telemedicine Technologies for Diabetes in Pregnancy: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ming, Wai-Kit; Mackillop, Lucy H; Farmer, Andrew J; Loerup, Lise; Bartlett, Katy; Levy, Jonathan C; Tarassenko, Lionel; Velardo, Carmelo; Kenworthy, Yvonne; Hirst, Jane E

    2016-11-09

    Diabetes in pregnancy is a global problem. Technological innovations present exciting opportunities for novel approaches to improve clinical care delivery for gestational and other forms of diabetes in pregnancy. To perform an updated and comprehensive systematic review and meta-analysis of the literature to determine whether telemedicine solutions offer any advantages compared with the standard care for women with diabetes in pregnancy. The review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Randomized controlled trials (RCT) in women with diabetes in pregnancy that compared telemedicine blood glucose monitoring with the standard care were identified. Searches were performed in SCOPUS and PubMed, limited to English language publications between January 2000 and January 2016. Trials that met the eligibility criteria were scored for risk of bias using the Cochrane Collaborations Risk of Bias Tool. A meta-analysis was performed using Review Manager software version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). A total of 7 trials were identified. Meta-analysis demonstrated a modest but statistically significant improvement in HbA1c associated with the use of a telemedicine technology. The mean HbA1c of women using telemedicine was 5.33% (SD 0.70) compared with 5.45% (SD 0.58) in the standard care group, representing a mean difference of -0.12% (95% CI -0.23% to -0.02%). When this comparison was limited to women with gestational diabetes mellitus (GDM) only, the mean HbA1c of women using telemedicine was 5.22% (SD 0.70) compared with 5.37% (SD 0.61) in the standard care group, mean difference -0.14% (95% CI -0.25% to -0.04%). There were no differences in other maternal and neonatal outcomes reported. There is currently insufficient evidence that telemedicine technology is superior to standard care for women with diabetes in pregnancy; however, there was no evidence of harm. No trials were

  10. Differences in research funding for women scientists: a systematic comparison of UK investments in global infectious disease research during 1997-2010.

    Science.gov (United States)

    Head, Michael G; Fitchett, Joseph R; Cooke, Mary K; Wurie, Fatima B; Atun, Rifat

    2013-12-09

    There has not previously been a systematic comparison of awards for research funding in infectious diseases by sex. We investigated funding awards to UK institutions for all infectious disease research from 1997 to 2010, across disease categories and along the research and development continuum. Systematic comparison. Data were obtained from several sources for awards from the period 1997 to 2010 and each study assigned to-disease categories; type of science (preclinical, phases I-III trials, product development, implementation research); categories of funding organisation. Fold differences and statistical analysis were used to compare total investment, study numbers, mean grant and median grant between men and women. 6052 studies were included in the final analysis, comprising 4357 grants (72%) awarded to men and 1695 grants (28%) awarded to women, totalling £2.274 billion. Of this, men received £1.786 billion (78.5%) and women £488 million (21.5%). The median value of award was greater for men (£179 389; IQR £59 146-£371 977) than women (£125 556; IQR £30 982-£261 834). Awards were greater for male principal investigators (PIs) across all infectious disease systems, excepting neurological infections and sexually transmitted infections. The proportion of total funding awarded to women ranged from 14.3% in 1998 to 26.8% in 2009 (mean 21.4%), and was lowest for preclinical research at 18.2% (£285.5 million of £1.573 billion) and highest for operational research at 30.9% (£151.4 million of £489.7 million). There are consistent differences in funding received by men and women PIs: women have fewer funded studies and receive less funding in absolute and in relative terms; the median funding awarded to women is lower across most infectious disease areas, by funder, and type of science. These differences remain broadly unchanged over the 14-year study period.

  11. Epinephrine in cardiac arrest: systematic review and meta-analysis.

    Science.gov (United States)

    Morales-Cané, Ignacio; Valverde-León, María Del Rocío; Rodríguez-Borrego, María Aurora

    2016-12-08

    evaluate the effectiveness of epinephrine used during cardiac arrest and its effect on the survival rates and neurological condition. systematic review of scientific literature with meta-analysis, using a random effects model. The following databases were used to research clinical trials and observational studies: Medline, Embase and Cochrane, from 2005 to 2015. when the Return of Spontaneous Circulation (ROSC) with administration of epinephrine was compared with ROSC without administration, increased rates were found with administration (OR 2.02. 95% CI 1.49 to 2.75; I2 = 95%). Meta-analysis showed an increase in survival to discharge or 30 days after administration of epinephrine (OR 1.23; 95% IC 1.05-1.44; I2=83%). Stratification by shockable and non-shockable rhythms showed an increase in survival for non-shockable rhythm (OR 1.52; 95% IC 1.29-1.78; I2=42%). When compared with delayed administration, the administration of epinephrine within 10 minutes showed an increased survival rate (OR 2.03; 95% IC 1.77-2.32; I2=0%). administration of epinephrine appears to increase the rate of ROSC, but when compared with other therapies, no positive effect was found on survival rates of patients with favorable neurological status. avaliar a efetividade da adrenalina na parada cardíaca e seu efeito na sobrevivência e no estado neurológico. revisão sistemática da literatura científica com meta-análise utilizando um modelo de efeitos aleatórios. Revisão em Medline, Embase e Cochrane, desde 2005 até 2015 de ensaios clínicos e estudos observacionais. observou-se aumento nas taxas de retorno de circulação espontânea com a administração de adrenalina (OR 2,02; 95% IC 1,49-2,75; I2=95%) comparadas com a não administração de adrenalina. A meta-análise mostrou um aumento da sobrevivência na alta ou depois de 30 dias da administração de adrenalina (OR 1,23; 95% IC 1,05-1,44; I2=83%). Quando estratificados por ritmos desfibrilháveis e não desfibrilh

  12. ANALYSIS AND CORRECTION OF SYSTEMATIC HEIGHT MODEL ERRORS

    Directory of Open Access Journals (Sweden)

    K. Jacobsen

    2016-06-01

    Full Text Available The geometry of digital height models (DHM determined with optical satellite stereo combinations depends upon the image orientation, influenced by the satellite camera, the system calibration and attitude registration. As standard these days the image orientation is available in form of rational polynomial coefficients (RPC. Usually a bias correction of the RPC based on ground control points is required. In most cases the bias correction requires affine transformation, sometimes only shifts, in image or object space. For some satellites and some cases, as caused by small base length, such an image orientation does not lead to the possible accuracy of height models. As reported e.g. by Yong-hua et al. 2015 and Zhang et al. 2015, especially the Chinese stereo satellite ZiYuan-3 (ZY-3 has a limited calibration accuracy and just an attitude recording of 4 Hz which may not be satisfying. Zhang et al. 2015 tried to improve the attitude based on the color sensor bands of ZY-3, but the color images are not always available as also detailed satellite orientation information. There is a tendency of systematic deformation at a Pléiades tri-stereo combination with small base length. The small base length enlarges small systematic errors to object space. But also in some other satellite stereo combinations systematic height model errors have been detected. The largest influence is the not satisfying leveling of height models, but also low frequency height deformations can be seen. A tilt of the DHM by theory can be eliminated by ground control points (GCP, but often the GCP accuracy and distribution is not optimal, not allowing a correct leveling of the height model. In addition a model deformation at GCP locations may lead to not optimal DHM leveling. Supported by reference height models better accuracy has been reached. As reference height model the Shuttle Radar Topography Mission (SRTM digital surface model (DSM or the new AW3D30 DSM, based on ALOS

  13. Association between Iron Deficiency Anemia and Febrile Seizure: a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Nasehi

    2013-04-01

    Full Text Available Febrile seizure is the most common convulsive disorder in children and different studies reported controversial results about the association between this disorder and iron deficiency. In some studies, iron level in children with febrile seizure is higher than control and in some reports it is less than the control group. So, we systematically reviewed all the studies in this field and analyzed their findings using meta-analysis methods. This review and meta-analysis was conducted by iron and fever keywords on articles published in the databases PubMed, Google Scholar and Federated search of medical digital library that includes a variety of international databases. All articles dated at the end of March 2012 were studied. Case-control studies were selected and quality assessment of studies were surveyed by STROB criteria and information requirements, including the status of iron deficiency anemia, iron levels and ferritin level of eligible studies were extracted and analyzed by Comprehensive Meta-Analysis Version 2.0 software and the Forest and Funnel chart was drawn. Finally 11 studies included 1357 children with febrile seizure and 1347 children in the control group were evaluated. The odds ratio of iron deficiency anemia in children with febrile seizure in comparison to the control group was 1.27 (OR = 1.27, CI95%: 1.03 -1.56. Ferritin level was not significant between the two groups (p=0.08, but the iron level in the two groups was significant (p=0.000. Iron deficiency is considered as a risk factor in the incidence of febrile seizure and interventional studies can be helpful to confirm this hypothesis.

  14. Comparison of characteristics of international and national databases for rheumatoid arthritis: a systematic literature review

    NARCIS (Netherlands)

    Gvozdenović, E.; Koevoets, R.; Langenhoff, J.; Allaart, C. F.; Landewé, R. B. M.

    2014-01-01

    To evaluate current (inter)national registers and observational cohorts in Europe, and to compare inclusion criteria, aims, collected data, and participation in the European League Against Rheumatism (EULAR) repository. We performed a systematic search strategy in six literature databases for

  15. Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: A systematic comparison of their impact on cognition

    NARCIS (Netherlands)

    van den Berg, Esther; Kloppenborg, Raoul P.; Kessels, Roy P. C.; Kappelle, L. Jaap; Biessels, Geert Jan

    2009-01-01

    Vascular risk factors, such as type 2 diabetes mellitus, hypertension, dyslipidemia and obesity, have been associated with an increased risk of cognitive dysfunction, particularly in the elderly. The aim of this systematic review was to compare these risk factors with regard to the nature and

  16. Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis.

    Science.gov (United States)

    Milanović, Zoran; Pantelić, Saša; Čović, Nedim; Sporiš, Goran; Mohr, Magni; Krustrup, Peter

    2018-01-25

    A previous meta-analysis showed that maximal oxygen uptake increased by 3.51 mL/kg/min (95% CI 3.07 to 4.15) during a recreational football programme of 3-6 months in comparison with continuous moderate-intensity running, strength training or a passive control group. In addition, narrative reviews have demonstrated beneficial effects of recreational football on physical fitness and health status. The purpose of this systematic review and meta-analysis was to evaluate the magnitude of effects of recreational football on blood pressure, body composition, lipid profile and muscular fitness with reference to age, gender and health status. Systematic review and meta-analysis. MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to 1 February 2017. In addition, Google Scholar alerts were set up in January 2012 to identify potential papers with the following key terms: recreational football, recreational soccer, street football and street soccer. Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of exercises or passive control group were included. Training programmes had to last at least 2 weeks to meet the inclusion criteria. The primary outcome measures were blood pressure, resting heart rate, body composition, muscular fitness, and blood lipids and glucose tolerance. A total of 31 papers met the inclusion criteria and were included. The effect of recreational football on systolic blood pressure (SBP) versus no-exercise controls was most likely extremely largely beneficial (effect size (ES)=4.20 mm Hg; 95% CI 1.87 to 6.53). In addition, a most likely very large beneficial (ES=3.89 mm Hg; 95% CI 2.33 to 5.44) effect was observed for diastolic blood pressure (DBP), when compared with non-active groups. Furthermore, a most likely extremely large beneficial effect was shown for SBP and DBP in

  17. Methodological quality of systematic reviews in subfertility: a comparison of two different approaches.

    Directory of Open Access Journals (Sweden)

    Ivor Popovich

    Full Text Available BACKGROUND: Systematic reviews are used widely to guide health care decisions. Several tools have been created to assess systematic review quality. The measurement tool for assessing the methodological quality of systematic reviews known as the AMSTAR tool applies a yes/no score to eleven relevant domains of review methodology. This tool has been reworked so that each domain is scored based on a four point scale, producing R-AMSTAR. METHODS AND FINDINGS: We aimed to compare the AMSTAR and R-AMSTAR tools in assessing systematic reviews in the field of assisted reproduction for subfertility. All published systematic reviews on assisted reproductive technology, with the latest search for studies taking place from 2007-2011, were considered. Reviews that contained no included studies or considered diagnostic outcomes were excluded. Thirty each of Cochrane and non-Cochrane reviews were randomly selected from a search of relevant databases. Both tools were then applied to all sixty reviews. The results were converted to percentage scores and all reviews graded and ranked based on this. AMSTAR produced a much wider variation in percentage scores and achieved higher inter-rater reliability than R-AMSTAR according to kappa statistics. The average rating for Cochrane reviews was consistent between the two tools (88.3% for R-AMSTAR versus 83.6% for AMSTAR but inconsistent for non-Cochrane reviews (63.9% R-AMSTAR vs. 38.5% AMSTAR. In comparing the rankings generated between the two tools Cochrane reviews changed an average of 4.2 places, compared to 2.9 for non-Cochrane. CONCLUSION: R-AMSTAR provided greater guidance in the assessment of domains and produced quantitative results. However, there were many problems with the construction of its criteria and AMSTAR was much easier to apply consistently. We recommend that AMSTAR incorporates the findings of this study and produces additional guidance for its application in order to improve its reliability and

  18. Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and meta-analysis.

    Science.gov (United States)

    Maïano, C; Hue, O; Morin, A J S; Moullec, G

    2016-07-01

    Although there have been numerous studies examining the prevalence of overweight and obesity among children and adolescents with intellectual disabilities, they have not yet been integrated and synthesized through a systematic quantitative review process. The purpose of this systematic review and meta-analysis was to determine: (i) the prevalence of overweight/obesity among children and adolescents with intellectual disabilities; (ii) the sources of heterogeneity in studies reporting the prevalence of overweight/obesity in this population; and (iii) the risk of overweight/obesity in this population compared with their typically developing peers. A systematic literature search was performed and 16 studies, published between 1985 and 2015, met the inclusion criteria. The resulting pooled prevalence estimates for overweight, overweight-obesity and obesity were respectively: (i) 15%, 30%, and 13%, in children; and (ii) 18%, 33%, and 15% in adolescents. Subgroup analyses showed significant variations in the pooled prevalence estimates as a function of geographical region, recruitment setting, additional diagnoses, and norms used to define overweight or obesity. The findings also showed adolescents with intellectual disabilities to be respectively 1.54 and 1.80 times more at risk of overweight-obesity and obesity than typically developing adolescents. Unfortunately, no such comparison is available for children. © 2016 World Obesity. © 2016 World Obesity.

  19. How can interventions increase motivation for physical activity? A systematic review and meta-analysis

    OpenAIRE

    Crutzen, Rik; Nurmi, Johanna; Beattie, Marguerite; Dombrowski, Stephan; Knittle, Keegan; Hankonen, Nelli

    2018-01-01

    Motivation is a proximal determinant of behavior in many psychological theories, and increasing motivation is central to most behavior change interventions. This systematic review and meta-analysis sought to fill a gap in the literature by identifying features of behavior change interventions associated with favorable changes in three prominent motivational constructs: intention, stage of change and autonomous motivation. A systematic literature search identified 88 intervention studies (N = ...

  20. Validity of recalled v. recorded birth weight: a systematic review and meta-analysis

    OpenAIRE

    Shenkin, S.D.; Zhang, M.G.; Der, G.; Mathur, S.; Mina, T.H.; Reynolds, R.M.

    2017-01-01

    Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EM...

  1. A Systematic Comparison of Vertical GPS Time Series Calculated by Five Processing Centers for Detecting Climatic-Induced Crustal Movements

    Science.gov (United States)

    Setti Junior, P. D. T.; Wdowinski, S.

    2016-12-01

    Vertical crustal movements, as observed by continuous GPS measurements, are sensitive to load changes induced by atmospheric and hydrological processes, as lake level fluctuations, ice melt, groundwater depletion, or drought. These movements are often dominated by a seasonal signal but also by year-to-year changes, which reflect a long-term climatic signal. Recently, we developed a new technique that extracts the climatic signal by removing the seasonal signal from vertical GPS time series (Wdowinski et al., 2016). However, the method's results, which are the climatic signals, are very sensitive to the quality of the time series and the choice of reference frame (RF). In this study, we conduct a systematic comparison between eight vertical GPS time series calculated by five processing centers and evaluate their suitability to extract the climatic signal. We use the solutions produced by Central Washington University (CWU), New Mexico Institute of Technology (NMT), Nevada Geodetic Laboratory (NGL), Scripps Orbit and Permanent Array Center (SOPAC) and Jet Propulsion Laboratory (JPL), as well as combined solution calculated by the Plate Boundary Observatory (PBO) and GPS Explorer. We use the solutions constrained in the IGS08 RF and in the case of NGL, we also use the NA12 solutions. Three of the processing centers, CWU, NGL and JPL use the GIPSY software, whereas the other two, NMT and SOPAC, use GAMIT. Both combined solutions integrate between GIPSY and GAMIT solutions. We conducted our comparative analysis in two study areas, one in western US taking advantage of the two decades long time series of the Basin and Range network, and the other in eastern U.S. and Canada (Washington DC area, Newfoundland, and Ottawa area). Preliminary results suggest that the three GIPSY solutions (CWU, NGL and JPL) are more consistent between one another compared with the GAMIT solutions. The GIPSY solutions also yield climatic signal that is more consistent with regional climatic

  2. Re-analysis as a Comparison of Constructions

    Directory of Open Access Journals (Sweden)

    Jochen Gläser

    2000-12-01

    Full Text Available An interesting methodological aspect of secondary analysis is that it enables comparisons between constructions that constitute qualitative data analysis. This comparison is even more focused if a reanalysis is conducted, that means an analysis that reexamines both the primary study's data and the primary study's research question. In this article, a reanalysis is described that used interviews from the archive at the Special Collaborative Centre 186 (Sfb 186. One of the primary study's results was formulated as a hypothesis and subsequently "tested" by conducting a qualitative content analysis of the interviews. A comparison of primary study and reanalysis reveals critical decisions which may lead the data analyses to different results. These decisions are usually made implicitly and will show up only if contradictions between results are explained. As a second result of the comparison, typical threats to primary and secondary analyses are discussed. Primary studies seem to suffer from a "closure pressure", that it is a necessity to make sense of the data at all costs. This may stimulate researchers to close gaps in their data by speculation and to neglect contradicting evidence. Secondary analyses are thematically and methodically restricted by the primary study's data collection. Finally, the reanalysis confirmed that it is possible to use interviews from archives: The losses of information due to archiving and anonymisation seemed to have no significant influence on the reanalysis. URN: urn:nbn:de:0114-fqs0003257

  3. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics.

    Science.gov (United States)

    Seppala, Lotta J; Wermelink, Anne M A T; de Vries, Max; Ploegmakers, Kimberley J; van de Glind, Esther M M; Daams, Joost G; van der Velde, Nathalie

    2018-04-01

    Falls are a major public health problem in older adults. Earlier studies showed that psychotropic medication use increases the risk of falls. The aim of this study is to update the current knowledge by providing a comprehensive systematic review and meta-analysis on psychotropic medication use and falls in older adults. This study is a systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase. Key search concepts were "falls," "aged," "medication," and "causality." Studies were included that investigated psychotropics (antipsychotics, antidepressants, anxiolytics, sedatives, and hypnotics) as risk factors for falls in participants ≥60 years of age or participants with a mean age of ≥70 years. Meta-analyses were performed using generic inverse variance method pooling unadjusted and adjusted odds ratio (OR) estimates separately. In total, 248 studies met the inclusion criteria for qualitative synthesis. Meta-analyses using adjusted data showed the following pooled ORs: antipsychotics 1.54 [95% confidence interval (CI) 1.28-1.85], antidepressants 1.57 (95% Cl 1.43-1.74), tricyclic antidepressants 1.41 (95% CI 1.07-1.86), selective serotonin reuptake inhibitors 2.02 (95% CI 1.85-2.20), benzodiazepines 1.42 (95%, CI 1.22-1.65), long-acting benzodiazepines 1.81 (95%, CI 1.05-3.16), and short-acting benzodiazepines 1.27 (95%, CI 1.04-1.56) Most of the meta-analyses resulted in substantial heterogeneity that did not disappear after stratification for population and healthcare setting. Antipsychotics, antidepressants, and benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Prescription bias could not be accounted for. Future studies need to address pharmacologic subgroups as fall risk may differ depending on specific medication properties. Precise and uniform

  4. Muscle strength and power in persons with multiple sclerosis - A systematic review and meta-analysis.

    Science.gov (United States)

    Jørgensen, Mlk; Dalgas, U; Wens, I; Hvid, L G

    2017-05-15

    Multiple sclerosis (MS) is a chronic disease in the central nervous system which causes a number of physical symptoms including impairments of muscle mechanical function (muscle strength, muscle power and explosive muscle strength (~rate of force development, RFD)). However, a full overview of the existing knowledge regarding muscle mechanical function in persons with MS (PwMS) is still pending. To systematically review 1) the psychometric properties of isokinetic dynamometry testing in PwMS, and 2) studies comparing muscle mechanical function in PwMS to matched healthy controls (HC). In addition, a meta-analysis will evaluate 3) the effects of progressive resistance training on muscle mechanical function in PwMS. A systematic literature search was performed in eight databases. To be included in the review, the study had to 1) enroll participants with a confirmed diagnosis of MS; 2) assess muscle mechanical function 3) had undergone peer-review. The psychometric properties of isokinetic dynamometry were reviewed with respect to validity, reliability, and responsiveness. Comparison of muscle strength between PwMS and HC was performed across contraction velocities, contraction modes and muscle groups, as were the rate of force development. The effects of progressive resistance training on muscle mechanical function were evaluated in a meta-analysis using a random effects model and standardized mean difference (SMD). A total of four, twenty-four, and ten studies were identified for aim 1, 2, and 3, respectively. High Intraclass correlations coefficients (range: 0.87-0.99) for isokinetic dynamometry was reported when assessing knee extensor and knee flexor muscle strength independent of contraction velocity. Compared to match HC, PwMS display impaired muscle strength, power and explosive muscle strength. Muscle strength impairments were most pronounced during maximal moderate to fast dynamic muscle contractions of the lower extremities. Progressive resistance training

  5. Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

    Science.gov (United States)

    Roll, Stephanie; Müller-Nordhorn, Jacqueline; Keil, Thomas; Scholz, Hans; Eidt, Daniela; Greiner, Wolfgang; Willich, Stefan N

    2008-01-01

    Background In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE) or polyester (Dacron®) grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron® and PTFE). Methods We performed a systematic literature search in MEDLINE, Cochrane-Library – CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results. Results Nine randomized controlled trials (RCT) were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron® and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron® grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28]), no significant heterogeneity (p = 0.32, I2 = 14%)). Similarly, there were no significant differences with regard to secondary patency rates. Conclusion Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron® and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other. PMID:19099583

  6. Dacron® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Eidt Daniela

    2008-12-01

    Full Text Available Abstract Background In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE or polyester (Dacron® grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron® and PTFE. Methods We performed a systematic literature search in MEDLINE, Cochrane-Library – CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results. Results Nine randomized controlled trials (RCT were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron® and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron® grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28], no significant heterogeneity (p = 0.32, I2 = 14%. Similarly, there were no significant differences with regard to secondary patency rates. Conclusion Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron® and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other.

  7. Clinical recommendations of Cochrane reviews in pediatric gastroenterology: systematic analysis.

    Science.gov (United States)

    Goda, Yvonne; Sauer, Harald; Schöndorf, Dominik; Hennes, Pia; Gortner, Ludwig; Gräber, Stefan; Meyer, Sascha

    2015-01-01

    Systematic and up-to-date Cochrane reviews in pediatrics in general and in pediatric gastroenterology in particular are important tools in disseminating the best available evidence to the medical community, thus providing the physician at the bedside with invaluable information and recommendations with regard to specific clinical questions. A systematic literature review was conducted, including all Cochrane reviews published by the Cochrane Review Group in the field of pediatric gastroenterology between 1993 and 2012, with regard to the percentage of reviews that concluded that a certain intervention provided a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence was inconclusive. In total, 86 reviews in the field of pediatric gastroenterology were included. The majority of reviews assessed pharmacological interventions (46/86); other important fields included prevention (15/86) and nutrition (9/86). A total of 33/86 reviews issued definite recommendations (positive, 19/86; negative, 14/86). The remaining 53/86 reviews were either inconclusive (24/86) or only of limited conclusiveness (29/86). The percentage of inconclusive reviews increased from 9% (1998-2002) to 19% (2003-2007; P < 0.05) to finally 24% (2008-2012) (P < 0.05). The three most common reasons for the need for further research were heterogeneity of studies (26/86), small number of patients (18/86), and insufficient data (16/86). Further high-quality research is necessary to increase the proportion of reviews with clear recommendations. Funding and research agencies are key to selecting the most appropriate research programs. © 2014 Japan Pediatric Society.

  8. Comparison study of inelastic analysis codes for high temperature structure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Bum; Lee, H. Y.; Park, C. K.; Geon, G. P.; Lee, J. H

    2004-02-01

    LMR high temperature structures subjected to operating and transient loadings may exhibit very complex deformation behaviors due to the use of ductile material such as 316SS and the systematic analysis technology of high temperature structure for reliable safety assessment is essential. In this project, comparative study with developed inelastic analysis program NONSTA and the existing analysis codes was performed applying various types of loading including non-proportional loading. The performance of NONSTA was confirmed and the effect of inelastic constants on the analysis result was analyzed. Also, the applicability of the inelastic analysis was enlarged as a result of applying both the developed program and the existing codes to the analyses of the enhanced creep behavior and the elastic follow-up behavior of high temperature structures and the necessary items for improvements were deduced. Further studies on the improvement of NONSTA program and the decision of the proper values of inelastic constants are necessary.

  9. Combination of pharmacotherapy and psychotherapy in the treatment of chronic depression: A systematic review and meta-analysis

    Science.gov (United States)

    2012-01-01

    Background Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences. This review examined whether the combination of pharmacological treatments and psychotherapy is associated with higher effectiveness than pharmacotherapy alone via meta-analysis; and identified possible treatment effect modifiers via meta-regression-analysis. Methods A systematic search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, ISI Web of Science, BIOSIS, PsycINFO, and CINAHL. Primary efficacy outcome was a response to treatment; primary acceptance outcome was dropping out of the study. Only randomized controlled trials were considered. Results We identified 8 studies with a total of 9 relevant comparisons. Our analysis revealed small, but statistically not significant effects of combined therapies on outcomes directly related to depression (BR = 1.20) with substantial heterogeneity between studies (I² = 67%). Three treatment effect modifiers were identified: target disorders, the type of psychotherapy and the type of pharmacotherapy. Small but statistically significant effects of combined therapies on quality of life (SMD = 0.18) were revealed. No differences in acceptance rates and the long-term effects between combined treatments and pure pharmacological interventions were observed. Conclusions This systematic review could not provide clear evidence for the combination of pharmacotherapy and psychotherapy. However, due to the small amount of primary studies further research is needed for a conclusive decision. PMID:22694751

  10. Comparison of two stochastic techniques for reliable urban runoff prediction by modeling systematic errors

    DEFF Research Database (Denmark)

    Del Giudice, Dario; Löwe, Roland; Madsen, Henrik

    2015-01-01

    from different fields and have not yet been compared in environmental modeling. To compare the two approaches, we develop a unifying terminology, evaluate them theoretically, and apply them to conceptual rainfall-runoff modeling in the same drainage system. Our results show that both approaches can......In urban rainfall-runoff, commonly applied statistical techniques for uncertainty quantification mostly ignore systematic output errors originating from simplified models and erroneous inputs. Consequently, the resulting predictive uncertainty is often unreliable. Our objective is to present two...... approaches which use stochastic processes to describe systematic deviations and to discuss their advantages and drawbacks for urban drainage modeling. The two methodologies are an external bias description (EBD) and an internal noise description (IND, also known as stochastic gray-box modeling). They emerge...

  11. Testosterone deficiency in testicular cancer survivors - a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Bandak, Mikkel; Jørgensen, N; Juul, A.

    2016-01-01

    of late effects related to hypogonadism. We performed a critical review of PubMed in January 2015 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Twelve publications were selected for inclusion in this analysis. Eleven studies evaluated the risk of TD...

  12. Hydrocarbon Fuel Thermal Performance Modeling based on Systematic Measurement and Comprehensive Chromatographic Analysis

    Science.gov (United States)

    2016-07-31

    distribution unlimited Hydrocarbon Fuel Thermal Performance Modeling based on Systematic Measurement and Comprehensive Chromatographic Analysis Matthew...vital importance for hydrocarbon -fueled propulsion systems: fuel thermal performance as indicated by physical and chemical effects of cooling passage... analysis . The selection and acquisition of a set of chemically diverse fuels is pivotal for a successful outcome since test method validation and

  13. Structures and expectations: A systematic analysis of Margaret Paston’s formulaic and expressive language

    DEFF Research Database (Denmark)

    Wood, Johanna

    2009-01-01

    It is shown how a model based on a critical discourse analysis approach, in conjunction with frame analysis, offers a systematic way to analyse 15th century letters. It is argued that in this framework all contexts are “local contexts”. Letters present particular difficulties because they are for...

  14. Structures and expectations: A systematic analysis of Margaret Paston’s formulaic and expressive language

    DEFF Research Database (Denmark)

    Wood, Johanna

    2009-01-01

    It is shown how a model based on a critical discourse analysis approach, in conjunction with frame analysis, offers a systematic way to analyse 15th century letters. It is argued that in this framework all contexts are “local contexts”. Letters present particular difficulties because...

  15. Use of letrozole in assisted reproduction: a systematic review and meta-analysis

    Science.gov (United States)

    Requena, Antonio; Herrero, Julio; Landeras, José; Navarro, Esperanza; Neyro, José L.; Salvador, Cristina; Tur, Rosa; Callejo, Justo; Checa, Miguel A.; Farré, Magí; Espinós, Juan J.; Fábregues, Francesc; Graña-Barcia, María

    2008-01-01

    BACKGROUND Letrozole is the third-generation aromatase inhibitor (AI) most widely used in assisted reproduction. AIs induce ovulation by inhibiting estrogen production; the consequent hypoestrogenic state increases GnRH release and pituitary follicle-stimulating hormone (FSH) synthesis. METHODS A systematic search of the literature was performed for both prospective and retrospective studies. Meta-analyses of randomized clinical trials (RCTs) were performed for three comparisons: letrozole versus clomiphene citrate (CC), letrozole + FSH versus FSH in intrauterine insemination (IUI) and letrozole + FSH versus FSH in IVF. In the absence of RCTs, non-randomized studies were pooled. RESULTS Nine studies were included in the meta-analysis. Four RCTs compared the overall effect of letrozole with CC in patients with polycystic ovary syndrome. The pooled result was not significant for ovulatory cycles (OR = 1.17; 95% CI 0.66–2.09), or for pregnancy rate per cycle (OR = 1.47; 95% CI 0.73–2.96) or for pregnancy rate per patient (OR = 1.37; 95% CI 0.70–2.71). In three retrospective studies which compared L + FSH with FSH in ovarian stimulation for IUI, the pooled OR was 1.15 (95% CI 0.78−1.71). A final meta-analysis included one RCT and one cohort study that compared letrozole + gonadotrophin versus gonadotrophin alone: the pooled pregnancy rate per patient was not significantly different (OR = 1.40; 95% CI 0.67–2.91). CONCLUSIONS Letrozole is as effective as other methods of ovulation induction. Further randomized-controlled studies are warranted to define more clearly the efficacy and safety of letrozole in human reproduction. PMID:18812422

  16. A State-of-the-Art Systematic Content Analysis of Games for Health.

    Science.gov (United States)

    Lu, Amy Shirong; Kharrazi, Hadi

    2018-02-01

    As the field of games for health continues to gain momentum, it is crucial to document the field's scale of growth, identify design patterns, and to address potential design issues for future health game development. Few studies have explored the attributes and usability features of games for health as a whole over time. We offer the first comprehensive systematic content analysis of digital games for health by examining 1743 health games released between 1983 and 2016 in 23 countries extracted from nine international English health game databases and directories. The majority of these games were developed in the United States (67.18%) and France (18.59%). The most popular platforms included web browsers (72.38%) and Windows (14.41%). Approximately four out of five (79.12%) of the games were available at no cost. We coded 1553 accessible games for an in-depth analysis and further assessed 1303 for usability. Popular health topics represented included: cognitive training (37.41%), indirect health education (13.33%), and medical care provision (9.98%). Most games (75.66%) could be completed within 60 minutes. The main game usability problems identified included a lack of customization, nonskippable contents, and a lack of feedback and instruction to the players. While most of the usability problems have improved as did the software and hardware technology, the players' ability to skip nonplayable contents has become slightly more restricted overtime. Comparison with game efficacy publications suggested that a further understanding of the scope for games for health is needed on a global level.

