WorldWideScience

Sample records for systematic image-driven analysis

  1. 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...

  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. Chromatographic screening techniques in systematic toxicological analysis.

    Science.gov (United States)

    Drummer, O H

    1999-10-15

    A review of techniques used to screen biological specimens for the presence of drugs was conducted with particular reference to systematic toxicological analysis. Extraction systems of both the liquid-liquid and solid-phase type show little apparent difference in their relative ability to extract a range of drugs according to their physio-chemical properties, although mixed-phase SPE extraction is a preferred technique for GC-based applications, and liquid-liquid were preferred for HPLC-based applications. No one chromatographic system has been shown to be capable of detecting a full range of common drugs of abuse, and common ethical drugs, hence two or more assays are required for laboratories wishing to cover a reasonably comprehensive range of drugs of toxicological significance. While immunoassays are invariably used to screen for drugs of abuse, chromatographic systems relying on derivatization and capable of extracting both acidic and basic drugs would be capable of screening a limited range of targeted drugs. Drugs most difficult to detect in systematic toxicological analysis include LSD, psilocin, THC and its metabolites, fentanyl and its designer derivatives, some potent opiates, potent benzodiazepines and some potent neuroleptics, many of the newer anti-convulsants, alkaloids colchicine, amantins, aflatoxins, antineoplastics, coumarin-based anti-coagulants, and a number of cardiovascular drugs. The widespread use of LC-MS and LC-MS-MS for specific drug detection and the emergence of capillary electrophoresis linked to MS and MS-MS provide an exciting possibility for the future to increase the range of drugs detected in any one chromatographic screening system.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    . 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......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...... 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...

  5. 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

  6. 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

  7. Systematic review with meta-analysis

    DEFF Research Database (Denmark)

    Roda, G; Narula, N; Pinotti, R

    2017-01-01

    BACKGROUND: Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. AIM: To perform a systematic review ...

  8. 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.

  9. 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

  10. Systematic safety analysis of old nuclear power plants

    International Nuclear Information System (INIS)

    Dredemis, G.

    1985-11-01

    A program of systematic safety analysis of old nuclear power plants has been engaged by French safety authorities. Beyond the reshaping of safety documents (safety reports, general rules of operation, incidental and accidental procedures, internal emergency plan and manual of quality organization), this examination consisted of an analysis of the operation experience of circuits frequently actuated and a systematic analysis of safety circuits. This paper is based on the presentation of the exercise carried out at the Ardennes nuclear power plant operating for 15 years. This paper reviews also the main studies and modifications engaged on this power plant [fr

  11. 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

  12. 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…

  13. [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.

  14. 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.

  15. 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.

  16. 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...

  17. 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.

  18. 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.

  19. Transgender Phonosurgery: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Song, Tara Elena; Jiang, Nancy

    2017-05-01

    Objectives Different surgical techniques have been described in the literature to increase vocal pitch. The purpose of this study is to systematically review these surgeries and perform a meta-analysis to determine which technique increases pitch the most. Data Sources CINAHL, Cochrane, Embase, Medline, PubMed, and Science Direct. Review Methods A systematic review and meta-analysis of the literature was performed using the CINAHL, Cochrane, Embase, Medline, PubMed, and Science Direct databases. Studies were eligible for inclusion if they evaluated pitch-elevating phonosurgical techniques in live humans and performed pre- and postoperative acoustic analysis. Data were gathered regarding surgical technique, pre- and postoperative fundamental frequencies, perioperative care measures, and complications. Results Twenty-nine studies were identified. After applying inclusion and exclusion criteria, a total of 13 studies were included in the meta-analysis. Mechanisms of pitch elevation included increasing vocal cord tension (cricothyroid approximation), shortening the vocal cord length (cold knife glottoplasty, laser-shortening glottoplasty), and decreasing mass (laser reduction glottoplasty). The most common interventions were shortening techniques and cricothyroid approximation (6 studies each). The largest increase in fundamental frequency was seen with techniques that shortened the vocal cords. Preoperative speech therapy, postoperative voice rest, and reporting of patient satisfaction were inconsistent. Many of the studies were limited by low power and short length of follow-up. Conclusions Multiple techniques for elevation of vocal pitch exist, but vocal cord shortening procedures appear to result in the largest increase in fundamental frequency.

  20. 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.

  1. Cinnamon in glycaemic control: Systematic review and meta analysis.

    Science.gov (United States)

    Akilen, Rajadurai; Tsiami, Amalia; Devendra, Devasenan; Robinson, Nicola

    2012-10-01

    Cinnamon seems to be highly bioactive, appearing to mimic the effect of insulin through increased glucose uptake in adipocytes and skeletal muscles. This systematic review and Meta analysis examined the effect of cinnamon on glycaemic control in patients with Type 2 Diabetes mellitus. A systematic literature search was conducted from the earliest possible date through to 01 August 2011. Search terms included free text terms, MeSH and Medline medical index terms such as: "cinnamon", "cinnamomum", "cinnamomum cassia", "cinnamomum zeylanicum", "type 2 diabetes mellitus". Each was crossed with the term "diabetes mellitus". In addition, references of key articles were hand searched. A total of 6 clinical trials met the strict inclusion criteria and considered a total of 435 patients; follow up between 40 days-4 months, doses ranging from 1 g to 6 g per day. Meta-analysis of RCTs showed a significant decrease in mean HbA1c [0.09%; 95% CI was 0.04-0.14] and mean FPG [0.84 mmol/l; 95% CI was 0.66-1.02]. Use of cinnamon showed a beneficial effect on glycaemic control (both HbA1c and FPG) and the short term (cinnamon on glycaemic control looks promising. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. 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

  3. 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...

  4. Motivational interviewing: a systematic review and meta-analysis

    Science.gov (United States)

    Rubak, Sune; Sandbæk, Annelli; Lauritzen, Torsten; Christensen, Bo

    2005-01-01

    Background Motivational Interviewing is a well-known, scientifically tested method of counselling clients developed by Miller and Rollnick and viewed as a useful intervention strategy in the treatment of lifestyle problems and disease. Aim To evaluate the effectiveness of motivational interviewing in different areas of disease and to identify factors shaping outcomes. Design of study A systematic review and meta-analysis of randomised controlled trials using motivational interviewing as the intervention. Method After selection criteria a systematic literature search in 16 databases produced 72 randomised controlled trials the first of which was published in 1991. A quality assessment was made with a validated scale. A meta-analysis was performed as a generic inverse variance meta-analysis. Results Meta-analysis showed a significant effect (95% confidence interval) for motivational interviewing for combined effect estimates for body mass index, total blood cholesterol, systolic blood pressure, blood alcohol concentration and standard ethanol content, while combined effect estimates for cigarettes per day and for HbA1c were not significant. Motivational interviewing had a significant and clinically relevant effect in approximately three out of four studies, with an equal effect on physiological (72%) and psychological (75%) diseases. Psychologists and physicians obtained an effect in approximately 80% of the studies, while other healthcare providers obtained an effect in 46% of the studies. When using motivational interviewing in brief encounters of 15 minutes, 64% of the studies showed an effect. More than one encounter with the patient ensures the effectiveness of motivational interviewing. Conclusion Motivational interviewing in a scientific setting outperforms traditional advice giving in the treatment of a broad range of behavioural problems and diseases. Large-scale studies are now needed to prove that motivational interviewing can be implemented into daily

  5. Toward Pervasive Gait Analysis With Wearable Sensors: A Systematic Review.

    Science.gov (United States)

    Chen, Shanshan; Lach, John; Lo, Benny; Yang, Guang-Zhong

    2016-11-01

    After decades of evolution, measuring instruments for quantitative gait analysis have become an important clinical tool for assessing pathologies manifested by gait abnormalities. However, such instruments tend to be expensive and require expert operation and maintenance besides their high cost, thus limiting them to only a small number of specialized centers. Consequently, gait analysis in most clinics today still relies on observation-based assessment. Recent advances in wearable sensors, especially inertial body sensors, have opened up a promising future for gait analysis. Not only can these sensors be more easily adopted in clinical diagnosis and treatment procedures than their current counterparts, but they can also monitor gait continuously outside clinics - hence providing seamless patient analysis from clinics to free-living environments. The purpose of this paper is to provide a systematic review of current techniques for quantitative gait analysis and to propose key metrics for evaluating both existing and emerging methods for qualifying the gait features extracted from wearable sensors. It aims to highlight key advances in this rapidly evolving research field and outline potential future directions for both research and clinical applications.

  6. 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

  7. Systematic Sustainable Process Design and Analysis of Biodiesel Processes

    Directory of Open Access Journals (Sweden)

    Seyed Soheil Mansouri

    2013-09-01

    Full Text Available Biodiesel is a promising fuel alternative compared to traditional diesel obtained from conventional sources such as fossil fuel. Many flowsheet alternatives exist for the production of biodiesel and therefore it is necessary to evaluate these alternatives using defined criteria and also from process intensification opportunities. This work focuses on three main aspects that have been incorporated into a systematic computer-aided framework for sustainable process design. First, the creation of a generic superstructure, which consists of all possible process alternatives based on available technology. Second, the evaluation of this superstructure for systematic screening to obtain an appropriate base case design. This is done by first reducing the search space using a sustainability analysis, which provides key indicators for process bottlenecks of different flowsheet configurations and then by further reducing the search space by using economic evaluation and life cycle assessment. Third, the determination of sustainable design with/without process intensification using a phenomena-based synthesis/design method. A detailed step by step application of the framework is highlighted through a biodiesel production case study.

  8. 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.

  9. Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Helen M Stallman

    Full Text Available Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for 'sleepwalking' OR 'somnambulism' in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%-10.3%. The current prevalence rate of sleepwalking-within the last 12 months-was significantly higher in children 5.0% (95% CI 3.8%-6.5% than adults 1.5% (95% CI 1.0%-2.3%. There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed.

  10. Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Stallman, Helen M; Kohler, Mark

    2016-01-01

    Sleepwalking is thought to be a common arousal disorder; however, the epidemiology of this disorder has not yet been systematically examined. A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted for 'sleepwalking' OR 'somnambulism' in any field, to identify studies that reported the epidemiology of sleepwalking or sleepwalking disorders. Fifty-one studies assessed the prevalence rates of sleepwalking in a total sample of 100 490. The meta-analysis showed the estimated lifetime prevalence of sleepwalking was 6.9% (95% CI 4.6%-10.3%). The current prevalence rate of sleepwalking-within the last 12 months-was significantly higher in children 5.0% (95% CI 3.8%-6.5%) than adults 1.5% (95% CI 1.0%-2.3%). There was no evidence of developmental trends in sleepwalking across childhood. The significant risk of bias across all studies suggests these results should be used cautiously. Further epidemiological research that addresses methodological problems found in studies of sleepwalking to date is needed.

  11. Three-dimensional cephalometric analysis in orthodontics: a systematic review.

    Science.gov (United States)

    Pittayapat, P; Limchaichana-Bolstad, N; Willems, G; Jacobs, R

    2014-05-01

    The scientific evidence of 3D cephalometry in orthodontics has not been well established. The aim of this systematic review was to evaluate the evidence for the diagnostic efficacy of 3D cephalometry in orthdontics, focusing on measurement accuracy and reproducibility of landmark identification. PubMed, EMBASE and the Cochrane library (from beginning to March 13, 2012) were searched. Search terms included: cone-beam computed tomography; tomography, spiral computed; imaging, three-dimensional; orthodontics. Two reviewers read the retrieved articles and selected relevant publications based on pre-established inclusion criteria. The selected publications had to elucidate the hierarchical model of the efficacy of diagnostic imaging systems by Fryback and Thornbury. The data was then extracted according to two protocols, which were based on the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Next, levels of evidence were categorized into 3 groups: low, moderate and high evidence. 571 publications were found by database search strategies and 50 additional studies by hand search. A total of 35 publications were included in this review. Limited evidence for the diagnostic efficacy of 3D cephalometry was found. Only 6 studies met the criteria for a moderate level of evidence. Accordingly, this systematic review reveals that there is still need for methodologically standardized studies on 3D cephalometric analysis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. Coffee and gastric cancer: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Botelho Francisco

    2006-01-01

    Full Text Available We systematically reviewed the literature on the association between coffee consumption and gastric cancer and performed a meta-analysis of the results. Published cohort and case-control studies were identified in PubMed and reference lists. Random effects meta-analysis was used to pool effects from 23 studies, and heterogeneity was explored by stratification and meta-regression. The odds ratio (OR for the overall association between coffee and gastric cancer (highest vs. lowest category of exposure was 0.97 (95%CI: 0.86-1.09, similar for cohort (OR = 1.02; 95%CI: 0.76-1.37 and case-control studies (population-based: OR = 0.90; 95%CI: 0.70-1.15; hospital-based: OR = 0.97; 95%CI: 0.83-1.13. The OR was 1.26 (95%CI: 1.02-1.57 when considering five studies conducted in the USA, 0.97 (95%CI: 0.82-1.14 for the five Japanese studies, 0.98 (95%CI: 0.81-1.17 for the six studies from Europe, and 0.64 (95%CI: 0.47-0.86 for the two studies from South America. In this meta-analysis we found no adverse effect of coffee associated with gastric cancer. Knowledge on the level of exposure to different coffee constituents may provide a deeper understanding of this reassuring result and the real role of coffee on cancer risk.

  17. Coffee and gastric cancer: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Francisco Botelho

    Full Text Available We systematically reviewed the literature on the association between coffee consumption and gastric cancer and performed a meta-analysis of the results. Published cohort and case-control studies were identified in PubMed and reference lists. Random effects meta-analysis was used to pool effects from 23 studies, and heterogeneity was explored by stratification and meta-regression. The odds ratio (OR for the overall association between coffee and gastric cancer (highest vs. lowest category of exposure was 0.97 (95%CI: 0.86-1.09, similar for cohort (OR = 1.02; 95%CI: 0.76-1.37 and case-control studies (population-based: OR = 0.90; 95%CI: 0.70-1.15; hospital-based: OR = 0.97; 95%CI: 0.83-1.13. The OR was 1.26 (95%CI: 1.02-1.57 when considering five studies conducted in the USA, 0.97 (95%CI: 0.82-1.14 for the five Japanese studies, 0.98 (95%CI: 0.81-1.17 for the six studies from Europe, and 0.64 (95%CI: 0.47-0.86 for the two studies from South America. In this meta-analysis we found no adverse effect of coffee associated with gastric cancer. Knowledge on the level of exposure to different coffee constituents may provide a deeper understanding of this reassuring result and the real role of coffee on cancer risk.

  18. Risk of recurrent stillbirth: systematic review and meta-analysis.

    Science.gov (United States)

    Lamont, Kathleen; Scott, Neil W; Jones, Gareth T; Bhattacharya, Sohinee

    2015-06-24

    To determine the risk of recurrent stillbirth. Systematic review and meta-analysis of cohort and case-control studies. Embase, Medline, Cochrane Library, PubMed, CINAHL, and Scopus searched systematically with no restrictions on date, publication, or language to identify relevant studies. Supplementary efforts included searching relevant internet resources as well as hand searching the reference lists of included studies. Where published information was unclear or inadequate, corresponding authors were contacted for more information. Cohort and case-control studies from high income countries were potentially eligible if they investigated the association between stillbirth in an initial pregnancy and risk of stillbirth in a subsequent pregnancy. Stillbirth was defined as fetal death occurring at more than 20 weeks' gestation or a birth weight of at least 400 g. Two reviewers independently screened titles to identify eligible studies based on inclusion and exclusion criteria agreed a priori, extracted data, and assessed the methodological quality using scoring criteria from the critical appraisal skills programme. Random effects meta-analyses were used to combine the results of the included studies. Subgroup analysis was performed on studies that examined unexplained stillbirth. 13 cohort studies and three case-control studies met the inclusion criteria and were included in the meta-analysis. Data were available on 3,412,079 women with pregnancies beyond 20 weeks duration, of who 3,387,538 (99.3%) had had a previous live birth and 24,541 (0.7%) a stillbirth. A total of 14,283 stillbirths occurred in subsequent pregnancies, 606/24,541 (2.5%) in women with a history of stillbirth and 13,677/3,387,538 (0.4%) among women with no such history (pooled odds ratio 4.83, 95% confidence interval 3.77 to 6.18). 12 studies specifically assessed the risk of stillbirth in second pregnancies. Compared with women who had a live birth in their first pregnancy, those who experienced a

  19. Systematic Analysis of Hollow Fiber Model of Tuberculosis Experiments.

    Science.gov (United States)

    Pasipanodya, Jotam G; Nuermberger, Eric; Romero, Klaus; Hanna, Debra; Gumbo, Tawanda

    2015-08-15

    The in vitro hollow fiber system model of tuberculosis (HFS-TB), in tandem with Monte Carlo experiments, was introduced more than a decade ago. Since then, it has been used to perform a large number of tuberculosis pharmacokinetics/pharmacodynamics (PK/PD) studies that have not been subjected to systematic analysis. We performed a literature search to identify all HFS-TB experiments published between 1 January 2000 and 31 December 2012. There was no exclusion of articles by language. Bias minimization was according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Steps for reporting systematic reviews were followed. There were 22 HFS-TB studies published, of which 12 were combination therapy studies and 10 were monotherapy studies. There were 4 stand-alone Monte Carlo experiments that utilized quantitative output from the HFS-TB. All experiments reported drug pharmacokinetics, which recapitulated those encountered in humans. HFS-TB studies included log-phase growth studies under ambient air, semidormant bacteria at pH 5.8, and nonreplicating persisters at low oxygen tension of ≤ 10 parts per billion. The studies identified antibiotic exposures associated with optimal kill of Mycobacterium tuberculosis and suppression of acquired drug resistance (ADR) and informed predictions about optimal clinical doses, expected performance of standard doses and regimens in patients, and expected rates of ADR, as well as a proposal of new susceptibility breakpoints. The HFS-TB model offers the ability to perform PK/PD studies including humanlike drug exposures, to identify bactericidal and sterilizing effect rates, and to identify exposures associated with suppression of drug resistance. Because of the ability to perform repetitive sampling from the same unit over time, the HFS-TB vastly improves statistical power and facilitates the execution of time-to-event analyses and repeated event analyses, as well as dynamic system pharmacology mathematical

  20. A Systematic Analysis of Candidate Genes Associated with Nicotine Addiction.

    Science.gov (United States)

    Liu, Meng; Li, Xia; Fan, Rui; Liu, Xinhua; Wang, Ju

    2015-01-01

    Nicotine, as the major psychoactive component of tobacco, has broad physiological effects within the central nervous system, but our understanding of the molecular mechanism underlying its neuronal effects remains incomplete. In this study, we performed a systematic analysis on a set of nicotine addiction-related genes to explore their characteristics at network levels. We found that NAGenes tended to have a more moderate degree and weaker clustering coefficient and to be less central in the network compared to alcohol addiction-related genes or cancer genes. Further, clustering of these genes resulted in six clusters with themes in synaptic transmission, signal transduction, metabolic process, and apoptosis, which provided an intuitional view on the major molecular functions of the genes. Moreover, functional enrichment analysis revealed that neurodevelopment, neurotransmission activity, and metabolism related biological processes were involved in nicotine addiction. In summary, by analyzing the overall characteristics of the nicotine addiction related genes, this study provided valuable information for understanding the molecular mechanisms underlying nicotine addiction.

  1. 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...

  2. 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

  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. Systematic Epigenomic Analysis Reveals Chromatin States Associated with Melanoma Progression.

    Science.gov (United States)

    Fiziev, Petko; Akdemir, Kadir C; Miller, John P; Keung, Emily Z; Samant, Neha S; Sharma, Sneha; Natale, Christopher A; Terranova, Christopher J; Maitituoheti, Mayinuer; Amin, Samirkumar B; Martinez-Ledesma, Emmanuel; Dhamdhere, Mayura; Axelrad, Jacob B; Shah, Amiksha; Cheng, Christine S; Mahadeshwar, Harshad; Seth, Sahil; Barton, Michelle C; Protopopov, Alexei; Tsai, Kenneth Y; Davies, Michael A; Garcia, Benjamin A; Amit, Ido; Chin, Lynda; Ernst, Jason; Rai, Kunal

    2017-04-25

    The extent and nature of epigenomic changes associated with melanoma progression is poorly understood. Through systematic epigenomic profiling of 35 epigenetic modifications and transcriptomic analysis, we define chromatin state changes associated with melanomagenesis by using a cell phenotypic model of non-tumorigenic and tumorigenic states. Computation of specific chromatin state transitions showed loss of histone acetylations and H3K4me2/3 on regulatory regions proximal to specific cancer-regulatory genes in important melanoma-driving cell signaling pathways. Importantly, such acetylation changes were also observed between benign nevi and malignant melanoma human tissues. Intriguingly, only a small fraction of chromatin state transitions correlated with expected changes in gene expression patterns. Restoration of acetylation levels on deacetylated loci by histone deacetylase (HDAC) inhibitors selectively blocked excessive proliferation in tumorigenic cells and human melanoma cells, suggesting functional roles of observed chromatin state transitions in driving hyperproliferative phenotype. Through these results, we define functionally relevant chromatin states associated with melanoma progression. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  5. Analysis of productivity costs in cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Jordi Gol-Montserrat

    2017-06-01

    Full Text Available ABSTRACTIntroductionThe concept of indirect costs – or productivity losses to both patients and their informal caregivers arising from an illness – started to gain more importance two decades ago with the intention of strengthening cost estimates prior to evaluating, which historically was performed only with direct cost data.ObjectiveThe aim of this study is to explore the methodological differences in estimating productivity costs in studies of cancer diseases, as well as providing an updated and comprehensive overview of the worldwide relevance of productivity costs of cancer.MethodsThe study is conducted using a systematic literature review.ResultsThe literature search resulted in 332 articles. After removing those not meeting eligibility criteria or duplicities, 27 articles were included in the qualitative analysis. It is observed that the weight of cost productivity is noticeable; in several cases, it may represent over 50% of the total. The most common method of estimation is the Human Capital method. However, certain heterogeneity is observed in the method of estimating, as well as in the resultant figures.ConclusionsMore efforts are needed to standardize calculations and allow for real comparisons between countries.

  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. 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

  8. Radiographic caries detection: A systematic review and meta-analysis.

    Science.gov (United States)

    Schwendicke, Falk; Tzschoppe, Markus; Paris, Sebastian

    2015-08-01

    This systematic review aimed at evaluating the accuracy of radiographic caries detection for different lesions at different locations. Studies reporting on the accuracy (sensitivity/specificity) of radiographic detection of natural primary caries lesions under clinical or in vitro conditions were included. Risk of bias was assessed using QUADAS-2. Pooled sensitivity, specificity and diagnostic odds ratios (DORs) were calculated using random-effects meta-analysis. Analyses were performed separately for occlusal and proximal lesions, with further discrimination between any kind of lesions, dentine lesions, and cavitated lesions. Electronic databases (Medline, Embase, Cochrane Central) and grey literature were systematically searched, complemented by cross-referencing from bibliographies. From 947 identified articles, 442 were analyzed full-text. 117 studies (13,375 teeth, 19,108 surfaces) were included, the majority of them reporting on permanent teeth and having high risk of bias. The detection of any kind (i.e. also initial) lesions had low sensitivities (pooled DOR [95% CI]: 0.24 [0.21/0.26] to 0.42 [0.31/0.34]), but moderate to high specificities (0.70 [0.76/0.84] to 0.97 [0.95/0.98]). For dentine lesions, sensitivities were higher (from 0.36 [0.24/0.49] for proximal to 0.56 [0.53/0.59] for occlusal lesions), and specificities ranged between 0.87 [0.85/0.89] and 0.95 [0.94/0.96]. No studies reported on cavitated occlusal lesions, whilst for cavitated proximal lesions, sensitivities increased above 0.60, whilst sensitivities remained high (above 0.90). Radiographic caries detection is highly accurate for cavitated proximal lesions, and seems also suitable to detect dentine caries lesions. For detecting initial lesions, more sensitive methods could be considered in population with high caries risk and prevalence. Radiographic caries detection is especially suitable for detecting more advanced caries lesions, and has limited risks for false positive diagnoses. For

  9. 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.

  10. Systematic analysis of alternative first exons in plant genomes

    Directory of Open Access Journals (Sweden)

    Zeng Changqing

    2007-10-01

    Full Text Available Abstract Background Alternative splicing (AS contributes significantly to protein diversity, by selectively using different combinations of exons of the same gene under certain circumstances. One particular type of AS is the use of alternative first exons (AFEs, which can have consequences far beyond the fine-tuning of protein functions. For example, AFEs may change the N-termini of proteins and thereby direct them to different cellular compartments. When alternative first exons are distant, they are usually associated with alternative promoters, thereby conferring an extra level of gene expression regulation. However, only few studies have examined the patterns of AFEs, and these analyses were mainly focused on mammalian genomes. Recent studies have shown that AFEs exist in the rice genome, and are regulated in a tissue-specific manner. Our current understanding of AFEs in plants is still limited, including important issues such as their regulation, contribution to protein diversity, and evolutionary conservation. Results We systematically identified 1,378 and 645 AFE-containing clusters in rice and Arabidopsis, respectively. From our data sets, we identified two types of AFEs according to their genomic organisation. In genes with type I AFEs, the first exons are mutually exclusive, while most of the downstream exons are shared among alternative transcripts. Conversely, in genes with type II AFEs, the first exon of one gene structure is an internal exon of an alternative gene structure. The functionality analysis indicated about half and ~19% of the AFEs in Arabidopsis and rice could alter N-terminal protein sequences, and ~5% of the functional alteration in type II AFEs involved protein domain addition/deletion in both genomes. Expression analysis indicated that 20~66% of rice AFE clusters were tissue- and/or development- specifically transcribed, which is consistent with previous observations; however, a much smaller percentage of Arabidopsis

  11. 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

  12. 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).

  13. 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.

  14. 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.

  15. A systematic analysis and comparison of warfarin initiation strategies

    Science.gov (United States)

    French, Benjamin; Wang, Le; Gage, Brian F.; Horenstein, Richard B.; Limdi, Nita A.; Kimmel, Stephen E.

    2016-01-01

    Objective Randomized trials have reported inconsistent evidence regarding the effectiveness of algorithms that use genotypes to initiate warfarin therapy. The Clarification of Optimal Anticoagulation through Genetics (COAG) trial initiated therapy based on predicted maintenance doses, with a pharmacogenetic-guided algorithm in one study group and a clinically guided algorithm in the other. The European Pharmacogenetics of Anticoagulant Therapy (EU-PACT) consortium initiated therapy based on loading doses, with an algorithm-based prediction in one study group and a fixed-dose regimen in the other. To understand the differences between these trials, we compared the initial doses between alternative dosing algorithms (the pharmacogenetic-guided and clinically guided algorithms developed by Gage and colleagues and those developed by the International Warfarin Pharmacogenetics Consortium), and between the COAG and EU-PACT dose-initiation strategies. Methods Secondary analysis of the COAG trial—a double-blind, randomized controlled trial (2009–2013)—conducted at 18 clinical centers in the United States, which included 1,010 adults initiating warfarin therapy, of whom 719 achieved maintenance dose. Results Among COAG participants, the distribution of initial doses differed between algorithms, but exhibited similar prediction accuracy for maintenance dose. However, had the COAG trial implemented the EU-PACT strategy, the 3-day initial dose would have been 4.8 mg greater among participants randomized to pharmacogenetic-guided dosing, but only 2.5 mg greater among participants randomized to clinically guided dosing (P<0.001). Conclusions Compared to the COAG trial, the EU-PACT trial used systematically larger loading doses in the pharmacogenetic-guided group and might have inadequately adjusted for clinical variability in warfarin dose requirements in the fixed-dose group. PMID:27383664

  16. 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.)

  17. 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

  18. Anxiety as a Predictor for Cognitive Decline and Dementia : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Gulpers, Bernice; Ramakers, Inez; Hamel, Renske; Kohler, Sebastian; Oude Voshaar, Richard C.; Verhey, Frans

    2016-01-01

    Because anxiety is postulated as a risk factor for dementia, we performed a systematic review and meta-analysis to investigate whether anxiety predicts cognitive decline and/or dementia, taking the stage of cognitive decline as well as setting into account. Methods: A systematic literature search up

  19. Meta-epidemiologic analysis indicates that MEDLINE searches are sufficient for diagnostic test accuracy systematic reviews

    NARCIS (Netherlands)

    van Enst, Wynanda A.; Scholten, Rob J. P. M.; Whiting, Penny; Zwinderman, Aeilko H.; Hooft, Lotty

    2014-01-01

    To investigate how the summary estimates in diagnostic test accuracy (DTA) systematic reviews are affected when searches are limited to MEDLINE. A systematic search was performed to identify DTA reviews that had conducted exhaustive searches and included a meta-analysis. Primary studies included in

  20. 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

  1. 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

  2. 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

  3. Overweight, Obesity, and Depression: A Systematic Review and Meta-analysis of Longitudinal Studies

    NARCIS (Netherlands)

    Luppino, F.S.; de Wit, L.M.; Bouvy, P.F.; Stijnen, T.; Cuijpers, P.; Penninx, B.W.J.H.; Zitman, F.G.

    2010-01-01

    Context: Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. Objective: To conduct a systematic review and meta-analysis on the longitudinal relationship

  4. Research Protocol for Systematic Review and Meta-Analysis of Elder Abuse Prevalence Studies.

    Science.gov (United States)

    Yon, Yongjie; Mikton, Christopher; Gassoumis, Zachary D; Wilber, Kathleen H

    2017-06-01

    Elder abuse is an important public health and human rights issue, yet its true extent is not well understood. To address this, we will conduct a systematic review and meta-analysis of elder abuse prevalence studies from around the world. This protocol describes the methodological approach to be adopted for conducting this systematic review and meta-analysis. In particular, the protocol describes the search strategies and eligibility criteria to be used to identify and select studies and how data from the selected studies will be extracted for analysis. The protocol also describes the analytical approach that will be used to calculate pooled prevalence estimates and discusses the use of meta-regression to assess how studies' characteristics influence the prevalence estimates. This protocol conforms to the Preferred Reporting Items for Systematic reviews and Meta-Analysis - or PRISMA - guidelines and has been registered with the PROSPERO International Prospective Register of systematic reviews.

  5. Cryptococcal meningitis in systemic lupus erythematosus patients : pooled analysis and systematic review

    NARCIS (Netherlands)

    Fang, Wenjie; Chen, Min; Liu, Jia; Hagen, Ferry; Ms, Abdullah; Al-Hatmi, A M S; Zhang, Peilian; Guo, Yun; Boekhout, Teun; Deng, Danqi; Xu, Jianping; Pan, Weihua; Liao, Wanqing

    2016-01-01

    Cryptococcal meningitis is an important fungal infection among systemic lupus erythematosus patients. We conducted a pooled analysis and systematic review to describe the epidemiological and clinical profile of cryptococcal meningitis in systemic lupus erythematosus patients. From two hospitals in

  6. Overweight, Obesity, and Depression A Systematic Review and Meta-analysis of Longitudinal Studies

    NARCIS (Netherlands)

    Luppino, Floriana S.; de Wit, Leonore M.; Bouvy, Paul F.; Stijnen, Theo; Cuijpers, Pim; Penninx, Brenda W. J. H.; Zitman, Frans G.

    Context: Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. Objective: To conduct a systematic review and meta-analysis on the longitudinal relationship

  7. Risk of Hypothyroidism following Hemithyroidectomy: Systematic Review and Meta-Analysis of Prognostic Studies.

    NARCIS (Netherlands)

    Verloop, H.; Louwerens, M.; Schoones, J.W.; Kievit, J.; Smit, J.W.A.; Dekkers, O.M.

    2012-01-01

    Context: The reported risk of hypothyroidism after hemithyroidectomy shows considerable heterogeneity in literature. Objective: The aim of this systematic review and meta-analysis was to determine the overall risk of hypothyroidism, both clinical and subclinical, after hemithyroidectomy.

  8. 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

  9. 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 ...

  10. An introduction to systematic reviews and meta-analysis: A ...

    African Journals Online (AJOL)

    The increasing urgency for evidence based practice, especially in resource limited settings has inspired many initiatives to this effect. In Africa there is limited skill in research synthesis and the production of systematic reviews. The Centre for the Development of Best Practices in Health, together with the South African ...

  11. 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....

  12. 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

  13. Epidemiology of Rotavirus in the Iranian Children: A Systematic Review and Meta-analysis

    OpenAIRE

    Monavari, Seyed Hamid Reza; Hadifar, Shima; Mostafaei, Shayan; Miri, Ali; Keshavarz, Mohsen; Babaei, Farhad; Moghoofei, Mohsen

    2017-01-01

    Rotavirus is associated with increased risk for severe diarrhea in infants and young children worldwide. This systematic review and meta-analysis was performed to determine the prevalence rate of rotavirus from different parts of Iran and provide an overall relative frequency (RF) for Iran. We performed a systematic literature review from several databases including PubMed, ISI Web of Science, Scopus, OVID, MAG IRAN, IranMedex, and Iranian Scientific Information Database. We searched the foll...

  14. 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...

  15. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis

    OpenAIRE

    Kim, Gaeun; Kang, Seong Hee; Kim, Moon Young; Baik, Soon Koo

    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 s...

  16. Prevalence of asthenopia in children: a systematic review with meta-analysis

    OpenAIRE

    Vilela, Manuel A.P.; Pellanda, Lucia C.; Fassa, Anaclaudia G.; Castagno, Victor D.

    2015-01-01

    OBJECTIVE: To estimate the prevalence of asthenopia in 0-18 year-old children through a systematic review and meta-analysis of prevalence studies.SOURCES: Inclusion criteria were population-based studies from 1960 to May of 2014 reporting the prevalence of asthenopia in children. The search was performed independently by two reviewers in the PubMed, EMBASE, and LILACS databases, with no language restriction. This systematic review was performed in accordance with the Cochrane Collaboration gu...

  17. Issues affecting the level of prosthetics research evidence: Secondary analysis of a systematic review.

    Science.gov (United States)

    Hafner, Brian J; Sawers, Andrew B

    2016-02-01

    Systematic reviews of scientific literature are valuable sources of synthesized knowledge. Systematic review results may also be used to inform readers about challenges inherent to an area of research, guide future research efforts, and facilitate improvements in evidence quality. To identify methodological issues that affected the overall level of scientific evidence reported in a contemporary systematic review and to offer suggestions for enhancing publications' contribution to the overall evidence. Secondary analysis of a systematic review. Publications included in a systematic review related to microprocessor-controlled prosthetic knees were analyzed with respect to established methodological quality criteria. Common issues were identified and discussed. Internal validity was commonly affected by variable comparison conditions, limited justification of accommodation time, potential fatigue and learning effects, lack of blinding, small sample sizes, limited evidence of measurement reliability, subject attrition, and limited descriptions of selection criteria. Similarly, external validity was affected by limited descriptions of the study sample, indeterminate representativeness, and suboptimal description of the interventions. Results suggest that efforts to address methodological limitations, educate evidence consumers, and improve research reporting are needed to advance the quality and use of evidence in the field of prosthetics. Critical analysis of the strengths and limitations of publications included in a systematic review can inform evidence consumers and contributors about challenges inherent to a field of research. Results of this analysis suggest that efforts to address identified limitations are needed to enhance the overall level of prosthetics evidence. © The International Society for Prosthetics and Orthotics 2014.

  18. Application of multicriteria decision analysis in health care: a systematic review and bibliometric analysis.

    Science.gov (United States)

    Adunlin, Georges; Diaby, Vakaramoko; Xiao, Hong

    2015-12-01

    The use of Multi-Criteria Decision Analysis (MCDA) in health care has become common. However, the literature lacks systematic review trend analysis on the application of MCDA in health care. To systematically identify applications of MCDA to the areas of health care, and to report on publication trends. English language studies published from January 1, 1980 until October 1, 2013 were included. Electronic databases searches were supplemented by searching conference proceedings and relevant journals. Studies considered for inclusion were those using MCDA techniques within the areas of health care, and involving the participation of decision makers. A bibliometric analysis was undertaken to present the publication trends. A total of 66 citations met the inclusion criteria. An increase in publication trend occurred in the years 1990, 1997, 1999, 2005, 2008, and 2012. For the remaining years, the publication trend was either steady or declining. The trend shows that the number of publications reached its highest peak in 2012 (n = 9). Medical Decision Making was the dominant with the highest number published papers (n = 7). The majority of the studies were conducted in the US (n = 29). Medical Decision Making journal published the highest number of articles (n = 7). Analytic Hierarchy Process (n = 33) was the most used MCDA technique. Cancer was the most researched disease topic (n = 12). The most covered area of application was diagnosis and treatment (n = 26). The review shows that MCDA has been applied to a broad range of areas in the health care, with the use of a variety of methodological approaches. Further research is needed to develop practice guidelines for the appropriate application and reporting of MCDA methods. © 2014 John Wiley & Sons Ltd.

  19. 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...

  20. 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...

  1. Primary care efficiency measurement using data envelopment analysis: a systematic review

    NARCIS (Netherlands)

    Pelone, Ferruccio; Kringos, Dionne Sofia; Romaniello, Alessandro; Archibugi, Monica; Salsiri, Chiara; Ricciardi, Walter

    2015-01-01

    There is a gap between the demand and supply of efficiency analyses within primary care (PC), despite the threatening financial sustainability of health care systems. This paper provides a systematic literature review on PC efficiency analysis using Data Envelopment Analysis (DEA). We reviewed 39

  2. Use of network meta-analysis in systematic reviews: a survey of authors.

    Science.gov (United States)

    Lee, Andrew W

    2016-01-19

    The reporting of network meta-analysis in systematic reviews has increased rapidly since 2009. This qualitative study was undertaken to identify authors' perceptions of the use of these methods and of what standards for conduct and reporting should apply. This is a survey of authors of systematic reviews reporting network meta-analysis. The response rate was 32 % of the authors contacted, with these authors responsible for 34 % of the fully published systematic reviews identified within the period searched. Almost all authors would use the method again. Elements of reporting standards were proposed. Responses revealed some tensions between the view that use of network meta-analysis should be more easily accessible, particularly in the form of software tools, and concern that there is some inappropriate use of the methods, which wider use and greater accessibility could exacerbate. Authors demonstrated strong support for adoption of standards for conduct and reporting. The elements of reporting standards proposed are consistent with those included in the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension statement. Adoption of standards for conduct and reporting will be a significant step towards clarifying what is appropriate use of the methods and what is not. This should be followed by the development of a critical appraisal tool to support end users of systematic reviews reporting network meta-analysis.

  3. 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.

  4. Valerian for Sleep: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Bent, Stephen; Padula, Amy; Moore, Dan; Patterson, Michael; Mehling, Wolf

    2014-01-01

    Insomnia affects approximately one-third of the adult population and contributes to increased rates of absenteeism, health care use, and social disability. Extracts of the roots of valerian (Valeriana officinalis) are widely used for inducing sleep and improving sleep quality. A systematic review of randomized, placebo-controlled trials of valerian for improving sleep quality is presented. An extensive literature search identified 16 eligible studies examining a total of 1093 patients. Most studies had significant methodologic problems, and the valerian doses, preparations, and length of treatment varied considerably. A dichotomous outcome of sleep quality (improved or not) was reported by 6 studies and showed a statistically significant benefit (relative risk of improved sleep = 1.8, 95% confidence interval, 1.2-2.9), but there was evidence of publication bias in this summary measure. The available evidence suggests that valerian might improve sleep quality without producing side effects. Future studies should assess a range of doses of standardized preparations of valerian and include standard measures of sleep quality and safety. PMID:17145239

  5. 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.

  6. 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.

  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. 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.

  9. 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.

  10. 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.

  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. Static Analysis of Android Apps: A Systematic Literature Review

    OpenAIRE

    Li, Li; Bissyande, Tegawendé François D Assise; Papadakis, Mike; Rasthofer, Siegfried; Bartel, Alexandre; Octeau, Damien; Klein, Jacques; Le Traon, Yves

    2017-01-01

    Context: Static analysis exploits techniques that parse program source code or bytecode, often traversing program paths to check some program properties. Static analysis approaches have been proposed for different tasks, including for assessing the security of Android apps, detecting app clones, automating test cases generation, or for uncovering non-functional issues related to performance or energy. The literature thus has proposed a large body of works, each of which attempts to tackle one...

  13. 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

    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. 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. 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. 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.

  14. 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

  15. 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

  16. 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.…

  17. Training for thorax diagnostics. Systematic cardiopulmonary image analysis

    International Nuclear Information System (INIS)

    Kirchner, Johannes

    2010-01-01

    The training book on thorax diagnostics using image analysis is supposed to be a supplement to the usual textbooks based on comprehensive experiences of radiologists. The covered issues are the following: heart insufficiency, acute/ chronic bronchitis and pulmonary emphysema; pneumonia and tuberculosis; bronchial carcinoma; lung fibrosis, sarcoidosis and pneumoconiosis, pleural effusion and pneumothorax.

  18. 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…

  19. 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.

  20. 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.

  1. 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...

  2. 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,

  3. 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:

  4. 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:

  5. 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…

  6. HLA associations and HLA sharing in recurrent miscarriage: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Meuleman, Tess; Lashley, Lisa E. L. O.; Dekkers, Olaf M.; van Lith, Jan M. M.; Claas, Frans H. J.; Bloemenkamp, Kitty W. M.

    2015-01-01

    Problem: The aim of this meta-analysis was to evaluate whether specific maternal HLA alleles and HLA sharing of couples are associated with the occurrence of recurrent miscarriage (RM). Method of study: A systematic literature search was performed for studies that evaluated the association between

  7. HLA associations and HLA sharing in recurrent miscarriage : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Meuleman, Tess; Lashley, Lisa E L O; Dekkers, Olaf M.; van Lith, Jan M M; Claas, Frans H J; Bloemenkamp, Kitty W M

    2015-01-01

    Problem: The aim of this meta-analysis was to evaluate whether specific maternal HLA alleles and HLA sharing of couples are associated with the occurrence of recurrent miscarriage (RM). Method of study: A systematic literature search was performed for studies that evaluated the association between

  8. 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,

  9. Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Kamper, S.J.; Ostelo, R.W.J.G.; Rubinstein, S.M.; Nellensteijn, J.M.; Peul, W.C.; Arts, M.P.; van Tulder, M.W.

    2014-01-01

    Purpose: Assessing the benefits of surgical treatments for sciatica is critical for clinical and policy decision-making. To compare minimally invasive (MI) and conventional microdiscectomy (MD) for patients with sciatica due to lumbar disc herniation. Methods: A systematic review and meta-analysis

  10. Preimplantation genetic screening: a systematic review and meta-analysis of RCTs

    NARCIS (Netherlands)

    Mastenbroek, S.; Twisk, M.; van der Veen, F.; Repping, S.

    2011-01-01

    Preimplantation genetic screening (PGS) has increasingly been used in the past decade. Here we present a systematic review and meta-analysis of RCTs on the effect of PGS on the probability of live birth after IVF. PubMed and trial registers were searched for RCTs on PGS. Trials were assessed

  11. Longevity of Posterior Composite Restorations: A Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Opdam, N.J.; Sande, F.H. van de; Bronkhorst, E.; Cenci, M.S.; Bottenberg, P.; Pallesen, U.; Gaengler, P.; Lindberg, A.; Huysmans, M.C.D.N.J.M.; Dijken, J.W. van

    2014-01-01

    The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and

  12. 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

  13. Post-stroke infection: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Westendorp, Willeke F.; Nederkoorn, Paul J.; Vermeij, Jan-Dirk; Dijkgraaf, Marcel G.; van de Beek, Diederik

    2011-01-01

    stroke is the main cause of disability in high-income countries, and ranks second as a cause of death worldwide. Patients with acute stroke are at risk for infections, but reported post-stroke infection rates vary considerably. We performed a systematic review and meta-analysis to estimate the

  14. 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.

  15. 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…

  16. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs

    NARCIS (Netherlands)

    de Vries, Max; Seppala, Lotta J.; Daams, Joost G.; van de Glind, Esther M. M.; Masud, Tahir; van der Velde, Nathalie

    2018-01-01

    Use of certain medications is recognized as a major and modifiable risk factor for falls. Although the literature on psychotropic drugs is compelling, the literature on cardiovascular drugs as potential fall-risk-increasing drugs is conflicting. The aim of this systematic review and meta-analysis is

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

    NARCIS (Netherlands)

    Aune, D.; Lau, R.; Chan, D.S.; 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

  18. 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…

  19. 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.

  20. 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

  1. Effects of Exercise Therapy on Balance Capacity in Chronic Stroke: Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Duijnhoven, H.J.R. van; Heeren, A.; Peters, M.A.; Veerbeek, J.M.; Kwakkel, G.; Geurts, A.C.H.; Weerdesteyn, V.

    2016-01-01

    BACKGROUND AND PURPOSE: The purpose of this systematic review and meta-analysis was to investigate the effects of exercise training on balance capacity in people in the chronic phase after stroke. Furthermore, we aimed to identify which training regimen was most effective. METHODS: Electronic

  2. 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

  3. 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:

  4. Probiotics for childhood functional gastrointestinal disorders: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Korterink, Judith J.; Ockeloen, Lize; Benninga, Marc A.; Tabbers, Merit M.; Hilbink, Mirrian; Deckers-Kocken, Judith M.

    2014-01-01

    A systematic review and meta-analysis were performed to investigate the quantity and quality of the current evidence regarding the effect of different probiotic strains in the treatment of functional gastrointestinal disorders (FGID) in children and adolescents. Probiotics are more effective than

  5. School-Based Mentoring for Adolescents: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Wood, Sarah; Mayo-Wilson, Evan

    2012-01-01

    Objectives: To evaluate the impact of school-based mentoring for adolescents (11-18 years) on academic performance, attendance, attitudes, behavior, and self-esteem. Method: A systematic review and meta-analysis. The authors searched 12 databases from 1980 to 2011. Eight studies with 6,072 participants were included, 6 were included in…

  6. A Systematic Review and Meta-Analysis of Indicated Interventions to Increase School Attendance

    Science.gov (United States)

    Maynard, Brandy R.; Tyson-McCrea, Katherine; Pigott, Therese; Kelly, Michael

    2011-01-01

    The main objective of this systematic review and meta-analysis was to examine the effects of intervention programs on school attendance behaviors of elementary and secondary school students to inform policy and practice. The specific questions guiding this study were: (1) Do indicated programs with a goal of increasing student attendance affect…

  7. Bone health in phenylketonuria: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Demirdas, Serwet; Coakley, Katie E.; Bisschop, Peter H.; Hollak, Carla E. M.; Bosch, Annet M.; Singh, Rani H.

    2015-01-01

    Patients with Phenylketonuria (PKU) reportedly have decreased bone mineral density (BMD). The primary aim of this study was to perform a systematic review and meta-analysis to determine the extent and significance of low BMD in early treated patients with PKU. Secondary aims were to assess other

  8. Systematic review and meta-analysis of cyclodiene insecticides and breast cancer

    NARCIS (Netherlands)

    Khanjani, Narges; Hoving, Jan Lucas; Forbes, Andrew Benjamin; Sim, Malcolm Ross

    2007-01-01

    Cyclodienes are a group of organochlorine pesticides that have been the focus of increasing numbers of breast cancer etiology studies in recent years. The aim of this systematic review and meta-analysis was to summarize and pool the results of breast cancer and cyclodiene insecticide contamination

  9. The effects of light therapy on sleep problems : A systematic review and meta-analysis

    NARCIS (Netherlands)

    van Maanen, A.; Meijer, A.M.; van der Heijden, K.B.; Oort, F.J.

    2016-01-01

    Although bright light therapy seems a promising treatment for sleep problems, research shows inconclusive results. This meta-analysis is the first to systematically review the effect of light therapy on sleep problems in general and on specific types of sleep problems in particular (circadian rhythm

  10. 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

  11. Exploratory analysis of spatial and temporal data a systematic approach

    CERN Document Server

    Andrienko, Natalia

    2006-01-01

    Exploratory data analysis (EDA) is about detecting and describing patterns, trends, and relations in data, motivated by certain purposes of investigation. As something relevant is detected in data, new questions arise, causing specific parts to be viewed in more detail. So EDA has a significant appeal: it involves hypothesis generation rather than mere hypothesis testing. The authors describe in detail and systemize approaches, techniques, and methods for exploring spatial and temporal data in particular. They start by developing a general view of data structures and characteristics and then build on top of this a general task typology, distinguishing between elementary and synoptic tasks. This typology is then applied to the description of existing approaches and technologies, resulting not just in recommendations for choosing methods but in a set of generic procedures for data exploration. Professionals practicing analysis will profit from tested solutions - illustrated in many examples - for reuse in the c...

  12. Triclosan: A review on systematic risk assessment and control from the perspective of substance flow analysis.

    Science.gov (United States)

    Huang, Chu-Long; Abass, Olusegun K; Yu, Chang-Ping

    2016-10-01

    Triclosan (TCS) is a broad spectrum antibacterial agent mainly used in Pharmaceutical and Personal Care Products. Its increasing use over recent decades have raised its concentration in the environment, with commonly detectable levels found along the food web-from aquatic organisms to humans in the ecosystem. To date, there is shortage of information on how to investigate TCS's systematic risk on exposed organisms including humans, due to the paucity of systematic information on TCS flows in the anthroposphere. Therefore, a more holistic approach to mass flow balancing is required, such that the systematic risk of TCS in all environmental matrices are evaluated. From the perspective of Substance Flow Analysis (SFA), this review critically summarizes the current state of knowledge on TCS production, consumption, discharge, occurrence in built and natural environments, its exposure and metabolism in humans, and also the negative effects of TCS on biota and humans. Recent risk concerns have mainly focused on TCS removal efficiencies and metabolism, but less attention is given to the effect of mass flows from source to fate during risk exposure. However, available data for TCS SFA is limited but SFA can derive logical systematic information from limited data currently available for systematic risk assessment and reduction, based on mass flow analysis. In other words, SFA tool can be used to develop a comprehensive flow chart and indicator system for the risk assessment and reduction of TCS flows in the anthroposphere, thereby bridging knowledge gaps to streamline uncertainties related to policy-making on exposure pathways within TCS flow-lines. In the final analysis, specifics on systematic TCS risk assessment via SFA, and areas of improvement on human adaptation to risks posed by emerging contaminants are identified and directions for future research are suggested. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Developing, Conducting, and Publishing Appropriate Systematic Review and Meta-Analysis Articles.

    Science.gov (United States)

    Kelley, Brian P; Chung, Kevin C

    2018-02-01

    The volume of medical literature is growing at a rate that renders decision-making difficult without specialized summary tools. Systematic reviews and meta-analyses are important research instruments used to condense and clarify a broad scope of information into manageable summaries. When used effectively, these reports can pool cumulative data across primary studies, formulate clinical guidelines, and guide future research endeavors. However, errors in study design can result in ineffective or misleading analyses. This article presents the appropriate uses for systematic review and meta-analysis by introducing a framework for creating summary studies, and supplying specific examples of pitfalls in study design and execution.

  14. Systematic analysis of maintenance strategies of technical systems

    International Nuclear Information System (INIS)

    Laakso, K.; Stroemberg, A.

    2001-01-01

    The paper describes an approach to evaluate and improve the effectiveness of the maintenance strategies of technical systems in operating power plants. In the Experience Based Reliability Centred Maintenance (EBRCM) approach, the analyses of the history of occurred faults and the preventive maintenance program are combined. Changes in the maintenance programs are proposed for reduction of faults or increasing the cost-efficiency of maintenance. The justification of changes is based on simple maintenance indicators and study of the underlying failure and maintenance data. To make the analysis resource-efficient and generate easily the maintenance indicators, suitable data analysis and warehouse tools are used. They facilitate the online access and treatment of the work orders and other planning information in plant information systems. In order to direct the analysis to the important items from maintenance point of view, the equipment of the plant are classified based on their importance for reaching the maintenance objectives such as plant safety, plant availability and worker protection. Maintenance optimisation is directed to those important equipment which exhibit a high number of failures. The other equipment of less maintenance importance, but which exhibit high preventive maintenance costs and low numbers of failures are also analysed to improve the cost-effectiveness of maintenance. After experiences from performing two case studies, both on a standby safety system and a continuously operating process system, Barsebdck Kraft AB adopted the experience based RCM approach as standard method for evaluation of the maintenance action programs and planning of modifications in them. The strength is the applicability and continuity of this method, i.e. each year again. (orig.)

  15. 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.

  16. 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.

  17. Systematic risk analysis: first steps towards a new definition of beta

    OpenAIRE

    Michel Fliess; Cédric Join

    2009-01-01

    International audience; We suggest a new model-free definition of the beta coefficient, which plays an important rôle in systematic risk management. This setting, which is based on the existence of trends for financial time series via nonstandard analysis (Fliess M., Join C.: A mathematical proof of the existence of trends in financial time series, Proc. Int. Conf. Systems Theory: Modelling, Analysis and Control, Fes, 2009, online: http://hal.inria.fr/inria-00352834/en/) leads to convincing c...

