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de Diego-Alonso C, Blasco-Abadía J, Buesa-Estéllez A, Giner-Nicolás R, López-Royo MP, Roldán-Pérez P, Doménech-García V, Bellosta-López P, Fini N. Relationship between Participation in Daily Life Activities and Physical Activity in Stroke Survivors: A Protocol for a Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2167. [PMID: 37570407 PMCID: PMC10419119 DOI: 10.3390/healthcare11152167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Stroke survivors undertake low levels of physical activity and participation in daily life activities, but the correlation between these two domains still carries some degree of uncertainty. This systematic review and meta-analyses-based data synthesis will aim to describe and estimate the relationship between participation in daily life activities and physical activity in stroke survivors. Six databases (MEDLINE/PubMed, Web of Science, Scopus, PEDro, SPORTDiscus, and Rehabilitation & Sport Medicine Source) will be searched. Studies assessing participation alongside physical activity levels in adult stroke survivors in English or Spanish will be included. The study selection, assessment of the risk of bias, and data extraction will be conducted independently by two investigators. If available, correlation values between physical activity and participation outcomes will be extracted. The Hedges-Olkin method will be used for pooling correlation values between participation and physical activity measures. Subgroup analyses will be performed according to the time elapsed since the stroke (i.e., ≤6 months and >6 months). This will be the first systematic review with a meta-analysis to provide information on the relationship between physical activity and participation in stroke survivors. Findings are likely to inform the design of health prevention protocols and the development of healthy behavior change interventions.
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Affiliation(s)
- Cristina de Diego-Alonso
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Julia Blasco-Abadía
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Almudena Buesa-Estéllez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Rafael Giner-Nicolás
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - María Pilar López-Royo
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Patricia Roldán-Pérez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Víctor Doménech-García
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Pablo Bellosta-López
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Campus Universitario, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (C.d.D.-A.); (J.B.-A.); (A.B.-E.); (R.G.-N.); (M.P.L.-R.); (P.R.-P.); (V.D.-G.)
| | - Natalie Fini
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, VIC 3052, Australia;
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Sadafi S, Ebrahimi A, Sadeghi M, Emami Aleagha O. Association between tumor necrosis factor-alpha polymorphisms ( rs361525, rs1800629, rs1799724, 1800630, and rs1799964) and risk of psoriasis in studies following Hardy-Weinberg equilibrium: A systematic review and meta-analysis. Heliyon 2023; 9:e17552. [PMID: 37456021 PMCID: PMC10338315 DOI: 10.1016/j.heliyon.2023.e17552] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Psoriasis is a disease with an immunogenetic background in which cytokines have important effects on its prevalence and incidence. The present meta-analysis evaluated the relationship between tumor necrosis factor-alpha (TNF-α) polymorphisms (rs361525, rs1800629, rs1799724, 1800630, and rs1799964) and psoriasis risk in studies following Hardy-Weinberg equilibrium (HWE). Materials and methods Four databases were searched to retrieve relevant studies reporting the distributions of TNF-α polymorphisms in psoriasis cases compared to controls. The effect sizes were the 95% confidence intervals (CIs) and odds ratios (ORs). Subgroup analysis, sensitivity analyses, publication bias, trial sequential analysis (TSA), and meta-regression were performed on the initial pooled results of TNF-α polymorphisms. Results Thirty-six articles with 71 studies were included in the meta-analysis (twenty-six: rs361525, twenty-seven: rs1800629, nine: rs1799724, four: 1800630, and five: rs1799964). The pooled ORs for -238 G/A rs361525 polymorphism were 2.33 (p < 0.00001), 2.79 (p < 0.0001), 2.35 (p < 0.00001), 2.44 (p < 0.00001), and 2.45 (p < 0.00001), as well as 1.57 (p < 0.00001), 1.98 (p = 0.01), 1.61 (p < 0.00001), 1.64 (p < 0.00001), and 1.79 (p < 0.00001) for -857 C/T rs1799724 polymorphism in allelic, homozygous, heterozygous, dominant, and recessive models, respectively. Ethnicity, psoriasis type, and sample size affected the pooled results of rs361525, rs1800629, and rs1799724 polymorphisms. Based on TSA, there were just sufficient cases for -238 G/A rs361525 polymorphism in five genetic models and -857C/T rs1799724 polymorphism in allelic, heterozygous, and dominant models. Conclusions The A allele and GA and GG genotypes of -238 G/A rs361525 polymorphism and T allele, TT and CT genotypes of -857C/T rs1799724 polymorphism were related to increased risks in psoriasis cases. Well-designed studies (with no deviation from HWE in controls) with more cases are recommended in the future.
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Affiliation(s)
- Sepehr Sadafi
- Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Ebrahimi
- Dermatology Department, Hajdaie Dermatology Clinic, Medicine School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Omid Emami Aleagha
- Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Yang M, Peng R, Li X, Peng J, Liu L, Chen L. Association between chronic obstructive pulmonary disease and periodontal disease: a systematic review and meta-analysis. BMJ Open 2023; 13:e067432. [PMID: 37369414 PMCID: PMC10410961 DOI: 10.1136/bmjopen-2022-067432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives Studies have suggested contradictory results on the relationship between chronic obstructive pulmonary disease (COPD) and periodontal disease (PD). The aim of this study was to determine whether PD increased the risk of COPD and COPD-related clinical events. Design A systematic review and meta-analysis. Data sources PubMed, Ovid EMBASE and Ovid CENTRAL were searched from inception to 22 February 2023. Eligibility criteria for studies We included trials and observational studies evaluating association of PD with the risk of COPD or COPD-related events (exacerbation and mortality), with statistical adjustment for smoking. Data extraction and synthesis Two investigators independently extracted data from selected studies using a standardised Excel file. Quality of studies was evaluated using the Newcastle-Ottawa Scale. OR with 95% CI was pooled in a random-effect model with inverse variance method. Results 22 observational studies with 51 704 participants were included. Pooled analysis of 18 studies suggested that PD was weakly associated with the risk of COPD (OR: 1.20, 95% CI 1.09 to 1.32). However, in stratified and subgroup analyses, with strict adjustment for smoking, PD no longer related to the risk of COPD (adjusting for smoking intensity: OR: 1.14, 95% CI 0.86 to 1.51; smokers only: OR: 1.46, 95% CI 0.92 to 2.31; never smokers only: OR: 0.93, 95% CI 0.72 to 1.21). Moreover, PD did not increase the risk of COPD-related exacerbation or mortality (OR: 1.18, 95% CI 0.71 to 1.97) in the pooled result of four studies. Conclusions This study demonstrates PD confers no risk for COPD and COPD-related events when strictly adjusted by smoking. Large-scale prospective cohort studies with control of potential confounding factors are warranted to validate the present findings.
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Affiliation(s)
- Mei Yang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ran Peng
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, 363 Hospital, Chengdu, Sichuan, China
| | - Xiaoou Li
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junjie Peng
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine, 363 Hospital, Chengdu, Sichuan, China
| | - Lei Chen
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Scheer JR, Helminen EC, Cascalheira CJ, Jaipuriyar V, Shaw TJ, Zabelski S, Behari K, Pirog S, Batchelder AW, Possemato K, Hughes TL, Sullivan TP. Probable PTSD, PTSD symptom severity, and comorbid PTSD and hazardous drinking among sexual minority women compared to heterosexual women: A meta-analysis. Clin Psychol Rev 2023; 102:102283. [PMID: 37150043 PMCID: PMC10205673 DOI: 10.1016/j.cpr.2023.102283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/24/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023]
Abstract
Posttraumatic stress disorder (PTSD) is more prevalent among sexual minority women (SMW) than among heterosexual women. PTSD risk varies among SMW, but no meta-analysis has clarified sexual identity-related disparities in probable PTSD among women or SMW's heterogeneity in PTSD risk. SMW are also at pronounced risk of comorbid PTSD and hazardous drinking (HD). However, the difference in comorbid PTSD/HD between SMW and heterosexual women is understudied. This meta-analysis aimed to provide a comprehensive understanding of differences between SMW and heterosexual women and among SMW across demographic characteristics. Peer-reviewed publications that were written in English and reported quantitative data on PTSD specific to SMW were included. Eligible publications (n = 45) were identified through a systematic search of 11 electronic databases, supplemented by a search of reference lists of relevant papers. We found that probable PTSD, PTSD symptom severity, and probable comorbid PTSD/HD are highly prevalent among SMW, with SMW of color, transgender and gender diverse people, and bi+ women (e.g., bisexual, pansexual, queer) being at greatest risk. These results emphasize the need to improve accurate assessment of trauma-related sequelae among SMW and to develop, disseminate, and implement culturally sensitive treatments to reduce PTSD and comorbid PTSD/HD among at-risk SMW.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA.