  17. Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases.

    Science.gov (United States)

    Montgomery, Connor; Blackburn, Jeff; Withers, Daniel; Tierney, Gregory; Moran, Cathal; Simms, Ciaran

    2016-12-30

    The mechanisms of ACL injury in rugby are not well defined. To describe the mechanisms of ACL injury in male professional rugby players using systematic video analysis. 36 cases from games played in top professional leagues and international matches were analysed. 5 analysts independently assessed all videos to record the estimated frame/time of initial ground contact, frame/time of ACL tear and a range of play specific variables. This included contact versus non-contact ACL injuries, injury timing, joint flexion angles and foot contact with the ground. 37 side-stepping manoeuvres from a control game were analysed to allow comparison of non-injury versus injury situations. 57% of ACL injuries occurred in a contact manner. 2 main scenarios were identified: (1) offensive running and (2) being tackled, indicating that the ball carrier might be at higher risk of ACL injury. The majority of non-contact ACL injuries resulted from a side-stepping manoeuvre. In most non-contact cases, initial ground contact was through heel strike. Statistical assessment of heel strike at initial ground contact versus non-heel strike cases showed a significant difference in injury versus non-injury outcomes, with heel strike associated with higher injury risk. Non-contact ACL injuries had lower median knee flexion angles and a more dorsiflexed ankle when compared with a control group (10° vs 20°, p≤0.001 and 10° vs 0°, p=0.033 respectively). Over half of ACL injuries in rugby in our analysis resulted from a contact mechanism. For non-contact injuries, lower knee flexion angles and heel-first ground contact in a side-stepping manoeuvre were associated with ACL injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Bond strength of universal adhesives: A systematic review and meta-analysis.

    Science.gov (United States)

    Rosa, Wellington Luiz de Oliveira da; Piva, Evandro; Silva, Adriana Fernandes da

    2015-07-01

    A systematic review was conducted to determine whether the etch-and-rinse or self-etching mode is the best protocol for dentin and enamel adhesion by universal adhesives. This report followed the PRISMA Statement. A total of 10 articles were included in the meta-analysis. Two reviewers performed a literature search up to October 2014 in eight databases: PubMed, Web of Science, Scopus, BBO, SciELO, LILACS, IBECS and The Cochrane Library. In vitro studies evaluating the bond strength of universal adhesives to dentin and/or enamel by the etch-and-rinse and self-etch strategies were eligible to be selected. Statistical analyses were conducted using RevMan 5.1 (The Cochrane Collaboration, Copenhagen, Denmark). A global comparison was performed with random-effects models at a significance level of puniversal adhesives (p≥0.05). However, for the ultra-mild All-Bond Universal adhesive, the etch-and-rinse strategy was significantly different than the self-etch mode in terms of dentin micro-tensile bond strength, as well as in the global analysis of enamel micro-tensile and micro-shear bond strength (p≤0.05). The enamel bond strength of universal adhesives is improved with prior phosphoric acid etching. However, this effect was not evident for dentin with the use of mild universal adhesives with the etch-and-rinse strategy. Selective enamel etching prior to the application of a mild universal adhesive is an advisable strategy for optimizing bonding. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Comparison between Still photography and videography for smile analysis

    Directory of Open Access Journals (Sweden)

    Jyoti Chaudhary

    2017-01-01

    Full Text Available Introduction: The aim of this systematic review was to compare still photography and videography for smile analysis. Materials and Methods: Based on the available data, two authors conducted an electronic database PubMed search from January 1, 2000, to December 31, 2015, and ten strategies were designed using five keywords along with their respective synonyms. Twelve articles were shortlisted for the systematic review. Results: The search yielded 91 articles, of which 12 were included based on the selection criteria. Of these 12, five concluded videography compared to be a better tool. Seven articles had variable conclusions based on the study setting and population evaluated. Conclusions: Digital video clips offer a tremendous amount of information for analyzing the dynamic character of the smile, but a standard digital photograph allows for immediate viewing.

  20. Network meta-analysis: a technique to gather evidence from direct and indirect comparisons

    Science.gov (United States)

    2017-01-01

    Systematic reviews and pairwise meta-analyses of randomized controlled trials, at the intersection of clinical medicine, epidemiology and statistics, are positioned at the top of evidence-based practice hierarchy. These are important tools to base drugs approval, clinical protocols and guidelines formulation and for decision-making. However, this traditional technique only partially yield information that clinicians, patients and policy-makers need to make informed decisions, since it usually compares only two interventions at the time. In the market, regardless the clinical condition under evaluation, usually many interventions are available and few of them have been studied in head-to-head studies. This scenario precludes conclusions to be drawn from comparisons of all interventions profile (e.g. efficacy and safety). The recent development and introduction of a new technique – usually referred as network meta-analysis, indirect meta-analysis, multiple or mixed treatment comparisons – has allowed the estimation of metrics for all possible comparisons in the same model, simultaneously gathering direct and indirect evidence. Over the last years this statistical tool has matured as technique with models available for all types of raw data, producing different pooled effect measures, using both Frequentist and Bayesian frameworks, with different software packages. However, the conduction, report and interpretation of network meta-analysis still poses multiple challenges that should be carefully considered, especially because this technique inherits all assumptions from pairwise meta-analysis but with increased complexity. Thus, we aim to provide a basic explanation of network meta-analysis conduction, highlighting its risks and benefits for evidence-based practice, including information on statistical methods evolution, assumptions and steps for performing the analysis. PMID:28503228

  1. Accommodating error analysis in comparison and clustering of molecular fingerprints.

    Science.gov (United States)

    Salamon, H; Segal, M R; Ponce de Leon, A; Small, P M

    1998-01-01

    Molecular epidemiologic studies of infectious diseases rely on pathogen genotype comparisons, which usually yield patterns comprising sets of DNA fragments (DNA fingerprints). We use a highly developed genotyping system, IS6110-based restriction fragment length polymorphism analysis of Mycobacterium tuberculosis, to develop a computational method that automates comparison of large numbers of fingerprints. Because error in fragment length measurements is proportional to fragment length and is positively correlated for fragments within a lane, an align-and-count method that compensates for relative scaling of lanes reliably counts matching fragments between lanes. Results of a two-step method we developed to cluster identical fingerprints agree closely with 5 years of computer-assisted visual matching among 1,335 M. tuberculosis fingerprints. Fully documented and validated methods of automated comparison and clustering will greatly expand the scope of molecular epidemiology.

  2. AA1000 and SA8000 compared: a systematic comparison of contemporary accountability standards

    NARCIS (Netherlands)

    Göbbels, M.; Jonker, J.

    2003-01-01

    One of the ways to deal with stakeholder issues, is the use and application of accountability standards. Two recent accountability standards (AA1000 and SA8000) will be the subject of comparison in this paper. Firstly, the constituent elements of these new standards will be briefly described. The

  3. A systematic analysis of the association studies between CASP8 ...

    Indian Academy of Sciences (India)

    precision medicine or health. Keywords: Breast cancer; CASP8; rs1045485 polymorphism; meta-analysis. Introduction. CASP8 ... peptidase that can activate various cellular proteases or proteins, leading to apoptosis through the .... While meta-analysis shed light on the trend of association between SNP and disease risk,.

  4. The isoelectric region of proteins: a systematic analysis.

    Directory of Open Access Journals (Sweden)

    Michael Widmann

    Full Text Available BACKGROUND: Binding of proteins in ion exchange chromatography is dominated by electrostatic interactions and can be tuned by adjusting pH and ionic strength of the solvent. Therefore, the isoelectric region (IER, the pH region of almost zero charge near the pI, has been used to predict the binding properties of proteins. PRINCIPAL FINDINGS: Usually the IER is small and binding and elution is carried out at pH values near to the pI. However, some proteins with an extended IER have been shown to bind and elute far away from its pI. To analyze factors that mediate the size of the IER and to identify proteins with an extended IER, two protein families consisting of more than 7000 proteins were systematically investigated. Most proteins were found to have a small IER and thus are expected to bind or elute near to their pI, while only a small fraction of less than 2% had a large IER. CONCLUSIONS: Only four factors, the number of histidines, the pI, the number of titratable amino acids and the ratio of acidic to basic residues, are sufficient to reliably classify proteins by their IER based on their sequence only, and thus to predict their binding and elution behaviour in ion exchange chromatography.

  5. Systematic Analysis of Painful Total Knee Prosthesis, a Diagnostic Algorithm

    Directory of Open Access Journals (Sweden)

    Oliver Djahani

    2013-12-01

    Full Text Available   Remaining pain after total knee arthroplasty (TKA is a common observation in about 20% of postoperative patients; where in about 60% of these knees require early revision surgery within five years. Obvious causes of this pain could be identified simply with clinical examinations and standard radiographs. However, unexplained painful TKA still remains a challenge for the surgeon. The management should include a multidisciplinary approach to the patient`s pain as well as addressing the underlying etiology. There are a number of extrinsic (tendinopathy, hip, ankle, spine, CRPS and so on and intrinsic (infection, instability, malalignment, wear and so on causes of painful knee replacement. On average, diagnosis takes more than 12 months and patients become very dissatisfied and some of them even acquire psychological problems. Hence, a systematic diagnostic algorithm might be helpful. This review article aims to act as a guide to the evaluation of patients with painful TKA described in 10 different steps. Furthermore, the preliminary results of a series of 100 consecutive cases will be discussed. Revision surgery was performed only in those cases with clear failure mechanism.

  6. Molecular malaria diagnostics: A systematic review and meta-analysis.

    Science.gov (United States)

    Roth, Johanna M; Korevaar, Daniël A; Leeflang, Mariska M G; Mens, Pètra F

    2016-01-01

    Accurate diagnosis of malaria is essential for identification and subsequent treatment of the disease. Currently, microscopy and rapid diagnostic tests are the most commonly used diagnostics, next to treatment based on clinical signs only. These tests are easy to deploy, but have a relatively high detection limit. With declining prevalence in many areas, there is an increasing need for more sensitive diagnostics. Molecular tools may be a suitable alternative, although costs and technical requirements currently hamper their implementation in resource limited settings. A range of (near) point-of-care diagnostics is therefore under development, including simplifications in sample preparation, amplification and/or read-out of the test. Accuracy data, in combination with technical characteristics, are essential in determining which molecular test, if any, would be the most promising to be deployed. This review presents a comprehensive overview of the currently available molecular malaria diagnostics, ranging from well-known tests to platforms in early stages of evaluation, and systematically evaluates their published accuracy. No important difference in accuracy was found between the most commonly used PCR-based assays (conventional, nested and real-time PCR), with most of them having high sensitivity and specificity, implying that there are no reasons other than practical ones to choose one technique over the other. Loop-mediated isothermal amplification and other (novel) diagnostics appear to be highly accurate as well, with some offering potential to be used in resource-limited settings.

  7. Critical analysis and systematization of rat pancreatectomy terminology.

    Science.gov (United States)

    Eulálio, José Marcus Raso; Bon-Habib, Assad Charbel Chequer; Soares, Daiane de Oliveira; Corrêa, Paulo Guilherme Antunes; Pineschi, Giovana Penna Firme; Diniz, Victor Senna; Manso, José Eduardo Ferreira; Schanaider, Alberto

    2016-10-01

    To critically analyze and standardize the rat pancreatectomy nomenclature variants. It was performed a review of indexed manuscripts in PUBMED from 01/01/1945 to 31/12/2015 with the combined keywords "rat pancreatectomy" and "rat pancreas resection". The following parameters was considered: A. Frequency of publications; B. Purpose of the pancreatectomy in each article; C. Bibliographic references; D. Nomenclature of techniques according to the pancreatic parenchyma resection percentage. Among the 468, the main objectives were to surgically induce diabetes and to study the genes regulations and expressions. Five rat pancreatectomy technique references received 15 or more citations. Twenty different terminologies were identified for the pancreas resection: according to the resected parenchyma percentage (30 to 95%); to the procedure type (total, subtotal and partial); or based on the selected anatomical region (distal, longitudinal and segmental). A nomenclature systematization was gathered by cross-checking information between the main surgical techniques, the anatomic parameters descriptions and the resected parenchyma percentages. The subtotal pancreatectomy nomenclature for parenchymal resection between 80 and 95% establishes a surgical parameter that also defines the total and partial pancreatectomy limits and standardizes these surgical procedures in rats.

  8. Breastfeeding and intelligence: a systematic review and meta-analysis.

    Science.gov (United States)

    Horta, Bernardo L; Loret de Mola, Christian; Victora, Cesar G

    2015-12-01

    This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests. Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity. We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random-effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta-regression, none of the study characteristics explained the heterogeneity among the studies. Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  9. Multimorbidity and depression: A systematic review and meta-analysis.

    Science.gov (United States)

    Read, Jennifer R; Sharpe, Louise; Modini, Matthew; Dear, Blake F

    2017-10-15

    Multimorbidity, the presence of two or more chronic conditions, is increasingly common and complicates the assessment and management of depression. The aim was to investigate the relationship between multimorbidity and depression. A systematic literature search was conducted using the databases; PsychINFO, Medline, Embase, CINAHL and Cochrane Central. Results were meta-analysed to determine risk for a depressive disorder or depressive symptoms in people with multimorbidity. Forty articles were identified as eligible (n = 381527). The risk for depressive disorder was twice as great for people with multimorbidity compared to those without multimorbidity [RR: 2.13 (95% CI 1.62-2.80) pdepressive disorder with each additional chronic condition compared to the odds of having a depressive disorder with no chronic physical condition [OR: 1.45 (95% CI 1.28-1.64) pdepressive symptoms [r = 0.26 (95% CI 0.18-0.33) p depression were used in these studies, the majority assessed the presence or absence of multimorbidity by self-report measures. Depression is two to three times more likely in people with multimorbidity compared to people without multimorbidity or those who have no chronic physical condition. Greater knowledge of this risk supports identification and management of depression. Copyright © 2017. Published by Elsevier B.V.

  10. Social comparison processes and catastrophising in fibromyalgia: A path analysis.

    Science.gov (United States)

    Cabrera-Perona, V; Buunk, A P; Terol-Cantero, M C; Quiles-Marcos, Y; Martín-Aragón, M

    2017-06-01

    In addition to coping strategies, social comparison may play a role in illness adjustment. However, little is known about the role of contrast and identification in social comparison in adaptation to fibromyalgia. To evaluate through a path analysis in a sample of fibromyalgia patients, the association between identification and contrast in social comparison, catastrophising and specific health outcomes (fibromyalgia illness impact and psychological distress). 131 Spanish fibromyalgia outpatients (mean age: 50.15, SD = 11.1) filled out a questionnaire. We present a model that explained 33% of the variance in catastrophising by direct effects of more use of upward contrast and downward identification. In addition, 35% of fibromyalgia illness impact variance was explained by less upward identification, more upward contrast and more catastrophising and 42% of the variance in psychological distress by a direct effect of more use of upward contrast together with higher fibromyalgia illness impact. We suggest that intervention programmes with chronic pain and fibromyalgia patients should focus on enhancing the use of upward identification in social comparison, and on minimising the use of upward contrast and downward identification in social comparison.

  11. Dual-use tools and systematics-aware analysis workflows in the ATLAS Run-II analysis model

    CERN Document Server

    FARRELL, Steven; The ATLAS collaboration

    2015-01-01

    The ATLAS analysis model has been overhauled for the upcoming run of data collection in 2015 at 13 TeV. One key component of this upgrade was the Event Data Model (EDM), which now allows for greater flexibility in the choice of analysis software framework and provides powerful new features that can be exploited by analysis software tools. A second key component of the upgrade is the introduction of a dual-use tool technology, which provides abstract interfaces for analysis software tools to run in either the Athena framework or a ROOT-based framework. The tool interfaces, including a new interface for handling systematic uncertainties, have been standardized for the development of improved analysis workflows and consolidation of high-level analysis tools. This presentation will cover the details of the dual-use tool functionality, the systematics interface, and how these features fit into a centrally supported analysis environment.

  12. Dual-use tools and systematics-aware analysis workflows in the ATLAS Run-2 analysis model

    CERN Document Server

    FARRELL, Steven; The ATLAS collaboration; Calafiura, Paolo; Delsart, Pierre-Antoine; Elsing, Markus; Koeneke, Karsten; Krasznahorkay, Attila; Krumnack, Nils; Lancon, Eric; Lavrijsen, Wim; Laycock, Paul; Lei, Xiaowen; Strandberg, Sara Kristina; Verkerke, Wouter; Vivarelli, Iacopo; Woudstra, Martin

    2015-01-01

    The ATLAS analysis model has been overhauled for the upcoming run of data collection in 2015 at 13 TeV. One key component of this upgrade was the Event Data Model (EDM), which now allows for greater flexibility in the choice of analysis software framework and provides powerful new features that can be exploited by analysis software tools. A second key component of the upgrade is the introduction of a dual-use tool technology, which provides abstract interfaces for analysis software tools to run in either the Athena framework or a ROOT-based framework. The tool interfaces, including a new interface for handling systematic uncertainties, have been standardized for the development of improved analysis workflows and consolidation of high-level analysis tools. This paper will cover the details of the dual-use tool functionality, the systematics interface, and how these features fit into a centrally supported analysis environment.

  13. A comparison of two search methods for determining the scope of systematic reviews and health technology assessments.

    Science.gov (United States)

    Forsetlund, Louise; Kirkehei, Ingvild; Harboe, Ingrid; Odgaard-Jensen, Jan

    2012-01-01

    This study aims to compare two different search methods for determining the scope of a requested systematic review or health technology assessment. The first method (called the Direct Search Method) included performing direct searches in the Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and the Health Technology Assessments (HTA). Using the comparison method (called the NHS Search Engine) we performed searches by means of the search engine of the British National Health Service, NHS Evidence. We used an adapted cross-over design with a random allocation of fifty-five requests for systematic reviews. The main analyses were based on repeated measurements adjusted for the order in which the searches were conducted. The Direct Search Method generated on average fewer hits (48 percent [95 percent confidence interval {CI} 6 percent to 72 percent], had a higher precision (0.22 [95 percent CI, 0.13 to 0.30]) and more unique hits than when searching by means of the NHS Search Engine (50 percent [95 percent CI, 7 percent to 110 percent]). On the other hand, the Direct Search Method took longer (14.58 minutes [95 percent CI, 7.20 to 21.97]) and was perceived as somewhat less user-friendly than the NHS Search Engine (-0.60 [95 percent CI, -1.11 to -0.09]). Although the Direct Search Method had some drawbacks such as being more time-consuming and less user-friendly, it generated more unique hits than the NHS Search Engine, retrieved on average fewer references and fewer irrelevant results.

  14. The effects of lasers on bond strength to ceramic materials: A systematic review and meta-analysis.

    Science.gov (United States)

    García-Sanz, Verónica; Paredes-Gallardo, Vanessa; Mendoza-Yero, Omel; Carbonell-Leal, Miguel; Albaladejo, Alberto; Montiel-Company, José María; Bellot-Arcís, Carlos

    2018-01-01

    Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective. A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed. Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces. High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type.

  15. The effects of lasers on bond strength to ceramic materials: A systematic review and meta-analysis

    Science.gov (United States)

    García-Sanz, Verónica; Mendoza-Yero, Omel; Carbonell-Leal, Miguel; Albaladejo, Alberto; Montiel-Company, José María; Bellot-Arcís, Carlos

    2018-01-01

    Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective. A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed. Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces. High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type. PMID:29293633

  16. Streptococcus suis Meningitis: A Systematic Review and Meta-analysis

    Science.gov (United States)

    van Samkar, Anusha; Brouwer, Matthijs C.; Schultsz, Constance; van der Ende, Arie; van de Beek, Diederik

    2015-01-01

    Background Streptococcus suis is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on S. suis meningitis to define the clinical characteristics, predisposing factors and outcome. Methodology Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with S. suis meningitis in whom at least one clinical characteristic was described. Findings We identified 913 patients with S. suis meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%). Exposure to pigs or pork was present in 395 of 648 patients (61%) while other predisposing factors were less common. 514 of 528 patients presented with fever (97%), 429 of 451 with headache (95%), 462 of 496 with neck stiffness (93%) and 78 of 384 patients (20%) had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%). Treatment included dexamethasone in 157 of 300 (52%) of patients and was associated with reduced hearing loss in S. suis meningitis patients included in a randomized controlled trial. Conclusion S. suis meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss. PMID:26505485

  17. Comparison of Marginal Bone Loss Between Implants with Internal and External Connections: A Systematic Review.

    Science.gov (United States)

    Palacios-Garzón, Natalia; Mauri-Obradors, Elisabeth; Roselló-LLabrés, Xavier; Estrugo-Devesa, Albert; Jané-Salas, Enric; López-López, José

    The objective of this systematic review was to compare the loss of marginal bone between implants with internal and external connections by analyzing results reported in studies published after 2010. A literature search in MEDLINE with the keywords "dental implant connections, external internal implant connection, bone loss implant designs, internal and external connection implant studies in humans" was conducted. Clinical trials on human beings, comparing both connections and published in English, from 2010 to 2016 were selected. Their methodologic quality was assessed using the Jadad scale. From the initial search, 415 articles were obtained; 32 were chosen as potentially relevant based on their titles and abstracts. Among them, only 10 finally met the inclusion criteria. A total of 1,523 patients with 3,965 implants were analyzed. Six out of 10 studies observed that internal connections showed significantly less bone loss compared with external connections. The remaining four articles did not find statistically significant differences between the two connections. According to this systematic review and considering its limitation due to the degree of heterogeneity between the included studies, both internal and external connections present high survival rates. To assess whether marginal bone loss differs significantly between the two connections, more homogenous clinical studies are needed with identical implant characteristics, larger samples, and longer follow-up periods. Studies included in this review and characterized by long-term follow-ups showed that the external connection is a reliable connection on a long-term basis.

  18. A systematic intercomparison of regional flood frequency analysis models in a simulation framework

    Science.gov (United States)

    Ganora, Daniele; Laio, Francesco; Claps, Pierluigi

    2015-04-01

    Regional frequency analysis (RFA) is a well-established methodology to provide an estimate of the flood frequency curve (or other discharge-related variables), based on the fundamental concept of substituting temporal information at a site (no data or short time series) by exploiting observations at other sites (spatial information). Different RFA paradigms exist, depending on the way the information is transferred to the site of interest. Despite the wide use of such methodology, a systematic comparison between these paradigms has not been performed. The aim of this study is to provide a framework wherein carrying out the intercomparison: we thus synthetically generate data through Monte Carlo simulations for a number of (virtual) stations, following a GEV parent distribution; different scenarios can be created to represent different spatial heterogeneity patterns by manipulating the parameters of the parent distribution at each station (e.g. with a linear variation in space of the shape parameter of the GEV). A special case is the homogeneous scenario where each station record is sampled from the same parent distribution. For each scenario and each simulation, different regional models are applied to evaluate the 200-year growth factor at each station. Results are than compared to the exact growth factor of each station, which is known in our virtual world. Considered regional approaches include: (i) a single growth curve for the whole region; (ii) a multiple-region model based on cluster analysis which search for an adequate number of homogeneous subregions; (iii) a Region-of-Influence model which defines a homogeneous subregion for each site; (iv) a spatially-smooth estimation procedure based on linear regressions.. A further benchmark model is the at-site estimate based on the analysis of the local record. A comprehensive analysis of the results of the simulations shows that, if the scenario is homogeneous (no spatial variability), all the regional approaches

  19. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis.

    Science.gov (United States)

    Cipriani, Andrea; Hawton, Keith; Stockton, Sarah; Geddes, John R

    2013-06-27

    To assess whether lithium has a specific preventive effect for suicide and self harm in people with unipolar and bipolar mood disorders. Systematic review and meta-analysis. Medline, Embase, CINAHL, PsycINFO, CENTRAL, web based clinical trial registries, major textbooks, authors of important papers and other experts in the discipline, and websites of pharmaceutical companies that manufacture lithium or the comparator drugs (up to January 2013). Randomised controlled trials comparing lithium with placebo or active drugs in long term treatment for mood disorders. Two reviewers assessed studies for inclusion and risk of bias and extracted data. The main outcomes were the number of people who completed suicide, engaged in deliberate self harm, and died from any cause. 48 randomised controlled trials (6674 participants, 15 comparisons) were included. Lithium was more effective than placebo in reducing the number of suicides (odds ratio 0.13, 95% confidence interval 0.03 to 0.66) and deaths from any cause (0.38, 0.15 to 0.95). No clear benefits were observed for lithium compared with placebo in preventing deliberate self harm (0.60, 0.27 to 1.32). In unipolar depression, lithium was associated with a reduced risk of suicide (0.36, 0.13 to 0.98) and also the number of total deaths (0.13, 0.02 to 0.76) compared with placebo. When lithium was compared with each active individual treatment a statistically significant difference was found only with carbamazepine for deliberate self harm. Lithium tended to be generally better than the other active comparators, with small statistical variation between the results. Lithium is an effective treatment for reducing the risk of suicide in people with mood disorders. Lithium may exert its antisuicidal effects by reducing relapse of mood disorder, but additional mechanisms should also be considered because there is some evidence that lithium decreases aggression and possibly impulsivity, which might be another mechanism mediating the

  20. Climateprediction.com: Public Involvement, Multi-Million Member Ensembles and Systematic Uncertainty Analysis

    Science.gov (United States)

    Stainforth, D. A.; Allen, M.; Kettleborough, J.; Collins, M.; Heaps, A.; Stott, P.; Wehner, M.

    2001-12-01

    The climateprediction.com project is preparing to carry out the first systematic uncertainty analysis of climate forecasts using large ensembles of GCM climate simulations. This will be done by involving schools, businesses and members of the public, and utilizing the novel technology of distributed computing. Each participant will be asked to run one member of the ensemble on their PC. The model used will initially be the UK Met Office's Unified Model (UM). It will be run under Windows and software will be provided to enable those involved to view their model output as it develops. The project will use this method to carry out large perturbed physics GCM ensembles and thereby analyse the uncertainty in the forecasts from such models. Each participant/ensemble member will therefore have a version of the UM in which certain aspects of the model physics have been perturbed from their default values. Of course the non-linear nature of the system means that it will be necessary to look not just at perturbations to individual parameters in specific schemes, such as the cloud parameterization, but also to the many combinations of perturbations. This rapidly leads to the need for very large, perhaps multi-million member ensembles, which could only be undertaken using the distributed computing methodology. The status of the project will be presented and the Windows client will be demonstrated. In addition, initial results will be presented from beta test runs using a demo release for Linux PCs and Alpha workstations. Although small by comparison to the whole project, these pilot results constitute a 20-50 member perturbed physics climate ensemble with results indicating how climate sensitivity can be substantially affected by individual parameter values in the cloud scheme.

  1. Causes of Death Following Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Xiong, Tian-Yuan; Liao, Yan-Biao; Zhao, Zhen-Gang; Xu, Yuan-Ning; Wei, Xin; Zuo, Zhi-Liang; Li, Yi-Jian; Cao, Jia-Yu; Tang, Hong; Jilaihawi, Hasan; Feng, Yuan; Chen, Mao

    2015-09-21

    Transcatheter aortic valve replacement (TAVR) is an effective alternative to surgical aortic valve replacement in patients at high surgical risk. However, there is little published literature on the exact causes of death. The PubMed database was systematically searched for studies reporting causes of death within and after 30 days following TAVR. Twenty-eight studies out of 3934 results retrieved were identified. In the overall analysis, 46.4% and 51.6% of deaths were related to noncardiovascular causes within and after the first 30 days, respectively. Within 30 days of TAVR, infection/sepsis (18.5%), heart failure (14.7%), and multiorgan failure (13.2%) were the top 3 causes of death. Beyond 30 days, infection/sepsis (14.3%), heart failure (14.1%), and sudden death (10.8%) were the most common causes. All possible subgroup analyses were made. No significant differences were seen for proportions of cardiovascular deaths except the comparison between moderate (mean STS score 4 to 8) and high (mean STS score >8) -risk patients after 30 days post-TAVR (56.0% versus 33.5%, P=0.005). Cardiovascular and noncardiovascular causes of death are evenly balanced both in the perioperative period and at long-term follow-up after TAVR. Infection/sepsis and heart failure were the most frequent noncardiovascular and cardiovascular causes of death. This study highlights important areas of clinical focus that could further improve outcomes after TAVR. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta-analysis.

    Science.gov (United States)

    Cairo, Francesco; Pagliaro, Umberto; Buti, Jacopo; Baccini, Michela; Graziani, Filippo; Tonelli, Paolo; Pagavino, Gabriella; Tonetti, Maurizio S

    2016-11-01

    The aim of this study was to perform a systematic review (SR) of randomized controlled trials (RCTs) to explore if periodontal plastic surgery procedures for the treatment of single and multiple gingival recessions (Rec) may improve aesthetics at patient and professional levels. In order to combine evidence from direct and indirect comparisons by different trials a Bayesian network meta-analysis (BNM) was planned. A literature search on PubMed, Cochrane libraries, EMBASE, and hand-searched journals until January 2016 was conducted to identify RCTs presenting aesthetic outcomes after root coverage using standardized evaluations at patient and professional level. A total of 16 RCTs were selected in the SR; three RTCs presenting professional aesthetic evaluation with Root coverage Aesthetic Score (RES) and three showing final self-perception using the Visual Analogue Scale (VAS Est) could be included in a BNM model. Coronally Advanced Flap plus Connective Tissue Graft (CAF + CTG) and CAF + Acellular Dermal Matrix (ADM) and Autologous Fibroblasts (AF) were associated with the best RES outcomes (best probability = 24% and 64%, respectively), while CAF + CTG and CAF + CTG + Enamel matrix Derivatives (EMD) obtained highest values of VAS Est score (best probability = 44% and 26%, respectively). Periodontal Plastic Surgery (PPS) techniques applying grafts underneath CAF with or without the adding of EMD are associated with improved aesthetics assessed by final patient perception and RES as professional evaluation system. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Systematic reviews in Library and Information Science: analysis and evaluation of the search process

    Directory of Open Access Journals (Sweden)

    José Antonio Salvador-Oliván

    2018-05-01

    Full Text Available Objective: An essential component of a systematic review is the development and execution of a literature search to identify all available and relevant published studies. The main objective of this study is to analyse and evaluate whether the systematic reviews in Library and Information Science (LIS provide complete information on all the elements that make up the search process. Methods: A search was launched in WOS, Scopus, LISTA, Library Science Database, Medline databases and a wiki published from 2000 to February 2017, in order to find and identify systematic reviews. The search was designed to find those records whose titles included the words “systematic review” and/or “meta-analysis”. A list was created with the twelve items recommended from of the main publication guides, to assess the information degree on each of them. Results and conclusions: Most of the reviews in LIS are created by information professionals. From the 94 systematic reviews selected for analysis, it was found that only a 4.3% provided the complete reporting on the search method. The most frequently included item is the name of the database (95.6% and the least one is the name of the host (35.8%. It is necessary to improve and complete the information about the search processes in the complete reports from LIS systematic reviews for reproducibility, updating and quality assessment improvement.