  18. Gestational syphilis and stillbirth in the Americas: a systematic review and meta-analysis

    OpenAIRE

    Lauren Arnesen; Suzanne Serruya; Pablo Duran

    2015-01-01

    OBJECTIVE: To perform a systematic review and meta-analysis of reported estimates of the association between gestational syphilis (GS) and stillbirth in the Americas region. METHODS: Cochrane Library, Embase, LILACS, MEDLINE/PubMed, PLOS, and ScienceDirect were searched for original research studies quantifying the relationship between GS and stillbirth in the region. A final sample of eight studies was selected. A cumulative meta-analysis plus four subgroup meta-analyses of study data on the...

  19. 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 ...

  20. 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.

  1. 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.

  2. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements.

    Science.gov (United States)

    Cawood, A L; Elia, M; Stratton, R J

    2012-04-01

    Disease-related malnutrition is common, detrimentally affecting the patient and healthcare economy. Although use of high protein oral nutritional supplements (ONS) has been recommended to counteract the catabolic effects of disease and to facilitate recovery from illness, there is a lack of systematically obtained evidence to support these recommendations. This systematic review involving 36 randomised controlled trials (RCT) (n=3790) (mean age 74 years; 83% of trials in patients >65 years) and a series of meta-analyses of high protein ONS (>20% energy from protein) demonstrated a range of effects across settings and patient groups in favour of the high protein ONS group. These included reduced complications (odds ratio (OR) 0.68 (95%CI 0.55-0.83), p20% energy from protein). The systematic review and meta-analysis provides evidence that high protein supplements produce clinical benefits, with economic implications. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Childhood maltreatment and obesity: systematic review and meta-analysis.

    Science.gov (United States)

    Danese, A; Tan, M

    2014-05-01

    Obesity is a prevalent global-health problem associated with substantial morbidity, impairment and economic burden. Because most readily available forms of treatment are ineffective in the long term, it is essential to advance knowledge of obesity prevention by identifying potentially modifiable risk factors. Findings from experimental studies in non-human primates suggest that adverse childhood experiences may influence obesity risk. However, observations from human studies showed heterogeneous results. To address these inconsistencies, we performed Medline, PsycInfo and Embase searches till 1 August 2012 for articles examining the association between childhood maltreatment and obesity. We then conducted a meta-analysis of the identified studies and explored the effects of various possible sources of bias. A meta-analysis of 41 studies (190 285 participants) revealed that childhood maltreatment was associated with elevated risk of developing obesity over the life-course (odds ratio=1.36; 95% confidence interval=1.26-1.47). Results were not explained by publication bias or undue influence of individual studies. Overall, results were not significantly affected by the measures or definitions used for maltreatment or obesity, nor by confounding by childhood or adult socioeconomic status, current smoking, alcohol intake or physical activity. However, the association was not statistically significant in studies of children and adolescents, focusing on emotional neglect, or adjusting for current depression. Furthermore, the association was stronger in samples including more women and whites, but was not influenced by study quality. Child maltreatment is a potentially modifiable risk factor for obesity. Future research should clarify the mechanisms through which child maltreatment affects obesity risk and explore methods to remediate this effect.

  4. 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

  5. Adhesive systems under fissure sealants: yes or no?: A systematic review and meta-analysis.

    Science.gov (United States)

    Bagherian, Ali; Sarraf Shirazi, Alireza; Sadeghi, Ramin

    2016-06-01

    The authors of this systematic review and meta-analysis had 2 aims: to evaluate fissure sealant retention with and without the use of an adhesive system and to compare fissure sealant retention using etch-and-rinse adhesive systems versus self-etching adhesive systems. The authors conducted a literature search (all articles published through November 1, 2015) to identify studies for inclusion in this systematic review. They assessed the quality of the evidence provided using the modified Jadad scale and performed meta-analyses using a random-effects model. The authors considered 12 studies that met the inclusion criteria for the systematic review. In addition, they used 5 of 9 studies related to the first part of the study and 3 of 4 studies related to the second part of the study that met the inclusion criteria for meta-analysis. In the analysis of the first part of the systematic review, the authors found that adhesive systems had a significant positive effect on fissure sealant (odds ratio, 3.294; 95% confidence interval, 1.292-8.401; P = .013). In the analysis of the second part of the systematic review, the authors found that etch-and-rinse adhesives were superior to self-etching adhesives in the fissure sealant procedure (odds ratio, 14.569; 95% confidence interval, 2.616-81.131; P = .002). The use of adhesive systems beneath fissure sealants can increase the retention of fissure sealants. Also, when adhesive systems are used with fissure sealants, etch-and-rinse systems are preferable. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Phototherapy for Vitiligo: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Bae, Jung Min; Jung, Han Mi; Hong, Bo Young; Lee, Joo Hee; Choi, Won Joon; Lee, Ji Hae; Kim, Gyong Moon

    2017-07-01

    References to the expected treatment response to phototherapy would be helpful in the management of vitiligo because phototherapy requires long treatment durations over several months. To estimate the treatment response of vitiligo to phototherapy. A comprehensive database search of MEDLINE, EMBASE, and the Cochrane library from inception to January 26, 2016, was performed for all prospective studies. The main keywords used were vitiligo, phototherapy, psoralen, PUVA, ultraviolet, NBUVB, and narrowband. All prospective studies reporting phototherapy outcome for at least 10 participants with generalized vitiligo were included. Of 319 studies initially identified, the full texts of 141 studies were assessed for eligibility, and 35 were finally included in the analysis. Of these, 29 studies included 1201 patients undergoing narrowband UV-B (NBUVB) phototherapy, and 9 included 227 patients undergoing psoralen-UV-A (PUVA) phototherapy. Two reviewers independently extracted the following data: study design, number and characteristics of the participants, phototherapy protocol, and rate of repigmentation based on the quartile scale. Single-arm meta-analyses were performed for the NBUVB and PUVA groups. Sample size-weighted means were calculated using a random-effects model for the repigmentation rates of the included studies. The primary outcomes were at least mild (≥25%), at least moderate (≥50%), and marked (≥75%) responses on a quartile scale. Response rates were calculated as the number of participants who showed the corresponding repigmentation divided by the number of all participants enrolled in the individual studies. The meta-analysis included 35 unique studies (1428 unique patients). For NBUVB phototherapy, an at least mild response occurred in 62.1% (95% CI, 46.9%-77.3%) of 130 patients in 3 studies at 3 months, 74.2% (95% CI, 68.5%-79.8%) of 232 patients in 11 studies at 6 months, and 75.0% (95% CI, 60.9%-89.2%) of 512 patients in 8 studies at 12 months

  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. 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.

  13. A systematic comparison of software dedicated to meta-analysis of causal studies

    Directory of Open Access Journals (Sweden)

    Yu Ly-Mee

    2007-09-01

    Full Text Available Abstract Background Our objective was to systematically assess the differences in features, results, and usability of currently available meta-analysis programs. Methods Systematic review of software. We did an extensive search on the internet (Google, Yahoo, Altavista, and MSN for specialized meta-analysis software. We included six programs in our review: Comprehensive Meta-analysis (CMA, MetAnalysis, MetaWin, MIX, RevMan, and WEasyMA. Two investigators compared the features of the software and their results. Thirty independent researchers evaluated the programs on their usability while analyzing one data set. Results The programs differed substantially in features, ease-of-use, and price. Although most results from the programs were identical, we did find some minor numerical inconsistencies. CMA and MIX scored highest on usability and these programs also have the most complete set of analytical features. Conclusion In consideration of differences in numerical results, we believe the user community would benefit from openly available and systematically updated information about the procedures and results of each program's validation. The most suitable program for a meta-analysis will depend on the user's needs and preferences and this report provides an overview that should be helpful in making a substantiated choice.

  14. Diagnostic accuracy of xpert test in tuberculosis detection: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ravdeep Kaur

    2016-01-01

    Full Text Available Background: World Health Organization (WHO recommends the use of Xpert MTB/RIF assay for rapid diagnosis of tuberculosis (TB and detection of rifampicin resistance. This systematic review was done to know about the diagnostic accuracy and cost-effectiveness of the Xpert MTB/RIF assay. Methods: A systematic literature search was conducted in following databases: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, MEDLINE, PUBMED, Scopus, Science Direct and Google Scholar for relevant studies for studies published between 2010 and December 2014. Studies given in the systematic reviews were accessed separately and used for analysis. Selection of studies, data extraction and assessment of quality of included studies was performed independently by two reviewers. Studies evaluating the diagnostic accuracy of Xpert MTB/RIF assay among adult or predominantly adult patients (≥14 years, presumed to have pulmonary TB with or without HIV infection were included in the review. Also, studies that had assessed the diagnostic accuracy of Xpert MTB/RIF assay using sputum and other respiratory specimens were included. Results: The included studies had a low risk of any form of bias, showing that findings are of high scientific validity and credibility. Quantitative analysis of 37 included studies shows that Xpert MTB/RIF is an accurate diagnostic test for TB and detection of rifampicin resistance. Conclusion: Xpert MTB/RIF assay is a robust, sensitive and specific test for accurate diagnosis of tuberculosis as compared to conventional tests like culture and microscopic examination.

  15. 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.

  16. 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.

  17. Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Esteves Lima, Rafael Paschoal; Cyrino, Renata Magalhães; de Carvalho Dutra, Bernardo; Oliveira da Silveira, Juliana; Martins, Carolina Castro; Miranda Cota, Luis Otávio; Costa, Fernando Oliveira

    2016-01-01

    To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM. The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI). There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21). There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.

  18. Suboccipital Decompressive Craniectomy for Cerebellar Infarction: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ayling, Oliver G S; Alotaibi, Naif M; Wang, Justin Z; Fatehi, Mostafa; Ibrahim, George M; Benavente, Oscar; Field, Thalia S; Gooderham, Peter A; Macdonald, R Loch

    2018-02-01

    Suboccipital decompressive craniectomy (SDC) for cerebellar infarction has been traditionally performed with minimal high-quality evidence. The aim of this systematic review and meta-analysis is to investigate the impact of SDC on functional outcomes, mortality, and adverse events in patients with cerebellar infarcts. A systematic review and meta-analysis in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Our primary outcome was the proportion of patients with moderate-severe disability after SDC. Secondary outcomes included mortality and adverse events. A sensitivity analysis was conducted to examine the roles of age, preoperative neurologic status, external ventricular drain insertion, and debridement of infarcted tissue on SDC outcomes. Eleven studies (with 283 patients) met our inclusion criteria. The pooled event rate for moderate-severe disability was 28% (95% confidence interval [CI], 20%-37%) and for mortality, it was 20% (95% CI, 12%-31%). The estimated overall rate of adverse events for SDC was 23% (95% CI, 14%-35%). Sensitivity analysis found less mortality with mean age SDC is based on retrospective observational studies. SDC for cerebellar infarction is associated with better outcomes compared with decompressive surgery for hemispheric infarctions. Lack of standardized reporting methods for SDC is a considerable drawback to the development of a better understanding of the impact of this surgery on patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 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.

  20. 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

  1. The effectiveness of exercise therapy for temporomandibular dysfunction: a systematic review and meta-analysis.

    Science.gov (United States)

    Dickerson, Shantil M; Weaver, Jarod M; Boyson, Ashley N; Thacker, Jared A; Junak, Andrew A; Ritzline, Pamela D; Donaldson, Megan B

    2017-08-01

    To investigate the effectiveness of exercise therapy on pain, function, and mobility outcomes in patients with temporomandibular joint dysfunction. Systematic review with meta-analysis. A systematic review and meta-analysis undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that met the inclusion criteria: (1) randomized controlled trials; (2) a population with the diagnosis of temporomandibular joint dysfunction; and (3) interventions that included exercise therapy were considered for review. When studies demonstrated homogeneity on outcome measures, the mean differences or standardized mean differences with 95% confidence interval were calculated and pooled in a meta-analysis for pooled synthesis. Six articles with a total of 419 participants were included in the review and only four studies were included in the meta-analysis. Mobility and mixed exercise therapy approaches appear to be the most common exercise approaches utilized for management of temporomandibular joint dysfunction. Exercise therapy and the associated dosage provide moderate short-term and varying long-term benefits in reduction of pain and improvement of range of motion of the in patients with temporomandibular joint dysfunction. Included studies suggest a mobility or a mixed approach to exercise therapies have impact on reducing pain, significant impact for increasing range of motion, but lack a significant impact for functional improvement. Therapy, level 1a-.

  2. A citation analysis of systematic review and meta-analysis published in Chinese journals.

    Science.gov (United States)

    Du, Liang; Chen, Yaolong; Huang, Jin; Li, Youping

    2012-05-01

    The numbers of systematic reviews (SRs) and meta-analyses (MAs) published in China have dramatically increased in recent years. Comprehensive analysis of their citation status may prove beneficial to the production and integration of high quality research, thereby increasing the quality of medical policy-making, research, and clinical practice. The Chinese Medical Citation Index (up to February 2010) was searched to identify SRs/MAs. Data were input using Microsoft Excel 2007 and statistical analysis was performed using SPSS 15.0 software. A total of 2224 SRs/MAs were included. Among the 591 different publications distributed from 1994 to 2009, the median publication count per publication was two (1-270). The total citation count was 2796, with an average of 1.26 citations per publication (0-57 citation). SRs/MAs that were never cited amounted to 1380 papers (62.1%), distributed in 272 journals (46.0%). MAs were easier to find than SRs. The major conditions affecting citation were whether or not the report was published in a Western field (r = 0.287, P = 0.000); whether or not the report was published in an "evidence-based" titled journal (r =-0.480, P = 0.002); and the length of time since publication (r = 0.455, P = 0.000). Since 2004, publication of SRs/MAs has exhibited a downward trend, forming a negative correlation with publication count. Over half of the SRs/MAs included had never been cited by the time research had concluded. In many other cases these reports exhibited extremely low citation rates. Citation of traditional Chinese medicine SRs/MAs exceeded that of Western medicine studies. This indirectly suggests that the quality of SRs/MAs usage is relatively low in China. This may be a result of various reasons and suggests that emphasis should be placed on raising the quality of SRs/MAs and significance of practical application. © 2012 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  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. Prevalence and Causes of Cesarean Section in Iran: Systematic Review and Meta-Analysis

    OpenAIRE

    AZAMI-AGHDASH, Saber; GHOJAZADEH, Morteza; DEHDILANI, Nima; MOHAMMADI, Marzieh; ASL AMIN ABAD, Ramin

    2014-01-01

    Abstract Unfortunately, the prevalence of cesarean section has increased in recent years. Whereas awareness of the prevalence and causes is inevitable for planning and effective interventions, so aim of this study has designed and conducted for reviewing of systematic Prevalence and caesarean causes in Iran. In this meta-analysis, the required information have been collected using several keywords which are Cesarean section rate, Cesarean section prevalence, delivery, childhood, childbirth, r...

  5. Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis

    OpenAIRE

    Moore, Sophie E; Norman, Rosana E; Suetani, Shuichi; Thomas, Hannah J; Sly, Peter D; Scott, James G

    2017-01-01

    AIM To identify health and psychosocial problems associated with bullying victimization and conduct a meta-analysis summarizing the causal evidence. METHODS A systematic review was conducted using PubMed, EMBASE, ERIC and PsycINFO electronic databases up to 28 February 2015. The study included published longitudinal and cross-sectional articles that examined health and psychosocial consequences of bullying victimization. All meta-analyses were based on quality-effects models. Evidence for cau...

  6. 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...

  7. Screening for group B Streptococcus in pregnant women: a systematic review and meta-analysis

    OpenAIRE

    Taminato, Mônica; Fram, Dayana; Torloni, Maria Regina; Belasco, Angélica Gonçalves Silva; Saconato, Humberto; Barbosa, Dulce Aparecida

    2011-01-01

    Infection with Group B Streptococcus (GBS) is considered an important public health problem. It is associated with: Neonatal sepsis, meningitis, pneumonia, neonatal death, septic abortion, chorioamnionitis, endometritis and other perinatal infections. The aim of this study was to determine the best screening strategy for GBS in pregnant women. For this a systematic review and meta-analysis were carried out in the Nursing Department of the Federal University of São Paulo, Cochrane Center, Braz...

  8. Diagnostic indicators of non-cardiovascular chest pain: a systematic review and meta-analysis

    OpenAIRE

    Wertli, Maria M; Ruchti, Katrin B; Steurer, Johann; Held, Ulrike

    2013-01-01

    BACKGROUND: Non-cardiovascular chest pain (NCCP) has a high healthcare cost, but insufficient guidelines exist for its diagnostic investigation. The objective of the present work was to identify important diagnostic indicators and their accuracy for specific and non-specific conditions underlying NCCP. METHODS: A systematic review and meta-analysis were performed. In May 2012, six databases were searched. Hand and bibliography searches were also conducted. Studies evaluating a diagnostic test...

  9. Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis

    OpenAIRE

    Boronat-Catal?, Montserrat; Montiel-Company, Jos? Mar?a; Bellot-Arc?s, Carlos; Almerich-Silla, Jos? Manuel; Catal?-Pizarro, Montserrat

    2017-01-01

    The aim of this systematic review and meta-analysis was to examine the current evidence on the possible effects of breastfeeding on different malocclusion traits in primary and mixed dentition. A systematic search was made in three databases, using terms related to breastfeeding and malocclusion in primary and mixed dentition. Of the 31 articles that met the inclusion criteria and were included in the qualitative analysis, nine were included in the quantitative analysis. The quality of the 31...

  10. 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…

  11. Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Medley, Amy; Kennedy, Caitlin; O'Reilly, Kevin; Sweat, Michael

    2009-01-01

    Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of…

  12. Review of applications of Bayesian meta-analysis in systematic reviews

    Directory of Open Access Journals (Sweden)

    Melissa Glenda Lewis

    2015-01-01

    Full Text Available Background: Systematic reviews are important sources of evidence in health care research. These reviews may or may not include meta-analysis as a statistical assimilation of the results of several studies in order to acquire a pooled estimate. Systematic review with meta-analysis is considered as a robust method of evidence synthesis. The methodology concerned with traditional meta-analysis does not incorporate external prior information. Hence, Bayesian methods are essential due to the natural process of incorporating the past information and updating the belief. Bayesian methods to meta-analysis have been developed with a motivation from the limitations of traditional meta-analysis such as dealing with missing data, problem with limited number of studies and problem with sparse event data in both the groups. The present article aims to unearth as to what extent Bayesian methods have been used in systematic reviews, evolution and its applications. This article also highlights the existing challenges and opportunities. Methods: The literature search was performed in databases such as Cochrane, PubMed, ProQuest and Scopus using the keywords “Bayesian Meta-analysis” and “Bayesian Meta-analyses”. All the methodology and application oriented papers specific to Bayesian meta-analysis were considered relevant for this review. Conclusion: Bayesian meta-analysis has gained popularity in the field of evidence synthesis of clinical trials. However, it did not pick up momentum in summarizing public health interventions, owing to the fact that public health interventions are targeted to highly heterogeneous population, multi-component interventions, and multiple outcomes and influenced by the context

  13. 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

  14. 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

  15. 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

    2018-01-11

    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.

  16. Effects of resistant maltodextrin on bowel movements: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Watanabe N

    2018-03-01

    Full Text Available Norikazu Watanabe,1 Masataka Suzuki,1 Yoshitake Yamaguchi,2 Yukari Egashira3 1Yakujihou Marketing Jimusho Co Ltd., Tokyo, 2Research Laboratory, Matsutani Chemical Industry Co Ltd., Hyogo, 3Laboratory of Food and Nutrition, Graduate School of Horticulture, Chiba University, Chiba, Japan Abstract: It is well known that dietary fiber helps to relieve and prevent constipation, and there are a number of scientific papers, including systematic reviews and meta-analyses on the effects of naturally derived dietary fiber on bowel movements. In recent years, there has been an increase in the manufacture of dietary fiber ingredients obtained from food raw materials, and these are now commonly available in the market. Resistant maltodextrin (RMD, a soluble dietary fiber, is manufactured from starch, and industrially produced soluble dietary fiber is used worldwide. While there are many reports on the effects of RMD on bowel movements, no systematic review or meta-analysis has been reported. We conducted a systematic review and meta-analysis to clarify the effect of RMD on bowel movements based on stool frequency and stool volume. We also investigated the subjective evaluation of RMD effects on bowel movements. Of a total of 314 potentially relevant articles, 28 articles met the eligibility criteria, and 29 randomized controlled trials were identified. As a result of integration analyses, we found that the intake of RMD significantly increased stool volume and stool frequency compared with placebo intake. Furthermore, RMD intake tended to improve sensation of complete/incomplete evacuation. In conclusion, the evidence suggests that RMD has a positive effect on bowel movements, contributing to normal bowel function. This finding will help in the development of new criteria for choice of dietary fiber in the process of developing food products. Keywords: resistant maltodextrin, dietary fiber, bowel movement, systematic review, meta-analysis

  17. 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.

  18. Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis

    NARCIS (Netherlands)

    Goto, Atsushi; Arah, Onyebuchi A.; Goto, Maki; Terauchi, Yasuo; Noda, Mitsuhiko

    2013-01-01

    To provide a systematic and quantitative summary of the association between severe hypoglycaemia and risk of cardiovascular disease in people with type 2 diabetes and to examine the sensitivity of the association to possible uncontrolled confounding by unmeasured comorbid severe illness using a bias

  19. Antibiotics for the treatment of leptospirosis: Systematic review and meta-analysis of controlled trials

    Directory of Open Access Journals (Sweden)

    Jaykaran Charan

    2013-01-01

    Full Text Available Leptospirosis is a zoonotic disease prevalent mainly in developing countries and is associated with high case fatality. Antibiotics especially penicillin are the mainstay of treatment for a suspected or confirm case of leptospirosis but role of Penicillin has not been evaluated systematically in the light of current evidence. The present systematic review and meta-analysis is done to evaluate the role of antibiotics in the treatment of leptospirosis. Parallel group clinical trials involving use of penicillin in treatment of leptospirosis were searched from all available sources. Ten clinical trials were found suitable as per laid inclusion criteria eligible for present systematic review and five clinical trials were included in meta-analysis. Clinical trials included for meta-analysis were compared on the basis of mortality, fever days, numbers of patients presenting with oliguria, and number of patients undergoing need-based dialysis. Analysis was done by comprehensive meta-analysis software 2. Qualitative outcomes are summarized as odds ratio and quantitative outcomes are summarized as standard mean difference with 95% confidence interval. Random and fixed models are used for analysis. There was no significant difference between penicillin group and controlled group for mortality (Odds ratio 1.59 (95% CI 0.59-4.29, P = 0.35, fever days (std difference in mean = −0.223 (95% CI 0.394-0.995, P = 0.358, number of patients presenting with oliguria (Odds ratio 1.795 (95% CI 0.325-9.929, P = 0.502, and number of patients who underwent need based dialysis (Odds ratio 1.587 (95% CI 0.919-2.731, P = 0.098. Role of various antibiotics in treatment of leptospirosis is uncertain, and can be attributed to nonavailability of adequate clinical trials. Role of penicillin in the treatment of leptospirosis can be debated.

  20. 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.

  1. Causes of vision loss worldwide, 1990–2010: a systematic analysis

    OpenAIRE

    Bourne, Rupert R A; Stevens, Gretchen A; White, Richard A; Smith, Jennifer L; Flaxman, Seth R; Price, Holly; Jonas, Jost B; Keeffe, Jill; Leasher, Janet; Naidoo, Kovin; Pesudovs, Konrad; Resnikoff, Serge; Taylor, Hugh R

    2013-01-01

    Background: Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking. Methods: We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment ([MSVI] visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the pr...

  2. 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.

  3. Systematic review and meta-analysis of randomized trials on probiotics for hepatic encephalopathy

    DEFF Research Database (Denmark)

    Holte, Kathrine; Krag, Aleksander; Gluud, Lise Lotte

    2012-01-01

    Aim:  The objective of this systematic review and meta-analysis was to assess the efficacy of probiotics and synbiotics in patients with hepatic encephalopathy. Methods:  Eligible trials were identified by searching electronic databases including MEDLINE, the Cochrane Library, Science Citation...... or synbiotics did not significantly affect the psychometric tests. Overall adverse events were reported in four trials with no difference between probiotics and placebo groups (RR = 0.32, 95% CI = 0.04-2.57; I(2)  = 59%). Regression analysis showed evidence of small-study effects. Conclusion:  The present meta...

  4. 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.

  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. Efficacy of cosmetic products in cellulite reduction: systematic review and meta-analysis.

    Science.gov (United States)

    Turati, F; Pelucchi, C; Marzatico, F; Ferraroni, M; Decarli, A; Gallus, S; La Vecchia, C; Galeone, C

    2014-01-01

    The number of original articles investigating the efficacy of cosmetic products in cellulite reduction increased rapidly in the last decade; however, to our knowledge, no systematic review and meta-analysis has been performed so far. We conducted a systematic review of in vivo studies on humans adopting the PRISMA guidelines. Moreover, we used a meta-analytic approach to estimate the overall effect of cosmetic creams in cellulite treatment from controlled trials with more than 10 patients per arm, using thigh circumference reduction as the outcome measure. Medline and Embase were searched up to August 2012 to identify eligible studies. Twenty-one original studies were included in the present systematic review. All studies were clinical trials, most of them recruited women only and 67% had an intra-patient study design. About half of the active cosmetic creams tested only contained one active ingredient among xanthenes, herbals or retinoids. The other studies tested cosmetic creams with more complex formulations and most of them included xanthenes. A total of seven controlled trials satisfied the inclusion criteria for the meta-analysis. The pooled mean difference of thigh circumference reduction between the treated and the controlled group was -0.46 cm (95% confidence intervals, CI: -0.85, -0.08), with significant heterogeneity between studies (P cellulite reduction and supports a moderate efficacy in thigh circumference reduction. © 2013 European Academy of Dermatology and Venereology.

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Paravertebral Block for Inguinal Herniorrhaphy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Law, Lawrence Siu-Chun; Tan, Mingjuan; Bai, Yaowu; Miller, Timothy E; Li, Yi-Ju; Gan, Tong-Joo

    2015-08-01

    Paravertebral block (PVB) is a safe and effective anesthetic technique for thoracotomy and mastectomy. However, no systematic review or meta-analysis has focused on PVB for inguinal herniorrhaphy. Our study compares PVB with general anesthesia/systemic analgesia, neuraxial blocks, and other peripheral nerve blocks. We analyzed 14 randomized controlled trials from PubMed, MEDLINE, CENTRAL, EMBASE, and CINAHL up to February 2015, without language restriction, comparing PVB under sedation with general anesthesia/systematic analgesia (135 vs 133 patients), neuraxial blocks (191 vs 186 patients), and other peripheral nerve blocks (119 vs 117 patients). We investigated pain scores, consumption of postoperative analgesia, incidence of postoperative nausea and vomiting (PONV), length of hospital stay, postanesthesia care unit bypassing rate, time to perform blocks, intraoperative hemodynamics, and incidence of urinary retention. Joint hypothesis testing was adopted for pain and analgesics, PONV, and hemodynamic variables. All analyses were performed with RevMan 5.2.11 (Cochrane Collaboration, Copenhagen). Hartung-Knapp-Sidik-Jonkman method was used for post hoc testing. PVB reduced PONV (nausea: risk ratio [RR] = 0.22; 95% confidence interval [CI], 0.05-0.93; numbers needed to treat [NNT] = 4.5; I = 15% and vomiting: RR = 0.15; 95% CI, 0.03-0.76; NNT = 8.3; I = 0%) compared with general anesthesia/systematic analgesia (quality of evidence [QoE]: high). Compared with neuraxial blocks, PVB resulted in less postoperative nausea (RR = 0.34 [95% CI, 0.13-0.91], NNT = 8.3, I = 0%) and urinary retention (RR = 0.14 [95% CI, 0.05-0.42], NNT = 7.4, I = 0%) than neuraxial blocks (QoE: high). More time was needed to perform PVB than neuraxial blocks (standardized mean difference = 1.90 [95% CI, 0.02-3.77], I = 92%; mean difference = 5.33 minutes; QoE: moderate). However, the available data could not reject the null hypothesis of noninferiority on all pain scores and analgesic

  12. A composite likelihood method for bivariate meta-analysis in diagnostic systematic reviews.

    Science.gov (United States)

    Chen, Yong; Liu, Yulun; Ning, Jing; Nie, Lei; Zhu, Hongjian; Chu, Haitao

    2017-04-01

    Diagnostic systematic review is a vital step in the evaluation of diagnostic technologies. In many applications, it involves pooling pairs of sensitivity and specificity of a dichotomized diagnostic test from multiple studies. We propose a composite likelihood (CL) method for bivariate meta-analysis in diagnostic systematic reviews. This method provides an alternative way to make inference on diagnostic measures such as sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Its main advantages over the standard likelihood method are the avoidance of the nonconvergence problem, which is nontrivial when the number of studies is relatively small, the computational simplicity, and some robustness to model misspecifications. Simulation studies show that the CL method maintains high relative efficiency compared to that of the standard likelihood method. We illustrate our method in a diagnostic review of the performance of contemporary diagnostic imaging technologies for detecting metastases in patients with melanoma.

  13. Intolerance of Uncertainty in Eating Disorders: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Brown, Melanie; Robinson, Lauren; Campione, Giovanna Cristina; Wuensch, Kelsey; Hildebrandt, Tom; Micali, Nadia

    2017-09-01

    Intolerance of uncertainty is an empirically supported transdiagnostic construct that may have relevance in understanding eating disorders. We conducted a meta-analysis and systematic review of intolerance of uncertainty in eating disorders using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We calculated random-effects standardised mean differences (SMD) for studies utilising the Intolerance of Uncertainty Scale (IUS) and summarised additional studies descriptively. Women with eating disorders have significantly higher IUS scores compared with healthy controls (SMD = 1.90; 95% C.I. 1.24 to 2.56; p eating disorders and potential target of cognitive, behavioural, interoceptive and affective symptoms. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  14. Constipation preceding Parkinson's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Adams-Carr, Kerala L; Bestwick, Jonathan P; Shribman, Samuel; Lees, Andrew; Schrag, Anette; Noyce, Alastair J

    2016-07-01

    To systematically review published literature to estimate the magnitude of association between premorbid constipation and later diagnosis of Parkinson's disease. Constipation is a recognised non-motor feature of Parkinson's and has been reported to predate diagnosis in a number of observational studies. A systematic review and meta-analysis was carried out following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) criteria. A literature search was undertaken in December 2014 using PubMed and the search terms 'Parkinson's disease' and 'constipation'. Articles were screened for suitability and reviewed against inclusion and exclusion criteria. Studies were included if they assessed constipation by means of a structured questionnaire or if constipation/drugs used to treat constipation were coded in patient medical records. Data were extracted using a standardised template and effect size estimates combined using a fixed-effects model. Heterogeneity was explored with the I(2) statistic. 9 studies were included in the meta-analysis, with a combined sample size of 741 593 participants. Those with constipation had a pooled OR of 2.27 (95% CI 2.09 to 2.46) for developing subsequent Parkinson's disease compared with those without constipation. Weak evidence for heterogeneity was found (I(2)=18.9%, p=0.282). Restricting analysis to studies assessing constipation more than 10 years prior to Parkinson's disease gave a pooled OR of 2.13 (95% CI 1.78 to 2.56; I(2)=0.0%). This systematic review and meta-analysis demonstrates that people with constipation are at a higher risk of developing Parkinson's disease compared with those without and that constipation can predate Parkinson's diagnosis by over a decade. 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/

  15. Bone Density and Clinical Periodontal Attachment in Postmenopausal Women: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Penoni, D C; Fidalgo, T K S; Torres, S R; Varela, V M; Masterson, D; Leão, A T T; Maia, L C

    2017-03-01

    Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and has been considered a risk factor for periodontal disease. The aim of this systematic review and meta-analysis was to verify the scientific evidence for the association of periodontal attachment loss with low BMD in postmenopausal women. A systematic search of the literature was performed in databases until August 2016, in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria included studies that compared clinical attachment loss (CAL) between postmenopausal women with low and normal BMD. Studies using similar methodology, with lower and higher risk of bias, were pooled into 3 different meta-analyses to compare CAL among women with normal BMD, osteoporosis, and osteopenia. In the first meta-analysis, mean CAL was compared among groups. In the other 2 meta-analyses, the mean percentages of sites with CAL ≥4 mm and ≥6 mm were respectively compared among groups. From 792 unique citations, 26 articles were selected for the qualitative synthesis. Eleven of the studies were appraised as presenting low risk of bias, and the association between low BMD and CAL was observed in 10 of these studies. Thirteen cross-sectional articles were included in the meta-analysis for osteoporosis and 9 in the osteopenia analysis. Women with low BMD presented greater mean CAL than those with normal BMD (osteoporosis = 0.34 mm [95% confidence interval (CI), 0.20-0.49], P osteoporosis = 3.04 [95% CI, 1.23-4.85], P = 0.001; osteopenia = 1.74 [95% CI, 0.36-3.12], P = 0.01) and CAL ≥6 mm (osteoporosis = 5.07 [95% CI, 2.74-7.40], P osteoporosis or osteopenia may exhibit greater CAL compared with women with normal BMD.

  16. Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    A Nemezio, Mariana; Mh De Oliveira, Katharina; C Romualdo, Priscilla; M Queiroz, Alexandra; Wg Paula-E-Silva, Francisco; Ab Silva, Raquel; C Küchler, Erika

    2017-01-01

    To perform a systematic review and meta-analysis to establish if fever is associated with primary tooth eruption. Literature searches involved Pubmed, MEDLINE, Web of Science, Scopus and Cochrane. The potentially relevant studies had the full text analyzed. Only studies concerning fever during eruption period of primary tooth in humans were included. Papers in non-English language, and papers that included syndromic patients or patients with any disease were excluded. The meta-analyses were performed with Review Manager (version 5.3). Only studies that reported the results as dichotomous data were analyzed with Cochran-Mantel-Haenszel test in meta-analysis function of Review Manager 5.3. The fixed-effects model was used to evaluate the association between tooth eruption and fever. Search identified 83 potential studies. After exclusion of the duplicated studies, or were not related to the criteria of inclusion only 6 studies were selected for the systematic review. In the overall meta-analysis, no association was found [OR = 1.32 (0.88-1.96)] between fever and primary tooth eruption. However, in the subgroup analysis, when the method used to measure fever was the rectal temperature there was an association [OR = 2.82 (1.55-5.14)] between fever and primary tooth eruption. There are few suitable studies in the literature regarding the association between primary tooth eruption and fever. However, our study found an association between fever and primary tooth eruption only when rectal temperature was performed. Nemezio MA, De Oliveira KMH, Romualdo PC, Queiroz AM, Paula-e-Silva FWG, Silva RAB, Kuchler EC. Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2017;10(3):293-298.

  17. [Quality appraisal of systematic reviews and meta-analysis of pneumonia in China].

    Science.gov (United States)

    Hou, Zheng-kun; Li, Jian-sheng; Yu, Xue-qing; Li, Bin; Zhou, Hong-yan; Zhang, Yan-xia

    2009-04-01

    To review and analyze the prevailing information and quality of published systematic reviews and Meta-analysis of pneumonia in China. After a CNKI, VIP, Wanfang and CMB database retrieval of systematic reviews and Meta-analysis of pneumonia published in Chinese journals, two reviewers, blinded to author (s), et al, independently collected and analyzed the common information and quality, using the form of Cochrane systematic reviews (CSR) and the quality of reporting of Meta-analysis (QUOROM) statement. Eleven papers, of which 4 were systematic reviews, 7 Meta-analysis were identified. Three hundred and twenty-six studies were analyzed with involvement of 17 971 individuals distributed in 30 domestic administrative regions and 7 foreign countries. None of these articles used the form of CSR or the QUOROM statement to report their results. In all 4 domains and 40 items of the form of CSR, 4 articles addressed 25 items, 3 addressed 2, 2 addressed 1, 1 addressed 5, 0 addressed 7, and the overall proportion for correspondent item information presented was 70.6% (113/160). In all 6 domains and 18 minor terms of the QUOROM statement, 7 articles addressed 10 items, 5 addressed 2, 4 addressed 2, 2 addressed 2, 1 addressed 1, 0 addressed 1, and the overall proportion for correspondent minor terms information presented was 73.8% (93/126). In all 48 checklist items, 7 articles addressed 10 items, 6 addressed 2, 5 addressed 1, 4 addressed 3, 3 addressed 5, 2 addressed 7, 1 addressed 6, 0 addressed 14, and the overall proportion for correspondent item information presented was 39.9% (134/336). These studies of systematic reviews and Meta-analyses of pneumonia in China starts late, only a few of researchers and participants join in the project, and the financial support is insufficient. The quality of literature is passable, but it is weak in some areas such as data sources, selection searching, validity assessment, review methods, study characteristics, etc. The authors suggest

  18. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Liu, Li; Xia, Qing; Wang, Wen; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    Antepartum hemorrhage (APH) is an important cause of perinatal mortality and maternal morbidity in pregnant women with placenta previa in the world. However, the epidemiological characteristics are not completely understood. We performed an initial systematic review and meta-analysis to assess the prevalence of APH in pregnant women with placenta previa. It was totally performed following the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement. PubMed, Elsevier Science Direct, and the Cochrane Library were searched before April 2016. A meta-analysis with a random-effects model based on a proportions approach was performed to determine the prevalence. Stratified analyses, meta-regression method, and sensitivity analysis were utilized to analyze the heterogeneity. A total of 29 articles were included. The pooled overall prevalence of APH among pregnant women with placenta previa was 51.6% (95% CI 42.7–60.6) in a heterogeneous set of studies (I2 = 97.9). Correlation analysis found that there was a positive correlation between prevalence and percentage of multiparous (r = 0.534, P = 0.027) and a negative correlation between prevalence and survey year (r = −0.400, P = 0.031). In conclusion, the prevalence of APH was a high condition among pregnant women with placenta previa. PMID:28067303

  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. Association between circadian preference and academic achievement: A systematic review and meta-analysis.

    Science.gov (United States)

    Tonetti, Lorenzo; Natale, Vincenzo; Randler, Christoph

    2015-01-01

    The association between circadian preference and academic achievement has been assessed through a systematic review and meta-analysis. The literature searches retrieved 1647 studies; 31 studies, with a total sample size of 27 309 participants, fulfilled the inclusion criteria and were included in the meta-analysis. With reference to all these 31 studies, before running the meta-analysis, the sign of the correlation between the investigated variables was set in a way that a positive correlation showed that eveningness was related to worse academic performance. The meta-analysis yielded a small overall effect size of 0.143 (CI [0,129; 0,156]) under a fixed effects model (Z = 20.584, p academic performance, both in school pupils and university students; for the first time, it has been shown that such relationship changes over time, being weaker in university students.

  2. 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

  3. 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.

  4. 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

  5. Association between polypharmacy and death: A systematic review and meta-analysis.

    Science.gov (United States)

    Leelakanok, Nattawut; Holcombe, Andrea L; Lund, Brian C; Gu, Xiaomei; Schweizer, Marin L

    Polypharmacy has been linked to a myriad of adverse consequences, and escalating rates of polypharmacy present an emerging concern, particularly among older adults. This systematic review and meta-analysis summarizes the existing literature concerning the association between polypharmacy and mortality. A systematic literature review was done by searching the EMBASE, PubMed, Scopus, and International Pharmaceutical Abstract databases to identify studies assessing the association between polypharmacy and death published until June 2016. Studies that investigated the association between polypharmacy and mortality were eligible for this systematic review and meta-analysis. Data were extracted by the first and second authors independently using a data extraction form. Disagreement was resolved by consensus. A meta-analysis was performed using random effect models. Heterogeneity was assessed using the I 2 statistic. Forty-seven studies were included in this meta-analysis. The underlying populations were heterogeneous (I 2 = 91.5%). When defined as a discrete variable, pooled risk estimates demonstrated a significant association between polypharmacy and death (pooled-adjusted odds ratio [aOR] 1.08 [95% CI 1.04-1.12]). When defined categorically, a dose-response relationship was observed across escalating thresholds for defining polypharmacy. Categorical thresholds for polypharmacy using values of 1-4 medications, 5 medications, and 6-9 medications were significantly associated with death (P discrete and categorical definitions. The causality of this relationship remains unclear, but it emphasizes the need for approaches to health care delivery that achieve an optimal balance of risk and benefit in medication prescribing. Copyright © 2017 American Pharmacists Association®. All rights reserved.

  6. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis.

    Science.gov (United States)

    Kim, Gaeun; Kang, Seong Hee; Kim, Moon Young; Baik, Soon Koo

    2017-01-01

    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, 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.

  7. Anti-malarial treatment outcomes in Ethiopia: a systematic review and meta-analysis.

    Science.gov (United States)

    Gebreyohannes, Eyob Alemayehu; Bhagavathula, Akshaya Srikanth; Seid, Mohammed Assen; Tegegn, Henok Getachew

    2017-07-03

    Ethiopia is among countries with a high malaria burden. There are several studies that assessed the efficacy of anti-malarial agents in the country and this systematic review and meta-analysis was performed to obtain stronger evidence on treatment outcomes of malaria from the existing literature in Ethiopia. A systematic literature search using the preferred reporting items for systematic review and meta-analysis (PRISMA) statement was conducted on studies from Pubmed, Google Scholar, and ScienceDirect databases to identify published and unpublished literature. Comprehensive meta-analysis software was used to perform all meta-analyses. The Cochrane Q and the I 2 were used to evaluate heterogeneity of studies. Random effects model was used to combine studies showing heterogeneity of Cochrane Q p  50. Twenty-one studies were included in the final analysis with a total number of 3123 study participants. Treatment outcomes were assessed clinically and parasitologically using World Health Organization guidelines. Adequate clinical and parasitological response was used to assess treatment success at the 28th day. Overall, a significant high treatment success of 92.9% (95% CI 89.1-96.6), p Ethiopia, but associated with high rates of adverse drug reactions (ADRs). However, these ADRs were not serious enough to discontinue anti-malarial treatment. The results of this study suggest that the current anti-malarial medications are effective and safe; however, greater priority should be placed on the discovery of new anti-malarial drugs to achieve successful outcomes as resistance seems inevitable since cases of anti-malarial drug resistance have been reported from other areas of the world.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. The effectiveness of interprofessional education in healthcare: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Salman Yousuf Guraya

    2018-03-01

    Full Text Available Interprofessional education (IPE emphasizes collaborative practice that aims at promoting the working relationships between two or more healthcare professions. However, there is paucity of literature about the effectiveness of IPE program in the healthcare. This systematic review and meta-analysis aims to objectively determine the effectiveness of IPE in that field in terms of the improvement of students' knowledge, skills and attitudes. The databases of OVID, ISI Knowledge of Science, and Medline (PubMed were searched for the full-text English language articles published during 2000–2016 using the MeSH terms “interprofessional education” AND “healthcare professionals” AND “multi-professional” AND “impact” AND “effectiveness” OR “collaborative practice” OR “medical students” in Endnote X7. A systematic search finally selected 12 articles for detailed review and meta-analysis. The effect summary value of 1.37 with confidence interval of 0.92–1.82 identifies statistically significant effectiveness of intervention by IPE program in healthcare. The Z test value of 5.99, significant at 5% level of significance, also shows a significant impact of IPE intervention as calculated by the random-effects model. This meta-analysis shows a positive impact and effectiveness of educational intervention by IPE program in various disciplines of healthcare. However, analysis of further clinical trials may be helpful in identifying the effect of IPE program on the students’ clinical competence.

  13. Statin Treatment and Mortality in Bacterial Infections – A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Björkhem-Bergman, Linda; Bergman, Peter; Andersson, Jan; Lindh, Jonatan D.

    2010-01-01

    Background Several studies have reported improved survival in severe bacterial infections among statin treated patients. In addition, statins have been ascribed beneficial anti-inflammatory effects. The aim of this study was to evaluate the effect of statin-treatment on mortality in patients with bacterial infections, by means of a systematic review and a meta-analysis. Methodology and Principal Findings Studies investigating the association between statin use and mortality in patients with bacterial disease were identified in a systematic literature review and a meta-analysis was performed to calculate the overall odds ratio of mortality in statin users. The literature search identified 947 citations from which 40 relevant studies were extracted. In all, 15 studies comprising 113 910 patients were included in the final analysis. Statin use was associated with a significantly (pstatin treatment was no longer significant, with an OR of 0.79 (95% CI 0.58–1.07). Conclusion/Significance According to the meta-analysis of observational studies presented here, patients on statin therapy seem to have a better outcome in bacterial infections. However, the association did not reach statistical significance after adjustment for apparent publication bias. Thus, there is a great need for randomised controlled trials investigating the possible beneficial effect of statins in bacterial infections. PMID:20502712

  14. Association between developmental defects of enamel and dental caries: A systematic review and meta-analysis.

    Science.gov (United States)

    Vargas-Ferreira, F; Salas, M M S; Nascimento, G G; Tarquinio, S B C; Faggion, C M; Peres, M A; Thomson, W M; Demarco, F F

    2015-06-01

    Dental caries is the main problem oral health and it is not well established in the literature if the enamel defects are a risk factor for its development. Studies have reported a potential association between developmental defects enamel (DDE) and dental caries occurrence. We investigated the association between DDE and caries in permanent dentition of children and teenagers. A systematic review was carried out using four databases (Pubmed, Web of Science, Embase, and Science Direct), which were searched from their earliest records until December 31, 2014. Population-based studies assessing differences in dental caries experience according to the presence of enamel defects (and their types) were included. PRISMA guidelines for reporting systematic reviews were followed. Meta-analysis was performed to assess the pooled effect, and meta-regression was carried out to identify heterogeneity sources. From the 2558 initially identified papers, nine studies fulfilled all inclusion criteria after checking the titles, abstracts, references, and complete reading. Seven of them were included in the meta-analysis with random model. A positive association between enamel defects and dental caries was identified; meta-analysis showed that individuals with DDE had higher pooled odds of having dental caries experience [OR 2.21 (95% CI 1.3; 3.54)]. Meta-regression analysis demonstrated that adjustment for sociodemographic factors, countries' socioeconomic status, and bias (quality of studies) explained the high heterogeneity observed. A higher chance of dental caries should be expected among individuals with enamel defects. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Effect of breastfeeding on malocclusions: a systematic review and meta-analysis.

    Science.gov (United States)

    Peres, Karen Glazer; Cascaes, Andreia Morales; Nascimento, Gustavo Giacomelli; Victora, Cesar Gomes

    2015-12-01

    The objective of this systematic review was to investigate whether breastfeeding decreases the risk of malocclusions. Six databases were systematically searched to the end of October 2014. Observational and interventional studies were included. Breastfeeding was evaluated in three categories: (i) ever versus never; (ii) exclusive versus absence of exclusive; and (iii) longer periods versus shorter periods. All types of malocclusion were considered as the outcome. Pooled adjusted odds ratio and its 95% confidence interval (95%CI) were obtained from meta-analyses. Heterogeneity was assessed with both the Q-test and the I-square. Funnel plots and Egger's test were employed to assess publication bias. Forty-eight studies were included in the systematic review, and 41 were included in the overall meta-analysis (n = 27 023 participants). Subjects who were ever breastfed were less likely to develop malocclusions than those never breastfed (OR 0.34; 95% CI 0.24; 0.48), those who were exclusively breastfed presented lower risk to present malocclusion than those with absence of exclusive breastfeeding (OR 0.54; 95% CI 0.38; 0.77), and subjects longer breastfed were less likely to have malocclusions than those shorter breastfed (OR 0.40; 95% CI 0.29; 0.54). Breastfeeding decreases the risk of malocclusions. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  16. Charged Particle Radiation Therapy for Uveal Melanoma: A Systematic Review and Meta-Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhen, E-mail: Wang.Zhen@mayo.edu [Mayo Clinic, Rochester, Minnesota (United States); Nabhan, Mohammed [Mayo Clinic, Rochester, Minnesota (United States); Schild, Steven E. [Mayo Clinic, Scottsdale, Arizona (United States); Stafford, Scott L.; Petersen, Ivy A.; Foote, Robert L.; Murad, M. Hassan [Mayo Clinic, Rochester, Minnesota (United States)

    2013-05-01

    Charged particle therapy (CPT) delivered with either protons, helium ions, or carbon ions, has been used to treat uveal melanoma. The present analysis was performed to systematically evaluate the efficacy and adverse effects of CPT for uveal melanoma. We searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and SciVerse Scopus and cross-referenced recent systematic reviews through January 2012. Two independent reviewers identified clinical trials and observational studies of CPT (protons, helium ions, and carbon ions). These reviewers extracted data and assessed study quality. Twenty-seven studies enrolling 8809 uveal melanoma patients met inclusion criteria. The rate of local recurrence was significantly less with CPT than with brachytherapy (odds ratio [OR] = 0.22, 95% confidence interval [CI], 0.21-0.23). There were no significant differences in mortality or enucleation rates. Results were robust in multiple sensitivity analyses. CPT was also associated with lower retinopathy and cataract formation rates. Data suggest better outcomes may be possible with charged particle therapy with respect to local recurrence, retinopathy, and cataract formation rates. The overall quality of the evidence is low, and higher quality comparative effectiveness studies are needed to provide better evidence.

  17. Charged Particle Radiation Therapy for Uveal Melanoma: A Systematic Review and Meta-Analysis

    International Nuclear Information System (INIS)

    Wang, Zhen; Nabhan, Mohammed; Schild, Steven E.; Stafford, Scott L.; Petersen, Ivy A.; Foote, Robert L.; Murad, M. Hassan

    2013-01-01

    Charged particle therapy (CPT) delivered with either protons, helium ions, or carbon ions, has been used to treat uveal melanoma. The present analysis was performed to systematically evaluate the efficacy and adverse effects of CPT for uveal melanoma. We searched EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and SciVerse Scopus and cross-referenced recent systematic reviews through January 2012. Two independent reviewers identified clinical trials and observational studies of CPT (protons, helium ions, and carbon ions). These reviewers extracted data and assessed study quality. Twenty-seven studies enrolling 8809 uveal melanoma patients met inclusion criteria. The rate of local recurrence was significantly less with CPT than with brachytherapy (odds ratio [OR] = 0.22, 95% confidence interval [CI], 0.21-0.23). There were no significant differences in mortality or enucleation rates. Results were robust in multiple sensitivity analyses. CPT was also associated with lower retinopathy and cataract formation rates. Data suggest better outcomes may be possible with charged particle therapy with respect to local recurrence, retinopathy, and cataract formation rates. The overall quality of the evidence is low, and higher quality comparative effectiveness studies are needed to provide better evidence

  18. Hamstring strength and flexibility after hamstring strain injury: a systematic review and meta-analysis.

    Science.gov (United States)

    Maniar, Nirav; Shield, Anthony J; Williams, Morgan D; Timmins, Ryan G; Opar, David A

    2016-08-01

    To systematically review the evidence base related to hamstring strength and flexibility in previously injured hamstrings. Systematic review and meta-analysis. A systematic literature search was conducted of PubMed, CINAHL, SPORTDiscus, Cochrane Library, Web of Science and EMBASE from inception to August 2015. Full-text English articles which included studies which assessed at least one measure of hamstring strength or flexibility in men and women with prior hamstring strain injury within 24 months of the testing date. Twenty-eight studies were included in the review. Previously injured legs demonstrated deficits across several variables. Lower isometric strength was found hamstring to quadricep strength ratios were also reduced well after return to play (60:60°/s, d=-0.32; 240:240°/s, d=-0.43) and functional (30:240°/s, d=-0.88), but these effects were inconsistent across measurement methods. After hamstring strain, acute isometric and passive straight leg raise deficits resolve within 20-50 days. Deficits in eccentric and concentric strength and strength ratios persist after return to play, but this effect was inconsistent across measurement methods. Flexibility and isometric strength should be monitored throughout rehabilitation, but dynamic strength should be assessed at and following return to play. 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/

  19. The use of misoprostol for cervical priming prior to hysteroscopy: a systematic review and analysis

    Directory of Open Access Journals (Sweden)

    Hua Y

    2016-09-01

    Full Text Available Ying Hua, Wenwen Zhang, Xiaoli Hu, Ansu Yang, Xueqiong Zhu Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China Abstract: The effects of misoprostol use on cervical priming prior to hysteroscopy have been controversial. Therefore, a systematic literature review and meta-analysis of studies were conducted to assess the effect of misoprostol on cervical priming prior to hysteroscopy. All studies published before July 2014 with data related to the use of misoprostol for cervical priming compared with placebo or no medication prior to hysteroscopy, were identified. Twenty-five randomized controlled trials involving 2,203 females were systematically analyzed. The results showed that, compared with placebo or no medication, the use of misoprostol prior to hysteroscopy led to a significant relief of the need for cervical dilatation, resulted in a significantly greater cervical width, had fewer hysteroscopy complications, and mild and insignificant side effects. Subgroup analyses revealed that the regimen of 200 or 400 µg vaginal misoprostol may be a simple and effective method for cervical priming, especially prior to operative hysteroscopy. Keywords: misoprostol, hysteroscopy, cervical priming, cervical dilatation, complications, systematic review 

  20. Content analysis of advertisements related to oral health in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Pournaghi Azar, F; Mamizadeh, M; Nikniaz, Z; Ghojazadeh, M; Hajebrahimi, S; Salehnia, F; Mashhadi Abdolahi, H

    2018-03-01

    The evidence about the content of TV advertisements broadcast during children's viewing times with an emphasis on the number of food advertisements and the number of cariogenic food advertisements was systematically reviewed and meta-analyzed. A systematic review and meta-analysis. Articles published up until October 2017 in PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Persian databases such as Magiran, IranDoc, and Iranmedex with the keywords that were related to advertising and oral health in children were searched and screened by two reviewers independently, and the outcomes of interest were extracted. Meta-analysis was performed using the Comprehensive Meta-Analysis, version 2.0. A total of 480 titles were retrieved and reduced to 256 eligible studies after deletion of duplicates, and finally, after closer assessment of titles and abstracts, five articles were selected for systematic review and meta-analysis. Of the included studies, three were conducted in the UK, one in India, and one in Greece. About 38.0% (95% confidence interval: 19.6-60.6, P = 0.296) of advertisements were related to food and also about 70.6% (95% confidence interval: 53.7-83.3, P advertisements were related to cariogenic foods. Food advertising during children's programs is dominated by food items that are potentially harmful to oral health. Moreover, the advertisements shifted toward food items that appeared healthy but contain a large amount of hidden sugar. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Fractal analysis in radiological and nuclear medicine perfusion imaging: a systematic review.