| | - Emily C Helminen
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA; College of Health Science and Technology, Rochester Institute of Technology, USA
| | - Cory J Cascalheira
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA; Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, NM, USA
| | - Virinca Jaipuriyar
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Thomas J Shaw
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sasha Zabelski
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Kriti Behari
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Sophia Pirog
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Abigail W Batchelder
- Harvard Medical School, Harvard University, Boston, MA, USA; Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Kyle Possemato
- VA Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, Syracuse, NY, USA
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY, USA; Columbia University School of Nursing Center for Sexual and Gender Minority Research, New York, NY, USA
| | - Tami P Sullivan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Olsen RB, Orr LL, Bell SH, Petraglia E, Badillo-Goicoechea E, Miyaoka A, Stuart EA. Using a Multi-Site RCT to Predict Impacts for a Single Site: Do Better Data and Methods Yield More Accurate Predictions? JOURNAL OF RESEARCH ON EDUCATIONAL EFFECTIVENESS 2023; 17:184-210. [PMID: 38450254 PMCID: PMC10914338 DOI: 10.1080/19345747.2023.2180464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/01/2023] [Indexed: 03/08/2024]
Abstract
Multi-site randomized controlled trials (RCTs) provide unbiased estimates of the average impact in the study sample. However, their ability to accurately predict the impact for individual sites outside the study sample, to inform local policy decisions, is largely unknown. To extend prior research on this question, we analyzed six multi-site RCTs and tested modern prediction methods-lasso regression and Bayesian Additive Regression Trees (BART)-using a wide range of moderator variables. The main study findings are that: (1) all of the methods yielded accurate impact predictions when the variation in impacts across sites was close to zero (as expected); (2) none of the methods yielded accurate impact predictions when the variation in impacts across sites was substantial; and (3) BART typically produced "less inaccurate" predictions than lasso regression or than the Sample Average Treatment Effect. These results raise concerns that when the impact of an intervention varies considerably across sites, statistical modelling using the data commonly collected by multi-site RCTs will be insufficient to explain the variation in impacts across sites and accurately predict impacts for individual sites.
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Affiliation(s)
- Robert B Olsen
- George Washington Institute of Public Policy, The George Washington University, Washington, DC 20052
| | - Larry L Orr
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Chevy, Chase, MD 20815
| | | | | | - Elena Badillo-Goicoechea
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205
| | | | - Elizabeth A Stuart
- Departments of Mental Health, Biostatistics, and Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205
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McKeen L, Morris P, Wang C, Morris MD, O'Connor AM. Connecting a disconnected trial network with a new trial: optimizing the estimation of a comparative effect in a network meta-analysis. BMC Med Res Methodol 2023; 23:79. [PMID: 37013490 PMCID: PMC10069097 DOI: 10.1186/s12874-023-01896-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND In network meta-analysis, estimation of a comparative effect can be performed for treatments that are connected either directly or indirectly. However, disconnected trial networks may arise, which poses a challenge to comparing all available treatments of interest. Several modeling approaches attempt to compare treatments from disconnected networks but not without strong assumptions and limitations. Conducting a new trial to connect a disconnected network can enable calculation of all treatment comparisons and help researchers maximize the value of the existing networks. Here, we develop an approach to finding the best connecting trial given a specific comparison of interest. METHODS We present formulas to quantify the variation in the estimation of a particular comparative effect of interest for any possible connecting two-arm trial. We propose a procedure to identify the optimal connecting trial that minimizes this variation in effect estimation. RESULTS We show that connecting two treatments indirectly might be preferred to direct connection through a new trial, by leveraging information from the existing disconnected networks. Using a real network of studies on the use of vaccines in the treatment of bovine respiratory disease (BRD), we illustrate a procedure to identify the best connecting trial and confirm our findings via simulation. CONCLUSION Researchers wishing to conduct a connecting two-arm study can use the procedure provided here to identify the best connecting trial. The choice of trial that minimizes the variance of a comparison of interest is network dependent and it is possible that connecting treatments indirectly may be preferred to direct connection.
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Affiliation(s)
- Lauren McKeen
- Department of Statistics, Iowa State University, Ames, USA
| | - Paul Morris
- Department of Statistics, Iowa State University, Ames, USA
| | - Chong Wang
- Department of Statistics, Iowa State University, Ames, USA.
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, USA.
| | - Max D Morris
- Department of Statistics, Iowa State University, Ames, USA
| | - Annette M O'Connor
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, USA
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, USA
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Mesas AE, Núñez de Arenas-Arroyo S, Martinez-Vizcaino V, Garrido-Miguel M, Fernández-Rodríguez R, Bizzozero-Peroni B, Torres-Costoso AI. Is daytime napping an effective strategy to improve sport-related cognitive and physical performance and reduce fatigue? A systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2023; 57:417-426. [PMID: 36690376 DOI: 10.1136/bjsports-2022-106355] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To estimate the association between daytime napping and cognitive and physical sport performance and fatigue after normal sleep and partial sleep deprivation (less sleep duration than necessary). DESIGN Systematic review and meta-analysis. DATA SOURCES The PubMed, Scopus, Web of Science, Cochrane Central, SportDiscus and PsycINFO databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials on the effect of daytime napping on sport performance and fatigue available from inception to 2 December 2022. Standardised mean differences (SMD) and their 95% compatibility intervals (CI) were estimated with the DerSimonian-Laird method through random effect models. RESULTS In the 22 included trials, 291 male participants (164 trained athletes and 127 physically active adults) aged between 18 and 35 years were studied. When performed after a normal night of sleep, napping from 12:30 hours to 16:50 hours (with 14:00 hours being the most frequent time) improved cognitive (SMD=0.69, 95% CI: 0.37 to 1.00; I2=71.5%) and physical performance (SMD=0.99, 95% CI: 0.67 to 1.31; I2=89.1%) and reduced the perception of fatigue (SMD=-0.76, 95% CI: -1.24 to -0.28; I2=89.5%). The positive effects of napping were also confirmed after partial sleep deprivation. Overall, the benefits were higher with a nap duration between 30 and <60 min and when the time from nap awakening to test was greater than 1 hour. CONCLUSIONS After a night of normal sleep or partial sleep deprivation, a daytime nap between 30 and <60 min has a moderate-to-high effect on the improvement of cognitive performance and physical performance and on the reduction of perceived fatigue. PROSPERO REGISTRATION NUMBER CRD42020212272.