  4. Occupational and environmental scleroderma. Systematic review and meta-analysis.

    Science.gov (United States)

    Rubio-Rivas, Manuel; Moreno, Rafael; Corbella, Xavier

    2017-03-01

    The etiology of systemic sclerosis (SSc) remains unknown; however, several occupational and environmental factors have been implicated. Our objective was to perform a meta-analysis of all studies published on SSc associated with occupational and environmental exposure. The review was undertaken by means of MEDLINE and SCOPUS from 1960 to 2014 and using the terms: "systemic," "scleroderma," or "systemic sclerosis/chemically induced" [MesH]. The Newcastle-Ottawa Scale was used for the qualifying assessment. The inverse variance-weighted method was performed. The meta-analysis of silica exposure included 15 case-control studies [overall OR 2.81 (95%CI 1.86-4.23; p < 0.001)] and 4 cohort studies [overall RR 17.52 (95%CI 5.98-51.37; p < 0.001)]; the meta-analysis of solvents exposure included 13 case-control studies (overall OR 2.00 [95%CI 1.32-3.02; p = 0.001); the meta-analysis of breast implants exposure included 4 case-control studies (overall OR 1.68 (95%CI 1.65-1.71; p < 0.001)) and 6 cohort studies (overall RR 2.13 (95%CI 0.86-5.27; p = 0.10)); the meta-analysis of epoxy resins exposure included 4 case-control studies (overall OR 2.97 (95%CI 2.31-3.83; p < 0.001)), the meta-analysis of pesticides exposure included 3 case-control studies (overall OR 1.02 (95%CI 0.78-1.32; p = 0.90)) and, finally, the meta-analysis of welding fumes exposure included 4 studies (overall OR 1.29 (95%CI 0.44-3.74; p = 0.64)). Not enough studies citing risks related to hair dyes have been published to perform an accurate meta-analysis. Silica and solvents were the two most likely substances related to the pathogenesis of SSc. While silica is involved in particular jobs, solvents are widespread and more people are at risk of having incidental contact with them.

  5. Data Analysis A Model Comparison Approach, Second Edition

    CERN Document Server

    Judd, Charles M; Ryan, Carey S

    2008-01-01

    This completely rewritten classic text features many new examples, insights and topics including mediational, categorical, and multilevel models. Substantially reorganized, this edition provides a briefer, more streamlined examination of data analysis. Noted for its model-comparison approach and unified framework based on the general linear model, the book provides readers with a greater understanding of a variety of statistical procedures. This consistent framework, including consistent vocabulary and notation, is used throughout to develop fewer but more powerful model building techniques. T

  6. SYSTEMATIZATION AND ANALYSIS OF PARTIALLY AND FULLY HOMOMORPHIC CRYPTOSYSTEM

    Directory of Open Access Journals (Sweden)

    A. V. Epishkina

    2016-12-01

    Full Text Available In this article provides an overview of the known partially and fully homomorphic cryptosystem, such as: RSA, ElGamal, Paillier, Gentry and Halevi. Justified the homomorphic properties of the considered cryptosystems. The comparative analysis of the homomorphic encryption algorithms has been committed

  7. Trends in Autism Research: A Systematic Journal Analysis

    Science.gov (United States)

    Graff, Heidi J.; Berkeley, Sheri; Evmenova, Anya S.; Park, Kristy L.

    2014-01-01

    Autism Spectrum Disorder (ASD) is a lifelong disability for which prevalence rates continue to increase. Persons with ASD vary widely in both severity of disability and services required. Therefore it is important to identify trends in research and evaluate progress in the field. The current study uses a journal analysis to evaluate research over…

  8. A Systematic Analysis of Audiological Services in EHDI

    Science.gov (United States)

    Munoz, Karen F.; Bradham, Tamala S.; Nelson, Lauri

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. For audiological evaluation and services, 299 items were listed by 49 coordinators, and themes were identified within each SWOT category.…

  9. Analysis of possible systematic errors in the Oslo method

    International Nuclear Information System (INIS)

    Larsen, A. C.; Guttormsen, M.; Buerger, A.; Goergen, A.; Nyhus, H. T.; Rekstad, J.; Siem, S.; Toft, H. K.; Tveten, G. M.; Wikan, K.; Krticka, M.; Betak, E.; Schiller, A.; Voinov, A. V.

    2011-01-01

    In this work, we have reviewed the Oslo method, which enables the simultaneous extraction of the level density and γ-ray transmission coefficient from a set of particle-γ coincidence data. Possible errors and uncertainties have been investigated. Typical data sets from various mass regions as well as simulated data have been tested against the assumptions behind the data analysis.

  10. Accident Analysis Methods and Models — a Systematic Literature Review

    NARCIS (Netherlands)

    Wienen, Hans Christian Augustijn; Bukhsh, Faiza Allah; Vriezekolk, E.; Wieringa, Roelf J.

    2017-01-01

    As part of our co-operation with the Telecommunication Agency of the Netherlands, we want to formulate an accident analysis method and model for use in incidents in telecommunications that cause service unavailability. In order to not re-invent the wheel, we wanted to first get an overview of all

  11. Systematic comparison of crystalline and amorphous phases: Charting the landscape of water structures and transformations

    International Nuclear Information System (INIS)

    Pietrucci, Fabio; Martoňák, Roman

    2015-01-01

    Systematically resolving different crystalline phases starting from the atomic positions, a mandatory step in algorithms for the prediction of structures or for the simulation of phase transitions, can be a non-trivial task. Extending to amorphous phases and liquids which lack the discrete symmetries, the problem becomes even more difficult, involving subtle topological differences at medium range that, however, are crucial to the physico-chemical and spectroscopic properties of the corresponding materials. Typically, system-tailored order parameters are devised, like global or local symmetry indicators, ring populations, etc. We show that a recently introduced metric provides a simple and general solution to this intricate problem. In particular, we demonstrate that a map can be traced displaying distances among water phases, including crystalline as well as amorphous states and the liquid, consistently with experimental knowledge in terms of phase diagram, structural features, and preparation routes

  12. A comparison of national guidelines for network meta-analysis.

    Science.gov (United States)

    Laws, Andrew; Kendall, Robyn; Hawkins, Neil

    2014-07-01

    Within technology appraisals, it is necessary to compare the complete set of treatments that may be used in the patient group under consideration. Randomized controlled trials are a key source of evidence for these comparisons. The techniques of network meta-analysis allow the networks of trial evidence to be evaluated to obtain estimates of comparative efficacy between sets of treatments. These techniques may be the only source of estimates of comparative effectiveness if trials directly comparing the treatments of interest have not been conducted, and may provide useful additional evidence if both direct and indirect comparisons exist. We examined both published and draft guidelines from reimbursement and health technology appraisal bodies, and considered their recommendations using appropriate methodology for the conduct of indirect comparisons and the assessments of their validity. Guidelines from 33 countries were reviewed. Of these, guidelines from 9 countries-Australia, Belgium, Canada, France, Germany, Scotland, Spain, South Africa, and the United Kingdom (England and Wales)-included detailed recommendations on the conduct of network meta-analysis. The recommendations were summarized. No two recommendations from the multiple national guidelines are mutually exclusive. It is possible to perform one network meta-analysis for submission to multiple national jurisdictions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. A Systematic Analysis of Quality of Teaching Surveys

    OpenAIRE

    Martin Davies; Joe Hirschberg; Jenny Lye; Carol Johnston

    2008-01-01

    All tertiary institutions in Australia use the same Course Evaluation Questionnaire (CEQ) however for the internal evaluation of teaching they use their own surveys. This paper performs an analysis of the internal Quality of Teaching Surveys (QTS) used in Australian Universities. We classify the questions within the QTS surveys. This classification is used to explore how different universities’ surveys are similar to each other. We find that some universities use a QTS that is quite distinct ...

  14. Systematic analysis of the lysine acetylome in Vibrio parahemolyticus.

    Science.gov (United States)

    Pan, Jianyi; Ye, Zhicang; Cheng, Zhongyi; Peng, Xiaojun; Wen, Liangyou; Zhao, Fukun

    2014-07-03

    Lysine acetylation of proteins is a major post-translational modification that plays an important regulatory role in almost every aspect of cells, both eukaryotes and prokaryotes. Vibrio parahemolyticus, a model marine bacterium, is a worldwide cause of bacterial seafood-borne illness. Here, we conducted the first lysine acetylome in this bacterium through a combination of highly sensitive immune-affinity purification and high-resolution LC-MS/MS. Overall, we identified 1413 lysine acetylation sites in 656 proteins, which account for 13.6% of the total proteins in the cells; this is the highest ratio of acetyl proteins that has so far been identified in bacteria. The bioinformatics analysis of the acetylome showed that the acetylated proteins are involved in a wide range of cellular functions and exhibit diverse subcellular localizations. More specifically, proteins related to protein biosynthesis and carbon metabolism are the preferential targets of lysine acetylation. Moreover, two types of acetylation motifs, a lysine or arginine at the +4/+5 positions and a tyrosine, histidine, or phenylalanine at the +1/+2 positions, were revealed from the analysis of the acetylome. Additionally, protein interaction network analysis demonstrates that a wide range of interactions are modulated by protein acetylation. This study provides a significant beginning for the in-depth exploration of the physiological role of lysine acetylation in V. parahemolyticus.

  15. High-intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis.

    Science.gov (United States)

    Costigan, S A; Eather, N; Plotnikoff, R C; Taaffe, D R; Lubans, D R

    2015-10-01

    High-intensity interval training (HIIT) may be a feasible and efficacious strategy for improving health-related fitness in young people. The objective of this systematic review and meta-analysis was to evaluate the utility of HIIT to improve health-related fitness in adolescents and to identify potential moderators of training effects. Studies were considered eligible if they: (1) examined adolescents (13-18 years); (2) examined health-related fitness outcomes; (3) involved an intervention of ≥4 weeks in duration; (4) included a control or moderate intensity comparison group; and (5) prescribed high-intensity activity for the HIIT condition. Meta-analyses were conducted to determine the effect of HIIT on health-related fitness components using Comprehensive Meta-analysis software and potential moderators were explored (ie, study duration, risk of bias and type of comparison group). The effects of HIIT on cardiorespiratory fitness and body composition were large, and medium, respectively. Study duration was a moderator for the effect of HIIT on body fat percentage. Intervention effects for waist circumference and muscular fitness were not statistically significant. HIIT is a feasible and time-efficient approach for improving cardiorespiratory fitness and body composition in adolescent populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Treatment for School Refusal among Children and Adolescents: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Maynard, Brandy R.; Heyne, David; Brendel, Kristen Esposito; Bulanda, Jeffery J.; Thompson, Aaron M.; Pigott, Terri D.

    2018-01-01

    Objective: School refusal is a psychosocial problem associated with adverse short- and long-term consequences for children and adolescents. The authors conducted a systematic review and meta-analysis to examine the effects of psychosocial treatments for children and adolescents with school refusal. Method: A comprehensive search process was used…

  17. Calcineurin inhibitor sparing with mycophenolate in kidney transplantation: a systematic review and meta-analysis.

    LENUS (Irish Health Repository)

    Moore, Jason

    2009-02-27

    Limiting the exposure of kidney transplant recipients to calcineurin inhibitors (CNIs) has potential merit, but there is no clear consensus on the utility of current strategies. In an attempt to aid clarification, we conducted a systematic review and meta-analysis of randomized trials that assessed CNI sparing (minimization or elimination) with mycophenolate as sole adjunctive immunosuppression.

  18. Mode of delivery after successful external cephalic version: a systematic review and meta-analysis

    NARCIS (Netherlands)

    de Hundt, Marcella; Velzel, Joost; de Groot, Christianne J.; Mol, Ben W.; Kok, Marjolein

    2014-01-01

    To assess the mode of delivery in women after a successful external cephalic version by performing a systematic review and meta-analysis. We searched MEDLINE, Embase, ClinicalTrials.gov, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library for studies reporting on the

  19. Iron deficiency in children with HIV-associated anaemia: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Esan, Michael O.; Jonker, Femkje A. M.; Hensbroek, Michael Boele van; Calis, Job C. J.; Phiri, Kamija S.

    2012-01-01

    We conducted a systematic review and meta-analysis to determine the prevalence of iron deficiency in HIV-infected children from high- and low-income settings and compared it with that of HIV-uninfected controls. We searched five major databases for primary studies reporting on anaemia and iron

  20. Effective Interventions in Overweight or Obese Young Children: Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Hoek, van E.; Feskens, E.J.M.; Bouwman, L.I.; Janse, A.J.

    2014-01-01

    Abstract Background: Treatment programs for overweight and obese young children are of variable effectiveness, and the characteristics of effective programs are unknown. In this systematic review with meta-analysis, the effectiveness of treatment programs for these children is summarized. Methods:

  1. Medicinal plants with promising antileishmanial activity in Iran: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Masoud Soosaraei

    2017-09-01

    Conclusion: The most Iranian plants used as anti-leishmanial activity were Artemisia species, Allium sativum, Achilleamille folium, Peganum harmala and Thymus vulgaris. The present systematic and meta-analysis review provide valuable information about natural products with anti-Leishmania activity, which would be examined in the future experimental and clinical trials and herbal combination therapy.

  2. Bioelectrical impedance analysis to estimate body composition in surgical and oncological patients: a systematic review

    NARCIS (Netherlands)

    Haverkort, E. B.; Reijven, P. L. M.; Binnekade, J. M.; de van der Schueren, M. A. E.; Earthman, C. P.; Gouma, D. J.; de Haan, R. J.

    2015-01-01

    Bioelectrical impedance analysis (BIA) is a commonly used method for the evaluation of body composition. However, BIA estimations are subject to uncertainties.The aim of this systematic review was to explore the variability of empirical prediction equations used in BIA estimations and to evaluate

  3. A systematic review and meta-regression analysis of mivacurium for tracheal intubation

    NARCIS (Netherlands)

    Vanlinthout, L.E.H.; Mesfin, S.H.; Hens, N.; Vanacker, B.F.; Robertson, E.N.; Booij, L.H.D.J.

    2014-01-01

    We systematically reviewed factors associated with intubation conditions in randomised controlled trials of mivacurium, using random-effects meta-regression analysis. We included 29 studies of 1050 healthy participants. Four factors explained 72.9% of the variation in the probability of excellent

  4. Saline contrast hysterosonography in abnormal uterine bleeding : a systematic review and meta-analysis

    NARCIS (Netherlands)

    de Kroon, CD; de Bock, GH; Dieben, SWM; Jansen, FW

    2003-01-01

    Objective To assess the diagnostic accuracy of saline contrast hysterosonography in the evaluation of the uterine cavity in women complaining of abnormal uterine bleeding. Design A systematic review and meta-analysis of diagnostic studies that compared saline contrast hysterosonography to a gold

  5. Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Schuts, Emelie C.; Hulscher, Marlies E. J. L.; Mouton, Johan W.; Verduin, Cees M.; Stuart, James W. T. Cohen; Overdiek, Hans W. P. M.; van der Linden, Paul D.; Natsch, Stephanie; Hertogh, Cees M. P. M.; Wolfs, Tom F. W.; Schouten, Jeroen A.; Kullberg, Bart Jan; Prins, Jan M.

    2016-01-01

    Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes,

  6. Current evidence on hospital antimicrobial stewardship objectives : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Schuts, Emelie C.; Hulscher, Marlies E J L; Mouton, Johan W.; Verduin, Cees M.; Stuart, James W T Cohen; Overdiek, Hans W P M; van der Linden, Paul D.; Natsch, Stephanie; Hertogh, Cees M P M; Wolfs, Tom F W; Schouten, Jeroen A.; Kullberg, Bart Jan; Prins, Jan M.

    2016-01-01

    BACKGROUND: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes:

  7. Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Schuts, E.C.; Hulscher, M.E.J.L.; Mouton, J.W.; Verduin, C.M.; Stuart, J.W.; Overdiek, H.W.; Linden, P.D. van der; Natsch, S.S.; Hertogh, C.M.; Wolfs, T.F.; Schouten, J.A.; Kullberg, B.J.; Prins, J.M.

    2016-01-01

    BACKGROUND: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes:

  8. Systematic In Vivo RNAi Analysis Identifies IAPs as NEDD8-E3 Ligases

    DEFF Research Database (Denmark)

    Broemer, Meike; Tenev, Tencho; Rigbolt, Kristoffer T G

    2010-01-01

    -like proteins (UBLs), and deconjugating enzymes that remove the Ub or UBL adduct. Systematic in vivo RNAi analysis identified three NEDD8-specific isopeptidases that, when knocked down, suppress apoptosis. Consistent with the notion that attachment of NEDD8 prevents cell death, genetic ablation of deneddylase 1...

  9. Quasi-random Monte Carlo application in CGE systematic sensitivity analysis

    NARCIS (Netherlands)

    Chatzivasileiadis, T.

    2017-01-01

    The uncertainty and robustness of Computable General Equilibrium models can be assessed by conducting a Systematic Sensitivity Analysis. Different methods have been used in the literature for SSA of CGE models such as Gaussian Quadrature and Monte Carlo methods. This paper explores the use of

  10. Dairy products and colorectal cancer risk : a systematic review and meta-analysis of cohort studies

    NARCIS (Netherlands)

    Aune, D.; Lau, R.; Chan, D.S.M.; Vieira, R.; Greenwood, D.C.; Kampman, E.; Norat, T.

    2012-01-01

    Background: Previous studies of the association between intake of dairy products and colorectal cancer risk have indicated an inverse association with milk, however, the evidence for cheese or other dairy products is inconsistent. Methods: We conducted a systematic review and meta-analysis to

  11. Biochemical Cardiovascular Risk Factors After Hypertensive Pregnancy Disorders: A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Hermes, W.; Ket, J.C.; Pampus, M.G. van; Franx, A.; Veenendaal, M.V.; Kolster, C.; Tamsma, J.T.; Bloemenkamp, K.W.; Ponjee, G.; van der Hout, E.; Ten Horn, H.; Loix, S.; Mol, B.W.; Groot, C.J. de

    2012-01-01

    The objective of this study was to perform a systematic review and meta-analysis of studies assessing biochemical cardiovascular risk factors in women with previous hypertensive pregnancy disorders and women with previous normotensive pregnancies. Data were collected from PubMed and EMBASE (from

  12. Biochemical Cardiovascular Risk Factors After Hypertensive Pregnancy Disorders : A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Hermes, Wietske; Ket, Johannes C. F.; van Pampus, Maria G.; Franx, Arie; Veenendaal, Marjolein V. E.; Kolster, Clara; Tamsma, Jouke T.; Bloemenkamp, Kitty W. M.; Ponjee, Gabrielle; van der Hout, Evelien; ten Horn, Hilde; Loix, Stephanie; Mol, Ben Willem; de Groot, Christianne J. M.

    2012-01-01

    The objective of this study was to perform a systematic review and meta-analysis of studies assessing biochemical cardiovascular risk factors in women with previous hypertensive pregnancy disorders and women with previous normotensive pregnancies. Data were collected from PubMed and EMBASE (from

  13. Psychological Treatments for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Lackner, Jeffrey M.; Mesmer, Christina; Morley, Stephen; Dowzer, Clare; Hamilton, Simon

    2004-01-01

    This study conducted a systematic review to assess the quality of existing literature on psychological treatments for irritable bowel syndrome and to quantify the evidence for their efficacy. Three independent reviewers (2 from England, 1 from the United States) coded the quality of 32 studies, 17 of which provided data suitable for meta-analysis.…

  14. Suprapubic compared with transurethral bladder catheterization for gynecologic surgery: a systematic review and meta-analysis.

    LENUS (Irish Health Repository)

    Healy, Eibhlín F

    2012-09-01

    Suprapubic catheterization is commonly used for postoperative bladder drainage after gynecologic procedures. However, recent studies have suggested an increased rate of complications compared with urethral catheterization. We undertook a systematic review and meta-analysis of randomized controlled trials comparing suprapubic catheterization and urethral catheterization in gynecologic populations.

  15. Systematic Analysis of Quantitative Logic Model Ensembles Predicts Drug Combination Effects on Cell Signaling Networks

    Science.gov (United States)

    2016-08-27

    bovine serum albumin (BSA) diluted to the amount corresponding to that in the media of the stimulated cells. Phospho-JNK comprises two isoforms whose...information accompanies this paper on the CPT: Pharmacometrics & Systems Pharmacology website (http://www.wileyonlinelibrary.com/psp4) Systematic Analysis of Quantitative Logic Model Morris et al. 553 www.wileyonlinelibrary/psp4

  16. Shift work, long working hours and preterm birth: a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Melick, M. J. G. J.; Van Beukering, M. D. M.; Mol, B. W.; Frings-Dresen, M. H. W.; Hulshof, C. T. J.

    2014-01-01

    Specific physical activities or working conditions are suspected for increasing the risk of preterm birth (PTB). The aim of this meta-analysis is to review and summarize the pre-existing evidence on the effect of shift work or long working hours on the risk of PTB. We conducted a systematic search

  17. How Will DSM-5 Affect Autism Diagnosis? A Systematic Literature Review and Meta-Analysis

    Science.gov (United States)

    Kulage, Kristine M.; Smaldone, Arlene M.; Cohn, Elizabeth G.

    2014-01-01

    We conducted a systematic review and meta-analysis to determine the effect of changes to the Diagnostic and Statistical Manual (DSM)-5 on autism spectrum disorder (ASD) and explore policy implications. We identified 418 studies; 14 met inclusion criteria. Studies consistently reported decreases in ASD diagnosis (range 7.3-68.4%) using DSM-5…

  18. Female- and Male-Specific Risk Factors for Stroke : A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Poorthuis, Michiel H F; Algra, Annemijn M; Algra, Ale; Kappelle, L Jaap; Klijn, Catharina J M

    2017-01-01

    Importance: The incidence of stroke is higher in men than in women. The influence of sex-specific risk factors on stroke incidence and mortality is largely unknown. Objective: To conduct a systematic review and meta-analysis of female- and male-specific risk factors for stroke. Data Sources: PubMed,

  19. Female- and Male-Specific Risk Factors for Stroke: A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Poorthuis, M.H.; Algra, A.M.; Kappelle, L.J.; Klijn, C.J.M.

    2017-01-01

    Importance: The incidence of stroke is higher in men than in women. The influence of sex-specific risk factors on stroke incidence and mortality is largely unknown. Objective: To conduct a systematic review and meta-analysis of female- and male-specific risk factors for stroke. Data Sources: PubMed,

  20. Treatment strategies for women with WHO group II anovulation: systematic review and network meta-analysis

    NARCIS (Netherlands)

    Wang, Rui; Kim, Bobae V.; van Wely, Madelon; Johnson, Neil P.; Costello, Michael F.; Zhang, Hanwang; Ng, Ernest Hung Yu; Legro, Richard S.; Bhattacharya, Siladitya; Norman, Robert J.; Mol, Ben Willem J.

    2017-01-01

    To compare the effectiveness of alternative first line treatment options for women with WHO group II anovulation wishing to conceive. Systematic review and network meta-analysis. Cochrane Central Register of Controlled Trials, Medline, and Embase, up to 11 April 2016. Randomised controlled trials

  1. Systematic Review and Meta-analysis: Fecal Microbiota Transplantation for Treatment of Active Ulcerative Colitis

    NARCIS (Netherlands)

    Narula, Neeraj; Kassam, Zain; Yuan, Yuhong; Colombel, Jean-Frederic; Ponsioen, Cyriel; Reinisch, Walter; Moayyedi, Paul

    2017-01-01

    Background: Changes in the colonic microbiota may play a role in the pathogenesis of ulcerative colitis (UC) and restoration of healthy gut microbiota may ameliorate disease. A systematic review and meta-analysis was conducted to assess fecal microbiota transplantation (FMT) as a treatment for

  2. Vitamin D and Depression: A Systematic Review and Meta-Analysis Comparing Studies with and without Biological Flaws

    OpenAIRE

    Simon Spedding

    2014-01-01

    Efficacy of Vitamin D supplements in depression is controversial, awaiting further literature analysis. Biological flaws in primary studies is a possible reason meta-analyses of Vitamin D have failed to demonstrate efficacy. This systematic review and meta-analysis of Vitamin D and depression compared studies with and without biological flaws. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was un...

  3. Physiotherapy intervention in Parkinson's disease: systematic review and meta-analysis.

    Science.gov (United States)

    Tomlinson, Claire L; Patel, Smitaa; Meek, Charmaine; Herd, Clare P; Clarke, Carl E; Stowe, Rebecca; Shah, Laila; Sackley, Catherine; Deane, Katherine H O; Wheatley, Keith; Ives, Natalie

    2012-08-06

    To assess the effectiveness of physiotherapy compared with no intervention in patients with Parkinson's disease. Systematic review and meta-analysis of randomised controlled trials. Literature databases, trial registries, journals, abstract books, and conference proceedings, and reference lists, searched up to the end of January 2012. Randomised controlled trials comparing physiotherapy with no intervention in patients with Parkinson's disease were eligible. Two authors independently abstracted data from each trial. Standard meta-analysis methods were used to assess the effectiveness of physiotherapy compared with no intervention. Tests for heterogeneity were used to assess for differences in treatment effect across different physiotherapy interventions used. Outcome measures were gait, functional mobility and balance, falls, clinician rated impairment and disability measures, patient rated quality of life, adverse events, compliance, and economic analysis outcomes. 39 trials of 1827 participants met the inclusion criteria, of which 29 trials provided data for the meta-analyses. Significant benefit from physiotherapy was reported for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed (0.04 m/s, 95% confidence interval 0.02 to 0.06, P<0.001), Berg balance scale (3.71 points, 2.30 to 5.11, P<0.001), and scores on the unified Parkinson's disease rating scale (total score -6.15 points, -8.57 to -3.73, P<0.001; activities of daily living subscore -1.36, -2.41 to -0.30, P=0.01; motor subscore -5.01, -6.30 to -3.72, P<0.001). Indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect differed across the interventions for any outcomes assessed, apart from motor subscores on the unified Parkinson's disease rating scale (in which one trial was found to be the cause of the heterogeneity). Physiotherapy has short term benefits in Parkinson's disease. A wide range of physiotherapy techniques

  4. Conventional vs. e-learning in nursing education: A systematic review and meta-analysis.

    Science.gov (United States)

    Voutilainen, Ari; Saaranen, Terhi; Sormunen, Marjorita

    2017-03-01

    By and large, in health professions training, the direction of the effect of e-learning, positive or negative, strongly depends on the learning outcome in question as well as on learning methods which e-learning is compared to. In nursing education, meta-analytically generated knowledge regarding the comparisons between conventional and e-learning is scarce. The aim of this review is to discover the size of the effect of e-learning on learning outcomes in nursing education and to assess the quality of studies in which e-learning has been compared to conventional learning. A systematic search of six electronic databases, PubMed, Ovid MEDLINE®, CINAHL (EBSCOhost), Cochrane Library, PsycINFO, and ERIC, was conducted in order to identify relevant peer-reviewed English language articles published between 2011 and 2015. The quality of the studies included as well as the risk of bias in each study was assessed. A random-effects meta-analysis was performed to generate a pooled mean difference in the learning outcome. Altogether, 10 studies were eligible for the quality assessment and meta-analysis. Nine studies were evaluated as good quality studies, but not without a risk of bias. Performance bias caused a high risk in nearly all the studies. In the meta-analysis, an e-learning method resulted in test scores that were, on average, five points higher than a conventional method on a 0-100 scale. Heterogeneity between the studies was very large. The size and direction of the effect of a learning method on learning outcomes appeared to be strongly situational. We suggest that meta-regressions should be performed instead of basic meta-analyses in order to reveal factors that cause variation in the learning outcomes of nursing education. It might be necessary to perform separate meta-analyses between e-learning interventions aimed at improving nursing knowledge and those aimed at improving nursing skills. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Reference materials and interlaboratory comparison for actinide analysis

    International Nuclear Information System (INIS)

    Hanssens, Alain; Viallesoubranne, Carole; Roche, Claude; Liozon, Gerard

    2008-01-01

    Measurement quality is crucial for the safety of nuclear facilities and is a primary requirement for fissile material monitoring and accountancy. CETAMA (Cea Committee for the establishment of analysis methods), in collaboration with Cea and AREVA laboratories, fabricates certified reference materials and organizes interlaboratory comparison programs for plutonium and uranium assay in solution. A new plutonium metal measurement standard (MP3) is currently being prepared by Cea and is a subject of cooperative work in view of its certification and use by analysis laboratories. U and Pu interlaboratory comparisons are carried out at regular intervals on benchmark samples in coordination with working groups from French nuclear laboratories. These programs are supported by international cooperation. 'Chemical' methods (potentiometry, gravimetric analysis, etc.) generally provide the best accuracy. Coulometry is the benchmark technique for plutonium assay: its metrological qualities should be an incentive for wider use by laboratories performing precise control assays of plutonium as well as uranium. Gravimetric analysis provides excellent results for analysis of pure uranyl nitrate solutions. In view of its many advantages we encourage laboratories to employ this technique to assay pure U or Pu solutions. 'Physical' or 'physicochemical' methods are increasingly used, and their performance has improved. K-edge absorption spectrometry and isotope dilution mass spectrometry are capable of reaching measurement quality levels comparable to those of the best 'chemical' methods. (authors)

  6. Reference materials and interlaboratory comparison for actinide analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hanssens, Alain; Viallesoubranne, Carole; Roche, Claude; Liozon, Gerard [Commissariat a l' Energie Atomique, Marcoule: BP 17171, 30207 Bagnols sur Ceze (France)

    2008-07-01

    Measurement quality is crucial for the safety of nuclear facilities and is a primary requirement for fissile material monitoring and accountancy. CETAMA (Cea Committee for the establishment of analysis methods), in collaboration with Cea and AREVA laboratories, fabricates certified reference materials and organizes interlaboratory comparison programs for plutonium and uranium assay in solution. A new plutonium metal measurement standard (MP3) is currently being prepared by Cea and is a subject of cooperative work in view of its certification and use by analysis laboratories. U and Pu interlaboratory comparisons are carried out at regular intervals on benchmark samples in coordination with working groups from French nuclear laboratories. These programs are supported by international cooperation. 'Chemical' methods (potentiometry, gravimetric analysis, etc.) generally provide the best accuracy. Coulometry is the benchmark technique for plutonium assay: its metrological qualities should be an incentive for wider use by laboratories performing precise control assays of plutonium as well as uranium. Gravimetric analysis provides excellent results for analysis of pure uranyl nitrate solutions. In view of its many advantages we encourage laboratories to employ this technique to assay pure U or Pu solutions. 'Physical' or 'physicochemical' methods are increasingly used, and their performance has improved. K-edge absorption spectrometry and isotope dilution mass spectrometry are capable of reaching measurement quality levels comparable to those of the best 'chemical' methods. (authors)

  7. Systematics and Population Level Analysis of Anopheles darlingi

    Directory of Open Access Journals (Sweden)

    Conn JE

    1998-01-01

    Full Text Available A new phylogenetic analysis of the Nyssorhynchus subgenus (Danoff-Burg and Conn, unpub. data using six data sets {morphological (all life stages; scanning electron micrographs of eggs; nuclear ITS2 sequences; mitochondrial COII, ND2 and ND6 sequences} revealed different topologies when each data set was analyzed separately but no heterogeneity between the data sets using the arn test. Consequently, the most accurate estimate of the phylogeny was obtained when all the data were combined. This new phylogeny supports a monophyletic Nyssorhynchus subgenus but both previously recognized sections in the subgenus (Albimanus and Argyritarsis were demonstrated to be paraphyletic relative to each other and four of the seven clades included species previously placed in both sections. One of these clades includes both Anopheles darlingi and An. albimanus, suggesting that the ability to vector malaria effectively may have originated once in this subgenus. Both a conserved (315 bp and a variable (425 bp region of the mitochondrial COI gene from 15 populations of An. darlingi from Belize, Bolivia, Brazil, French Guiana, Peru and Venezuela were used to examine the evolutionary history of this species and to test several analytical assumptions. Results demonstrated (1 parsimony analysis is equally informative compared to distance analysis using NJ; (2 clades or clusters are more strongly supported when these two regions are combined compared to either region separately; (3 evidence (in the form of remnants of older haplotype lineages for two colonization events; and (4 significant genetic divergence within the population from Peixoto de Azevedo (State of Mato Grosso, Brazil. The oldest lineage includes populations from Peixoto, Boa Vista (State of Roraima and Dourado (State of São Paulo.

  8. Inflammation and sarcopenia: A systematic review and meta-analysis.

    Science.gov (United States)

    Bano, Giulia; Trevisan, Caterina; Carraro, Sara; Solmi, Marco; Luchini, Claudio; Stubbs, Brendon; Manzato, Enzo; Sergi, Giuseppe; Veronese, Nicola

    2017-02-01

    Inflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects standardized mean differences (SMDs) ±95% confidence intervals (CIs) as the effect size. Out of 1370 initial hits, 17 studies with a total of 11249 participants (3072 with sarcopenia and 8177 without) were meta-analyzed. Sarcopenic participants had significantly higher levels of CRP (SMD=0.51; 95%CI 0.26, 0.77; psarcopenia versus controls. Sarcopenic people did not have higher levels of TNF-α than controls (SMD=0.28; 95%CI -0.26, 0.83; p=0.31; I 2 =97%). In conclusion, sarcopenia seems to be associated with elevated serum CRP levels; future longitudinal studies are needed to clarify this relationship. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Applications of social network analysis to obesity: a systematic review.