    Science.gov (United States)

    Michallek, Florian; Dewey, Marc

    2014-01-01

    To provide an overview of recent research in fractal analysis of tissue perfusion imaging, using standard radiological and nuclear medicine imaging techniques including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and to discuss implications for different fields of application. A systematic review of fractal analysis for tissue perfusion imaging was performed by searching the databases MEDLINE (via PubMed), EMBASE (via Ovid) and ISI Web of Science. Thirty-seven eligible studies were identified. Fractal analysis was performed on perfusion imaging of tumours, lung, myocardium, kidney, skeletal muscle and cerebral diseases. Clinically, different aspects of tumour perfusion and cerebral diseases were successfully evaluated including detection and classification. In physiological settings, it was shown that perfusion under different conditions and in various organs can be properly described using fractal analysis. Fractal analysis is a suitable method for quantifying heterogeneity from radiological and nuclear medicine perfusion images under a variety of conditions and in different organs. Further research is required to exploit physiologically proven fractal behaviour in the clinical setting. • Fractal analysis of perfusion images can be successfully performed. • Tumour, pulmonary, myocardial, renal, skeletal muscle and cerebral perfusion have already been examined. • Clinical applications of fractal analysis include tumour and brain perfusion assessment. • Fractal analysis is a suitable method for quantifying perfusion heterogeneity. • Fractal analysis requires further research concerning the development of clinical applications.

  2. Effects of inspiratory muscle training in COPD patients: A systematic review and meta-analysis.

    Science.gov (United States)

    Beaumont, Marc; Forget, Patrice; Couturaud, Francis; Reychler, Gregory

    2018-04-17

    In chronic obstructive pulmonary disease (COPD), quality of life and exercise capacity are altered in relationship to dyspnea. Benefits of inspiratory muscle training (IMT) on quality of life, dyspnea and exercise capacity were demonstrated, but when it is associated to pulmonary rehabilitation (PR), its efficacy on dyspnea is not demonstrated. The aim of this systematic review with meta analysis was to verify the effect of IMT using threshold devices in COPD patients on dyspnea, quality of life, exercise capacity and inspiratory muscles strength, and the added effect on dyspnea of IMT associated with PR (versus PR alone). This systematic review and meta-analysis was conducted on the databases from PubMed, Science direct, Cochrane library, Web of science, Pascal. Following key words were used: inspiratory, respiratory, ventilatory, muscle and training. The searching period extended to December 2017. Two reviewers independently assessed studies quality. Forty-three studies were included in the systematic review and thirty- seven studies in the meta-analysis. Overall treatment group consisted of six hundred forty two patients. Dyspnea (Baseline Dyspnea Index) is decreased after IMT. Quality of life (Saint George's Respiratory Questionnaire), exercise capacity (six minute walk test) and Maximal inspiratory pressure were increased after IMT. During PR, no added effect of IMT on dyspnea was found. IMT using threshold devices improves inspiratory muscle strength, exercise capacity and quality of life, decreases dyspnea. However, there is no added effect of IMT on dyspnea during PR (compared with PR alone). This article is protected by copyright. All rights reserved. © 2018 John Wiley & Sons Ltd.

  3. Using digital notifications to improve attendance in clinic: systematic review and meta-analysis

    Science.gov (United States)

    Robotham, Dan; Satkunanathan, Safarina; Reynolds, John; Stahl, Daniel; Wykes, Til

    2016-01-01

    Objectives Assess the impact of text-based electronic notifications on improving clinic attendance, in relation to study quality (according to risk of bias), and to assess simple ways in which notifications can be optimised (ie, impact of multiple notifications). Design Systematic review, study quality appraisal assessing risk of bias, data synthesised in meta-analyses. Data sources MEDLINE, EMBASE, PsycINFO, Web of Science and Cochrane Database of Systematic Reviews (01.01.05 until 25.4.15). A systematic search to discover all studies containing quantitative data for synthesis into meta-analyses. Eligibility criteria Studies examining the effect of text-based electronic notifications on prescheduled appointment attendance in healthcare settings. Primary analysis included experimental studies where randomisation was used to define allocation to intervention and where a control group consisting of ‘no reminders’ was used. Secondary meta-analysis included studies comparing text reminders with voice reminders. Studies lacking sufficient information for inclusion (after attempting to contact study authors) were excluded. Outcome measures Primary outcomes were rate of attendance/non-attendance at healthcare appointments. Secondary outcome was rate of rescheduled and cancelled appointments. Results 26 articles were included. 21 included in the primary meta-analysis (8345 patients receiving electronic text notifications, 7731 patients receiving no notifications). Studies were included from Europe (9), Asia (7), Africa (2), Australia (2) and America (1). Patients who received notifications were 23% more likely to attend clinic than those who received no notification (risk ratio=1.23, 67% vs 54%). Those receiving notifications were 25% less likely to ‘no show’ for appointments (risk ratio=.75, 15% vs 21%). Results were similar when accounting for risk of bias, region and publication year. Multiple notifications were significantly more effective at improving

  4. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis.

    Science.gov (United States)

    Silva, André B; Sousa, Nelson; Azevedo, Luís F; Martins, Carlos

    2017-10-01

    A growing body of evidence suggests that physical activity and exercise may improve erectile function. To conduct a systematic review and meta-analysis evaluating the effects of physical activity modalities and exercise on erectile function in erectile dysfunction trials. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. We searched 6 electronic databases between January 1990 and July 2016 and hand-searched reference lists for randomised controlled trials. Only patients with a diagnosis of erectile dysfunction were included. The mean differences between intervention and control groups were calculated for meta-analysis. 7 studies were eligible, including 478 participants allocated to aerobic, pelvic or combined exercise interventions. Follow-up ranged from 8 weeks to 2 years. The risk of bias in the trials was deemed moderate to high mainly due to impossible blinding of patients and personnel, as well as questionable blinding of outcome assessors. Random-effects meta-analyses were performed. Pooled data showed a statistically significant improvement in erectile function score (mean difference 3.85, 95% CI 2.33 to 5.37). A benefit was still demonstrable after a sensitivity analysis because the mean difference in International Index of Erectile Function (IIEF) score ranged from 3.39 (95% CI 1.92 to 4.87) to 4.28 (95% CI 2.54 to 6.02). A benefit was also detected in short-term and long-term interventions as well as in trials evaluating physical activity and exercise alone or in addition to usual care. The present study suggests that physical activity and exercise interventions improve patient-reported erectile dysfunction, particularly aerobic exercise with moderate-to-vigorous intensity. 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/.

  5. Flexible band versus rigid ring annuloplasty for tricuspid regurgitation: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Nelson; Phan, Steven; Tian, David H; Yan, Tristan D; Phan, Kevin

    2017-05-01

    Up to 20% of patients have pre-discharge residual moderate to severe tricuspid regurgitation (TR) after tricuspid repair. Reoperations for recurrent TR carry high mortality rates, which emphasizes the importance of identifying the optimal technique for the surgical management of TR. The present study is a systematic review and meta-analysis that aims to compare short and long term survival and freedom from TR of flexible band ring versus rigid ring for annuloplasty of TR. We conducted a systematic review and meta-analysis of comparative studies to evaluate these procedures. A systematic search of the literature was performed from six electronic databases. Pooled meta-analysis was conducted using odds ratio (OR) and weighted mean difference (WMD). The rates of in-hospital mortality were not different between the two groups, with cumulative rates of 6.9% for flexible band and 7.3% for rigid ring (OR: 0.92; 95% CI: 0.49-1.71). Rates of stroke were also similar with 1.7% of flexible band and 1.3% of rigid rings suffering a perioperative stroke (OR: 1.29; 95% CI: 0.74-2.23). Rigid ring had significantly better freedom from grade ≥2 TR at 5 years (OR: 0.44; 95% CI: 0.20-0.99) and overall (P=0.005). There was no significant difference in overall rates of reoperation (P=0.232) and survival (P=0.086) between flexible band and rigid ring. Both rigid ring and flexible band offer acceptable outcomes for the treatment of TR. Compared to flexible band, rates of TR are stable after rigid ring annuloplasty and long term freedom from TR are superior for rigid ring devices. Large prospective randomized trials are required in order to validate these findings and assess for improvements in patient survival.

  6. Antenatal corticosteroids for neonates born before 25 Weeks-A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mangesh Deshmukh

    Full Text Available Efficacy of antenatal corticosteroids before 25 weeks of gestation is unclear.To assess and compare neonatal outcomes following ANC exposure at 22, 23 and 24 weeks of gestation by conducting systematic review and meta- analysis.A systematic review of randomised controlled trials (RCT and non-RCTs reporting on neonatal outcomes after exposure to ANC up to 246 weeks of gestation using the Cochrane systematic review methodology. Databases Pubmed, CINAHL, Embase, Cochrane Central library, and online abstracts of conference proceedings including the Pediatric Academic Society (PAS were searched in Feb 2017. Primary outcome was in-hospital mortality defined as death before discharge during the first admission. Secondary outcomes included severe intraventricular hemorrhage (IVH> grade III and IV/or periventricular leukomalacia (PVL, necrotising enterocolitis (NEC >stage II and chronic lung disease (CLD. Meta-analysis was performed using a random-effects model. The level of evidence (LOE was summarised using the GRADE guidelines.There were no RCTs; 8 high quality non-RCTs were included in the review. Meta-analysis showed reduction in mortality [N = 10109; OR = 0.47(0.39-0.56, p<0.00001; LOE: Moderate] and severe IVH and PVL [N = 5084; OR = 0.71(0.61-0.82, p<0.00001; LOE: Low] after exposure to ANC in neonates born <25 weeks. There was no significant difference in CLD [N = 4649; OR = 1.19(0.85-1.65 p = 0.31; LOE: Low] and NEC [N = 5403; OR = 0.95 (0.76-1.19 p = 0.65; LOE: Low]. Mortality was comparable in neonates born at 22, 23 or 24 weeks.Moderate to low quality evidence indicates that exposure to ANC is associated with reduction in mortality and IVH/or PVL in neonates born before 25 weeks.

  7. Epidemiology of brucellosis in Iran: A comprehensive systematic review and meta-analysis study.

    Science.gov (United States)

    Mirnejad, Reza; Jazi, Faramarz Masjedian; Mostafaei, Shayan; Sedighi, Mansour

    2017-08-01

    Brucellosis is still one of the most challenging issues for health and the economy in many developing countries such as Iran. Considering the high prevalence of brucellosis, the aim of the current study was to systematically review published data about the annual incidence rate of this infection from different parts of Iran and provide an overall relative frequency (RF) for Iran using meta-analysis. We searched several databases including PubMed, ISI Web of Science, Scopus, google scholar, IranMedex and Iranian Scientific Information Database (SID) by using the following keywords: "Brucella", "Brucellosis", "Malta fever", "Mediterranean fever", "undulant fever", "zoonosis" and "Iran" in Title/Abstract/Keywords fields. Articles/Abstracts, which used clinical specimens and reported the incidence of brucellosis, were included in this review. Quality of studies was assessed by STROB and PRISMA forms. All statistical analyses were performed using STATA 11.0 (STATA Corp, College Station, TX) and P-values under 0.05 were considered statistically significant. Out of the 8326 results, we found 34 articles suitable, according to inclusion and exlusion criteria, for inclusion in this systematic review and meta-analysis. The pooled incidence of brucellosis was estimated 0.001% (95% confidence interval (CI) = 0.0005-0.0015%) annually. Relative frequency of brucellosis in different studies varied from 7.0/100000 to 276.41/100000 in Qom and Kermanshah provinces, respectively. This systematic-review and meta-analysis study showed that the highest incidences of brucellosis are occurred in west and northwest regions of Iran. Totally, the incidence of the disease in Iran is in the high range. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Utility of a Systematic Approach to Teaching Photographic Nasal Analysis to Otolaryngology Residents.

    Science.gov (United States)

    Robitschek, Jon; Dresner, Harley; Hilger, Peter

    2017-12-01

    Photographic nasal analysis constitutes a critical step along the path toward accurate diagnosis and precise surgical planning in rhinoplasty. The learned process by which one assesses photographs, analyzes relevant anatomical landmarks, and generates a global view of the nasal aesthetic is less widely described. To discern the common pitfalls in performing photographic nasal analysis and to quantify the utility of a systematic approach model in teaching photographic nasal analysis to otolaryngology residents. This prospective observational study included 20 participants from a university-based otolaryngology residency program. The control and intervention groups underwent baseline graded assessment of 3 patients. The intervention group received instruction on a systematic approach model for nasal analysis, and both groups underwent postintervention testing at 10 weeks. Data were collected from October 1, 2015, through June 1, 2016. A 10-minute, 11-slide presentation provided instruction on a systematic approach to nasal analysis to the intervention group. Graded photographic nasal analysis using a binary 18-point system. The 20 otolaryngology residents (15 men and 5 women; age range, 24-34 years) were adept at mentioning dorsal deviation and dorsal profile with focused descriptions of tip angle and contour. Areas commonly omitted by residents included verification of the Frankfort plane, position of the lower lateral crura, radix position, and ratio of the ala to tip lobule. The intervention group demonstrated immediate improvement after instruction on the teaching model, with the mean (SD) postintervention test score doubling compared with their baseline performance (7.5 [2.7] vs 10.3 [2.5]; P Otolaryngology residents demonstrated proficiency at incorporating nasal deviation, tip angle, and dorsal profile contour into their nasal analysis. They often omitted verification of the Frankfort plane, position of lower lateral crura, radix depth, and ala-to-tip lobule

  9. "Bed Side" Human Milk Analysis in the Neonatal Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Fusch, Gerhard; Kwan, Celia; Kotrri, Gynter; Fusch, Christoph

    2017-03-01

    Human milk analyzers can measure macronutrient content in native breast milk to tailor adequate supplementation with fortifiers. This article reviews all studies using milk analyzers, including (i) evaluation of devices, (ii) the impact of different conditions on the macronutrient analysis of human milk, and (iii) clinical trials to improve growth. Results lack consistency, potentially due to systematic errors in the validation of the device, or pre-analytical sample preparation errors like homogenization. It is crucial to introduce good laboratory and clinical practice when using these devices; otherwise a non-validated clinical usage can severely affect growth outcomes of infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Quality of Life and Aesthetic Plastic Surgery: A Systematic Review and Meta-analysis

    OpenAIRE

    Dreher, Rodrigo; Blaya, Carolina; Ten?rio, Juliana L.C.; Saltz, Renato; Ely, Pedro B.; Ferr?o, Ygor A.

    2016-01-01

    Background: Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis. Methods: The search was made in two electronic databases (LILACS and PUBMED) using Mesh and non-Mesh terms related to aesthetic plastic surgery and QoL. We performed qualitative and quantita...

  11. Nutritional strategies in the management of Alzheimer\\'s disease: systematic review and meta-analysis

    OpenAIRE

    Shirley Steffany Muñoz Fernandez

    2016-01-01

    Alzheimer\\'s disease (AD) is one of the main causes of dependency and disability in the elderly population. A number of investigations have been seeking its prevention and/or management. In this context, it is important to highlight the role of modifiable risk factors, such as nutrition. This study aims to conduct a systematic review and subsequent meta-analysis, to assess the effect of food and/or nutrients for the management of AD at different stages. This work was steered based on the Coch...

  12. A Systematic Approach to Explorative Scenario Analysis in Emergy Assessment with Emphasis on Resilience

    DEFF Research Database (Denmark)

    Kamp, Andreas; Østergård, Hanne

    2016-01-01

    Fossil energy depletion (specifically peak oil) and climate change are imagined to profoundly affect human civilisation. This motivates assessment of resilience, a concept associated with the ability to persist and maintain function. Explorative scenarios may be used to cast light on what...... the future may bring. We develop a systematic approach to explorative scenario analysis and attempt to quantify aspects of resilience specifically for emergy assessment (EmA) of production systems. We group system inputs into five categories: (1) fossil fuels, their derivatives, metals and minerals, (2) on...

  13. Probiotics for childhood functional gastrointestinal disorders: a systematic review and meta-analysis.

    Science.gov (United States)

    Korterink, Judith J; Ockeloen, Lize; Benninga, Marc A; Tabbers, Merit M; Hilbink, Mirrian; Deckers-Kocken, Judith M

    2014-04-01

    A systematic review and meta-analysis were performed to investigate the quantity and quality of the current evidence regarding the effect of different probiotic strains in the treatment of functional gastrointestinal disorders (FGID) in children and adolescents. Probiotics are more effective than placebo in the treatment of patients with abdominal pain-related FGID, especially with respect to patients with irritable bowel syndrome. To date, however, probiotics have not proved effective for children with functional constipation. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. 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.

  15. How do autoimmune diseases cluster in families? A systematic review and meta-analysis

    Science.gov (United States)

    2013-01-01

    Background A primary characteristic of complex genetic diseases is that affected individuals tend to cluster in families (that is, familial aggregation). Aggregation of the same autoimmune condition, also referred to as familial autoimmune disease, has been extensively evaluated. However, aggregation of diverse autoimmune diseases, also known as familial autoimmunity, has been overlooked. Therefore, a systematic review and meta-analysis were performed aimed at gathering evidence about this topic. Methods Familial autoimmunity was investigated in five major autoimmune diseases, namely, rheumatoid arthritis, systemic lupus erythematosus, autoimmune thyroid disease, multiple sclerosis and type 1 diabetes mellitus. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Articles were searched in Pubmed and Embase databases. Results Out of a total of 61 articles, 44 were selected for final analysis. Familial autoimmunity was found in all the autoimmune diseases investigated. Aggregation of autoimmune thyroid disease, followed by systemic lupus erythematosus and rheumatoid arthritis, was the most encountered. Conclusions Familial autoimmunity is a frequently seen condition. Further study of familial autoimmunity will help to decipher the common mechanisms of autoimmunity. PMID:23497011

  16. Is caries a risk factor for dental trauma? A systematic review and meta-analysis.

    Science.gov (United States)

    Soares, Thais Rodrigues Campos; Fidalgo, Tatiana Kelly da Silva; Quirino, Andrea Soares; Ferreira, Daniele Masterson Tavares Pereira; Chianca, Thomaz Kauark; Risso, Patrícia de Andrade; Maia, Lucianne Cople

    2017-02-01

    The association between trauma and caries is still controversial in the literature. The aim of this study was to evaluate the possible association between caries and dental trauma through a systematic review with meta-analysis. A systematic literature search was performed in PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library, and Open Grey databases. The MeSH terms used were 'Tooth injuries', 'Tooth fractures', 'Tooth avulsion', 'Tooth movement'; 'Dental caries'; 'DMF index'; and 'Tooth demineralization'. MeSH synonyms, related terms, and free terms were included. The inclusion criteria comprised clinical investigations of subjects with and without caries that had suffered dental trauma. Quality assessment and bias control were carried out. Meta-analysis was performed using the comprehensive meta-analysis software (version 3.2). Heterogeneity was assessed using the I 2 index, and the odds ratio was also calculated (P dental trauma and dental caries in permanent teeth [OR: 1.490, 95%, CI: 1.209-1.835]. However, for children with primary teeth, the results showed a negative association (P = 0.006) between dental trauma and caries [OR: 0.706, 95%, CI: 0.550-0.906]. The results demonstrated positive and negative association between the presence of caries and dental trauma in permanent and primary teeth, respectively. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. 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.

  18. Willems method of dental age estimation in children: A systematic review and meta-analysis.

    Science.gov (United States)

    Sehrawat, J S; Singh, Monika

    2017-11-01

    Age estimation from dental developmental stages is considered comparatively more accurate, reliable and precise than other methods used in forensic sciences. Willems method is the revised version of Demirjian method, based on modified dental maturity scores to estimate age of children in years for both the sexes. To test the applicability and accuracy level of Willems method of dental age estimation in diverse population samples by quantifying the variations between the chronological and estimated ages of an individual. A systematic search of online databases (Pubmed, Scopus, Embase, Medline, Trip and Web of Science) was performed for identifying the articles utilizing Willems dental maturity scaling method for age estimation in children. All the research articles published in peer-reviewed English language journals between 2001 and January 2017 were included for present systematic review and meta-analysis. Out of the total 973 selected articles; thirty one studies were recruited for qualitative analysis and out of them, 15 studies were selected/identified for quantitative and meta-analysis. It was found that Willems method overestimates the age of children to a comparatively lesser extent (-0.04 and -0.02 years) than the Demirjian method (around six months). Willems method of dental age estimation gives comparatively lesser overestimations of age than other methods reported in the available literature and is thus, accurate and reliable enough to be utilized for forensic purposes. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  19. 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.

  20. Collective empowerment strategies for patients with Diabetes Mellitus: A systematic review and meta-analysis.

    Science.gov (United States)

    Baldoni, Nayara Ragi; Aquino, Jéssica Azevedo; Sanches-Giraud, Cristina; Di Lorenzo Oliveira, Cláudia; de Figueiredo, Roberta Carvalho; Cardoso, Clareci Silva; Santos, Thiago Reis; Alves, Geisa Cristina Silva; Dal Fabbro, Amaury Lelis; Baldoni, André Oliveira

    2017-04-01

    To perform a systematic review and meta-analysis to identify and analyze collective empowerment strategies for patients with Diabetes Mellitus (DM). The systematic review was performed using PubMed/MEDLINE, Science Direct and BVS. The term "Diabetes Mellitus" was used with each of the following describers, along with the connector "AND": "self-care", "health education", "motivation" and "empowerment". Inclusion criteria were: intervention study with control group published between 2004 and 2014. For meta-analysis, RevMan V 5.3 software was used. Among the nine analyzed articles, 66.7% (n=6) were developed in patients diagnosed with DM2. Concerning the indicators for intervention effectiveness evaluation, all articles (n=9) used glycated hemoglobin (HbA1c) and the most used instrument was Summary of Diabetes Self Care Activities Measure, representing 44.4% (n=4) of the studies. The types of strategies used were similar in the articles. There was evidence of a decrease in HbA1c levels in 66.7% (n=6). The meta-analysis found significant evidence indicating beneficial effects of empowerment. Programs based on collective empowerment in DM have shown the interventions lead to improvement in clinical parameters, behavior, increased knowledge about DM, and self-care. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  1. Obesity and dental caries in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Hayden, Ceara; Bowler, Jennifer O; Chambers, Stephanie; Freeman, Ruth; Humphris, Gerald; Richards, Derek; Cecil, Joanne E

    2013-08-01

    Obesity and dental caries have become increasingly prevalent challenges to public health. Research results into the relationship between obesity and dental caries in children have been mixed and inconclusive. The aim of this review and meta-analysis was to provide evidence to quantify the relationship between obesity and dental caries in children using a systematic approach. A systematic search for papers between 1980 and 2010 addressing childhood obesity and dental caries was conducted and a random effects model meta-analysis applied. Fourteen papers met the selection criteria. Overall, a significant relationship between childhood obesity and dental caries (effect size = 0.104, P = 0.049) was found. When analysed by dentition type (primary versus permanent), there was a nonsignificant association of obesity and dental caries in permanent and primary dentitions, yet on accounting only for standardized definitions for assessment of child obesity using body mass index, a strong significant relationship was evident in children with permanent dentitions. Moderating for study country of origin (newly 'industrialized' versus industrialized) showed a significant relationship between obesity and dental caries in children from industrialized but not newly industrialized countries. Cofactors such as age and socioeconomic class were significant moderators. Future analysis should investigate these confounding variables, helping shape the future of obesity management programmes and oral health interventions, through determining common risk factors. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Relationship between nurse psychological empowerment and job satisfaction: A systematic review and meta-analysis.

    Science.gov (United States)

    Li, Huanhuan; Shi, Ying; Li, Yuan; Xing, Zhuangjie; Wang, Shouqi; Ying, Jie; Zhang, Meiling; Sun, Jiao

    2018-02-23

    This systematic review and meta-analysis aimed to synthesize and analyse studies that explored the relationship between the psychological empowerment and job satisfaction of nurses. Nurse turnover is an important cause of staff shortage. Job satisfaction is a major predictor of nurse turnover and is connected to the psychological empowerment of nurses. This systematic review and meta-analysis is based on the Joanna Briggs Institute guidelines. A total of 1,572 articles on psychological empowerment and job satisfaction were retrieved from PubMed, PsycINFO, EMBASE and Web of Science. The articles were written in English and published before or by April 2017. Studies on the relationship between psychological empowerment and job satisfaction were summarized. The majority of the included studies revealed that psychological empowerment and job satisfaction are significantly correlated. Only two studies showed that the two factors are not significantly correlated. The result of this meta-analysis is consistent with the results of most studies. One study reported that psychological empowerment partially mediates the structural empowerment and job satisfaction of school health nurses. Two studies, however, did not find that the mediating role of psychological empowerment between structural empowerment and job satisfaction. The results of this review provided evidence for the importance of psychological empowerment for the job satisfaction of among nurses. Exploring the correlation between psychological empowerment and job satisfaction can provide guidelines and recommendation for the development of strategies to promote nurse retention and alleviate nursing shortage. © 2018 John Wiley & Sons Ltd.

  3. Acute bacterial meningitis in Iran: Systematic review and meta-analysis.

    Science.gov (United States)

    Houri, Hamidreza; Pormohammad, Ali; Riahi, Seyed Mohammad; Nasiri, Mohammad Javad; Fallah, Fatemeh; Dabiri, Hossein; Pouriran, Ramin

    2017-01-01

    Bacterial meningitis persists in being a substantial cause of high mortality and severe neurological morbidity, despite the advances in antimicrobial therapy. Accurate data has not been available regarding the epidemiology of bacterial meningitis particularly in developing countries, yet. Indeed, the present systematic review provides a comprehensive data analysis on the prevalence and epidemiology of bacterial meningitis in Iran. We systematically reviewed articles from 1994 to 2015. The reports which contained the prevalence and etiology of acute bacterial meningitis by valid clinical and laboratory diagnosis were comprised in the present study. Our analysis indicated that Streptococcus pneumoniae (30% [I2 = 56% p < 0.01]), Haemophilus influenza type b (15% [I2 = 82.75% p < 0.001]), coagulase negative staphylococci (CoNS) (14% [I2 = 60.5% p < 0.06]), and Neisseria meningitidis (13% [I2 = 74.16% p < 0.001]) were the most common cause of acute bacterial meningitis among meningitis cases in Iran. Notably, high frequency rates of nosocomial meningitis pathogens were detected in the present analysis. It was magnificently attained that the majority of cases for bacterial meningitis in Iran could be avertable by public immunization schemes and by preventive care to inhibit the broadening of hospital acquired pathogens.

  4. esATAC: An Easy-to-use Systematic pipeline for ATAC-seq data analysis.

    Science.gov (United States)

    Wei, Zheng; Zhang, Wei; Fang, Huan; Li, Yanda; Wang, Xiaowo

    2018-03-07

    ATAC-seq is rapidly emerging as one of the major experimental approaches to probe chromatin accessibility genome-wide. Here, we present "esATAC", a highly integrated easy-to-use R/Bioconductor package, for systematic ATAC-seq data analysis. It covers essential steps for full analyzing procedure, including raw data processing, quality control and downstream statistical analysis such as peak calling, enrichment analysis and transcription factor footprinting. esATAC supports one command line execution for preset pipelines, and provides flexible interfaces for building customized pipelines. esATAC package is open source under the GPL-3.0 license. It is implemented in R and C ++. Source code and binaries for Linux, MAC OS X and Windows are available through Bioconductor https://www.bioconductor.org/packages/release/bioc/html/esATAC.html). xwwang@tsinghua.edu.cn. Supplementary data are available at Bioinformatics online.

  5. 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...... we investigated in detail to extract a list of potential COPD breath marker molecules. First, we observed that no candidate markers were detected in all 12 studies. Only three were reported in more than one paper, thus reliable exhaled markers are still missing. A major challenge is the heterogeneity...... 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...

  6. Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis.

    Science.gov (United States)

    Mehlum, Camilla S; Rosenberg, Tine; Dyrvig, Anne-Kirstine; Groentved, Aagot Moeller; Kjaergaard, Thomas; Godballe, Christian

    2018-01-01

    The Ni classification of vascular change from 2011 is well documented for evaluating pharyngeal and laryngeal lesions, primarily focusing on cancer. In the planning of surgery it may be more relevant to differentiate neoplasia from non-neoplasia. We aimed to evaluate the ability of the Ni classification to predict laryngeal or hypopharyngeal neoplasia and to investigate if a changed cutoff value would support the recent European Laryngological Society (ELS) proposal of perpendicular vascular changes as indicative of neoplasia. PubMed, Embase, Cochrane, and Scopus databases. A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We systematically searched for publications from 2011 until 2016. All retrieved studies were reviewed and qualitatively assessed. The pooled sensitivity and specificity of the Ni classification with two different cutoffs were calculated, and bubble and summary receiver operating characteristics plots were created. The combined sensitivity of five studies (n = 687) with Ni type IV-V defined as test-positive was 0.89 (95% confidence interval [CI]: 0.76-0.95), and specificity was 0.82 (95% CI: 0.72-0.89). The equivalent combined sensitivity of four studies (n = 624) with Ni type V defined as test-positive was 0.82 (95% CI: 0.75-0.87), and specificity was 0.93 (95% CI: 0.82-0.97). The diagnostic accuracy of the Ni classification in predicting neoplasia was high, without significant difference between the two analyzed cutoff values. Implementation of the proposed ELS classification of vascular changes seems reasonable from a clinical perspective, with comparable accuracy. Attention must be drawn to the accompanying risk of exposing patients to unnecessary surgery. Laryngoscope, 128:168-176, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Open Versus Arthroscopic Latarjet Procedure for Anterior Shoulder Instability: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Hurley, Eoghan T; Lim Fat, Daren; Farrington, Shane K; Mullett, Hannan

    2018-03-01

    Anterior shoulder instability with significant glenoid bone loss is a challenging condition. The open Latarjet procedure is the established standard treatment method in this setting, but there is an increasing use of the arthroscopic technique. To systematically review the current evidence in the literature to ascertain if the open or arthroscopic Latarjet procedure resulted in improved patient outcomes. Systematic review and meta-analysis. A literature search of MEDLINE, EMBASE, and the Cochrane Library was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Cohort studies comparing the open and arthroscopic Latarjet procedures for anterior shoulder instability were included. Clinical outcomes were compared, with all statistical analysis performed using Review Manager (version 5.3). A P value of Latarjet procedures resulted in a similar number of total recurrent instability (2.0% vs 2.4%; P = .75), revision procedures (2.4% vs 5.4%; P = .06), and total complications (13.8% vs 11.9%; P = .50), but the open procedure had a lower rate of persistent apprehension (10.2% vs 35.7%; P Latarjet procedures result in significant improvements in patient function and outcome scores, with low rates of recurrent instability and similar complication rates. While technically challenging, the arthroscopic procedure has been shown to be a safe and viable alternative. However, there is a significant learning curve associated with the arthroscopic Latarjet procedure. The significant learning curve associated with this procedure suggests the arthroscopic procedure may be advisable to perform only in high-volume centers with experienced arthroscopists.

  8. Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality.

    Science.gov (United States)

    Biddle, Stuart J H; García Bengoechea, Enrique; Wiesner, Glen

    2017-03-28

    Sedentary behaviour (sitting time) has becoming a very popular topic for research and translation since early studies on TV viewing in children in the 1980s. The most studied area for sedentary behaviour health outcomes has been adiposity in young people. However, the literature is replete with inconsistencies. We conducted a systematic review of systematic reviews and meta-analyses to provide a comprehensive analysis of evidence and state-of-the-art synthesis on whether sedentary behaviours are associated with adiposity in young people, and to what extent any association can be considered 'causal'. Searches yielded 29 systematic reviews of over 450 separate papers. We analysed results by observational (cross-sectional and longitudinal) and intervention designs. Small associations were reported for screen time and adiposity from cross-sectional evidence, but associations were less consistent from longitudinal studies. Studies using objective accelerometer measures of sedentary behaviour yielded null associations. Most studies assessed BMI/BMI-z. Interventions to reduce sedentary behaviour produced modest effects for weight status and adiposity. Accounting for effects from sedentary behaviour reduction alone is difficult as many interventions included additional changes in behaviour, such as physical activity and dietary intake. Analysis of causality guided by the classic Bradford Hill criteria concluded that there is no evidence for a causal association between sedentary behaviour and adiposity in youth, although a small dose-response association exists. Associations between sedentary behaviour and adiposity in children and adolescents are small to very small and there is little to no evidence that this association is causal. This remains a complex field with different exposure and outcome measures and research designs. But claims for 'clear' associations between sedentary behaviour and adiposity in youth, and certainly for causality, are premature or misguided.

  9. Outcome of Surgical Treatment for Thoracic Outlet Syndrome: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Peek, Jesse; Vos, Cornelis G; Ünlü, Çağdaş; van de Pavoordt, Henricus D W M; van den Akker, Peter J; de Vries, Jean-Paul P M

    2017-04-01

    Many publications report outcomes of surgical treatment for thoracic outlet syndrome (TOS); however, high-quality reviews and meta-analyses are lacking. This systematic review and meta-analysis summarizes and compares the outcomes and major complications of the surgical procedures for the 3 types of TOS: arterial, venous, and neurogenic. MEDLINE, EMBASE, and CINAHL databases, and the Cochrane Database of Systematic Reviews were searched for papers published between January 1980 and February 2015, using the keywords thoracic outlet syndrome, and treatment and surgical. Articles were eligible for inclusion if the following criteria were met: studies describing outcomes of surgery for TOS, published in English, human studies, and available full-text. The exclusion criteria were case-series and case reports (n < 5), reviews, abstracts, and studies of endoscopic-assisted or robotic endoscopic-assisted transaxillary first rib resection. A total of 12 papers met our inclusion criteria and were finally included in this systematic review. All included articles showed improvement of complaints after surgical treatment. In our meta-analysis, improvement to Derkash's classification category excellent/good was achieved in 90% of the arterial and venous TOS groups. Preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand scores show improvement of 28.3 points after operative treatment of neurogenic TOS. In conclusion, surgical treatment of TOS seems to be beneficial in most patients and is relatively safe. The largest challenge remains the diagnosis of TOS, especially neurogenic TOS, because standardized diagnostic criteria are lacking. Future studies should focus on the diagnostic work-up of TOS. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Physical activity and physical self-concept in youth: systematic review and meta-analysis.

    Science.gov (United States)

    Babic, Mark J; Morgan, Philip J; Plotnikoff, Ronald C; Lonsdale, Chris; White, Rhiannon L; Lubans, David R

    2014-11-01

    Evidence suggests that physical self-concept is associated with physical activity in children and adolescents, but no systematic review of this literature has been conducted. The primary aim of this systematic review and meta-analysis was to determine the strength of associations between physical activity and physical self-concept (general and sub-domains) in children and adolescents. The secondary aim was to examine potential moderators of the association between physical activity and physical self-concept. A systematic search of six electronic databases (MEDLINE, CINAHL, SPORTDiscus, ERIC, Web of Science and Scopus) with no date restrictions was conducted. Random effects meta-analyses with correction for measurement were employed. The associations between physical activity and general physical self-concept and sub-domains were explored. A risk of bias assessment was conducted by two reviewers. The search identified 64 studies to be included in the meta-analysis. Thirty-three studies addressed multiple outcomes of general physical self-concept: 28 studies examined general physical self-concept, 59 examined perceived competence, 25 examined perceived fitness, and 55 examined perceived appearance. Perceived competence was most strongly associated with physical activity (r = 0.30, 95% CI 0.24-0.35, p self-concept (r = 0.25, 95% CI 0.16-0.34, p self-concept (p self-concept and its various sub-domains in children and adolescents. Age and sex are key moderators of the association between physical activity and physical self-concept.

  11. [Intraoperative goal directed hemodynamic therapy in noncardiac surgery: a systematic review and meta-analysis].

    Science.gov (United States)

    Ripollés, Javier; Espinosa, Angel; Martínez-Hurtado, Eugenio; Abad-Gurumeta, Alfredo; Casans-Francés, Rubén; Fernández-Pérez, Cristina; López-Timoneda, Francisco; Calvo-Vecino, José María

    2016-01-01

    The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014). Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary) and mortality (secondary). Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal), and predefined sensitivity analysis. 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p<0.001). No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p=0.30). Quality sensitive analyses confirmed the main overall results. Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac surgery, although it was not able to show a significant decrease in

  12. Intraoperative goal directed hemodynamic therapy in noncardiac surgery: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Javier Ripollés

    Full Text Available Abstract Background: The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. Methods: A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014. Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary and mortality (secondary. Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal, and predefined sensitivity analysis. Results: 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p < 0.001. No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p = 0.30. Quality sensitive analyses confirmed the main overall results. Conclusions: Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac

  13. Intraoperative goal directed hemodynamic therapy in noncardiac surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Ripollés, Javier; Espinosa, Angel; Martínez-Hurtado, Eugenio; Abad-Gurumeta, Alfredo; Casans-Francés, Rubén; Fernández-Pérez, Cristina; López-Timoneda, Francisco; Calvo-Vecino, José María

    2016-01-01

    The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. A systematic search was performed in Medline PubMed, Embase, and the Cochrane Library (last update, October 2014). Inclusion criteria were randomized clinical trials in which intraoperative goal directed hemodynamic therapy was compared to conventional fluid management in noncardiac surgery. Exclusion criteria were trauma and pediatric surgery studies and that using pulmonary artery catheter. End-points were postoperative complications (primary) and mortality (secondary). Those studies that fulfilled the entry criteria were examined in full and subjected to quantifiable analysis, predefined subgroup analysis (stratified by type of monitor, therapy, and hemodynamic goal), and predefined sensitivity analysis. 51 RCTs were initially identified, 24 fulfilling the inclusion criteria. 5 randomized clinical trials were added by manual search, resulting in 29 randomized clinical trials in the final analysis, including 2654 patients. A significant reduction in complications for goal directed hemodynamic therapy was observed (RR: 0.70, 95% CI: 0.62-0.79, p<0.001). No significant decrease in mortality was achieved (RR: 0.76, 95% CI: 0.45-1.28, p=0.30). Quality sensitive analyses confirmed the main overall results. Intraoperative goal directed hemodynamic therapy with minimally invasive monitoring decreases postoperative complications in noncardiac surgery, although it was not able to show a significant decrease in

  14. Association of sleep bruxism with ceramic restoration failure: A systematic review and meta-analysis.

    Science.gov (United States)

    de Souza Melo, Gilberto; Batistella, Elis Ângela; Bertazzo-Silveira, Eduardo; Simek Vega Gonçalves, Thais Marques; Mendes de Souza, Beatriz Dulcineia; Porporatti, André Luís; Flores-Mir, Carlos; De Luca Canto, Graziela

    2018-03-01

    Ceramic restorations are popular because of their excellent optical properties. However, failures are still a major concern, and dentists are confronted with the following question: is sleep bruxism (SB) associated with an increased frequency of ceramic restoration failures? The purpose of this systematic review and meta-analysis was to assess whether the presence of SB is associated with increased ceramic restoration failure. Observational studies and clinical trials that evaluated the short- and long-term survival rate of ceramic restorations in SB participants were selected. Sleep bruxism diagnostic criteria must have included at least 1 of the following: questionnaire, clinical evaluation, or polysomnography. Seven databases, in addition to 3 nonpeer-reviewed literature databases, were searched. The risk of bias was assessed by using the meta-analysis of statistics assessment and review instrument (MAStARI) checklist. Eight studies were included for qualitative synthesis, but only 5 for the meta-analysis. Three studies were categorized as moderate risk and 5 as high risk of bias. Clinical and methodological heterogeneity across studies were considered high. Increased hazard ratio (HR=7.74; 95% confidence interval [CI]=2.50 to 23.95) and odds ratio (OR=2.52; 95% CI=1.24 to 5.12) were observed considering only anterior ceramic veneers. Nevertheless, limited data from the meta-analysis and from the restricted number of included studies suggested that differences in the overall odds of failure concerning SB and other types of ceramic restorations did not favor or disfavor any association (OR=1.10; 95% CI=0.43 to 2.8). The overall quality of evidence was considered very low according to the GRADE criteria. Within the limitations of this systematic review, the overall result from the meta-analysis did not favor any association between SB and increased odds of failure for ceramic restorations. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry

  15. Economic analysis of the health impacts of housing improvement studies: a systematic review

    Science.gov (United States)

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-01-01

    Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

  16. Using a Systematic Approach to Identifying Organizational Factors in Root Cause Analysis

    International Nuclear Information System (INIS)

    Gallogly, Kay Wilde

    2011-01-01

    This presentation set the scene for the second discussion session. In her presentation, the author observed that: - Investigators do not see the connection between the analysis tools available and the identification of HOF. Most investigators use the tools in a cursory manner and so do not derive the full benefits of the tools. Some tools are used for presentation purposes as opposed to being used for analytical purposes e.g. event and causal factors charts. In some cases, the report will indicate that specific analytical tools were used in the investigation but the analysis is not in the body of the report. - Some investigators are documenting HOF causes but do not recognize them as such. This indicates a lack of understanding of HOF. - Others investigators focus on technical issues because of their own comfort level. - The culture of the Organisation will affect the depth of the investigation and therefore the use of the analytical tools to pursue HOF issues. - The author contends that if analysis tools are applied systematically to gather factually based data, then HOF issues can be identified. The use of factual information (without judgement and subjectivity) is important to maintain the credibility of the investigation especially when HOF issues are identified. - Systematic use of tools assists in better communication of the issues to foster greater understanding and acceptance by senior management. - Barrier Analysis, Change Analysis, and TWIN (Task Demands, Work Environment, Individual Capabilities, and Human Nature) all offer the opportunity to identify HOF issues if the analyst pursues this line of investigation. It was illustrated that many elements of the TWIN Error Precursors are themselves Organisational in nature. - The TWIN model applied to the Anatomy of an Event will help to distinguish those which are Organisational issues (Latent Organisational Weaknesses, Error Precursors and Flawed Defences) and those which are human factors (Active Errors

  17. The Systematic Approach to Training: Analysis and Evaluation in the Department of Safeguards

    International Nuclear Information System (INIS)

    Ticevic, S.; Weichselbraun, A.; Pickett, S.; Crete, J.-M.

    2015-01-01

    In applying a systematic approach to training (SAT), identifying the learning needs is the first step - a learning needs analysis allows the organization to identify the competencies required to perform a particular job. A systematic approach can provide a clear structure for training and education programme development as well as the necessary evaluation and feedback so that the organization can adjust the development accordingly and deliver the optimal learning experience. In this presentation we will describes two key elements of a SAT used in the Safeguards Training Section in the Department of Safeguards: Analysis and Evaluation. Analysis is the first part of a SAT needed to define competencies for Safeguards staff in order to improve training development within the Department. We describe the training needs analysis used to capture and articulate the various competencies required for safeguards implementation based upon an analysis of tasks and activities carried out by staff members in the Department. Firstly, we highlight the different qualitative methods used to gather information from staff and the process of evaluating and organizing this information into a structured framework. Secondly, we describe how this framework provides the necessary reference to specify learning objectives, evaluate training effectiveness, review and revise training offerings, and select appropriate training paths based on identified needs. In addition, as part of the SAT, evaluation is performed to identify the usefulness of course outcomes and improvements for future offerings based on lessons learned, to ensure that appropriate knowledge and skills are being taught and to demonstrate the value of training by meeting the organization's needs. We present how the Kirkpatrick four-level evaluation model has been implemented by Safeguards Training Section in order to evaluate course effectiveness after the training has been completed, and discuss how the current evaluation

  18. Cluster analysis and subgrouping to investigate inter-individual variability to non-invasive brain stimulation: a systematic review.

    Science.gov (United States)

    Pellegrini, Michael; Zoghi, Maryam; Jaberzadeh, Shapour

    2018-01-12

    Cluster analysis and other subgrouping techniques have risen in popularity in recent years in non-invasive brain stimulation research in the attempt to investigate the issue of inter-individual variability - the issue of why some individuals respond, as traditionally expected, to non-invasive brain stimulation protocols and others do not. Cluster analysis and subgrouping techniques have been used to categorise individuals, based on their response patterns, as responder or non-responders. There is, however, a lack of consensus and consistency on the most appropriate technique to use. This systematic review aimed to provide a systematic summary of the cluster analysis and subgrouping techniques used to date and suggest recommendations moving forward. Twenty studies were included that utilised subgrouping techniques, while seven of these additionally utilised cluster analysis techniques. The results of this systematic review appear to indicate that statistical cluster analysis techniques are effective in identifying subgroups of individuals based on response patterns to non-invasive brain stimulation. This systematic review also reports a lack of consensus amongst researchers on the most effective subgrouping technique and the criteria used to determine whether an individual is categorised as a responder or a non-responder. This systematic review provides a step-by-step guide to carrying out statistical cluster analyses and subgrouping techniques to provide a framework for analysis when developing further insights into the contributing factors of inter-individual variability in response to non-invasive brain stimulation.

  19. Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis.

    Science.gov (United States)

    Pilkington, Pamela D; Milne, Lisa C; Cairns, Kathryn E; Lewis, James; Whelan, Thomas A

    2015-06-01

    Perinatal distress is a significant public health problem that adversely impacts the individual and their family. The primary objective of this systematic review and meta-analysis was to identify factors that partners can modify to protect each other from developing perinatal depression and anxiety. In accordance with the PRISMA statement, we reviewed the risk and protective factors associated with perinatal depression and anxiety symptoms that partners can potentially modify without professional assistance (PROSPERO reference CRD42014007524). Participants were new or expectant parents aged 16 years or older. The partner factors were sub-grouped into themes (e.g., instrumental support) based on a content analysis of the scale items and measure descriptions. A series of meta-analyses were conducted to estimate the pooled effect sizes of associations. We included 120 publications, reporting 245 associations with depression and 44 with anxiety. Partner factors with sound evidence that they protect against both perinatal depression and anxiety are: emotional closeness and global support. Partner factors with a sound evidence base for depression only are communication, conflict, emotional and instrumental support, and relationship satisfaction. This review is limited by the lack of generalizability to single parents and the inability to systematically review moderators and mediators, or control for baseline symptoms. The findings suggest that future prevention programs targeting perinatal depression and anxiety should aim to enhance relationship satisfaction, communication, and emotional closeness, facilitate instrumental and emotional support, and minimize conflict between partners. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. 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 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.

  1. High-Intensity Interval Training in Heart Transplant Recipients: A Systematic Review with Meta-Analysis.

    Science.gov (United States)

    Perrier-Melo, Raphael José; Figueira, Fernando Augusto Marinho Dos Santos; Guimarães, Guilherme Veiga; Costa, Manoel da Cunha

    2018-02-01

    Heart transplantation (HTx) is considered an efficient and gold-standard procedure for patients with end-stage heart failure. After surgery, patients have lower aerobic power (VO2max) and compensatory hemodynamic responses. The aim of the present study was to assess through a systematic review with meta-analysis whether high-intensity interval training (HIIT) can provide benefits for those parameters. This is a systematic review with meta-analysis, which searched the databases and data portals PubMed, Web of Science, Scopus, Science Direct and Wiley until December 2016 (pairs). The following terms and descriptors were used: "heart recipient" OR "heart transplant recipient" OR "heart transplant" OR "cardiac transplant" OR "heart graft". Descriptors via DeCS and Mesh were: "heart transplantation'' OR "cardiac transplantation". The words used in combination (AND) were: "exercise training" OR "interval training" OR "high intensity interval training" OR "high intensity training" OR "anaerobic training" OR "intermittent training" OR "sprint training". The initial search identified 1064 studies. Then, only those studies assessing the influence of HIIT on the post-HTx period were added, resulting in three studies analyzed. The significance level adopted was 0.05. Heart transplant recipients showed significant improvement in VO2peak, heart rate and peak blood pressure in 8 to 12 weeks of intervention.

  2. Body checking and body avoidance in eating disorders: Systematic review and meta-analysis.

    Science.gov (United States)

    Nikodijevic, Alexandra; Buck, Kimberly; Fuller-Tyszkiewicz, Matthew; de Paoli, Tara; Krug, Isabel

    2018-05-01

    This review sought to systematically review and quantify the evidence related to body checking and body avoidance in eating disorders (EDs) to gauge the size of effects, as well as examine potential differences between clinical and nonclinical populations, and between different ED subtypes. PsycINFO, PsycARTICLES, PsycEXTRA, Cochrane Library, and MEDLINE databases were searched for academic literature published until October 2017. A grey literature search was also conducted. Fifty-two studies were identified for the systematic review, of which 34 were eligible for meta-analysis. Only female samples were included in the meta-analysis. ED cases experienced significantly higher body checking (d = 1.26, p < .001) and body avoidance (d = 1.88, p < .001) overall relative to healthy controls, but neither behaviour varied by ED subtype. In nonclinical samples, body checking (r = .60) and body avoidance (r = .56) were significantly correlated with ED pathology (p < .001). These findings support transdiagnostic theoretical models and approaches to ED treatment and early intervention programmes. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

  3. Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Thomas Fonseka

    2015-03-01

    Full Text Available Objective: To conduct a systematic review and meta-analysis comparing outcomes between Open Radical Cystectomy (ORC, Laparoscopic Radical Cystectomy (LRC and Robot-assisted Radical Cystectomy (RARC. RARC is to be compared to LRC and ORC and LRC compared to ORC. Material and methods: A systematic review of the literature was conducted, collating studies comparing RARC, LRC and ORC. Surgical and oncological outcome data were extracted and a meta-analysis was performed. Results: Twenty-four studies were selected with total of 2,104 cases analyzed. RARC had a longer operative time (OPT compared to LRC with no statistical difference between length of stay (LOS and estimated blood loss (EBL. RARC had a significantly shorter LOS, reduced EBL, lower complication rate and longer OPT compared to ORC. There were no significant differences regarding lymph node yield (LNY and positive surgical margins (PSM. LRC had a reduced EBL, shorter LOS and increased OPT compared to ORC. There was no significant difference regarding LNY. Conclusion: RARC is comparable to LRC with better surgical results than ORC. LRC has better surgical outcomes than ORC. With the unique technological features of the robotic surgical system and increasing trend of intra-corporeal reconstruction it is likely that RARC will become the surgical option of choice.