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Affiliation(s)
- Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha - Campus de Cuenca, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - Vicente Martinez-Vizcaino
- Health and Social Research Center, Universidad de Castilla-La Mancha - Campus de Cuenca, Cuenca, Spain
- Department of Medical Sciences, Universidad Autónoma de Chile - Sede Talca, Talca, Chile
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha - Campus de Cuenca, Cuenca, Spain
- Facultad de Enfermería, Universidad de Castilla-La Mancha - Campus de Albacete, Albacete, Spain
| | - Ruben Fernández-Rodríguez
- Health and Social Research Center, Universidad de Castilla-La Mancha - Campus de Cuenca, Cuenca, Spain
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha - Campus de Cuenca, Cuenca, Spain
- Instituto Superior de Educación Física, Universidad de la Republica Uruguay, Rivera, Uruguay
| | - Ana I Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha - Campus de Cuenca, Cuenca, Spain
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha - Campus de Toledo, Toledo, Spain
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Liu Z, Al Amer FM, Xiao M, Xu C, Furuya-Kanamori L, Hong H, Siegel L, Lin L. The normality assumption on between-study random effects was questionable in a considerable number of Cochrane meta-analyses. BMC Med 2023; 21:112. [PMID: 36978059 PMCID: PMC10053115 DOI: 10.1186/s12916-023-02823-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Studies included in a meta-analysis are often heterogeneous. The traditional random-effects models assume their true effects to follow a normal distribution, while it is unclear if this critical assumption is practical. Violations of this between-study normality assumption could lead to problematic meta-analytical conclusions. We aimed to empirically examine if this assumption is valid in published meta-analyses. METHODS In this cross-sectional study, we collected meta-analyses available in the Cochrane Library with at least 10 studies and with between-study variance estimates > 0. For each extracted meta-analysis, we performed the Shapiro-Wilk (SW) test to quantitatively assess the between-study normality assumption. For binary outcomes, we assessed between-study normality for odds ratios (ORs), relative risks (RRs), and risk differences (RDs). Subgroup analyses based on sample sizes and event rates were used to rule out the potential confounders. In addition, we obtained the quantile-quantile (Q-Q) plot of study-specific standardized residuals for visually assessing between-study normality. RESULTS Based on 4234 eligible meta-analyses with binary outcomes and 3433 with non-binary outcomes, the proportion of meta-analyses that had statistically significant non-normality varied from 15.1 to 26.2%. RDs and non-binary outcomes led to more frequent non-normality issues than ORs and RRs. For binary outcomes, the between-study non-normality was more frequently found in meta-analyses with larger sample sizes and event rates away from 0 and 100%. The agreements of assessing the normality between two independent researchers based on Q-Q plots were fair or moderate. CONCLUSIONS The between-study normality assumption is commonly violated in Cochrane meta-analyses. This assumption should be routinely assessed when performing a meta-analysis. When it may not hold, alternative meta-analysis methods that do not make this assumption should be considered.
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Affiliation(s)
- Ziyu Liu
- Department of Statistics, Florida State University, Tallahassee, FL, USA
| | - Fahad M Al Amer
- Department of Mathematics, College of Science and Arts, Najran University, Najran, Saudi Arabia
| | - Mengli Xiao
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Chang Xu
- Ministry of Education Key Laboratory for Population Health Across-Life Cycle & Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Anhui, China
- School of Public Health, Anhui Medical University, Anhui, China
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia
| | - Hwanhee Hong
- Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, NC, USA
| | - Lianne Siegel
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Lifeng Lin
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
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Sequi-Dominguez I, Mavridis D, Cavero-Redondo I, Saz-Lara A, Martinez-Vizcaino V, Núñez de Arenas-Arroyo S. Comparative effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents: a systematic review and network meta-analysis. Br J Sports Med 2023:bjsports-2022-106285. [PMID: 36963807 DOI: 10.1136/bjsports-2022-106285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Arterial stiffness is an early and detectable marker of vascular changes leading to atherosclerotic cardiovascular disease (ACVD). Our objective was to compare the effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents. DESIGN A systematic review and network meta-analysis (NMA) was conducted including experimental studies reporting the effects of exercise interventions on pulse wave velocity (PWV) in children and adolescents. DATA SOURCES Cochrane Central Register of Controlled Trials, EMBASE (via Scopus), PubMed (via Medline) and Web of Science from database inception to 25 March 2022. ELIGIBILITY CRITERIA Experimental studies reporting the effects of exercise interventions on PWV in children and adolescents. RESULTS Fourteen studies were included in the NMA, all of them were randomised controlled trials except one quasi-experimental study, with an overall risk of bias of some concern. Regarding PWV reduction, all exercise modalities were more effective than control, with standardised mean difference ranging from -1.93 (95% CI: -2.84 to -1.02) and -1.11 (95% CI: -2.01 to -0.21) for aerobic exercise and high intensity interval training (HIIT), respectively, to -0.59 (95% CI: -1.39 to 0.22) for combined exercise. Only sensorimotor training was not superior to the control group 0.11 (95% CI: -1.10 to 1.32). CONCLUSION Our results support that exercise interventions, especially aerobic exercise or HIIT, can improve arterial stiffness at early ages. The potential to address ACVD early and mitigate long-term consequences via exercise interventions in children and adolescents with higher arterial stiffness requires further investigation. PROSPERO REGISTRATION NUMBER CRD42022322536.
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Affiliation(s)
- Irene Sequi-Dominguez
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha - Campus de Albacete, Albacete, Spain
| | - Dimitris Mavridis
- Department of Primary Education, University of Ioannina, Ioannina, Greece
- Faculty of Medicine, Université Paris Descartes BU, Paris, France
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
| | - Vicente Martinez-Vizcaino
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
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Yang X, Fridman AJ, Unsworth N, Casement MD. Pupillary motility responses to affectively salient stimuli in individuals with depression or elevated risk of depression: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 148:105125. [PMID: 36924842 DOI: 10.1016/j.neubiorev.2023.105125] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/16/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
Elaborative affective processing is observed in depression, and pupillary reactivity, a continuous, sensitive, and reliable indicator of physiological arousal and neurocognitive processing, is increasingly utilized in studies of depression-related characteristics. As a first attempt to quantitively summarize existing evidence on depression-related pupillary reactivity alterations, this review and meta-analysis evaluated the direction, magnitude, and specificity of pupillary indices of affective processing towards positively, negatively, and neutrally-valenced stimuli among individuals diagnosed with depression or with elevated risk of depression. Studies on pupillary responses to affective stimuli in the target groups were identified in PsycINFO and PubMed databases. Twenty-two articles met inclusion criteria for the qualitative review and 16 for the quantitative review. Three-level frequentist and Bayesian models were applied to summarize pooled effects from baseline-controlled stimuli-induced average changes in pupillary responses. In general, compared to non-depressed individuals, individuals with depression or elevated risk of depression exhibited higher pupillary reactivity (d =0.15) towards negatively-valenced stimuli during affective processing. Pupillary motility towards negatively-valenced stimuli may be a promising trait-like marker for depression vulnerability.
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Affiliation(s)
- Xi Yang
- Department of Psychology, University of Oregon, 1451 Onyx St, Eugene, OR US 97403, USA.
| | - Andrew J Fridman
- Department of Psychology, University of Oregon, 1451 Onyx St, Eugene, OR US 97403, USA.
| | - Nash Unsworth
- Department of Psychology, University of Oregon, 1451 Onyx St, Eugene, OR US 97403, USA.
| | - Melynda D Casement
- Department of Psychology, University of Oregon, 1451 Onyx St, Eugene, OR US 97403, USA.
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Social physical anxiety and eating disorders: A systematic review and meta-analysis. Body Image 2023; 45:133-141. [PMID: 36871312 DOI: 10.1016/j.bodyim.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 03/07/2023]
Abstract
The present study's aim was to summarize existing quantitative evidence linking social physique anxiety (SPA) and eating disorders (ED). Eligible studies were searched for up to June 2, 2022 in six databases: MEDLINE, Current Contents Connect, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global. Studies were considered eligible if they included information derived from self-report instruments that allowed for computing the relationship between SPA and ED. Pooled effect sizes (r) were computed using three-level meta-analytic models. Potential sources of heterogeneity were examined using univariable and multivariable meta-regressions. Influence analyses and a three-parameter selection model (3PSM) were used for the purpose of examining the robustness of the results and publication bias, respectively. Results summarizing 170 effect sizes from 69 studies (N = 41,257) showed two main groups of findings. Firstly, that SPA and ED were very largely related (i.e., r = .51). Secondly, that this relationship was stronger (i) among individuals from Western countries, and (ii) when ED scores concerned the diagnostic feature of bulimia/anorexia nervosa involving body image disturbances. The present study adds to the current understanding of ED by suggesting that SPA is a maladaptive emotion with a potential role in the onset and maintenance of these group of pathologies.