    Science.gov (United States)

    Zhang, S; de la Haye, K; Ji, M; An, R

    2018-04-20

    People's health behaviours and outcomes can be profoundly shaped by the social networks they are embedded in. Based on graph theory, social network analysis is a research framework for the study of social interactions and the structure of these interactions among social actors. A literature search was conducted in PubMed and Web of Science for articles published until August 2017 that applied social network analysis to examine obesity and social networks. Eight studies (three cross-sectional and five longitudinal) conducted in the US (n = 6) and Australia (n = 2) were identified. Seven focused on adolescents' and one on adults' friendship networks. They examined structural features of these networks that were associated with obesity, including degree distribution, popularity, modularity maximization and K-clique percolation. All three cross-sectional studies that used exponential random graph models found individuals with similar body weight status and/or weight-related behaviour were more likely to share a network tie than individuals with dissimilar traits. Three longitudinal studies using stochastic actor-based models found friendship network characteristics influenced change in individuals' body weight status and/or weight-related behaviour over time. Future research should focus on diverse populations and types of social networks and identifying the mechanisms by which social networks influence obesity to inform network-based interventions. © 2018 World Obesity Federation.

  10. Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bittencourt, Hugo Souza; Reis, Helena França Correia Dos; Lima, Melissa Santos; Gomes, Mansueto

    2017-02-01

    Non-invasive ventilation (NIV) may perfect respiratory and cardiac performance in patients with heart failure (HF). The objective of the study to establish, through systematic review and meta-analysis, NIV influence on functional capacity of HF patients. A systematic review with meta-analysis of randomized studies was carried out through research of databases of Cochrane Library, SciELO, Pubmed and PEDro, using the key-words: heart failure, non-invasive ventilation, exercise tolerance; and the free terms: bi-level positive airway pressure (BIPAP), continuous positive airway pressure (CPAP), and functional capacity (terms were searched for in English and Portuguese) using the Boolean operators AND and OR. Methodological quality was ensured through PEDro scale. Weighted averages and a 95% confidence interval (CI) were calculated. The meta-analysis was done thorugh the software Review Manager, version 5.3 (Cochrane Collaboration). Four randomized clinical trials were included. Individual studies suggest NIV improved functional capacity. NIV resulted in improvement in the distance of the six-minute walk test (6MWT) (68.7m 95%CI: 52.6 to 84.9) in comparison to the control group. We conclude that the NIV is an intervention that promotes important effects in the improvement of functional capacity of HF patients. However, there is a gap in literature on which are the most adequate parameters for the application of this technique. Resumo A ventilação não invasiva (VNI) pode aperfeiçoar o desempenho cardíaco e respiratório dos pacientes com insuficiência cardíaca (IC). O objetivo do estudo é estabelecer, por meio de revisão sistemática e meta-análise, a influência da VNI na capacidade funcional (CF) de indivíduos com IC. Foi realizada uma revisão sistemática com meta-análise de estudos randomizados através da pesquisa nas bases de dados Biblioteca Cochrane, SciELO, Pubmed e PEDro, utilizando-se as palavras-chave: insuficiência cardíaca, ventilação n

  11. Optimizing Bus Passenger Complaint Service through Big Data Analysis: Systematized Analysis for Improved Public Sector Management

    Directory of Open Access Journals (Sweden)

    Weng-Kun Liu

    2016-12-01

    Full Text Available With the advances in industry and commerce, passengers have become more accepting of environmental sustainability issues; thus, more people now choose to travel by bus. Government administration constitutes an important part of bus transportation services as the government gives the right-of-way to transportation companies allowing them to provide services. When these services are of poor quality, passengers may lodge complaints. The increase in consumer awareness and developments in wireless communication technologies have made it possible for passengers to easily and immediately submit complaints about transportation companies to government institutions, which has brought drastic changes to the supply–demand chain comprised of the public sector, transportation companies, and passengers. This study proposed the use of big data analysis technology including systematized case assignment and data visualization to improve management processes in the public sector and optimize customer complaint services. Taichung City, Taiwan, was selected as the research area. There, the customer complaint management process in public sector was improved, effectively solving such issues as station-skipping, allowing the public sector to fully grasp the service level of transportation companies, improving the sustainability of bus operations, and supporting the sustainable development of the public sector–transportation company–passenger supply chain.

  12. Predicting adult obesity from childhood obesity : A systematic review and meta-analysis

    OpenAIRE

    Simmonds, M.; Llewellyn, A.; Owen, C. G.; Woolacott, N.

    2016-01-01

    A systematic review and meta-analysis was performed to investigate the ability of simple measures of childhood obesity such as body mass index (BMI) to predict future obesity in adolescence and adulthood. Large cohort studies, which measured obesity both in childhood and in later adolescence or adulthood, using any recognized measure of obesity were sought. Study quality was assessed. Studies were pooled using diagnostic meta-analysis methods. Fifteen prospective cohort studies were included ...

  13. Systematically In Silico Comparison of Unihormonal and Bihormonal Artificial Pancreas Systems

    Directory of Open Access Journals (Sweden)

    Xiaoteng Gao

    2013-01-01

    Full Text Available Automated closed-loop control of blood glucose concentration is a daily challenge for type 1 diabetes mellitus, where insulin and glucagon are two critical hormones for glucose regulation. According to whether glucagon is included, all artificial pancreas (AP systems can be divided into two types: unihormonal AP (infuse only insulin and bihormonal AP (infuse both insulin and glucagon. Even though the bihormonal AP is widely considered a promising direction, related studies are very scarce due to this system’s short research history. More importantly, there are few studies to compare these two kinds of AP systems fairly and systematically. In this paper, two switching rules, P-type and PD-type, were proposed to design the logic of orchestrates switching between insulin and glucagon subsystems, where the delivery rates of both insulin and glucagon were designed by using IMC-PID method. These proposed algorithms have been compared with an optimal unihormonal system on virtual type 1 diabetic subjects. The in silico results demonstrate that the proposed bihormonal AP systems have outstanding superiorities in reducing the risk of hypoglycemia, smoothing the glucose level, and robustness with respect to insulin/glucagon sensitivity variations, compared with the optimal unihormonal AP system.

  14. Aspergillus Polymerase Chain Reaction: Systematic Review of Evidence for Clinical Use in Comparison With Antigen Testing

    Science.gov (United States)

    White, P. Lewis; Wingard, John R.; Bretagne, Stéphane; Löffler, Jürgen; Patterson, Thomas F.; Slavin, Monica A.; Barnes, Rosemary A.; Pappas, Peter G.; Donnelly, J. Peter

    2015-01-01

    Background. Aspergillus polymerase chain reaction (PCR) was excluded from the European Organisation for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) definitions of invasive fungal disease because of limited standardization and validation. The definitions are being revised. Methods. A systematic literature review was performed to identify analytical and clinical information available on inclusion of galactomannan enzyme immunoassay (GM-EIA) (2002) and β-d-glucan (2008), providing a minimal threshold when considering PCR. Categorical parameters and statistical performance were compared. Results. When incorporated, GM-EIA and β-d-glucan sensitivities and specificities for diagnosing invasive aspergillosis were 81.6% and 91.6%, and 76.9% and 89.4%, respectively. Aspergillus PCR has similar sensitivity and specificity (76.8%–88.0% and 75.0%–94.5%, respectively) and comparable utility. Methodological recommendations and commercial PCR assays assist standardization. Although all tests have limitations, currently, PCR is the only test with independent quality control. Conclusions. We propose that there is sufficient evidence that is at least equivalent to that used to include GM-EIA and β-d-glucan testing, and that PCR is now mature enough for inclusion in the EORTC/MSG definitions. PMID:26113653

  15. Comparison of remicade to curcumin for the treatment of Crohn's disease: A systematic review.

    Science.gov (United States)

    Schneider, Allaire; Hossain, Ivy; VanderMolen, Julia; Nicol, Kara

    2017-08-01

    The aim of this study was to review the literature to assess if there is evidence to support the use of Curcumin as a safe complementary therapy in treating Crohn's Disease (CD) in conjunction with Remicade. Systematic searches were performed by three researchers using electronic databases (ProQuest Medical Library, CINAHL Complete, and PUBMED) to locate and identify articles to meet a predetermined set of inclusion criteria. Specifically full text, peer-reviewed articles published after 2007 were included if they studied human participants 18 years or older. Tumor necrosis factor-alpha (TNF-a) and Interleukin-1 (IL-1) levels increase in CD patients. Remicade reduces TNF-a in adults with CD. The issues are eventual loss of response (LOR) once IL-1 increases, and severe risks such as malignancy. CD patients using Curcumin saw a 55 point mean reduction in the Crohn's Disease Activity Index, reducing IL-1 and Crp. Plus it reduced TNF-a and PPMTase which improved colorectal cancer outcomes. LOR of Remicade occurs when IL-1 increases, and it can cause malignancy. Research shows Curcumin reduces IL-1 and improves cancer outcomes. Future research, using both Remicade and Curcumin, would have to be done, but preliminary data would suggest using both would reduce LOR. Curcumin, even by itself, was found to be a cheap and safe way to reduce CD symptoms and inflammatory markers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. A systematic comparison of motion artifact correction techniques for functional near-infrared spectroscopy

    DEFF Research Database (Denmark)

    Cooper, Robert J; Selb, Juliette; Gagnon, Louis

    2012-01-01

    a significant reduction in the mean-squared error (MSE) and significant increase in the contrast-to-noise ratio (CNR) of the recovered HRF when compared to no correction and compared to a process of rejecting motion-contaminated trials. Spline interpolation produces the largest average reduction in MSE (55....... Principle component analysis, spline interpolation, wavelet analysis, and Kalman filtering approaches are compared to one another and to standard approaches using the accuracy of the recovered, simulated hemodynamic response function (HRF). Each of the four motion correction techniques we tested yields......%) while wavelet analysis produces the highest average increase in CNR (39%). On the basis of this analysis, we recommend the routine application of motion correction techniques (particularly spline interpolation or wavelet analysis) to minimize the impact of motion artifacts on functional NIRS data....

  17. A systematic methodology for the robust quantification of energy efficiency at wastewater treatment plants featuring Data Envelopment Analysis.

    Science.gov (United States)

    Longo, S; Hospido, A; Lema, J M; Mauricio-Iglesias, M

    2018-05-10

    This article examines the potential benefits of using Data Envelopment Analysis (DEA) for conducting energy-efficiency assessment of wastewater treatment plants (WWTPs). WWTPs are characteristically heterogeneous (in size, technology, climate, function …) which limits the correct application of DEA. This paper proposes and describes the Robust Energy Efficiency DEA (REED) in its various stages, a systematic state-of-the-art methodology aimed at including exogenous variables in nonparametric frontier models and especially designed for WWTP operation. In particular, the methodology systematizes the modelling process by presenting an integrated framework for selecting the correct variables and appropriate models, possibly tackling the effect of exogenous factors. As a result, the application of REED improves the quality of the efficiency estimates and hence the significance of benchmarking. For the reader's convenience, this article is presented as a step-by-step guideline to guide the user in the determination of WWTPs energy efficiency from beginning to end. The application and benefits of the developed methodology are demonstrated by a case study related to the comparison of the energy efficiency of a set of 399 WWTPs operating in different countries and under heterogeneous environmental conditions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Stub, Trine; Musial, Frauke; Kristoffersen, Agnete A; Alræk, Terje; Liu, Jianping

    2016-06-01

    Homeopathy is a popular treatment modality among patient, however there is sparse research about adverse effects of homeopathy. A concept unique for homeopathy, is homeopathic aggravation that is understood as a transient worsening of the patients' symptoms before an expected improvement occurs. From a risk perspective it is vital that a distinction between homeopathic aggravations and adverse effects is established. There is a lack of systematic information on how frequent adverse effects and homeopathic aggravations are reported in studies. Therefore, a systematic review and meta-analysis were performed. Sixteen electronic databases were searched for Randomized Controlled Trials (RCTs). The searches were limited from the year 1995 to January 2011. Forty-one RCTs, with a total of 6.055 participants were included. A subtotal of 39 studies was included in the additional meta-analysis. A total of 28 trials (68%) reported adverse effects and five trials (12%) reported homeopathic aggravations. The meta-analysis (including six subgroup comparisons) demonstrated that no significant difference was found between homeopathy and control with OR 0.99, 95% CI 0.86-1.14, I(2)=54%. More than two third of the adverse effects were classified as grade 1 (68%) and two third were classified as grade 2 (25%) and grade 3 (6%) according to the Common Terminology Criteria for Adverse Effects. Homeopathic aggravation was classified as grade 1 (98%) and grade 3 (2%), suggesting that homeopathic aggravations were reported to be less severe than adverse effects. The methodological quality according to a method recommended in the Cochrane handbook for RCTs, was high. Adverse effects including the concept of homeopathic aggravations are commonly reported in trials. The meta-analysis demonstrated that the proportion of patients experiencing adverse effects to be similar for patients randomized to homeopathic treatment compared to patients randomized to placebo and conventional medicine

  19. [Systematic umbilical cord blood analysis at birth: feasibility and reliability in a French labour ward].

    Science.gov (United States)

    Ernst, D; Clerc, J; Decullier, E; Gavanier, G; Dupuis, O

    2012-10-01

    At birth, evaluation of neonatal well-being is crucial. It is though important to perform umbilical cord blood gas analysis, and then to analyze the samples. We wanted to establish the feasibility and reliability of systematic umbilical cord blood sampling in a French labour ward. Study of systematic umbilical cord blood gas analysis was realized retrospectively from 1000 consecutive deliveries. We first established the feasibility of the samples. Feasibility was defined by the ratio of complete cord acid-base data on the number of deliveries from alive newborns. Afterwards, we established the reliability on the remaining cord samples. Reliability was the ratio of samples that fulfilled quality criteria defined by Westgate et al. and revised by Kro et al., on the number of complete samples from alive newborns. At last, we looked for factors that would influence these results. The systematic umbilical cord blood sample feasibility reached 91.6%, and the reliability reached 80.7%. About the delivery mode, 38.6% of emergency caesarians (IC 95% [30.8-46.3]; Panalysis were significantly less validated during emergency caesarians. Realization of systematic cord blood gas analysis was followed by 8.4% of incomplete samples, and by 19.3% that were uninterpretable. Training sessions should be organized to improve the feasibility and reliability, especially during emergency caesarians. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  20. A Systematic Analysis of a Deep Mouse Epididymal Sperm Proteome

    Energy Technology Data Exchange (ETDEWEB)

    Chauvin, Theodore; Xie, Fang; Liu, Tao; Nicora, Carrie D.; Yang, Feng; Camp, David G.; Smith, Richard D.; Roberts, Kenneth P.

    2012-12-21

    Spermatozoa are highly specialized cells that, when mature, are capable of navigating the female reproductive tract and fertilizing an oocyte. The sperm cell is thought to be largely quiescent in terms of transcriptional and translational activity. As a result, once it has left the male reproductive tract, the sperm cell is essentially operating with a static population of proteins. It is therefore theoretically possible to understand the protein networks contained in a sperm cell and to deduce its cellular function capabilities. To this end we have performed a proteomic analysis of mouse sperm isolated from the cauda epididymis and have confidently identified 2,850 proteins, which is the most comprehensive sperm proteome for any species reported to date. These proteins comprise many complete cellular pathways, including those for energy production via glycolysis, β-oxidation and oxidative phosphorylation, protein folding and transport, and cell signaling systems. This proteome should prove a useful tool for assembly and testing of protein networks important for sperm function.

  1. Abreaction for conversion disorder: systematic review with meta-analysis.

    Science.gov (United States)

    Poole, Norman A; Wuerz, Axel; Agrawal, Niruj

    2010-08-01

    The value of drug interviews in the treatment of conversion disorder is at present unknown. To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder. Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques. Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery. The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.

  2. Systematic analysis of protein turnover in primary cells.

    Science.gov (United States)

    Mathieson, Toby; Franken, Holger; Kosinski, Jan; Kurzawa, Nils; Zinn, Nico; Sweetman, Gavain; Poeckel, Daniel; Ratnu, Vikram S; Schramm, Maike; Becher, Isabelle; Steidel, Michael; Noh, Kyung-Min; Bergamini, Giovanna; Beck, Martin; Bantscheff, Marcus; Savitski, Mikhail M

    2018-02-15

    A better understanding of proteostasis in health and disease requires robust methods to determine protein half-lives. Here we improve the precision and accuracy of peptide ion intensity-based quantification, enabling more accurate protein turnover determination in non-dividing cells by dynamic SILAC-based proteomics. This approach allows exact determination of protein half-lives ranging from 10 to >1000 h. We identified 4000-6000 proteins in several non-dividing cell types, corresponding to 9699 unique protein identifications over the entire data set. We observed similar protein half-lives in B-cells, natural killer cells and monocytes, whereas hepatocytes and mouse embryonic neurons show substantial differences. Our data set extends and statistically validates the previous observation that subunits of protein complexes tend to have coherent turnover. Moreover, analysis of different proteasome and nuclear pore complex assemblies suggests that their turnover rate is architecture dependent. These results illustrate that our approach allows investigating protein turnover and its implications in various cell types.

  3. Agonist Binding to Chemosensory Receptors: A Systematic Bioinformatics Analysis

    Directory of Open Access Journals (Sweden)

    Fabrizio Fierro

    2017-09-01

    Full Text Available Human G-protein coupled receptors (hGPCRs constitute a large and highly pharmaceutically relevant membrane receptor superfamily. About half of the hGPCRs' family members are chemosensory receptors, involved in bitter taste and olfaction, along with a variety of other physiological processes. Hence these receptors constitute promising targets for pharmaceutical intervention. Molecular modeling has been so far the most important tool to get insights on agonist binding and receptor activation. Here we investigate both aspects by bioinformatics-based predictions across all bitter taste and odorant receptors for which site-directed mutagenesis data are available. First, we observe that state-of-the-art homology modeling combined with previously used docking procedures turned out to reproduce only a limited fraction of ligand/receptor interactions inferred by experiments. This is most probably caused by the low sequence identity with available structural templates, which limits the accuracy of the protein model and in particular of the side-chains' orientations. Methods which transcend the limited sampling of the conformational space of docking may improve the predictions. As an example corroborating this, we review here multi-scale simulations from our lab and show that, for the three complexes studied so far, they significantly enhance the predictive power of the computational approach. Second, our bioinformatics analysis provides support to previous claims that several residues, including those at positions 1.50, 2.50, and 7.52, are involved in receptor activation.

  4. Systematic approach to scenario development using FEP analysis

    International Nuclear Information System (INIS)

    Bailey, L.E.E.; Lever, D.A.

    2001-01-01

    UK regulatory requirements require that the 'assessed radiological risk ... to a representative member of the potentially exposed group at greatest risk should be consistent with a risk target of 10 -6 per year' and that risks should be 'summed over all situations that could give rise to exposure to the group'. It is a further requirement that a repository performance assessment provides a 'comprehensive record of the judgements and assumptions on which the risk assessments are based'. In order to meet these requirements, Nirex, working with AEA Technology, has developed an approach to performance assessment based on the identification and analysis of features, events and processes (FEPs). The objectives of the approach are to provide a comprehensive, traceable and clear presentation of a performance assessment for a deep geological radioactive waste repository. The approach to scenario development is fundamental to the overall Nirex strategy for performance assessment, eventually leading to a repository safety case for regulatory submission. This paper outlines the main concepts of the approach, illustrated with examples of work undertaken by Nirex to demonstrate its practicality. Due to the current status of the Nirex repository programme, the approach has not yet been used to conduct a full performance assessment of a repository located at a specific site. (authors)

  5. Bisphenol S and F: A Systematic Review and Comparison of the Hormonal Activity of Bisphenol A Substitutes

    Science.gov (United States)

    Bolden, Ashley L.

    2015-01-01

    Background Increasing concern over bisphenol A (BPA) as an endocrine-disrupting chemical and its possible effects on human health have prompted the removal of BPA from consumer products, often labeled “BPA-free.” Some of the chemical replacements, however, are also bisphenols and may have similar physiological effects in organisms. Bisphenol S (BPS) and bisphenol F (BPF) are two such BPA substitutes. Objectives This review was carried out to evaluate the physiological effects and endocrine activities of the BPA substitutes BPS and BPF. Further, we compared the hormonal potency of BPS and BPF to that of BPA. Methods We conducted a systematic review based on the Office of Health Assessment and Translation (OHAT) protocol. Results We identified the body of literature to date, consisting of 32 studies (25 in vitro only, and 7 in vivo). The majority of these studies examined the hormonal activities of BPS and BPF and found their potency to be in the same order of magnitude and of similar action as BPA (estrogenic, antiestrogenic, androgenic, and antiandrogenic) in vitro and in vivo. BPS also has potencies similar to that of estradiol in membrane-mediated pathways, which are important for cellular actions such as proliferation, differentiation, and death. BPS and BPF also showed other effects in vitro and in vivo, such as altered organ weights, reproductive end points, and enzyme expression. Conclusions Based on the current literature, BPS and BPF are as hormonally active as BPA, and they have endocrine-disrupting effects. Citation Rochester JR, Bolden AL. 2015. Bisphenol S and F: a systematic review and comparison of the hormonal activity of bisphenol A substitutes. Environ Health Perspect 123:643–650; http://dx.doi.org/10.1289/ehp.1408989 PMID:25775505

  6. Indirect health costs in ulcerative colitis and Crohn's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Kawalec, Paweł; Malinowski, Krzysztof Piotr

    2015-04-01

    The aim of this systematic review was to collect all current data on indirect costs related to inflammatory bowel disease as well as assessing homogeneity and comparability, and conducting a meta-analysis. Costs were collected using databases from Medline, Embase and Centre for Reviews and Dissemination databases, then average annual cost per patient was calculated and expressed in 2013-rate USD using the consumer price index and purchasing power parity (scenario 1) and then adjusted to specific gross domestic product (scenario 2) to make them comparable. The studies were then included in quantitative synthesis using the meta-analysis and bootstrap methods. This systematic review was carried out and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. From 18 publications, overall annual indirect costs per patient as a result of the quantitative synthesis among all studies eligible for meta-analysis ranged from US$2425.01-US$9622.15 depending on the scenario and model used for analysis. The cost of presenteeism was assessed in only two studies. Considering heterogeneity among all identified studies random-effect model presented the most accurate results of meta-analysis equal to US$7189.27 and US$9622.15 per patient per year for scenario 1 and scenario 2, respectively. This systematic review revealed the existence of a relatively small number of studies that reported on the great economic burden of the disease upon society. A great variety of methodologies and cost components resulted in a very large discrepancy in indirect costs and made meta-analysis difficult to perform, so two scenarios were considered and meta-analysis conducted in subgroups to make data more comparable.

  7. Systematic analysis of short internal indels and their impact on protein folding

    Directory of Open Access Journals (Sweden)

    Guo Jun-tao

    2010-08-01

    Full Text Available Abstract Background Protein sequence insertions/deletions (indels can be introduced during evolution or through alternative splicing (AS. Alternative splicing is an important biological phenomenon and is considered as the major means of expanding structural and functional diversity in eukaryotes. Knowledge of the structural changes due to indels is critical to our understanding of the evolution of protein structure and function. In addition, it can help us probe the evolution of alternative splicing and the diversity of functional isoforms. However, little is known about the effects of indels, in particular the ones involving core secondary structures, on the folding of protein structures. The long term goal of our study is to accurately predict the protein AS isoform structures. As a first step towards this goal, we performed a systematic analysis on the structural changes caused by short internal indels through mining highly homologous proteins in Protein Data Bank (PDB. Results We compiled a non-redundant dataset of short internal indels (2-40 amino acids from highly homologous protein pairs and analyzed the sequence and structural features of the indels. We found that about one third of indel residues are in disordered state and majority of the residues are exposed to solvent, suggesting that these indels are generally located on the surface of proteins. Though naturally occurring indels are fewer than engineered ones in the dataset, there are no statistically significant differences in terms of amino acid frequencies and secondary structure types between the "Natural" indels and "All" indels in the dataset. Structural comparisons show that all the protein pairs with short internal indels in the dataset preserve the structural folds and about 85% of protein pairs have global RMSDs (root mean square deviations of 2Å or less, suggesting that protein structures tend to be conserved and can tolerate short insertions and deletions. A few pairs

  8. Risk of neuropsychiatric adverse events associated with varenicline: systematic review and meta-analysis.

    Science.gov (United States)

    Thomas, Kyla H; Martin, Richard M; Knipe, Duleeka W; Higgins, Julian P T; Gunnell, David

    2015-03-12

    To determine the risk of neuropsychiatric adverse events associated with use of varenicline compared with placebo in randomised controlled trials. Systematic review and meta-analysis comparing study effects using two summary estimates in fixed effects models, risk differences, and Peto odds ratios. Medline, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), and clinicaltrials.gov. Randomised controlled trials with a placebo comparison group that reported on neuropsychiatric adverse events (depression, suicidal ideation, suicide attempt, suicide, insomnia, sleep disorders, abnormal dreams, somnolence, fatigue, anxiety) and death. Studies that did not involve human participants, did not use the maximum recommended dose of varenicline (1 mg twice daily), and were cross over trials were excluded. In the 39 randomised controlled trials (10,761 participants), there was no evidence of an increased risk of suicide or attempted suicide (odds ratio 1.67, 95% confidence interval 0.33 to 8.57), suicidal ideation (0.58, 0.28 to 1.20), depression (0.96, 0.75 to 1.22), irritability (0.98, 0.81 to 1.17), aggression (0.91, 0.52 to 1.59), or death (1.05, 0.47 to 2.38) in the varenicline users compared with placebo users. Varenicline was associated with an increased risk of sleep disorders (1.63, 1.29 to 2.07), insomnia (1.56, 1.36 to 1.78), abnormal dreams (2.38, 2.05 to 2.77), and fatigue (1.28, 1.06 to 1.55) but a reduced risk of anxiety (0.75, 0.61 to 0.93). Similar findings were observed when risk differences were reported. There was no evidence for a variation in depression and suicidal ideation by age group, sex, ethnicity, smoking status, presence or absence of psychiatric illness, and type of study sponsor (that is, pharmaceutical industry or other). This meta-analysis found no evidence of an increased risk of suicide or attempted suicide, suicidal ideation, depression, or death with varenicline. These findings provide some reassurance for users

  9. Neural Correlates of Word Recognition: A Systematic Comparison of Natural Reading and Rapid Serial Visual Presentation.

    Science.gov (United States)

    Kornrumpf, Benthe; Niefind, Florian; Sommer, Werner; Dimigen, Olaf

    2016-09-01

    Neural correlates of word recognition are commonly studied with (rapid) serial visual presentation (RSVP), a condition that eliminates three fundamental properties of natural reading: parafoveal preprocessing, saccade execution, and the fast changes in attentional processing load occurring from fixation to fixation. We combined eye-tracking and EEG to systematically investigate the impact of all three factors on brain-electric activity during reading. Participants read lists of words either actively with eye movements (eliciting fixation-related potentials) or maintained fixation while the text moved passively through foveal vision at a matched pace (RSVP-with-flankers paradigm, eliciting ERPs). The preview of the upcoming word was manipulated by changing the number of parafoveally visible letters. Processing load was varied by presenting words of varying lexical frequency. We found that all three factors have strong interactive effects on the brain's responses to words: Once a word was fixated, occipitotemporal N1 amplitude decreased monotonically with the amount of parafoveal information available during the preceding fixation; hence, the N1 component was markedly attenuated under reading conditions with preview. Importantly, this preview effect was substantially larger during active reading (with saccades) than during passive RSVP with flankers, suggesting that the execution of eye movements facilitates word recognition by increasing parafoveal preprocessing. Lastly, we found that the N1 component elicited by a word also reflects the lexical processing load imposed by the previously inspected word. Together, these results demonstrate that, under more natural conditions, words are recognized in a spatiotemporally distributed and interdependent manner across multiple eye fixations, a process that is mediated by active motor behavior.

  10. Systematic review and cladistic analysis of the Hernandariinae (Opiliones: Gonyleptidae

    Directory of Open Access Journals (Sweden)

    Marcio Bernardino DaSilva

    2010-08-01

    Full Text Available The harvestmen subfamily Hernandariinae is reviewed and a new classification is proposed based on cladistic analysis using 67 morphological characters. The subfamily is composed of six genera and 23 species and occurs in south-southeastern Brazil, Paraguay, and northeastern Argentina. Fourteen new combinations are proposed: Hernandaria armatifrons (Roewer, 1917; H. una (Mello-Leitão, 1927; Acrogonyleptes granulatus (H. Soares, 1966; A. pectinifemur (Soares & Soares, 1947; Acanthogonyleptes alticola (Mello-Leitão, 1922; A. editus (Roewer, 1943; A. fallax (Mello-Leitão, 1932; A. fulvigranulatus (Mello-Leitão, 1922; A. marmoratus (Mello-Leitão, 1940; A. pictus (Piza, 1942; A. singularis (Mello-Leitão, 1935; A. soaresi (Mello-Leitão, 1944; A. variolosus (Mello-Leitão, 1944. Seven synonymies are proposed: Proweyhia Mello-Leitão, 1927 and Metaxundarava Mello-Leitão, 1927 = Hernandaria Sørensen, 1884; Apembolephaenus calcaratus Soares & Soares, 1945 = H. armatifrons (Roewer, 1917; Sphaerobunus Rower, 1917 and Paraproweyhia Soares & Soares, 1947 = Acrogonyleptes Roewer, 1917; Paraproweyhia curitibae Soares & Soares, 1947 = Acrogonyleptes exochus (Mello-Leitão, 1931; and Melloleitaniana curitibae B. Soares, 1943 = Acrogonyleptes spinifrons Roewer, 1917. Three species are revalidated: Acrogonyleptes granulatus (H. Soares, 1966, A. pectinifemur (Soares & Soares, 1947, and A. spinifrons Roewer, 1917. Seven new species are described: Hernandaria sundermannorum sp. nov. (São Paulo State, Brazil, Hernandaria anitagaribaldiae sp. nov. (Santa Catarina State, Brazil, Hernandaria zumbii sp. nov. (Santa Catarina State, Brazil, Hernandaria chicomendesi sp. nov. (Santa Catarina State, Brazil, Acrogonyleptes cheguevarai sp. nov. (Rio Grande do Sul State, Brazil, Pseudotrogulus pagu sp. nov. (São Paulo State, Brazil, Pseudotrogulus trotskyi sp. nov. (Paraná State, Brazil.