  4. Effects of joint stabilizers on proprioception and stability: A systematic review and meta-analysis.

    Science.gov (United States)

    Ghai, Shashank; Driller, Matthew; Ghai, Ishan

    2017-05-01

    The current review and meta-analysis systematically investigated the effect of joint stabilizers on proprioception, postural stability, and neurological activity. Systematic identification of published literature was performed on online databases; Scopus, PEDro, SportDiscus, and EMBASE, followed by a critical PEDro methodological quality appraisal. Data from the studies were extracted and summarized in a tabular format. Of 2954 records, 50 studies, involving 1443 participants met our inclusion criteria. In the included studies, 60% of studies reported significant enhancements (p  0.05) and 21% of studies reported no effects of joint stabilizers on proprioception and/or postural stability. Meta-analysis of pooled studies demonstrated beneficial effects of joint stabilizers on the knee (95% CI: 0.35°-0.61°) and ankle (at 10: 0.1°-0.65°) joint proprioception, and negligible effects on postural stability (-0.28°-0.19°). The pooled evidence suggests that application of joint stabilizers enhances joint proprioception and stability by not merely altering the mechanical stability of the underlying musculoskeletal structures but by also causing subtle changes in cerebral haemodynamics and musculoskeletal activation. These findings support clinical implications of joint stabilizers as a prophylactic and rehabilitation measure in modern sports and rehabilitation settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Prevalence and Predictors of Clozapine-Associated Constipation: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Shirazi, Ayala; Stubbs, Brendon; Gomez, Lucia; Moore, Susan; Gaughran, Fiona; Flanagan, Robert J; MacCabe, James H; Lally, John

    2016-06-02

    Constipation is a frequently overlooked side effect of clozapine treatment that can prove fatal. We conducted a systematic review and meta-analysis to estimate the prevalence and risk factors for clozapine-associated constipation. Two authors performed a systematic search of major electronic databases from January 1990 to March 2016 for articles reporting the prevalence of constipation in adults treated with clozapine. A random effects meta-analysis was conducted. A total of 32 studies were meta-analyzed, establishing a pooled prevalence of clozapine-associated constipation of 31.2% (95% CI: 25.6-37.4) (n = 2013). People taking clozapine were significantly more likely to be constipated versus other antipsychotics (OR 3.02 (CI: 1.91-4.77), p studies). Meta-regression identified two significant study-level factors associated with constipation prevalence: significantly higher (p = 0.02) rates of constipation were observed for those treated in inpatient versus outpatient or mixed settings and for those studies in which constipation was a primary or secondary outcome measure (36.9%) compared to studies in which constipation was not a specified outcome measure (24.8%, p = 0.048). Clozapine-associated constipation is common and approximately three times more likely than with other antipsychotics. Screening and preventative strategies should be established and appropriate symptomatic treatment applied when required.

  6. Social science and linguistic text analysis of nurses' records: a systematic review and critique.

    Science.gov (United States)

    Buus, Niels; Hamilton, Bridget Elizabeth

    2016-03-01

    The two aims of the paper were to systematically review and critique social science and linguistic text analyses of nursing records in order to inform future research in this emerging area of research. Systematic searches in reference databases and in citation indexes identified 12 articles that included analyses of the social and linguistic features of records and recording. Two reviewers extracted data using established criteria for the evaluation of qualitative research papers. A common characteristic of nursing records was the economical use of language with local meanings that conveyed little information to the uninitiated reader. Records were dominated by technocratic-medical discourse focused on patients' bodies, and they depicted only very limited aspects of nursing practice. Nurses made moral evaluations in their categorisation of patients, which reflected detailed surveillance of patients' disturbing behaviour. The text analysis methods were rarely transparent in the articles, which could suggest research quality problems. For most articles, the significance of the findings was substantiated more by theoretical readings of the institutional settings than by the analysis of textual data. More probing empirical research of nurses' records and a wider range of theoretical perspectives has the potential to expose the situated meanings of nursing work in healthcare organisations. © 2015 John Wiley & Sons Ltd.

  7. The efficacy of motivational interviewing for disordered gambling: systematic review and meta-analysis.

    Science.gov (United States)

    Yakovenko, Igor; Quigley, Leanne; Hemmelgarn, Brenda R; Hodgins, David C; Ronksley, Paul

    2015-04-01

    Motivational interviewing is a client-centered therapeutic intervention that aims to resolve ambivalence toward change. We conducted a systematic review and meta-analysis on the efficacy of motivational interviewing, compared to non-motivational interviewing controls, in the treatment of disordered gambling. Electronic databases were searched for randomized controlled trials that evaluated change in gambling behavior using motivational interviewing in adult disordered gamblers. The primary outcomes were the weighted mean difference (WMD) for change in average days gambled per month and average dollars lost per month. The search strategy yielded 447 articles, of which 20 met criteria for full text review. Overall, 8 studies (N=730) fulfilled the inclusion criteria for systematic review and 5 (N=477) were included in the meta-analysis. Motivational interviewing was associated with significant reduction in gambling frequency up to a year after treatment delivery. For gambling expenditure, motivational interviewing yielded significant reductions in dollars spent gambling compared to non-motivational controls at post-treatment only (1-3 months). Overall, the results of this review suggest that motivational interviewing is an efficacious style of therapy for disordered gambling in the short term. Whether treatment effects are maintained over time remains unclear. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Childhood neglect in eating disorders: A systematic review and meta-analysis.

    Science.gov (United States)

    Pignatelli, Annalisa M; Wampers, Martien; Loriedo, Camillo; Biondi, Massimo; Vanderlinden, Johan

    2017-01-01

    Individuals with eating disorders (EDs) often report a history of early traumatization. Although great attention has been paid to certain types of trauma, such as sexual and emotional abuse, less is known about the occurrence of childhood neglect in individuals with EDs. The aim of the present meta-analysis was to provide an estimate of the prevalence of childhood emotional neglect (EN) and physical neglect (PN) in individuals with EDs. A systematic literature search, a critical appraisal of the collected studies, and a meta-analysis were conducted. An electronic search of EMBASE, PsycINFO, PubMed, and the Cochrane Library from the inception of these databases up to July 2015 was performed. The final meta-analyzed data set included 7 studies focusing on EN in EDs (N = 963) and 6 on PN in EDs (N = 665). Our meta-analytic data showed that among individuals with EDs, the prevalence of childhood EN is 53.3%, whereas 45.4% reported experience of childhood PN. These preliminary findings confirm the high prevalence of childhood EN and PN in ED samples compared to the general population and underline the importance of systematically screening for the presence of neglect as a possible traumatic experience in individuals with EDs, as its presence may have important consequences for the therapeutic approach.

  9. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis.

    Science.gov (United States)

    Steffl, Michal; Bohannon, Richard W; Sontakova, Lenka; Tufano, James J; Shiells, Kate; Holmerova, Iva

    2017-01-01

    Physical activity (PA) has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCO host , and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37-0.55). The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia.

  10. Benign Paroxysmal Positional Vertigo of Lateral Semicircular Canal: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Aly M. Nagy El-Makhzangy

    2015-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is the most common cause of vertigo of peripheral origin. The lateral semicircular canal (LSCC follows the posterior semicircular canal (PSCC as the site of pathology in the majority of patients. Therapy, aiming at relocating particles causing aberrant LSCC stimulation has been applied by forced prolonged positioning, barbecue, and particle repositioning maneuvers. Results of the different techniques are variable. This systematic review/meta-analysis aimed to find out which therapy technique yields higher cure rates. MedLine database provided at National Library of Medicine was searched for randomized controlled trials comparing results of different therapeutic techniques for patients with LSCC BPPV. For studies included in qualitative analysis/synthesis, the following were collected independently by the author: number of participants, count of patients with geotropic and apogeotropic LSCC in each treatment group, and resolution of vertigo/nystagmus assessed by symptomatic improvement and negative supine roll test 1–24 hours following intervention considering the type of LSCC BPPV (geotropic/apogeotropic. Level Ia evidence (systematic review of RCTs shows superiority of Gufoni maneuver over sham for both geotropic and apogeotropic LSCC BPPV. Comparisons between different therapeutic maneuvers for LSCC BPPV based on results of published RCTs could not be set.

  11. Prognostic Value of MACC1 in Digestive System Neoplasms: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Wu, Zhenzhen; Zhou, Rui; Su, Yuqi; Sun, Li; Liao, Yulin; Liao, Wangjun

    2015-01-01

    Metastasis associated in colon cancer 1 (MACC1), a newly identified oncogene, has been associated with poor survival of cancer patients by multiple studies. However, the prognostic value of MACC1 in digestive system neoplasms needs systematic evidence to verify. Therefore, we aimed to provide further evidence on this topic by systematic review and meta-analysis. Literature search was conducted in multiple databases and eligible studies analyzing survival data and MACC1 expression were included for meta-analysis. Hazard ratio (HR) for clinical outcome was chosen as an effect measure of interest. According to our inclusion criteria, 18 studies with a total of 2,948 patients were identified. Pooled HRs indicated that high MACC1 expression significantly correlates with poorer OS in patients with digestive system neoplasms (HR = 1.94; 95% CI: 1.49-2.53) as well as poorer relapse-free survival (HR = 1.94, 95% CI: 1.33-2.82). The results of subgroup studies categorized by methodology, anatomic structure, and cancer subtype for pooled OS were all consistent with the overall pooled HR for OS as well. No publication bias was detected according to test of funnel plot asymmetry and Egger's test. In conclusion, high MACC1 expression may serve as a prognostic biomarker to guide individualized management in clinical practice for digestive system neoplasms.

  12. Hepatitis C virus infections in oral lichen planus: a systematic review and meta-analysis.

    Science.gov (United States)

    Alaizari, N A; Al-Maweri, S A; Al-Shamiri, H M; Tarakji, B; Shugaa-Addin, B

    2016-09-01

    A role for hepatitis C virus in oral lichen planus has been postulated. This systematic review and meta-analysis of the existing epidemiological studies was conducted to determine if there is a correlation between oral lichen planus and hepatitis C virus infection. We examined the association between hepatitis C virus and oral lichen planus by conducting a systematic review and meta-analysis of case-control studies that examined the prevalence of anti-HCV antibodies in the serum of cases and controls. We searched PubMed, Embase and The Cochrane Library databases from 2005 to January 2015. Associations were measured using random-effect odds ratios (ORs) combined with 95% confidence intervals. Nineteen eligible studies, encompassing 1807 cases of OLP and 2519 controls, were retrieved and included in this review. The summary estimate OR for all studies was 6.07 (95% CI: 2.73-13.48), showing a statistically significant difference in the proportion of HCV seropositivity among oral lichen planus patients, compared with controls and substantial heterogeneity between studies (I(2) = 65%) as a result of a variety of geographical distributions. The association of hepatitis C virus infection with oral lichen planus emphasizes the importance of hepatitis C virus screening in oral lichen planus patients. © 2015 Australian Dental Association.

  13. Meta-epidemiologic analysis indicates that MEDLINE searches are sufficient for diagnostic test accuracy systematic reviews.

    Science.gov (United States)

    van Enst, Wynanda A; Scholten, Rob J P M; Whiting, Penny; Zwinderman, Aeilko H; Hooft, Lotty

    2014-11-01

    To investigate how the summary estimates in diagnostic test accuracy (DTA) systematic reviews are affected when searches are limited to MEDLINE. A systematic search was performed to identify DTA reviews that had conducted exhaustive searches and included a meta-analysis. Primary studies included in selected reviews were assessed to determine whether they were indexed on MEDLINE. The effect of omitting non-MEDLINE studies from meta-analyses was investigated by calculating the summary relative diagnostic odds ratio (RDORs) = DORMEDLINE only/DORall studies. We also calculated the summary difference in sensitivity and specificity between all studies and only MEDLINE-indexed studies. Ten reviews contributing 15 meta-analyses met inclusion criteria for quantitative analysis. The RDOR comparing MEDLINE-only studies with all studies was 1.04 (95% confidence interval [CI], 0.95, 1.15). Summary estimates of sensitivity and specificity remained almost unchanged (difference in sensitivity: -0.08%; 95% CI -1% to 1%; difference in specificity: -0.1%; 95% CI -0.8% to 1%). Restricting to studies indexed on MEDLINE did not influence the summary estimates of the meta-analyses in our sample. In certain circumstances, for instance, when resources are limited, it may be appropriate to restrict searches to MEDLINE. However, the impact on individual reviews cannot be predicted. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Racism and health service utilisation: A systematic review and meta-analysis.

    Science.gov (United States)

    Ben, Jehonathan; Cormack, Donna; Harris, Ricci; Paradies, Yin

    2017-01-01

    Although racism has been posited as driver of racial/ethnic inequities in healthcare, the relationship between racism and health service use and experience has yet to be systematically reviewed or meta-analysed. This paper presents a systematic review and meta-analysis of quantitative empirical studies that report associations between self-reported racism and various measures of healthcare service utilisation. Data were reviewed and extracted from 83 papers reporting 70 studies. Studies included 250,850 participants and were conducted predominately in the U.S. The meta-analysis included 59 papers reporting 52 studies, which were analysed using random effects models and mean weighted effect sizes. Racism was associated with more negative patient experiences of health services (HSU-E) (OR = 0.351 (95% CI [0.236,0.521], k = 19), including lower levels of healthcare-related trust, satisfaction, and communication. Racism was not associated with health service use (HSU-U) as an outcome group, and was not associated with most individual HSU-U outcomes, including having had examinations, health service visits and admissions to health professionals and services. Racism was associated with health service use outcomes such as delaying/not getting healthcare, and lack of adherence to treatment uptake, although these effects may be influenced by a small sample of studies, and publication bias, respectively. Limitations to the literature reviewed in terms of study designs, sampling methods and measurements are discussed along with suggested future directions in the field.

  15. Efficacy and safety of Carica papaya leaf extract in the dengue: A systematic review and meta-analysis

    OpenAIRE

    Charan, Jaykaran; Saxena, Deepak; Goyal, Jagdish Prasad; Yasobant, Sandul

    2016-01-01

    Background: Dengue is an infectious disease associated with high mortality and morbidity. Being a viral disease, there is no specific drug available for treatment. There are some reports that Carica papaya leaf extract may improve the clinical condition of dengue patients; however, to support this, at present, there is no systematically searched and synthesized evidence available. Objectives: This systematic review and meta-analysis was designed to search the available evidence related to the...

  16. Association of Epicardial Adipose Tissue and High?Risk Plaque Characteristics: A Systematic Review and Meta?Analysis

    OpenAIRE

    Nerlekar, Nitesh; Brown, Adam J.; Muthalaly, Rahul G.; Talman, Andrew; Hettige, Thushan; Cameron, James D.; Wong, Dennis T. L.

    2017-01-01

    Background Epicardial adipose tissue (EAT) is hypothesized to alter atherosclerotic plaque composition, with potential development of high?risk plaque (HRP). EAT can be measured by volumetric assessment (EAT?v) or linear thickness (EAT?t). We performed a systematic review and random?effects meta?analysis to assess the association of EAT with HRP and whether this association is dependent on the measurement method used. Methods and Results Electronic databases were systematically searched up to...

  17. 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 ...

  18. Decision-making in obesity without eating disorders: a systematic review and meta-analysis of Iowa gambling task performances

    OpenAIRE

    Rotge, J. Y.; Poitou, C.; Fossati, P.; Aron-Wisnewsky, J.; Oppert, J.-M.

    2017-01-01

    International audience; Background: There is evidence that obesity is associated with impairments in executive functions, such as deficits in decision-making, planning or problem solving, which might interfere with weight loss in obese individuals. We performed a systematic review and meta-analysis of decision-making abilities, as measured with the Iowa gambling task (IGT), in obesity without eating disorders.Methods: A systematic search was conducted to identify studies comparing IGT perform...

  19. Ontology-based systematic representation and analysis of traditional Chinese drugs against rheumatism.

    Science.gov (United States)

    Liu, Qingping; Wang, Jiahao; Zhu, Yan; He, Yongqun

    2017-12-21

    Rheumatism represents any disease condition marked with inflammation and pain in the joints, muscles, or connective tissues. Many traditional Chinese drugs have been used for a long time to treat rheumatism. However, a comprehensive information source for these drugs is still missing, and their anti-rheumatism mechanisms remain unclear. An ontology for anti-rheumatism traditional Chinese drugs would strongly support the representation, analysis, and understanding of these drugs. In this study, we first systematically collected reported information about 26 traditional Chinese decoction pieces drugs, including their chemical ingredients and adverse events (AEs). By mostly reusing terms from existing ontologies (e.g., TCMDPO for traditional Chinese medicines, NCBITaxon for taxonomy, ChEBI for chemical elements, and OAE for adverse events) and making semantic axioms linking different entities, we developed the Ontology of Chinese Medicine for Rheumatism (OCMR) that includes over 3000 class terms. Our OCMR analysis found that these 26 traditional Chinese decoction pieces are made from anatomic entities (e.g., root and stem) from 3 Bilateria animals and 23 Mesangiospermae plants. Anti-inflammatory and antineoplastic roles are important for anti-rheumatism drugs. Using the total of 555 unique ChEBI chemical entities identified from these drugs, our ChEBI-based classification analysis identified 18 anti-inflammatory, 33 antineoplastic chemicals, and 9 chemicals (including 3 diterpenoids and 3 triterpenoids) having both anti-inflammatory and antineoplastic roles. Furthermore, our study detected 22 diterpenoids and 23 triterpenoids, including 16 pentacyclic triterpenoids that are likely bioactive against rheumatism. Six drugs were found to be associated with 184 unique AEs, including three AEs (i.e., dizziness, nausea and vomiting, and anorexia) each associated with 5 drugs. Several chemical entities are classified as neurotoxins (e.g., diethyl phthalate) and allergens (e

  20. 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

  1. Compliance of systematic reviews in veterinary journals with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) literature search reporting guidelines.

    Science.gov (United States)

    Toews, Lorraine C

    2017-07-01

    Complete, accurate reporting of systematic reviews facilitates assessment of how well reviews have been conducted. The primary objective of this study was to examine compliance of systematic reviews in veterinary journals with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for literature search reporting and to examine the completeness, bias, and reproducibility of the searches in these reviews from what was reported. The second objective was to examine reporting of the credentials and contributions of those involved in the search process. A sample of systematic reviews or meta-analyses published in veterinary journals between 2011 and 2015 was obtained by searching PubMed. Reporting in the full text of each review was checked against certain PRISMA checklist items. Over one-third of reviews (37%) did not search the CAB Abstracts database, and 9% of reviews searched only 1 database. Over two-thirds of reviews (65%) did not report any search for grey literature or stated that they excluded grey literature. The majority of reviews (95%) did not report a reproducible search strategy. Most reviews had significant deficiencies in reporting the search process that raise questions about how these searches were conducted and ultimately cast serious doubts on the validity and reliability of reviews based on a potentially biased and incomplete body of literature. These deficiencies also highlight the need for veterinary journal editors and publishers to be more rigorous in requiring adherence to PRISMA guidelines and to encourage veterinary researchers to include librarians or information specialists on systematic review teams to improve the quality and reporting of searches.

  2. Systematic Review and Meta-Analysis of Neuropsychiatric Symptoms and Executive Functioning in Adults With Phenylketonuria

    Science.gov (United States)

    Bilder, Deborah A.; Noel, J. Kay; Baker, Erin R.; Irish, William; Chen, Yinpu; Merilainen, Markus J.; Prasad, Suyash; Winslow, Barbara J.

    2016-01-01

    ABSTRACT This systematic review and meta-analysis (MA) investigates the impact of elevated blood phenylalanine (Phe) on neuropsychiatric symptoms in adults with phenylketonuria (PKU). The meta-analysis of PKU is challenging because high-quality evidence is lacking due to the limited number of affected individuals and few placebo-controlled, double-blind studies of adults with high and low blood Phe. Neuropsychiatric symptoms associated with PKU exceed general population estimates for inattention, hyperactivity, depression, and anxiety. High Phe is associated with an increased prevalence of neuropsychiatric symptoms and executive functioning deficits whereas low Phe is associated with improved neurological performance. Findings support lifelong maintenance of low blood Phe. PMID:27805419

  3. Current understanding of bleeding with ibrutinib use: a systematic review and meta-analysis.

    Science.gov (United States)

    Caron, François; Leong, Darryl P; Hillis, Christopher; Fraser, Graeme; Siegal, Deborah

    2017-05-09

    Ibrutinib therapy was associated with an increased risk of bleeding in previous trials. In this systematic review and meta-analysis of published trials including patients treated with ibrutinib, the relative risk (95% confidence interval [CI]) of overall bleeding was significantly higher in ibrutinib recipients (2.72 [1.62-6.58]), but major bleeding did not show a significant difference (1.66 [0.96-2.85]). The incidences (95% CI) of major bleeding and any bleeding were 3.0 (2.3-3.7) and 20.8 (19.1-22.1) per 100 patient-years, respectively. This analysis is limited by reporting bias from variable ascertainment of bleeding and lack of allocation concealment in some studies and differing exposures between groups, leading to potential overestimation of event rates in the ibrutinib group.

  4. Design of sustainable chemical processes: Systematic retrofit analysis, generation and evaluation alternatives

    DEFF Research Database (Denmark)

    Carvalho, Ana; Gani, Rafiqul; Matos, Henrique

    2008-01-01

    eliminating the need to identify trade-off-based solutions. These indicators are also able to reduce (where feasible) a set of safety indicators. An indicator sensitivity analysis algorithm has been added to the methodology to define design targets and to generate sustainable process alternatives. A computer......The objective of this paper is to present a generic and systematic methodology for identifying the feasible retrofit design alternatives of any chemical process. The methodology determines a set of mass and energy indicators from steady-state process data, establishes the operational and design...... targets, and through a sensitivity-based analysis, identifies the design alternatives that can match a set of design targets. The significance of this indicator-based method is that it is able to identify alternatives, where one or more performance criteria (factors) move in the same direction thereby...

  5. Oral Health of Children With Attention Deficit Hyperactivity Disorder: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Chau, Yvonne C Y; Peng, Si-Min; McGrath, Colman P J; Yiu, Cynthia K Y

    2017-11-01

    This systematic review investigated the oral health of children with ADHD. A structured search strategy was performed on five electronic databases: SCOPUS, Web of Science, COCHRANE, PubMed, and PsychInfo. Studies were included in the review if they reported clinical oral health outcomes on a population diagnosed with ADHD under the age of 18 years old. Qualitative and quantitative analysis was performed on pooled prevalence and mean/median values for caries, trauma, periodontal problems, and tooth wear. Twenty-seven effective articles were reviewed by two calibrated assessors. Meta-analysis of the results found higher mean number of decayed surfaces, plaque index, and trauma prevalence among children with ADHD. Children with ADHD show increased risk for caries and traumatic dental injuries, and may have poorer oral hygiene compared with children without ADHD. More awareness among clinicians would promote better caries- and trauma-preventive advice and management.

  6. Risk of ischemic stroke in patients with systemic sclerosis: A systematic review and meta-analysis.

    Science.gov (United States)

    Ungprasert, Patompong; Sanguankeo, Anawin; Upala, Sikarin

    2016-01-01

    Several chronic inflammatory disorders, such as rheumatoid arthritis and idiopathic inflammatory myositis, have been shown to increase risk of ischemic stroke but the data on systemic sclerosis (SSc) remains unclear. We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing risk of ischemic stroke in patients with SSc versus non-SSc participants. Pooled risk ratio and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. Four retrospective cohort studies were identified and included in our data analysis. We found a statistically significant elevated ischemic stroke risk in patients with SSc with a pooled risk ratio of 1.68 (95% CI, 1.26-2.24). The statistical heterogeneity was moderate with an I(2) of 69%. Our study demonstrated a statistically significant increased ischemic stroke risk among patients with SSc.

  7. Patient Education and Peritoneal Dialysis Modality Selection: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Devoe, Daniel J; Wong, Ben; James, Matthew T; Ravani, Pietro; Oliver, Matthew J; Barnieh, Lianne; Roberts, Derek J; Pauly, Robert; Manns, Braden J; Kappel, Joanne; Quinn, Robert R

    2016-09-01

    Educational interventions are increasingly used to promote peritoneal dialysis (PD), the most common form of home therapy for end-stage renal disease. A systematic review of the evidence in support of dialysis modality education is needed to inform the design of patient-targeted interventions to increase selection of PD. We performed a systematic review and meta-analysis to characterize the relationship between patient-targeted educational interventions and choosing and receiving PD. Systematic review and meta-analysis. Published original studies and abstracts. We searched MEDLINE, EMBASE, CINAHL and EBMR. We included controlled observational studies and randomized trials of educational interventions designed to increase PD selection. Predialysis educational interventions. The primary outcome was choosing PD, defined as intention to use PD regardless of whether PD was ever used. The secondary outcome, receiving PD, was defined as an individual receiving PD as his or her treatment. Of 3,540 citations, 15 studies met our inclusion criteria, including 1 randomized trial. In the single randomized trial (N=70), receipt of an educational intervention was associated with a more than 4-fold increase in the odds of choosing PD (OR, 4.60; 95% CI, 1.19-17.74). Based on results from 4 observational studies (N=7,653), patient-targeted educational interventions were associated with a 2-fold increase in the odds of choosing PD (pooled OR, 2.15; 95% CI, 1.07-4.32; I(2)=76.7%). Based on results from 9 observational studies (N=8,229), patient-targeted educational intervention was associated with a 3-fold increase in the odds of receiving PD as the initial treatment modality (OR, 3.50; 95% CI, 2.82-4.35; I(2)=24.9%). Most studies were observational studies, which can establish an association between education and choosing PD or receiving PD, but does not establish causality. This systematic review demonstrates a strong association between patient-targeted education interventions and

  8. Systematic review on sports performance in beach volleyball from match analysis

    Directory of Open Access Journals (Sweden)

    Alexandre Igor Araripe Medeiros

    2014-10-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2014v16n6p698   The present article aimed to perform a systematic review of the available literature in relation to the analysis of sports performance in beach volleyball from match analysis. Web of Science, SportDiscus®, PubMed, Scopus and Academic Search Complete databases were used to identify peer-reviewed published articles. The authors conducted a content analysis according to goals, variables of analysis and methods used in studies. In general, three research lines were determined: analysis of the functional dependence of the game actions and their relation with success, performance according to gender, and the effect of changing the rules on the game performance. In relation to methodology, an evolution from descriptive studies to studies of comparative nature can be seen and, more recently, there has been a focus on predictive nature. This new trend breaks with the research based on simple cause and effect relations, and focuses on the analysis of the game events, namely related to tactical-technical performance indicators, in a non-linear and interactive way, considering the game as a complex and dynamic system. The limitations of the studies analyzed show the need for further studies to investigate the identification of game patterns for the different game levels; integration of situational variables in the study of the performance of teams (such as match status and the quality of opposition.

  9. The role of Pap test screening against cervical cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Meggiolaro, A; Unim, B; Semyonov, L; Miccoli, S; Maffongelli, E; La Torre, G

    2016-01-01

    The first aim of this article is to quantify the role of Pap test in cervical cancer prevention, updating the pool of available studies included in a previous meta-analysis. Potential sources of meta-analysis heterogeneity were investigated as second aim. Further evidence of cost-effectiveness has been provided about age and best time interval to perform Pap test screening. The articles' search was conducted using four medical electronic databases: PubMed, Google Scholar, ISI Web, and Scopus. Papers published until the 30th November 2013 were included. The research on Google Scholar was limited to the first 10 pages of web for each study design. A systematic review/meta-analysis was performed according to PRISMA Statement. New-Castle-Ottawa Scale and Jadad have been adopted for articles quality assessment. From 4143 screened articles, 34 met eligibility criteria and 30 case-control studies were included in meta-analysis. Meta-analysis was carried out using StatsDirect2.8.0. Heterogeneity was investigated with qualitative and quantitative approaches in sensitivity-analysis. Despite a great heterogeneity (Cochran Q=504.466, df=29, pPap test has been identified (OR=0.33; 95%CI=0.268-0.408, P Pap test against cervical cancer has been confirmed especially among women <40 years. Annual screening still remains the most cost-effective preventive strategy.

  10. Effects of chlorhexidine varnish on caries during orthodontic treatment: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Elaine Machado Pingueiro OKADA

    Full Text Available Abstract This study aimed to perform a systematic review and meta-analysis to evaluate the effectiveness of chlorhexidine varnish on the reduction of caries incidence during fixed orthodontic treatment. The literature searches involved The Cochrane Library, Medline, Scopus, OpenSigle databases and manual searches. The search on OpenSigle did not produce any additional articles. Clinical studies conducted in patients with orthodontic fixed appliances that used professional application of chlorhexidine varnish were included. The effect-size was calculated and a meta-analysis was performed. From 182 abstracts, a total of six articles fulfilled the inclusion criteria. After reading the full articles, one was excluded because of lack of a control group. Three articles were used for continuous data analysis, and two articles were used for the dichotomous data analysis. The pooled meta-analysis with continuous data demonstrated chlorhexidine varnish effectiveness on caries reduction (p = 0.003, with a mean difference and confidence interval of −1.49 [−2.47, −0.51]. On the basis of the pooled meta-analysis of continuous data, we were able to conclude that professional application of chlorhexidine varnish is effective in caries incidence reduction during fixed orthodontic treatment.

  11. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Huang, Ruixue; Wang, Ke; Hu, Jianan

    2016-08-06

    It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder) = -0.30, 95% CI (-0.51--0.09), p = 0.005) in the subjects. Probiotics had an effect on both the healthy population (MD = -0.25, 95% CI (-0.47--0.03), p = 0.03) and patients with major depressive disorder (MDD) (MD = -0.73, 95% CI (-1.37--0.09), p = 0.03). Probiotics had an effect on the population aged under 60 (MD = -0.43, 95% CI (-0.72--0.13), p = 0.005), while it had no effect on people aged over 65 (MD = -0.18, 95% CI (-0.47-0.11), p = 0.22). This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.

  12. Systematic identification and analysis of frequent gene fusion events in metabolic pathways.

    Science.gov (United States)

    Henry, Christopher S; Lerma-Ortiz, Claudia; Gerdes, Svetlana Y; Mullen, Jeffrey D; Colasanti, Ric; Zhukov, Aleksey; Frelin, Océane; Thiaville, Jennifer J; Zallot, Rémi; Niehaus, Thomas D; Hasnain, Ghulam; Conrad, Neal; Hanson, Andrew D; de Crécy-Lagard, Valérie

    2016-06-24

    Gene fusions are the most powerful type of in silico-derived functional associations. However, many fusion compilations were made when fusions need updating to handle the current avalanche of sequenced genomes. The availability of a large fusion dataset would help probe functional associations and enable systematic analysis of where and why fusion events occur. Here we present a systematic analysis of fusions in prokaryotes. We manually generated two training sets: (i) 121 fusions in the model organism Escherichia coli; (ii) 131 fusions found in B vitamin metabolism. These sets were used to develop a fusion prediction algorithm that captured the training set fusions with only 7 % false negatives and 50 % false positives, a substantial improvement over existing approaches. This algorithm was then applied to identify 3.8 million potential fusions across 11,473 genomes. The results of the analysis are available in a searchable database at http://modelseed.org/projects/fusions/ . A functional analysis identified 3,000 reactions associated with frequent fusion events and revealed areas of metabolism where fusions are particularly prevalent. Customary definitions of fusions were shown to be ambiguous, and a stricter one was proposed. Exploring the genes participating in fusion events showed that they most commonly encode transporters, regulators, and metabolic enzymes. The major rationales for fusions between metabolic genes appear to be overcoming pathway bottlenecks, avoiding toxicity, controlling competing pathways, and facilitating expression and assembly of protein complexes. Finally, our fusion dataset provides powerful clues to decipher the biological activities of domains of unknown function.

  13. Regression and local control rates after radiotherapy for jugulotympanic paragangliomas: Systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Hulsteijn, Leonie T. van; Corssmit, Eleonora P.M.; Coremans, Ida E.M.; Smit, Johannes W.A.; Jansen, Jeroen C.; Dekkers, Olaf M.

    2013-01-01

    The primary treatment goal of radiotherapy for paragangliomas of the head and neck region (HNPGLs) is local control of the tumor, i.e. stabilization of tumor volume. Interestingly, regression of tumor volume has also been reported. Up to the present, no meta-analysis has been performed giving an overview of regression rates after radiotherapy in HNPGLs. The main objective was to perform a systematic review and meta-analysis to assess regression of tumor volume in HNPGL-patients after radiotherapy. A second outcome was local tumor control. Design of the study is systematic review and meta-analysis. PubMed, EMBASE, Web of Science, COCHRANE and Academic Search Premier and references of key articles were searched in March 2012 to identify potentially relevant studies. Considering the indolent course of HNPGLs, only studies with ⩾12 months follow-up were eligible. Main outcomes were the pooled proportions of regression and local control after radiotherapy as initial, combined (i.e. directly post-operatively or post-embolization) or salvage treatment (i.e. after initial treatment has failed) for HNPGLs. A meta-analysis was performed with an exact likelihood approach using a logistic regression with a random effect at the study level. Pooled proportions with 95% confidence intervals (CI) were reported. Fifteen studies were included, concerning a total of 283 jugulotympanic HNPGLs in 276 patients. Pooled regression proportions for initial, combined and salvage treatment were respectively 21%, 33% and 52% in radiosurgery studies and 4%, 0% and 64% in external beam radiotherapy studies. Pooled local control proportions for radiotherapy as initial, combined and salvage treatment ranged from 79% to 100%. Radiotherapy for jugulotympanic paragangliomas results in excellent local tumor control and therefore is a valuable treatment for these types of tumors. The effects of radiotherapy on regression of tumor volume remain ambiguous, although the data suggest that regression can

  14. [Application of systematic etiological analysis in final and differential diagnosis of hereditary hemolytic anemia].

    Science.gov (United States)

    Li, J Y; Gu, H H; Zheng, S J; Zha, Z S; Hua, M X; Jiang, J J; Cai, B; Zhou, L; Jia, Y; Fang, C P; Qian, B H

    2016-06-14

    Study on the application of the systematic analysis strategies of etiology in final and differential diagnosis of hereditary hemolytic anemia (HHA). Analysis of 1 506 patients with suspected hemolytic anemia (HA) in systematic hemolytic etiological analysis. ①1 413(94%) of the total 1 506 patients [male 799, female 707, median age 22-year-old (4 days to 86-year-old) ]were caused by membranopathy, hemoglobinopathy and enzymopathy, documented the three major causes of HHA. 369 cases (26%) of the 1 413 patients showed complex type of HA, which had the coexistence of two or more hereditary defects concerning HA in red cells, the other 1 044 cases (74%) were HA with single hemolytic cause. ②In 1 044 cases of single HA, hemoglobinopathy, membranopathy and enzymopathy was 22%, 63% and 15%, respectively. When single HA plused complex HA, the hemoglobinopathy, membranopathy and enzymopathy was 29%, 57% and 14% respectively. The difference was not statistically significant (P >0.05). ③ The most common double heterozygosis with different genetic defects was hemoglobinopathy complicated with membranopathy (50%, 184/369). The complex HA was also found in patients with the enzymopathy complicated with membranopathy (18%, 66/369) and with hemoglobinopathy (4%, 13/369). Some of complex HA patients had the same kinds of genetic defects which means double hemoglobinopathies (29 cases, 8% ), membranopathies (57 cases, 15% ) and enzymopathies (9 cases, 2%). Other kinds (11 cases, 3%) of complex HA, anemia and jaundice were seen in HAA patients accompanied with acquired and secondary defects or other system abnormalities. The parallel etiologic examination of three major genetic hemolytic diseases can be 94% of patients for classification. The results showed that the first cause of HAA was membranopathy, second hemoglobinopathy and then enzymopathy. Complex hemolysis is not uncommon and single factor analysis alone is not enough to provide scientific basis for diagnosis.

  15. Association between depression and resilience in older adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Wermelinger Ávila, Maria Priscila; Lucchetti, Alessandra Lamas Granero; Lucchetti, Giancarlo

    2017-03-01

    The objective of this study is to determine whether resilience is associated with depressive symptoms in geriatric populations. A systematic review and meta-analysis were performed (up to March 2015) following the Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations on three databases (PubMed/Medline, Scopus, and Web of Science) with no language restrictions, using a Boolean expression. For inclusion in the study, articles had to assess the older population (60 years or older), assess both depressive and resilience symptoms, and investigate the association between these two variables. Articles not employing validated resilience and depression scales or assessing populations younger than 60 years were excluded. The quality of the selected studies was assessed using the Quality Assessment Tool for Quantitative Studies. A total of 1094 articles were retrieved from the three databases, 367 of which were duplicates and therefore excluded, giving 727 articles for analysis. Of these articles, seven met the eligibility criteria. All of the included articles were observational and cross-sectional, found an inverse relationship between depression and resilience, and were conducted in three countries: the USA, China, and Belgium. A moderate inverse correlation was found on the meta-analysis (r = -0.35, 95% confidence interval: -0.41 to -0.28). Few studies were found on this subject in the older population. An association between greater resilience and less depressive symptomatology was identified, albeit based on cross-sectional studies. These results highlight the need for further studies in the area and the importance of fostering the use of interventions to promote resilience in older adults as a means of preventing and managing depressive symptoms in this population. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries.

    Science.gov (United States)

    Miller, Andrew C; Rosati, Shannon F; Suffredini, Anthony F; Schrump, David S

    2014-06-01

    The incidence of thoracic injuries resulting from cardiopulmonary resuscitation (CPR) is not well characterized. We describe a case in which a CPR-associated atrial rupture was identified with ultrasound and successfully managed in the intensive care unit with a bedside thoracotomy and atrial repair. We then describe a systematic review with pooled data analysis of CPR-associated cardiovascular, pulmonary, pleural, and thoracic wall injuries. PubMed, Scopus, EMBASE, and Web of Science were searched to identify relevant published studies. Unpublished studies were identified by searching the Australian and New Zealand Clinical Trials Registry, World Health Organization International Clinical Trials Registry Platform, Cochrane Library, ClinicalTrials.gov, Current Controlled Trials, and Google. Inclusion criteria for the pooled analysis were any clinical or autopsy study in which (a) patients underwent cardiopulmonary resuscitation, (b) chest compressions were administered either manually or with the assistance of active compression-decompression devices, and (c) autopsy or dedicated imaging assessments were conducted to identify complications. Exclusion criteria for the pooled analysis were pre-clinical studies, case reports and abstracts. Nine-hundred twenty-eight potentially relevant references were identified. Twenty-seven references met inclusion criteria. A systematic review of the literature is provided with pooled data analysis. The incidence of reported CPR-associated cardiovascular and thoracic wall injuries varies widely. CPR with active compression-decompression devices has a higher reported incidence of cardiopulmonary injuries. Bedside ultrasound may be a useful adjunct to assess and risk-stratify patients to identify serious or life-threatening CPR-associated injuries. Published by Elsevier Ireland Ltd.

  17. LncRNA expression and implication in osteosarcoma: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Wang Y

    2017-11-01

    Full Text Available Ying Wang,1,2,* Yuelong Huang,2,* Peng Xiang,3 Wei Tian2 1Department of Molecular Orthopaedics, Beijing Institute of Traumatology and Orthopaedics, 2Department of Spinal Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, 3Department of Urology, Peking University First Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Purpose: Osteosarcoma is the most prevalent primary bone tumor in children, adolescents, and older adults, typically presenting with poor survival outcomes. In recent years, ample evidence has shown that many long noncoding RNAs (lncRNAs have been aberrantly expressed in osteosarcoma, demonstrating their potential to serve as prognostic markers. In this study, we performed a meta-analysis on four lncRNAs (TUG1, UCA1, BCAR4, and HULC to systematically evaluate their prognostic value in osteosarcoma.Materials and methods: The eligible articles were systematically searched in PubMed, Web of Science, Embase, and Elsevier ScienceDirect (up to September 22, 2017, and one meta-analysis concerning the association between lncRNA expression and the overall survival (OS of osteosarcoma patients was performed. Survival outcomes were analyzed by OS. Subgroup analyses were performed.Results: A total of 1,361 patients with osteosarcoma and 12 lncRNAs from 16 articles were included in the study. Of the listed lncRNAs, the high expression of 10 lncRNAs indicated worse survival outcomes, while only two lncRNAs were shown to positively affect patients’ OS.Conclusion: This meta-analysis indicated that the abnormally expressed lncRNAs might significantly affect the survival of osteosarcoma patients. Combined use of these lncRNAs may serve as potential novel biomarkers for the indication of clinical outcomes of osteosarcoma patients as well as the selection of adjuvant chemotherapy strategies for clinical treatment of this disease. Keywords: lncRNAs, osteosarcoma

  18. Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies.

    Science.gov (United States)

    Bécares, Laia; Dewey, Michael E; Das-Munshi, Jayati

    2017-12-14

    Despite increased ethnic diversity in more economically developed countries it is unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes. We systematically searched Medline, PsychINFO, Sociological Abstracts, Web of Science from inception to 31 March 2016. We obtained additional data from study authors. We conducted random-effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation, and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences, and psychosis. We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences [odds ratio (OR) 0.82 (95% confidence interval (CI) 0.76-0.89)] and suicidal ideation [OR 0.88 (95% CI 0.79-0.98)] for each 10 percentage-point increase in own ethnic density. For CMD, depression, and anxiety, associations were indicative of protective effects of own ethnic density; however, results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis. The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.

  19. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Ruixue Huang

    2016-08-01

    Full Text Available It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder = −0.30, 95% CI (−0.51–−0.09, p = 0.005 in the subjects. Probiotics had an effect on both the healthy population (MD = −0.25, 95% CI (−0.47–−0.03, p = 0.03 and patients with major depressive disorder (MDD (MD = −0.73, 95% CI (−1.37–−0.09, p = 0.03. Probiotics had an effect on the population aged under 60 (MD = −0.43, 95% CI (−0.72–−0.13, p = 0.005, while it had no effect on people aged over 65 (MD = −0.18, 95% CI (−0.47–0.11, p = 0.22. This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.

  20. Smoking and olfactory dysfunction: A systematic literature review and meta-analysis.

    Science.gov (United States)

    Ajmani, Gaurav S; Suh, Helen H; Wroblewski, Kristen E; Pinto, Jayant M

    2017-08-01

    A systematic review and meta-analysis of the literature was undertaken, examining the association between tobacco smoking and olfactory function in humans, utilizing PubMed and Web of Science (1970-2015) as data sources. Systematic literature review and meta-analysis. This database review of studies of smoking and olfaction, with a focus on identifying high-quality studies (based on modified versions of the Newcastle-Ottawa Scale), used validated olfactory tests among the generally healthy population. We identified 11 studies meeting inclusion criteria. Of 10 cross-sectional studies, two were excluded from meta-analysis because the cohorts they studied were included in another article in the review. In meta-analysis, current smokers had substantially higher odds of olfactory dysfunction compared to never smokers (odds ratio [OR] = 1.59, 95% confidence interval [CI] = 1.37-1.85). In contrast, former smokers were found to have no difference in risk of impaired olfaction compared to never smokers (OR = 1.05, 95% CI = 0.91-1.21). The single longitudinal study reviewed found a trend toward increased risk of olfactory decline over time in ever smokers; this trend was stronger in current as compared to former smokers. Current smoking, but not former smoking, is associated with significantly increased risk of olfactory dysfunction, suggesting that the effects of smoking on olfaction may be reversible. Future studies that prospectively evaluate the impact of smoking cessation on improvement in olfactory function are warranted. N/A. Laryngoscope, 127:1753-1761, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Can chocolate consumption reduce cardio-cerebrovascular risk? A systematic review and meta-analysis.

    Science.gov (United States)

    Gianfredi, Vincenza; Salvatori, Tania; Nucci, Daniele; Villarini, Milena; Moretti, Massimo

    2018-02-01

    A systematic review and meta-analysis of the literature was performed to assess the relationship between chocolate intake and cardio-cerebrovascular risk in the general population. A structured search of the literature was performed in the PubMed database up to September 26, 2016, using predetermined keywords. Epidemiologic studies evaluating the risk for cardiovascular diseases (CVDs; i.e., stroke, acute myocardial infarction [MI], heart failure, coronary heart disease) were included according to different rates of chocolate intake. The software ProMeta 3 was used to perform the meta-analysis. The systematic review identified 16 eligible studies. The majority of the studies showed a protective effect of chocolate intake compared with unexposed individuals. The overall risk ratio (effect size [ES]) of CVD for the highest versus the lowest category of chocolate consumption was 0.77 (95% confidence interval [CI], 0.71-0.84; P = 0.000) with a moderate heterogeneity. The risk related to subgroups of CVD and in particular, the risk for MI was further analyzed: ES = 0.78 (95% CI, 0.64-0.94; P = 0.009) without statistical heterogeneity (I 2  = 46.56%; P = 0.13). Moreover, the analysis performed based on sex found an ES = 0.85 (95% CI, 0.77-0.95; P = 0.003) for women, with a very low grade of heterogeneity (I 2  = 62.21%; P = 0.005). The results of the meta-analysis showed a potential protective effect of moderate consumption of chocolate on cardiovascular risk, especially for women, and against MI for both sexes. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The incidence of concussion in youth sports: a systematic review and meta-analysis.

    Science.gov (United States)

    Pfister, Ted; Pfister, Ken; Hagel, Brent; Ghali, William A; Ronksley, Paul E

    2016-03-01

    To conduct a comprehensive systematic review and meta-analysis of studies assessing the incidence of concussion in youth athletes. Specifically, we estimate the overall risk of concussion in youth sports and compare sport-specific estimates of concussion risk. Systemic review and meta-analysis. A search of Medline, Embase (1980 through September 2014), and SportDiscus (1985 through September 2014) supplemented by manual searches of bibliographies and conference proceedings. We included studies if they met the inclusion criteria of study design (prospective cohort study), relevant sports identified from the literature (eg, American football, rugby, hockey, lacrosse, soccer/football, basketball, baseball, softball, wrestling, field hockey, track, taekwondo, volleyball and cheerleading), population (males and females ≤18 years old), and outcome (concussion). Of the 698 studies reviewed for eligibility, 23 articles were accepted for systematic review and 13 of which were included in a meta-analysis. Random effects models were used to pool overall and sport-specific concussion incidence rates per 1000 athlete exposures (AEs). The overall risk of concussion was estimated at 0.23 (95% CI 0.19 to 0.28). The three sports with the highest incidence rates were rugby, hockey and American football at 4.18, 1.20 and 0.53, respectively. Lowest incidence rates per 1000 AEs occurred in volleyball, baseball and cheerleading at 0.03, 0.06 and 0.07, respectively. Quality of the included studies varied, with the majority of studies not reporting age and gender-specific incidence rates or an operational definition for concussion. There are striking differences in the rates of incident youth concussion across 12 sports. This systematic review and meta-analysis can serve as the current sport-specific baseline risk of concussion among youth athletes. 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/

  3. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Tie-Wu Jia

    Full Text Available Soil-transmitted helminth (STH infections (i.e., Ascaris lumbricoides, hookworm, and Trichuris trichiura affect more than a billion people. Preventive chemotherapy (i.e., repeated administration of anthelmintic drugs to at-risk populations, is the mainstay of control. This strategy, however, does not prevent reinfection. We performed a systematic review and meta-analysis to assess patterns and dynamics of STH reinfection after drug treatment.We systematically searched PubMed, ISI Web of Science, EMBASE, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure, WanFang Database, Chinese Scientific Journal Database, and Google Scholar. Information on study year, country, sample size, age of participants, diagnostic method, drug administration strategy, prevalence and intensity of infection pre- and posttreatment, cure and egg reduction rate, evaluation period posttreatment, and adherence was extracted. Pooled risk ratios from random-effects models were used to assess the risk of STH reinfection after treatment. Our protocol is available on PROSPERO, registration number: CRD42011001678.From 154 studies identified, 51 were included and 24 provided STH infection rates pre- and posttreatment, whereas 42 reported determinants of predisposition to reinfection. At 3, 6, and 12 months posttreatment, A. lumbricoides prevalence reached 26% (95% confidence interval (CI: 16-43%, 68% (95% CI: 60-76% and 94% (95% CI: 88-100% of pretreatment levels, respectively. For T. trichiura, respective reinfection prevalence were 36% (95% CI: 28-47%, 67% (95% CI: 42-100%, and 82% (95% CI: 62-100%, and for hookworm, 30% (95% CI: 26-34%, 55% (95% CI: 34-87%, and 57% (95% CI: 49-67%. Prevalence and intensity of reinfection were positively correlated with pretreatment infection status.STH reinfections occur rapidly after treatment, particularly for A. lumbricoides and T. trichiura. Hence, there is a need for frequent anthelmintic drug administrations to

  4. Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Beaudart, Charlotte; Zaaria, Myriam; Pasleau, Françoise; Reginster, Jean-Yves; Bruyère, Olivier

    2017-01-01

    Objective The purpose of this study was to perform a systematic review to assess the short-, middle- and long-term consequences of sarcopenia. Methods Prospective studies assessing the consequences of sarcopenia were searched across different electronic databases (MEDLINE, EMBASE, EBM Reviews, Cochrane Database of Systematic Reviews, EBM Reviews ACP Journal Club, EBM Reviews DARE and AMED). Only studies that used the definition of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia were included. Study selection and data extraction were performed by two independent reviewers. For outcomes reported by three or more studies, a meta-analysis was performed. The study results are expressed as odds ratios (OR) with 95% CI. Results Of the 772 references identified through the database search, 17 were included in this systematic review. The number of participants in the included studies ranged from 99 to 6658, and the duration of follow-up varied from 3 months to 9.8 years. Eleven out of 12 studies assessed the impact of sarcopenia on mortality. The results showed a higher rate of mortality among sarcopenic subjects (pooled OR of 3.596 (95% CI 2.96–4.37)). The effect was higher in people aged 79 years or older compared with younger subjects (p = 0.02). Sarcopenia is also associated with functional decline (pooled OR of 6 studies 3.03 (95% CI 1.80–5.12)), a higher rate of falls (2/2 studies found a significant association) and a higher incidence of hospitalizations (1/1 study). The impact of sarcopenia on the incidence of fractures and the length of hospital stay was less clear (only 1/2 studies showed an association for both outcomes). Conclusion Sarcopenia is associated with several harmful outcomes, making this geriatric syndrome a real public health burden. PMID:28095426

  5. Return to Play Following Shoulder Stabilization: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Ialenti, Marc N.; Mulvihill, Jeffrey D.; Feinstein, Max; Zhang, Alan L.; Feeley, Brian T.

    2017-01-01

    Background: Anterior shoulder instability can be a disabling condition for the young athlete; however, the best surgical treatment remains controversial. Traditionally, anterior shoulder instability was treated with open stabilization. More recently, arthroscopic repair of the Bankart injury with suture anchor fixation has become an accepted technique. Hypothesis: No systematic reviews have compared the rate of return to play following arthroscopic Bankart repair with suture anchor fixation with the Bristow-Latarjet procedure and open stabilization. We hypothesized that the rate of return to play will be similar regardless of surgical technique. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a systematic review and meta-analysis focused on return to play following shoulder stabilization. Inclusion criteria included studies in English that reported on rate of return to play and clinical outcomes following primary arthroscopic Bankart repair with suture anchors, the Latarjet procedure, or open stabilization. Statistical analyses included Student t tests and analyses of variance. Results: Sixteen papers reporting on 1036 patients were included. A total of 545 patients underwent arthroscopic Bankart repair with suture anchors, 353 with the Latarjet procedure, and 138 with open repair. No significant difference was found in patient demographic data among the studies. Patients returned to sport at the same level of play (preinjury level) more consistently following arthroscopic Bankart repair (71%) or the Latarjet procedure (73%) than open stabilization (66%) (P Latarjet procedure (3.5%) than after arthroscopic Bankart repair (6.6%) or open stabilization (6.7%) (P Latarjet procedure than open stabilization. Despite this difference, >65% of all treated athletes returned to sport at their preinjury levels, with other outcome measures being similar among the treatment groups. Therefore, arthroscopic Bankart repair, the Latarjet procedure, and

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

    Science.gov (United States)

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

    2018-02-15

    Motivation is a proximal determinant of behaviour, and increasing motivation is central to most health behaviour change interventions. This systematic review and meta-analysis sought to identify features of physical activity interventions associated with favourable changes in three prominent motivational constructs: intention, stage of change and autonomous motivation. A systematic literature search identified 89 intervention studies (k = 200; N = 19,212) which assessed changes in these motivational constructs for physical activity. Intervention descriptions were coded for potential moderators, including behaviour change techniques (BCTs), modes of delivery and theory use. Random effects comparative subgroup analyses identified 18 BCTs and 10 modes of delivery independently associated with changes in at least one motivational outcome (effect sizes ranged from d = 0.12 to d = 0.74). Interventions delivered face-to-face or in gym settings, or which included the BCTs 'behavioural goal setting', 'self-monitoring (behaviour)' or 'behavioural practice/rehearsal', or which combined self-monitoring (behaviour) with any other BCT derived from control theory, were all associated with beneficial changes in multiple motivational constructs (effect sizes ranged from d = 0.12 to d = 0.46). Meta-regression analyses indicated that increases in intention and stage of change, but not autonomous motivation, were significantly related to increases in physical activity. The intervention characteristics associated with changes in motivation seemed to form clusters related to behavioural experience and self-regulation, which have previously been linked to changes in physical activity behaviour. These BCTs and modes of delivery merit further systematic study, and can be used as a foundation for improving interventions targeting increases in motivation for physical activity.