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Jing Y, Murad MH, Lin L. A Bayesian model for combining standardized mean differences and odds ratios in the same meta-analysis. J Biopharm Stat 2023; 33:167-190. [PMID: 35920674 PMCID: PMC9895126 DOI: 10.1080/10543406.2022.2105345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 07/08/2022] [Indexed: 02/08/2023]
Abstract
In meta-analysis practice, researchers frequently face studies that report the same outcome differently, such as a continuous variable (e.g., scores for rating depression) or a binary variable (e.g., counts of patients with depression dichotomized by certain latent and unreported depression scores). For combining these two types of studies in the same analysis, a simple conversion method has been widely used to handle standardized mean differences (SMDs) and odds ratios (ORs). This conventional method uses a linear function connecting the SMD and log OR; it assumes logistic distributions for (latent) continuous measures. However, the normality assumption is more commonly used for continuous measures, and the conventional method may be inaccurate when effect sizes are large or cutoff values for dichotomizing binary events are extreme (leading to rare events). This article proposes a Bayesian hierarchical model to synthesize SMDs and ORs without using the conventional conversion method. This model assumes exact likelihoods for continuous and binary outcome measures, which account for full uncertainties in the synthesized results. We performed simulation studies to compare the performance of the conventional and Bayesian methods in various settings. The Bayesian method generally produced less biased results with smaller mean squared errors and higher coverage probabilities than the conventional method in most cases. Nevertheless, this superior performance depended on the normality assumption for continuous measures; the Bayesian method could lead to nonignorable biases for non-normal data. In addition, we used two case studies to illustrate the proposed Bayesian method in real-world settings.
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Affiliation(s)
- Yaqi Jing
- Department of Statistics, Florida State University, Tallahassee, FL, USA
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| | | | - Lifeng Lin
- Department of Statistics, Florida State University, Tallahassee, FL, USA
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
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Yang XY, Gong QL, Li YJ, Ata EB, Hu MJ, Sun YY, Xue ZY, Yang YS, Sun XP, Shi CW, Yang GL, Huang HB, Jiang YL, Wang JZ, Cao X, Wang N, Zeng Y, Yang WT, Wang CF. The global prevalence of highly pathogenic avian influenza A (H5N8) infection in birds: A systematic review and meta-analysis. Microb Pathog 2023; 176:106001. [PMID: 36682670 DOI: 10.1016/j.micpath.2023.106001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
The zoonotic pathogen avian influenza A H5N8 causes enormous economic losses in the poultry industry and poses a serious threat to the public health. Here, we report the first systematic review and meta-analysis of the worldwide prevalence of birds. We filtered 45 eligible articles from seven databases. A random-effects model was used to analyze the prevalence of H5N8 in birds. The pooled prevalence of H5N8 in birds was 1.6%. In the regions, Africa has the highest prevalence (8.0%). Based on the source, village (8.3%) was the highest. In the sample type, the highest prevalence was organs (79.7%). In seasons, the highest prevalence was autumn (28.1%). The largest prevalence in the sampling time was during 2019 or later (7.0%). Furthermore, geographical factors also were associated with the prevalence. Therefore, we recommend site-specific prevention and control tools for this strain in birds and enhance the surveillance to reduce the spread of H5N8.
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Affiliation(s)
- Xue-Yao Yang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Qing-Long Gong
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Yan-Jin Li
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Emad Beshir Ata
- Parasitology and Animal Diseases Dep., Vet. Res. Institute, National Research Centre, 12622, Dokki, Cairo, Egypt
| | - Man-Jie Hu
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Yong-Yang Sun
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Zhi-Yang Xue
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Ying-Shi Yang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Xue-Pan Sun
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Chun-Wei Shi
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Gui-Lian Yang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Hai-Bin Huang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Yan-Long Jiang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Jian-Zhong Wang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Xin Cao
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Nan Wang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Yan Zeng
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China
| | - Wen-Tao Yang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China.
| | - Chun-Feng Wang
- College of Veterinary Medicine, College of Animal Science and Technology, Jilin Provincial Engineering Research Center of Animal Probiotics, Key Laboratory of Animal Production and Product Quality Safety of Ministry of Education, Jilin Agricultural University, 2888 Xincheng Street, Changchun, 130118, China.
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Din S, Selinger CP, Black CJ, Ford AC. Systematic review with network meta-analysis: Risk of Herpes zoster with biological therapies and small molecules in inflammatory bowel disease. Aliment Pharmacol Ther 2023; 57:666-675. [PMID: 36585944 DOI: 10.1111/apt.17379] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Biologics and small molecules for inflammatory bowel disease (IBD) may increase infection risk. Herpes zoster causes acute and long-term symptoms, but vaccination is not recommended in patients with IBD, unless >50 years of age. AIMS To examine risk of Herpes zoster infection with all licensed biologics and small molecules for IBD using network meta-analysis. METHODS We searched the literature to 4th October 2022, for randomised controlled trials of these drugs in luminal Crohn's disease or ulcerative colitis reporting data on occurrence of Herpes zoster infection during follow-up. We used a frequentist approach and a random effects model, pooling data as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS We identified 25 trials (9935 patients). Only tofacitinib 10 mg b.d. (RR = 6.90; 95% CI 1.56-30.63, number needed to harm (NNH) = 97; 95% CI 19-1022) and upadacitinib 45 mg o.d. (RR = 7.89; 95% CI 1.04-59.59, NNH = 83; 95% CI 10-14,305) were significantly more likely to increase risk of Herpes zoster infection. Janus kinase inhibitors were the most likely drug class to increase risk of infection, and risk increased with higher doses (RR with lowest dose = 3.16; 95% CI 1.02-9.84, NNH = 265; 95% CI 65-28,610, RR with higher dose = 5.91; 95% CI 2.21-15.82, NNH = 117; 95% CI 39-473). CONCLUSIONS In a network meta-analysis, the janus kinase inhibitor tofacitinib, and all janus kinase inhibitors considered as a class, were most likely to increase risk of Herpes zoster infection. Risk increased with higher doses.
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Affiliation(s)
- Shahida Din
- Edinburgh Inflammatory Bowel Diseases Unit, Western General Hospital, Edinburgh, UK
| | | | - Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK.,Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
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Rajaram S, Damasceno NRT, Braga RAM, Martinez R, Kris-Etherton P, Sala-Vila A. Effect of Nuts on Markers of Inflammation and Oxidative Stress: A Narrative Review. Nutrients 2023; 15:nu15051099. [PMID: 36904099 PMCID: PMC10005658 DOI: 10.3390/nu15051099] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Oxidative stress and inflammation are mediators in the pathophysiology of several non-communicable diseases (NCDs). Tree nuts and peanuts lower risk factors of cardiometabolic disease, including blood lipids, blood pressure and insulin resistance, among others. Given their strong antioxidant/anti-inflammatory potential, it is plausible that nuts may also exert a favorable effect on inflammation and oxidative stress. Evidence from systematic reviews and meta-analyses of cohort studies and randomized controlled trials (RCTs) suggest a modest protective effect of total nuts; however, the evidence is inconsistent for specific nut types. In this narrative review, the state of evidence to date is summarized for the effect of nut intake on biomarkers of inflammation and oxidative stress, and an attempt is made to define the gaps in research while providing a framework for future research. Overall, it appears that some nuts, such as almonds and walnuts, may favorably modify inflammation, and others, such as Brazil nuts, may favorably influence oxidative stress. There is a pressing need for large RCTs with an adequate sample size that consider different nut types, and the dose and duration of nut intervention, while evaluating a robust set of biomarkers for inflammation and oxidative stress. Building a stronger evidence base is important, especially since oxidative stress and inflammation are mediators of many NCDs and can benefit both personalized and public health nutrition.