  11. Induced Abortion: a Systematic Review and Meta-analysis.

    Science.gov (United States)

    Dastgiri, Saeed; Yoosefian, Maryam; Garjani, Mehraveh; Kalankesh, Leila R

    2017-03-01

    Induced abortion accounts for 1 in 8 of approximately 600000 maternal deaths that occur annually worldwide. Induced abortion rate can be considered as one of the indicators for assessing availability of the appropriate reproductive health plans for women and identifying needs for appropriate related health policies and programs. Researchers searched Pubmed, Google Scholar, CINAHL, Embase, PsycINFO, Cochrane, Iranian Scientific Information Database (SID), Iranian biomedical journals (Iranmedex), and Iranian Research Institute of Information and Documentation (Irandoc) between January 2000 and June 2013, which reported induced abortion. Search terms from two categories including abortion and termination of pregnancy were compiled. The search terms were "induced abortion", "illegal abortion", "illegal abortion", "unsafe abortion", and "criminal abortion". The search was also conducted with "induced termination of pregnancy", "illegal termination of pregnancy", "illegal termination of pregnancy", "unsafe termination of pregnancy" and "criminal termination of pregnancy". Meta-analysis was carried out by using OpenMeta software. Induced abortion rates were calculated based on the random effect model. Overall induced abortion rate was obtained 58.1 per 1000 women (95%CI: 55.16-61.04). In continental level, rate of induced abortion was 14 per 1000 women (95%CI: 11-16). Nation-wide and local rates were obtained 67.27 per 1000 women (95% CI: 60.02-74.23) and 148.92 (95% CI: 140.06-157.79) respectively. Induced abortion is a major public health problem that occurs worldwide whether under the legal restriction or freedom, and it remains as reproductive health concern globally. To eliminate the need for induced abortion is at the core of any effort for preventing this issue. Option with the highest priority is to prevent unwanted pregnancies through promoting reproductive health plans for women of reproductive age. In case the prevention strategies fail, universal provision of

  12. Effect of whey protein supplementation on body composition changes in women: a systematic review and meta-analysis.

    Science.gov (United States)

    Bergia, Robert E; Hudson, Joshua L; Campbell, Wayne W

    2018-04-23

    A preponderance of evidence supports the beneficial effects of whey protein (WP) supplementation on body composition in men; however, there is currently insufficient evidence to make an equivalent claim in women. This systematic review and meta-analysis assessed the effects of WP supplementation with or without energy restriction (ER) and resistance training (RT) on changes in body mass, lean mass, and fat mass in women. Pubmed, Scopus, Cochrane, and CINAHL were searched using the keywords "whey protein," "body composition," and "lean mass." Two researchers independently screened 1845 abstracts and extracted 276 articles. Thirteen randomized controlled trials with 28 groups met the inclusion criteria. Globally, WP supplementation increased lean mass (WMD, 0.37 kg; 95% confidence interval [CI], 0.06 to 0.67) while not influencing changes in fat mass (-0.20 kg; 95%CI, -0.67 to 0.27) relative to non-WP control. The beneficial effect of WP on lean mass was lost when only studies with RT were included in the analysis (n = 7 comparisons; 0.23 kg; 95%CI, -0.17 to 0.63). The beneficial effect of WP on lean mass was more robust when only studies with an ER component were included (n = 6 comparisons; 0.90 kg; 95%CI, 0.31 to 1.49). There was no effect of WP on lean mass in studies without ER (n = 9 comparisons; 0.22 kg; 95%CI, -0.12 to 0.57). Whey protein supplementation improves body composition by modestly increasing lean mass without influencing changes in fat mass. Body composition improvements from WP are more robust when combined with ER .

  13. Different Toxicity of Cetuximab and Panitumumab in Metastatic Colorectal Cancer Treatment: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Petrelli, Fausto; Ardito, Raffaele; Ghidini, Antonio; Zaniboni, Alberto; Ghidini, Michele; Barni, Sandro; Tomasello, Gianluca

    2018-01-01

    Over the last few years only one large randomized phase III study has tried to prospectively assess the safety of cetuximab and panitumumab in a head-to-head comparison. Despite the similar overall toxicity profile, cetuximab and panitumumab retain peculiar safety characteristics that deserve to be deeply investigated. We conducted a systematic review for randomized trials in PubMed, the Cochrane Central Register of Controlled Trials, SCOPUS, Web of Science, and EMBASE using the terms ("cetuximab" or "panitumumab") AND ("colorectal cancer" OR "colorectal carcinoma"). Data of adverse events were aggregated to obtain pooled incidence rates of prespecified adverse events. Incidence of skin toxicities was the primary outcome. A χ2 test was used for comparisons of proportions and an odds ratio (OR) was calculated for comparison. A total of 38 studies were included for analysis. Cetuximab was associated with fewer G3-4 skin toxicities (OR = 0.62, 95% CI 0.53-0.62; p < 0.001), slightly more frequent G3-4 acne-like rash (OR = 1.24, 95% CI 1.04-1.48; p = 0.04), and paronychia (OR 1.36, 95% CI 1.1-1.7), but fewer cases of skin fissures (OR = 0.64, 95% CI 0.44-0.93; p = 0.02) and pruritus (OR = 0.45, 95% CI 0.35-0.58; p < 0.001) than PANI. In conclusion, this meta-analysis shows that cetuximab- and panitumumab-based chemotherapy have different toxicity profiles in terms of the rate of severe adverse events. © 2018 S. Karger AG, Basel.

  14. Cost-effectiveness analysis of vaccinations and decision makings on vaccination programmes in Hong Kong: A systematic review.

    Science.gov (United States)

    Wong, Carlos K H; Liao, Qiuyan; Guo, Vivian Y W; Xin, Yiqiao; Lam, Cindy L K

    2017-05-31

    To describe and systematically review the modelling and reporting of cost-effectiveness analysis of vaccination in Hong Kong, and to identify areas for quality enhancement in future cost-effectiveness analyses. We conducted a comprehensive and systematic review of cost-effectiveness studies related to vaccination and government immunisation programmes in Hong Kong published from 1990 to 2015, through database search of Pubmed, Web of Science, Embase, and OVID Medline. Methodological quality of selected studies was assessed using Consolidated Health Economic Evaluation Reporting Standards checklist (CHEERS). Decision making of vaccination was obtained from Scientific Committee on Vaccine Preventable Diseases (SCVPD) and Department of Health in Hong Kong. Nine eligible studies reporting twelve comparative cost-effectiveness comparisons of vaccination programme for influenza (n=2), pneumococcal disease (n=3), influenza plus pneumococcal disease (n=1), chickenpox (n=2), Haemophilus influenzae b (n=1), hepatitis A (n=1), cervical cancer (n=1) and rotavirus (n=1) were identified. Ten comparisons (83.3%) calculated the incremental cost-effectiveness ratio (ICER) of a vaccination strategy versus status quo as outcomes in terms of cost in USD per life-years, cost per quality-adjusted life-years, or cost per disability-adjusted life-years. Among those 10 comparisons in base-case scenario, 4 evaluated interventions were cost-saving relative to status quo while the ICER estimates in 3 of the 6 remaining comparisons were far below commonly accepted threshold and WHO willingness-to-pay threshold, suggestive of very cost-effective. Seven studies were of good quality based on the CHEERS checklist; one was of moderate quality; and one was of excellent quality. The common methodological problems were characterisation of heterogeneity and reporting of study parameters. There was a paucity of cost-effectiveness models evaluating vaccination targeted to the Hong Kong population. All

  15. Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis.

    Science.gov (United States)

    Welton, Nicky J; McAleenan, Alexandra; Thom, Howard Hz; Davies, Philippa; Hollingworth, Will; Higgins, Julian Pt; Okoli, George; Sterne, Jonathan Ac; Feder, Gene; Eaton, Diane; Hingorani, Aroon; Fawsitt, Christopher; Lobban, Trudie; Bryden, Peter; Richards, Alison; Sofat, Reecha

    2017-05-01

    Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model. Systematic review, meta-analysis and cost-effectiveness analysis. Primary care. Adults. Screening strategies, defined by screening test, age at initial and final screens, screening interval and format of screening {systematic opportunistic screening [individuals offered screening if they consult with their general practitioner (GP)] or systematic population screening (when all eligible individuals are invited to screening)}. Sensitivity, specificity and diagnostic odds ratios; the odds ratio of detecting new AF cases compared with no screening; and the mean incremental net benefit compared with no screening. Two reviewers screened the search results, extracted data and assessed the risk of bias. A DTA meta-analysis was perfomed, and a decision tree and Markov model was used to evaluate the cost-effectiveness of the screening strategies. Diagnostic test accuracy depended on the screening test and how it was interpreted. In general, the screening tests identified in our review had high sensitivity (> 0.9). Systematic population and systematic opportunistic screening strategies were found to be similarly effective, with an estimated 170 individuals needed to be screened to detect one additional AF case compared with no screening. Systematic opportunistic screening was more likely to be cost

  16. Systematic Analysis and Innovation for Development Policies of Beijing Seed Industry at Transformation Stage

    Institute of Scientific and Technical Information of China (English)

    Qing LIU; Fengjun LU; Guozhi ZHANG; Lijiao XIE

    2015-01-01

    At transformation stage,seed Industry is not only a fundamental and strategic industry during the construction of World City,but also part of urban and modern agriculture in Beijing. Based on the analysis of the theory of industrial economics and system theory,the article constructs the seed industry policy analysis model,systematically analyzes the support points of national level and the city of Beijing seed industry policy,and studies policy input,mechanism,output and effects by way of systematic analysis,as well as proposes polices and suggestions on promotion of development for Beijing seed industry and on construction of new seed industry from talent incentive,platform construction,seed trading and enterprise cultivation.

  17. Efficacy of chitosan dressing on endoscopic sinus surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhou, Jing-Chun; Zhang, Jing-Jing; Zhang, Wei; Ke, Zhao-Yang; Zhang, Bo

    2017-09-01

    Chitosan dressing might be promising to promote the recovery following endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the influence of chitosan dressing on ESS. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of chitosan dressing on endoscopic sinus surgery were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were synechia and hemostasis. Meta-analysis was performed using random-effect model. Four RCTs involving 268 patients were included in the meta-analysis. Overall following ESS, compared with control intervention, chitosan dressing significantly reduced synechia (RR = 0.25; 95% CI 0.13-0.49; P chitosan dressing could significantly decrease edema and improve hemostasis, but had no effect on granulations, mucosal edema, crusting and infection.

  18. Is Recreational Soccer Effective for Improving VO2max A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Milanović, Zoran; Pantelić, Saša; Čović, Nedim; Sporiš, Goran; Krustrup, Peter

    2015-09-01

    Soccer is the most popular sport worldwide, with a long history and currently more than 500 million active participants, of whom 300 million are registered football club members. On the basis of scientific findings showing positive fitness and health effects of recreational soccer, FIFA (Fédération Internationale de Football Association) introduced the slogan "Playing football for 45 min twice a week-best prevention of non-communicable diseases" in 2010. The objective of this paper was to perform a systematic review and meta-analysis of the literature to determine the effects of recreational soccer on maximal oxygen uptake (VO2max). Six electronic databases (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) were searched for original research articles. A manual search was performed to cover the areas of recreational soccer, recreational physical activity, recreational small-sided games and VO2max using the following key terms, either singly or in combination: recreational small-sided games, recreational football, recreational soccer, street football, street soccer, effect, maximal oxygen uptake, peak oxygen uptake, cardiorespiratory fitness, VO2max. The inclusion criteria were divided into four sections: type of study, type of participants, type of interventions and type of outcome measures. Probabilistic magnitude-based inferences for meta-analysed effects were based on standardised thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations for baseline fitness. Seventeen studies met the inclusion criteria and were included in the systematic review and meta-analysis. Mean differences showed that VO2max increased by 3.51 mL/kg/min (95 % CI 3.07-4.15) over a recreational soccer training programme in comparison with other training models. The meta-analysed effects of recreational soccer on VO2max compared with the controls of no exercise, continuous running and strength

  19. Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Lau, Ho Ming; Smit, Johannes H; Fleming, Theresa M; Riper, Heleen

    2016-01-01

    The development and use of serious games for mental health disorders are on the rise. Yet, little is known about the impact of these games on clinical mental health symptoms. We conducted a systematic review and meta-analysis of randomized controlled trials that evaluated the effectiveness of serious games on symptoms of mental disorder. We conducted a systematic search in the PubMed, PsycINFO, and Embase databases, using mental health and serious games-related keywords. Ten studies met the inclusion criteria and were included in the review, and nine studies were included in the meta-analysis. All of the serious games were provided via personal computer, mostly on CD-ROM without the need for an internet connection. The studies targeted age groups ranging from 7 to 80 years old. The serious games focused on symptoms of depression ( n  = 2), post-traumatic stress disorder ( n  = 2), autism spectrum disorder ( n  = 2), attention deficit hyperactivity disorder ( n  = 1), cognitive functioning ( n  = 2), and alcohol use disorder ( n  = 1). The studies used goal-oriented ( n  = 4) and cognitive training games ( n  = 6). A total of 674 participants were included in the meta-analysis (380 in experimental and 294 in control groups). A meta-analysis of 9 studies comprising 10 comparisons, using a random effects model, showed a moderate effect on improvement of symptoms [ g  = 0.55 (95% confidence interval 0.28-0.83); P  games over no intervention controls. Though the number of comparisons in the meta-analysis was small, these findings suggest that serious gaming interventions may be effective for reducing disorder-related symptoms. More studies are needed in order to attain deeper knowledge of the efficacy for specific mental disorders and the longer term effects of this new type of treatment for mental disorders.

  20. Systematic comparison of the response properties of protein and RNA mediated gene regulatory motifs.

    Science.gov (United States)

    Iyengar, Bharat Ravi; Pillai, Beena; Venkatesh, K V; Gadgil, Chetan J

    2017-05-30

    We present a framework enabling the dissection of the effects of motif structure (feedback or feedforward), the nature of the controller (RNA or protein), and the regulation mode (transcriptional, post-transcriptional or translational) on the response to a step change in the input. We have used a common model framework for gene expression where both motif structures have an activating input and repressing regulator, with the same set of parameters, to enable a comparison of the responses. We studied the global sensitivity of the system properties, such as steady-state gain, overshoot, peak time, and peak duration, to parameters. We find that, in all motifs, overshoot correlated negatively whereas peak duration varied concavely with peak time. Differences in the other system properties were found to be mainly dependent on the nature of the controller rather than the motif structure. Protein mediated motifs showed a higher degree of adaptation i.e. a tendency to return to baseline levels; in particular, feedforward motifs exhibited perfect adaptation. RNA mediated motifs had a mild regulatory effect; they also exhibited a lower peaking tendency and mean overshoot. Protein mediated feedforward motifs showed higher overshoot and lower peak time compared to the corresponding feedback motifs.

  1. Homeopathy and systematics: a systematic analysis of the therapeutic effects of the plant species used in homeopathy.

    Science.gov (United States)

    Bharatan, V

    2008-07-01

    The therapeutic effects of the plant species used in homeopathy have never been subjected to systematic analysis. A survey of the various Materiae Medicae shows that over 800 plant species are the source of medicines in homeopathy. As these medicines are considered related to one another with respect to their therapeutic effects for treating similar symptoms, the aim is to classify and map them using the concept of homology. This involves placing the discipline of homeopathy into a comparative framework using these plant medicines as taxa, therapeutic effects as characters, and contemporary cladistic techniques to analyse these relationships. The results are compared using cladograms based on different data sets used in biology (e.g. morphological characters and DNA sequences) to test whether similar cladistic patterns exist among these medicines. By classifying the therapeutic actions, genuine homologies can be distinguished from homoplasies. As this is a comparative study it has been necessary first to update the existing nomenclature of the plant species in the homeopathic literature in line with the current International Code of Botanical Nomenclature.

  2. Anatomy of large animal spines and its comparison to the human spine: a systematic review.

    Science.gov (United States)

    Sheng, Sun-Ren; Wang, Xiang-Yang; Xu, Hua-Zi; Zhu, Guo-Qing; Zhou, Yi-Fei

    2010-01-01

    Animal models have been commonly used for in vivo and in vitro spinal research. However, the extent to which animal models resemble the human spine has not been well known. We conducted a systematic review to compare the morphometric features of vertebrae between human and animal species, so as to give some suggestions on how to choose an appropriate animal model in spine research. A literature search of all English language peer-reviewed publications was conducted using PubMed, OVID, Springer and Elsevier (Science Direct) for the years 1980-2008. Two reviewers extracted data on the anatomy of large animal spines from the identified articles. Each anatomical study of animals had to include at least three vertebral levels. The anatomical data from all animal studies were compared with the existing data of the human spine in the literature. Of the papers retrieved, seven were included in the review. The animals in the studies involved baboon, sheep, porcine, calf and deer. Distinct anatomical differences of vertebrae were found between the human and each large animal spine. In cervical region, spines of the baboon and human are more similar as compared to other animals. In thoracic and lumbar regions, the mean pedicle height of all animals was greater than the human pedicles. There was similar mean pedicle width between animal and the human specimens, except in thoracic segments of sheep. The human spinal canal was wider and deeper in the anteroposterior plane than any of the animals. The mean human vertebral body width and depth were greater than that of the animals except in upper thoracic segments of the deer. However, the mean vertebral body height was lower than that of all animals. This paper provides a comprehensive review to compare vertebrae geometries of experimental animal models to the human vertebrae, and will help for choosing animal model in vivo and in vitro spine research. When the animal selected for spine research, the structural similarities and

  3. Systematic review and meta-analysis: tools for the information age.

    Science.gov (United States)

    Weatherall, Mark

    2017-11-01

    The amount of available biomedical information is vast and growing. Natural limitations of the way clinicians and researchers approach this treasure trove of information comprise difficulties locating the information, and once located, cognitive biases may lead to inappropriate use of the information. Systematic reviews and meta-analyses represent important tools in the information age to improve knowledge and action. Systematic reviews represent a census approach to identifying literature to avoid non-response bias. They are a necessary prelude to producing combined quantitative summaries of associations or treatment effects. Meta-analysis comprises the arithmetical techniques for producing combined summaries from individual study reports. Careful, thoughtful and rigorous use of these tools is likely to enhance knowledge and action. Use of standard guidelines, such as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, or embedding these activities within collaborative groups such as the Cochrane Collaboration, are likely to lead to more useful systematic review and meta-analysis reporting. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Positron Emission Tomography in Prostate Cancer: Summary of Systematic Reviews and Meta-Analysis.

    Science.gov (United States)

    Jadvar, Hossein

    2015-09-01

    Prostate cancer is a prevalent public health problem worldwide. Over the past decade, there has been tremendous research activity in the potential use of positron emission tomography with a number of radiotracers targeted to various biological aspects of this complex tumor. Systematic reviews and meta-analysis are important contributions to the relevant literature that summarize the evidence while reducing the effect of various sources of bias in the published data. The accumulation of relevant data in this clinical setting has recently provided the opportunity for systematic reviews. In this brief article, I summarize the published systematic reviews and meta-analysis of positron emission tomography in prostate cancer. Most robust evidence suggests a probable role for first-line use of positron emission tomography with radiolabeled choline in restating patients with biochemical relapse of prostate cancer with the diagnostic performance that appears to be positively associated with the serum prostate specific antigen level and velocity. Future systematic reviews will be needed for other emerging radiotracers such as those based on prostate specific membrane antigen and gastrin-releasing peptide receptor.

  5. Comparison between exergy and energy analysis for biodiesel production

    International Nuclear Information System (INIS)

    Amelio, A.; Van de Voorde, T.; Creemers, C.; Degrève, J.; Darvishmanesh, S.; Luis, P.; Van der Bruggen, B.

    2016-01-01

    This study investigates the exergy concept for use in chemical engineering applications, and compares the energy and exergy methodology for the production process of biodiesel. A process for biodiesel production was suggested and simulated in view of the energy and exergy analysis. A method was developed to implement the exergy concept in Aspen Plus 7.3. A comparison between the energy and the exergy approach reveals that the concepts have similarities but also some differences. In the exergy study, the reaction section has the largest losses whereas in the energy study separation steps are the most important. An optimization, using both concepts, was carried out using the same parameters. The optimized results were different depending on the objective function. It was concluded that exergy analysis is crucial during the design or redesign step in order to investigate thermodynamic efficiencies in each part of the process. - Highlights: • New flowsheet for the production of biodiesel simulated with Aspen Plus. • Calculation of the exergetic costs and several interesting indexes. • Comparison of exergy and energy analysis for the process studied.

  6. Association Between the Estrogen Receptor Beta (ESR2) Rs1256120 Single Nucleotide Polymorphism and Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zhao, Linlu; Roffey, Darren M; Chen, Suzan

    2017-06-01

    A systematic review and meta-analysis. The aim of this study was to assess and synthesize the current evidence on the association between the rs1256120 single nucleotide polymorphism (SNP) of the estrogen receptor beta gene (ESR2) and adolescent idiopathic scoliosis (AIS). Hormonal disturbance has been postulated as a potential etiological factor in the development of AIS. As estrogen receptors are important mediators of estrogen response, mutations in these genes, including rs1256120 of ESR2, have been chosen as susceptibility candidates for AIS predisposition. The association of rs1256120 with AIS has been investigated in several recent studies, but showed conflicting evidence. We conducted a systematic review to evaluate the strength of this body of evidence and quantitative synthesis to examine sources of heterogeneity. This study conformed to PRISMA guidelines. Using a sensitive search strategy, PubMed (MEDLINE), EMBASE, and HuGE Literature Finder databases were searched to identify relevant studies for inclusion in the systematic review and meta-analysis. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. The inverse variance model was used to calculate summary odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the allelic (C vs. T) and genotypic comparisons. Planned subgroup and sensitivity analyses were performed. Three studies were included for systematic review and meta-analysis (n = 1264 AIS cases and n=1020 controls). A null relationship was found between rs1256120 and AIS (allelic OR = 1.20, 95% CI: 0.81-1.78, P = 0.36, I = 84.9%), with the first reported association likely to be false-positive and contributing substantially to heterogeneity. Findings from the systematic review and meta-analysis suggest that rs1256120 of ESR2 is unlikely to be a predisposing or disease-modifying genetic risk factor for AIS. 2.

  7. Tissue Engineering of the Urethra: A Systematic Review and Meta-analysis of Preclinical and Clinical Studies.

    Science.gov (United States)

    Versteegden, Luuk R M; de Jonge, Paul K J D; IntHout, Joanna; van Kuppevelt, Toin H; Oosterwijk, Egbert; Feitz, Wout F J; de Vries, Rob B M; Daamen, Willeke F

    2017-10-01

    Urethra repair by tissue engineering has been extensively studied in laboratory animals and patients, but is not routinely used in clinical practice. To systematically investigate preclinical and clinical evidence of the efficacy of tissue engineering for urethra repair in order to stimulate translation of preclinical studies to the clinic. A systematic search strategy was applied in PubMed and EMBASE. Studies were independently screened for relevance by two reviewers, resulting in 80 preclinical and 23 clinical studies of which 63 and 13 were selected for meta-analysis to assess side effects, functionality, and study completion. Analyses for preclinical and clinical studies were performed separately. Full circumferential and inlay procedures were assessed independently. Evaluated parameters included seeding of cells and type of biomaterial. Meta-analysis revealed that cell seeding significantly reduced the probability of encountering side effects in preclinical studies. Remarkably though, cells were only sparsely used in the clinic (4/23 studies) and showed no significant reduction of side effects. ln 21 out of 23 clinical studies, decellularized templates were used, while in preclinical studies other biomaterials showed promising outcomes as well. No direct comparison to current clinical practice could be made due to the limited number of randomized controlled studies. Due to a lack of controlled (pre)clinical studies, the efficacy of tissue engineering for urethra repair could not be determined. Meta-analysis outcome measures were similar to current treatment options described in literature. Surprisingly, it appeared that favorable preclinical results, that is inclusion of cells, were not translated to the clinic. Improved (pre)clinical study designs may enhance clinical translation. We reviewed all available literature on urethral tissue engineering to assess the efficacy in preclinical and clinical studies. We show that improvements to (pre)clinical study

  8. Performance Analysis Comparison Of Coca Cola And Pepsi

    OpenAIRE

    The, Glenny Marselia; Saerang, David Paul Elia; Tumewu, Ferdinand

    2014-01-01

    All companies fight to get as many consumers as they can and it makes, product, price, place and promotion become important factors to make a company has a successful marketing campaign. The companies spend much money for create an attractive product at an affordable price, a place that can be reached, and the promotion that can be well-received by the public. So, regarding that fact, the researcher writes a study about the performance analysis comparison of Coca Cola and Pepsi in Manado b...

  9. Qualitative content analysis for international comparison of data usage agreements

    Directory of Open Access Journals (Sweden)

    Christian Haux

    2017-04-01

    Undertaking an overview of privacy conditions can be a valuable step in comparing privacy and security requirements in different national regulations. The qualitative content analysis was found a suitable approach for this purpose because it enables the detection of fine characteristics. By using an incremental design, it is possible to adapt the coding system to include additional partners. However, the current coding system has the limitation that heterogeneity between the agreements leads to a fine granularity of categories that hamper the comparability between partners. Despite these problems, the approach allows the comparison of data privacy and supports the development of a data integration process for international harmonisation.

  10. Analysis of stock market anomalies: US cross-sectoral comparison

    OpenAIRE

    Jílek, Lukáš

    2012-01-01

    The purpose of this thesis is to analyze anomalies in the US stock market. Special attention is put on Day of the week effect, January effect, and Part of the month effect. We focus on comparison of companies with low and high capitalization. We perform an analysis across 6 major industrial sectors. Then, we discuss the findings with results of past projects and finally, we try to find a speculative investment strategy. We found out that neither Day of the week effect nor January effect do no...

  11. Addressing dichotomous data for participants excluded from trial analysis: a guide for systematic reviewers.

    Directory of Open Access Journals (Sweden)

    Elie A Akl

    Full Text Available Systematic reviewer authors intending to include all randomized participants in their meta-analyses need to make assumptions about the outcomes of participants with missing data.The objective of this paper is to provide systematic reviewer authors with a relatively simple guidance for addressing dichotomous data for participants excluded from analyses of randomized trials.This guide is based on a review of the Cochrane handbook and published methodological research. The guide deals with participants excluded from the analysis who were considered 'non-adherent to the protocol' but for whom data are available, and participants with missing data.Systematic reviewer authors should include data from 'non-adherent' participants excluded from the primary study authors' analysis but for whom data are available. For missing, unavailable participant data, authors may conduct a complete case analysis (excluding those with missing data as the primary analysis. Alternatively, they may conduct a primary analysis that makes plausible assumptions about the outcomes of participants with missing data. When the primary analysis suggests important benefit, sensitivity meta-analyses using relatively extreme assumptions that may vary in plausibility can inform the extent to which risk of bias impacts the confidence in the results of the primary analysis. The more plausible assumptions draw on the outcome event rates within the trial or in all trials included in the meta-analysis. The proposed guide does not take into account the uncertainty associated with assumed events.This guide proposes methods for handling participants excluded from analyses of randomized trials. These methods can help in establishing the extent to which risk of bias impacts meta-analysis results.

  12. Mapping vulnerability to bipolar disorder: a systematic review and meta-analysis of neuroimaging studies

    Science.gov (United States)

    Fusar-Poli, Paolo; Howes, Oliver; Bechdolf, Andreas; Borgwardt, Stefan

    2012-01-01

    Background Although early interventions in individuals with bipolar disorder may reduce the associated personal and economic burden, the neurobiologic markers of enhanced risk are unknown. Methods Neuroimaging studies involving individuals at enhanced genetic risk for bipolar disorder (HR) were included in a systematic review. We then performed a region of interest (ROI) analysis and a whole-brain meta-analysis combined with a formal effect-sizes meta-analysis in a subset of studies. Results There were 37 studies included in our systematic review. The overall sample for the systematic review included 1258 controls and 996 HR individuals. No significant differences were detected between HR individuals and controls in the selected ROIs: striatum, amygdala, hippocampus, pituitary and frontal lobe. The HR group showed increased grey matter volume compared with patients with established bipolar disorder. The HR individuals showed increased neural response in the left superior frontal gyrus, medial frontal gyrus and left insula compared with controls, independent from the functional magnetic resonance imaging task used. There were no publication biases. Sensitivity analysis confirmed the robustness of these results. Limitations As the included studies were cross-sectional, it remains to be determined whether the observed neurofunctional and structural alterations represent risk factors that can be clinically used in preventive interventions for prodromal bipolar disorder. Conclusion Accumulating structural and functional imaging evidence supports the existence of neurobiologic trait abnormalities in individuals at genetic risk for bipolar disorder at various scales of investigation. PMID:22297067

  13. Association between depression and periodontitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Araújo, Milena Moreira; Martins, Carolina Castro; Costa, Lidiane Cristina Machado; Cota, Luís Otávio Miranda; Faria, Rodrigo Lamounier Araújo Melo; Cunha, Fabiano Araújo; Costa, Fernando Oliveira

    2016-03-01

    The aim of this systematic review and meta-analysis was to assess the scientific evidence on the association between depression and periodontitis. An electronic search was conducted in three databases until October 2015 (PROSPERO-CRD42014006451). Hand searches and grey literature were also included. Search retrieved 423 potentially studies. Two independent reviewers selected the studies, extracted data and assessed risk bias through a modified version of Newcastle-Ottawa scale. Meta-analysis was performed for the presence/absence of periodontitis (dichotomic). Summary effect measures and odds ratio (OR) 95% CI were calculated. After selecting the studies, 15 were included in the systematic review (eight cross-sectional, six case-control and one cohort study). Six studies reported that depression was associated with periodontitis, whereas nine studies did not. The majority of studies had low risk of bias by methodological quality assessment. Meta-analysis of seven cross-sectional studies showed no significant association between depression and periodontitis (OR = 1.03, 95% CI = 0.75-1.41). Findings from the present systematic review showed a great heterogeneity among the studies and the summary effect measure of the meta-analysis cannot affirm an association between depression and periodontitis. Future studies with different designs in distinct populations should be conducted to investigate this association. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Technology-enhanced simulation in emergency medicine: a systematic review and meta-analysis.

    Science.gov (United States)

    Ilgen, Jonathan S; Sherbino, Jonathan; Cook, David A

    2013-02-01

    Technology-enhanced simulation is used frequently in emergency medicine (EM) training programs. Evidence for its effectiveness, however, remains unclear. The objective of this study was to evaluate the effectiveness of technology-enhanced simulation for training in EM and identify instructional design features associated with improved outcomes by conducting a systematic review. The authors systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Original research articles in any language were selected if they compared simulation to no intervention or another educational activity for the purposes of training EM health professionals (including student and practicing physicians, midlevel providers, nurses, and prehospital providers). Reviewers evaluated study quality and abstracted information on learners, instructional design (curricular integration, feedback, repetitive practice, mastery learning), and outcomes. From a collection of 10,903 articles, 85 eligible studies enrolling 6,099 EM learners were identified. Of these, 56 studies compared simulation to no intervention, 12 compared simulation with another form of instruction, and 19 compared two forms of simulation. Effect sizes were pooled using a random-effects model. Heterogeneity among these studies was large (I(2) ≥ 50%). Among studies comparing simulation to no intervention, pooled effect sizes were large (range = 1.13 to 1.48) for knowledge, time, and skills and small to moderate for behaviors with patients (0.62) and patient effects (0.43; all p 0.1). Qualitative comparisons of different simulation curricula are limited, although feedback, mastery learning, and higher fidelity were associated with improved learning outcomes. Technology-enhanced simulation for EM learners is associated with moderate or large favorable effects in comparison with no intervention and generally small and nonsignificant benefits in comparison

  15. Physiological adaptation of endothelial function to pregnancy: systematic review and meta-analysis.

    Science.gov (United States)

    Lopes van Balen, V A; van Gansewinkel, T A G; de Haas, S; van Kuijk, S M J; van Drongelen, J; Ghossein-Doha, C; Spaanderman, M E A

    2017-12-01

    To establish reference values for flow-mediated dilatation (FMD) and brachial artery diameter (BAD) in pregnancy and to provide insight into the physiological and pathological course of endothelial adaptation throughout human singleton pregnancy. A meta-analysis was performed following a systematic review of current literature on FMD, as a derivative for endothelial function, and BAD, throughout uncomplicated and complicated pregnancy. PubMed (NCBI) and EMBASE (Ovid) electronic databases were used for the literature search, which was performed from inception to 9 June 2016. To allow judgment of changes in comparison with the non-pregnant state, studies were required to report both non-pregnant mean reference of FMD (matched control group, prepregnancy or postpartum measurement) and mean FMD at a predetermined and reported gestational age. Pooled mean differences between the reference and pregnant FMD values were calculated for predefined intervals of gestational age. Fourteen studies that enrolled 1231 participants met the inclusion criteria. Publication dates ranged from 1999 to 2014. In uncomplicated pregnancy, FMD was increased in the second and third trimesters. Between 15 and 21 weeks of gestation, absolute FMD increased the most, by a mean (95% CI) of 1.89% (0.25-3.53%). This was a relative increase of 22.5% (3.0-42.0%) compared with the non-pregnant reference. BAD increased progressively, in a steady manner, by the second trimester but not significantly in the first half of the second trimester. We could not discern differences in FMD and BAD between complicated and uncomplicated pregnancies at 29-35 weeks' gestation, reported in the three studies that met our inclusion criteria. Despite the increase in FMD and BAD throughout gestation, both reference curves were characterized by wide 95% CIs. During healthy pregnancy, endothelium-dependent vasodilatation and BAD increase. Women with a complicated pregnancy had FMD values within the lower range when

  16. Mononostril versus Binostril Endoscopic Transsphenoidal Approach for Pituitary Adenomas: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Guodao Wen

    Full Text Available Over the past several decades, the endoscopic endonasal transsphenoidal approach (EETA has gradually become a preferred option of pituitary adenomas surgery because of its minimal invasiveness and high efficiency. However, some EETA operations were performed through one nostril (mononostril, while other EETA operations were performed through both nostrils (binostril. Therefore, we conducted this study to compare the pros and cons of these two methods in an attempted to confirm which method is more effective.We executed a systematic literature search of PubMed, the Cochrane Library, and the Web of Science and Medline (1992-2015. The language is limited to English and all studies should meet the inclusion criteria. Comparisons were made for postoperative outcomes, complications, and other relevant parameters between the mononostril and the binostril group. Statistical analyses of categorical variables were undertaken by the use of Stata 12.0 and SPASS 19.0.Thirty studies, involving 4805 patients, were included. The two groups had similar results in GTR rate (included GTR rate of macroadenomas, hormonal remission rate, improvement in visual function, postoperative CSF leak, permanent diabetes insipidus, meningitis, and sinusitis. The binostril group had less temporary diabetes insipidus (2.9% vs. 5.3%, p = 0.022, less anterior pituitary insufficiency (2.3% vs. 6.4%, p = 0.000 and few hospitalization days (3.2 days vs. 4.4 days, p<0.05 than the mononostril group. However, the mononostril group had less rate of epistaxis (0.4% vs. 1.5%, p = 0.008 than the binostril group. For invasive macroadenomas, the binostril group seem to demonstrate a tendency towards better outcomes though there was no subgroup analysis between the two groups.The binostril approach had less temporary diabetes insipidus, anterior pituitary insufficiency, and a shorter length of hospital stay, although they demonstrated a higher rate of epistaxis than the mononstril group

  17. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials.