  7. Danshen injection as adjuvant treatment for unstable angina pectoris: A systematic review and meta-analysis.

    Science.gov (United States)

    Wu, Jia-Rui; Liu, Shi; Zhang, Xiao-Meng; Zhang, Bing

    2017-04-01

    To systematically evaluate the clinical effectiveness and safety of Danshen Injection (, DS) as one adjuvant treatment for conventional therapy with Western medicine (WM) for unstable angina pectoris (UAP). Using literature databases, a thorough and systematic retrieval of randomized controlled trials (RCTs) comparing DS plus WM with WM was conducted from inception to April 2015. The extracted data from included studies was analyzed by Review Manager 5.2 software. The Cochrane risk of bias tool was used to assess the quality of included studies, and Begg's and Egger's tests conducted by Stata 12.0 were used to evaluate the potential presence of publication bias. A total of 17 RCTs, which involving 1,433 participants, were identified and reviewed. The meta-analysis indicated that the combined use of DS and WM was significantly superior to WM alone for UAP in terms of the total effectiveness rate of angina pectoris [risk ratio (RR) =1.23, 95% confidence interval (CI): 1.17, 1.29, P<0.01] and the total effectiveness rate of electrocardiogram (ECG) [RR=1.18, 95%CI: 1.06, 1.30, P=0.001]. Additionally, DS could also further reduce the content of fibrinogen, adjust blood lipid level, correct T wave inversion, and so on. Fifteen adverse drug reactions were reported in two studies, Four of which appeared in the experimental group. Based on the systematic review, the combined use of DS and WM was more effective than WM alone, it can be further widely used in clinic, however, there was no exact conclusion for its safety.

  8. Salvianolate injection in the treatment of unstable angina pectoris: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Dan; Wu, Jiarui; Liu, Shi; Zhang, Xiaomeng; Zhang, Bing

    2016-12-01

    To systematically evaluate the clinical efficacy and safety of Salvianolate injection in the treatment of unstable angina pectoris (UAP). Using literature databases, we conducted a thorough and systematic retrieval of randomized controlled trials (RCTs) that using Salvianolate injection for treating UAP. The Cochrane Risk of Bias Assessment Tool was used to evaluate the methodological quality of the RCTs, and then the data were extracted and meta-analyzed by RevMan5.2 software. A total of 22 RCTs with 2050 participants were included. The meta-analysis indicated that the combined use of Salvianolate injection and western medicine (WM) in the treatment of UAP can achieve a superior effect in angina pectoris total effective rate (risk ratio [RR] = 1.22, 95% confidence interval [CI] (1.17, 1.27), Z = 10.15, P < 0.00001], and the total effectiveness rate of electrocardiogram [RR = 1.26, 95% CI (1.19,1.34), Z = 7.77, P < 0.00001]. In addition, Salvianolate injection can improve the nitroglycerin withdrawal rate and the serum level of NO, decrease high-sensitivity C-reactive protein. Adverse drug reactions (ADRs) or adverse drug events (ADEs) were reported in 6 RCTs involving 15 cases; however, there were no serious ADRs/ADEs. Based on the systematic review, the combined use of Salvianolate injection and WM in the treatment of UAP can achieve a better effect; however, there was no definitive conclusion about its safety. More the large-sample and multicenter RCTs are needed to support its clinical usage.

  9. Cryptococcal meningitis in systemic lupus erythematosus patients: pooled analysis and systematic review.

    Science.gov (United States)

    Fang, Wenjie; Chen, Min; Liu, Jia; Hagen, Ferry; Ms, Abdullah; Al-Hatmi; Zhang, Peilian; Guo, Yun; Boekhout, Teun; Deng, Danqi; Xu, Jianping; Pan, Weihua; Liao, Wanqing

    2016-09-07

    Cryptococcal meningitis is an important fungal infection among systemic lupus erythematosus patients. We conducted a pooled analysis and systematic review to describe the epidemiological and clinical profile of cryptococcal meningitis in systemic lupus erythematosus patients. From two hospitals in China and nine literature databases, cases and prevalence data were collected for pooled analysis and meta-analysis, respectively. Categorical variables of cases were compared using a χ(2)-test on the statistical program of SAS. A multiple regression analysis was performed to ascertain independent predictors significantly correlated with prognosis. Meta-analysis was conducted by the statistical program of R. The prevalence of cryptococcal meningitis in systemic lupus erythematosus patients was 0.5%. Patients were predominantly females and adults. A prednisone equivalent of more than 30 mg/day before infection was associated with higher mortality (odds ratio (OR)=9.69 (1.54, 60.73)). In all, 36.8-38.9% patients showed low lupus activity when they developed the crytococcal infection. Moreover, 38.2% of the patients were misdiagnosed. The estimated case-fatality rate was 23.6%. Our results suggest that more emphasis should be placed to further understand lupus-related cryptococcal meningitis and to develop better prophylaxis and management strategies to combat this condition.

  10. Systematic Review On Massive Open Online Courses Based On PrimaryMeta-Analysis

    Directory of Open Access Journals (Sweden)

    Ahmed Ibrahim Safana

    2017-01-01

    Full Text Available The research conducted a systematic review on peer reviewed literature of Massive Open Online courses that encapsulated the finding of more than 40 articles by employing the procedure of meta-analysis and primary-analysis in the bid of addressing the research question is MOOCs a way out to African Institutions An open code context method was applied to validate the articles for the sake of comparisons. The validation result shows a certain level of overlapping based on the Open Code Context procedure on the reviewed literature researched which led to meta-analysis that minimized the overlap. The primary data collected have been analyzed using the primary-analysis procedure. Even though the size of the random effect means was as minimum as 0.23 hence a significant difference from zero statistically. A heterogeneous distribution of fixed effect model was applied to the primary- analysis and the mean effect size was 0.21 and 0.22 using the random effect model. The result the gaps the implication and the prospect future of the research was particularized and discussed.

  11. A systematic review and meta-analysis of probiotics for the treatment of allergic rhinitis.

    Science.gov (United States)

    Zajac, Alexander E; Adams, Austin S; Turner, Justin H

    2015-06-01

    Probiotics have proven beneficial in a number of immune-mediated and allergic diseases. Several human studies have evaluated the efficacy of probiotics in allergic rhinitis; however, evidence for their use has yet to be firmly established. The current systematic review seeks to synthesize the results of available randomized trials. In a systematic review and meta-analysis, the Medline, EMBASE, and Cochrane Library databases were reviewed and randomized controlled trials (RCTs) were extracted based on defined inclusion criteria. The effect of probiotics on Rhinitis Quality of Life (RQLQ) scores, Rhinitis Total Symptom Scores (RTSS), as well as total and antigen-specific serum immunoglobulin E (IgE) levels were evaluated by meta-analysis. A total of 23 studies with 1919 patients were identified, including 21 double-blind RCTs and 2 randomized crossover studies. Multiple probiotic strains, study populations, and outcome measures were used in individual trials. Seventeen studies showed a significant clinical benefit from the use of probiotics in at least 1 outcome measure when compared to placebo, whereas 6 trials showed no benefit. Among the trials eligible for meta-analysis, the use of probiotics resulted in a significant improvement in RQLQ scores compared to placebo (standard mean difference [SMD] -2.23; p = 0.02). Probiotics had no effect on RTSS (SMD -0.36; p = 0.13) or total IgE levels (SMD 0.01; p = 0.94), although there was a trend toward a reduction in antigen-specific IgE (SMD 0.20; p = 0.06) in the placebo group compared to probiotic. Probiotics may be beneficial in improving symptoms and quality of life in patients with allergic rhinitis; however, current evidence remains limited due to study heterogeneity and variable outcome measures. Additional high-quality studies are needed to establish appropriate recommendations. © 2015 ARS-AAOA, LLC.

  12. Neuropathic pain prevalence following spinal cord injury: A systematic review and meta-analysis.

    Science.gov (United States)

    Burke, D; Fullen, B M; Stokes, D; Lennon, O

    2017-01-01

    Following spinal cord injury (SCI), chronic pain is a common secondary complication with neuropathic pain (NP) cited as one of the most distressing and debilitating conditions leading to poor quality of life, depression and sleep disturbances. Neuropathic pain presenting at or below the level of injury is largely refractory to current pharmacological and physical treatments. No consensus on the prevalence of NP post SCI currently exists, hence this systematic review was undertaken. The review comprised three phases: a methodological assessment of databases [PubMed, Embase, Web of Knowledge, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and Physiotherapy Evidence Database (PEDro)] identifying potential papers and screening for inclusion criteria by two independent reviewers; data extraction; and finally rating of internal validity and strength of the evidence, using a published valid and reliable scale. Meta-analysis estimated pooled point prevalence rates using a random effects model. In total, 17 studies involving 2529 patients were included in the review. Overall point prevalence rates for NP were established at 53% (38.58-67.47); 19% (13.26-26.39) for at-level NP and 27% (19.89-34.61) for below-level NP, with high heterogeneity noted (I 2  = 84-93%). Prevalence rates for NP following SCI are high. Future studies should include established definitions, classification systems and assessment tools for NP at defined time points post SCI to follow the trajectory of this problem across the lifespan and include indices of sleep, mood and interference to allow for appropriate, optimal and timely NP management for each patient. WHAT DOES THIS REVIEW ADD?: This is the first systematic review and meta-analysis to record pooled point prevalence of neuropathic pain post spinal cord injury at 53%. Additional pooled analysis shows that neuropathic pain is more common below the level of lesion, in patients with tetraplegia, older patients

  13. The Review Systematic and Meta Analysis of Prevalence and Causes of Nosocomial Infection in Iran

    Directory of Open Access Journals (Sweden)

    Pezhman Bagheri

    2014-12-01

    Full Text Available Background and Aim: The variation of reported nosocomial infection is very high respectively. It seems review systematic and Meta analysis of related documents gives precise estimate of this subject for correct politisize. So tha aim of this study the review systematic and meta analysis of prevalence and causes of nosocomial infection in iran. Materials and Methods: For this study all articles published in Iranian journals and international journals, Final Report of Research Projects, related papers presented at congresses and thesis were reviewed with using standard and sensitive keywords. Then, all articles published between 1997-2010 years that had eligibility Inclusion criteria after quality control, using random model, intered to process of meta-analysis. Results: The finding show that the best estimate of total prevalence of nosocomial infection in Iran is 30.43% and the most common infections of nosocomial infection are respiratory infection 39.4%%, urinary infection 23.88%, bacteremia 21.98% and the most common factors of nosocomial infection are Pseudomonas aeroginosa 26.78%, klebsiella 31.42%, Staphylococcus 23.6% and E.coli 30.93%. The research also found a substantial heterogeneity that using meta regression method the main cause of produce of this heterogeneity, participants people, sample size, average age of the samples, time of study and gender were introduced. Conclusions: The simple review of studied documents in this survey show that prevalence rate of different nosocomial infection in Iran is high relatively. Hence make appropriate and evidence-based educational and control programs to reduce nosocomial infections prevalence rate in Iran should be considered by policy makers.

  14. Workplace bullying and sickness absence: a systematic review and meta-analysis of the research literature.

    Science.gov (United States)

    Nielsen, Morten Birkeland; Indregard, Anne-Marthe Rustad; Øverland, Simon

    2016-09-01

    The association between workplace bullying and sickness absence remains unclear. This paper presents a systematic review and meta-analysis of research on the association. We conducted a systematic review and meta-analysis of published primary studies on workplace bullying and sickness absence. Studies based on prospective design or registry data on sickness absence were included. Cross-sectional studies with self-reported sickness absence were excluded. Seventeen primary studies were included in the review, sixteen originated from the Nordic countries and fifteen included registry data on sickness absence. All but one study found that exposure to workplace bullying was associated with increased risk of sickness absence. A meta-analysis of ten independent studies showed that exposure to bullying increased the risk of sickness absence (odds ratio 1.58, 95% CI 1.39-1.79). Five studies included variables that moderated the association between bullying and absenteeism. None of the studies included mediating variables. No studies examined sickness absence as a risk factor for later exposure to bullying. Following the GRADE guidelines, the evidence for an association between bullying and sickness absence is moderate. Workplace bullying is a risk factor for sickness absence, but the mechanisms to explain this relationship are not sufficiently described. It is unclear whether sickness absence predicts later exposure to bullying. While, the methodological quality of the reviewed studies was high, the knowledge base is small. There is a need for more research on how and when bullying is related to sickness absence and the possible bidirectional relationships involved.

  15. The influence of zinc sulfate on neonatal jaundice: a systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Li; Wu, De; Wang, Baotian; Bu, Xiaosong; Tang, Jiulai

    2018-05-01

    Zinc sulfate may be a promising approach to treat neonatal jaundice. However, the results remain controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of zinc sulfate on hyperbilirubinemia among neonates. PubMed, EMbase, Web of science, EBSCO, Cochrane library databases, Ovid, BMJ database, and CINAHL were systematically searched. Randomized controlled trials (RCTs) assessing the effect of zinc sulfate versus placebo on the prevention of jaundice in neonates were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were total serum bilirubin (TSB) on three days and seven days, the incidence of hyperbilirubinemia. Meta-analysis was performed using random- or fixed-effect models. Five RCTs involving 645 patients were included in the meta-analysis. Overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce TSB on three days (mean difference (MD) = 0.09 mg/dL; 95% confidence interval (CI) = -0.49 to 0.67; p = .77), TSB on seven days (MD = -0.37 mg/dL; 95% CI = -98 to 0.25; p = .25) as well as the incidence of hyperbilirubinemia (OR = 1.14; 95% CI = 0.74 to 1.76; p = .56). Zinc sulfate showed no influence on phototherapy requirement (OR = 0.90; 95% CI = 0.41 to 1.98; p = .79), but resulted in significantly decreased duration of phototherapy (MD = -16.69 h; 95% CI = -25.09 to -8.3 h; p < .0001). Zinc sulfate could not reduce the TSB on three days and seven days, the incidence of hyperbilirubinemia and phototherapy requirement, but lead to significantly decreased duration of phototherapy.

  16. Efficacy and Safety of Scarpa Fascia Preservation During Abdominoplasty: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Xiao, Xiangyang; Ye, Limin

    2017-06-01

    Scarpa fascia preservation might be a promising approach to reduce seroma and other complications after abdominoplasty. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of scarpa fascia preservation in patients with abdominoplasty. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials and clinical controlled trials assessing the effect of scarpa fascia preservation versus control (without scarpa fascia) during abdominoplasty were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were seroma and hematoma/bleeding. Meta-analysis was performed using random-effect model. Four studies involving 630 patients were included in the meta-analysis. Overall, compared with the control group, scarpa fascia preservation was associated with a significant reduced seroma (OR 0.16; 95% CI 0.06-0.43; P = 0.0004), time until drain removal (std. mean difference = -0.92; 95% CI -1.31 to -0.54; Pfascia preservation was associated with a significant decreased seroma, time until drain removal, drain output, and hospital stay, but could not change hematoma/bleeding, infection and suture rupture following abdominoplasty. Scarpa fascia preservation should be recommended during abdominoplasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  17. Dental implants in patients with osteoporosis: a systematic review with meta-analysis.

    Science.gov (United States)

    de Medeiros, F C F L; Kudo, G A H; Leme, B G; Saraiva, P P; Verri, F R; Honório, H M; Pellizzer, E P; Santiago Junior, J F

    2018-04-01

    There is currently no consensus regarding the survival rate of osseointegrated implants in patients with osteoporosis. A systematic review with meta-analysis was performed to evaluate the survival rate of implants in such patients. The PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO databases were used to identify articles published up to September 2016. The systematic review was performed in accordance with PRISMA/PICO requirements and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk (RR) of implant failure and mean marginal bone loss were analyzed within a 95% confidence interval (CI). Fifteen studies involving 8859 patients and 29,798 implants were included. The main outcome of the meta-analysis indicated that there was no difference in implant survival rate between patients with and without osteoporosis, either at the implant level (RR 1.39, 95% CI 0.93-2.08; P=0.11) or at the patient level (RR 0.98, 95% CI 0.50-1.89; P=0.94). However, the meta-analysis for the secondary outcome revealed a significant difference in marginal bone loss around implants between patients with and without osteoporosis (0.18mm, 95% CI 0.05-0.30, P=0.005). Data heterogeneity was low. An increase in peri-implant bone loss was observed in the osteoporosis group. Randomized and controlled clinical studies should be conducted to analyze possible biases. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Prognostic factors in pediatric pulmonary arterial hypertension: A systematic review and meta-analysis.

    Science.gov (United States)

    Ploegstra, Mark-Jan; Zijlstra, Willemijn M H; Douwes, Johannes M; Hillege, Hans L; Berger, Rolf M F

    2015-04-01

    Despite the introduction of targeted therapies in pediatric pulmonary arterial hypertension (PAH), prognosis remains poor. For the definition of treatment strategies and guidelines, there is a high need for an evidence-based recapitulation of prognostic factors. The aim of this study was to identify and evaluate prognostic factors in pediatric PAH by a systematic review of the literature and to summarize the prognostic value of currently reported prognostic factors using meta-analysis. Medline, EMBASE and Cochrane Library were searched on April 1st 2014 to identify original studies that described predictors of mortality or lung-transplantation exclusively in children with PAH. 1053 citations were identified, of which 25 were included for further analysis. Hazard ratios (HR) and 95% confidence intervals were extracted from the papers. For variables studied in at least three non-overlapping cohorts, a combined HR was calculated using random-effects meta-analysis. WHO functional class (WHO-FC, HR 2.7), (N-terminal pro-) brain natriuretic peptide ([NT-pro]BNP, HR 3.2), mean right atrial pressure (mRAP, HR 1.1), cardiac index (HR 0.7), indexed pulmonary vascular resistance (PVRi, HR 1.3) and acute vasodilator response (HR 0.3) were identified as significant prognostic factors (p ≤ 0.001). This systematic review combined with separate meta-analyses shows that WHO-FC, (NT-pro)BNP, mRAP, PVRi, cardiac index and acute vasodilator response are consistently reported prognostic factors for outcome in pediatric PAH. These variables are useful clinical tools to assess prognosis and should be incorporated in treatment strategies and guidelines for children with PAH. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. 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.

  20. Antimicrobial photodynamic therapy in the treatment of aggressive periodontitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Souza, Emmanuel; Medeiros, Ana Cláudia; Gurgel, Bruno César; Sarmento, Carlos

    2016-01-01

    The aim of this systematic review was to investigate whether the use of antimicrobial photodynamic therapy (aPDT) as an adjuvant to scaling and root planning (SRP) yields better results than SRP alone or associated with systemic antibiotics in the treatment of aggressive periodontitis (AgP). A meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statements and Cochrane Collaboration recommendations. The search for relevant studies (earliest record to January 2015) was carried out in seven databases, followed by a manual search. Methodological quality assessment of the studies selected was based on an analysis of the risk of bias. At each time point of follow-up, the existence of significant differences (p < 0.05) in clinical attachment level (CAL) gain and probing depth (PD) reduction (primary outcomes) between groups was assessed with RevMan software 5.0. Heterogeneity between studies was assessed by the Higgin test (I (2)). Four randomized controlled trials (RCTs) satisfied the eligibility criteria of this review. Only one study was found to have a low risk of bias. There were no significant differences in PD reduction (mean difference 0.33, 95 % confidence interval -0.32 to 0.98, p = 0.32) and CAL gain (mean difference 0.20, 95 % confidence interval -0.41 to 0.81, p = 0.53) between the test and control interventions. At present, therefore, when compared to SRP alone or associated with systemic antibiotics, the evidence suggests that the association of aPDT + SRP is of no additional benefit in the nonsurgical treatment of AgP.

  1. A systematic review and meta-analysis of salivary cortisol measurement in domestic canines.

    Science.gov (United States)

    Cobb, M L; Iskandarani, K; Chinchilli, V M; Dreschel, N A

    2016-10-01

    Salivary cortisol is widely used as an indicator of stress and welfare in canine research. However, much remains unclear about the basic features of this hormone marker in domestic dogs. This systematic review and meta-analysis aimed to determine a reference range for cortisol concentration in the saliva of dogs and examine how canine characteristics, environmental effects and experimental considerations relate to salivary cortisol concentrations. A systematic review of literature databases and conference proceedings from 1992 to 2012 identified 61 peer-reviewed studies using domestic dog salivary cortisol. Researchers were contacted via email, and 31 raw data sets representing a total of 5,153 samples from 1,205 dogs were shared. Meta-analysis provided a cortisol concentration range of 0 to 33.79 μg/dL (mean 0.45 μg/dL, SEM 0.13). Significant effects (P dog breed, body weight, dog type, coat color, assay type, exercise, eating, or use of salivary stimulant. Care should be taken when using cortisol studies for dogs at a group or population level as there is a large amount of intraindividual and interindividual variability and external variables could influence salivary cortisol concentration. This analysis highlights the importance of carefully controlling experimental design to compare samples within and between individual dogs, as well as establishing and using best practices for saliva collection. Caution should be exercised in comparing different studies, as the results could be the reflection of a plethora of factors. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-04-01

    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, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to May 2015. We included studies that reported recalled birth weight and recorded birth weight. We excluded studies investigating a clinical population. Two reviewers independently reviewed citations, extracted data, assessed risk of bias. Data were pooled in a random effects meta-analysis for correlation and mean difference. In total, 40 studies were eligible for qualitative synthesis (n=78,997 births from 78,196 parents). Agreement between recalled and recorded birth weight was high: pooled estimate of correlation in 23 samples from 19 studies (n=7406) was 0.90 [95% confidence interval (CI) 0.87-0.93]. The difference between recalled and recorded birth weight in 29 samples from 26 studies (n=29,293) was small [range -86-129 g; random effects estimate 1.4 g (95% CI -4.0-6.9 g)]. Studies were heterogeneous, with no evidence for an effect of time since birth, person reporting, recall bias, or birth order. In post-hoc subgroup analysis, recall was higher than recorded birth weight by 80 g (95% CI 57-103 g) in low and middle income countries. In conclusion, there is high agreement between recalled and recorded birth weight. If birth weight is recalled, it is suitable for use in epidemiological studies, at least in high income countries.

  3. Effectiveness of Reirradiation for Painful Bone Metastases: A Systematic Review and Meta-Analysis

    International Nuclear Information System (INIS)

    Huisman, Merel; Bosch, Maurice A.A.J. van den; Wijlemans, Joost W.; Vulpen, Marco van; Linden, Yvette M. van der; Verkooijen, Helena M.

    2012-01-01

    Purpose: Reirradiation of painful bone metastases in nonresponders or patients with recurrent pain after initial response is performed in up to 42% of patients initially treated with radiotherapy. Literature on the effect of reirradiation for pain control in those patients is scarce. In this systematic review and meta-analysis, we quantify the effectiveness of reirradiation for achieving pain control in patients with painful bone metastases. Methods and Materials: A free text search was performed to identify eligible studies using the MEDLINE, EMBASE, and the Cochrane Collaboration library electronic databases. After study selection and quality assessment, a pooled estimate was calculated for overall pain response for reirradiation of metastatic bone pain. Results: Our literature search identified 707 titles, of which 10 articles were selected for systematic review and seven entered the meta-analysis. Overall study quality was mediocre. Of the 2,694 patients initially treated for metastatic bone pain, 527 (20%) patients underwent reirradiation. Overall, a pain response after reirradiation was achieved in 58% of patients (pooled overall response rate 0.58, 95% confidence interval = 0.49–0.67). There was a substantial between-study heterogeneity (I 2 = 63.3%, p = 0.01) because of clinical and methodological differences between studies. Conclusions: Reirradiation of painful bone metastases is effective in terms of pain relief for a small majority of patients; approximately 40% of patients do not benefit from reirradiation. Although the validity of results is limited, this meta-analysis provides a comprehensive overview and the most quantitative estimate of reirradiation effectiveness to date.

  4. The effect of exercise training on cutaneous microvascular reactivity: A systematic review and meta-analysis.

    Science.gov (United States)

    Lanting, Sean M; Johnson, Nathan A; Baker, Michael K; Caterson, Ian D; Chuter, Vivienne H

    2017-02-01

    This study aimed to review the efficacy of exercise training for improving cutaneous microvascular reactivity in response to local stimulus in human adults. Systematic review with meta-analysis. A systematic search of Medline, Cinahl, AMED, Web of Science, Scopus, and Embase was conducted up to June 2015. Included studies were controlled trials assessing the effect of an exercise training intervention on cutaneous microvascular reactivity as instigated by local stimulus such as local heating, iontophoresis and post-occlusive reactive hyperaemia. Studies where the control was only measured at baseline or which included participants with vasospastic disorders were excluded. Two authors independently reviewed and selected relevant controlled trials and extracted data. Quality was assessed using the Downs and Black checklist. Seven trials were included, with six showing a benefit of exercise training but only two reaching statistical significance with effect size ranging from -0.14 to 1.03. The meta-analysis revealed that aerobic exercise had a moderate statistically significant effect on improving cutaneous microvascular reactivity (effect size (ES)=0.43, 95% CI: 0.08-0.78, p=0.015). Individual studies employing an exercise training intervention have tended to have small sample sizes and hence lacked sufficient power to detect clinically meaningful benefits to cutaneous microvascular reactivity. Pooled analysis revealed a clear benefit of exercise training on improving cutaneous microvascular reactivity in older and previously inactive adult cohorts. Exercise training may provide a cost-effective option for improving cutaneous microvascular reactivity in adults and may be of benefit to those with cardiovascular disease and metabolic disorders such as diabetes. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. Systematic meta-analysis on association of human papilloma virus and oral cancer.

    Science.gov (United States)

    Chaitanya, Nallan C S K; Allam, Neeharika Satya Jyothi; Gandhi Babu, D B; Waghray, Shefali; Badam, R K; Lavanya, Reddy

    2016-01-01

    Oral cancer is a disease with complex etiology. There is a strong evidence for the role of smoking, alcohol, genetic susceptibility, and indications that DNA viruses could also be involved in oral cancer. Recognized initially as sexually transmitted agent, human papilloma virus (HPV) is now considered a human carcinogen. Papilloma viruses are epitheliotropic viruses. A strong association of cervical cancer has been implicated with high-risk HPV16 and HPV18 infections, establishing the viral pathogenesis of the carcinoma. The etiopathogenesis is still unclear referring mainly to conflicting evidences in the detection of such viruses in oral carcinoma in spite of few studies suggesting their positive correlation. This systematic meta-analysis aimed to provide evidence-based analysis of literature relating oral cancer and HPV, along with identification of reliable diagnostic methodology for identifying HPV in oral and oropharyngeal cancer. A systematic review was performed using PubMed (from the year 1995 to 2015), Medline, Cochrane, ScienceDirect, and the Internet search. Reviewed literature included randomized control trials, cross sectional and cohort studies. Pooled data were analyzed by calculating relative risk and odds ratios (ORs), using a binary random-effects model. Out of 1497 cases, 588 patients were positive for HPV DNA, detected by various methods. About 39.27% of case samples were positive for HPV DNA. The calculated OR was 2.82 and 95% confidence interval, which showed significantly an increased risk of HPV among case group when compared to that of controls. The present meta-analysis suggests a potentially significant casual relation between HPV and oral and oropharyngeal cancers.

  6. Evaluation of formocresol versus ferric sulphate primary molar pulpotomy: a systematic review and meta-analysis.

    Science.gov (United States)

    Peng, L; Ye, L; Guo, X; Tan, H; Zhou, X; Wang, C; Li, R

    2007-10-01

    To present a systematic review of the effects of formocresol and ferric sulphate when used as medicaments in pulpotomized primary molar teeth. The study list was obtained by using MEDLINE, the Cochrane Library, EMBASE and SCI search. Only those papers which met the inclusion criteria were accepted. The quality of studies used for meta-analysis was assessed by a series of validity criteria according to Jadad's scale. A systematic review and meta-analysis were performed. Eleven clinical studies comprising four randomized-clinical trials (RCTs), four controlled clinical trials (CCTs) and three retrospective studies were included. The results of the meta-analysis of six prospective clinical trials suggested that the two popular pulpotomy medicaments were not significantly different in terms of clinical outcomes, radiographic findings, prevalence of apical and furcal destruction, internal root resorption or pulp canal obliteration. The relative risk (RR) value and 95% CI for those parameters were 0.72 (0.43-1.23), 0.87 (0.59-1.30), 0.67 (0.27-1.66), 1.77 (0.56-5.58) and 1.41 (0.63-3.15), respectively. The overall clinical and radiographic success rates based on the data of treatments with ferric sulphate from the 11 studies included ranged from 78% to 100% (mean 91.6 +/- 8.15%) and from 42% to 97% (mean 73.5 +/- 18.40%), respectively. In primary molar teeth with exposure of vital pulps by caries or trauma, pulpotomies performed with either formocresol or ferric sulphate have similar clinical and radiographic success. Ferric sulphate may be recommended as a suitable replacement for formocresol.

  7. A Systematic Review and Meta-Analysis of Qigong for the Fibromyalgia Syndrome

    Directory of Open Access Journals (Sweden)

    Romy Lauche

    2013-01-01

    Full Text Available Objectives. The fibromyalgia syndrome (FMS is a chronic condition with only few evidence-based complementary and alternative therapies available. This paper presents a systematic review and meta-analysis of the effectiveness of Qigong for fibromyalgia syndrome. Methods. The PubMed/MEDLINE, Cochrane Library, Embase, PsycINFO, and Cambase databases were screened in December 2012 to identify randomized controlled trials comparing Qigong to control interventions. Major outcome measures were pain and quality of life; and secondary outcomes included sleep quality, fatigue, depression, and safety. Standardized mean differences (SMD and 95% confidence intervals were calculated. Results. Seven trials were located with a total of 395 FMS patients. Analyses revealed low quality evidence for short-term improvement of pain, quality of life, and sleep quality and very low quality evidence for improvement of fatigue after Qigong for FMS, when compared to usual care. No evidence was found for superiority of Qigong compared to active treatments. No serious adverse events were reported. Discussion. This systematic review found that Qigong may be a useful approach for FMS patients. According to the quality of evidence, only a weak recommendation for Qigong can be made at this point. Further high quality RCTs are required for the conclusive judgment of its long-term effects.

  8. Chicken Essence for Cognitive Function Improvement: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Siew Li Teoh

    2016-01-01

    Full Text Available Chicken essence (CE is a popular traditional remedy in Asia, which is believed to improve cognitive functions. CE company claimed that the health benefits were proven with research studies. A systematic review was conducted to determine the cognitive-enhancing effects of CE. We systematically searched a number of databases for randomized controlled trials with human subjects consuming CE and cognitive tests involved. Cochrane’s Risk of Bias (ROB tool was used to assess the quality of trials and meta-analysis was performed. Seven trials were included, where six healthy subjects and one subject with poorer cognitive functions were recruited. One trial had unclear ROB while the rest had high ROB. For executive function tests, there was a significant difference favoring CE (pooled standardized mean difference (SMD of −0.55 (−1.04, −0.06 and another with no significant difference (pooled SMD of 0.70 (−0.001, 1.40. For short-term memory tests, no significant difference was found (pooled SMD of 0.63 (−0.16, 1.42. Currently, there is a lack of convincing evidence to show a cognitive enhancing effect of CE.

  9. A Systematic Analysis of Functional Safety Certification Practices in Industrial Robot Software Development

    Directory of Open Access Journals (Sweden)

    Tong Xie

    2017-01-01

    Full Text Available For decades, industry robotics have delivered on the promise of speed, efficiency and productivity. The last several years have seen a sharp resurgence in the orders of industrial robots in China, and the areas addressed within industrial robotics has extended into safety-critical domains. However, safety standards have not yet been implemented widely in academia and engineering applications, particularly in robot software development. This paper presents a systematic analysis of functional safety certification practices in software development for the safety-critical software of industrial robots, to identify the safety certification practices used for the development of industrial robots in China and how these practices comply with the safety standard requirements. Reviewing from Chinese academic papers, our research shows that safety standards are barely used in software development of industrial robot. The majority of the papers propose various solutions to achieve safety, but only about two thirds of the papers refer to non-standardized approaches that mainly address the systematic level rather than the software development level. In addition, our research shows that with the development of artificial intelligent, an emerging field is still on the quest for standardized and suitable approaches to develop safety-critical software.

  10. Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982–2012: A Systematic Analysis

    Science.gov (United States)

    Lafond, Kathryn E.; Nair, Harish; Rasooly, Mohammad Hafiz; Valente, Fátima; Booy, Robert; Rahman, Mahmudur; Kitsutani, Paul; Yu, Hongjie; Guzman, Guiselle; Coulibaly, Daouda; Armero, Julio; Jima, Daddi; Howie, Stephen R. C.; Ampofo, William; Mena, Ricardo; Chadha, Mandeep; Sampurno, Ondri Dwi; Emukule, Gideon O.; Nurmatov, Zuridin; Corwin, Andrew; Heraud, Jean Michel; Noyola, Daniel E.; Cojocaru, Radu; Nymadawa, Pagbajabyn; Barakat, Amal; Adedeji, Adebayo; von Horoch, Marta; Olveda, Remigio; Nyatanyi, Thierry; Venter, Marietjie; Mmbaga, Vida; Chittaganpitch, Malinee; Nguyen, Tran Hien; Theo, Andros; Whaley, Melissa; Azziz-Baumgartner, Eduardo; Bresee, Joseph; Campbell, Harry; Widdowson, Marc-Alain

    2016-01-01

    Background The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide. Methods and Findings We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%–11%) of respiratory hospitalizations in children influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings. Conclusions Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo. PMID:27011229

  11. Systematic Analysis of Theses in the Field of Emergency Medicine in Turkey

    Directory of Open Access Journals (Sweden)

    Erdem CEVIK

    2015-03-01

    Full Text Available SUMMARY: Objectives: The aim of this study is to systematically evaluate the theses in the field of emergency medicine in Turkey and to determine whether they were published as a scientific paper. Methods: This is a retrospective observational study. Theses in the field of emergency medicine between 1998 and 2013 were browsed from the internet database of National Thesis Center (Council of Higher Education. Study type, both if it was in the field of emergency, or if it was published and the journal's scope of published studies were assessed and recorded in the study chart. Results: 579 theses were included in the study. 27.1% of them were published and 14.9% of them were published in SCI/SCI-E journals. Advisors of theses were emergency medicine specialists in 67.6% of theses and 493 (85.1% of them were in the field of emergency medicine. 77.4% of theses were observational and 20.9% were experimental study. Most of the experimental studies (72.7%, n=88 were animal studies. Conclusions: It was concluded that very few theses in the field of emergency medicine were published in journals that were indexed in SCI/SCI-E. Key words: Emergency medicine, systematic analysis, theses

  12. Probiotics for the management of type 2 diabetes mellitus: A systematic review and meta-analysis.

    Science.gov (United States)

    Samah, Syamimi; Ramasamy, Kalavathy; Lim, Siong Meng; Neoh, Chin Fen

    2016-08-01

    To systematically review evidence of probiotic interventions against type 2 diabetes mellitus (T2DM) and analyse the effects of probiotics on glycaemic control among T2DM patients. Electronic search using five electronic databases was performed until October 2015. Relevant studies were identified, extracted and assessed for risk of bias. The primary outcomes of this review were glycated haemoglobin (HbA1c) and fasting blood glucose (FBG). Fasting plasma insulin, homeostasis model assessment-insulin resistance, C-reactive protein, interleukin-6 and malondialdehyde, were identified as the secondary outcomes. Mean differences (MD) between probiotics and control groups for all outcomes were pooled using either Fixed- or Random-Effect Model. Statistical heterogeneity was assessed using I(2) and Chi(2) tests. Six randomised controlled trials (RCTs) were included in the systematic review, whereas only five were included in meta-analysis. Most RCTs were presented with low or unclear risk of bias. When compared to placebo, FBG was significantly lower with probiotic consumption (MD=-0.98mmol/L; 95% CI: -1.17, 0.78, pprobiotics, with a significantly lower FBG was noted. Findings on HbA1c, anti-inflammatory and anti-oxidative effects of probiotics in the clinical setting, however, remain inconsistent. The findings imply the need for well-designed clinical studies to further assess the potential beneficial effects of probiotics in management of T2DM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Online E-cigarette Marketing Claims: A Systematic Content and Legal Analysis.

    Science.gov (United States)

    Klein, Elizabeth G; Berman, Micah; Hemmerich, Natalie; Carlson, Cristen; Htut, SuSandi; Slater, Michael

    2016-07-01

    Electronic nicotine delivery systems (ENDS), or e-cigarettes, are heavily marketed online. The purpose of our study was to perform a systematic identification and evaluation of claims made within ENDS retailer and manufacturer websites, and the legal status of such claims. We employed a systematic search protocol with popular search engines using 6 terms: (1) e-cigarettes; (2) e-cigs; (3) e-juice; (4) e-liquid; (5) e-hookah; and (6) vape pen. We analyzed English-language websites where ENDS are sold for implicit and explicit health-related claims. A legal analysis determined whether such claims are permissible under the US Food and Drug Administration's regulations. The vast majority of ENDS manufacturer (N = 78) and retailer (N = 32) websites made at least one health-related claim (77% and 65%, respectively). Modified risk claims and secondhand smoke-related claims were most prevalent, with an average of 2 claims per site. Health-related claims are plentiful within ENDS manufacturer and retailer websites. Results demonstrate that these sites focus on potential benefits while minimizing or eliminating information about possible harmful effects of ENDS. These claims are subject to the current regulatory authority by the FDA, and pose a risk of misinforming consumers.

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

    Science.gov (United States)

    Steenen, Serge A; van Wijk, Arjen J; van der Heijden, Geert JMG; van Westrhenen, Roos; de Lange, Jan; de Jongh, Ad

    2016-01-01

    The 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 as a treatment for alleviating either state or trait anxiety in patients suffering from anxiety disorders. Eight studies met the inclusion criteria. These studies concerned panic disorder with or without agoraphobia (four studies, total n = 130), specific phobia (two studies, total n = 37), social phobia (one study, n = 16), and posttraumatic stress disorder (PTSD) (one study, n = 19). Three out of four panic disorder trials qualified for pooled analyses. These meta-analyses found no statistically significant differences between the efficacy of propranolol and benzodiazepines regarding the short-term treatment of panic disorder with or without agoraphobia. Also, no evidence was found for effects of propranolol on PTSD symptom severity through inhibition of memory reconsolidation. In conclusion, the quality of evidence for the efficacy of propranolol at present is insufficient to support the routine use of propranolol in the treatment of any of the anxiety disorders. PMID:26487439

  15. Is Pilocarpine Effective in Preventing Radiation-Induced Xerostomia? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Yang, Wei-fa; Liao, Gui-qing; Hakim, Samer G; Ouyang, Dai-qiao; Ringash, Jolie; Su, Yu-xiong

    2016-03-01

    To evaluate the efficacy of concomitant administration of pilocarpine on radiation-induced xerostomia in patients with head and neck cancers. The PubMed, Web of Science, Cochrane Library, and ClinicalTrials were searched to identify randomized, controlled trials studying the effect of concomitant administration of pilocarpine for radiation-induced xerostomia. Included trials were systematically reviewed, and quantifiable outcomes were pooled for meta-analysis. Outcomes of interest included salivary flow, clinician-rated xerostomia grade, patient-reported xerostomia scoring, quality of life, and adverse effects. Six prospective, randomized, controlled trials in 8 articles were included in this systematic review. The total number of patients was 369 in the pilocarpine group and 367 in the control group. Concomitant administration of pilocarpine during radiation could increase the unstimulated salivary flow rate in a period of 3 to 6 months after treatment, and also reduce the clinician-rated xerostomia grade. Patient-reported xerostomia was not significantly impacted by pilocarpine in the initial 3 months but was superior at 6 months. No significant difference of stimulated salivary flow rate could be confirmed between the 2 arms. Adverse effects of pilocarpine were mild and tolerable. The concomitant administration of pilocarpine during radiation increases unstimulated salivary flow rate and reduces clinician-rated xerostomia grade after radiation. It also relieves patients' xerostomia at 6 months and possibly at 12 months. However, pilocarpine has no effect on stimulated salivary flow rate. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Systematic analysis of the heat exchanger arrangement problem using multi-objective genetic optimization

    International Nuclear Information System (INIS)

    Daróczy, László; Janiga, Gábor; Thévenin, Dominique

    2014-01-01

    A two-dimensional cross-flow tube bank heat exchanger arrangement problem with internal laminar flow is considered in this work. The objective is to optimize the arrangement of tubes and find the most favorable geometries, in order to simultaneously maximize the rate of heat exchange while obtaining a minimum pressure loss. A systematic study was performed involving a large number of simulations. The global optimization method NSGA-II was retained. A fully automatized in-house optimization environment was used to solve the problem, including mesh generation and CFD (computational fluid dynamics) simulations. The optimization was performed in parallel on a Linux cluster with a very good speed-up. The main purpose of this article is to illustrate and analyze a heat exchanger arrangement problem in its most general form and to provide a fundamental understanding of the structure of the Pareto front and optimal geometries. The considered conditions are particularly suited for low-power applications, as found in a growing number of practical systems in an effort toward increasing energy efficiency. For such a detailed analysis with more than 140 000 CFD-based evaluations, a design-of-experiment study involving a response surface would not be sufficient. Instead, all evaluations rely on a direct solution using a CFD solver. - Highlights: • Cross-flow tube bank heat exchanger arrangement problem. • A fully automatized multi-objective optimization based on genetic algorithm. • A systematic study involving a large number of CFD (computational fluid dynamics) simulations

  17. On the effects of systematic errors in analysis of nuclear scattering data.

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, M.T.; Steward, C.; Amos, K.; Allen, L.J.

    1995-07-05

    The effects of systematic errors on elastic scattering differential cross-section data upon the assessment of quality fits to that data have been studied. Three cases are studied, namely the differential cross-section data sets from elastic scattering of 200 MeV protons from {sup 12}C, of 350 MeV {sup 16}O-{sup 16}O scattering and of 288.6 MeV {sup 12}C-{sup 12}C scattering. First, to estimate the probability of any unknown systematic errors, select sets of data have been processed using the method of generalized cross validation; a method based upon the premise that any data set should satisfy an optimal smoothness criterion. In another case, the S function that provided a statistically significant fit to data, upon allowance for angle variation, became overdetermined. A far simpler S function form could then be found to describe the scattering process. The S functions so obtained have been used in a fixed energy inverse scattering study to specify effective, local, Schroedinger potentials for the collisions. An error analysis has been performed on the results to specify confidence levels for those interactions. 19 refs., 6 tabs., 15 figs.

  18. Translocation of particles deposited in the respiratory system: a systematic review and statistical analysis.

    Science.gov (United States)

    Nakane, Hideo

    2012-07-01

    Many epidemiological studies have demonstrated that ambient particulate matter poses consistent risks for respiratory and cardiovascular disorders. The translocation of inhaled particles is one hypothesis that could explain such systemic effects. The objectives of this study were to conduct a systematic review of previous reports on particle translocation from the respiratory system and to discuss factors important for translocation. A PubMed search was conducted in August 2011 for the period from 1967 with four main keyword domains (particle, translocation, detection site, and exposure route). The systematic review identified 61 original articles written in English that met the specified criteria (i.e., information on experiment and particle detection). Categorical regression analysis was performed with the site of particle detection as the objective variable, and particle size, particle material, animal species, and exposure route as the explanatory variables. All explanatory variables showed statistically significant effects. The effects for particle size and particle material were large, while the effects for animal species and exposure route were relatively small. There was a broad relationship between particle size and detection site: ≤50 nm for brain and remote organs; ≤1 μm for blood; and ≤10 μm for lung tissues. However, these results should be considered within the context of several limitations, such as deficiency of information.

  19. Domestic Violence Against Women In Turkey: A Systematic Review And Meta Analysis.

    Science.gov (United States)

    Özcan, Neslihan Keser; Günaydın, Sevil; Çitil, Elif Tuğçe

    2016-10-01

    This study was performed to determine the prevalence of and risk factors for domestic violence against women in Turkey. The data about domestic violence against women point out a serious problem all around the world along with including cultural differences. The prevalence of domestic violence against women was determined through a meta-analysis, and the risk factors were determined through a systematic review. A systematic search of eight electronic databases was conducted. In this study, 34 primary studies that were published between January 2000 and January 2015 were examined. The highest prevalence belonged to verbal violence followed by physical, emotional, economic, and sexual violence. Despite different questioning methods, it was determined that 22 risk factors were most commonly examined in the studies, and these risk factors were summed up under three separate categories: socio demographical characteristics, well-being related characteristics and marriage related characteristics. It is of further interest that the most commonly examined characteristics were socio demographic characteristics. Just as throughout the world, domestic violence is a common problem in Turkey. Nurses and midwives should focus not only on women's disorders but also on the difficulties the patient faces in regard to being a family. It presents valid evidence to produce policies on violence prevention. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Prevalence of asthenopia in children: a systematic review with meta-analysis.

    Science.gov (United States)

    Vilela, Manuel A P; Pellanda, Lucia C; Fassa, Anaclaudia G; Castagno, Victor D

    2015-01-01

    To estimate the prevalence of asthenopia in 0-18 year-old children through a systematic review and meta-analysis of prevalence studies. Inclusion criteria were population-based studies from 1960 to May of 2014 reporting the prevalence of asthenopia in children. The search was performed independently by two reviewers in the PubMed, EMBASE, and LILACS databases, with no language restriction. This systematic review was performed in accordance with the Cochrane Collaboration guidelines and the PRISMA Statement. Downs and Black score was used for quality assessment. Out of 1692 potentially relevant citations retrieved from electronic databases and searches of reference lists, 26 were identified as potentially eligible. Five of these studies met the inclusion criteria, comprising a total of 2465 subjects. Pooled prevalence of asthenopia was 19.7% (12.4-26.4%). The majority of children with asthenopia did not present visual acuity or refraction abnormalities. The largest study evaluated 1448 children aged 6 years and estimated a prevalence of 12.6%. Associated risk factors were not clearly established. Although asthenopia is a frequent and relevant clinical problem in childhood, with potential consequences for learning, the scarcity of studies about the prevalence and clinical impact of asthenopia hinders the effective planning of public health measures. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Prevalence of asthenopia in children: a systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Manuel A.P. Vilela

    2015-08-01

    Full Text Available OBJECTIVE: To estimate the prevalence of asthenopia in 0-18 year-old children through a systematic review and meta-analysis of prevalence studies.SOURCES: Inclusion criteria were population-based studies from 1960 to May of 2014 reporting the prevalence of asthenopia in children. The search was performed independently by two reviewers in the PubMed, EMBASE, and LILACS databases, with no language restriction. This systematic review was performed in accordance with the Cochrane Collaboration guidelines and the PRISMA Statement. Downs and Black score was used for quality assessment.SUMMARY OF FINDINGS: Out of 1692 potentially relevant citations retrieved from electronic databases and searches of reference lists, 26 were identified as potentially eligible. Five of these studies met the inclusion criteria, comprising a total of 2465 subjects. Pooled prevalence of asthenopia was 19.7% (12.4-26.4%. The majority of children with asthenopia did not present visual acuity or refraction abnormalities. The largest study evaluated 1448 children aged 6 years and estimated a prevalence of 12.6%. Associated risk factors were not clearly established.CONCLUSION: Although asthenopia is a frequent and relevant clinical problem in childhood, with potential consequences for learning, the scarcity of studies about the prevalence and clinical impact of asthenopia hinders the effective planning of public health measures.

  2. Chicken Essence for Cognitive Function Improvement: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Teoh, Siew Li; Sudfangsai, Suthinee; Lumbiganon, Pisake; Laopaiboon, Malinee; Lai, Nai Ming; Chaiyakunapruk, Nathorn

    2016-01-20

    Chicken essence (CE) is a popular traditional remedy in Asia, which is believed to improve cognitive functions. CE company claimed that the health benefits were proven with research studies. A systematic review was conducted to determine the cognitive-enhancing effects of CE. We systematically searched a number of databases for randomized controlled trials with human subjects consuming CE and cognitive tests involved. Cochrane's Risk of Bias (ROB) tool was used to assess the quality of trials and meta-analysis was performed. Seven trials were included, where six healthy subjects and one subject with poorer cognitive functions were recruited. One trial had unclear ROB while the rest had high ROB. For executive function tests, there was a significant difference favoring CE (pooled standardized mean difference (SMD) of -0.55 (-1.04, -0.06)) and another with no significant difference (pooled SMD of 0.70 (-0.001, 1.40)). For short-term memory tests, no significant difference was found (pooled SMD of 0.63 (-0.16, 1.42)). Currently, there is a lack of convincing evidence to show a cognitive enhancing effect of CE.

  3. Oscillometric and auscultatory blood pressure measurement methods in children: a systematic review and meta-analysis.

    Science.gov (United States)

    Duncombe, Stephanie L; Voss, Christine; Harris, Kevin C

    2017-02-01

    The phase-out of mercury from clinical settings calls for valid alternatives to assess blood pressure (BP) in children. Aneroid devices provide a mercury-free alternative to BP measurements by auscultation, whereas oscillometric (automated) devices are increasingly becoming the norm in clinical practice due to their ease of use. The aim of this systematic review and meta-analysis was to investigate the accuracy of oscillometric and aneroid BP devices compared with the mercury sphygmomanometer for the measurement of BP in children. We systematically searched four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) and relevant journals for eligible articles published before 30 July 2015. We screened 1415 articles, and two authors independently reviewed 92 full-text articles. We included 29 articles (38 studies) with 26 879 children. Random-effects model meta-analyses revealed that oscillometric devices yield higher measurements of SBP than auscultation with a mercury sphygmomanometer (pooled effect estimate 2.53 mmHg; 95% CI 0.57-4.50; P devices and found comparable results. Oscillometric devices may serve as a suitable alternative to auscultation for initial BP screening in the pediatric population.

  4. Meaning in life and physical health: systematic review and meta-analysis.

    Science.gov (United States)

    Czekierda, Katarzyna; Banik, Anna; Park, Crystal L; Luszczynska, Aleksandra

    2017-12-01

    This systematic review and meta-analysis aimed to clarify the associations between meaning in life and physical health using random-effects models. Conceptualisation of meaning (order in world vs. purpose in life), type of health indicators, participants' health status, and age issues were investigated as moderators. Systematic searches of six databases resulted in inclusion of k = 66 studies (total N = 73,546). Findings indicated that meaning in life and physical health formed weak-to-moderate associations (the overall estimate of the average effect = 0.258). Conceptualisation of meaning, participants' health status, and their age did not moderate these associations. Operationalisation of health moderated the relationship between meaning in life and health. The strongest associations were found for subjective indicators of physical health. Significant albeit weak associations between meaning in life and objective indices of health were found. Furthermore, stronger effects were observed when the measures of meaning combined items referring to meaning in life and meaning-related sense of harmony, peace, and well-being, compared to measures focusing solely on meaning in life. Overall, the results point to the potential role of meaning in life in explaining physical health.

  5. Vitamin D and food allergies in children: A systematic review and meta-analysis.

    Science.gov (United States)

    Willits, Erin K; Wang, Zhen; Jin, Jay; Patel, Bhavisha; Motosue, Megan; Bhagia, Amrita; Almasri, Jehad; Erwin, Patricia J; Kumar, Seema; Joshi, Avni Y

    2017-05-01

    Vitamin D insufficiency has been associated with immune dysfunction and linked to the epidemic of atopic diseases in the Western hemisphere, yet there are studies with conflicting results, and the risk has not been quantified uniformly across studies. To perform a systematic review and meta-analysis to evaluate and quantify if vitamin D deficiency is associated with the presence and persistence of food allergy. A systematic review was undertaken to assess for the association between food allergy and vitamin D status in children. A total of 368 citations relevant to this systematic review were identified. In the whole review, 5105 children were included. We did not find a significant association between 25 hydroxy vitamin D (25(OH)D) status and risk of food allergy in children (odds ratio [OR] 1.35 [95% confidence interval {CI}, 0.79-2.29]; p = 0.27, I2 = 58.3%). We conducted subgroup analyses based on different cutoffs of the 25(OH)D status (20 versus 30 ng/mL). Only one study used 30 ng/mL and found that children with children with a 25(OH)D status of ≥30 ng/mL (OR 2.04 [95% CI, 1.02-4.04]; p = 0.04). Four studies compared children with a 25(OH)D status of children with a 25(OH)D status of ≥20 ng/mL and found no significant differences (OR 1.18 [95% CI, 0.62-2.27]; p = 0.62, I2 = 62.7%). Based on the studies analyzed, this systematic review did not identify a significant association between vitamin D status and food allergy. Interpretation of the included studies was limited by a lack of a standard definition for vitamin D deficiency and insufficient knowledge regarding the optimal vitamin D status needed to impact immune function. Longitudinal studies are warranted to assess if vitamin D might contribute to the development of food allergy.