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Affiliation(s)
- Sujatha Rajaram
- School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA
- Correspondence: ; Tel.: +1-909-558-4500 (ext. 47228)
| | | | | | - Raquel Martinez
- School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA
| | - Penny Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, State College, PA 16801, USA
| | - Aleix Sala-Vila
- Cardiovascular Epidemiology and Genetics Group, IMIM Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain
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Katakis P, Schlief M, Barnett P, Rains LS, Rowe S, Pilling S, Johnson S. Effectiveness of outpatient and community treatments for people with a diagnosis of 'personality disorder': systematic review and meta-analysis. BMC Psychiatry 2023; 23:57. [PMID: 36681805 PMCID: PMC9862782 DOI: 10.1186/s12888-022-04483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 12/19/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Quality of care and access to effective interventions have been widely criticised as limited for people diagnosed with 'personality disorder' or who have comparable needs (described in some recent papers as "Complex Emotional Needs" (CEN). It is important to identify effective interventions and the optimal context and mode of delivery for people with CEN. We aimed to investigate the effectiveness of psychosocial interventions delivered in community and outpatient settings in treating symptoms associated with 'personality disorder', and the moderating effects of treatment-related variables. METHODS We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, HMIC, ASSIA for articles published in English, from inception to November 23, 2020. We included randomized controlled trials examining interventions provided in community or outpatient settings for CEN. The primary outcome was 'personality disorder' symptoms, while secondary outcomes included anxiety symptoms, depressive symptoms, and global psychiatric symptoms. Random-effects meta-analysis was conducted for each outcome, and meta-regression analysis was performed to assess the moderating effects of treatment characteristics. The quality of the studies and the degree of publication bias was assessed. RESULTS We included 54 trials (n = 3716 participants) in the meta-analysis. We found a large effect size (g = 0.78, 95% CI: 0.56 to 1.01, p < 0.0001) favoring interventions for 'borderline personality disorder' (BPD) symptoms over Treatment as Usual or Waitlist (TAU/WL), and the efficacy was maintained at follow-up (g = 1.01, 95% CI: 0.37 to 1.65, p = 0.002). Interventions effectively reduced anxiety symptoms (g = 0.58, 95% CI: 0.21 to 0.95, p = 0.002), depressive symptoms (g = 0.57, 95% CI: 0.32 to 0.83, p < 0.0001), and global psychiatric symptoms (g = 0.50, 95% CI: 0.35 to 0.66, p < 0.0001) compared to TAU/WL. The intervention types were equally effective in treating all symptom categories assessed. Treatment duration and treatment intensity did not moderate the effectiveness of the interventions for any outcome. CONCLUSIONS People with a 'personality disorder' diagnosis benefited from psychological and psychosocial interventions delivered in community or outpatient settings, with all therapeutic approaches showing similar effectiveness. Mental health services should provide people with CEN with specialised treatments in accordance with the availability and the patients' preferences.
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Affiliation(s)
- Panos Katakis
- Division of Psychiatry, University College London, London, UK.
| | - Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Luke Sheridan Rains
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, London, UK
| | - Steve Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Lennon RP, Rabago D, Deneke E, Lu X, Broszko CM, Simoyan O, Clemente Fuentes RW. Results of a Military Family Medicine Scholarly Activity Training Needs Assessment. Mil Med 2023; 188:e374-e381. [PMID: 33928387 DOI: 10.1093/milmed/usab174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/30/2021] [Accepted: 04/19/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Scholarly activity among family medicine physicians is an important element of military medical readiness, both in terms of required scholarship during training and ongoing scholarship to address ongoing and emergent operational medical threats. Most literature on barriers to scholarly activity are limited to training programs and lack an important element in overcoming barriers-their priority to physicians. This study seeks to address these gaps by identifying prioritized research training needs of military family medicine physicians at all levels of training and practice. MATERIALS AND METHODS An institutional review board (IRB)-approved, cross-sectional, online survey was conducted from January 22, 2019, to February 7, 2020, using a modified version of the Hennessy-Hicks Training Needs Analysis Questionnaire. Respondents ranked their perceived level of skill and need for training for 20 literature-based elements of research success. They also self-identified research experience, level of training, and service membership. One-way analysis of variance to 95% CI was used to compare differences in self-reported research experience, number of peer-reviewed publications, number of external grants, and number of IRB protocols among services (Army, Navy, and Air Force), primary roles (resident, faculty, clinician, and leadership), and gender. Chi-squared tests were used to compare proportional differences, also to 95% CI. RESULTS Of 124 respondents, most were members of the Air Force (46%), Navy (24%), or Army (13%), serving in clinician (40%) or faculty (32%) roles. Most respondents (67%) reported three or fewer publications and had never been a primary investigator or co-investigator on an external grant. Of the 34 respondents who identified as a faculty at some point in their career, 26 (77%) reported two or more peer-reviewed publications, and 20 (59%) had fewer than six publications. The faculty had significantly more research experience and peer-reviewed publications than residents, clinicians, or leaders (3.92 vs 2.19, 2.24, and 3.40, respectively, P < .001, η2 = 0.22; 5.11 vs 1.13, 2.12, and 4.33, respectively, P < .001, η2 = 0.25). Gender differences in priority ranking were found, but each gender identified the same top three training needs. Among the top 10 training needs for scholarly activity for military family medicine physicians, 7 may be addressed with specific training modules: (1) obtaining funding/grants for research, (2) accessing research resources (e.g., research administrators and other staff, information, equipment, money, and time), (3) establishing a relationship with research mentors, (4) undertaking health promotion studies, (5) designing a research study, (6) writing reports of your research studies, and (7) using technical equipment, including computer software, to find and organize published research or prepare manuscripts. CONCLUSIONS Knowledge of military family medicine physicians' prioritized research training needs enables a focused approach to support an essential component of military medical readiness: primary care scholarship. Addressing these needs may begin with raising awareness of military primary care research network resources. Furthermore, a coordinated effort to develop specific training modules to address needs and ongoing research to identify, target training by audience need, and prioritize needs as they change over time are indicated to ensure that military family medicine physicians maintain and develop a flourishing culture of scholarly engagement.
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Affiliation(s)
- Robert P Lennon
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
| | - David Rabago
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
| | - Erin Deneke
- Caron Treatment Centers, Wernersville, PA 19565, USA
| | - Xinyu Lu
- Caron Treatment Centers, Wernersville, PA 19565, USA
| | - Christine M Broszko
- Family Medicine Residency Program, Eglin Air Force Base Hospital, 96th Medical Group, Eglin AFB, FL 32542, USA
| | | | - Roselyn W Clemente Fuentes
- Department of Flight Medicine, Eglin Air Force Base Hospital, 96th Medical Group, Eglin AFB, FL 32542, USA
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Liu Z, Tian Z, Zhao D, Liang Y, Dai S, Liu M, Hou S, Dong X, Zhaxinima, Yang Y. Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials. J Clin Endocrinol Metab 2022; 108:232-249. [PMID: 36337001 DOI: 10.1210/clinem/dgac585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Indexed: 11/09/2022]
Abstract
CONTEXT Previous meta-analyses have suggested that the effects of coenzyme Q10 (CoQ10) on lipid profiles remain debatable. Additionally, no meta-analysis has explored the optimal intake of CoQ10 for attenuating lipid profiles in adults. OBJECTIVE This study conducted a meta-analysis to determine the effects of CoQ10 on lipid profiles and assess their dose-response relationships in adults. METHODS Databases (Web of Science, PubMed/Medline, Embase, and the Cochrane Library) were systematically searched until August 10, 2022. The random effects model was used to calculate the mean differences (MDs) and 95% CI for changes in circulating lipid profiles. The novel single-stage restricted cubic spline regression model was applied to explore nonlinear dose-response relationships. RESULTS Fifty randomized controlled trials with a total of 2794 participants were included in the qualitative synthesis. The pooled analysis revealed that CoQ10 supplementation significantly reduced total cholesterol (TC) (MD -5.53 mg/dL; 95% CI -8.40, -2.66; I2 = 70%), low-density lipoprotein cholesterol (LDL-C) (MD -3.03 mg/dL; 95% CI -5.25, -0.81; I2 = 54%), and triglycerides (TGs) (MD -9.06 mg/dL; 95% CI -14.04, -4.08; I2 = 65%) and increased high-density lipoprotein cholesterol (HDL-C) (MD 0.83 mg/dL; 95% CI 0.01, 1.65; I2 = 82%). The dose-response analysis showed an inverse J-shaped nonlinear pattern between CoQ10 supplementation and TC in which 400-500 mg/day CoQ10 largely reduced TC (χ2 = 48.54, P < .01). CONCLUSION CoQ10 supplementation decreased the TC, LDL-C, and TG levels, and increased HDL-C levels in adults, and the dosage of 400 to 500 mg/day achieved the greatest effect on TC.