    Science.gov (United States)

    Chiavaroli, Laura; Nishi, Stephanie K; Khan, Tauseef A; Braunstein, Catherine R; Glenn, Andrea J; Mejia, Sonia Blanco; Rahelić, Dario; Kahleová, Hana; Salas-Salvadó, Jordi; Jenkins, David J A; Kendall, Cyril W C; Sievenpiper, John L

    2018-05-25

    The evidence for the Portfolio dietary pattern, a plant-based dietary pattern that combines recognized cholesterol-lowering foods (nuts, plant protein, viscous fibre, plant sterols), has not been summarized. To update the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of controlled trials using GRADE of the effect of the Portfolio dietary pattern on the primary therapeutic lipid target for cardiovascular disease prevention, low-density lipoprotein cholesterol (LDL-C), and other established cardiometabolic risk factors. We searched MEDLINE, EMBASE, and The Cochrane Library through April 19, 2018. We included controlled trials ≥ 3-weeks assessing the effect of the Portfolio dietary pattern on cardiometabolic risk factors compared with an energy-matched control diet free of Portfolio dietary pattern components. Two independent reviewers extracted data and assessed risk of bias. The primary outcome was LDL-C. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 -statistic). GRADE assessed the certainty of the evidence. Eligibility criteria were met by 7 trial comparisons in 439 participants with hyperlipidemia, in which the Portfolio dietary pattern was given on a background of a National Cholesterol Education Program (NCEP) Step II diet. The combination of a portfolio dietary pattern and NCEP Step II diet significantly reduced the primary outcome LDL-C by ~17% (MD, -0.73mmol/L, [95% CI, -0.89 to -0.56 mmol/L]) as well as non-high-density lipoprotein cholesterol, apolipoprotein B, total cholesterol, triglycerides, systolic and diastolic blood pressure, C-reactive protein, and estimated 10-year coronary heart disease (CHD) risk, compared with an NCEP Step 2 diet alone (PPortfolio dietary pattern leads to clinically

  18. Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis.

    Science.gov (United States)

    Van Doren, Jessica; Arns, Martijn; Heinrich, Hartmut; Vollebregt, Madelon A; Strehl, Ute; K Loo, Sandra

    2018-02-14

    Neurofeedback (NF) has gained increasing interest in the treatment of attention-deficit/hyperactivity disorder (ADHD). Given learning principles underlie NF, lasting clinical treatment effects may be expected. This systematic review and meta-analysis addresses the sustainability of neurofeedback and control treatment effects by considering randomized controlled studies that conducted follow-up (FU; 2-12 months) assessments among children with ADHD. PubMed and Scopus databases were searched through November 2017. Within-group and between-group standardized mean differences (SMD) of parent behavior ratings were calculated and analyzed. Ten studies met inclusion criteria (NF: ten studies, N = 256; control: nine studies, N = 250). Within-group NF effects on inattention were of medium effect size (ES) (SMD = 0.64) at post-treatment and increased to a large ES (SMD = 0.80) at FU. Regarding hyperactivity/impulsivity, NF ES were medium at post-treatment (SMD = 0.50) and FU (SMD = 0.61). Non-active control conditions yielded a small significant ES on inattention at post-treatment (SMD = 0.28) but no significant ES at FU. Active treatments (mainly methylphenidate), had large ES for inattention (post: SMD = 1.08; FU: SMD = 1.06) and medium ES for hyperactivity/impulsivity (post: SMD = 0.74; FU: SMD = 0.67). Between-group analyses also revealed an advantage of NF over non-active controls [inattention (post: SMD = 0.38; FU: SMD = 0.57); hyperactivity-impulsivity (post: SMD = 0.25; FU: SMD = 0.39)], and favored active controls for inattention only at pre-post (SMD = - 0.44). Compared to non-active control treatments, NF appears to have more durable treatment effects, for at least 6 months following treatment. More studies are needed for a properly powered comparison of follow-up effects between NF and active treatments and to further control for non-specific effects.

  19. Hepatitis E seroprevalence in the Americas: A systematic review and meta-analysis.

    Science.gov (United States)

    Horvatits, Thomas; Ozga, Ann-Kathrin; Westhölter, Dirk; Hartl, Johannes; Manthey, Carolin F; Lütgehetmann, Marc; Rauch, Geraldine; Kriston, Levente; Lohse, Ansgar W; Bendall, Richard; Wedemeyer, Heiner; Dalton, Harry R; Pischke, Sven

    2018-04-16

    While hepatitis E virus infections are a relevant topic in Europe, knowledge about epidemiology of hepatitis E virus infections in the USA and Latin America is still limited. Aim of this study was to estimate anti-hepatitis E virus IgG seroprevalence in the Americas and to assess whether low socioeconomic status is associated with hepatitis E virus exposure. We performed a systematic review and meta-analysis. Literature search was performed in PubMed for articles published 01/1994-12/2016. Prevalence was estimated using a mixed-effects model and reported in line with PRISMA reporting guidelines. Seroprevalence was significantly higher in the USA than in Latin America, independently of assay, patient cohort, methodological quality or study year (OR: 1.82 (1.06-3.08), P = .03). Patients in the USA had a more than doubled estimated seroprevalence (up to 9%, confidence interval 5%-15.6%) than those in Brazil (up to 4.2%, confidence interval 2.4%-7.1%; OR: 2.27 (1.25-4.13); P = .007) and Mixed Caribbean (up to 1%, OR: 8.33 (1.15-81.61); P = .04). A comparison with published data from Europe demonstrated that anti-hepatitis E virus seroprevalence in the USA and Europe did not differ significantly (OR: 1.33 (0.81-2.19), P = .25), while rate in South America was significantly lower than that in Europe (OR: 0.67 (0.45-0.98), P = .04). Hepatitis E virus is common in the USA. Surprisingly, the risk of hepatitis E virus exposure was low in many South American countries. Seroprevalence did not differ significantly between Europe and the USA. Hence, hepatitis E virus is not limited to countries with low sanitary standards, and a higher socioeconomic status does not protect populations from hepatitis E virus exposure. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis

    Science.gov (United States)

    Didari, Tina; Mozaffari, Shilan; Nikfar, Shekoufeh; Abdollahi, Mohammad

    2015-01-01

    AIM: To investigate the efficacy of probiotics in irritable bowel syndrome (IBS) patients. METHODS: PubMed, Cochrane library, Scopus, Google Scholar, and Clinicaltrial.gov databases were searched for literature published between September 2007 and December 2013. The applied Mesh terms were “probiotics,” “irritable bowel syndrome,” and “irritable bowel syndrome treatment.” The collected data contained24 clinical trials, of which 15 were eligible for meta-analysis and nine were reviewed systematically. All studies were randomized placebo-controlled trials in patients with IBS that investigated the efficacy of probiotics in IBS improvement. The Jadad score was used to assess the methodological quality of trials. The quality scale ranges from 0 to 5 points, with a score ≤ 2 indicating a low quality report, and a score of ≥ 3 indicating a high quality report. Relative risk (RR), standardized effect size, and 95%CI were calculated using the DerSimonian-Laird method. The Cochran Q test was used to test heterogeneity with P probiotics to placebo was 1.96 (95%CI: 1.14-3.36; P = 0.01). RR of responders to therapies based on a global symptom score in IBS patients for two included trials comparing probiotics with placebo was 2.43 (95%CI: 1.13-5.21; P = 0.02). For adequate improvement of general symptoms in IBS patients, the RR of seven included trials (six studies) comparing probiotics with placebo was 2.14 (95%CI: 1.08-4.26; P = 0.03). Distension, bloating, and flatulence were evaluated using an IBS severity scoring system in three trials (two studies) to compare the effect of probiotic therapy in IBS patients with placebo, the standardized effect size of mean differences for probiotics therapy was -2.57 (95%CI: -13.05--7.92). CONCLUSION: Probiotics reduce pain and symptom severity scores. The results demonstrate the beneficial effects of probiotics in IBS patients in comparison with placebo. PMID:25780308

  1. Current Status of Sodium Bicarbonate in Coronary Angiography: An Updated Comprehensive Meta-Analysis and Systematic Review

    Directory of Open Access Journals (Sweden)

    Sadegh Ali-Hassan-Sayegh

    2015-01-01

    Full Text Available This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes. We searched major electronic databases for studies in randomized controlled trials. A value of P50% indicated significant heterogeneity between the studies. Literature search of all databases retrieved 650 studies. 29 studies enrolled in meta-analysis. Pooled analysis indicated about the incidence of CIN (OR of 0.718; 95% CI: 0.60 to 0.85; P=0.000, requirement of hemodialysis (OR of 1.00; 95% CI: 0.49 to 2.01; P=0.9, mean changes of serum creatinine (WMD of 2.321; 95% CI: 1.995 to 2.648; P=0.000, length of hospital stays (WMD of −0.774; 95% CI: −1.65 to 0.10; P=0.08, major adverse cardiovascular events (OR = 1.075, 95% CI: 0.59 to 1.95; P=0.8, and mortality (OR of 0.73; 95% CI: 0.42 to 1.26; P=0.2. Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride. In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.

  2. Follicular flushing during oocyte retrieval: a systematic review and meta-analysis.

    Science.gov (United States)

    Roque, Matheus; Sampaio, Marcos; Geber, Selmo

    2012-11-01

    The purpose of this systematic review and meta-analysis was to examine the literature and identify randomized controlled trials (RCTs), in order to answer if performing follicular flushing during the oocyte retrieval may improve the assisted reproductive technologies (ART) outcomes. An exhaustive electronic search was performed using MEDLINE and EMBASE databases. Only RCTs comparing follicular flushing to aspiration only during ART, were included. We included 5 trials, with a total of 482 patients randomized, with median ages ranging from 30.5 to 37.1. The data analyses did not show significant differences regarding live birth rate, clinical pregnancies rates, and the number of oocytes retrieved. The duration of oocyte retrieval was significantly increased in the follicular flushing group. The results from this systematic review and meta-analysis suggest that there is no advantage to use of routine follicular flushing during OR in an unselected group of patients.

  3. Analysis phase of systematic approach to training (SAT) for nuclear plant personnel

    International Nuclear Information System (INIS)

    2000-08-01

    The IAEA and many Member States have recognized the benefits of a systematic approach when training nuclear power plant personnel. The Systematic Approach to Training (SAT) fully described in the IAEA publications, is recommended as the best practice for attaining and maintaining the competence and qualification of NPP personnel. Typically, SAT is organised into distinct phases of Analysis, Design, Development, Implementation, and Evaluation, and relies on Feedback as a process for continuous improvement This document is addressed to nuclear power operating organisations facing the challenge of developing training programs for their own personnel. The intention was to provide Member States with examples of the Analysis phase to form foundation of SAT-based training programs. This document is also available in CD form

  4. Bibliometrics of systematic reviews: analysis of citation rates and journal impact factors

    Science.gov (United States)

    2013-01-01

    Background Systematic reviews are important for informing clinical practice and health policy. The aim of this study was to examine the bibliometrics of systematic reviews and to determine the amount of variance in citations predicted by the journal impact factor (JIF) alone and combined with several other characteristics. Methods We conducted a bibliometric analysis of 1,261 systematic reviews published in 2008 and the citations to them in the Scopus database from 2008 to June 2012. Potential predictors of the citation impact of the reviews were examined using descriptive, univariate and multiple regression analysis. Results The mean number of citations per review over four years was 26.5 (SD ±29.9) or 6.6 citations per review per year. The mean JIF of the journals in which the reviews were published was 4.3 (SD ±4.2). We found that 17% of the reviews accounted for 50% of the total citations and 1.6% of the reviews were not cited. The number of authors was correlated with the number of citations (r = 0.215, P reviews published in the top quartile of JIFs (≥ 5.16) received citations in the bottom quartile (eight or fewer), whereas 9% of reviews published in the lowest JIF quartile (≤ 2.06) received citations in the top quartile (34 or more). Six percent of reviews in journals with no JIF were also in the first quartile of citations. Conclusions The JIF predicted over half of the variation in citations to the systematic reviews. However, the distribution of citations was markedly skewed. Some reviews in journals with low JIFs were well-cited and others in higher JIF journals received relatively few citations; hence the JIF did not accurately represent the number of citations to individual systematic reviews. PMID:24028376

  5. Is there a social gradient of sarcopenia? A meta-analysis and systematic review protocol.

    Science.gov (United States)

    Green, Darci; Duque, Gustavo; Fredman, Nick; Rizvi, Aoun; Brennan-Olsen, Sharon Lee

    2018-01-13

    Sarcopenia (or loss of muscle mass and function) is a relatively new area within the field of musculoskeletal research and medicine. Investigating whether there is a social gradient, including occupation type and income level, of sarcopenia, as observed for other diseases, will contribute significantly to the limited evidence base for this disease. This new information may inform the prevention and management of sarcopenia and widen the evidence base to support existing and future health campaigns. We will conduct a systematic search of the databases PubMed, Ovid, CINAHL, Scopus and EMBASE to identify articles that investigate associations between social determinants of health and sarcopenia in adults aged 50 years and older. Eligibility of the selected studies will be determined by two independent reviewers. The methodological quality of eligible studies will be assessed according to predetermined criteria. Established statistical methods to identify and control for heterogeneity will be used, and where appropriate, we will conduct a meta-analysis. In the event that heterogeneity prevents numerical synthesis, a best evidence analysis will be employed. This systematic review protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and will be registered with the International Prospective Register of Systematic Reviews (PROSPERO). This systematic review will use published data, thus ethical permissions will not be required. In addition to peer-reviewed publication, our results will be presented at (inter)national conferences relevant to the field of sarcopenia, ageing and/or musculoskeletal health and disseminated both electronically and in print. CRD42017072253. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. The cognitive profile of behavioural variant FTD and its similarities with ALS: a systematic review and meta-analysis.

    Science.gov (United States)

    Beeldman, Emma; Raaphorst, Joost; Klein Twennaar, Michelle; Govaarts, Rosanne; Pijnenburg, Yolande A L; de Haan, Rob J; de Visser, Marianne; Schmand, Ben A

    2018-02-09

    Approximately 30% of patients with amyotrophic lateral sclerosis (ALS) have cognitive impairment and 8%-14% fulfil the criteria for behavioural variant frontotemporal dementia (bv-FTD). The cognitive profiles of ALS and bv-FTD have been reported to be comparable, but this has never been systematically investigated. We aimed to determine the cognitive profile of bv-FTD and examine its similarities with that of ALS, to provide evidence for the existence of a cognitive disease continuum encompassing bv-FTD and ALS. We therefore systematically reviewed neuropsychological studies on bv-FTD patients and healthy volunteers. Neuropsychological tests were divided in 10 cognitive domains and effect sizes were calculated for all domains and compared with the cognitive profile of ALS by means of a visual comparison and a Pearson's r correlation coefficient. We included 120 studies, totalling 2425 bv-FTD patients and 2798 healthy controls. All cognitive domains showed substantial effect sizes, indicating cognitive impairment in bv-FTD patients compared to healthy controls. The cognitive domains with the largest effect sizes were social cognition, verbal memory and fluency (1.77-1.53). The cognitive profiles of bv-FTD and ALS (10 cognitive domains, 1287 patients) showed similarities on visual comparison and a moderate correlation 0.58 (p=0.13). When social cognition, verbal memory, fluency, executive functions, language and visuoperception were considered, i.e. the cognitive profile of ALS, Pearson's r was 0.73 (p=0.09), which raised to 0.92 (p=0.03), when language was excluded in this systematic analysis of patients with a non-language subtype of FTD. The cognitive profile of bv-FTD consists of deficits in social cognition, verbal memory, fluency and executive functions and shows similarities with the cognitive profile of ALS. These findings support a cognitive continuum encompassing ALS and bv-FTD. © Article author(s) (or their employer(s) unless otherwise stated in the text

  7. ANALYSIS AND COMPARISON OF EXISTING DECISION SUPPORT TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    V. A. Rybak

    2016-01-01

    Full Text Available The article presents the results of an analytical review and comparison of the most common managerial decision support technologies: the analytic hierarchy method, neural networks, fuzzy set theory, genetic algorithms and neural-fuzzy modeling. The advantages and disadvantages of these approaches are shown. Determine the scope of their application. It is shown that the hierarchy analysis method works well with the full initial information, but due to the need for expert comparison of alternatives and the selection of evaluation criteria has a high proportion of subjectivity. For problems in the conditions of risk and uncertainty prediction seems reasonable use of the theory of fuzzy sets and neural networks. It is also considered technology collective decision applied both in the general election, and the group of experts. It reduces the time for conciliation meetings to reach a consensus by the preliminary analysis of all views submitted for the plane in the form of points. At the same time the consistency of opinion is determined by the distance between them.

  8. Duloxetine compared with fluoxetine and venlafaxine: use of meta-regression analysis for indirect comparisons

    Directory of Open Access Journals (Sweden)

    Lançon Christophe

    2006-07-01

    Full Text Available Abstract Background Data comparing duloxetine with existing antidepressant treatments is limited. A comparison of duloxetine with fluoxetine has been performed but no comparison with venlafaxine, the other antidepressant in the same therapeutic class with a significant market share, has been undertaken. In the absence of relevant data to assess the place that duloxetine should occupy in the therapeutic arsenal, indirect comparisons are the most rigorous way to go. We conducted a systematic review of the efficacy of duloxetine, fluoxetine and venlafaxine versus placebo in the treatment of Major Depressive Disorder (MDD, and performed indirect comparisons through meta-regressions. Methods The bibliography of the Agency for Health Care Policy and Research and the CENTRAL, Medline, and Embase databases were interrogated using advanced search strategies based on a combination of text and index terms. The search focused on randomized placebo-controlled clinical trials involving adult patients treated for acute phase Major Depressive Disorder. All outcomes were derived to take account for varying placebo responses throughout studies. Primary outcome was treatment efficacy as measured by Hedge's g effect size. Secondary outcomes were response and dropout rates as measured by log odds ratios. Meta-regressions were run to indirectly compare the drugs. Sensitivity analysis, assessing the influence of individual studies over the results, and the influence of patients' characteristics were run. Results 22 studies involving fluoxetine, 9 involving duloxetine and 8 involving venlafaxine were selected. Using indirect comparison methodology, estimated effect sizes for efficacy compared with duloxetine were 0.11 [-0.14;0.36] for fluoxetine and 0.22 [0.06;0.38] for venlafaxine. Response log odds ratios were -0.21 [-0.44;0.03], 0.70 [0.26;1.14]. Dropout log odds ratios were -0.02 [-0.33;0.29], 0.21 [-0.13;0.55]. Sensitivity analyses showed that results were

  9. A systematic review and meta-analysis of ketamine for the prevention of persistent post-surgical pain.

    Science.gov (United States)

    McNicol, E D; Schumann, R; Haroutounian, S

    2014-11-01

    While post-operative pain routinely resolves, persistent post-surgical pain (PPSP) is common in certain surgeries; it causes disability, lowers quality of life and has economic consequences. The objectives of this systematic review and meta-analysis were to evaluate the effectiveness of ketamine in reducing the prevalence and severity of PPSP and to assess safety associated with its use. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE through December 2012 for articles in any language. We included randomized, controlled trials in adults in which ketamine was administered perioperatively via any route. Seventeen studies, the majority of which administered ketamine intravenously, met all inclusion criteria. The overall risk of developing PPSP was not significantly reduced at any time point in the ketamine group vs. placebo, nor did comparisons of pain severity scores reach statistical significance. Sensitivity analysis of exclusively intravenous ketamine studies included in this meta-analysis demonstrated statistically significant reductions in risk of developing PPSP at 3 and 6 months (P = 0.01 and P = 0.04, respectively). Adverse event rates were similar between ketamine and placebo groups. The study data from our review are heterogeneous and demonstrate efficacy of intravenously administered ketamine only in comparison with placebo. Highly variable timing and dosing of ketamine in these studies suggest that no unifying effective regimen has emerged. Future research should focus on clinically relevant outcomes, should stratify patients with pre-existing pain and possible central sensitization and should enroll sufficiently large numbers to account for loss to follow-up in long-term studies. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. The Big Five and tertiary academic performance: A systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Vedel, Anna

    2014-01-01

    This article reports a systematic review and meta-analysis of the relationships between the Big Five personality traits and tertiary academic performance. Five frequently used personality measures formed a restricted inclusion criteria pertaining to predictor variables: NEO Personality Inventory...... with Agreeableness, Conscientiousness, and Openness. Conscientiousness was the strongest predictor of GPA by far with a weighted summary effect of .26. Subgroup analyses tested a potential moderator variable not explored hitherto: academic major of study participants. Academic major was indeed found to moderate...

  11. A systematic review and meta-analysis of psychological predictors of successful assisted reproductive technologies

    OpenAIRE

    Purewal, S.; Chapman, S. C. E.; van den Akker, O. B. A.

    2017-01-01

    Objectives The aim of this systematic review and meta-analysis was to perform an updated investigation of the effects of depression and anxiety on pregnancy outcomes following assisted reproductive technologies. A bibliographic search was performed using PubMed, PsycINFO, Embase, Science Direct databases. Data retrieved were analysed using a random effects model to estimate standardised mean differences. Results Of the 22 included studies, 18 investigated depression, 15 state anxiety, and sev...

  12. Influence of oral processing on appetite and food intake - A systematic review and meta-analysis.

    OpenAIRE

    Krop, EM; Hetherington, MM; Nekitsing, C; Miquel, S; Postelnicu, L; Sarkar, A

    2018-01-01

    Food delivers energy, nutrients and a pleasurable experience. Slow eating and prolonged oro-sensory exposure to food during consumption can enhance the processes that promote satiation. This systematic review and meta-analysis investigated the effects of oral processing on subjective measures of appetite (hunger, desire to eat) and objectively measured food intake. The aim was to investigate the influence of oral processing characteristics, specifically "chewing" and "lubrication", on "appeti...

  13. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis

    OpenAIRE

    Young, Rebekah; Nix, Sheree; Wholohan, Aaron; Bradhurst, Rachael; Reed, Lloyd

    2013-01-01

    Background Ankle joint equinus, or restricted dorsiflexion range of motion (ROM), has been linked to a range of pathologies of relevance to clinical practitioners. This systematic review and meta-analysis investigated the effects of conservative interventions on ankle joint ROM in healthy individuals and athletic populations. Methods Keyword searches of Embase, Medline, Cochrane and CINAHL databases were performed with the final search being run in August 2013. Studies were eligible for inclu...

  14. Positron Emission Tomography in Prostate Cancer: Summary of Systematic Reviews and Meta-Analysis

    OpenAIRE

    Jadvar, Hossein

    2015-01-01

    Prostate cancer is a prevalent public health problem worldwide. Over the past decade, there has been tremendous research activity in the potential use of positron emission tomography with a number of radiotracers targeted to various biological aspects of this complex tumor. Systematic reviews and meta-analysis are important contributions to the relevant literature that summarize the evidence while reducing the effect of various sources of bias in the published data. The accumulation of releva...

  15. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis

    OpenAIRE

    Buitrago-Lopez, Adriana; Sanderson, Jean; Johnson, Laura; Warnakula, Samantha; Wood, Angela; Di Angelantonio, Emanuele; Franco, Oscar H

    2011-01-01

    Objective To evaluate the association of chocolate consumption with the risk of developing cardiometabolic disorders. Design Systematic review and meta-analysis of randomised controlled trials and observational studies. Data sources Medline, Embase, Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, reference lists of relevant studies to October 2010, and email contact with authors. Study selection Randomised trials and cohort, case-control, and cross sectional studies car...

  16. CD147/EMMPRIN overexpression and prognosis in cancer: A systematic review and meta-analysis

    OpenAIRE

    Xin, Xiaoyan; Zeng, Xianqin; Gu, Huajian; Li, Min; Tan, Huaming; Jin, Zhishan; Hua, Teng; Shi, Rui; Wang, Hongbo

    2016-01-01

    CD147/EMMPRIN (extracellular matrix metalloproteinase inducer) plays an important role in tumor progression and a number of studies have suggested that it is an indicator of tumor prognosis. This current meta-analysis systematically reevaluated the predictive potential of CD147/EMMPRIN in various cancers. We searched PubMed and Embase databases to screen the literature. Fixed-effect and random-effect meta-analytical techniques were used to correlate CD147 expression with outcome measures. A t...

  17. Treatments to Prevent Bone Loss in Functional Hypothalamic Amenorrhea: A Systematic Review and Meta-Analysis

    OpenAIRE

    Altayar, Osama; Al Nofal, Alaa; Carranza Leon, B. Gisella; Prokop, Larry J.; Wang, Zhen; Murad, M. Hassan

    2017-01-01

    Objective: We conducted a systematic review and meta-analysis of studies that evaluated the effect of hormonal therapy [estrogen therapy including oral contraceptive pills (OCP)] and bisphosphonates in preventing bone loss in patients with functional hypothalamic amenorrhea (FHA). Methods: We searched several electronic databases for controlled and noncontrolled studies that enrolled females of any age presenting with FHA (including athletic, weight loss, and stress-associated amenorrhea/olig...

  18. A comparison of methods for teaching receptive labeling to children with autism spectrum disorders: a systematic replication.

    Science.gov (United States)

    Grow, Laura L; Kodak, Tiffany; Carr, James E

    2014-01-01

    Previous research has demonstrated that the conditional-only method (starting with a multiple-stimulus array) is more efficient than the simple-conditional method (progressive incorporation of more stimuli into the array) for teaching receptive labeling to children with autism spectrum disorders (Grow, Carr, Kodak, Jostad, & Kisamore,). The current study systematically replicated the earlier study by comparing the 2 approaches using progressive prompting with 2 boys with autism. The results showed that the conditional-only method was a more efficient and reliable teaching procedure than the simple-conditional method. The results further call into question the practice of teaching simple discriminations to facilitate acquisition of conditional discriminations. © Society for the Experimental Analysis of Behavior.

  19. Pulsed Direct Current Electrospray: Enabling Systematic Analysis of Small Volume Sample by Boosting Sample Economy.

    Science.gov (United States)

    Wei, Zhenwei; Xiong, Xingchuang; Guo, Chengan; Si, Xingyu; Zhao, Yaoyao; He, Muyi; Yang, Chengdui; Xu, Wei; Tang, Fei; Fang, Xiang; Zhang, Sichun; Zhang, Xinrong

    2015-11-17

    We had developed pulsed direct current electrospray ionization mass spectrometry (pulsed-dc-ESI-MS) for systematically profiling and determining components in small volume sample. Pulsed-dc-ESI utilized constant high voltage to induce the generation of single polarity pulsed electrospray remotely. This method had significantly boosted the sample economy, so as to obtain several minutes MS signal duration from merely picoliter volume sample. The elongated MS signal duration enable us to collect abundant MS(2) information on interested components in a small volume sample for systematical analysis. This method had been successfully applied for single cell metabolomics analysis. We had obtained 2-D profile of metabolites (including exact mass and MS(2) data) from single plant and mammalian cell, concerning 1034 components and 656 components for Allium cepa and HeLa cells, respectively. Further identification had found 162 compounds and 28 different modification groups of 141 saccharides in a single Allium cepa cell, indicating pulsed-dc-ESI a powerful tool for small volume sample systematical analysis.

  20. Efficacy of targeted therapy for advanced renal cell carcinoma: A systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Chao Wei

    Full Text Available ABSTRACT We conducted a systematic review and meta-analysis of the literature on the efficacy of the targeted therapies in the treatment of advanced RCC and, via an indirect comparison, to provide an optimal treatment among these agents. A systematic search of Medline, Scopus, Cochrane Library and Clinical Trials unpublished was performed up to Jan 1, 2015 to identify eligible randomized trials. Outcomes of interest assessing a targeted agent included progression free survival (PFS, overall survival (OS and objective response rate (ORR. Thirty eligible randomized controlled studies, total twentyfourth trails (5110 cases and 4626 controls were identified. Compared with placebo and IFN-α, single vascular epithelial growth factor (receptor tyrosine kinase inhibitor and mammalian target of rapamycin agent (VEGF(r-TKI & mTOR inhibitor were associated with improved PFS, improved OS and higher ORR, respectively. Comparing sorafenib combination vs sorafenib, there was no significant difference with regard to PFS and OS, but with a higher ORR. Comparing single or combination VEGF(r-TKI & mTOR inhibitor vs BEV + IFN-α, there was no significant difference with regard to PFS, OS, or ORR. Our network ITC meta-analysis also indicated a superior PFS of axitinib and everolimus compared to sorafenib. Our data suggest that targeted therapy with VEGF(r-TKI & mTOR inhibitor is associated with superior efficacy for treating advanced RCC with improved PFS, OS and higher ORR compared to placebo and IFN-α. In summary, here we give a comprehensive overview of current targeted therapies of advanced RCC that may provide evidence for the adequate targeted therapy selecting.

  1. Insulin resistance in patients with type 1 diabetes assessed by glucose clamp studies: systematic review and meta-analysis

    NARCIS (Netherlands)

    Donga, Esther; Dekkers, Olaf M.; Corssmit, Eleonora P. M.; Romijn, Johannes A.

    2015-01-01

    Objective: The aim of this study was to perform a systematic review and meta-analysis on insulin resistance in adult patients with type 1 diabetes mellitus compared to healthy controls, assessed by hyperinsulinemic euglycemic clamp studies. Design and methods: We conducted a systematic search of

  2. Falls Prevention Education for Older Adults during and after Hospitalization: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Lee, Den-Ching A.; Pritchard, Elizabeth; McDermott, Fiona; Haines, Terry P.

    2014-01-01

    Objectives: To assess the effectiveness of patient education in reducing falls, promoting behavioural change and the uptake of prevention activities in older adults during and after hospitalization. Design: Systematic review and meta-analysis. Methods: A systematic search of five health science databases was performed up to November 2012. Studies…

  3. ABERRANT RESTING-STATE BRAIN ACTIVITY IN POSTTRAUMATIC STRESS DISORDER: A META-ANALYSIS AND SYSTEMATIC REVIEW

    NARCIS (Netherlands)

    Koch, Saskia B. J.; van Zuiden, Mirjam; Nawijn, Laura; Frijling, Jessie L.; Veltman, Dick J.; Olff, Miranda

    2016-01-01

    About 10% of trauma-exposed individuals develop PTSD. Although a growing number of studies have investigated resting-state abnormalities in PTSD, inconsistent results suggest a need for a meta-analysis and a systematic review. We conducted a systematic literature search in four online databases

  4. Systematic review and meta-analysis of skin substitutes in the treatment of diabetic foot ulcers: Highlights of a Cochrane systematic review

    NARCIS (Netherlands)

    Santema, T. B. Katrien; Poyck, Paul P. C.; Ubbink, Dirk T.