  6. Using digital notifications to improve attendance in clinic: systematic review and meta-analysis.

    Science.gov (United States)

    Robotham, Dan; Satkunanathan, Safarina; Reynolds, John; Stahl, Daniel; Wykes, Til

    2016-10-24

    Assess the impact of text-based electronic notifications on improving clinic attendance, in relation to study quality (according to risk of bias), and to assess simple ways in which notifications can be optimised (ie, impact of multiple notifications). Systematic review, study quality appraisal assessing risk of bias, data synthesised in meta-analyses. MEDLINE, EMBASE, PsycINFO, Web of Science and Cochrane Database of Systematic Reviews (01.01.05 until 25.4.15). A systematic search to discover all studies containing quantitative data for synthesis into meta-analyses. Studies examining the effect of text-based electronic notifications on prescheduled appointment attendance in healthcare settings. Primary analysis included experimental studies where randomisation was used to define allocation to intervention and where a control group consisting of 'no reminders' was used. Secondary meta-analysis included studies comparing text reminders with voice reminders. Studies lacking sufficient information for inclusion (after attempting to contact study authors) were excluded. Primary outcomes were rate of attendance/non-attendance at healthcare appointments. Secondary outcome was rate of rescheduled and cancelled appointments. 26 articles were included. 21 included in the primary meta-analysis (8345 patients receiving electronic text notifications, 7731 patients receiving no notifications). Studies were included from Europe (9), Asia (7), Africa (2), Australia (2) and America (1). Patients who received notifications were 23% more likely to attend clinic than those who received no notification (risk ratio=1.23, 67% vs 54%). Those receiving notifications were 25% less likely to 'no show' for appointments (risk ratio=.75, 15% vs 21%). Results were similar when accounting for risk of bias, region and publication year. Multiple notifications were significantly more effective at improving attendance than single notifications. Voice notifications appeared more effective than text

  7. Scaling analysis in modeling transport and reaction processes a systematic approach to model building and the art of approximation

    CERN Document Server

    Krantz, William B

    2007-01-01

    This book is unique as the first effort to expound on the subject of systematic scaling analysis. Not written for a specific discipline, the book targets any reader interested in transport phenomena and reaction processes. The book is logically divided into chapters on the use of systematic scaling analysis in fluid dynamics, heat transfer, mass transfer, and reaction processes. An integrating chapter is included that considers more complex problems involving combined transport phenomena. Each chapter includes several problems that are explained in considerable detail. These are followed by several worked examples for which the general outline for the scaling is given. Each chapter also includes many practice problems. This book is based on recognizing the value of systematic scaling analysis as a pedagogical method for teaching transport and reaction processes and as a research tool for developing and solving models and in designing experiments. Thus, the book can serve as both a textbook and a reference boo...

  8. Stress ulcer prophylaxis versus placebo or no prophylaxis in adult hospitalised acutely ill patients-protocol for a systematic review with meta-analysis and trial sequential analysis

    DEFF Research Database (Denmark)

    Marker, Søren; Perner, Anders; Wetterslev, Jørn

    2017-01-01

    or no prophylaxis as control interventions. The participants will be adult hospitalised acutely ill patients with high risk of gastrointestinal bleeding. 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 using the Grading of Recommendations Assessment...

  9. Risk of venous thromboembolism in patients with celiac disease: A systematic review and meta-analysis.

    Science.gov (United States)

    Ungprasert, Patompong; Wijarnpreecha, Karn; Tanratana, Pansakorn

    2016-07-01

    Patients with celiac disease (CD) might be at an increased risk of developing venous thromboembolism (VTE) due to chronic inflammation and vitamin deficiency. However, epidemiologic studies attempting to investigate this risk have yielded inconsistent results. We conducted this meta-analysis with the aims to better characterize this possible association. We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of VTE in patients with CD versus participants without CD. Generic inverse variance method of DerSimonian and Laird was used to calculate the pooled risk ratio. Out of 279 potentially relevant articles, four studies met the inclusion criteria and were included in the meta-analysis. We found a statistically significant increased risk of VTE among patients with CD with the pooled risk ratio of 1.25 (95% confidence interval, 1.02-1.53). The statistical heterogeneity was moderate with an I(2) of 69%. A significantly increased risk of VTE among patients with CD was demonstrated in this meta-analysis. Further studies are required to clarify how this risk should be addressed in clinical practice. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  10. Inertial Sensor Technology for Elite Swimming Performance Analysis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Robert Mooney

    2015-12-01

    Full Text Available Technical evaluation of swimming performance is an essential factor of elite athletic preparation. Novel methods of analysis, incorporating body worn inertial sensors (i.e., Microelectromechanical systems, or MEMS, accelerometers and gyroscopes, have received much attention recently from both research and commercial communities as an alternative to video-based approaches. This technology may allow for improved analysis of stroke mechanics, race performance and energy expenditure, as well as real-time feedback to the coach, potentially enabling more efficient, competitive and quantitative coaching. The aim of this paper is to provide a systematic review of the literature related to the use of inertial sensors for the technical analysis of swimming performance. This paper focuses on providing an evaluation of the accuracy of different feature detection algorithms described in the literature for the analysis of different phases of swimming, specifically starts, turns and free-swimming. The consequences associated with different sensor attachment locations are also considered for both single and multiple sensor configurations. Additional information such as this should help practitioners to select the most appropriate systems and methods for extracting the key performance related parameters that are important to them for analysing their swimmers’ performance and may serve to inform both applied and research practices.

  11. Risk associated with central catheters for malignant tumor patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Lv, Yajuan; Hou, Yong; Pan, Bo; Ma, Yuwan; Li, Paiyun; Yu, Lili; Xu, Deguo; Song, Juanjuan; Shang, Heli; Wang, Hongyan; Tian, Yuan

    2018-02-23

    The risk of venous thrombosis and mortality associated with central catheter (PICC/CICC) for malignant tumor patients is not definite. So, we carried out a systematic review and meta-analysis to evaluate it. Among patients with comparing PICC with CICC, odds ratio (OR) or risk ratio (RR) was calculated with a random effect model meta-analysis. The result of the stratification analysis of 7 studies (PICC vs CICC) supported the theory that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs. 7 of 15 studies provided the information about the compared mortality rate of the patients. The result showed that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs (OR = 0.45, 95% CI:0.32-0.62, p < 0.0001, I 2 = 0%,Tau 2 = 0.00). Meta-analysis of 8 studies of 2639 patients showed that pharmacological deep vein thrombosis prophylaxis drugs could decrease the risk of mortality of malignant tumor patients with CICCs (RR = 0.58, 95% CI:0.48-0.71, Z = 5.32, p < 0.0001, I 2 = 71%). We found that PICCs are associated with a raised risk of deep vein thrombosis, and pharmacological deep vein thrombosis prophylaxis drugs is a beneficial factor in decreasing the incidence of thrombosis, while warfarin may decrease the risk of mortality of malignant tumor patients with CICCs.

  12. Inertial Sensor Technology for Elite Swimming Performance Analysis: A Systematic Review

    Science.gov (United States)

    Mooney, Robert; Corley, Gavin; Godfrey, Alan; Quinlan, Leo R; ÓLaighin, Gearóid

    2015-01-01

    Technical evaluation of swimming performance is an essential factor of elite athletic preparation. Novel methods of analysis, incorporating body worn inertial sensors (i.e., Microelectromechanical systems, or MEMS, accelerometers and gyroscopes), have received much attention recently from both research and commercial communities as an alternative to video-based approaches. This technology may allow for improved analysis of stroke mechanics, race performance and energy expenditure, as well as real-time feedback to the coach, potentially enabling more efficient, competitive and quantitative coaching. The aim of this paper is to provide a systematic review of the literature related to the use of inertial sensors for the technical analysis of swimming performance. This paper focuses on providing an evaluation of the accuracy of different feature detection algorithms described in the literature for the analysis of different phases of swimming, specifically starts, turns and free-swimming. The consequences associated with different sensor attachment locations are also considered for both single and multiple sensor configurations. Additional information such as this should help practitioners to select the most appropriate systems and methods for extracting the key performance related parameters that are important to them for analysing their swimmers’ performance and may serve to inform both applied and research practices. PMID:26712760

  13. The effects of aromatherapy on sleep improvement: a systematic literature review and meta-analysis.

    Science.gov (United States)

    Hwang, Eunhee; Shin, Sujin

    2015-02-01

    To evaluate the existing data on aromatherapy interventions for improvement of sleep quality. Systematic literature review and meta-analysis on the effects of aromatherapy. Study Sources: Electronic databases, including the Korea Education and Research Information Service (KERIS), Korean studies Information Service System (KISS), National Assembly Library, and eight academies within the Korean Society of Nursing Science, were searched to identify studies published between 2000 and August 2013. Randomized controlled and quasi-experimental trials that included aromatherapy for the improvement of sleep quality. Of the 245 publications identified, 13 studies met the inclusion and exclusion criteria, and 12 studies were used in the meta-analysis. Meta-analysis of the 12 studies using a random-effects model revealed that the use of aromatherapy was effective in improving sleep quality (95% confidence interval [CI], 0.540-1.745; Z=3.716). Subgroup analysis revealed that inhalation aromatherapy (95% CI, 0.792-1.541; Z=6.107) was more effective than massage therapy (95% CI, 0.128-2.166; Z=2.205) in unhealthy (95% CI, 0.248-1.100; Z=3.100) and healthy (95% CI, 0.393-5.104; Z=2.287) participants, respectively. Readily available aromatherapy treatments appear to be effective and promote sleep. Thus, it is essential to develop specific guidelines for the efficient use of aromatherapy.

  14. Survival after radiotherapy in gastric cancer: Systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Valentini, Vincenzo; Cellini, Francesco; Minsky, Bruce D.; Mattiucci, Gian Carlo; Balducci, Mario; D'Agostino, Giuseppe; D'Angelo, Elisa; Dinapoli, Nicola; Nicolotti, Nicola; Valentini, Chiara; La Torre, Giuseppe

    2009-01-01

    Background and purpose: A systematic review and meta-analysis was performed to assess the impact of radiotherapy on both 3- and 5-year survival in patients with resectable gastric cancer. Methods: Randomized Clinical Trials (RCTs) in which radiotherapy, (preoperative, postoperative and/or intraoperative), was compared with surgery alone or surgery plus chemotherapy in resectable gastric cancer were identified by searching web-based databases and supplemented by manual examination of reference lists. Meta-analysis was performed using Risk Ratios (RRs). Random or fixed effects models were used to combine data. The methodological quality was evaluated by Chalmers' score. Results: Radiotherapy had a significant impact on 5-year survival. Using an intent to treat (ITT) and a Per Protocol (PP) analysis, the overall 5-year RR was 1.26 (95% CI: 1.08-1.48; NNT = 17) and 1.31 (95% CI: 1.04-1.66; NNT = 13), respectively. Although the quality of the studies was variable, the data were consistent and no clear publication bias was found. Conclusion: This meta-analysis showed a statistically significant 5-year survival benefit with the addition of radiotherapy in patients with resectable gastric cancer. Radiotherapy remains a standard component in the treatment of resectable gastric cancer and new RCTs need to address the impact of new conformal radiotherapy technologies.

  15. Insomnia and risk of dementia in older adults: Systematic review and meta-analysis.

    Science.gov (United States)

    de Almondes, Katie Moraes; Costa, Mônica Vieira; Malloy-Diniz, Leandro Fernandes; Diniz, Breno Satler

    2016-06-01

    There are cross-sectional evidences of an association between sleep disorders and cognitive impairment on older adults. However, there are no consensus by means of longitudinal studies data on the increased risk of developing dementia related to insomnia. We conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia in individuals with insomnia in population-based prospective cohort studies. Five studies of 5.242 retrieved references were included in the meta-analysis. We used the generic inverse variance method with a random effects model to calculate the pooled risk of dementia in older adults with insomnia. We assessed heterogeneity in the meta-analysis by means of the Q-test and I2 index. Study quality was assessed with the Newcastle-Ottawa Scale The results showed that Insomnia was associated with a significant risk of all-cause dementia (RR = 1.53 CI95% (1.07-2.18), z = 2.36, p = 0.02). There was evidence for significant heterogeneity in the analysis (q-value = 2.4, p Insomnia is associated with an increased risk for dementia. This results provide evidences that future studies should investigate dementia prevention among elderly individuals through screening and proper management of insomnia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Brain-Derived Neurotrophic Factor Levels in Autism: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Saghazadeh, Amene; Rezaei, Nima

    2017-04-01

    Brain-derived neurotrophic factor (BDNF) plays an important role in activity-dependent synaptic plasticity. Altered blood BDNF levels have been frequently identified in people with autism spectrum disorders (ASD). There are however wide discrepancies in the evidence. Therefore, we performed the present systematic review and meta-analysis aimed at qualitative and quantitative synthesis of studies that measured blood BDNF levels in ASD and control subjects. Observational studies were identified through electronic database searching and also hand-searching of reference lists of relevant articles. A total of 183 papers were initially identified for review and eventually twenty studies were included in the meta-analysis. A meta-analysis of blood BDNF in 887 patients with ASD and 901 control subjects demonstrated significantly higher BDNF levels in ASD compared to controls with the SMD of 0.47 (95% CI 0.07-0.86, p = 0.02). In addition subgroup meta-analyses were performed based on the BDNF specimen. The present meta-analysis study led to conclusion that BDNF might play role in autism initiation/ propagation and therefore it can be considered as a possible biomarker of ASD.

  17. Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome.

    Science.gov (United States)

    Rodríguez-Zúñiga, Milton José Max; García-Perdomo, Herney Andrés

    2017-10-01

    Several studies have shown a relationship between psoriasis and metabolic syndrome (MS), but no meta-analysis has been restricted to studies that adjusted for confounders. To determine the association between psoriasis and MS. A systematic review and meta-analysis of observational studies on psoriasis and MS in adults was performed from MEDLINE, Scopus, SciELO, Google Scholar, Science Direct, and LILACS from inception to January 2016. We performed a random effects model meta-analysis for those studies reporting adjusted odds ratios (ORs) with 95% confidence intervals (CIs). The subgroup analysis was related to geographic location, diagnosis criteria and risk of bias. In all, 14 papers including a total of 25,042 patients with psoriasis were analyzed. We found that MS was present in 31.4% of patients with psoriasis (OR, 1.42; 95% CI, 1.28-1.65). Middle Eastern studies (in Israel, Turkey, and Lebanon) (OR, 1.76, 95% CI, 0.86-2.67) reported a greater risk for MS than European studies (in Germany, Italy, the United Kingdom, Norway, and Denmark) (OR, 1.40; 95% CI, 1.25-1.55). Few adjusted studies existed, and there was inconsistency between publications. Because of the increased risk for MS, clinicians should consider screening patients with psoriasis for metabolic risk factors. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Midodrine for orthostatic hypotension: a systematic review and meta-analysis of clinical trials.

    Science.gov (United States)

    Parsaik, Ajay K; Singh, Balwinder; Altayar, Osama; Mascarenhas, Soniya S; Singh, Shannon K; Erwin, Patricia J; Murad, M Hassan

    2013-11-01

    To perform a systematic review and meta-analysis of clinical trials evaluating the efficacy and safety of midodrine in orthostatic hypotension (OH). We searched major databases and related conference proceedings through June 30, 2012. Two reviewers independently selected studies and extracted data. Random-effects meta-analysis was used to pool the outcome measures across studies. Seven trials were included in the efficacy analysis (enrolling 325 patients, mean age 53 years) and two additional trials were included in the safety analysis. Compared to placebo, the mean change in systolic blood pressure was 4.9 mmHg (p = 0.65) and the mean change in mean arterial pressure from supine to standing was -1.7 mmHg (p = 0.45). The change in standing systolic blood pressure before and after giving midodrine was 21.5 mmHg (p midodrine. The quality of evidence was limited by imprecision, heterogeneity and increased risk of bias. There is insufficient and low quality evidence to support the use of midodrine for OH.

  19. IgM ELISA for leptospirosis diagnosis: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Maria Ines Rosa

    Full Text Available Abstract A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library was conducted. The medical subject headings (MeSHs and the words “leptospirosis”, “human leptospirosis” and “IgM ELISA” were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87% and specificity was 90% (CI 95%, 89%-91%. In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85% and 91% (CI 95%, 90%-91%, respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.

  20. A systematic review and meta-analysis of teachers’ development of digital literacy

    DEFF Research Database (Denmark)

    Khalid, Md. Saifuddin; Slættalíð, Tóri; Parveen, Mahmuda

    2015-01-01

    Teachers’ development of digital literacy (DL) is gaining importance with the increase in the integration and adoption of information and communication technologies in educational contexts. The focus has been predominantly on students and not much on teachers, who require greater attention due...... of teachers’ as an agenda for the transformation at both individual level and organizational level. Applying the methodology elaborated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, 16 peer-reviewed articles were selected. Constant-comparative method was used...... for the qualitative analysis. This paper reports on three main categories: (a) definition of digital literacy, (b) development of digital literacy of pre-service and in-service teachers and (c) models for the development and evaluation of digital literacy. The general definitions of DL include the elements...

  1. Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Snorgaard, Ole; Møller, Grith; Andersen, Henning K

    2017-01-01

    Objective: Nutrition therapy is an integral part of selfmanagement education in patients with type 2 diabetes. Carbohydrates with a low glycemic index are recommended, but the ideal amount of carbohydrate in the diet is unclear. We performed a meta-analysis comparing diets containing low...... to moderate amounts of carbohydrate (LCD) (energy percentage below 45%) to diets containing high amounts of carbohydrate (HCD) in subjects with type 2 diabetes. Research design and methods: We systematically reviewed Cochrane library databases, EMBASE, and MEDLINE in the period 2004–2014 for guidelines, meta...... to moderate carbohydrate diets have greater effect on glycemic control in type 2 diabetes compared with high-carbohydrate diets in the first year of intervention. The greater the carbohydrate restriction, the greater glucose lowering, a relationship that has not been demonstrated earlier. Apart from...

  2. Effects and safety of acupuncture for DFUs: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Ting Shuai

    2016-01-01

    Full Text Available Objective: To systematically evaluate the effect and safety of acupuncture for the treatment of diabetic foot ulcers (DFUs. Methods: Six databases, including Pubmed, Web of Science, EMbase, the Cochrane Library, the Chinese Biomedical Literature Database (CBM, and the China National Knowledge Infrastructure (CNKI, were electronic searched for randomized controlled trials (RCTs. Retrieval periods from each database were stopped until 30 October, 2014. Cochrane risk of bias assessment tool was used to assess the methodological quality of included studies. Results: A total of 8 trials involving 481 participants met the inclusion criteria. The results of meta and descriptive analysis suggested that acupuncture effectively improved total effective rate of DFUs, shortened ulcer healing time , and improved the blood flow volume, but acupuncture did not ameliorate vessel diameter and peak velocity. No serious adverse events were identified in acupuncture group. Conclusions: Acupuncture is more effective in shortening overall treatment time. Acupuncture has advantages over the control group in curative effect.

  3. Robotic Versus Laparoscopic Bariatric Surgery: a Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Li, Kun; Zou, Jianan; Tang, Jianxiong; Di, Jianzhong; Han, Xiaodong; Zhang, Pin

    2016-12-01

    We aim to summarize the available literature on patients treated with robotic bariatric surgery (RBS) or laparoscopic bariatric surgery (LBS) and compare the clinical outcomes between RBS and LBS. A systematic literature was conducted in accordance with the PRISMA guidelines. Thirty-four observational studies met our inclusion criteria, and 27 studies of 27,997 patients were included in the meta-analysis. There were no significant differences between RBS and LBS regarding overall postoperative complications, major complications, the length of hospital stay, reoperation, conversion, and mortality. Nevertheless, RBS was burdened by longer operative times and higher hospital costs when compared with LBS. On the contrary, the incidence of anastomotic leak was lower in RBS than in LBS. Further studies with a longer follow-up are recommended.

  4. Qualitative Evaluation Methods in Ethics Education: A Systematic Review and Analysis of Best Practices.

    Science.gov (United States)

    Watts, Logan L; Todd, E Michelle; Mulhearn, Tyler J; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

    2017-01-01

    Although qualitative research offers some unique advantages over quantitative research, qualitative methods are rarely employed in the evaluation of ethics education programs and are often criticized for a lack of rigor. This systematic review investigated the use of qualitative methods in studies of ethics education. Following a review of the literature in which 24 studies were identified, each study was coded based on 16 best practices characteristics in qualitative research. General thematic analysis and grounded theory were found to be the dominant approaches used. Researchers are effectively executing a number of best practices, such as using direct data sources, structured data collection instruments, non-leading questioning, and expert raters. However, other best practices were rarely present in the courses reviewed, such as collecting data using multiple sources, methods, raters, and timepoints, evaluating reliability, and employing triangulation analyses to assess convergence. Recommendations are presented for improving future qualitative research studies in ethics education.

  5. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Kamper, S.J.; Apeldoorn, A.T.; Chiarotto, A.

    2015-01-01

    Objective To assess the long term effects of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain. Design Systematic review and random effects meta-analysis of randomised controlled trials. Data sources Electronic searches of Cochrane Back Review Group Trials...... Register, CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to February 2014, supplemented by hand searching of reference lists and forward citation tracking of included trials. Study selection criteria Trials published in full; participants with low back pain for more than three months......; multidisciplinary rehabilitation involved a physical component and one or both of a psychological component or a social or work targeted component; multidisciplinary rehabilitation was delivered by healthcare professionals from at least two different professional backgrounds; multidisciplinary rehabilitation...

  6. Behavior Therapy for Tourette Syndrome: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Wile, Daryl J; Pringsheim, Tamara M

    2013-08-01

    When tics caused by Tourette Syndrome cause meaningful impairment for patients, a comprehensive treatment approach includes education of patients, peers, and family, treatment of comorbid behavioral disorders if present, and consideration of behavior therapy and pharmacotherapy for tics themselves. This systematic review and meta-analysis demonstrates that behavior therapies based on Habit Reversal Therapy, including the Comprehensive Behavioral Intervention for Tics are effective in reducing tic severity when compared with supportive psychotherapy. When these behavior therapies are unavailable, Exposure with Response Prevention may also be effective. Both face-to-face and telehealth delivery methods for behavior therapy improve tic severity, and broader distribution of behavior therapy through increased training or telehealth methods is encouraged. High-quality randomized trials comparing behavior therapies for tics with pharmacotherapy are needed.

  7. CYD-TDV dengue vaccine: systematic review and meta-analysis of efficacy, immunogenicity and safety.

    Science.gov (United States)

    Godói, Isabella Piassi; Lemos, Livia Lovato Pires; de Araújo, Vânia Eloisa; Bonoto, Braúlio Cesar; Godman, Brian; Guerra Júnior, Augusto Afonso

    2017-03-01

    Dengue virus (DENV) is a serious global health problem. CYD-TDC (Dengvaxia ® ) was the first vaccine to gain regulatory approval to try and address this problem. Summarize all available evidence on the immunogenicity, efficacy and safety of the CYD-TDV dengue vaccine. Meta-analysis and systematic review. The best and worst immunogenicity results were for DENV4 and DENV1, respectively. Vaccine efficacy of 60% was derived from studies with participants aged 2-16 years old, with DENV4 and DENV2 presenting the best and worst results, respectively. Erythema and swelling were more frequent with CYD-TDV. No differences were detected for systemic adverse events. CYD-TDV showed moderate efficacy in children and adolescents. From the immunogenicity results in adults, we can expect satisfactory efficacy from vaccination in this population.

  8. SustainPro - A tool for systematic process analysis, generation and evaluation of sustainable design alternatives

    DEFF Research Database (Denmark)

    Carvalho, Ana; Matos, Henrique A.; Gani, Rafiqul

    2013-01-01

    . The software tool is based on the implementation of an extended systematic methodology for sustainable process design (Carvalho et al. 2008 and Carvalho et al. 2009). Using process information/data such as the process flowsheet, the associated mass / energy balance data and the cost data, SustainPro guides......Chemical processes are continuously facing challenges from the demands of the global market related to economics, environment and social issues. This paper presents the development of a software tool (SustainPro) and its application to chemical processes operating in batch or continuous modes...... the user through the necessary steps according to work-flow of the implemented methodology. At the end the design alternatives, are evaluated using environmental impact assessment tools and safety indices. The extended features of the methodology incorporate Life Cycle Assessment analysis and economic...

  9. Expressed Emotion in relatives of persons with dementia: a systematic review and meta-analysis.

    Science.gov (United States)

    Safavi, Roxanne; Berry, Katherine; Wearden, Alison

    2017-02-01

    Expressed Emotion (EE) refers to a number of key aspects of interpersonal relationships which have been shown to relate to outcomes in relatives of people with health conditions. A systematic review and meta-analysis of EE and outcomes in relatives of persons with dementia is reported. Potential research studies were identified via a search of three electronic databases; PsychINFO, MEDLINE and the Web of Science between 1960 and 2015. We reviewed 12 studies investigating correlations between EE and well-being in relatives of patients with dementia. Factors hypothesised to influence EE including attributions, social support, coping strategies and relationship quality were also reviewed. High-EE relatives were found to have increased levels of burden (Z = 6.967, P problems to factors that were personal to and controllable by the patient. Relatives with less social support, inefficient coping strategies and a poor relationship with the patients, were more likely to be classified as high-EE.

  10. Preeclampsia and Future Cardiovascular Health: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Wu, Pensée; Haththotuwa, Randula; Kwok, Chun Shing; Babu, Aswin; Kotronias, Rafail A; Rushton, Claire; Zaman, Azfar; Fryer, Anthony A; Kadam, Umesh; Chew-Graham, Carolyn A; Mamas, Mamas A

    2017-02-01

    Preeclampsia is a pregnancy-specific disorder resulting in hypertension and multiorgan dysfunction. There is growing evidence that these effects persist after pregnancy. We aimed to systematically evaluate and quantify the evidence on the relationship between preeclampsia and the future risk of cardiovascular diseases. We studied the future risk of heart failure, coronary heart disease, composite cardiovascular disease, death because of coronary heart or cardiovascular disease, stroke, and stroke death after preeclampsia. A systematic search of MEDLINE and EMBASE was performed to identify relevant studies. We used random-effects meta-analysis to determine the risk. Twenty-two studies were identified with >6.4 million women including >258 000 women with preeclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that preeclampsia was independently associated with an increased risk of future heart failure (risk ratio [RR], 4.19; 95% confidence interval [CI], 2.09-8.38), coronary heart disease (RR, 2.50; 95% CI, 1.43-4.37), cardiovascular disease death (RR, 2.21; 95% CI, 1.83-2.66), and stroke (RR, 1.81; 95% CI, 1.29-2.55). Sensitivity analyses showed that preeclampsia continued to be associated with an increased risk of future coronary heart disease, heart failure, and stroke after adjusting for age (RR, 3.89; 95% CI, 1.83-8.26), body mass index (RR, 3.16; 95% CI, 1.41-7.07), and diabetes mellitus (RR, 4.19; 95% CI, 2.09-8.38). Preeclampsia is associated with a 4-fold increase in future incident heart failure and a 2-fold increased risk in coronary heart disease, stroke, and death because of coronary heart or cardiovascular disease. Our study highlights the importance of lifelong monitoring of cardiovascular risk factors in women with a history of preeclampsia. © 2017 American Heart Association, Inc.

  11. Diastolic dysfunction as a predictor of weaning failure: A systematic review and meta-analysis.

    Science.gov (United States)

    de Meirelles Almeida, C A; Nedel, W L; Morais, V D; Boniatti, M M; de Almeida-Filho, O C

    2016-08-01

    Weaning failure and prolonged mechanical ventilation are associated with increased morbidity, cost of care, and high mortality rates. In the last few years, cardiac performance has been recognized as a common etiology of weaning failure, and growing evidence suggests that left ventricular diastolic dysfunction is a key factor that determines weaning outcomes. Therefore, we performed a systematic review and a meta-analysis to evaluate whether diastolic dysfunction in the critically ill patient subjected to mechanical ventilation is an independent predictor of weaning failure. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar, and ClinicalTrials.gov from inception to September 2014, along with conferences proceeding from January 2005 through September 2014, and included Observational Studies and Randomized Clinical Trials evaluating predictors of weaning failure. Ten studies were included in the systematic review; and 7, in the meta-analysis (6 observational studies and 1 randomized controlled trial). Patients who developed weaning failure had a higher E/e' ratio when compared with those who did not (mean difference, 2.65; 95% confidence interval, 0.52-4.79; P= .01); however, there was no difference in the E/A ratio (mean difference, 0.07; 95% confidence interval, -0.04 to 0.18; P= .22). Both the E/e' and E/A ratios were associated with weaning-induced pulmonary edema at the end of a spontaneous breathing trial. A higher E/e' ratio is significantly associated with weaning failure, although a high heterogeneity of diastolic dysfunction criteria and different clinical scenarios limit additional conclusions linking diastolic dysfunction with weaning failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Steffl M

    2017-05-01

    Full Text Available Michal Steffl,1 Richard W Bohannon,2 Lenka Sontakova,1 James J Tufano,1 Kate Shiells,3 Iva Holmerova3 1Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University Prague, Prague, Czech Republic; 2Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC, USA; 3Faculty of Humanities, Centre of Gerontology, Charles University Prague, Prague, Czech Republic Abstract: Physical activity (PA has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCOhost, and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37–0.55. The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia. Keywords: aging, sarcopenia, physical activity 

  13. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

    Science.gov (United States)

    Rando-Matos, Yolanda; Pons-Vigués, Mariona; López, María José; Córdoba, Rodrigo; Ballve-Moreno, José Luis; Puigdomènech-Puig, Elisa; Benito-López, Vega Estíbaliz; Arias-Agudelo, Olga Lucía; López-Grau, Mercè; Guardia-Riera, Anna; Trujillo, José Manuel; Martin-Cantera, Carlos

    2017-01-01

    The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36%) than for asthma (5-31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.

  14. In silico method for systematic analysis of feature importance in microRNA-mRNA interactions

    Directory of Open Access Journals (Sweden)

    Wen Zhining

    2009-12-01

    Full Text Available Abstract Background MicroRNA (miRNA, which is short non-coding RNA, plays a pivotal role in the regulation of many biological processes and affects the stability and/or translation of mRNA. Recently, machine learning algorithms were developed to predict potential miRNA targets. Most of these methods are robust but are not sensitive to redundant or irrelevant features. Despite their good performance, the relative importance of each feature is still unclear. With increasing experimental data becoming available, research interest has shifted from higher prediction performance to uncovering the mechanism of microRNA-mRNA interactions. Results Systematic analysis of sequence, structural and positional features was carried out for two different data sets. The dominant functional features were distinguished from uninformative features in single and hybrid feature sets. Models were developed using only statistically significant sequence, structural and positional features, resulting in area under the receiver operating curves (AUC values of 0.919, 0.927 and 0.969 for one data set and of 0.926, 0.874 and 0.954 for another data set, respectively. Hybrid models were developed by combining various features and achieved AUC of 0.978 and 0.970 for two different data sets. Functional miRNA information is well reflected in these features, which are expected to be valuable in understanding the mechanism of microRNA-mRNA interactions and in designing experiments. Conclusions Differing from previous approaches, this study focused on systematic analysis of all types of features. Statistically significant features were identified and used to construct models that yield similar accuracy to previous studies in a shorter computation time.

  15. Antiviral Therapy in Steroid-refractory Ulcerative Colitis with Cytomegalovirus: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Shukla, Tushar; Singh, Siddharth; Loftus, Edward V; Bruining, David H; McCurdy, Jeffrey D

    2015-11-01

    The role of antiviral therapy in patients with ulcerative colitis (UC) with cytomegalovirus (CMV) remains unclear. We therefore performed a systematic review and meta-analysis to assess the association between antiviral therapy and the risk of colectomy. Multiple electronic databases were searched systematically through July 2014 for studies reporting the risk of colectomy in patients with UC with CMV stratified by treatment with antiviral agents. Colectomy rates were assessed for the overall cohort and stratified by corticosteroid (CS) refractoriness. We estimated summary odds ratios and 95% confidence intervals, using random-effects model, and used Grading of Recommendations Assessment, Development, and Evaluation criteria to appraise the quality of evidence. Fifteen observational studies (333 patients with UC with CMV, 43.2% treated with antiviral agents) were identified, of which 8 stratified patients according to CS-refractory disease (55.4% treated with antiviral agents). Antiviral therapy resulted in a significantly lower risk of colectomy in patients with CS-refractory disease (odds ratio, 0.20; 95% confidence interval, 0.08-0.49; I = 0%) but not in the overall population of patients with UC (odds ratio, 0.92; 95% confidence interval, 0.31-2.76; I = 65). The quality evidence was low. The results were stable when restricting the analysis to patients with a tissue diagnosis of CMV and studies that defined CS-refractory disease as a failure to respond to intravenous CS. Antiviral therapy may benefit a subgroup of patients with UC who are refractory to CS. Further prospective trials are required to confirm these findings.

  16. Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis.

    Science.gov (United States)

    Strawn, Jeffrey R; Welge, Jeffrey A; Wehry, Anna M; Keeshin, Brooks; Rynn, Moira A

    2015-03-01

    Randomized controlled trials have demonstrated that antidepressants are efficacious in the treatment of anxiety disorders in youth. However, there are no recent, systematic analyses of the efficacy, safety, or tolerability of these medications in pediatric anxiety disorders. A systematic review and meta-analysis of prospective, randomized, parallel-group, controlled trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in pediatric patients with non-obsessive compulsive disorder (OCD) anxiety disorders was undertaken using a search of PubMed/Medline (1966-2014). The meta-analysis utilized random-effects models to evaluate change in the Pediatric Anxiety Rating Scale or similar anxiety scale, suicidality, and adverse events. Additionally, pharmacologic variables were explored with regard to effect size, although no correction for multiple comparisons was made with regard to these relationships. Nine trials involving 1,673 patients and six medications were included. All SSRI/SSNRIs evaluated demonstrated efficacy, and the meta-analytic estimate of effect was of moderate magnitude (Cohen's d = 0.62, confidence interval [CI]: 0.34-0.89, P = .009) and there was evidence of modest heterogeneity (I(2) = 0.29, P = .103). Activation trended toward being more likely with antidepressant treatment (OR: 1.86, CI: 0.98-3.53, P = .054), but no increased risk was observed for nausea/abdominal symptoms (P = .262), discontinuation as a result of an adverse event (P = .132), or suicidality (OR: 1.3, CI: 0.53-3.2, P = .514). Finally, the effect size correlated with the serotonergic specificity of the agent (R = .79, P = .021). Data for nine SSRI/SSNRIs suggest superiority of antidepressants relative to placebo for the treatment of pediatric anxiety disorders with a moderate effect size. © 2014 Wiley Periodicals, Inc.

  17. Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis.

    Science.gov (United States)

    Richards, Suzanne H; Anderson, Lindsey; Jenkinson, Caroline E; Whalley, Ben; Rees, Karen; Davies, Philippa; Bennett, Paul; Liu, Zulian; West, Robert; Thompson, David R; Taylor, Rod S

    2018-02-01

    Background Although psychological interventions are recommended for the management of coronary heart disease (CHD), there remains considerable uncertainty regarding their effectiveness. Design Systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for CHD. Methods The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and PsycINFO were searched to April 2016. Retrieved papers, systematic reviews and trial registries were hand-searched. We included RCTs with at least 6 months of follow-up, comparing the direct effects of psychological interventions to usual care for patients following myocardial infarction or revascularisation or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data and assessed risk of bias. Studies were pooled using random effects meta-analysis and meta-regression was used to explore study-level predictors. Results Thirty-five studies with 10,703 participants (median follow-up 12 months) were included. Psychological interventions led to a reduction in cardiovascular mortality (rfcelative risk 0.79, 95% confidence interval [CI] 0.63 to 0.98), although no effects were observed for total mortality, myocardial infarction or revascularisation. Psychological interventions improved depressive symptoms (standardised mean difference [SMD] -0.27, 95% CI -0.39 to -0.15), anxiety (SMD -0.24, 95% CI -0.38 to -0.09) and stress (SMD -0.56, 95% CI -0.88 to -0.24) compared with controls. Conclusions We found that psychological intervention improved psychological symptoms and reduced cardiac mortality for people with CHD. However, there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD.

  18. Anterior Palatoplasty for Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Binar, Murat; Karakoc, Omer

    2018-03-01

    Objective The aim of this study was to determine the general outcomes and surgical success rates of anterior palatoplasty (AP) in patients with obstructive sleep apnea (OSA). Data Sources A systematic review of the literature and meta-analysis of published data were performed by searching the Cochrane, SAGE, MEDLINE, and Google Scholar databases, from January 1, 2007, to March 27, 2017, using relevant keywords. Review Methods The search scanned for studies with patients who had undergone AP (with or without tonsillectomy) as a single-stage, single-level surgical intervention for treatment of OSA. Two independent reviewers (M.B. and O.K.) inspected titles and abstracts of the studies according to established criteria. The full texts were then reviewed to extract the clinical and polysomnographic data. The primary outcome was the surgical success rate, defined as a reduction in the apnea-hypopnea index (AHI) of 50% or greater and an AHI of less than 20 postoperatively. The PRISMA statement was followed. Results After systematic evaluation of potentially relevant articles, 14 studies were downloaded, and 6 studies, consisting of 170 patients, met the study criteria. A fixed effects model was used to analyze the data. The surgical success rate of AP was 60.6%. No serious complications were reported in the literature. Conclusion The results of the present meta-analysis support AP as a moderately effective surgical method for the treatment of OSA. Comparative and randomized controlled prospective studies showing long-term results, with pre- and postoperative data, should be conducted to demonstrate the exact outcomes and reliability of this surgical technique.

  19. Systematic Analysis of Blood Cell Transcriptome in End-Stage Chronic Respiratory Diseases

    Science.gov (United States)

    Botturi, Karine; Reynaud-Gaubert, Martine; Mussot, Sacha; Stern, Marc; Danner-Boucher, Isabelle; Mornex, Jean-François; Pison, Christophe; Dromer, Claire; Kessler, Romain; Dahan, Marcel; Brugière, Olivier; Le Pavec, Jérôme; Perros, Frédéric; Humbert, Marc; Gomez, Carine; Brouard, Sophie; Magnan, Antoine

    2014-01-01

    Background End-stage chronic respiratory diseases (CRD) have systemic consequences, such as weight loss and susceptibility to infection. However the mechanisms of such dysfunctions are as yet poorly explained. We hypothesized that the genes putatively involved in these mechanisms would emerge from a systematic analysis of blood mRNA profiles from pre-transplant patients with cystic fibrosis (CF), pulmonary hypertension (PAH), and chronic obstructive pulmonary disease (COPD). Methods Whole blood was first collected from 13 patients with PAH, 23 patients with CF, and 28 Healthy Controls (HC). Microarray results were validated by quantitative PCR on a second and independent group (7PAH, 9CF, and 11HC). Twelve pre-transplant COPD patients were added to validate the common signature shared by patients with CRD for all causes. To further clarify a role for hypoxia in the candidate gene dysregulation, peripheral blood mononuclear cells from HC were analysed for their mRNA profile under hypoxia. Results Unsupervised hierarchical clustering allowed the identification of 3 gene signatures related to CRD. One was common to CF and PAH, another specific to CF, and the final one was specific to PAH. With the common signature, we validated T-Cell Factor 7 (TCF-7) and Interleukin 7 Receptor (IL-7R), two genes related to T lymphocyte activation, as being under-expressed. We showed a strong impact of the hypoxia on modulation of TCF-7 and IL-7R expression in PBMCs from HC under hypoxia or PBMCs from CRD. In addition, we identified and validated genes upregulated in PAH or CF, including Lectin Galactoside-binding Soluble 3 and Toll Like Receptor 4, respectively. Conclusions Systematic analysis of blood cell transcriptome in CRD patients identified common and specific signatures relevant to the systemic pathologies. TCF-7 and IL-7R were downregulated whatever the cause of CRD and this could play a role in the higher susceptibility to infection of these patients. PMID:25329529

  20. Do antibiotics decrease implant failure and postoperative infections? A systematic review and meta-analysis.

    Science.gov (United States)

    Ata-Ali, J; Ata-Ali, F; Ata-Ali, F

    2014-01-01

    The purpose of this study was to systematically review and perform a comprehensive meta-analysis of the current literature to answer the following question: among patients receiving dental implants, does the use of antibiotics, when compared with a control group, reduce the frequency of implant failure and postoperative infection? A manual and electronic PubMed search of the literature was made to identify randomized controlled trials (RCTs) on the efficacy of antibiotics compared with a control group (not receiving antibiotics or receiving placebo). Four RCTs were included in the final review. These four RCTs grouped a total of 2063 implants and a total of 1002 patients. Antibiotic use significantly lowered the implant failure rate (P = 0.003), with an odds ratio of 0.331, implying that antibiotic treatment reduced the odds of failure by 66.9%. The number needed to treat (NNT) to prevent one patient from having an implant failure was 48 (95% confidence interval 31-109). In contrast, antibiotic use did not significantly reduce the incidence of postoperative infection (P = 0.754). Based on the results of this meta-analysis, and pending further research in the field, it can be concluded that there is evidence in favour of systematic antibiotic use in patients receiving dental implants, since such treatment significantly reduces implant failure. In contrast, antibiotic use does not exert a significant preventive effect against postoperative infection. Our recommendations for future research focus on the performance of large-scale RCTs to identify the best choice of antibiotic, timing of administration, and dose. Increased effort is also required to reach consensus and define the most effective antibiotic treatment protocol for patients who are allergic to beta-lactams and for those who are not. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Distance management of inflammatory bowel disease: systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Vivian W; Reich, Krista M; Fedorak, Richard N

    2014-01-21

    To review the effectiveness of distance management methods in the management of adult inflammatory bowel disease (IBD) patients. A systematic review and meta-analysis of randomized controlled trials comparing distance management and standard clinic follow-up in the management of adult IBD patients. Distance management intervention was defined as any remote management method in which there is a patient self-management component whereby the patient interacts remotely via a self-guided management program, electronic interface, or self-directs open access to clinic follow up. The search strategy included electronic databases (Medline, PubMed, CINAHL, The Cochrane Central Register of Controlled Trials, EMBASE, KTPlus, Web of Science, and SCOPUS), conference proceedings, and internet search for web publications. The primary outcome was the mean difference in quality of life, and the secondary outcomes included mean difference in relapse rate, clinic visit rate, and hospital admission rate. Study selection, data extraction, and risk of bias assessment were completed by two independent reviewers. The search strategy identified a total of 4061 articles, but only 6 randomized controlled trials met the inclusion and exclusion criteria for the systematic review and meta-analysis. Three trials involved telemanagement, and three trials involved directed patient self-management and open access clinics. The total sample size was 1463 patients. There was a trend towards improved quality of life in distance management patients with an end IBDQ quality of life score being 7.28 (95%CI: -3.25-17.81) points higher than standard clinic follow-up. There was a significant decrease in the clinic visit rate among distance management patients mean difference -1.08 (95%CI: -1.60--0.55), but no significant change in relapse rate or hospital admission rate. Distance management of IBD significantly decreases clinic visit utilization, but does not significantly affect relapse rates or hospital

  2. Contamination of cockroaches (Insecta: Blattaria) to medically fungi: A systematic review and meta-analysis.

    Science.gov (United States)

    Nasirian, H

    2017-12-01

    Fungal infections have emerged worldwide. Cockroaches have been proved vectors of medically fungi. A systematic meta-analysis review about cockroach fungal contamination was investigated. Relevant topics were collected between January 2016 and January 2017. After a preliminary review among 392 collected papers, 156 were selected to become part of the detailed systematic meta-analysis review. Cockroaches contaminated to 38 fungi species belonging to 19 families and 12 orders. About 38, 25 and 13 fungal species were recovered from the American, German and brown-banded cockroaches, respectively with a variety of medical importance. Except the fungi isolated from German and brown-banded cockroaches, 15 species have been isolated only from the American cockroaches. The global world mean and trend of cockroach fungal contamination were 84.1 and 50.6-100%, respectively in the human dwelling environments. There is a significant difference between cockroach fungal contamination in the urban and rural environments (P0.05). The external and internal cockroach fungal contamination is more dangerous than entire surfaces, while the internal is more dangerous than the external surface. The German and brown-banded cockroach fungal contamination are more dangerous than the American cockroaches in the hospital environments. The study indicates that globally cockroach fungal contamination has been increased recognizing as agents of human infections and associating with high morbidity and mortality in immune-compromised patients. These facts, along with insecticide resistance emergence and increasing globally cockroach infestation, reveal importance of cockroaches and need for their control more than ever. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Danshenchuanxiongqin injection in the treatment of unstable angina pectoris: a systematic review and Meta-analysis.

    Science.gov (United States)

    Zhang, Xiaomeng; Wu, Jiarui; Zhang, Bing; Zhou, Wei

    2016-04-01

    To evaluate systematically the efficacy and safety of Danshenchuanxiongqin Injection (DCI) in the treatment of unstable angina pectoris (UAP). Randomized controlled trials (RCTs) regarding DCI used for treating UAP were searched in English and Chinese electronic databases from inception to January 2014. Two reviewers independently retrieved RCTs and extracted relevant information. The Cochrane risk of bias method was used to assess the quality of included studies, and a Meta-analysis was conducted with Review Manager 5.2 software. Eleven RCTs involving 1034 participants were included. The methodological quality was relatively passable. The Meta-analysis indicated that the combined use of DCI and conventional treatment with Western Medicine (WM) was more efficacious in the outcomes of total effective rate [Relative Risk (RR) = 1.27, 95% CI (confidence interval; 1.18, 1.35), P < 0.000 01], the total effective rate of ECG [RR = 1.40, 95% CI (1.18, 1.66), P < 0.000 01], total cholesterol [Mean difference (MD) = -0.58, 95% CI (- 0.83, - 0.33), P < 0.000 01], total triglycerides [MD = - 0.36, 95% CI (- 0.54, - 0.17), P = 0.0001], and the number of ST-segment depression [MD = -0.36, 95% CI (- 0.54, - 0.17), P = 0.0001]. There were two adverse drug reactions reported in one study. Based on the systematic review, DCI combined with WM appeared to be efficacious in the treatment UAP. However, the evidence of DCI for treating UAP requires large-scale and double-blind RCTs to substantiate these findings.

  4. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

    Science.gov (United States)

    Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

    2015-07-01

    Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. 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.

  5. Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Hole, Jenny; Hirsch, Martin; Ball, Elizabeth; Meads, Catherine

    2015-10-24

    Music is a non-invasive, safe, and inexpensive intervention that can be delivered easily and successfully. We did a systematic review and meta-analysis to assess whether music improves recovery after surgical procedures. We included randomised controlled trials (RCTs) of adult patients undergoing surgical procedures, excluding those involving the central nervous system or head and neck, published in any language. We included RCTs in which any form of music initiated before, during, or after surgery was compared with standard care or other non-drug interventions. We searched MEDLINE, Embase, CINAHL, and Cochrane Central. We did meta-analysis with RevMan (version 5.2), with standardised mean differences (SMD) and random-effects models, and used Stata (version 12) for meta-regression. This study is registered with PROSPERO, number CRD42013005220. We identified 4261 titles and abstracts, and included 73 RCTs in the systematic review, with size varying between 20 and 458 participants. Choice of music, timing, and duration varied. Comparators included routine care, headphones with no music, white noise, and undisturbed bed rest. Music reduced postoperative pain (SMD -0·77 [95% CI -0·99 to -0·56]), anxiety (-0·68 [-0·95 to -0·41]), and analgesia use (-0·37 [-0·54 to -0·20]), and increased patient satisfaction (1·09 [0·51 to 1·68]), but length of stay did not differ (SMD -0·11 [-0·35 to 0·12]). Subgroup analyses showed that choice of music and timing of delivery made little difference to outcomes. Meta-regression identified no causes of heterogeneity in eight variables assessed. Music was effective even when patients were under general anaesthetic. Music could be offered as a way to help patients reduce pain and anxiety during the postoperative period. Timing and delivery can be adapted to individual clinical settings and medical teams. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Barriers to accessing methamphetamine treatment: A systematic review and meta-analysis.

    Science.gov (United States)

    Cumming, Craig; Troeung, Lakkhina; Young, Jesse T; Kelty, Erin; Preen, David B

    2016-11-01

    Methamphetamine use is associated with a range of poor health, social and justice outcomes. In many parts of the world increased methamphetamine use has been identified as a major public health concern. Methamphetamine treatment programmes have been effective in reducing and ceasing use, however a range of barriers have prevented these programmes being widely adopted by methamphetamine users. This review examines the barriers to accessing meth/amphetamine treatment identified in the literature. Databases were systematically searched using relevant terms for peer-reviewed articles describing original research exploring the barriers to accessing treatment for meth/amphetamine use. Reviews and grey literature were excluded. Eleven studies conducted in 5 countries were included in data synthesis; this involved a systematic review of all 11 studies, and meta-analysis of the prevalence of barriers reported in 6 studies that published sufficient quantitative data. Psychosocial/internal barriers to accessing methamphetamine treatment were most prevalent across studies (10/11 studies). Meta-analysis confirmed the four most commonly endorsed barriers to treatment access across studies all psychosocial barriers were embarrassment or stigma (60%, 95% CI: 54-67%); belief that treatment was unnecessary (59%, 95% CI:54-65%); preferring to withdraw alone without assistance (55%, 95% CI:45-65); and privacy concerns (51%, 95% CI:44-59%). The primary barriers to accessing methamphetamine treatment are psychosocial/internal. Services and treatment models that address these barriers are urgently required. There is a growing need for methamphetamine-appropriate treatment services. Further research evaluating treatment engagement and effectiveness for methamphetamine and polysubstance use, including the development of effective pharmacotherapies is warranted. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. 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.

  8. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yolanda Rando-Matos

    Full Text Available The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose among all populations.Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1 original scientific studies about smokefree legislation, 2 Data before and after legislation were collected, and 3 Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment.A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers. Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months. Four (50% of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36% than for asthma (5-31%. Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46% of the studies.Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms and, to a lesser degree, rates of hospitalization for

  9. Mechanical properties of provisional dental materials: A systematic review and meta-analysis.

    Science.gov (United States)

    Astudillo-Rubio, Daniela; Delgado-Gaete, Andrés; Bellot-Arcís, Carlos; Montiel-Company, José María; Pascual-Moscardó, Agustín; Almerich-Silla, José Manuel

    2018-01-01

    Provisional restorations represent an important phase during the rehabilitation process, knowledge of the mechanical properties of the available materials allows us to predict their clinical performance. At present, there is no systematic review, which supports the clinicians' criteria, in the selection of a specific material over another for a particular clinical situation. The purpose of this systematic review and meta-analysis was to assess and compare the mechanical properties of dimethacrylates and monomethacrylates used in fabricating direct provisional restorations, in terms of flexural strength, fracture toughness and hardness. This review followed the PRISMA guidelines. The searches were conducted in PubMed, Embase, Web of Science, Scopus, the New York Academy of Medicine Grey Literature Report and were complemented by hand-searching, with no limitation of time or language up to January 10, 2017. Studies that assess and compare the mechanical properties of dimethacrylate- and monomethacrylate-based provisional restoration materials were selected. A quality assessment of full-text articles were performed according to modified ARRIVE and CONSORT criteria and modified Cochrane Collaboration's tool for in vitro studies. Initially, 256 articles were identified. After removing the duplicates and applying the selection criteria, 24 articles were included in the qualitative synthesis and 7 were included in the quantitative synthesis (meta-analysis). It may be concluded that dimethacrylate-based provisional restorations presented better mechanical behavior than monomethacrylate-based ones in terms of flexural strength and hardness. Fracture toughness showed no significant differences. Within the monomethacrylate group, polymethylmethacrylate showed greater flexural strength than polyethylmethacrylate.

  10. Mechanical properties of provisional dental materials: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Daniela Astudillo-Rubio

    Full Text Available Provisional restorations represent an important phase during the rehabilitation process, knowledge of the mechanical properties of the available materials allows us to predict their clinical performance. At present, there is no systematic review, which supports the clinicians' criteria, in the selection of a specific material over another for a particular clinical situation. The purpose of this systematic review and meta-analysis was to assess and compare the mechanical properties of dimethacrylates and monomethacrylates used in fabricating direct provisional restorations, in terms of flexural strength, fracture toughness and hardness. This review followed the PRISMA guidelines. The searches were conducted in PubMed, Embase, Web of Science, Scopus, the New York Academy of Medicine Grey Literature Report and were complemented by hand-searching, with no limitation of time or language up to January 10, 2017. Studies that assess and compare the mechanical properties of dimethacrylate- and monomethacrylate-based provisional restoration materials were selected. A quality assessment of full-text articles were performed according to modified ARRIVE and CONSORT criteria and modified Cochrane Collaboration's tool for in vitro studies. Initially, 256 articles were identified. After removing the duplicates and applying the selection criteria, 24 articles were included in the qualitative synthesis and 7 were included in the quantitative synthesis (meta-analysis. It may be concluded that dimethacrylate-based provisional restorations presented better mechanical behavior than monomethacrylate-based ones in terms of flexural strength and hardness. Fracture toughness showed no significant differences. Within the monomethacrylate group, polymethylmethacrylate showed greater flexural strength than polyethylmethacrylate.