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Affiliation(s)
- Zhihao Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Zezhong Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Dan Zhao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Ying Liang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Suming Dai
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Meitong Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Shanshan Hou
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaoxi Dong
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
| | - Zhaxinima
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
| | - Yan Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, 518107, Guangdong Province, PR China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou 510080, China
- China-DRIs Expert Committee on Other Food Substances, Guangzhou 510080, China
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Tissera K, Orth D, Huynh M, Benson AC. The impact of augmented feedback (and technology) on learning and teaching cricket skill: A systematic review with meta-analysis. PLoS One 2022; 17:e0279121. [PMID: 36525446 PMCID: PMC9757599 DOI: 10.1371/journal.pone.0279121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Augmented feedback, including that provided using technology, can elicit multifaceted benefits on perceptual-motor learning and performance of sporting skills. However, current considerations of the applied value in supporting learning and teaching cricket skill is limited. This systematic review with meta-analysis aimed to understand the role and effectiveness of feedback-involved interventions on skill-based performance outcomes in cricket-related research. Six electronic databases were searched (SPORTDiscus, CINAHL, MEDLINE, Scopus, Web of Science and PsycINFO). Of 8,262 records identified, 11 studies met inclusion criteria; five of which were included in meta-analyses. Given no studies with an isolated feedback intervention-arm were identified, the two meta-analyses explored anticipation-based studies consisting of an intervention that included augmented feedback; positioned with respect to the key motor skill concepts of perception (anticipation accuracy) and action (performance success). Despite results highlighting improved performance outcomes for the feedback-involved intervention groups, with a large effect size for improved anticipation accuracy (Hedge's g = 1.21, 95% CIs [-0.37, 2.78]) and a medium effect size for overall performance success (Hedge's g = 0.55, 95% CIs [-0.39, 1.50]), results were not statistically significant and should be interpreted with caution given the wide confidence intervals. Considering the small number of studies available, in addition to the lack of isolated feedback protocols, further research is warranted to thoroughly explore the impact of augmented feedback on skill-based performance in cricket. Beyond the meta-analyses, the review also explored all included studies from an ecological dynamics perspective; presenting future avenues of research framed around evaluating the applied value of using augmented feedback (mediated with or without technology) for learning and teaching skill in cricket. Trial registration The protocol was preregistered with Open Science Framework (osf.io/384pd).
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Affiliation(s)
- Kevin Tissera
- Department of Health Sciences and Biostatistics, Sport Innovation Research Group, Swinburne University of Technology, Melbourne, Australia
- * E-mail:
| | - Dominic Orth
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Melbourne, Australia
| | - Minh Huynh
- School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, Australia
| | - Amanda C. Benson
- Department of Health Sciences and Biostatistics, Sport Innovation Research Group, Swinburne University of Technology, Melbourne, Australia
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Walter SD, Balakrishnan N. A method was developed for correcting the bias in the usual study weights in meta-analyses. J Clin Epidemiol 2022; 152:23-29. [PMID: 36150550 DOI: 10.1016/j.jclinepi.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 08/10/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Our goal was to evaluate the bias in the usual method of estimating study weights in a meta-analysis and to develop a suitable bias correction. STUDY DESIGN AND SETTING In meta-analyses, it is standard practice to weight studies by the inverse variance of their treatment effects. Weights are usually calculated by taking reciprocals of the estimated variances, but we show that this approach is biased. We established an exact expression for the bias with continuous data, yielding a correction factor for the study weights that yields improved estimation of the treatment effect. RESULTS With the usual method, the weight for each study is always overestimated, particularly with small samples; also, the variance of the summary treatment effect is underestimated. Our correction yields an unbiased estimate of the summary treatment effect with minimum variance. We illustrate the bias numerically for various scenarios and show how it can substantially affect actual meta-analyses in practice. CONCLUSION We recommend that the standard method of obtaining study weights should be modified by our bias correction factor. Our method is simple and straightforward to apply. Elimination of this bias will enhance the validity of conclusions from a meta-analysis, compared with the situation when the standard weights are used.
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Affiliation(s)
- Stephen D Walter
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
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71
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Widyaputri F, Rogers S, Lim L. Statistical Considerations for Meta-analysis of Diabetic Retinopathy Prevalence-Reply. JAMA Ophthalmol 2022; 140:1141-1142. [PMID: 36074497 DOI: 10.1001/jamaophthalmol.2022.3473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Felicia Widyaputri
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Sophie Rogers
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Lyndell Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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72
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Zhou S, Shen C. Statistical Considerations for Meta-analysis of Diabetic Retinopathy Prevalence. JAMA Ophthalmol 2022; 140:1141. [PMID: 36074416 DOI: 10.1001/jamaophthalmol.2022.3470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Shouhao Zhou
- College of Medicine, Department of Public Health Sciences, Pennsylvania State University, Hershey
| | - Chan Shen
- College of Medicine, Department of Public Health Sciences, Pennsylvania State University, Hershey.,College of Medicine, Department of Surgery, Pennsylvania State University, Hershey
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Sandalic D, Craig A, Tran Y, Arora M, Pozzato I, McBain C, Tonkin H, Simpson G, Gopinath B, Kaur J, Shetty S, Weber G, Middleton J. Cognitive Impairment in Individuals With Spinal Cord Injury: Findings of a Systematic Review With Robust Variance and Network Meta-analyses. Neurology 2022; 99:e1779-e1790. [PMID: 35985827 DOI: 10.1212/wnl.0000000000200957] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/25/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Estimates of the prevalence (10%-60%) of cognitive impairment in individuals with spinal cord injury (SCI) are too broad, and which domains of cognition are most affected is unclear. We performed a meta-analysis to investigate impairments across domains of cognitive functioning to provide a nuanced picture of research conducted to date into cognitive impairment after SCI. METHODS Results of peer-reviewed studies published in English between 1980 and 2021 comparing ≥20 participants with SCI with able-bodied controls were synthesized using meta-analysis. The primary outcomes were neurocognitive test scores categorized into 5 cognitive domains as listed in the Diagnostic and Statistical Manual of Mental Disorders: Complex Attention, Executive Functioning, Learning and Memory, Language, and Perceptual Motor Function. Two researchers independently assessed and verified extracted data to comply with meta-analytic reporting guidelines. Robust variance estimation meta-analysis was conducted to determine an overall pooled effect size across all cognitive domains using data extracted from studies. Using network meta-analysis, we synthesized eligible studies and made comparisons with the 5 domains of cognitive functioning serving as the outcomes and SCI as the condition. RESULTS Of 4,783 potential studies, 13 met final inclusion criteria. Studies met 6 of 8 quality assessment criteria generally. Results suggested that adults with SCI experience reduced cognitive functioning (effect size: -0.84; 95% CI -1.24 to -0.44, p < 0.001) compared with able-bodied individuals, with deficits mostly in attention (g = -0.64; 95% CI -0.92 to -0.38) and executive functioning (g = -0.61, 95% CI -0.89 to -0.04). Publication bias and high heterogeneity (I2: 86%) qualify these findings and highlight the need to improve research methods in this area. DISCUSSION Adults with SCI seem more likely than adults who are able-bodied to display cognitive impairments mostly in areas of attention and executive functioning. Research practices must become consistent to reduce heterogeneity so that the validity and reliability of the results of future studies into cognitive impairment after SCI improves.
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Affiliation(s)
- Danielle Sandalic
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia.
| | - Ashley Craig
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Yvonne Tran
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Mohit Arora
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Ilaria Pozzato
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Candice McBain
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Helen Tonkin
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Grahame Simpson
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Bamini Gopinath
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Jasbeer Kaur
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Sachin Shetty
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - Gerard Weber
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
| | - James Middleton
- From the John Walsh Centre for Rehabilitation Research (D.S., A.C., M.A., I.P., C.M., G.S., J.M.), The Kolling Institute, Royal North Shore Hospital, St Leonards; Northern Clinical School (DST, A.C., M.A., I.P., C.M., G.S., J.M.), Faculty of Medicine and Health, The University of Sydney; Royal North Shore Hospital (D.S., H.T., J.K.), St Leonards; Australian Institute of Health Innovation (Y.T., B.G.), Macquarie University, North Ryde; Prince of Wales Hospital (S.S.), Randwick; and Royal Rehab (G.W.), Ryde, NSW, Australia
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Zhang N, Gao M, Yu J, Zhang Q, Wang W, Zhou C, Liu L, Sun T, Liao X, Wang J. Understanding the association between adverse childhood experiences and subsequent attention deficit hyperactivity disorder: A systematic review and meta-analysis of observational studies. Brain Behav 2022; 12:e32748. [PMID: 36068993 PMCID: PMC9575611 DOI: 10.1002/brb3.2748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, which may be related to adverse childhood experiences (ACEs). Our study aims to explore the association between ACEs and subsequent ADHD, and analyze the potential moderators. METHODS Literature search was conducted by a combined computer-assisted and manual method. Studies were included if they had reported the association between ACEs and subsequent ADHD. Overall estimates of odds ratios (ORs) were obtained using random-effects meta-analyses, meta-regressions and further stratified analyses were conducted to examine potential moderator variables. RESULTS Totals of 70 studies involving nearly 4 million participants from among 6,452 unique articles were included. In the primary analyses, ACEs were found to be associated with subsequent ADHD (OR = 1.68, 95% CI: 1.54-1.83), and the negative effects of different forms of ACEs for ADHD were nonequivalent. Such as lived in the stepfamily, been adopted or fostered, and experienced sexual abuse were more deleterious than others. It was found that individuals who had experienced multiple ACEs or who are female were more vulnerable to ADHD. CONCLUSIONS The findings provide critical evidence for understanding the association between ACEs and ADHD. ACEs could increase the susceptibility of ADHD, especially for individuals who ever experienced multiple ACEs and females.