    2016-01-01

    Skin substitutes are increasingly used in the treatment of various types of acute and chronic wounds. The aim of this study was to perform a systematic review and meta-analysis to evaluate the effectiveness of skin substitutes on ulcer healing and limb salvage in the treatment of diabetic foot

  5. Using qualitative comparative analysis in a systematic review of a complex intervention.

    Science.gov (United States)

    Kahwati, Leila; Jacobs, Sara; Kane, Heather; Lewis, Megan; Viswanathan, Meera; Golin, Carol E

    2016-05-04

    Systematic reviews evaluating complex interventions often encounter substantial clinical heterogeneity in intervention components and implementation features making synthesis challenging. Qualitative comparative analysis (QCA) is a non-probabilistic method that uses mathematical set theory to study complex phenomena; it has been proposed as a potential method to complement traditional evidence synthesis in reviews of complex interventions to identify key intervention components or implementation features that might explain effectiveness or ineffectiveness. The objective of this study was to describe our approach in detail and examine the suitability of using QCA within the context of a systematic review. We used data from a completed systematic review of behavioral interventions to improve medication adherence to conduct two substantive analyses using QCA. The first analysis sought to identify combinations of nine behavior change techniques/components (BCTs) found among effective interventions, and the second analysis sought to identify combinations of five implementation features (e.g., agent, target, mode, time span, exposure) found among effective interventions. For each substantive analysis, we reframed the review's research questions to be designed for use with QCA, calibrated sets (i.e., transformed raw data into data used in analysis), and identified the necessary and/or sufficient combinations of BCTs and implementation features found in effective interventions. Our application of QCA for each substantive analysis is described in detail. We extended the original review findings by identifying seven combinations of BCTs and four combinations of implementation features that were sufficient for improving adherence. We found reasonable alignment between several systematic review steps and processes used in QCA except that typical approaches to study abstraction for some intervention components and features did not support a robust calibration for QCA. QCA was

  6. Executive functioning deficits among adults with Bipolar Disorder (types I and II): A systematic review and meta-analysis.

    Science.gov (United States)

    Dickinson, Tania; Becerra, Rodrigo; Coombes, Jacqui

    2017-08-15

    Executive functioning (EF) deficits contribute to a significant proportion of the burden of disease associated with bipolar disorder (BD). Yet, there is still debate in the literature regarding the exact profile of executive functioning in BD. The purpose of the present project was to assess whether EF deficits exist among adults suffering BD, and whether these deficits (if apparent) differ by BD subtype. A systematic search identified relevant literature. Randomised controlled trials that used neuropsychological assessment to investigate EF among adults 16-65 years) with a remitted DSM diagnosis of BD (type I or II) were included. Studies were published between 1994 and 2015. A systematic review and meta-analysis were undertaken. For individual studies, standardised mean differences (Cohen's d) and 95% confidence intervals were calculated and represented in forest plots to illustrate differences in executive performance between groups. Summary effects were produced and tests of heterogeneity employed to assess the dispersion and generalisability of results. Thirty-six studies met criteria for inclusion. Six domains of EF were identified: Set-shifting (SS), inhibition (INH), planning (PLA), verbal fluency (VF), working memory (WM), and attention (ATT). BD1s performed worse than HCs in all domains. BD2s demonstrated impairment in VF, WM, SS, and ATT. The results were mixed for comparisons between BD1s and BD2s, but revealed that BD2s can experience similar (or sometimes greater) EF impairment. Only a limited number of studies that included BD2 samples were available for inclusion in the current study. Subgroup analysis to elucidate potential moderators of within-study variance was not undertaken. This is the first systematic review and meta-analysis to have compared the EF of remitted BD1s, BD2s, and HCs. The results provided useful insight into the EF profile of patients with BD, and offered commentary as to some of the contradictory results reported in the

  7. K-U-Th systematics of terrestrial igneous rocks for planetological comparisons: volcanic rocks of the Earth oceanic island arc and Venus surface material

    International Nuclear Information System (INIS)

    Nikolaeva, O.V.

    1997-01-01

    Principles of the formation o data base for 339 samples of oceanic island arc (OIA) igneous rocks of the Earth available in literature are described as well as of the formation of fresh rock sample, characteristics of this sample, and K-U-Th-systematics of the fresh igneous rocks of Earth OIA. Results of comparison of the Venus measured rocks and Earth OIA rocks by K, U, Th

  8. A Comparison of Over-the-Counter Mechanical Nasal Dilators: A Systematic Review.

    Science.gov (United States)

    Kiyohara, Nicole; Badger, Christopher; Tjoa, Tjoson; Wong, Brian

    2016-09-01

    The internal nasal valve is the narrowest part of the nasal airway and a common site of inspiratory collapse and obstruction of nasal airflow. Over-the-counter mechanical nasal dilators are an alternative to surgical intervention that attempts to improve airflow through the internal nasal valve. To determine the efficacy of over-the-counter mechanical nasal dilators and classify these products by mechanism. A database of 33 available over-the-counter mechanical nasal dilators was generated via a PubMed search as well as an internet search via Amazon.com and Google, conducted from April 1, 2013, through December 31, 2015. Products determined to be unavailable or discontinued were excluded from the database. Of the devices examined in published literature, efficacy was based on objective measures, such as measured airflow, the cross-sectional area of the nasal valve, and changes in resistance. Measures of reported sleep quality or patient perception were excluded. An analysis of each product's mechanism revealed 4 broad classes: external nasal dilator strips, nasal stents, nasal clips, and septal stimulators. A review demonstrated 5 studies supporting the use of external nasal dilator strips, 4 studies supporting the use of nasal clips, 1 study supporting the use of nasal stents, and no studies supporting the use of septal stimulators. Our findings suggest that external nasal dilator strips and nasal clips effectively relieve obstruction of the internal nasal valve and may be an alternative to surgical intervention in some patients.

  9. Long-acting insulin analogues for type 1 diabetes: An overview of systematic reviews and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Laranjeira, Fernanda O; de Andrade, Keitty R C; Figueiredo, Ana C M G; Silva, Everton N; Pereira, Mauricio G

    2018-01-01

    The comparison between long acting insulin analogues (LAIA) and human insulin (NPH) has been investigated for decades, with many randomized controlled trials (RCTs) and systematic reviews giving mixed results. This overlapping and contradictory evidence has increased uncertainty on coverage decisions at health systems level. To conduct an overview of systematic reviews and update existing reviews, preparing new meta-analysis to determine whether LAIA are effective for T1D patients compared to NPH. We identified systematic reviews of RCTs that evaluated the efficacy of LAIA glargine or detemir, compared to NPH insulin for T1D, assessing glycated hemoglobin (A1C) and hypoglycemia. Data sources included Pubmed, Cochrane Library, EMBASE and hand-searching. The methodological quality of studies was independently assessed by two reviewers, using AMSTAR and Jadad scale. We found 11 eligible systematic reviews that contained a total of 25 relevant clinical trials. Two reviewers independently abstracted data. We found evidence that LAIA are efficacious compared to NPH, with estimates showing a reduction in nocturnal hypoglycemia episodes (RR 0.66; 95% CI 0.57; 0.76) and A1C (95% CI 0.23; 0.12). No significance was found related to severe hypoglycemia (RR 0.94; 95% CI 0.71; 1.24). This study design has allowed us to carry out the most comprehensive assessment of RCTs on this subject, filling a gap in diabetes research. Our paper addresses a question that is important not only for decision makers but also for clinicians.

  10. Materials used for indirect pulp treatment in primary teeth: a mixed treatment comparisons meta-analysis

    Directory of Open Access Journals (Sweden)

    Pablo Silveira dos Santos

    2017-12-01

    Full Text Available Abstract: This study aimed to systematically review the literature to address the question regarding the influence of different materials in the clinical and radiographic success of indirect pulp treatment in primary teeth. A literature search was carried out for articles published prior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIP and ClinicalTrials databases; relevant articles included randomized clinical trials that compared materials used for indirect pulp treatment in primary teeth. Two reviewers independently selected the studies and extracted the data. The effects of each material on the outcome (clinical and radiographic failures were analyzed using a mixed treatment comparisons meta-analysis. The ranking of treatments according to their probability of being the best choice was also calculated. From 1,088 potentially eligible studies, 11 were selected for full-text analysis, and 4 were included in the meta-analysis. In all papers, calcium hydroxide liner was used as the control group versus an adhesive system, resin-modified glass ionomer cement or placebo. The follow-up period ranged from 24 to 48 months, with dropout rates of 0-25.7%. The material type did not significantly affect the risk of failure of the indirect pulp treatment. However, calcium hydroxide presented a higher probability of failure. In conclusion, there is no scientific evidence showing the superiority of any material used for indirect pulp treatment in primary teeth.

  11. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jonah Musa

    Full Text Available Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally.The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS rates compared to control conditions in eligible women population at risk of cervical cancer.We used the PICO (Problem or Population, Interventions, Comparison and Outcome framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO. The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA. We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot.Out of 3072 study reports screened, 28 articles were found to

  12. Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kojima, Gotaro; Avgerinou, Christina; Iliffe, Steve; Walters, Kate

    2018-04-01

    To conduct a systematic review of the literature on prospective cohort studies examining associations between adherence to a Mediterranean diet and incident frailty and to perform a meta-analysis to synthesize the pooled risk estimates. Systematic review and meta-analysis. Embase, MEDLINE, CINAHL, PsycINFO, and Cochrane Library were systematically searched on September 14, 2017. We reviewed references of included studies and relevant review papers and performed forward citation tracking for additional studies. Corresponding authors were contacted for additional data necessary for a meta-analysis. Community-dwelling older adults (mean age ≥60). Incident frailty risk according to adherence to a Mediterranean diet. Two reviewers independently screened the title, abstract, and full text to ascertain the eligibility of 125 studies that the systematic search of the literature identified, and four studies were included (5,789 older people with mean follow-up of 3.9 years). Two reviewers extracted data from the studies independently. All four studies provided adjusted odds ratios (ORs) of incident frailty risk according to three Mediterranean diet score (MDS) groups (0-3, 4-5, and 6-9). Greater adherence to a Mediterranean diet was associated with significantly lower incident frailty risk (pooled OR = 0.62, 95% CI = 0.47-0.82, P = .001 for MDS 4-5; pooled OR = 0.44, 95% CI = 0.31-0.64, P Mediterranean diet is associated with significantly lower risk of incident frailty in community-dwelling older people. Future studies should confirm these findings and evaluate whether adherence to a Mediterranean diet can reduce the risk of frailty, including in non-Mediterranean populations. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  13. Pharmacotherapies for fatigue in chronic liver disease (CLD): a systematic review and meta-analysis (protocol).

    Science.gov (United States)

    Effiong, Andem; Kumari, Prerna

    2018-02-14

    This is the protocol for a systematic review (and meta-analysis) of an intervention. The primary objective of this systematic review will be to assess the benefits and harms of pharmacological therapies (pharmacotherapies) for the management of fatigue in adults with CLD of any etiology. The effects of pharmacological therapies on fatigue in CLD will be compared against those of placebo, no intervention, or non-pharmacological interventions. Specifically, this review will examine whether pharmacological therapies improve CLD-associated fatigue, and if they do, what key elements are associated with their effectiveness. The results of this systematic review will assist clinicians, policy-makers, researchers, and people with CLD in decision-making on how best to manage fatigue and its associated symptoms. MEDLINE, SCOPUS, EMBASE, EU Clinical Trials Register, WHO International Clinical Trials Registry Platform, CENTRAL (The Cochrane Library), ClinicalTrials.gov, reference lists of articles and conference proceedings will be searched for relevant studies. No language or date restrictions will be applied. Eligible studies will include adults with CLD of any etiology. Included studies will be randomized controlled trials. From included studies, data on participant characteristics, study design, setting, research ethics compliance, and intervention outcomes will be extracted. Risk of bias in included studies will be assessed using the Cochrane Risk of Bias Tool. A random-effects meta-analysis will be conducted. If substantial or considerable levels of heterogeneity are detected, analysis will be limited to a narrative synthesis. This systematic review will examine the effectiveness of pharmacological therapies on fatigue reduction in people with CLD. Such therapies may be more effective than non-pharmacological interventions in treating fatigue symptoms in CLD. Evidence derived from the findings of this study will guide future practice, policy, and research. PROSPERO, CRD

  14. Association between Hypertension and Epistaxis: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Min, Hyun Jin; Kang, Hyun; Choi, Geun Joo; Kim, Kyung Soo

    2017-12-01

    Objective Whether there is an association or a cause-and-effect relationship between epistaxis and hypertension is a subject of longstanding controversy. The objective of this systematic review and meta-analysis was to determine the association between epistaxis and hypertension and to verify whether hypertension is an independent risk factor of epistaxis. Data Sources A comprehensive search was performed using the MEDLINE, EMBASE, and Cochrane Library databases. Review Methods The review was performed according to the Meta-analysis of Observational Studies in Epidemiology guidelines and reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Results We screened 2768 unique studies and selected 10 for this meta-analysis. Overall, the risk of epistaxis was significantly increased for patients with hypertension (odds ratio, 1.532 [95% confidence interval (CI), 1.181-1.986]; number needed to treat, 14.9 [95% CI, 12.3-19.0]). Results of the Q test and I 2 statistics suggested considerable heterogeneity ([Formula: see text] = 0.038, I 2 = 49.3%). The sensitivity analysis was performed by excluding 1 study at a time, and it revealed no change in statistical significance. Conclusion Although this meta-analysis had some limitations, our study demonstrated that hypertension was significantly associated with the risk of epistaxis. However, since this association does not support a causal relationship between hypertension and epistaxis, further clinical trials with large patient populations will be required to determine the impact of hypertension on epistaxis.

  15. Comparison of transient PCRV model test results with analysis

    International Nuclear Information System (INIS)

    Marchertas, A.H.; Belytschko, T.B.

    1979-01-01

    Comparisons are made of transient data derived from simple models of a reactor containment vessel with analytical solutions. This effort is a part of the ongoing process of development and testing of the DYNAPCON computer code. The test results used in these comparisons were obtained from scaled models of the British sodium cooled fast breeder program. The test structure is a scaled model of a cylindrically shaped reactor containment vessel made of concrete. This concrete vessel is prestressed axially by holddown bolts spanning the top and bottom slabs along the cylindrical walls, and is also prestressed circumferentially by a number of cables wrapped around the vessel. For test purposes this containment vessel is partially filled with water, which comes in direct contact with the vessel walls. The explosive charge is immersed in the pool of water and is centrally suspended from the top of the vessel. The load history was obtained from an ICECO analysis, using the equations of state for the source and the water. A detailed check of this solution was made to assure that the derived loading did provide the correct input. The DYNAPCON code was then used for the analysis of the prestressed concrete containment model. This analysis required the simulation of prestressing and the response of the model to the applied transient load. The calculations correctly predict the magnitudes of displacements of the PCRV model. In addition, the displacement time histories obtained from the calculations reproduce the general features of the experimental records: the period elongation and amplitude increase as compared to an elastic solution, and also the absence of permanent displacement. However, the period still underestimates the experiment, while the amplitude is generally somewhat large

  16. Endoscopic versus microscopic trans-sphenoidal pituitary surgery: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Goudakos, J. K.; Markou, K. D.; Georgalas, C.

    2011-01-01

    Endoscopic trans-sphenoidal surgery has been increasingly replacing microscopic surgery as the state of the art trans-sphenoidal approach. To assess the efficacy and safety of pure endoscopic approach in comparison with microscopic approach in pituitary surgery. Literature review and meta-analysis.

  17. Living near nuclear power plants and thyroid cancer risk: A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Kim, Jae Young; Bang, Ye Jin; Ee, Won Jin

    2016-01-01

    There has been public concern regarding the safety of residing near nuclear power plants, and the extent of risk for thyroid cancer among adults living near nuclear power plants has not been fully explored. In the present study, a systematic review and meta-analysis of epidemiologic studies was conducted to investigate the association between living near nuclear power plants and the risk of thyroid cancer. Our study does not support an association between living near nuclear power plants and risk of thyroid cancer but does support a need for well designed future studies given the conflicting results from sensitivity analysis.

  18. Problematic gaming behaviour and health-related outcomes: A systematic review and meta-analysis.

    Science.gov (United States)

    Männikkö, Niko; Ruotsalainen, Heidi; Miettunen, Jouko; Pontes, Halley M; Kääriäinen, Maria

    2017-11-01

    This systematic review and meta-analysis aimed to investigate the interplay between problematic gaming behaviour and health-related outcomes at different developmental stages. A total of 50 empirical studies met the specified inclusion criteria, and a meta-analysis using correlation coefficients was used for the studies that reported adverse health implications regarding the impact of problematic gaming behaviour on depression, anxiety, obsessive-compulsive disorder and somatisation. Overall, the results suggested that problematic gaming behaviour is significantly associated with a wide range of detrimental health-related outcomes. Finally, the limitations of this review alongside its implications were discussed and considered for future research.

  19. Living near nuclear power plants and thyroid cancer risk: A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Young [Dept. of Preventive Medicine, Keimyung University College of Medicine, Daegu (Korea, Republic of); Bang, Ye Jin; Ee, Won Jin [Dept. of Preventive Medicine, Korea University College of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    There has been public concern regarding the safety of residing near nuclear power plants, and the extent of risk for thyroid cancer among adults living near nuclear power plants has not been fully explored. In the present study, a systematic review and meta-analysis of epidemiologic studies was conducted to investigate the association between living near nuclear power plants and the risk of thyroid cancer. Our study does not support an association between living near nuclear power plants and risk of thyroid cancer but does support a need for well designed future studies given the conflicting results from sensitivity analysis.

  20. Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Masoud SAATCHI

    2014-10-01

    Full Text Available Objective: Enterococcus faecalis (E. faecalis is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH. Whether a combination of CH and chlorhexidine (CHX is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature. Material and Methods: A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05. Results: Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles. Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001. Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115. Conclusions: According to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate

  1. Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

    Science.gov (United States)

    SAATCHI, Masoud; SHOKRANEH, Ali; NAVAEI, Hooman; MARACY, Mohammad Reza; SHOJAEI, Hasan

    2014-01-01

    Objective Enterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature. Material and Methods A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05. Results Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115). Conclusions According to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate the findings of

  2. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Hardt Jill

    2008-11-01

    Full Text Available Abstract Background Accurate assessment is required to assess current and changing physical activity levels, and to evaluate the effectiveness of interventions designed to increase activity levels. This study systematically reviewed the literature to determine the extent of agreement between subjectively (self-report e.g. questionnaire, diary and objectively (directly measured; e.g. accelerometry, doubly labeled water assessed physical activity in adults. Methods Eight electronic databases were searched to identify observational and experimental studies of adult populations. Searching identified 4,463 potential articles. Initial screening found that 293 examined the relationship between self-reported and directly measured physical activity and met the eligibility criteria. Data abstraction was completed for 187 articles, which described comparable data and/or comparisons, while 76 articles lacked comparable data or comparisons, and a further 30 did not meet the review's eligibility requirements. A risk of bias assessment was conducted for all articles from which data was abstracted. Results Correlations between self-report and direct measures were generally low-to-moderate and ranged from -0.71 to 0.96. No clear pattern emerged for the mean differences between self-report and direct measures of physical activity. Trends differed by measure of physical activity employed, level of physical activity measured, and the gender of participants. Results of the risk of bias assessment indicated that 38% of the studies had lower quality scores. Conclusion The findings suggest that the measurement method may have a significant impact on the observed levels of physical activity. Self-report measures of physical activity were both higher and lower than directly measured levels of physical activity, which poses a problem for both reliance on self-report measures and for attempts to correct for self-report – direct measure differences. This review reveals

  3. Development of a systematic methodology to select hazard analysis techniques for nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcelos, Vanderley de; Reis, Sergio Carneiro dos; Costa, Antonio Carlos Lopes da [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)]. E-mails: vasconv@cdtn.br; reissc@cdtn.br; aclc@cdtn.br; Jordao, Elizabete [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Faculdade de Engenharia Quimica]. E-mail: bete@feq.unicamp.br

    2008-07-01

    In order to comply with licensing requirements of regulatory bodies risk assessments of nuclear facilities should be carried out. In Brazil, such assessments are part of the Safety Analysis Reports, required by CNEN (Brazilian Nuclear Energy Commission), and of the Risk Analysis Studies, required by the competent environmental bodies. A risk assessment generally includes the identification of the hazards and accident sequences that can occur, as well as the estimation of the frequencies and effects of these unwanted events on the plant, people, and environment. The hazard identification and analysis are also particularly important when implementing an Integrated Safety, Health, and Environment Management System following ISO 14001, BS 8800 and OHSAS 18001 standards. Among the myriad of tools that help the process of hazard analysis can be highlighted: CCA (Cause- Consequence Analysis); CL (Checklist Analysis); ETA (Event Tree Analysis); FMEA (Failure Mode and Effects Analysis); FMECA (Failure Mode, Effects and Criticality Analysis); FTA (Fault Tree Analysis); HAZOP (Hazard and Operability Study); HRA (Human Reliability Analysis); Pareto Analysis; PHA (Preliminary Hazard Analysis); RR (Relative Ranking); SR (Safety Review); WI (What-If); and WI/CL (What-If/Checklist Analysis). The choice of a particular technique or a combination of techniques depends on many factors like motivation of the analysis, available data, complexity of the process being analyzed, expertise available on hazard analysis, and initial perception of the involved risks. This paper presents a systematic methodology to select the most suitable set of tools to conduct the hazard analysis, taking into account the mentioned involved factors. Considering that non-reactor nuclear facilities are, to a large extent, chemical processing plants, the developed approach can also be applied to analysis of chemical and petrochemical plants. The selected hazard analysis techniques can support cost

  4. Development of a systematic methodology to select hazard analysis techniques for nuclear facilities

    International Nuclear Information System (INIS)

    Vasconcelos, Vanderley de; Reis, Sergio Carneiro dos; Costa, Antonio Carlos Lopes da; Jordao, Elizabete

    2008-01-01

    In order to comply with licensing requirements of regulatory bodies risk assessments of nuclear facilities should be carried out. In Brazil, such assessments are part of the Safety Analysis Reports, required by CNEN (Brazilian Nuclear Energy Commission), and of the Risk Analysis Studies, required by the competent environmental bodies. A risk assessment generally includes the identification of the hazards and accident sequences that can occur, as well as the estimation of the frequencies and effects of these unwanted events on the plant, people, and environment. The hazard identification and analysis are also particularly important when implementing an Integrated Safety, Health, and Environment Management System following ISO 14001, BS 8800 and OHSAS 18001 standards. Among the myriad of tools that help the process of hazard analysis can be highlighted: CCA (Cause- Consequence Analysis); CL (Checklist Analysis); ETA (Event Tree Analysis); FMEA (Failure Mode and Effects Analysis); FMECA (Failure Mode, Effects and Criticality Analysis); FTA (Fault Tree Analysis); HAZOP (Hazard and Operability Study); HRA (Human Reliability Analysis); Pareto Analysis; PHA (Preliminary Hazard Analysis); RR (Relative Ranking); SR (Safety Review); WI (What-If); and WI/CL (What-If/Checklist Analysis). The choice of a particular technique or a combination of techniques depends on many factors like motivation of the analysis, available data, complexity of the process being analyzed, expertise available on hazard analysis, and initial perception of the involved risks. This paper presents a systematic methodology to select the most suitable set of tools to conduct the hazard analysis, taking into account the mentioned involved factors. Considering that non-reactor nuclear facilities are, to a large extent, chemical processing plants, the developed approach can also be applied to analysis of chemical and petrochemical plants. The selected hazard analysis techniques can support cost

  5. Intrinsic Risk Factors of Lateral Ankle Sprain: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Kobayashi, Takumi; Tanaka, Masashi; Shida, Masahiro

    2016-01-01

    Lateral ankle ligamentous sprain (LAS) is one of the most common injuries in recreational activities and competitive sports. Many studies have attempted to determine whether there are certain intrinsic factors that can predict LAS. However, no consensus has been reached on the predictive intrinsic factors. To identify the intrinsic risk factors of LAS by meta-analysis from data in randomized control trials and prospective cohort studies. A systematic computerized literature search of MEDLINE, CINAHL, ScienceDirect, SPORTDiscus, and Cochrane Register of Clinical Trials was performed. A computerized literature search from inception to January 2015 resulted in 1133 studies of the LAS intrinsic risk factors written in English. Systematic review. Level 4. The modified quality index was used to assess the quality of the design of the papers and the standardized mean difference was used as an index to pool included study outcomes. Eight articles were included in this systematic review. Meta-analysis results showed that body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and peroneus brevis reaction time correlated with LAS. Body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and the reaction time of the peroneus brevis were associated with significantly increased risk of LAS.

  6. Recurrence of hidradenitis suppurativa after surgical management: A systematic review and meta-analysis.

    Science.gov (United States)

    Mehdizadeh, Ali; Hazen, Paul G; Bechara, Falk G; Zwingerman, Nora; Moazenzadeh, Marzyeh; Bashash, Morteza; Sibbald, R Gary; Alavi, Afsaneh

    2015-11-01

    Hidradenitis suppurativa (HS) is a chronic inflammatory disease of apocrine-bearing skin. Treatment is challenging and long-standing. Surgery is one of the treatment options with varying reported success rates. This study provides a comprehensive systematic review of surgical approaches in the management of HS. A systematic literature search and meta-analysis of proportions were performed on the included studies. Of a total of 1147 retrieved articles, 22 were included in the analysis. These were the estimated average recurrences: wide excision, 13.0% (95% confidence interval [CI], 5.0-22.0%); local incision, 22.0% (95% CI, 10.0-37.0%); and deroofing, 27.0% (95% CI, 23.0-31.0%). In the wide excision group, recurrence rates were as follows: 15% (95% CI, 0-72%) for primary closure, 8% (95% CI, 2.0-16.0%) for using flaps, and 6.0% (95% CI, 0.0-24.0%) for grafting. The secondary intention healing option was most commonly chosen after local excision and deroofing. There was poor quality evidence and potential improper reporting of the results. This systematic review found lower recurrence rates with wide excision, using skin flaps or skin grafts as the closure methods. The heterogeneity of the patient populations was high and statistically significant within and across all types of excisions. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Depression in HIV and HCV co-infected patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Fialho, Renata; Pereira, Marco; Rusted, Jennifer; Whale, Richard

    2017-10-01

    The aim of this study was to carry out a systematic review and meta-analysis of the differences in the prevalence of depression and presence of depressive symptoms between HIV/HCV co-infection, HIV mono-infection, and hepatitis C virus (HCV) mono-infection. A systematic electronic search of bibliographic databases was performed to locate articles published from the earliest available online until December 2014. Outcomes of depression were based on clinical interviews and validated self-reported measures of depression/depressive symptoms. Of the 188 records initially screened, 29 articles were included in the descriptive systematic review and six were included in the meta-analysis. The meta-analytic results indicated that, as measured by self-reported measures of depression, HIV/HCV co-infected patients were significantly more likely to report depressive symptoms than either HIV (SMD = .24, 95% CI: .03-.46, p = .02) or HCV mono-infected (SMD = .55, 95% CI: .17-.94, p = .005) patients. The variability of the results of the reviewed studies, largely dependent on the samples' characteristics and the methods of assessment of depression, suggests that a clear interpretation of how depression outcomes are affected by the presence of HIV/HCV co-infection is still needed. Failing to diagnose depression or to early screen depressive symptoms may have a significant impact on patients' overall functioning and compromise treatments' outcomes.

  8. Partial versus complete fundoplication for the correction of pediatric GERD: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Peter Glen

    Full Text Available There is no consensus as to what extent of "wrap" is required in a fundoplication for correction of gastroesophageal reflux disease (GERD.To evaluate if a complete (360 degree or partial fundoplication gives better control of GERD.A systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children. Screening identified those comparing techniques. The primary outcome was recurrence of GERD following surgery. Dysphagia and complications were secondary outcomes of interest. Meta-analysis was performed when appropriate. Study quality was assessed using the Cochrane Risk of Bias Tool.2289 abstracts were screened, yielding 2 randomized controlled trials (RCTs and 12 retrospective cohort studies. The RCTs were pooled. There was no difference in surgical success between partial and complete fundoplication, OR 1.33 [0.67,2.66]. In the 12 cohort studies, 3 (25% used an objective assessment of the surgery, one of which showed improved outcomes with complete fundoplication. Twenty-five different complications were reported; common were dysphagia and gas-bloat syndrome. Overall study quality was poor.The comparison of partial fundoplication with complete fundoplication warrants further study. The evidence does not demonstrate superiority of one technique. The lack of high quality RCTs and the methodological heterogeneity of observational studies limits a powerful meta-analysis.

  9. Psoriasis increases risk of new-onset atrial fibrillation: a systematic review and meta-analysis of prospective observational studies.

    Science.gov (United States)

    Upala, Sikarin; Shahnawaz, Afeefa; Sanguankeo, Anawin

    2017-08-01

    Psoriasis is a common chronic immune-mediated dermatological disease that increases the risk of cardiovascular disease. We conducted a systematic review and meta-analysis to evaluate the association between psoriasis and atrial fibrillation from prospective observational studies. A comprehensive search of the databases of the MEDLINE and EMBASE was performed from inception through November 2015. The inclusion criterion was the prospective observational study that assessed the risk of new-onset atrial fibrillation in adults with psoriasis. Outcome was the adjusted hazard ratio (HR) of atrial fibrillation comparison between patients with psoriasis and controls. Pooled HR and 95% confidence intervals (CI) were calculated using a random-effects model. The initial search yielded 176 articles. Fifteen articles underwent full-length review and data were extracted from 4 observational studies. Incidence of atrial fibrillation was ascertained by cardiologist-reviewed electrocardiograms. There was a significant increased risk of new-onset atrial fibrillation in patients with psoriasis compared to controls with a pooled HR 1.42 (95%CI 1.22-1.65). Our meta-analysis of prospective studies demonstrated that patients with psoriasis have increased risk of new-onset atrial fibrillation. Future interventional studies addressing the impact of psoriasis treatment and prevention of atrial fibrillation should be performed.

  10. Ventriculoperitoneal shunt insertion for hydrocephalus in human immunodeficiency virus-infected adults: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Loan, James J M; Mankahla, Ncedile; Meintjes, Graeme; Fieggen, A Graham

    2017-10-16

    Hydrocephalus is a recognised complication of human immunodeficiency virus (HIV)-related opportunistic infections. Symptomatic raised cerebrospinal fluid pressure can be treated with ventriculoperitoneal shunt insertion (VPS). In HIV-infected patients however, there is a concern that VPS might be associated with unacceptably high rates of mortality. We aim to systematically review and appraise published literature to determine reported outcomes and identify predictors of outcome following VPS in relevant subgroups of HIV-infected adults. The following electronic databases will be searched: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE, CINAHL (EBSCOhost), LILACS (BIREME), Research Registry ( www.researchregistry.com ), the metaRegister of Controlled Trials (mRCT) ( www.controlled-trials.com ), ClinicalTrials.gov ( www.clinicaltrials.gov ) and OpenSIGLE database. Any randomised studies, cohort studies, case-control studies, interrupted time series or sequential case series reporting survival following VPS in HIV-infected individuals will be included. If high-quality homogenous studies exist, meta-analysis will be conducted to determine 1-, 6- and 12-month mortality with comparison made between underlying aetiologies of hydrocephalus. This study will generate a comprehensive review of VPS in HIV-infected patients for publication. The primary outcome of meta-analysis is 12-month survival. If only low-quality, heterogeneous studies are available, this study will demonstrate this deficiency and will be of value in justifying and aiding the design of future studies. PROSPERO CRD42016052239.

  11. The impact of targeted Rheumatoid Arthritis pharmacological treatment on mental health: A systematic review and network meta-analysis.