  11. DAPK1 Promoter Methylation and Cervical Cancer Risk: A Systematic Review and a Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Antonella Agodi

    Full Text Available The Death-Associated Protein Kinase 1 (DAPK1 gene has been frequently investigated in cervical cancer (CC. The aim of the present study was to carry out a systematic review and a meta-analysis in order to evaluate DAPK1 promoter methylation as an epigenetic marker for CC risk.A systematic literature search was carried out. The Cochrane software package Review Manager 5.2 was used. The fixed-effects or random-effects models, according to heterogeneity across studies, were used to calculate odds ratios (ORs and 95% Confidence Intervals (CIs. Furthermore, subgroup analyses were conducted by histological type, assays used to evaluate DAPK1 promoter methylation, and control sample source.A total of 20 papers, published between 2001 and 2014, on 1929 samples, were included in the meta-analysis. DAPK1 promoter methylation was associated with an increased CC risk based on the random effects model (OR: 21.20; 95%CI = 11.14-40.35. Omitting the most heterogeneous study, the between study heterogeneity decreased and the association increased (OR: 24.13; 95% CI = 15.83-36.78. The association was also confirmed in all the subgroups analyses.A significant strong association between DAPK1 promoter methylation and CC was shown and confirmed independently by histological tumor type, method used to evaluate methylation and source of control samples. Methylation markers may have value in early detection of CC precursor lesions, provide added reassurances of safety for women who are candidates for less frequent screens, and predict outcomes of women infected with human papilloma virus.

  12. Prevalence of Voice Disorders in Singers: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Pestana, Pedro Melo; Vaz-Freitas, Susana; Manso, Maria Conceição

    2017-11-01

    The study aimed to review the prevalence of self-reported voice disorders in singers. The study is a systematic review and meta-analysis. A systematic review of five major scientific databases was conducted. An extensive search strategy was used considering the rules of each database. Original articles were included only if they had data related to self-perception of dysphonia in the past. Furthermore, heterogeneity and its relative significance were assessed. There were 2371 articles identified; duplicates were deleted, screenings were conducted, and inclusion and exclusion criteria were applied. The final analysis was conducted on 11 studies. The most implemented instruments for the study were customized questionnaires. The findings about singing styles, voice use, and age were found to be different among subjects. The overall prevalence of self-reported dysphonia in singers was 46.09% (95% confidence interval: 38.16-54.12). The heterogeneity was considerable among the studied samples (I 2  = 90.59%). Four groups were then established-students, teachers, classical, and nonclassical-and compared regarding overall prevalence (21.76% in students, and significantly higher and nondifferent in the other three groups, 55.15%, 40.53%, and 46.96%, respectively) and heterogeneity (low only for the students' studies). Although with low homogeneity, singers present a high prevalence of self-perceived dysphonia over their careers. Singing students were the group with a lower prevalence. On the other hand, traditional and popular music singers, as well as singing teachers, revealed significantly higher prevalence of self-perceived dysphonia. Overall, singers are likely to report voice disorders, no matter their singing style or skills. This highlights the need of a preventive approach to address voice disorders in traditional and untrained singers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Item response theory analysis of cognitive tests in people with dementia: a systematic review.

    Science.gov (United States)

    McGrory, Sarah; Doherty, Jason M; Austin, Elizabeth J; Starr, John M; Shenkin, Susan D

    2014-02-19

    Performance on psychometric tests is key to diagnosis and monitoring treatment of dementia. Results are often reported as a total score, but there is additional information in individual items of tests which vary in their difficulty and discriminatory value. Item difficulty refers to an ability level at which the probability of responding correctly is 50%. Discrimination is an index of how well an item can differentiate between patients of varying levels of severity. Item response theory (IRT) analysis can use this information to examine and refine measures of cognitive functioning. This systematic review aimed to identify all published literature which had applied IRT to instruments assessing global cognitive function in people with dementia. A systematic review was carried out across Medline, Embase, PsychInfo and CINHAL articles. Search terms relating to IRT and dementia were combined to find all IRT analyses of global functioning scales of dementia. Of 384 articles identified four studies met inclusion criteria including a total of 2,920 people with dementia from six centers in two countries. These studies used three cognitive tests (MMSE, ADAS-Cog, BIMCT) and three IRT methods (Item Characteristic Curve analysis, Samejima's graded response model, the 2-Parameter Model). Memory items were most difficult. Naming the date in the MMSE and memory items, specifically word recall, of the ADAS-cog were most discriminatory. Four published studies were identified which used IRT on global cognitive tests in people with dementia. This technique increased the interpretative power of the cognitive scales, and could be used to provide clinicians with key items from a larger test battery which would have high predictive value. There is need for further studies using IRT in a wider range of tests involving people with dementia of different etiology and severity.

  14. How do authors of systematic reviews deal with research malpractice and misconduct in original studies? A cross-sectional analysis of systematic reviews and survey of their authors.

    Science.gov (United States)

    Elia, Nadia; von Elm, Erik; Chatagner, Alexandra; Pöpping, Daniel M; Tramèr, Martin R

    2016-03-02

    To study whether systematic reviewers apply procedures to counter-balance some common forms of research malpractice such as not publishing completed research, duplicate publications, or selective reporting of outcomes, and to see whether they identify and report misconduct. Cross-sectional analysis of systematic reviews and survey of their authors. 118 systematic reviews published in four journals (Ann Int Med, BMJ, JAMA, Lancet), and the Cochrane Library, in 2013. Number (%) of reviews that applied procedures to reduce the impact of: (1) publication bias (through searching of unpublished trials), (2) selective outcome reporting (by contacting the authors of the original studies), (3) duplicate publications, (4) sponsors' and (5) authors' conflicts of interest, on the conclusions of the review, and (6) looked for ethical approval of the studies. Number (%) of reviewers who suspected misconduct are reported. The procedures applied were compared across journals. 80 (68%) reviewers confirmed their data. 59 (50%) reviews applied three or more procedures; 11 (9%) applied none. Unpublished trials were searched in 79 (66%) reviews. Authors of original studies were contacted in 73 (62%). Duplicate publications were searched in 81 (69%). 27 reviews (23%) reported sponsors of the included studies; 6 (5%) analysed their impact on the conclusions of the review. Five reviews (4%) looked at conflicts of interest of study authors; none of them analysed their impact. Three reviews (2.5%) looked at ethical approval of the studies. Seven reviews (6%) suspected misconduct; only 2 (2%) reported it explicitly. Procedures applied differed across the journals. Only half of the systematic reviews applied three or more of the six procedures examined. Sponsors, conflicts of interest of authors and ethical approval remain overlooked. Research misconduct is sometimes identified, but rarely reported. Guidance on when, and how, to report suspected misconduct is needed. Published by the BMJ

  15. Nutritional Status in Nocturnal Hemodialysis Patients - A Systematic Review with Meta-Analysis.

    Science.gov (United States)

    Ipema, Karin J R; Struijk, Simone; van der Velden, Annet; Westerhuis, Ralf; van der Schans, Cees P; Gaillard, Carlo A J M; Krijnen, Wim P; Franssen, Casper F M

    2016-01-01

    Hemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition. Systematic review with meta-analysis. NHD patients. Systematic literature search from databases, Medline, Cinahl, EMBASE and The Cochrane Library, to identify studies reporting on nutritional status post-transition from CHD to NHD. Transition from CHD to NHD. Albumin, normalized protein catabolic rate (nPCR), dry body weight (DBW), body mass index (BMI), phase angle, protein intake, and energy intake. Systematic literature search revealed 13 studies comprising 282 patients that made the transition from CHD to NHD. Meta-analysis included nine studies in 229 patients. In control group controlled studies (n = 4), serum albumin increased significantly from baseline to 4-6 months in NHD patients compared with patients that remained on CHD (mean difference 1.3 g/l, 95% CI 0.02; 2.58, p = 0.05). In baseline controlled studies, from baseline to 4-6 months of NHD treatment, significant increases were ascertained in serum albumin (mean difference (MD) 1.63 g/l, 95% CI 0.73-2.53, p<0.001); nPCR (MD 0.16 g/kg/day; 95% CI 0.04-0.29, p = 0.01); protein intake (MD 18.9 g, 95% CI 9.7-28.2, p<0.001); and energy intake (MD 183.2 kcal, 95% CI 16.8-349.7, p = 0.03). Homogeneity was rejected only for nPCR (baseline versus 4-6 months). DBW, BMI, and phase angle did not significantly change. Similar results were obtained for comparison between baseline and 8-12 months of NHD treatment. Most studies had moderate sample sizes; some had incomplete dietary records

  16. Nutritional Status in Nocturnal Hemodialysis Patients – A Systematic Review with Meta-Analysis

    Science.gov (United States)

    Ipema, Karin J. R.; Struijk, Simone; van der Velden, Annet; Westerhuis, Ralf; van der Schans, Cees P.; Gaillard, Carlo A. J. M.; Krijnen, Wim P.; Franssen, Casper F. M.

    2016-01-01

    Background Hemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition. Study design Systematic review with meta-analysis. Population NHD patients. Search strategy Systematic literature search from databases, Medline, Cinahl, EMBASE and The Cochrane Library, to identify studies reporting on nutritional status post-transition from CHD to NHD. Intervention Transition from CHD to NHD. Outcomes Albumin, normalized protein catabolic rate (nPCR), dry body weight (DBW), body mass index (BMI), phase angle, protein intake, and energy intake. Results Systematic literature search revealed 13 studies comprising 282 patients that made the transition from CHD to NHD. Meta-analysis included nine studies in 229 patients. In control group controlled studies (n = 4), serum albumin increased significantly from baseline to 4–6 months in NHD patients compared with patients that remained on CHD (mean difference 1.3 g/l, 95% CI 0.02; 2.58, p = 0.05). In baseline controlled studies, from baseline to 4–6 months of NHD treatment, significant increases were ascertained in serum albumin (mean difference (MD) 1.63 g/l, 95% CI 0.73–2.53, p<0.001); nPCR (MD 0.16 g/kg/day; 95% CI 0.04–0.29, p = 0.01); protein intake (MD 18.9 g, 95% CI 9.7–28.2, p<0.001); and energy intake (MD 183.2 kcal, 95% CI 16.8–349.7, p = 0.03). Homogeneity was rejected only for nPCR (baseline versus 4–6 months). DBW, BMI, and phase angle did not significantly change. Similar results were obtained for comparison between baseline and 8–12 months

  17. Updated systematic review and meta-analysis of acupuncture for chronic knee pain.

    Science.gov (United States)

    Zhang, Qinhong; Yue, Jinhuan; Golianu, Brenda; Sun, Zhongren; Lu, Ying

    2017-12-01

    To assess the effectiveness and safety of acupuncture for the treatment of chronic knee pain (CKP). We searched the MEDLINE, EMBASE, Cochrane CENTERAL, CINAHL and four Chinese medical databases from their inception to June 2017. We included randomised controlled trials of acupuncture as the sole treatment or as an adjunctive treatment for CKP. The primary outcome was pain intensity measured by visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and 11-point numeric rating scale. Secondary outcome measurements included the 36-Item Short Form Health Survey and adverse events. The quality of all included studies was evaluated using the Cochrane risk-of-bias criteria and the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) checklist. Nineteen trials were included in this systematic review. Of these, data from 17 studies were available for analysis. Regarding the effectiveness of acupuncture alone or combined with other treatment, the results of the meta-analysis showed that acupuncture was associated with significantly reduced CKP at 12 weeks on WOMAC pain subscale (mean difference (MD) -1.12, 95% confidence interval (CI) -1.98 to -0.26, I 2 =62%, 3 trials, 608 participants) and VAS (MD -10.56, 95% CI -17.69 to -3.44, I 2 =0%, 2 trials, 145 patients). As for safety, no difference was found between the acupuncture and control groups (risk ratio 1.08, 95% CI 0.54 to 2.17, I 2 =29%). From this systematic review, we conclude that acupuncture may be effective at relieving CKP 12 weeks after acupuncture administration, based on the current evidence and our protocol. However, given the heterogeneity and methodological limitations of the included trials, we are currently unable to draw any strong conclusions regarding the effectiveness of acupuncture for chronic knee pain. In addition, we found that acupuncture appears to have a satisfactory safety profile, although further

  18. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs.

    Science.gov (United States)

    de Vries, Max; Seppala, Lotta J; Daams, Joost G; van de Glind, Esther M M; Masud, Tahir; van der Velde, Nathalie

    2018-04-01

    Use of certain medications is recognized as a major and modifiable risk factor for falls. Although the literature on psychotropic drugs is compelling, the literature on cardiovascular drugs as potential fall-risk-increasing drugs is conflicting. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the associations between cardiovascular medications and fall risk in older adults. Design: A systematic review and meta-analysis. Medline, Embase, and PsycINFO. Key search concepts were "fall," "aged," "causality," and "medication." Studies that investigated cardiovascular medications as risk factors for falls in participants ≥60 years old or participants with a mean age of 70 or older were included. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratios (ORs) separately. In total, 131 studies were included in the qualitative synthesis. Meta-analysis using adjusted ORs showed significant results (pooled OR [95% confidence interval]) for loop diuretics, OR 1.36 (1.17, 1.57), and beta-blocking agents, OR 0.88 (0.80, 0.97). Meta-analysis using unadjusted ORs showed significant results for digitalis, OR 1.60 (1.08, 2.36); digoxin, OR 2.06 (1.56, 2.74); and statins, OR 0.80 (0.65, 0.98). Most of the meta-analyses resulted in substantial heterogeneity that mostly did not disappear after stratification for population and setting. In a descriptive synthesis, consistent associations were not observed. Loop diuretics were significantly associated with increased fall risk, whereas beta-blockers were significantly associated with decreased fall risk. Digitalis and digoxin may increase the risk of falling, and statins may reduce it. For the majority of cardiovascular medication groups, outcomes were inconsistent. Furthermore, recent studies indicate that specific drug properties, such as selectivity of beta-blockers, may affect fall risk, and drug-disease interaction also may play

  19. Intranasal corticosteroids compared with oral antihistamines in allergic rhinitis: A systematic review and meta-analysis.

    Science.gov (United States)

    Juel-Berg, Nanna; Darling, Peter; Bolvig, Julie; Foss-Skiftesvik, Majken H; Halken, Susanne; Winther, Lone; Hansen, Kirsten Skamstrup; Askjaer, Nikolaj; Heegaard, Steffen; Madsen, Anders R; Opstrup, Morten S

    2017-01-09

    Intranasal corticosteroids (INS) (corticosteroid nasal sprays) and oral antihistamines (OA) are two of the most common treatments for patients with allergic rhinitis (AR). To our knowledge, there are no systematic reviews on this topic including trials published after 2007. To compare INS with nonsedating OAs as treatments for AR. The systematic review and meta-analysis were based on the Grades of Recommendation, Assessment, Development, and Evaluation principles and the Patient, Intervention, Comparison, and Outcome approach. Primary literature was searched up to January 22, 2015. Criteria for eligibility were randomized controlled trials that compared the efficacy and/or adverse effects of INS and OA in patients with AR. Continuous outcome data were analyzed by using standardized mean differences (SMD) for multiple outcome measures, and mean differences in the case of a single study or outcome. Pooled estimates of effects, 95% confidence interval (CI), were calculated by using random-effects models. The meta-analysis included five randomized controlled trials with a total of 990 patients. INS were superior to OAs in improving total nasal symptoms score (SMD -0.70 [95% CI, -0.93 to -0.47]) and in relieving the following: nasal obstruction (SMD -0.56 [95% CI, -0.82 to -0.29]), rhinorrhea (SMD -0.47 [95% CI, -1.00 to 0.05]), nasal itching (SMD -0.42 [95% CI, -0.65 to -0.18]), sneezing (SMD -0.52 [95% CI, -0.73 to -0.32]), and quality of life mean difference -0.90 [95% CI, -1.18 to -0.62]). There was no difference in relief of ocular symptoms (SMD -0.08 [95% CI, -0.23 to 0.08]). In addition, four randomized controlled trials were included in a narrative analysis. The results in the narrative analysis were comparable with those found in the meta-analysis. INS were superior to OAs in improving nasal symptoms and quality of life in patients with AR.

  20. Chronic subdural hematoma: a systematic review and meta-analysis of surgical procedures.

    Science.gov (United States)

    Liu, Weiming; Bakker, Nicolaas A; Groen, Rob J M

    2014-09-01

    In this paper the authors systematically evaluate the results of different surgical procedures for chronic subdural hematoma (CSDH). The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other databases were scrutinized according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement, after which only randomized controlled trials (RCTs) and quasi-RCTs were included. At least 2 different neurosurgical procedures in the management of chronic subdural hematoma (CSDH) had to be evaluated. Included studies were assessed for the risk of bias. Recurrence rates, complications, and outcome including mortality were taken as outcome measures. Statistical heterogeneity in each meta-analysis was assessed using the T(2) (tau-squared), I(2), and chi-square tests. The DerSimonian-Laird method was used to calculate the summary estimates using the fixed-effect model in meta-analysis. Of the 297 studies identified, 19 RCTs were included. Of them, 7 studies evaluated the use of postoperative drainage, of which the meta-analysis showed a pooled OR of 0.36 (95% CI 0.21-0.60; p < 0.001) in favor of drainage. Four studies compared twist drill and bur hole procedures. No significant differences between the 2 methods were present, but heterogeneity was considered to be significant. Three studies directly compared the use of irrigation before drainage. A fixed-effects meta-analysis showed a pooled OR of 0.49 (95% CI 0.21-1.14; p = 0.10) in favor of irrigation. Two studies evaluated postoperative posture. The available data did not reveal a significant advantage in favor of the postoperative supine posture. Regarding positioning of the catheter used for drainage, it was shown that a frontal catheter led to a better outcome. One study compared duration of drainage, showing that 48 hours of drainage was as effective as 96 hours of drainage. Postoperative drainage has the advantage of reducing recurrence without increasing complications

  1. Balloon Dilatation and Stenting for Aortic Coarctation: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Salcher, Maximilian; Naci, Huseyin; Law, Tyler J; Kuehne, Titus; Schubert, Stephan; Kelm, Marcus

    2016-06-01

    There is no systematic assessment of available evidence on effectiveness and comparative effectiveness of balloon dilatation and stenting for aortic coarctation. We systematically searched 4 online databases to identify and select relevant studies of balloon dilatation and stenting for aortic coarctation based on a priori criteria (PROSPERO 2014:CRD42014014418). We quantitatively synthesized results for each intervention from single-arm studies and obtained pooled estimates for relative effectiveness from pairwise and network meta-analysis of comparative studies. Our primary analysis included 15 stenting (423 participants) and 12 balloon dilatation studies (361 participants), including patients ≥10 years of age. Post-treatment blood pressure gradient reduction to ≤20 and ≤10 mm Hg was achieved in 89.5% (95% confidence interval, 83.7-95.3) and 66.5% (44.1-88.9%) of patients undergoing balloon dilatation, and in 99.5% (97.5-100.0%) and 93.8% (88.5-99.1%) of patients undergoing stenting, respectively. Odds of achieving ≤20 mm Hg were lower with balloon dilatation as compared with stenting (odds ratio, 0.105 [0.010-0.886]). Thirty-day survival rates were comparable. Numerically more patients undergoing balloon dilatation experienced severe complications during admission (6.4% [2.6-10.2%]) compared with stenting (2.6% [0.5-4.7%]). This was supported by meta-analysis of head-to-head studies (odds ratio, 9.617 [2.654-34.845]) and network meta-analysis (odds ratio, 16.23, 95% credible interval: 4.27-62.77) in a secondary analysis in patients ≥1 month of age, including 57 stenting (3397 participants) and 62 balloon dilatation studies (4331 participants). Despite the limitations of the evidence base consisting predominantly of single-arm studies, our review indicates that stenting achieves superior immediate relief of a relevant pressure gradient compared with balloon dilatation. © 2016 American Heart Association, Inc.

  2. The Effects of Qigong on Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Meng, Ding; Chunyan, Wang; Xiaosheng, Dong; Xiangren, Yi

    2018-01-01

    The purpose of this study was to investigate the effects of Qigong on type 2 diabetes mellitus (DM) using the systematic review and meta-analysis. All prospective, randomized, controlled clinical trials published in English or Chinese and involving the use of Qigong by patients with DM were searched in 7 electronic databases from their respective inception to June 2016. The meta-analysis was conducted using the Revman 5.2. The quality of the included trials was assessed using the Jadad rating scale. Two researchers independently completed the inclusion, data extraction, and quality assessment. Twenty-one trials with 1326 patients met the inclusion criteria and were reviewed. The meta-analysis demonstrated that, compared with no exercise, the Qigong had significant effects on fasting blood glucose (MD = -0.99, 95% CI (-1.23, 0.75), P Qigong training can improve the blood glucose status of the type 2 DM patients and has positive effects on the management of type 2 DM. However, future research with better quality still needs to be conducted to address the effects of Qigong on type 2 DM.

  3. The Effects of Qigong on Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Ding Meng

    2018-01-01

    Full Text Available Objective. The purpose of this study was to investigate the effects of Qigong on type 2 diabetes mellitus (DM using the systematic review and meta-analysis. Methods. All prospective, randomized, controlled clinical trials published in English or Chinese and involving the use of Qigong by patients with DM were searched in 7 electronic databases from their respective inception to June 2016. The meta-analysis was conducted using the Revman 5.2. The quality of the included trials was assessed using the Jadad rating scale. Two researchers independently completed the inclusion, data extraction, and quality assessment. Results. Twenty-one trials with 1326 patients met the inclusion criteria and were reviewed. The meta-analysis demonstrated that, compared with no exercise, the Qigong had significant effects on fasting blood glucose (MD = −0.99, 95% CI (−1.23, 0.75, P<0.0001, HbA1c (MD = −0.84, 95% CI (−1.02, −0.65, P<0.0001, and postprandial blood glucose (MD = −1.55, 95% CI (−2.19, −0.91, P<0.00001. Conclusion. The Qigong training can improve the blood glucose status of the type 2 DM patients and has positive effects on the management of type 2 DM. However, future research with better quality still needs to be conducted to address the effects of Qigong on type 2 DM.

  4. Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Villamor-Martínez, Eduardo; Pierro, Maria; Cavallaro, Giacomo; Mosca, Fabio; Kramer, Boris W; Villamor, Eduardo

    2018-02-20

    Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if the mother's own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCTs could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (three studies, risk ratio (RR) 0.89, 95% confidence interval (CI) 0.60-1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67-0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (three studies, RR 0.80, 95% CI 0.68-0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (two studies, RR 0.77, 95% CI 0.62-0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants.

  5. Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Eduardo Villamor-Martínez

    2018-02-01

    Full Text Available Bronchopulmonary dysplasia (BPD is the most common complication after preterm birth. Pasteurized donor human milk (DHM has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF if the mother’s own milk (MOM is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCTs could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (three studies, risk ratio (RR 0.89, 95% confidence interval (CI 0.60–1.32. However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90. An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (three studies, RR 0.80, 95% CI 0.68–0.95. Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (two studies, RR 0.77, 95% CI 0.62–0.96. In conclusion, our data suggest that DHM protects against BPD in very preterm infants.

  6. History of Bipolar Disorder and the Risk of Dementia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Diniz, Breno S; Teixeira, Antonio L; Cao, Fei; Gildengers, Ariel; Soares, Jair C; Butters, Meryl A; Reynolds, Charles F

    2017-04-01

    We carried out a systematic review and meta-analysis to evaluate whether history of bipolar disorder (BD) increases the risk of dementia. We searched PubMed and Scopus to identify studies that evaluated the risk of dementia in individuals with a history of BD. A total of 6 studies including 3,026 individuals with history of BD and 191,029 non-BD individuals were included in the meta-analysis. History of BD significantly increased the risk of diagnosis of dementia (pooled odds ratio: 2.36; 95% confidence interval: 1.36-4.09; z = 3.07, p analysis was found. History of BD is associated with significantly higher risk of dementia in older adults. Future studies are necessary to evaluate the potential mediators of this association and to evaluate interventions that may reduce the risk of dementia in this population. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Acupuncture for Acne Vulgaris: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Suzi S. Y. Mansu

    2018-01-01

    Full Text Available Purpose. To conduct a systematic review and meta-analysis to determine the current best available evidence of the efficacy and safety of acupuncture and related therapies for acne vulgaris. Methods. Eleven English and Chinese databases were searched to identify randomized controlled trials (RCTs of acne vulgaris compared to pharmacotherapies, no treatment, and sham or placebo acupuncture. Methodological quality was assessed using Cochrane Collaboration’s risk of bias tool. Meta-analysis was conducted using RevMan software. Results. Twelve RCTs were included in the qualitative review and 10 RCTs were included in meta-analysis. Methodological quality of trials was generally low. The chance of achieving ≥30% change in lesion count in the acupuncture group was no different to the pharmacotherapy group (RR: 1.07 [95% CI 0.98, 1.17]; I2=8% and ≥50% change in lesion count in the acupuncture group was not statistically different to the pharmacotherapy group (RR: 1.07 [95% CI 0.98, 1.17]; I2=50%. Conclusions. While caution should be exercised due to quality of the included studies, acupuncture and auricular acupressure were not statistically different to guideline recommended treatments but were with fewer side effects and may be a treatment option. Future trials should address the methodological weaknesses and meet standard reporting requirements stipulated in STRICTA.

  8. Garlic consumption and colorectal cancer risk in man: a systematic review and meta-analysis.

    Science.gov (United States)

    Chiavarini, Manuela; Minelli, Liliana; Fabiani, Roberto

    2016-02-01

    Colorectal cancer shows large incidence variations worldwide that have been attributed to different dietary factors. We conducted a meta-analysis on the relationship between garlic consumption and colorectal cancer risk. We systematically reviewed publications obtained by searching ISI Web of Knowledge, MEDLINE and EMBASE literature databases. We extracted the risk estimate of the highest and the lowest reported categories of intake from each study and conducted meta-analysis using a random-effects model. The pooled analysis of all fourteen studies, seven cohort and seven case-control, indicated that garlic consumption was not associated with colorectal cancer risk (OR=0·93; 95 % CI 0·82, 1·06, P=0·281; I 2=83·6 %, P≤0·001). Separate analyses on the basis of cancer sites and sex also revealed no statistically significant effects on cancer risk. However, when separately analysed on the basis of study type, we found that garlic was associated with an approximately 37 % reduction in colorectal cancer risk in the case-control studies (combined risk estimate=0·63, 95 % CI 0·48, 0·82, P=0·001; I 2=75·6 %, P≤0·001). Our results suggest that consumption of garlic is not associated with a reduced colorectal cancer risk. Further investigations are necessary to clarify the discrepancy between results obtained from different types of epidemiological studies.

  9. Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Wang, Ralph C; Smith-Bindman, Rebecca; Whitaker, Evans; Neilson, Jersey; Allen, Isabel Elaine; Stoller, Marshall L; Fahimi, Jahan

    2017-03-01

    Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone. MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design. Meta-analysis was conducted with a random-effects model and subgroup analyses were conducted to determine sources of heterogeneity. Eight randomized controlled trials (N=1,384) contained sufficient information for inclusion. The pooled risk of stone passage in the tamsulosin arm was 85% versus 66% in the placebo arm, but substantial heterogeneity existed across trials (I 2 =80.2%; Ptamsulosin (risk difference=22%; 95% confidence interval 12% to 33%; number needed to treat=5). The meta-analysis of the small stone subgroup (Tamsulosin significantly improves stone passage in patients with larger stones, whereas the effect of tamsulosin is diminished in those with smaller stones, who are likely to pass their stone regardless of treatment. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  10. Topical antifungal agents for seborrheic dermatitis: systematic review and meta-analysis.

    Science.gov (United States)

    Apasrawirote, Waraphorn; Udompataikul, Montree; Rattanamongkolgul, Suthee

    2011-06-01

    Assess the efficacy of topical antifungal agents for seborrheic dermatitis treatment. A systematic review and meta-analysis of all relevant randomized vehicle-controlled trials of topical antifungal agents for seborrheic dermatitis treatment were searched. The quality of the enrolled studies was measured by criteria from Cochrane Collaboration, followed by data extraction. Two reviewers independently assessed the present study articles. When there was a disagreement between the two reviewers, a consensus was made by the third reviewer. Pooled relative risk (PRR) statistical analysis was used to determine the efficacy of treatment. One thousand ninety five studies were reviewed and nine studies were included. Four reports studied the efficacy of ketoconazole, two of metronidazole, two of ciclopirox, and one of bifonazole. Ketoconazole was more effective than vehicle [PRR is 5.78 (95% CI, 2.17-15.40)], as was metronidazole [PRR is 1.83 (95% CI: 1.05-3.17)] ciclopirox [PRR is 3.00 (95% CI, 1.86-4.84)], and bifonazole [PRR is 1.86 (95% CI: 0.96-3.59)]. The meta-analysis in the present study showed that the topical antifungal agents that demonstrated strong and moderate evidence of the efficacy for seborrheic dermatitis treatment were ketoconazole and ciclopirox, respectively. They could be used as an alternative treatment for seborrheic dermatitis.

  11. Resistance training for rehabilitation after burn injury: A systematic literature review & meta-analysis.

    Science.gov (United States)

    Gittings, Paul M; Grisbrook, Tiffany L; Edgar, Dale W; Wood, Fiona M; Wand, Benedict M; O'Connell, Neil E

    2017-10-07

    Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury. Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and rated using the GRADE framework. Eleven studies matched our inclusion criteria. Primary analysis did not demonstrate significant improvements for increasing muscle strength (SMD 0.74, 95% CI -0.02 to 1.50, p=0.06). Sensitivity analysis to correct an apparent anomaly in published data suggested a positive effect (SMD 0.37, 95% CI 0.08-0.65, p=0.01). Psychological quality of life demonstrated benefit from training (MD=25.3, 95% CI 3.94-49.7). All studies were rated as having high risk of bias. The quality of the evidence was rated as low or very low. Further research with robust methodology is recommended to assess the potential benefit suggested in this review. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  12. The effectiveness of semantic feature analysis: an evidence-based systematic review.

    Science.gov (United States)

    Maddy, K M; Capilouto, G J; McComas, K L

    2014-06-01

    This review examines the effectiveness of semantic feature analysis as an intervention to improve naming abilities for persons with aphasia. A systematic search of the literature identified 11 studies that met the pre-determined inclusion criteria. Two independent raters evaluated each study for methodological quality and assigned appropriate levels of evidence using the Single Case Experimental Design scale. To determine clinical effectiveness, effect sizes using Cohen's d were calculated if sufficient data were available. Alternatively, percent of non-overlapping data was calculated. Results indicated that methodologically sound research has been conducted to determine the effectiveness of semantic feature analysis for persons with aphasia using single subject research designs. When using Cohen's d, the majority of participants showed a small effect size. However, when percent of non-overlapping data was calculated, a large treatment effect was present for the majority of participants. Semantic feature analysis was an effective intervention for improving confrontational naming for the majority of participants included in the current review. Further research is warranted to examine generalization effects. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Exposure to organochlorine pollutants and type 2 diabetes: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Mengling Tang

    Full Text Available OBJECTIVE: Though exposure to organochlorine pollutants (OCPs is considered a risk factor for type 2 diabetes (T2DM, epidemiological evidence for the association remains controversial. A systematic review and meta-analysis was applied to quantitatively evaluate the association between exposure to OCPs and incidence of T2DM and pool the inconsistent evidence. DESIGN AND METHODS: Publications in English were searched in MEDLINE and WEB OF SCIENCE databases and related reference lists up to August 2013. Quantitative estimates and information regarding study characteristics were extracted from 23 original studies. Quality assessments of external validity, bias, exposure measurement and confounding were performed, and subgroup analyses were conducted to examine the heterogeneity sources. RESULTS: We retrieved 23 eligible articles to conduct this meta-analysis. OR (odds ratio or RR (risk ratio estimates in each subgroup were discussed, and the strong associations were observed in PCB-153 (OR, 1.52; 95% CI, 1.19-1.94, PCBs (OR, 2.14; 95% CI, 1.53-2.99, and p,p'-DDE (OR, 1.33; 95% CI, 1.15-1.54 based on a random-effects model. CONCLUSIONS: This meta-analysis provides quantitative evidence supporting the conclusion that exposure to organochlorine pollutants is associated with an increased risk of incidence of T2DM.

  14. Role of Demodex mite infestation in rosacea: A systematic review and meta-analysis.

    Science.gov (United States)

    Chang, Yin-Shuo; Huang, Yu-Chen

    2017-09-01

    The reported prevalence and degrees of Demodex mite infestation in rosacea vary widely. We sought to conduct an evidence-based meta-analysis of the prevalence and degrees of Demodex mite infestation in patients with rosacea. Systematic literature review and meta-analysis were conducted. Odds ratios for prevalence of infestation and standardized mean difference (SMD) for Demodex density in patients with rosacea were pooled. Subgroup analysis for type of rosacea, control group, and sampling and examination methods were also performed. Twenty-three case-control studies included 1513 patients with rosacea. Compared with the control patients, patients with rosacea were more likely to be infested by Demodex mites [odds ratio, 9.039; 95% confidence interval (CI), 4.827-16.925] and had significantly higher Demodex density (SMD, 1.617; 95% CI, 1.090-2.145). Both erythematotelangiectatic rosacea (SMD, 2.686; 95% CI, 1.256-4.116) and papulopustular rosacea (SMD, 2.804; 95% CI, 1.464-4.145) had significantly higher Demodex density than did healthy control patients. Interstudy variability was high, and a causal relationship could not be established by case-control studies. Patients with rosacea had significantly higher prevalence and degrees of Demodex mite infestation than did control patients. Demodex mites may play a role in both erythematotelangiectatic rosacea and papulopustular rosacea. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Enzyme replacement therapy for Fabry disease: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Taciane Alegra

    2012-01-01

    Full Text Available The specific treatment available for Fabry disease (FD is enzyme replacement therapy (ERT with agalsidase alfa or beta. A systematic review and meta-analysis was conducted to assess the efficacy and safety of ERT for FD. Only double-blind, randomized clinical trials (RCTs comparing agalsidase alfa or beta and placebo were included. ERT with either agalsidase alfa or beta was considered similar for the purposes of analysis. Ten RCTs were identified, which showed improvements in neuropathic pain, in heart abnormalities and in globotriaosylceramide (GL-3 levels. A meta-analysis showed increased odds for fever, rigors, development of IgG antibodies to agalsidase, and no significant association with development of hypertension or reduction in the QRS complex duration on electrocardiogram. The RCTs included in this comparison enrolled few patients, were highly heterogeneous, and were focused mainly on surrogate endpoints, limiting any conclusions as to the real effect of ERT for FD. The available evidence suggests that response to ERT is variable across patient subgroups and that agalsidase may slow progression of FD, with slight improvement of existing changes. Nevertheless, many uncertainties remain, and further studies are necessary.

  16. Chinese Herbal Extractions for Relieving Radiation Induced Lung Injury: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Bo Deng

    2017-01-01

    Full Text Available Background. Radiation induced lung injury (RILI is one of the most common and severe side effects of thoracic radiotherapy. In this meta-analysis, the effects of Chinese herbal extractions (CHE for preventing and treating RILI are evaluated. Methods. Randomized Controlled Trials (RCTs from five databases were identified. Studies were evaluated and the relevant data were extracted by two authors independently. Differences were resolved by a third party. Meta-analysis was conducted using RevMan 5.0. Results. In total, 2734 participants receiving thoracic radiotherapy were included in 28 RCTs, and 16 CHE were evaluated. Meta-analysis showed that CHE intervention significantly reduced the incidence of acute radiation pneumonitis (RP and radiation induced pulmonary fibrosis (RIPF. In CHE group, total effective rate and remission rate of RILI patients were significantly higher. Patient’s quality of life (Qol and clinical symptoms and signs were improved significantly. Inflammatory cytokines decreased, and thymus dependent lymphocytes subgroups were improved. Conclusion. CHE intervention may have clinical effectiveness for relieving RILI and related symptoms and signs and lead to improvement of Qol. However, more double-blind, multicenter, large-scale RCTs are needed to support this theory. Trial Registration. PROSPERO International prospective register of systematic reviews has registration number CRD42016043538.

  17. Effects of Relaxation Therapy on Anxiety Disorders: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Kim, Hyeun-Sil; Kim, Eun Joo

    2018-04-01

    To explore the effect of relaxation therapy applied to people with anxiety disorders. Systematic review with meta-analysis. Sixteen Randomized Control Trials (RCTs) were included for meta-analysis to determine the effect of relaxation therapy. The overall effect of relaxation therapy on symptom of anxiety was significant with Hedges' g=0.62 (95% CI: 0.42-0.81), which indicates a medium-high effect; heterogeneity was statistically significant with I 2 =48.84. Subgroup analysis exploring the possible causes of heterogeneity found that types of comparison of TAU and CBT was significant (Q=4.20, p=0.04). The effect of relaxation therapy on symptoms of depression, phobia, and worry was significant; Hedges' g=0.44 (95% CI: 0.30-0.59), 0.40 (95% CI: 0.06-0.75), 0.54 (95% CI: 0.28-0.79), respectively. The results of this study provide evidence for the effectiveness of relaxation therapy for people with anxiety disorders. Therefore, relaxation therapy can be selected as a useful intervention for reducing negative emotions in people with anxiety disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Human papillomavirus vaccine efficacy in the prevention of anogenital warts: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Romina A Tejada

    2017-01-01

    Full Text Available Objective. To review evidence on the efficacy of HPV vaccines in the prevention of non-cancer lesions (anogenital warts [AGW], recurrent laryngeal papillomatosis and oral papillomatosis. Materials and methods. We conducted a systematic review of randomized trials. We performed random effect models and effects were reported as relative risks (RR and their confidence intervals (95%CI following both intention to treat (ITT and per protocol (PP analyses. Results. We included six studies (n=27 078. One study was rated as high risk of bias. One study could not be included in the meta-analysis because it provided combined results. We found that quadrivalent vaccine reduced the risk of AGW by 62% (RR: 0.38, 95%CI:0.32-0.45, I2:0% in the ITT analysis and by 95% (RR: 0.05, 95%CI:0.01-0.25, I2:66% in the PP analysis. Subgroup analyses of studies in women or with low-risk of bias provided similar results. Conclusion. HPV quadrivalent vaccine is efficacious in preventing AGW in men and women.

  19. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis.

    Science.gov (United States)

    Simmonds, M; Llewellyn, A; Owen, C G; Woolacott, N

    2016-02-01

    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 in the meta-analysis. BMI was the only measure of obesity reported in any study, with 200,777 participants followed up. Obese children and adolescents were around five times more likely to be obese in adulthood than those who were not obese. Around 55% of obese children go on to be obese in adolescence, around 80% of obese adolescents will still be obese in adulthood and around 70% will be obese over age 30. Therefore, action to reduce and prevent obesity in these adolescents is needed. However, 70% of obese adults were not obese in childhood or adolescence, so targeting obesity reduction solely at obese or overweight children needs to be considered carefully as this may not substantially reduce the overall burden of adult obesity. © 2015 World Obesity.

  20. Systematic analysis of molecular mechanisms for HCC metastasis via text mining approach.

    Science.gov (United States)

    Zhen, Cheng; Zhu, Caizhong; Chen, Haoyang; Xiong, Yiru; Tan, Junyuan; Chen, Dong; Li, Jin

    2017-02-21

    To systematically explore the molecular mechanism for hepatocellular carcinoma (HCC) metastasis and identify regulatory genes with text mining methods. Genes with highest frequencies and significant pathways related to HCC metastasis were listed. A handful of proteins such as EGFR, MDM2, TP53 and APP, were identified as hub nodes in PPI (protein-protein interaction) network. Compared with unique genes for HBV-HCCs, genes particular to HCV-HCCs were less, but may participate in more extensive signaling processes. VEGFA, PI3KCA, MAPK1, MMP9 and other genes may play important roles in multiple phenotypes of metastasis. Genes in abstracts of HCC-metastasis literatures were identified. Word frequency analysis, KEGG pathway and PPI network analysis were performed. Then co-occurrence analysis between genes and metastasis-related phenotypes were carried out. Text mining is effective for revealing potential regulators or pathways, but the purpose of it should be specific, and the combination of various methods will be more useful.

  1. Risk associated with central catheters for malignant tumor patients: a systematic review and meta-analysis

    Science.gov (United States)

    Lv, Yajuan; Hou, Yong; Pan, Bo; Ma, Yuwan; Li, Paiyun; Yu, Lili; Xu, Deguo; Song, Juanjuan; Shang, Heli; Wang, Hongyan; Tian, Yuan

    2018-01-01

    The risk of venous thrombosis and mortality associated with central catheter (PICC/CICC) for malignant tumor patients is not definite. So, we carried out a systematic review and meta-analysis to evaluate it. Among patients with comparing PICC with CICC, odds ratio (OR) or risk ratio (RR) was calculated with a random effect model meta-analysis. The result of the stratification analysis of 7 studies (PICC vs CICC) supported the theory that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs. 7 of 15 studies provided the information about the compared mortality rate of the patients. The result showed that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs (OR = 0.45, 95% CI:0.32–0.62, p PICCs are associated with a raised risk of deep vein thrombosis, and pharmacological deep vein thrombosis prophylaxis drugs is a beneficial factor in decreasing the incidence of thrombosis, while warfarin may decrease the risk of mortality of malignant tumor patients with CICCs. PMID:29552318

  2. Music therapy for people with schizophrenia or other psychoses:a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Gold, Christian; Heldal, Tor Olav; Dahle, Trond

    2006-01-01

    Commentary on the article "Music therapy for people with schizophrenia or other psychoses: a systematic review and meta-analysis" This article is an abbreviated and slightly edited version of a review that first appeared in the Cochrane Library. The Cochrane Library (including the Cochrane Database...... of Systematic Reviews, CDSR, as its central product) is a database for information about the effects of health care. While "health care" is understood in a very broad way (in fact including any type of "intervention" from surgery to intercessory prayer!), the term "effects" is understood in a narrow sense...... of music therapists. When reading this review, you will come across a lot of jargon that is common in systematic reviews and randomised studies. One such example which could easily be misunderstood is the term "intention-to-treat", which refers to a particular type of data analysis in RCTs (namely...

  3. Renal Perfusion and Function during Pneumoperitoneum: A Systematic Review and Meta-Analysis of Animal Studies.

    Directory of Open Access Journals (Sweden)

    Kimberley E Wever

    Full Text Available Both preclinical and clinical studies indicate that raised intra-abdominal pressure (IAP associated with pneumoperitoneum during laparoscopic surgical procedures can cause renal damage, the severity of which may be influenced by variables such as pressure level and duration. Several of these variables have been investigated in animal studies, but synthesis of all preclinical data has not been performed. This systematic review summarizes all available pre-clinical evidence on this topic, including an assessment of its quality and risk of bias. We performed meta-analysis to assess which aspects of the pneumoperitoneum determine the severity of its adverse effects. A systematic search in two databases identified 55 studies on the effect of pneumoperitoneum on renal function which met our inclusion criteria. There was high heterogeneity between the studies regarding study design, species, sex, pressure and duration of pneumoperitoneum, and type of gas used. Measures to reduce bias were poorly reported, leading to an unclear risk of bias in the majority of studies. Details on randomisation, blinding and a sample size calculation were not reported in ≥80% of the studies. Meta-analysis showed an overall increase in serum creatinine during pneumoperitoneum, and a decrease in urine output and renal blood flow. Subgroup analysis indicated that for serum creatinine, this effect differed between species. Subgroup analysis of pressure level indicated that urine output decreased as IAP level increased. No differences between types of gas were observed. Data were insufficient to reliably assess whether sex or IAP duration modulate the effect of pneumoperitoneum. Four studies assessing long-term effects indicated that serum creatinine normalized ≥24 hours after desufflation of pneumoperitoneum at 15mmHg. We conclude that harmful effects on renal function and perfusion during pneumoperitoneum appear to be robust, but evidence on long-term effects is very

  4. Renal Perfusion and Function during Pneumoperitoneum: A Systematic Review and Meta-Analysis of Animal Studies.

    Science.gov (United States)

    Wever, Kimberley E; Bruintjes, Moira H D; Warlé, Michiel C; Hooijmans, Carlijn R

    Both preclinical and clinical studies indicate that raised intra-abdominal pressure (IAP) associated with pneumoperitoneum during laparoscopic surgical procedures can cause renal damage, the severity of which may be influenced by variables such as pressure level and duration. Several of these variables have been investigated in animal studies, but synthesis of all preclinical data has not been performed. This systematic review summarizes all available pre-clinical evidence on this topic, including an assessment of its quality and risk of bias. We performed meta-analysis to assess which aspects of the pneumoperitoneum determine the severity of its adverse effects. A systematic search in two databases identified 55 studies on the effect of pneumoperitoneum on renal function which met our inclusion criteria. There was high heterogeneity between the studies regarding study design, species, sex, pressure and duration of pneumoperitoneum, and type of gas used. Measures to reduce bias were poorly reported, leading to an unclear risk of bias in the majority of studies. Details on randomisation, blinding and a sample size calculation were not reported in ≥80% of the studies. Meta-analysis showed an overall increase in serum creatinine during pneumoperitoneum, and a decrease in urine output and renal blood flow. Subgroup analysis indicated that for serum creatinine, this effect differed between species. Subgroup analysis of pressure level indicated that urine output decreased as IAP level increased. No differences between types of gas were observed. Data were insufficient to reliably assess whether sex or IAP duration modulate the effect of pneumoperitoneum. Four studies assessing long-term effects indicated that serum creatinine normalized ≥24 hours after desufflation of pneumoperitoneum at 15mmHg. We conclude that harmful effects on renal function and perfusion during pneumoperitoneum appear to be robust, but evidence on long-term effects is very limited. The

  5. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis.

    Science.gov (United States)

    López-López, José A; Humphriss, Rachel L; Beswick, Andrew D; Thom, Howard H Z; Hunt, Linda P; Burston, Amanda; Fawsitt, Christopher G; Hollingworth, William; Higgins, Julian P T; Welton, Nicky J; Blom, Ashley W; Marques, Elsa M R

    2017-11-02

    Objective  To compare the survival of different implant combinations for primary total hip replacement (THR). Design  Systematic review and network meta-analysis. Data sources  Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register. Review methods  Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small meta-analysis for revision. There was no evidence that the risk of revision surgery was reduced by other implant combinations compared with the reference implant combination. Although estimates are imprecise, metal-on-metal, small head, cemented implants (hazard ratio 4.4, 95% credible interval 1.6 to 16.6) and resurfacing (12.1, 2.1 to 120.3) increase the risk of revision at 0-2 years after primary THR compared with the reference implant combination. Similar results were observed for the 2-10 years period. 31 studies (2888 patients) were included in the analysis of Harris hip score. No implant combination had a better score than the reference implant combination. Conclusions  Newer implant combinations were not found to be better than the reference implant combination (metal-on-polyethylene (not highly cross linked), small head, cemented) in terms of risk of revision surgery or Harris hip score. Metal-on-metal, small head, cemented implants and resurfacing increased the risk of revision surgery compared with the reference implant combination. The results were consistent with observational evidence and were replicated in sensitivity analysis but were limited by poor reporting across studies. Systematic review registration  PROSPERO CRD42015019435. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  6. Plasma nutrient status of patients with Alzheimer's disease: Systematic review and meta-analysis.

    Science.gov (United States)

    Lopes da Silva, Sofia; Vellas, Bruno; Elemans, Saskia; Luchsinger, José; Kamphuis, Patrick; Yaffe, Kristine; Sijben, John; Groenendijk, Martine; Stijnen, Theo

    2014-07-01

    Alzheimer disease (AD) patients are at risk of nutritional insufficiencies because of physiological and psychological factors. Nutritional compounds are postulated to play a role in the pathophysiological processes that are affected in AD. We here provide the first systematic review and meta-analysis that compares plasma levels of micronutrients and fatty acids in AD patients to those in cognitively intact elderly controls. A secondary objective was to explore the presence of different plasma nutrient levels between AD and control populations that did not differ in measures of protein/energy nourishment. We screened literature published after 1990 in the Cochrane Central Register of Controlled Trials, Medline, and Embase electronic databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for AD patients, controls, micronutrient, vitamins, and fatty acids, resulting in 3397 publications, of which 80 met all inclusion criteria. Status of protein/energy malnutrition was assessed by body mass index, mini nutritional assessment score, or plasma albumin. Meta-analysis, with correction for differences in mean age between AD patients and controls, was performed when more than five publications were retrieved for a specific nutrient. We identified five or more studies for folate, vitamin A, vitamin B12, vitamin C, vitamin D, vitamin E, copper, iron, and zinc but fewer than five studies for vitamins B1 and B6, long-chain omega-3 fatty acids, calcium, magnesium, manganese, and selenium (the results of the individual publications are discussed). Meta-analysis showed significantly lower plasma levels of folate and vitamin A, vitamin B12, vitamin C, and vitamin E (P vitamin D (P = .075) were found in AD patients. No significant differences were observed for plasma levels of copper and iron. A meta-analysis that was limited to studies reporting no differences in protein/energy malnourishment between AD and control populations yielded

  7. Assessment of water quality management with a systematic qualitative uncertainty analysis.

    Science.gov (United States)

    Chen, Chi-Feng; Ma, Hwong-wen; Reckhow, Kenneth H

    2007-03-01

    Uncertainty is an inevitable source of noise in water quality management and will weaken the adequacy of decisions. Uncertainty is derived from imperfect information, natural variability, and knowledge-based inconsistency. To make better decisions, it is necessary to reduce uncertainty. Conventional uncertainty analyses have focused on quantifying the uncertainty of parameters and variables in a probabilistic framework. However, the foundational properties and basic constraints might influence the entire system more than the quantifiable elements and have to be considered in initial analysis steps. According to binary classification, uncertainty includes quantitative uncertainty and non-quantitative uncertainty, which is also called qualitative uncertainty. Qualitative uncertainty originates from human subjective and biased beliefs. This study provides an understanding of qualitative uncertainty in terms of its conceptual definitions and practical applications. A systematic process of qualitative uncertainty analysis is developed for assisting complete uncertainty analysis, in which a qualitative network could then be built with qualitative relationship and quantifiable functions. In the proposed framework, a knowledge elicitation procedure is required to identify influential factors and their interrelationship. To limit biased information, a checklist is helpful to construct the qualitative network. The checklist helps one to ponder arbitrary assumptions that have often been taken for granted and may yield an incomplete or inappropriate decision analysis. The total maximum daily loads (TMDL) program is used as a surrogate for water quality management in this study. 15 uncertainty causes of TMDL programs are elicited by reviewing an influence diagram, and a checklist is formed with tabular interrogations corresponding to each uncertainty cause. The checklist enables decision makers to gain insight on the uncertainty level of the system at early steps as a

  8. Renal Perfusion and Function during Pneumoperitoneum: A Systematic Review and Meta-Analysis of Animal Studies

    Science.gov (United States)

    Warlé, Michiel C.; Hooijmans, Carlijn R.