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Affiliation(s)
- Ning Zhang
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Man Gao
- Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinglong Yu
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qiang Zhang
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Weiguang Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Congxiao Zhou
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lingjia Liu
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ting Sun
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xing Liao
- Center of Evidence Based Traditional Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Junhong Wang
- Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Díaz LA, García-Salum T, Fuentes-López E, Reyes D, Ortiz J, Chahuan J, Levican J, Almonacid LI, Valenzuela GH, Serrano E, Budnik S, Gandara V, Gallardo A, Seydewitz MF, Ferrés M, Cofré C, Álvarez M, Pavez C, Candia R, Monrroy H, Espino A, Rada G, Ortiz L, Valderrama S, Salinas E, Toro A, Ortega M, Pizarro M, Medina RA, Riquelme A. High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort study. GASTROENTEROLOGÍA Y HEPATOLOGÍA (ENGLISH EDITION) 2022; 45. [PMCID: PMC9574026 DOI: 10.1016/j.gastre.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives Methods Results Conclusions
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Affiliation(s)
- Luis Antonio Díaz
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tamara García-Salum
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Diego Reyes
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Ortiz
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Chahuan
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Levican
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonardo I. Almonacid
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo H. Valenzuela
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eileen Serrano
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sigall Budnik
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Gandara
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Gallardo
- School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Marcela Ferrés
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Colomba Cofré
- Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel Álvarez
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Pavez
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto Candia
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hugo Monrroy
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alberto Espino
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriel Rada
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile,Epistemonikos Foundation, Santiago, Chile
| | - Luis Ortiz
- Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Valderrama
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Erick Salinas
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adriana Toro
- Pediatric Service, Clínica UC San Carlos, Red Salud UC Christus, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcos Ortega
- Department of Intensive Care Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of Respiratory Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Margarita Pizarro
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael A. Medina
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Corresponding authors
| | - Arnoldo Riquelme
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Corresponding authors
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Agarwal S. Neutrophil-Lymphocyte Ratio Predicting Case Severity in SARS-CoV-2 Infection: A Review. Cureus 2022; 14:e29760. [PMID: 36187170 PMCID: PMC9521818 DOI: 10.7759/cureus.29760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 12/15/2022] Open
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Cowlishaw S, Freijah I, Kartal D, Sbisa A, Mulligan A, Notarianni M, Couineau AL, Forbes D, O’Donnell M, Phelps A, Iverson KM, Heber A, O’Dwyer C, Smith P, Hosseiny F. Intimate Partner Violence (IPV) in Military and Veteran Populations: A Systematic Review of Population-Based Surveys and Population Screening Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148853. [PMID: 35886702 PMCID: PMC9316917 DOI: 10.3390/ijerph19148853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 12/23/2022]
Abstract
Intimate partner violence (IPV) may be a major concern in military and veteran populations, and the aims of this systematic review were to (1) provide best available estimates of overall prevalence based on studies that are most representative of relevant populations, and (2) contextualise these via examination of IPV types, impacts, and context. An electronic search of PsycINFO, CINHAL, PubMed, and the Cochrane Library databases identified studies utilising population-based designs or population screening strategies to estimate prevalence of IPV perpetration or victimisation reported by active duty (AD) military personnel or veterans. Random effects meta-analyses were used for quantitative analyses and were supplemented by narrative syntheses of heterogeneous data. Thirty-one studies involving 172,790 participants were included in meta-analyses. These indicated around 13% of all AD personnel and veterans reported any recent IPV perpetration, and around 21% reported any recent victimisation. There were higher rates of IPV perpetration in studies of veterans and health service settings, but no discernible differences were found according to gender, era of service, or country of origin. Psychological IPV was the most common form identified, while there were few studies of IPV impacts, or coercive and controlling behaviours. The findings demonstrate that IPV perpetration and victimisation occur commonly among AD personnel and veterans and highlight a strong need for responses across military and veteran-specific settings. However, there are gaps in understanding of impacts and context for IPV, including coercive and controlling behaviours, which are priority considerations for future research and policy.
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Affiliation(s)
- Sean Cowlishaw
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
- Correspondence:
| | - Isabella Freijah
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Dzenana Kartal
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Alyssa Sbisa
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Ashlee Mulligan
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - MaryAnn Notarianni
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Anne-Laure Couineau
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - David Forbes
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Meaghan O’Donnell
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Andrea Phelps
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Katherine M. Iverson
- Women’s Health Sciences Division, National Center for PTSD, Veterans Affairs Boston Healthcare System, 150 South Huntington Street, Boston, MA 02130, USA;
- Department of Psychiatry, Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118, USA
| | - Alexandra Heber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada;
- Veterans Affairs Canada, Charlottetown, PE C1A 8M9, Canada
| | - Carol O’Dwyer
- Phoenix Australia—Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; (I.F.); (D.K.); (A.S.); (A.-L.C.); (D.F.); (M.O.); (A.P.); (C.O.)
| | - Patrick Smith
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada; (A.M.); (M.N.); (P.S.); (F.H.)
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Badmus UO, Ač A, Klem K, Urban O, Jansen MAK. A meta-analysis of the effects of UV radiation on the plant carotenoid pool. PLANT PHYSIOLOGY AND BIOCHEMISTRY : PPB 2022; 183:36-45. [PMID: 35561499 DOI: 10.1016/j.plaphy.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Induction of metabolite biosynthesis and accumulation is one of the most prominent UV-mediated changes in plants, whether during eustress (positive response) or distress (negative response). However, despite evidence suggesting multiple linkages between UV exposure and carotenoid induction in plants, there is no consensus in the literature concerning the direction and/or amplitude of these effects. Here, we compiled publications that characterised the relative impact of UV on the content of individual carotenoids and subjected the created database to a meta-analysis in order to acquire new, fundamental insights in responses of the carotenoid pool to UV exposure. Overall, it was found that violaxanthin was the only carotenoid compound that was significantly and consistently induced as a result of UV exposure. Violaxanthin accumulation was accompanied by a UV dose dependent decrease in antheraxanthin and zeaxanthin. The resulting shift in the state of the xanthophyll cycle would normally occur when plants are exposed to low light and this is associated with increased susceptibility to photoinhibition. Although UV induced violaxanthin accumulation is positively linked to the daily UV dose, the current dataset is too small to establish a link with plant stress, or even experimental growth conditions. In summary, the effects of UV radiation on carotenoids are multifaceted and compound-specific, and there is a need for a systematic analysis of dose-response and wavelength dependencies, as well as of interactive effects with further environmental parameters.