    Science.gov (United States)

    Matcham, Faith; Galloway, James; Hotopf, Matthew; Roberts, Emmert; Scott, Ian C; Steer, Sophia; Norton, Sam

    2018-06-06

    Rheumatoid Arthritis (RA) pharmacotherapy may impact mental health (MH) outcomes by improving pain and stiffness; and potentially via targeting inflammatory processes common to RA and depression. The objectives of this review were to i) ascertain the frequency of MH assessment in RA pharmacotherapy trials; ii) quantify the efficacy of RA pharmacotherapy efficacy on MH outcomes; iii) explore the clinical and demographic factors related to MH outcomes. CENTRAL, PsychINFO, Web of Science, Medline, Embase and CINAHL were systematically searched from inception to March 2017 for randomised trials of disease-modifying anti-rheumatic drugs (DMARDs) in adult RA patients. The primary outcome was MH; self-reported physical health was extracted as a secondary outcome. Pairwise meta-analysis (PMA) created pooled effect sizes and 95%CIs for comparisons of all treatments versus comparators (active or placebo). Network meta-analysis (NMA) provided effect size estimates of targeted biologic DMARDs (bDMARDs) versus conventional synthetic DMARDs (csDMARDs) using indirect comparisons of different treatment modalities. 71 eligible studies were identified. 57 studies were included in the PMA, representing 23,535 patients. bDMARDs showed small effects on MH (standardised mean difference (SMD) versus csDMARDs = 0.19 to 0.30), and moderate effects on self-reported physical health (SMD versus csDMARDs = 0.46 to 0.50), with NMA determining no significant differences in effectiveness between bDMARD mode of action on either outcome. Effective pharmacotherapy alone is unlikely to substantially improve MH outcomes for most RA patients. Integrated MH care provided within routine clinical practice is essential to optimise mental and physical health outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł

    2015-04-01

    The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.

  13. Analysis of Existing Guidelines for the Systematic Planning Process of Clinical Registries.

    Science.gov (United States)

    Löpprich, Martin; Knaup, Petra

    2016-01-01

    Clinical registries are a powerful method to observe the clinical practice and natural disease history. In contrast to clinical trials, where guidelines and standardized methods exist and are mandatory, only a few initiatives have published methodological guidelines for clinical registries. The objective of this paper was to review these guidelines and systematically assess their completeness, usability and feasibility according to a SWOT analysis. The results show that each guideline has its own strengths and weaknesses. While one supports the systematic planning process, the other discusses clinical registries in great detail. However, the feasibility was mostly limited and the special requirements of clinical registries, their flexible, expandable and adaptable technological structure was not addressed consistently.

  14. Systematic review and meta-analysis of electrocautery versus scalpel for surgical skin incisions.

    Science.gov (United States)

    Aird, Lisa N F; Brown, Carl J

    2012-08-01

    The creation of surgical skin incisions has historically been performed using a cold scalpel. The use of electrocautery for this purpose has been controversial with respect to patient safety and surgical efficacy. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to compare skin incisions made by electrocautery and a scalpel. A systematic electronic literature search was performed using 2 electronic databases (MEDLINE and PubMed), and the methodological quality of included publications was evaluated. Six RCTs were identified comparing electrocautery (n = 606) and a scalpel (n = 628) for skin incisions. No significant difference in wound infection rates or scar cosmesis was identified between the treatment groups. Electrocautery significantly reduced the incision time and postoperative wound pain. A trend toward less incisional blood loss from skin incisions made with electrocautery was noted. Electrocautery is a safe and effective method for performing surgical skin incisions. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Role of Esophageal Metal Stents Placement and Combination Therapy in Inoperable Esophageal Carcinoma: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Lai, Andrew; Lipka, Seth; Kumar, Ambuj; Sethi, Sajiv; Bromberg, David; Li, Nanxing; Shen, Huafeng; Stefaniwsky, Lilia; Brady, Patrick

    2018-04-01

    More than 50% of patients with esophageal cancer already have inoperable disease at the time of diagnosis. Controversy surrounds the outcomes of patients with advanced esophageal cancer who receive palliative care by either stent alone or stent plus an additional modality. We set out to perform a systematic review and meta-analysis of studies assessing the use of metal stents as treatment options for symptomatic improvement, survival, and adverse events. We searched Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception until January 14, 2016, as well as other databases for randomized controlled trials (RCTs) comparing esophageal stent versus either esophageal stent plus brachytherapy, radiotherapy, or chemotherapy. For quality assurance purposes throughout the systematic review, multiple independent extractions were performed, and the process was executed as per the standards of the Cochrane collaboration. Primary outcomes were mean change in dysphagia score, overall survival, and quality of life. Secondary outcomes were adverse events including fever, severe pain, aspiration, fistula, stent migration, perforation, and restenosis. Eight RCTs enrolling 732 patients were included with three distinct comparisons: stents combination therapy vs stents alone (5 studies, n = 417), stents alone versus brachytherapy alone (2 studies, n = 274), and stents + brachytherapy vs brachytherapy alone (1 study, n = 41). Stents combination therapy was defined as stents plus radiotherapy, chemotherapy, or both. Mean change in dysphagia scores favored stents combination therapy versus stents alone, and the effect was seen in patients surviving longer than 3 months. Stents combination therapy was also associated with a more favorable overall survival. The risks of stent migration, aspiration pneumonia, and restenosis were lower in the stents combination group compared to stents alone, while the risks of severe pain, hemorrhage, and

  16. Steroid hormones and psychological responses to soccer matches: Insights from a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Maamer Slimani

    Full Text Available The present systematic review and meta-analysis aimed to assess the perturbations in hormonal and psychological homeostasis in response to soccer match-play. These perturbations were explored according to match outcome (i.e., win versus loss, gender, type of contest (i.e., competitive versus non-competitive fixtures and competitive level (i.e., novice versus high-level. The review was conducted according to the Population/Intervention or Exposure/Comparison/Outcome(s (PICO criteria and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA guidelines. Match outcome, type of contest and competitive levels were moderator variables in the examined steroid hormones responses to a soccer match-play. Different testosterone responses were seen between match winners (increase and losers (decrease when compared to pre-game or baseline values (p <0.05, whilst no changes could be detected for cortisol relative to match outcome in female soccer players. Males (Δ% = 6.26; ES = 0.28 demonstrated a marginally lower increase in testosterone levels when compared to females (Δ% = 49.16; ES = 1.00, though not statistically significant. Females (Δ% = 162.7; ES = 0.98 did not demonstrate elevated cortisol match response compared to males (Δ% = 34.60; ES = 1.20. Male novice soccer match-play increased cortisol levels compared to high-level soccer match-play (Q = 18.08, p<0.001. Competitive soccer matches increased cortisol levels compared to non-competitive fixtures (i.e., collegiate tournament. Additionally, competitive levels moderate the relationship between a soccer match and testosterone levels (p <0.001, regardless of gender differences. From the presented systematic review and meta-analysis it appears (1 cortisol changes are associated with cognitive anxiety in starter female soccer players, while (2 testosterone changes are associated with changes in mood state in females and social connectedness in male soccer players. This

  17. Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis.

    Science.gov (United States)

    Moreno-Conde, Alberto; Moner, David; Cruz, Wellington Dimas da; Santos, Marcelo R; Maldonado, José Alberto; Robles, Montserrat; Kalra, Dipak

    2015-07-01

    This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Therapies for bruxism: a systematic review and network meta-analysis (protocol).

    Science.gov (United States)

    Mesko, Mauro Elias; Hutton, Brian; Skupien, Jovito Adiel; Sarkis-Onofre, Rafael; Moher, David; Pereira-Cenci, Tatiana

    2017-01-13

    Bruxism is a sleep disorder characterized by grinding and clenching of the teeth that may be related to irreversible tooth injuries. It is a prevalent condition occurring in up to 31% of adults. However, there is no definitive answer as to which of the many currently available treatments (including drug therapy, intramuscular injections, physiotherapy, biofeedback, kinesiotherapy, use of intraoral devices, or psychological therapy) is the best for the clinical management of the different manifestations of bruxism. The aim of this systematic review and network meta-analysis is to answer the following question: what is the best treatment for adult bruxists? Comprehensive searches of the Cochrane Library, MEDLINE (via PubMed), Scopus, and LILACS will be completed using the following keywords: bruxism and therapies and related entry terms. Studies will be included, according to the eligibility criteria (Controlled Clinical Trials and Randomized Clinical Trials, considering specific outcome measures for bruxism). The reference lists of included studies will be hand searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized (i.e., GRADE). A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). A Bayesian network meta-analysis will explore the relative benefits between the various treatments. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses (PRISMA-NMA) statement. This systematic review aims at identifying and evaluating therapies to treat bruxism. This systematic review may lead to several recommendations, for both patients and researchers, as which is the best therapy for a specific patient case and how future studies need to be designed, considering what is available now and what is

  19. Financial conflicts of interest and conclusions about neuraminidase inhibitors for influenza: an analysis of systematic reviews.

    Science.gov (United States)

    Dunn, Adam G; Arachi, Diana; Hudgins, Joel; Tsafnat, Guy; Coiera, Enrico; Bourgeois, Florence T

    2014-10-07

    Industry funding and financial conflicts of interest may contribute to bias in the synthesis and interpretation of scientific evidence. To examine the association between financial conflicts of interest and characteristics of systematic reviews of neuraminidase inhibitors. Retrospective analysis. Reviews that examined the use of neuraminidase inhibitors in the prophylaxis or treatment of influenza, were published between January 2005 and May 2014, and used a systematic search protocol. Two investigators blinded to all information regarding the review authors independently assessed the presentation of evidence on the use of neuraminidase inhibitors as favorable or not favorable. Financial conflicts of interest were identified using the index reviews, other publications, and Web-based searches. Associations between financial conflicts of interest, favorability assessments, and presence of critical appraisals of evidence quality were analyzed. Twenty-six systematic reviews were identified, of which 13 examined prophylaxis and 24 examined treatment, accounting for 37 distinct assessments. Among assessments associated with a financial conflict of interest, 7 of 8 (88%) were classified as favorable, compared with 5 of 29 (17%) among those without a financial conflict of interest. Reviewers without financial conflicts of interest were more likely to include statements about the quality of the primary studies than those with financial conflicts of interest. The heterogeneity in populations and outcomes examined in the reviews precluded analysis of the contribution of selective inclusion of evidence on the discordance of the assessments made in the reviews. Many of the systematic reviews had overlapping authorship. Reviewers with financial conflicts of interest may be more likely to present evidence about neuraminidase inhibitors in a favorable manner and recommend the use of these drugs than reviewers without financial conflicts of interest. Australian National Health and

  20. Lower vs. higher fluid volumes in sepsis-protocol for a systematic review with meta-analysis

    DEFF Research Database (Denmark)

    Meyhoff, T S; Møller, M H; Hjortrup, P B

    2017-01-01

    sequential analysis of randomised clinical trials comparing different strategies to obtain separation in fluid volumes or balances during resuscitation of adult patients with sepsis. We will systematically search the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, BIOSIS and Epistemonikos...... for relevant literature. We will follow the recommendations by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The risk of systematic errors (bias) and random errors will be assessed, and the overall quality of evidence will be evaluated...

  1. Result from systematic compilation of barrel bolt findings in S/KWU type PWRs in the context of computational analysis

    International Nuclear Information System (INIS)

    Kilian, R.; Devrient, B.; Koenig, G.; Stanislowski, M.; Widera, M.; Beusekom, R. van; Wermelinger, T.

    2015-01-01

    In 2005 intergranular stress corrosion cracking (IGSCC) of barrel bolts was observed in several S/KWU type PWRs. The bolts, known as star bolts, are made of SS type 316 Ti (German Material No. 1.4571 K) bars which are cold worked to adjust the required mechanical properties. This damage mechanism was so far less understood for PWR primary conditions. Therefore an extended joint research program was launched by AREVA GmbH and VGB e.V. to clarify the specific conditions which contributed to the observed findings on barrel bolts. A systematic analysis of the IGSCC affecting parameters as material, heats, environment and mechanical load was performed based on a plant data compilation from all six S/KWU PWRs with comparable core barrel design using barrel and baffle bolts made from type 316Ti. Using the outcome of this systematic data compilation additional computational fluid dynamics calculations in combination with radiolysis calculations were performed. The results showed that by a combination of reduced volume exchange by local flow conditions and radiolysis reactions forming oxidizing species as dissolved oxygen and/or hydrogen peroxide may locally affect the corrosion behavior of cold worked austenitic stainless steels. Therefore, small local volumes with oxidizing water chemistry conditions are assumed to lead to the IGSCC of cold worked type 316Ti. The comparison of the initial cold worked microstructure by TEM with the cold worked and in service irradiated microstructure (void formation, dislocation loop density, etc.) clearly reveals that neutron irradiation hardening in terms of IASCC (Irradiation-Assisted Stress Corrosion Cracking) is not the leading mechanism for these cases of barrel bolt cracking in the analyzed PWRs. (authors)

  2. Use of Insulin and Insulin Analogs and Risk of Cancer — Systematic Review and Meta-Analysis of Observational Studies

    Science.gov (United States)

    Karlstad, Øystein; Starup-Linde, Jacob; Vestergaard, Peter; Hjellvik, Vidar; T. Bazelier, Marloes; K. Schmidt, Marjanka; Andersen, Morten; Auvinen, Anssi; Haukka, Jari; Furu, Kari; de Vries, Frank; L. de Bruin, Marie

    2014-01-01

    Background: An association of insulin use and risk of cancer has been reported but evidence is conflicting and methodological issues have been identified. Objective: To summarize results regarding insulin use and cancer risk by a systematic review and meta-analysis of cohort and case-control studies examining risk of cancer associated with insulin use in patients with diabetes. Data Sources: Systematic literature search in 5 databases: PubMed, Embase, Web of Science, Scopus and Cochrane Library. Study Eligibility Criteria (PICOS): Population: diabetes patients. Exposure: Users of any exogenous insulin. Comparison: Diabetes patients with or without use of antidiabetic drugs. Outcome: Any incident cancer. Study Design: Cohort and case-control studies. Results: 42 eligible studies examined risk of any cancer and 27 site-specific cancers. Results of individual studies were heterogeneous. Meta-analyses were significant for: Insulin vs No Insulin: Increased risk for pancreas, liver, kidney, stomach and respiratory cancer, decreased risk for prostate cancer. Insulin vs Non-Insulin Antidiabetics: Increased risk for any, pancreatic and colorectal cancer. Glargine vs Non-Glargine Insulin: Increased risk for breast cancer, decreased risk for colon cancer. Limitations: Few studies available for most cancer sites and exposure contrasts, and few assess effect of dose and duration of exposure. Methodological issues in several studies. Availability of confounders. Conclusions: Insulin use was associated with risk of cancer at several sites. Cautious interpretation of results is warranted as methodological issues and limitations in several of the included studies have been identified. Choice of study design may have a profound effect on estimated cancer risk. PMID:24215311

  3. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis.

    Science.gov (United States)

    Chopra, Vineet; Anand, Sarah; Hickner, Andy; Buist, Michael; Rogers, Mary Am; Saint, Sanjay; Flanders, Scott A

    2013-07-27

    Peripherally inserted central catheters (PICCs) are associated with an increased risk of venous thromboembolism. However, the size of this risk relative to that associated with other central venous catheters (CVCs) is unknown. We did a systematic review and meta-analysis to compare the risk of venous thromboembolism associated with PICCs versus that associated with other CVCs. We searched several databases, including Medline, Embase, Biosis, Cochrane Central Register of Controlled Trials, Conference Papers Index, and Scopus. Additional studies were identified through hand searches of bibliographies and internet searches, and we contacted study authors to obtain unpublished data. All human studies published in full text, abstract, or poster form were eligible for inclusion. All studies were of adult patients aged at least 18 years who underwent insertion of a PICC. Studies were assessed with the Newcastle-Ottawa risk of bias scale. In studies without a comparison group, the pooled frequency of venous thromboembolism was calculated for patients receiving PICCs. In studies comparing PICCs with other CVCs, summary odds ratios (ORs) were calculated with a random effects meta-analysis. Of the 533 citations identified, 64 studies (12 with a comparison group and 52 without) including 29 503 patients met the eligibility criteria. In the non-comparison studies, the weighted frequency of PICC-related deep vein thrombosis was highest in patients who were critically ill (13·91%, 95% CI 7·68-20·14) and those with cancer (6·67%, 4·69-8·64). Our meta-analysis of 11 studies comparing the risk of deep vein thrombosis related to PICCs with that related to CVCs showed that PICCs were associated with an increased risk of deep vein thrombosis (OR 2·55, 1·54-4·23, p<0·0001) but not pulmonary embolism (no events). With the baseline PICC-related deep vein thrombosis rate of 2·7% and pooled OR of 2·55, the number needed to harm relative to CVCs was 26 (95% CI 13-71). PICCs are

  4. The effects of various diets on glycemic outcomes during pregnancy: A systematic review and network meta-analysis.

    Directory of Open Access Journals (Sweden)

    Vanessa Ha

    Full Text Available Evidence to support dietary modifications to improve glycemia during pregnancy is limited, and the benefits of diet beyond limiting gestational weight gain is unclear. Therefore, a systematic review and network meta-analysis of randomized trials was conducted to compare the effects of various common diets, stratified by the addition of gestational weight gain advice, on fasting glucose and insulin, hemoglobin A1c (HbA1c, and homeostatic model assessment for insulin resistance (HOMA-IR in pregnant women.MEDLINE, EMBASE, Cochrane database, and reference lists of published studies were searched through April 2017. Randomized trials directly comparing two or more diets for ≥2-weeks were eligible. Bayesian network meta-analysis was performed for fasting glucose. Owing to a lack of similar dietary comparisons, a standard pairwise meta-analysis for the other glycemic outcomes was performed. The certainty of the pooled effect estimates was assessed using the GRADE tool.Twenty-one trials (1,865 participants were included. In general, when given alongside gestational weight gain advice, fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only. However, fasting glucose increased in high unsaturated or monounsaturated fatty acids diets. In the absence of gestational weight gain advice, fasting glucose improved in DASH-style diets compared to standard of care. Although most were non-significant, similar trends were observed for these same diets for the other glycemic outcomes. Dietary comparisons ranged from moderate to very low in quality of evidence.Alongside with gestational weight gain advice, most diets, with the exception of a high unsaturated or a high monounsaturated fatty acid diet, demonstrated a fasting glucose improvement compared with gestational weight gain advice only. When gestational weight gain advice was not given, the DASH-style diet appeared optimal on fasting glucose. However, a small

  5. The effects of various diets on glycemic outcomes during pregnancy: A systematic review and network meta-analysis

    Science.gov (United States)

    Ha, Vanessa; Bonner, Ashley J.; Jadoo, Jaynendr K.; Beyene, Joseph; Anand, Sonia S.

    2017-01-01

    Aims Evidence to support dietary modifications to improve glycemia during pregnancy is limited, and the benefits of diet beyond limiting gestational weight gain is unclear. Therefore, a systematic review and network meta-analysis of randomized trials was conducted to compare the effects of various common diets, stratified by the addition of gestational weight gain advice, on fasting glucose and insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in pregnant women. Methods MEDLINE, EMBASE, Cochrane database, and reference lists of published studies were searched through April 2017. Randomized trials directly comparing two or more diets for ≥2-weeks were eligible. Bayesian network meta-analysis was performed for fasting glucose. Owing to a lack of similar dietary comparisons, a standard pairwise meta-analysis for the other glycemic outcomes was performed. The certainty of the pooled effect estimates was assessed using the GRADE tool. Results Twenty-one trials (1,865 participants) were included. In general, when given alongside gestational weight gain advice, fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only. However, fasting glucose increased in high unsaturated or monounsaturated fatty acids diets. In the absence of gestational weight gain advice, fasting glucose improved in DASH-style diets compared to standard of care. Although most were non-significant, similar trends were observed for these same diets for the other glycemic outcomes. Dietary comparisons ranged from moderate to very low in quality of evidence. Conclusion/Interpretation Alongside with gestational weight gain advice, most diets, with the exception of a high unsaturated or a high monounsaturated fatty acid diet, demonstrated a fasting glucose improvement compared with gestational weight gain advice only. When gestational weight gain advice was not given, the DASH-style diet appeared optimal on

  6. Association between periodontitis and ischemic stroke: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Leira, Yago; Seoane, Juan; Blanco, Miguel; Rodríguez-Yáñez, Manuel; Takkouche, Bahi; Blanco, Juan; Castillo, José

    2017-01-01

    Several observational studies have suggested an association between periodontitis and cerebral ischemia. This meta-analysis aimed to investigate whether this link exists, and if so, the degree to which it is significant. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline for systematic review was used. The search strategy included using electronic databases and hand searching works published up to March 2015. MEDLINE via PubMed, EMBASE, Proceedings Web of Science and Current Contents Connect were searched by two independent reviewers. Case-control, cross-sectional or cohort studies including patients with measures of periodontitis and ischemic stroke were eligible to be included in the analysis. Quality assessments of selected studies were performed. From a total of 414 titles and abstracts, 57 potentially relevant full text papers were identified. After inclusion criteria were applied, 8 studies were included in the present systematic review (5 case-control and 3 cohort studies). Although it was not the intention, cross-sectional studies were excluded due to eligibility criteria were not accomplished. Therefore, meta-analyses were conducted with data retrieved from the 8 studies included. These meta-analyses showed statistically significant association between periodontitis and ischemic stroke in both cohort pooled relative risks at 2.52 (1.77–3.58), and case-control studies pooled relative risks at 3.04 (1.10–8.43). In conclusion, the present meta-analysis demonstrated an association between periodontitis and ischemic stroke. However, well-designed prospective studies should be carried out to provide robust evidence of the link between both diseases. In regards to ischemic stroke subtypes, further case-control studies should be carried out to investigate whether there is any association between the different subtypes of cerebral infarcts and periodontitis.

  7. The relationship between water, sanitation and schistosomiasis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jack E T Grimes

    2014-12-01

    Full Text Available Access to "safe" water and "adequate" sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that their transmission may be reduced through safe water and adequate sanitation. However, the evidence has not previously been compiled in a systematic review.We carried out a systematic review and meta-analysis of studies reporting schistosome infection rates in people who do or do not have access to safe water and adequate sanitation. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2013, without restrictions on year of publication or language. Studies' titles and abstracts were screened by two independent assessors. Papers deemed of interest were read in full and appropriate studies included in the meta-analysis. Publication bias was assessed through the visual inspection of funnel plots and through Egger's test. Heterogeneity of datasets within the meta-analysis was quantified using Higgins' I2.Safe water supplies were associated with significantly lower odds of schistosomiasis (odds ratio (OR = 0.53, 95% confidence interval (CI: 0.47-0.61. Adequate sanitation was associated with lower odds of Schistosoma mansoni, (OR = 0.59, 95% CI: 0.47-0.73 and Schistosoma haematobium (OR = 0.69, 95% CI: 0.57-0.84. Included studies were mainly cross-sectional and quality was largely poor.Our systematic review and meta-analysis suggests that increasing access to safe water and adequate sanitation are important measures to reduce the odds of schistosome infection. However, most of the studies were observational and quality was poor. Hence, there is a pressing need for adequately powered cluster randomized trials comparing schistosome infection risk with access to safe water and adequate sanitation, more studies which rigorously define water and sanitation, and new research on the relationships between water, sanitation, hygiene, human

  8. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Gaeun Kim

    Full Text Available Sarcopenia is a common syndrome in chronic diseases such as liver cirrhosis. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis.We conducted a systematic review (SR and meta-analysis (MA on the impact of sarcopenia on outcome in liver cirrhosis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Of the 312 studies identified, 20 were eligible according to our inclusion criteria. Most of the studies used CT to diagnose sarcopenia. Two studies used bioelectrical impedance analysis (BIA, 10 studies used skeletal muscle index (SMI and 8 studies used total psoas muscle area (TPA. Seven studies included Asian participants and the remaining 13 studies included Western participants. The prevalence rate of sarcopenia among participants was mean 48.1%, and appeared more among men with a rate of 61.6% whereas the rate was 36% for women. With respect to clinical outcomes, patients with sarcopenia had poorer survival rates and an increased risk of complications such as infection compared to those without sarcopenia. According to the analysis of race subgroup, Asians had a HR 2.45 (95% confidence interval (CI = 1.44-4.16, P = 0.001 of mortality whereas Westerners had a HR 1.45 (95% CI = 1.002-2.09, P<0.05.Based on this SR and MA, the presence of sarcopenia is related to a poor prognosis and occurrence of cirrhotic complications and could be used for risk assessment. Moreover, Asian participants had higher mortality related to sarcopenia compared to the Western participants.

  9. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis

    Science.gov (United States)

    Kim, Gaeun; Kim, Moon Young

    2017-01-01

    Background Sarcopenia is a common syndrome in chronic diseases such as liver cirrhosis. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis. Methods and findings We conducted a systematic review (SR) and meta-analysis (MA) on the impact of sarcopenia on outcome in liver cirrhosis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Of the 312 studies identified, 20 were eligible according to our inclusion criteria. Most of the studies used CT to diagnose sarcopenia. Two studies used bioelectrical impedance analysis (BIA), 10 studies used skeletal muscle index (SMI) and 8 studies used total psoas muscle area (TPA). Seven studies included Asian participants and the remaining 13 studies included Western participants. The prevalence rate of sarcopenia among participants was mean 48.1%, and appeared more among men with a rate of 61.6% whereas the rate was 36% for women. With respect to clinical outcomes, patients with sarcopenia had poorer survival rates and an increased risk of complications such as infection compared to those without sarcopenia. According to the analysis of race subgroup, Asians had a HR 2.45 (95% confidence interval (CI) = 1.44–4.16, P = 0.001) of mortality whereas Westerners had a HR 1.45 (95% CI = 1.002–2.09, Psarcopenia is related to a poor prognosis and occurrence of cirrhotic complications and could be used for risk assessment. Moreover, Asian participants had higher mortality related to sarcopenia compared to the Western participants. PMID:29065187

  10. Equation-free analysis of agent-based models and systematic parameter determination

    Science.gov (United States)

    Thomas, Spencer A.; Lloyd, David J. B.; Skeldon, Anne C.

    2016-12-01

    Agent based models (ABM)s are increasingly used in social science, economics, mathematics, biology and computer science to describe time dependent systems in circumstances where a description in terms of equations is difficult. Yet few tools are currently available for the systematic analysis of ABM behaviour. Numerical continuation and bifurcation analysis is a well-established tool for the study of deterministic systems. Recently, equation-free (EF) methods have been developed to extend numerical continuation techniques to systems where the dynamics are described at a microscopic scale and continuation of a macroscopic property of the system is considered. To date, the practical use of EF methods has been limited by; (1) the over-head of application-specific implementation; (2) the laborious configuration of problem-specific parameters; and (3) large ensemble sizes (potentially) leading to computationally restrictive run-times. In this paper we address these issues with our tool for the EF continuation of stochastic systems, which includes algorithms to systematically configuration problem specific parameters and enhance robustness to noise. Our tool is generic and can be applied to any 'black-box' simulator and determines the essential EF parameters prior to EF analysis. Robustness is significantly improved using our convergence-constraint with a corrector-repeat (C3R) method. This algorithm automatically detects outliers based on the dynamics of the underlying system enabling both an order of magnitude reduction in ensemble size and continuation of systems at much higher levels of noise than classical approaches. We demonstrate our method with application to several ABM models, revealing parameter dependence, bifurcation and stability analysis of these complex systems giving a deep understanding of the dynamical behaviour of the models in a way that is not otherwise easily obtainable. In each case we demonstrate our systematic parameter determination stage for

  11. The relationship between water, sanitation and schistosomiasis: a systematic review and meta-analysis.

    Science.gov (United States)

    Grimes, Jack E T; Croll, David; Harrison, Wendy E; Utzinger, Jürg; Freeman, Matthew C; Templeton, Michael R

    2014-12-01

    Access to "safe" water and "adequate" sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that their transmission may be reduced through safe water and adequate sanitation. However, the evidence has not previously been compiled in a systematic review. We carried out a systematic review and meta-analysis of studies reporting schistosome infection rates in people who do or do not have access to safe water and adequate sanitation. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2013, without restrictions on year of publication or language. Studies' titles and abstracts were screened by two independent assessors. Papers deemed of interest were read in full and appropriate studies included in the meta-analysis. Publication bias was assessed through the visual inspection of funnel plots and through Egger's test. Heterogeneity of datasets within the meta-analysis was quantified using Higgins' I2. Safe water supplies were associated with significantly lower odds of schistosomiasis (odds ratio (OR) = 0.53, 95% confidence interval (CI): 0.47-0.61). Adequate sanitation was associated with lower odds of Schistosoma mansoni, (OR = 0.59, 95% CI: 0.47-0.73) and Schistosoma haematobium (OR = 0.69, 95% CI: 0.57-0.84). Included studies were mainly cross-sectional and quality was largely poor. Our systematic review and meta-analysis suggests that increasing access to safe water and adequate sanitation are important measures to reduce the odds of schistosome infection. However, most of the studies were observational and quality was poor. Hence, there is a pressing need for adequately powered cluster randomized trials comparing schistosome infection risk with access to safe water and adequate sanitation, more studies which rigorously define water and sanitation, and new research on the relationships between water, sanitation, hygiene, human behavior

  12. Endoscopic versus surgical treatment of ampullary adenomas: a systematic review and meta-analysis

    Science.gov (United States)

    Mendonça, Ernesto Quaresma; Bernardo, Wanderley Marques; de Moura, Eduardo Guimarães Hourneaux; Chaves, Dalton Marques; Kondo, André; Pu, Leonardo Zorrón Cheng Tao; Baracat, Felipe Iankelevich

    2016-01-01

    The aim of this study is to address the outcomes of endoscopic resection compared with surgery in the treatment of ampullary adenomas. A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For this purpose, the Medline, Embase, Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were scanned. Studies included patients with ampullary adenomas and data considering endoscopic treatment compared with surgery. The entire analysis was based on a fixed-effects model. Five retrospective cohort studies were selected (466 patients). All five studies (466 patients) had complete primary resection data available and showed a difference that favored surgical treatment (risk difference [RD] = -0.24, 95% confidence interval [CI] = -0.44 to -0.04). Primary success data were identified in all five studies as well. Analysis showed that the surgical approach outperformed endoscopic treatment for this outcome (RD = -0.37, 95% CI = -0.50 to -0.24). Recurrence data were found in all studies (466 patients), with a benefit indicated for surgical treatment (RD = 0.10, 95% CI = -0.01 to 0.19). Three studies (252 patients) presented complication data, but analysis showed no difference between the approaches for this parameter (RD = -0.15, 95% CI = -0.53 to 0.23). Considering complete primary resection, primary success and recurrence outcomes, the surgical approach achieves significantly better results. Regarding complication data, this systematic review concludes that rates are not significantly different. PMID:26872081

  13. Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Deng, Chuiwen; Li, Wenli; Fei, Yunyun; Li, Yongzhe; Zhang, Fengchun

    2016-08-18

    Current knowledge about the overall and site-specific risk of malignancy associated with ankylosing spondylitis (AS) is inconsistent. We conducted a systematic review and meta-analysis to address this knowledge gap. Five databases (PubMed, EMBASE, Web of Science, the Cochrane library and the virtual health library) were systematically searched. A manual search of publications within the last 2 years in key journals in the field (Annals of the Rheumatic Diseases, Rheumatology and Arthritis &rheumatology) was also performed. STATA 11.2 software was used to conduct the meta-analysis. After screening, twenty-three studies, of different designs, were eligible for meta-analysis. AS is associated with a 14% (pooled RR 1.14; 95% CI 1.03-1.25) increase in the overall risk for malignancy. Compared to controls, patients with AS are at a specific increased risk for malignancy of the digestive system (pooled RR 1.20; 95% CI 1.01 to 1.42), multiple myelomas (pooled RR 1.92; 95% CI 1.37 to 3.69) and lymphomas (pooled RR 1.32; 95% CI 1.11 to 1.57). On subgroup analysis, evidence from high quality cohort studies indicated that AS patients from Asia are at highest risk for malignancy overall. Confirmation of findings from large-scale longitudinal studies is needed to identify specific risk factors and to evaluate treatment effects.

  14. Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis.

    Science.gov (United States)

    Gusman, David Jonathan R; Mello-Neto, João M; Alves, Breno Edson S; Matheus, Henrique R; Ervolino, Edilson; Theodoro, Letícia H; de Almeida, Juliano M

    Despite clinical trials and reviews attempt to assess a possible relationship between dementia and periodontal disease, no meta-analysis has been performed and this issue remains undetermined. The aim of this study is to conduct a