    2016-01-01

    Both preclinical and clinical studies indicate that raised intra-abdominal pressure (IAP) associated with pneumoperitoneum during laparoscopic surgical procedures can cause renal damage, the severity of which may be influenced by variables such as pressure level and duration. Several of these variables have been investigated in animal studies, but synthesis of all preclinical data has not been performed. This systematic review summarizes all available pre-clinical evidence on this topic, including an assessment of its quality and risk of bias. We performed meta-analysis to assess which aspects of the pneumoperitoneum determine the severity of its adverse effects. A systematic search in two databases identified 55 studies on the effect of pneumoperitoneum on renal function which met our inclusion criteria. There was high heterogeneity between the studies regarding study design, species, sex, pressure and duration of pneumoperitoneum, and type of gas used. Measures to reduce bias were poorly reported, leading to an unclear risk of bias in the majority of studies. Details on randomisation, blinding and a sample size calculation were not reported in ≥80% of the studies. Meta-analysis showed an overall increase in serum creatinine during pneumoperitoneum, and a decrease in urine output and renal blood flow. Subgroup analysis indicated that for serum creatinine, this effect differed between species. Subgroup analysis of pressure level indicated that urine output decreased as IAP level increased. No differences between types of gas were observed. Data were insufficient to reliably assess whether sex or IAP duration modulate the effect of pneumoperitoneum. Four studies assessing long-term effects indicated that serum creatinine normalized ≥24 hours after desufflation of pneumoperitoneum at 15mmHg. We conclude that harmful effects on renal function and perfusion during pneumoperitoneum appear to be robust, but evidence on long-term effects is very limited. The

  9. A systematic review and meta-analysis of the association between eating disorders and bone density.

    Science.gov (United States)

    Robinson, L; Aldridge, V; Clark, E M; Misra, M; Micali, N

    2016-06-01

    This meta-analysis investigates the effect of an eating disorder on bone mineral density in two eating disorder subtypes. Following conflicting findings in previous literature, this study finds that not only anorexia nervosa, but also bulimia nervosa has a detrimental effect on BMD. Key predictors of this relationship are discussed. This systematic review and meta-analysis investigates bone mineral density (BMD) in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) in comparison to healthy controls (HCs). AN has been associated with low BMD and a risk of fractures and mixed results have been obtained for the relationship between BN and BMD. Deciphering the effect these two ED subtypes on BMD will determine the effect of low body weight (a characteristic of AN) versus the effects of periods of restrictive eating and malnutrition which are common to both AN and BN. We conducted a systematic search through the electronic databases MedLine, EMBASE and PsychInfo and the Cochrane Library to investigate and quantify this relationship. We screened 544 articles and included 27 studies in a random-effect meta-analysis and calculated the standardised mean difference (SMD) in BMD between women with a current diagnosis of AN (n = 785) vs HCs (n = 979) and a current diagnosis of BN (n = 187) vs HCs (n = 350). The outcome measures investigated were spinal, hip, femoral neck and whole body BMD measured by DXA or DPA scanning. A meta-regression investigated the effect of factors including age, duration since diagnosis, duration of amenorrhea and BMI on BMD. The mean BMI of participants was 16.65 kg/m(2) (AN), 21.16 kg/m(2) (BN) and 22.06 kg/m(2) (HC). Spine BMD was lowest in AN subjects (SMD, -3.681; 95 % CI, -4.738, -2.625; p < 0.0001), but also lower in BN subjects compared with HCs (SMD, -0.472; 95 % CI, -0.688, -0.255; p < 0.0001). Hip, whole body and femoral neck BMD were reduced to a statistically significant level in AN but not BN

  10. Prehospital hypertonic fluid resuscitation for trauma patients: A systematic review and meta-analysis.

    Science.gov (United States)

    de Crescenzo, Claire; Gorouhi, Farzam; Salcedo, Edgardo S; Galante, Joseph M

    2017-05-01

    Prehospital assessment of a patient's circulation status and appropriate resuscitation with intravenous fluids plays a critical role in patients with obvious hemorrhage or systolic blood pressure below 90 mm Hg. We assessed the efficacy and safety of prehospital administration of crystalloids or colloids to improve the survival rate of trauma patients with acceptable safety profile. We searched SCOPUS, Embase, TRIP database, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and PubMed as per search protocol from January 1, 1900 to February 12, 2015. All randomized controlled trials were considered. All patients had penetrating or blunt trauma, excluding traumatic brain or thermal injuries. At least one of the comparators should be a crystalloid or colloid. Detailed search strategy was developed and utilized. Duplicates were removed from the search results. We, the co-first authors (C.d.C. and F.G.), independently reviewed the article titles and abstracts to assess eligibility. Eligible articles were downloaded for full text review to determine inclusion in the review and analysis. We (C.d.C. and F.G.) performed a methodological quality assessment of each included article. The primary outcome was mortality. The secondary outcomes included adverse events, infections, multiple organ dysfunction score, and length of stay at the hospital. Heterogeneity was measured by I value. An I value greater than 50% was considered to be substantial heterogeneity. Fixed effect analysis and random effect analysis were performed when needed. A total of nine trials (3,490 patients) were included in the systematic review, and six trials were included in meta-analyses. There were no significant differences between hypertonic saline with dextran and lactated Ringer's solution in 1 day using two studies (2.91; 95% CI, 0.58-14.54; p = 0.19) and 28- to 30-day survival rates using another two studies (1.47; 95% CI, 0.30-7.18; p = 0.63). Adding dextran to hypertonic saline did not

  11. Risk of aspirin continuation in spinal surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Goes, Rik; Muskens, Ivo S; Smith, Timothy R; Mekary, Rania A; Broekman, Marike L D; Moojen, Wouter A

    2017-12-01

    Aspirin is typically discontinued in spinal surgery because of increased risk of hemorrhagic complications. The risk of perioperative continuation of aspirin in neurosurgery needed to be evaluated. This study aimed to evaluate all available evidence about continuation of aspirin and to compare peri- and postoperative blood loss and complication rates between patients that continued aspirin and those who discontinued aspirin perioperatively in spinal surgery. Systematic review and meta-analysis were carried out. A meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies comparing aspirin continuation with discontinuation were included. Studies using a combination of anticlotting agents or non-spinal procedures were excluded. Operative outcomes (blood loss and operative length) and different complications (surgical site infection [SSI]), stroke, myocardial infarction within 30 days postoperatively) were extracted. Overall prevalence and means were calculated for the reported outcomes in fixed-effects models with heterogeneity (I-squared [I 2 ]) and effect modification (P-interaction) assessment. Out of 1,339 studies, three case series were included in the meta-analysis. No significant differences in mean operating time were seen between the aspirin-continuing group (mean=201.8 minutes, 95% confidence interval [CI]=193.3; 210.3; I 2 =95.4%; 170 patients) and the aspirin-discontinuing group (mean=178.4 minutes, 95% CI=119.1; 237.6; I 2 =93.5%; 200 patients); (P-interaction=0.78). No significant differences in mean perioperative blood loss were seen between the aspirin-continuing group (mean=553.9 milliliters, 95% CI=468.0; 639.9; I 2 =83.4%; 170 patients) and the aspirin-discontinuing group (mean=538.7 milliliters, 95% CI=427.6; 649.8; I 2 =985.5%; 200 patients); (P-interaction=0.96). Similar non-significant differences between the two groups were found for cardiac events, stroke, and

  12. [A Systematic Review and Meta-Analysis of the Pros and Cons of Consuming Liquids Preoperatively].

    Science.gov (United States)

    Lin, Fang-Tzu; Lin, Tsai-Rung; Liao, Chia-Wei; Chen, Shu-Hui

    2017-08-01

    Preoperative anesthesia long time fasting, may increase patient hemodynamic instability during surgery and may affect the patient's post-surgery electrolyte balance. No meta-analysis has been conducted to explore the effects of preoperative liquid intake amount on gastric fluid PH, gastric fluid volume, surgery inhalation of pulmonary complications, and patient self-perceptions quality of care systematic review and meta-analysis of the literature. To assess the pros and cons of preoperative liquid intake using a systematic review of the literature. The authors searched ten databases including NRC (Nursing Reference Center), CINAHL (Cumulative Index to Nursing and Allied Health Literature), WOS (Web of Science), PubMed, The Cochrane Library, UpToDate, DynaMed, NGC (National Guideline Clearinghouse), Airiti Library, and National Digital Library of Theses and Dissertations in Taiwan, to identify relevant articles that were published from 2003 to January 2017. Nine qualified articles were included in the analysis from the 30 articles that were selected using an initial keyword search. The Oxford Centre for Evidence-based Medicine 2011 Levels of Evidence was used as the evidence grade and the CASP (Critical Appraisal Skills Program) was used to evaluate the quality of the selected articles. The quantitative results were analyzed using Review Manager, Version 5.1. The quality of the literature was medium to high. A small to moderate dose of fluid consumed at 2 hours prior to surgery did not significantly increase gastric fluid volume during anesthesia, with a combined effect of 2.37 (95% CI [-5.12, 9.85], p = .54), and had no effect on gastric fluid PH, with a combined effect of 0.10 (95% CI [0.00, 0.20], p = .05). The results indicate that consuming a small to moderate dose of liquid at 2 hours prior to the provision of anesthesia does not significantly increase the gastric fluid volume or gastric fluid PH of patients during anesthesia. Moreover, the positive benefits

  13. Malignant Transformation Rate in Patients Presenting Oral Epithelial Dysplasia: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jaffer A. Shariff

    2015-01-01

    Full Text Available Objective. To perform a systematic review and meta-analysis on studies that assess malignant transformation rates (MTR of oral epithelial dysplasia. Materials and Methods. This review was planned and conducted in accordance with the meta-analysis of observational studies in epidemiology (MOOSE guidelines. PubMed, EMBASE, Google Scholar, and Cochrane databases were screened to identify observational studies. Quality assessments were completed by two reviewers independently using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Pooled-malignant transformation rate (MTR in person years, subgroup, sensitivity, and publication bias analysis were calculated using STATA 13.0 and Comprehensive Meta-Analysis software. Results. Sixteen observational cohort studies were identified with a total of 3708 participants from Asia, North America, and Europe. Analysis showed a MTR of 10.5% (pooled-MTR: 10.5, 95% CI: 3.7 to 17.3; fixed effect model, I2=0.0%; Q-value = 2.389; p>0.05 among patients with histologically confirmed oral epithelia dysplasia undergoing long-term follow-up. Higher MTR in person year were seen among the sever dysplastic cases (pooled-MTR: 14.4%, 95% CI: 5.3% to 23.5%, studies published in Europe (pooled-MTR: 12.6%, 95% CI: 8.0% to 24.3%, and retrospective studies (pooled-MTR: 11.0%, 95% CI: 2.2% to 19.9%. Conclusion. These studies show that oral epithelial dysplasia has a significant high rate of transformation to cancer.

  14. The Default Mode Network in Healthy Individuals: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Mak, Lauren E; Minuzzi, Luciano; MacQueen, Glenda; Hall, Geoffrey; Kennedy, Sidney H; Milev, Roumen

    2017-02-01

    When the brain is not engaged in goal-directed activities and at rest, there are still measureable patterns of activity. One resting-state network, the default mode network (DMN) is responsible for a self-referential introspective state. There are many factors that influence normal changes in brain activity. The purpose of this review is to summarize differences in DMN functional connectivity in healthy individuals by age, sex, cognitive function, and analysis type to characterize what is "normal." Studies were systematically selected up to August 2016. Two reviewers independently used predetermined inclusion and exclusion criteria to identify relevant studies. Studies that provided sufficient information were included in a subsequent voxel-wise meta-analysis. Strength of DMN functional connectivity follows an inverse U-shape, where it is strongest in adulthood and lowest in children and elderly. Cognitive function is positively correlated with DMN functional connectivity. Females exhibit stronger intranetwork connectivity compared with males. Effects of analysis type were inconclusive and more studies need to incorporate complementing techniques. The voxel-wise meta-analysis was only conducted for the age factor. Findings supported an immature network in children compared with adults and a stronger network in adults compared with elderly. This is the first study to review differences of DMN functional connectivity in healthy individuals by age, sex, cognitive function, and analysis type. Findings add to the understanding of normal variance. Furthermore, defining a normal comparative base may allow for the identification of DMN change into pathology. This is important since it may allow for the detection of an intermediate risk phenotype and could serve as a biomarker for treatment response.

  15. Efficacy of Helicobacter pylori eradication therapies in Korea: A systematic review and network meta-analysis.

    Science.gov (United States)

    Jung, Yoon Suk; Park, Chan Hyuk; Park, Jung Ho; Nam, Eunwoo; Lee, Hang Lak

    2017-08-01

    The efficacy of Helicobacter pylori eradication regimens may depend on the country where the studies were performed because of the difference in antibiotic resistance. We aimed to analyze the efficacy of H. pylori eradication regimens in Korea where clarithromycin resistance rate is high. We searched for all relevant randomized controlled trials published until November 2016 that investigated the efficacy of H. pylori eradication therapies in Korea. A network meta-analysis was performed to calculate the direct and indirect estimates of efficacy among the eradication regimens. Forty-three studies were identified through a systematic review, of which 34 studies, published since 2005, were included in the meta-analysis. Among 21 included regimens, quinolone-containing sequential therapy for 14 days (ST-Q-14) showed the highest eradication rate (91.4% [95% confidence interval [CI], 86.9%-94.4%] in the intention-to-treat [ITT] analysis). The eradication rate of the conventional triple therapy for 7 days, standard sequential therapy for 10 days, hybrid therapy for 10-14 days, and concomitant therapy for 10-14 days was 71.1% (95% CI, 68.3%-73.7%), 76.2% (95% CI, 72.8%-79.3%), 79.4% (95% CI, 75.5%-82.8%), and 78.3% (95% CI, 75.3%-80.9%), respectively, in the ITT analysis. In the network meta-analysis, ST-Q-14 showed a better comparative efficacy than the conventional triple therapy, standard sequential therapy, hybrid therapy, and concomitant therapy. In addition, tolerability of ST-Q-14 was comparable to those regimens. In Korea, ST-Q-14 showed the highest efficacy in terms of eradication and a comparable tolerability, compared to the results reported for the conventional triple therapy, standard sequential therapy, hybrid therapy, and concomitant therapy. © 2017 John Wiley & Sons Ltd.

  16. Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Bo-Yi; Qian, Zhengmin; Howard, Steven W; Vaughn, Michael G; Fan, Shu-Jun; Liu, Kang-Kang; Dong, Guang-Hui

    2018-04-01

    Although numerous studies have investigated the association of ambient air pollution with hypertension and blood pressure (BP), the results were inconsistent. We performed a comprehensive systematic review and meta-analysis of these studies. Seven international and Chinese databases were searched for studies examining the associations of particulate (diameter10 μm (PM 10 )) and gaseous (sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), nitrogen oxides (NO x ), ozone (O 3 ), carbon monoxide (CO)) air pollutants with hypertension or BP. Odds ratios (OR), regression coefficients (β) and their 95% confidence intervals were calculated to evaluate the strength of the associations. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also conducted. The overall meta-analysis showed significant associations of long-term exposures to PM 2.5 with hypertension (OR = 1.05), and of PM 10 , PM 2.5 , and NO 2 with DBP (β values: 0.47-0.86 mmHg). In addition, short-term exposures to four (PM 10 , PM 2.5 , SO 2 , NO 2 ), two (PM 2.5 and SO 2 ), and four air pollutants (PM 10 , PM 2.5 , SO 2 , and NO 2 ), were significantly associated with hypertension (ORs: 1.05-1.10), SBP (β values: 0.53-0.75 mmHg) and DBP (β values: 0.15-0.64 mmHg), respectively. Stratified analyses showed a generally stronger relationship among studies of men, Asians, North Americans, and areas with higher air pollutant levels. In conclusion, our study indicates a positive association between ambient air pollution and increased BP and hypertension. Geographical and socio-demographic factors may modify the pro-hypertensive effects of air pollutants. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Contrast-enhanced Ultrasound for Detection of Crohn's Disease Activity: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Serafin, Zbigniew; Białecki, Marcin; Białecka, Agnieszka; Sconfienza, Luca Maria; Kłopocka, Maria

    2016-03-01

    Reports on imaging of active Crohn's disease (aCD) using contrast-enhanced ultrasound (CEUS) are encouraging. However, the statistical power of most published papers is limited due to the small size of the patient groups included. This study was performed to verify the diagnostic value of CEUS in detecting aCD. A systematic literature search was performed by two independent reviewers for articles on the test characteristics of CEUS for the identification of aCD. The quality of the analysed studies was evaluated using a quality assessment tool for diagnostic accuracy studies (QUADAS-2). Pooling was performed using a diagnostic random-effect model and bivariate analysis. Eight articles were included in the final analysis, with a total of 332 patients. There was no significant publication bias. Significant heterogeneity was found regarding CEUS methodology and sonographic definitions of aCD. In a bivariate analysis, pooled sensitivity was 0.94 (95% CI 0.87-0.97) and pooled specificity was 0.79 (95% CI 0.67-0.88). Spearman correlation statistics presented no significant diagnostic threshold effect (r = 0.12, p > 0.9). Subgroup analysis showed that relative intestine wall enhancement had the highest diagnostic value (area under the curve 94%), while the presence of enhancement and analysis of the slope were less useful (area under the curve 91 and 90%, respectively). CEUS presents good sensitivity and moderate specificity in the detection of the aCD. Large-scale randomized trials with quantitative evaluation of CEUS images are necessary to promote this technique in clinical practice. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Female Sexual Function Following Surgical Treatment of Stress Urinary Incontinence: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bicudo-Fürst, Maria Cláudia; Borba Leite, Pedro Henrique; Araújo Glina, Felipe Placco; Baccaglini, Willy; de Carvalho Fürst, Rafael Vilhena; Bezerra, Carlos Alberto; Glina, Sidney

    2017-12-27

    The impact of surgery for stress urinary incontinence (SUI) on female sexual function has received attention in the medical literature, but not in a structured manner. To assess the most recent evidence on the impact of surgical management for female SUI on female sexual function. The review and meta-analysis of available articles published in Medline, Cochrane, LILACS, SCOPUS, Web of Science, CINHAL, and EMBASE included prospective randomized and non-randomized studies that assessed patients who underwent surgical treatment for UI through 2 validated questionnaires: the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Female Sexual Function Index (FSFI). The following terms were searched: (urinary incontinence OR female OR woman OR women) AND (suburethral slings OR transobturator tape* OR transobturator suburethral tape OR trans-obturator tape* OR urethral sling* OR midurethral sling* OR mid-urethral sling* OR "standard midurethral slings" OR tensionless vaginal tape* OR mini sling* OR Burch* OR "Burch colposuspension" OR "urologic surgical procedures" OR "tension-free vaginal tape" OR pubovaginal sling) AND (sexual behavior OR "Female Sexual Function Index" OR FSFI OR sexual function OR "Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire" OR PISQ-12). 1,043 articles were retrieved; 9 studies were included for qualitative analysis and 4 were included for meta-analysis. 25 articles were excluded because they used questionnaires other than the FSFI and PISQ-12. Meta-analysis of 2 studies composed of 411 women who underwent to retropubic and transobturator sling intervention and completed the PISQ-12 questionnaire showed an increase in sexual function of 2.40 points after transobturator compared with retropubic sling intervention (95% CI = -2.48 to -2.32; I 2  = 35%, P Urinary Incontinence: Systematic Review and Meta-Analysis. Sex Med Rev 2017;X:XXX-XXX. Copyright © 2017. Published by Elsevier Inc.

  19. A Systematic Review and Meta-Analysis of Baduanjin Qigong for Health Benefits: Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Liye Zou

    2017-01-01

    Full Text Available Objective. To investigate the effects of practicing Baduanjin Qigong on different health outcomes. Methods. Six electronic databases were used for literature search through entering the following key words: Baduanjin Qigong, quality of life, sleep quality, and health-related outcomes. Results. Nineteen randomized controlled trials were used for meta-analysis. The aggregated results from this systematic review have shown significant benefits in favour of Baduanjin Qigong on quality of life (SMD, −0.75; 95% CI −1.26 to −0.24; P=0.004, sleep quality (SMD, −0.55; 95% CI −0.97 to −0.12; P=0.01, balance (SMD, −0.94; 95% CI −1.59 to 0.30; P=0.004, handgrip strength (SMD, -0.69; 95% CI −1.2 to −0.19; P=0.007, trunk flexibility (SMD, −0.66; 95% CI −1.13 to −0.19; P=0.006, systolic (SMD, −0.60; 95% CI −0.94 to −0.27; P=0.0004 and diastolic blood pressure (SMD, −0.46; 95% CI −0.73 to −0.20; P=0.0005, and resting heart rate (SMD, −0.87; 95% CI −1.47 to −0.27; P=0.005. The aggregated results of meta-analyses examining the effect of Baduanjin Qigong on leg power, cardiopulmonary endurance, and pulmonary function remain unclear because of a small number of studies. Conclusions. The aggregated results from this systematic review show that Baduanjin Qigong practice is beneficial for quality of life, sleep quality, balance, handgrip strength, trunk flexibility, systolic and diastolic blood pressure, and resting heart rate. Further studies are necessary to confirm the effects of Baduanjin Qigong on leg power, cardiopulmonary endurance, and pulmonary function (e.g., vital capacity, while considering a long-term follow-up. Registration Number. This trial is registered with International Prospective Register of Systematic Reviews (PROSPERO: CRD42016036966.

  20. A Systematic Review and Meta-Analysis Baduanjin Qigong for Health Benefits: Randomized Controlled Trials.

    Science.gov (United States)

    Zou, Liye; SasaKi, Jeffer Eidi; Wang, Huiru; Xiao, Zhongjun; Fang, Qun; Zhang, Mark

    2017-01-01

    Objective . To investigate the effects of practicing Baduanjin Qigong on different health outcomes. Methods . Six electronic databases were used for literature search through entering the following key words: Baduanjin Qigong, quality of life, sleep quality, and health-related outcomes. Results . Nineteen randomized controlled trials were used for meta-analysis. The aggregated results from this systematic review have shown significant benefits in favour of Baduanjin Qigong on quality of life (SMD, -0.75; 95% CI -1.26 to -0.24; P = 0.004), sleep quality (SMD, -0.55; 95% CI -0.97 to -0.12; P = 0.01), balance (SMD, -0.94; 95% CI -1.59 to 0.30; P = 0.004), handgrip strength (SMD, -0.69; 95% CI -1.2 to -0.19; P = 0.007), trunk flexibility (SMD, -0.66; 95% CI -1.13 to -0.19; P = 0.006), systolic (SMD, -0.60; 95% CI -0.94 to -0.27; P = 0.0004) and diastolic blood pressure (SMD, -0.46; 95% CI -0.73 to -0.20; P = 0.0005), and resting heart rate (SMD, -0.87; 95% CI -1.47 to -0.27; P = 0.005). The aggregated results of meta-analyses examining the effect of Baduanjin Qigong on leg power, cardiopulmonary endurance, and pulmonary function remain unclear because of a small number of studies. Conclusions . The aggregated results from this systematic review show that Baduanjin Qigong practice is beneficial for quality of life, sleep quality, balance, handgrip strength, trunk flexibility, systolic and diastolic blood pressure, and resting heart rate. Further studies are necessary to confirm the effects of Baduanjin Qigong on leg power, cardiopulmonary endurance, and pulmonary function (e.g., vital capacity), while considering a long-term follow-up. Registration Number . This trial is registered with International Prospective Register of Systematic Reviews (PROSPERO): CRD42016036966.

  1. Weekend effect in upper gastrointestinal bleeding: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Pei-Ching Shih

    2018-01-01

    Full Text Available Aim To perform a systematic review and meta-analysis of the weekend effect on the mortality of patients with upper gastrointestinal bleeding(UGIB. Methods The review protocol has been registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42017073313 and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement. We conducted a search of the PUBMED, COCHRANE, EMBASE and CINAHL databases from inception to August 2017. All observational studies comparing mortality between UGIB patients with weekend versus weekday admissions were included. Articles that were published only in abstract form or not published in a peer-reviewed journal were excluded. The quality of articles was assessed using the Newcastle-Ottawa Scale. We pooled results from the articles using random-effect models. Heterogeneity was evaluated by the chi-square-based Q-test and I2test. To address heterogeneity, we performed sensitivity and subgroup analyses. Potential publication bias was assessed via funnel plot. Results Eighteen observational cohort studies involving 1,232,083 study patients were included. Weekend admission was associated with significantly higher 30-day or in-hospital mortality in all studies (OR = 1.12, 95% CI [1.07–1.17], P < 0.00001. Increased in-hospital mortality was also associated with weekend admission (OR = 1.12, 95% CI [1.08–1.17], P < 0.00001. No significant difference in in-hospital mortality was observed between patients admitted with variceal bleeding during the weekend or on weekdays (OR = 0.99, 95% CI [0.91–1.08], P = 0.82; however, weekend admission was associated with a 15% increase in in-hospital mortality for patients with non-variceal bleeding (OR = 1.15, 95% CI [1.09–1.21], P < 0.00001. The time to endoscopy for weekday admission was significantly less than that obtained for weekend admission (MD = −2.50, 95% CI [−4

  2. Physical therapies for Achilles tendinopathy: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Sussmilch-Leitch Samuel P

    2012-07-01

    Full Text Available Abstract Background Achilles tendinopathy (AT is a common condition, causing considerable morbidity in athletes and non-athletes alike. Conservative or physical therapies are accepted as first-line management of AT; however, despite a growing volume of research, there remains a lack of high quality studies evaluating their efficacy. Previous systematic reviews provide preliminary evidence for non-surgical interventions for AT, but lack key quality components as outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA Statement. The aim of this study was to conduct a systematic review and meta-analysis (where possible of the evidence for physical therapies for AT management. Methods A comprehensive strategy was used to search 11 electronic databases from inception to September 2011. Search terms included Achilles, tendinopathy, pain, physical therapies, electrotherapy and exercise (English language full-text publications, human studies. Reference lists of eligible papers were hand-searched. Randomised controlled trials (RCTs were included if they evaluated at least one non-pharmacological, non-surgical intervention for AT using at least one outcome of pain and/or function. Two independent reviewers screened 2852 search results, identifying 23 suitable studies, and assessed methodological quality and risk of bias using a modified PEDro scale. Effect size calculation and meta-analyses were based on fixed and random effects models respectively. Results Methodological quality ranged from 2 to 12 (/14. Four studies were excluded due to high risk of bias, leaving 19 studies, the majority of which evaluated midportion AT. Effect sizes from individual RCTs support the use of eccentric exercise. Meta-analyses identified significant effects favouring the addition of laser therapy to eccentric exercise at 12 weeks (pain VAS: standardised mean difference −0.59, 95% confidence interval −1.11 to −0.07, as well as no

  3. The Epidemiology of Injuries in Mixed Martial Arts: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Lystad, Reidar P; Gregory, Kobi; Wilson, Juno

    2014-01-01

    Mixed martial arts (MMA) has experienced a surge in popularity since emerging in the 1990s, but the sport has also faced concomitant criticism from public, political, and medical holds. Notwithstanding the polarized discourse concerning the sport, no systematic review of the injury problems in MMA has been published to date. To systematically review the epidemiologic data on injuries in MMA and to quantitatively estimate injury incidence and risk factor effect sizes. Systematic review and meta-analysis; Level of evidence, 4. Electronic searching of PubMed, Scopus, CINAHL, EMBASE, AMED, and SPORTDiscus databases to identify studies reporting on the epidemiology of injuries in MMA. Random-effects models were used to obtain pooled summary estimates of the injury incidence rate per 1000 athlete-exposures (IIRAE) and rate ratios with 95% confidence intervals (CIs). Heterogeneity was evaluated with the I (2) statistic. A total of 6 studies were eligible for inclusion in this review. The IIRAE summary estimate was found to be 228.7 (95% CI, 110.4-473.5). No studies reported injury severity. The most commonly injured anatomic region was the head (range, 66.8%-78.0%) followed by the wrist/hand (range, 6.0%-12.0%), while the most frequent injury types were laceration (range, 36.7%-59.4%), fracture (range, 7.4%-43.3%), and concussion (range, 3.8%-20.4%). The most notable risk factors pertained to the outcome of bouts. Losers incurred 3 times as many injuries as winners, and fighters in bouts ending with knockout or technical knockout incurred more than 2 times as many injuries as fighters in bouts ending with submission. Notwithstanding the paucity of data, the injury incidence in MMA appears to be greater than in most, if not all, other popular and commonly practiced combat sports. In general, the injury pattern in MMA is very similar to that in professional boxing but unlike that found in other combat sports such as judo and taekwondo. More epidemiologic research is

  4. 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

  5. Benefit of hindsight: systematic analysis of coronial inquest data to inform patient safety in hospitals.

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    Pudney, Val; Grech, Carol

    2016-09-01

    Objective The aim of the present study was to explore the potential of coronial inquest data to inform patient safety improvement in hospitals at a system level. Methods A retrospective analysis of 20 years of South Australian (SA) coronial inquest findings was performed using both qualitative content analysis methods and statistical descriptive analyses. Results In all, 113 cases were analysed. More than one-third of deaths (39%) were associated with emergency care. Analysis revealed 11 recurrent themes and two notable contributing factors that highlighted specific areas of concern for SA hospitals over that time period. The most common action recommended by coroners (49.6%; n=56 cases) was the review or development of policy, protocol, procedure or guidelines designed to improve patient care. In almost one-quarter (24%) of deaths reviewed, coroners alerted health authorities to poor standards of care and/or instructed individual clinicians to review the standard of their clinical practice. Conclusions The analysis provided a retrospective review of coronial inquest data associated with hospital care over a 20-year period. The findings highlight specific areas of concern for patient safety over that time. More broadly, this analysis contributes to an emerging body of evidence in the Australian academic literature that demonstrates the value of systematic analysis of coronial data at a system level to inform patient safety improvement in Australian healthcare. What is known about the topic? Australian coroners have an important role to play in public health and safety. Many areas of social inquiry across Australia use coronial inquest data to identify recurrent hazards and assist in the development of relevant social policy. However, there is very little research reported in the academic literature that associates analyses of coronial data with patient safety improvement in healthcare. Although coronial recommendations made from individual cases of avoidable death

  6. Long-term Non-Invasive Ventilation in Infants: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bedi, Prabhjot K; Castro-Codesal, Maria Luisa; Featherstone, Robin; AlBalawi, Mohammed M; Alkhaledi, Bashar; Kozyrskyj, Anita L; Flores-Mir, Carlos; MacLean, Joanna E

    2018-01-01

    The use of long-term non-invasive ventilation (NIV) to treat sleep and breathing disorders in children has increased substantially in the last decade; however, less data exist about its use in infants. Given that infants have distinct sleep and breathing patterns when compared to older children, the outcomes of infants on long-term NIV may differ as well. The aim of this study is to systematically review the use and outcomes of long-term NIV in infants. Ovid Medline, Ovid Embase, CINAHL (via EbscoHOST), PubMed, and Wiley Cochrane Library were systematically searched from January 1990 to July 2017. Studies on infants using long-term NIV outside of an acute care setting were included. Data were extracted on study design, population characteristics, and NIV outcomes. A total of 327 studies were full-text reviewed, with final inclusion of 60. Studies were distributed across airway (40%), neuromuscular (28%), central nervous system (10%), cardio-respiratory (2%), and multiple (20%) disease categories. Of the 18 airway studies reporting on NIV outcomes, 13 (72%) reported improvements in respiratory parameters. Of the 12 neuromuscular studies exclusively on spinal muscular atrophy type 1 (SMA1), six (50%) reported decreased hospitalizations and nine (75%) reported on mortality outcomes. Risk of bias was moderate to serious, and quality of the evidence was low to very low for all studies. Most studies had an observational design with no control group, limiting the potential for a meta-analysis. The outcomes reported in studies differed by the disease category being studied. Studies on airway conditions showed improvements in respiratory parameters for infants using NIV. Studies on neuromuscular disorder, which were almost exclusively on SMA1, reported decreased hospitalizations and prolonged survival. Overall, it appears that NIV is an effective long-term therapy for infants. However, the high risk of bias and low quality of the available evidence limited strong

  7. Patient navigators for people with chronic disease: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Kelly, Elizabeth; Ivers, Noah; Zawi, Rami; Barnieh, Lianne; Manns, Braden; Lorenzetti, Diane L; Nicholas, David; Tonelli, Marcello; Hemmelgarn, Brenda; Lewanczuk, Richard; Edwards, Alun; Braun, Ted; McBrien, Kerry A

    2015-03-14

    Individuals with chronic diseases may have difficulty optimizing their health and getting the care they need due to a combination of patient, provider, and health system level barriers. Patient navigator programs, in which trained personnel assess and assist patients in overcoming barriers to care, may improve care and outcomes for patients with chronic disease by providing an alternative approach to conventional information and support resources. This systematic review will evaluate the evidence for patient navigator programs, compared to usual care, in patients with chronic disease. We will include RCTs, cluster RCTs, and quasi-randomized RCTs that study the effects of patient navigator programs on clinical outcomes, patient experience, and markers of adherence to care. Studies will be identified by searching MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, PsycINFO, Social Work Abstracts, and the references of included studies. Two authors will screen titles and abstracts independently. Full texts will be reviewed for relevance and data extraction will be done independently by two authors. Studies will be included if they assess patients of any age with one or more chronic diseases. Outcomes will be categorized into groups characterized by their proximity to mechanism of action of the intervention: patient-level outcomes, intermediate outcomes, and process outcomes. Descriptive data about the elements of the patient navigator intervention will also be collected for potential subgroup analyses. Risk of bias will be assessed using the Effective Practice and Organisation of Care Group (EPOC) risk of bias tool. Data will be analyzed using random effects meta-analysis (relative risk for dichotomous data and mean difference for continuous data), if appropriate. A comprehensive review of patient navigator programs, including a summary of the elements of programs that are associated with a successful intervention, does not yet exist

  8. Mapping of non-numerical domains on space: a systematic review and meta-analysis.

    Science.gov (United States)

    Macnamara, Anne; Keage, Hannah A D; Loetscher, Tobias

    2018-02-01

    The spatial numerical association of response code (SNARC) effect is characterized by low numbers mapped to the left side of space and high numbers mapped to the right side of space. In addition to numbers, SNARC-like effects have been found in non-numerical magnitude domains such as time, size, letters, luminance, and more, whereby the smaller/earlier and larger/later magnitudes are typically mapped to the left and right of space, respectively. The purpose of this systematic and meta-analytic review was to identify and summarise all empirical papers that have investigated horizontal (left-right) SNARC-like mappings using non-numerical stimuli. A systematic search was conducted using EMBASE, Medline, and PsycINFO, where 2216 publications were identified, with 57 papers meeting the inclusion criteria (representing 112 experiments). Ninety-five of these experiments were included in a meta-analysis, resulting in an overall effect size of d = .488 for a SNARC-like effect. Additional analyses revealed a significant effect size advantage for explicit instruction tasks compared with implicit instructions, yet yielded no difference for the role of expertise on SNARC-like effects. There was clear evidence for a publication bias in the field, but the impact of this bias is likely to be modest, and it is unlikely that the SNARC-like effect is a pure artefact of this bias. The similarities in the response properties for the spatial mappings of numerical and non-numerical domains support the concept of a general higher order magnitude system. Yet, further research will need to be conducted to identify all the factors modulating the strength of the spatial associations.

  9. Eating problems in adolescents with Type 1 diabetes: a systematic review with meta-analysis.

    Science.gov (United States)

    Young, V; Eiser, C; Johnson, B; Brierley, S; Epton, T; Elliott, J; Heller, S

    2013-02-01

    We report a systematic review to determine (1) prevalence of eating problems compared with peers and (2) the association between eating problems and glycaemic control in young adults with Type 1 diabetes.   We conducted a systematic literature search via electronic databases and meta-analysis. Cohen's d (the mean difference score between Type 1 diabetes and comparison groups) was calculated for 13 studies that met inclusion criteria.   Eating problems [both disordered eating behaviour (39.3 and 32.5%; d = 0.52, 95% CI 0.10-0.94) and eating disorders (7.0 and 2.8%; d = 0.46, 95% CI 0.10-0.81)] were more common in adolescents with Type 1 diabetes compared with peers and both were associated with poorer glycaemic control (d = 0.40, 95% CI 0.17-0.64). In restricted analyses involving measures adapted for diabetes, associations between eating problems and poorer glycaemic control remained (d = 0.54, 95% CI 0.32-0.76). Disordered eating behaviour (51.8 and 48.1%; d = 0.06, 95% CI -0.05 to 0.21) and eating disorders (6.4 and 3.0%; d = 0.43, 95% CI -0.06 to 0.91) were more common in adolescents with Type 1 diabetes compared with peers, but differences were non-significant.   Eating problems are common among this age group. Future work in populations with Type 1 diabetes should develop sensitive measures of eating problems and interventions, and establish predictors of eating problems. Screening in clinics is recommended. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  10. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis.

    Science.gov (United States)

    Adam, Emma K; Quinn, Meghan E; Tavernier, Royette; McQuillan, Mollie T; Dahlke, Katie A; Gilbert, Kirsten E

    2017-09-01

    Changes in levels of the stress-sensitive hormone cortisol from morning to evening are referred to as diurnal cortisol slopes. Flatter diurnal cortisol slopes have been proposed as a mediator between chronic psychosocial stress and poor mental and physical health outcomes in past theory and research. Surprisingly, neither a systematic nor a meta-analytic review of associations between diurnal cortisol slopes and health has been conducted to date, despite extensive literature on the topic. The current systematic review and meta-analysis examined associations between diurnal cortisol slopes and physical and mental health outcomes. Analyses were based on 179 associations from 80 studies for the time period up to January 31, 2015. Results indicated a significant association between flatter diurnal cortisol slopes and poorer health across all studies (average effect size, r=0.147). Further, flatter diurnal cortisol slopes were associated with poorer health in 10 out of 12 subtypes of emotional and physical health outcomes examined. Among these subtypes, the effect size was largest for immune/inflammation outcomes (r=0.288). Potential moderators of the associations between diurnal cortisol slopes and health outcomes were examined, including type of slope measure and study quality indices. The possible roles of flatter slopes as either a marker or a mechanism for disease etiology are discussed. We argue that flatter diurnal cortisol slopes may both reflect and contribute to stress-related dysregulation of central and peripheral circadian mechanisms, with corresponding downstream effects on multiple aspects of biology, behavior, and health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Immune response to nucleotide-supplemented infant formulae: systematic review and meta-analysis.

    Science.gov (United States)

    Gutiérrez-Castrellón, Pedro; Mora-Magaña, Ignacio; Díaz-García, Luisa; Jiménez-Gutiérrez, Carlos; Ramirez-Mayans, Jaime; Solomon-Santibáñez, Guillermo A

    2007-10-01

    Human milk is recommended as the only alimentary source for the first six months of life. Additionally there is a medical and social need for safe and effective alternative forms of nutrition for infants who cannot be fed with breast milk. Recently the safety and efficacy of some ingredients in infant formulae, such as nucleotides have been discussed. This systematic review analyzed the available evidence to establish the efficacy, safety and dose-response effect of ribonucleotide-supplemented infant formulae (RSIFs). Randomised controlled clinical trials (RCTs) comparing RSIFs to formulae without nucleotides or breast milk were considered in this review. Outcome measures were: antibody titres to common paediatric vaccinations, total lymphocytes, lymphocyte subclasses and NK-cells, episodes of diarrhoea and acute respiratory infection. Publication quality was determined using Jadad and CONSORT guidelines. Results were combined using a random effects model and reported through standardised mean differences (WMD) or risk ratio (RR). Systematic review and meta-analysis showed that RSIFs were associated with a better antibody response to immunisation with Haemopillus influenzae vaccine [SMD 1.74 (99%CI 1.43-2.05), P=0.001], diphtheria toxoid [SMD 0.94 (0.75-1.12), P=0.001], oral polio vaccine [SMD 0.73 (0.51-0.95), P=0.001], and fewer episodes of diarrhoea [RR 0.67 (0.58-0.76), P=0.02]. We did not find a major risk of upper respiratory infections [RR 1.11 (0.90-1.36), P=0.50]. Available evidence suggests a positive benefit of RSFIs on infant health without any risk. These benefits begin with nucleotide addition of 1.9 mg/418.4 kJ and are maintained or increased with 10.78 mg/418.4 kJ.

  12. Echocardiogram changes following parathyroidectomy for primary hyperparathyroidism: A systematic review and meta-analysis.

    Science.gov (United States)

    Best, Corliss A E; Krishnan, Rohin; Malvankar-Mehta, Monali S; MacNeil, S Danielle

    2017-10-01

    The aim of the study is to systematically review the evidence on post parathyroidectomy (PTX) changes as measured by echocardiogram (ECHO) in patients with primary hyperparathyroidism (PHPT).PHPT may increase risk of cardiovascular morbidity/mortality. Conclusions of studies assessing ECHO changes, pre versus post PTX, are inconsistent.A systematic literature search was conducted to locate published and unpublished studies. Randomized control trials, nonrandomized control trials, and observational studies were included. Variables were reported as means and standard deviations. An inverse variance statistical method, with random-effects analysis model, was applied to continuous data. The effect measure was standardized mean difference, confidence interval of 95%. Primary outcome measure was left ventricular ejection fraction (LVEF). Secondary outcome measures were left ventricular mass index (LVMI), peak early over peak late diastolic velocity ratio (E/A ratio), isovolumetric relaxation time (IVRT), intraventricular septal thickness (IVST), and posterior wall thickness (PWT).Fourteen studies were included. Follow-up time ranged 3 to 67 months. No significant differences (P > .05) in primary outcome measure LVEF (SMD = -0.03, CI = -0.24, 0.19), or secondary outcome measures E/A Ratio (SMD = -0.05, CI = -0.24, 0.14), IVST (SMD = 0, CI = 0.31, 0.32), PWT (SMD = 0.01, CI = -0.38, 0.39), LVMI (SMD = -0.18, CI = -0.74, 0.38), and IVRT (SMD = -0.84, CI = -1.83, 0.14) were observed.There was no significant difference in LVEF pre to post PTX. Due to heterogeneity of current literature, we were unable to determine if other outcome measures of cardiac function are affected after PTX in patients with PHPT. We recommend a randomized control trial be conducted to make concrete conclusions.

  13. Nasal irrigation as an adjunctive treatment in allergic rhinitis: A systematic review and meta-analysis

    Science.gov (United States)

    Hermelingmeier, Kristina E.; Hellmich, Martin; Heubach, Christine P.; Mösges, Ralph

    2012-01-01

    Background: Saline nasal irrigation (SNI) is often recommended as additional nonpharmacologic treatment, having proven its efficacy in acute and chronic rhinosinusitis and for therapy after sinonasal surgery. To date, however, no systematic review or meta-analysis exists showing the influence of SNI on allergic rhinitis (AR). This study aimed to establish the impact of SNI on symptoms of AR in different patient groups. Methods: We conducted a systematic search of Medline, Embase, Cochrane Central Register of Controlled Trials, and ISI Web of Science databases for literature published from 1994 to 2010 on SNI in AR. Prospective, randomized, controlled trials that assessed the effects of SNI on four different outcome parameters were included. The evaluation focused on primary (symptom score) and secondary parameters (medicine consumption, mucociliary clearance, and quality of life). Results: Three independent reviewers chose 10 originals that satisfied the inclusion criteria (>400 participants total) from 50 relevant trials. SNI performed regularly over a limited period of up to 7 weeks was observed to have a positive effect on all investigated outcome parameters in adults and children with AR. SNI produced a 27.66% improvement in nasal symptoms, a 62.1% reduction in medicine consumption, a 31.19% acceleration of mucociliary clearance time, and a 27.88% improvement in quality of life. Conclusion: SNI using isotonic solution can be recommended as complementary therapy in AR. It is well tolerated, inexpensive, easy to use, and there is no evidence showing that regular, daily SNI adversely affects the patient's health or causes unexpected side effects. PMID:23168142

  14. Systematic analysis of funding awarded for mycology research to institutions in the UK, 1997-2010.

    Science.gov (United States)

    Head, Michael G; Fitchett, Joseph R; Atun, Rifat; May, Robin C

    2014-01-09

    Fungal infections cause significant global morbidity and mortality. We have previously described the UK investments in global infectious disease research, and here our objective is to describe the investments awarded to UK institutions for mycology research and outline potential funding gaps in the UK portfolio. Systematic analysis. UK institutions carrying out infectious disease research. Primary outcome is the amount of funding and number of studies related to mycology research. Secondary outcomes are describing the investments made to specific fungal pathogens and diseases, and also the type of science along the R&D value chain. We systematically searched databases and websites for information on research studies from public and philanthropic funding institutions awarded between 1997 and 2010, and highlighted the mycology-related projects. Of 6165 funded studies, we identified 171 studies related to mycology (total investment £48.4 million, 1.9% of all infection research, with mean annual funding £3.5 million). Studies related to global health represented 5.1% of this funding (£2.4 million, compared with 35.6% of all infectious diseases). Leading funders were the Biotechnology and Biological Sciences Research Council (£14.8 million, 30.5%) and Wellcome Trust (£12.0 million, 24.7%). Preclinical studies received £42.2 million (87.3%), with clinical trials, intervention studies and implementation research in total receiving £6.2 million (12.7%). By institution, University of Aberdeen received most funding (£16.9 million, 35%). Studies investigating antifungal resistance received £1.5 million (3.2%). There is little translation of preclinical research into clinical trials or implementation research in spite of substantial disease burden globally, and there are few UK institutions that carry out significant quantities of mycology research of any type. In the context of global health and the burden of disease in low-income countries, more investment is

  15. Status of drug-resistant tuberculosis in China: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Jingya; Gou, Haimei; Hu, Xuejiao; Hu, Xin; Shang, Mengqiao; Zhou, Juan; Zhou, Yi; Ye, Yuanxin; Song, Xingbo; Lu, Xiaojun; Chen, Xuerong; Ying, Binwu; Wang, Lanlan

    2016-06-01

    We conducted a systematic review and meta-analysis on drug-resistant tuberculosis in China to provide useful data for tuberculosis (TB) surveillance and treatment. Several databases, including PubMed, Embase, and the Chinese Biological Medical Database, were systematically searched between January 1, 1999, and August 31, 2015, using strict inclusion and exclusion criteria. The corresponding drug-resistant TB prevalence between the new and previously treated cases was significantly different in almost all of the economic regions. The Eastern coastal region is the most developed economic region with the lowest total drug-resistant TB prevalence (any drug resistance: 28%; 95% confidence interval [CI], 25%-32%; multidrug resistance: 9%; 95% CI, 8%-12%) and the lowest number of new cases (any drug resistance: 21%; 95% CI, 19%-23%; multidrug resistance: 4%; 95% CI, 3%-5%). The Northwest is the least developed area with the lowest drug-resistant TB prevalence for previously treated cases (any drug resistance: 45%; 95% CI, 36%-55%; multidrug resistance: 17%; 95% CI, 11%-26%). The prevalence (multidrug and first-line drug resistance) exhibited a downward trend from 1996-2014. The extensively drug-resistant prevalence in China was 3% (95% CI, 2%-5%) in this review. Overall, the status of drug-resistant tuberculosis in China is notably grim and exhibits regional epidemiologic characteristics. We are in urgent need of several comprehensive and effective control efforts to reverse this situation. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Disentangling the Association Between Child Abuse and Eating Disorders: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Caslini, Manuela; Bartoli, Francesco; Crocamo, Cristina; Dakanalis, Antonios; Clerici, Massimo; Carrà, Giuseppe

    2016-01-01

    The aim of this systematic review and meta-analysis was to estimate the association between distinct types of child abuse--sexual (CSA), physical (CPA), and emotional (CEA)--and different eating disorders (EDs). Electronic databases were searched through January 2014. Studies reporting rates of CSA, CPA, and CEA in people with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), as compared with individuals without EDs, were included. Pooled analyses were based on odds ratios (ORs), with relevant 95% confidence intervals (CIs), weighting each study with inverse variance models with random effects. Risk of publication bias was estimated. Thirty-two of 1714 studies assessed for eligibility met the inclusion criteria, involving more than 14,000 individuals. The association between EDs and any child abuse showed a random-effects pooled OR of 3.21 (95% CI = 2.29-4.51, p < .001) with moderate heterogeneity (I2 = 57.2%, p = .005), whereas for CSA, this was 1.92 (95% CI = 1.13-3.28, p = .017), 2.73 (95% CI = 1.96-3.79, p < .001), and 2.31 (95% CI = 1.66-3.20, p < .001), for AN, BN, and BED, respectively. However, adjusting for publication bias, the estimate for CSA and AN was not significant (OR = 1.06, 95% CI = 0.59-1.88, p = .85). Although CPA was associated with AN, BN, and BED, CEA was associated just with BN and BED. BN and BED are associated with childhood abuse, whereas AN shows mixed results. Individuals with similar trauma should be monitored for early recognition of EDs. The protocol was registered in PROSPERO (an international prospective register of systematic reviews) with the reference number CRD42014007360.

  17. A Systematic Analysis of Discordant Diagnoses in Digital Pathology Compared With Light Microscopy.

    Science.gov (United States)

    Williams, Bethany J; DaCosta, Philip; Goacher, Edward; Treanor, Darren

    2017-12-01

    - Relatively little is known about the significance and potential impact of glass-digital discordances, and this is likely to be of importance when considering digital pathology adoption. - To apply evidence-based medicine to collect and analyze reported instances of glass-digital discordance from the whole slide imaging validation literature. - We used our prior systematic review protocol to identify studies assessing the concordance of light microscopy and whole slide imaging between 1999 and 2015. Data were extracted and analyzed by a team of histopathologists to classify the type, significance, and potential root cause of discordances. - Twenty-three studies were included, yielding 8069 instances of a glass diagnosis being compared with a digital diagnosis. From these 8069 comparisons, 335 instances of discordance (4%) were reported, in which glass was the preferred diagnostic medium in 286 (85%), and digital in 44 (13%), with no consensus in 5 (2%). Twenty-eight discordances had the potential to cause moderate/severe patient harm. Of these, glass was the preferred diagnostic medium for 26 (93%). Of the 335 discordances, 109 (32%) involved the diagnosis or grading of dysplasia. For these cases, glass was the preferred diagnostic medium in 101 cases (93%), suggesting that diagnosis and grading of dysplasia may be a potential pitfall of digital diagnosis. In 32 of 335 cases (10%), discordance on digital was attributed to the inability to find a small diagnostic/prognostic object. - Systematic analysis of concordance studies reveals specific areas that may be problematic on whole slide imaging. It is important that pathologists are aware of these areas to ensure patient safety.

  18. Is Pilocarpine Effective in Preventing Radiation-Induced Xerostomia? A Systematic Review and Meta-analysis

    International Nuclear Information System (INIS)

    Yang, Wei-fa; Liao, Gui-qing; Hakim, Samer G.; Ouyang, Dai-qiao; Ringash, Jolie; Su, Yu-xiong

    2016-01-01

    Purpose: To evaluate the efficacy of concomitant administration of pilocarpine on radiation-induced xerostomia in patients with head and neck cancers. Methods and Materials: The PubMed, Web of Science, Cochrane Library, and ClinicalTrials were searched to identify randomized, controlled trials studying the effect of concomitant administration of pilocarpine for radiation-induced xerostomia. Included trials were systematically reviewed, and quantifiable outcomes were pooled for meta-analysis. Outcomes of interest included salivary flow, clinician-rated xerostomia grade, patient-reported xerostomia scoring, quality of life, and adverse effects. Results: Six prospective, randomized, controlled trials in 8 articles were included in this systematic review. The total number of patients was 369 in the pilocarpine group and 367 in the control group. Concomitant administration of pilocarpine during radiation could increase the unstimulated salivary flow rate in a period of 3 to 6 months after treatment, and also reduce the clinician-rated xerostomia grade. Patient-reported xerostomia was not significantly impacted by pilocarpine in the initial 3 months but was superior at 6 months. No significant difference of stimulated salivary flow rate could be confirmed between the 2 arms. Adverse effects of pilocarpine were mild and tolerable. Conclusions: The concomitant administration of pilocarpine during radiation increases unstimulated salivary flow rate and reduces clinician-rated xerostomia grade after radiation. It also relieves patients' xerostomia at 6 months and possibly at 12 months. However, pilocarpine has no effect on stimulated salivary flow rate.

  19. Is Pilocarpine Effective in Preventing Radiation-Induced Xerostomia? A Systematic Review and Meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Wei-fa; Liao, Gui-qing [Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou (China); Hakim, Samer G. [Department of Oral and Maxillofacial Surgery, University of Lübeck, Lübeck (Germany); Ouyang, Dai-qiao [Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou (China); Ringash, Jolie [Department of Radiation Oncology, Princess Margaret Cancer Centre and the University of Toronto, Toronto, Ontario (Canada); Su, Yu-xiong, E-mail: richsu@hku.hk [Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong (China)

    2016-03-01

    Purpose: To evaluate the efficacy of concomitant administration of pilocarpine on radiation-induced xerostomia in patients with head and neck cancers. Methods and Materials: The PubMed, Web of Science, Cochrane Library, and ClinicalTrials were searched to identify randomized, controlled trials studying the effect of concomitant administration of pilocarpine for radiation-induced xerostomia. Included trials were systematically reviewed, and quantifiable outcomes were pooled for meta-analysis. Outcomes of interest included salivary flow, clinician-rated xerostomia grade, patient-reported xerostomia scoring, quality of life, and adverse effects. Results: Six prospective, randomized, controlled trials in 8 articles were included in this systematic review. The total number of patients was 369 in the pilocarpine group and 367 in the control group. Concomitant administration of pilocarpine during radiation could increase the unstimulated salivary flow rate in a period of 3 to 6 months after treatment, and also reduce the clinician-rated xerostomia grade. Patient-reported xerostomia was not significantly impacted by pilocarpine in the initial 3 months but was superior at 6 months. No significant difference of stimulated salivary flow rate could be confirmed between the 2 arms. Adverse effects of pilocarpine were mild and tolerable. Conclusions: The concomitant administration of pilocarpine during radiation increas