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Affiliation(s)
- Uthman O Badmus
- School of Biological, Earth and Environmental Sciences & Environmental Research Institute, University College Cork, Distillery Fields, North Mall, Cork, Ireland.
| | - Alexander Ač
- Global Change Research Centre, Academy of Sciences of the Czech Republic, Belidla 4a, CZ-60300, Brno, Czech Republic
| | - Karel Klem
- Global Change Research Centre, Academy of Sciences of the Czech Republic, Belidla 4a, CZ-60300, Brno, Czech Republic
| | - Otmar Urban
- Global Change Research Centre, Academy of Sciences of the Czech Republic, Belidla 4a, CZ-60300, Brno, Czech Republic
| | - Marcel A K Jansen
- School of Biological, Earth and Environmental Sciences & Environmental Research Institute, University College Cork, Distillery Fields, North Mall, Cork, Ireland
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Beta-adrenergic receptor blockers and hepatocellular carcinoma survival: a systemic review and meta-analysis. Clin Exp Med 2022:10.1007/s10238-022-00842-z. [PMID: 35737170 DOI: 10.1007/s10238-022-00842-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/12/2022] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Preclinical data have revealed that beta-adrenergic stimulation can affect the growth and progression of different types of malignancies. Beta-adrenergic receptor blockers have been associated with improved survival in patients with many types of cancer. We performed a meta-analysis to investigate the association between beta-blocker use and hepatocellular carcinoma (HCC) prognosis. METHODS In this meta-analysis, a full search was conducted using PubMed, the Cochrane library and Embase to identify all relevant studies published up to May 2021. Available hazard ratios (HRs) were extracted for overall survival (OS), cancer-specific survival (CSS) and pooled using a random-effects meta-analysis. RESULTS Four studies involving 7252 patients with HCC met the inclusion criteria and were included in the systemic review. Three studies that reported OS data of 5148 patients were included in the meta-analysis. The random-effects model showed that beta-blocker use was associated with significantly improved OS in HCC (HR = 0.69, 95% CI = 0.54-0.88, P = 0.0031), without significant heterogeneity (I2 = 41%; Q = 6.42, P = 0.18). CONCLUSION This meta-analysis suggested that beta-blocker use can be associated with prolonged OS of patients with HCC.
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Davenport MK, Young CK, Kim MH, Gilberto JM, Beier ME. A lifespan development perspective and meta‐analysis on the relationship between age and organizational training. PERSONNEL PSYCHOLOGY 2022. [DOI: 10.1111/peps.12535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chen J, Or CK, Chen T. Effectiveness of Using Virtual Reality-Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2022; 24:e24111. [PMID: 35723907 PMCID: PMC9253973 DOI: 10.2196/24111] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/19/2021] [Accepted: 04/18/2022] [Indexed: 01/19/2023] Open
Abstract
Background In recent years, efforts have been made to implement virtual reality (VR) to support the delivery of poststroke upper extremity motor rehabilitation exercises. Therefore, it is important to review and analyze the existing research evidence of its effectiveness. Objective Through a systematic review and meta-analysis of randomized controlled trials, this study examined the effectiveness of using VR-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke. Methods This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The CINAHL Plus, MEDLINE, Web of Science, Embase, and Cochrane Library databases were searched on December 31, 2021. Changes in outcomes related to impairments in upper extremity functions and structures, activity limitations, and participation restrictions in life situations from baseline to after intervention, after intervention to follow-up assessment, and baseline to follow-up assessment were examined. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup analyses were performed to determine whether the differences in treatment outcomes depended on age, stroke recovery stage, VR program type, therapy delivery format, similarities in intervention duration between study groups, intervention duration in VR groups, and trial length. Results A total of 42 publications representing 43 trials (aggregated sample size=1893) were analyzed. Compared with the control groups that used either conventional therapy or no therapy, the intervention groups that used VR to support exercise therapy showed significant improvements in upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity; SMD 0.45, 95% CI 0.21-0.68; P<.001), range of motion (goniometer; SMD 1.01, 95% CI 0.50-1.52; P<.001), muscle strength (Manual Muscle Testing; SMD 0.79, 95% CI 0.28-1.30; P=.002), and independence in day-to-day activities (Functional Independence Measure; SMD 0.23, 95% CI 0.06-0.40; P=.01, and modified Rankin Scale; SMD 0.57, 95% CI 0.01-1.12; P=.046). Significant subgroup differences were observed in hand dexterity (Box and Block Test), spasticity (Ashworth Scale or modified Ashworth Scale), arm and hand motor ability (Wolf Motor Function Test and Manual Function Test), hand motor ability (Jebsen Hand Function Test), and quality of life (Stroke Impact Scale). There was no evidence that the benefits of VR-supported exercise therapy were maintained after the intervention ended. Conclusions VR-supported upper extremity exercise therapy can be effective in improving motor rehabilitation results. Our review showed that of the 12 rehabilitation outcomes examined during the course of VR-based therapy, significant improvements were detected in 2 (upper extremity motor function and range of motion), and both significant and nonsignificant improvements were observed in another 2 (muscle strength and independence in day-to-day activities), depending on the measurement tools or methods used. Trial Registration PROSPERO CRD42021256826; https://tinyurl.com/2uarftbh
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Affiliation(s)
- Jiayin Chen
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Calvin Kalun Or
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Tianrong Chen
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China (Hong Kong)
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82
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Garniasih D, Susanah S, Sribudiani Y, Hilmanto D. The incidence and mortality of childhood acute lymphoblastic leukemia in Indonesia: A systematic review and meta-analysis. PLoS One 2022; 17:e0269706. [PMID: 35696384 PMCID: PMC9191700 DOI: 10.1371/journal.pone.0269706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The incidence of childhood ALL in Indonesia is still largely unknown. The widely mentioned statistics from other countries turn out to be only estimated figures. Other data do not specify the types of leukemia and are not specifically focused on children. Therefore, this study aims to pool incidence and mortality statistics from available studies in Indonesia. METHODS We searched five different academic databases, including Pubmed, MEDLINE, Cochrane Library, Science Direct, and Google Scholar. Three Indonesian databases, such as the Indonesian Scientific Journal Database (ISJD), Neliti, and Indonesia One Search, were also utilized. Incidence was expressed as per 100,000 children. We used the Newcastle-Ottawa scale (NOS) to assess the quality of cohort studies. The inclusion criteria are cohort studies published in the languages of English or Indonesian. For this analysis, we define children as 0-18 years old. FINDINGS The incidence rate for childhood ALL was found to be 4.32 per 100,000 children (95% CI 2.65-5.99) with a prediction interval of 1.98 to 9.42 per 100,000 children. The incidence rate is higher in males, with 2.45 per 100,000 children (95% CI 1.98-2.91) and a prediction interval of 1.90 to 3.16 per 100,000 children. As for females, the incidence rate is 2.05 per 100,000 children (95% CI 1.52-2.77) with a prediction interval of 1.52 to 2.77 per 100,000 children. The mortality of childhood ALL ranges from 0.44 to 5.3 deaths per 100,000 children, while the CFR is 3.58% with varying true effect sizes of 2.84% to 4.52%. INTERPRETATION With 79.5 million children living in Indonesia in 2018, this means that there were roughly 3,434 new cases of childhood ALL. An organized effort between multiple sectors is needed to improve the registries of childhood ALL in Indonesia.
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Affiliation(s)
- Dina Garniasih
- Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Susi Susanah
- Department of Pediatrics, Universitas Padjadjaran, Bandung, Indonesia
- Research Center of Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Yunia Sribudiani
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Research Center of Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Dany Hilmanto
- Department of Pediatrics, Universitas Padjadjaran, Bandung, Indonesia
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Physical Activity, Positive and Negative Symptoms of Psychosis, and General Psychopathology among People with Psychotic Disorders: A Meta-Analysis. J Clin Med 2022; 11:jcm11102719. [PMID: 35628845 PMCID: PMC9144999 DOI: 10.3390/jcm11102719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 02/05/2023] Open
Abstract
Objective: Existing reviews provided evidence for the associations between higher physical activity (PA) and lower negative symptoms of psychosis among people with schizophrenia. This meta-analysis goes beyond existing syntheses and investigates associations between PA, positive and negative symptoms of psychosis, as well as symptoms of general psychopathology (referring mostly to cognitive functioning) among people with schizophrenia, but also other psychotic disorders. The moderating roles of the type of diagnosis and the type of exercise intervention were explored. Methods: The study was registered with PROSPERO (CRD42018118236). Six electronic databases were searched; n = 27 experimental and observational studies were included, and psychotic symptoms-related data were recorded in one direction (higher values indicate better mental health and lower symptomatology). Results: Higher levels of PA (or participating in PA interventions) were associated with better mental health, that is, lower levels of positive symptoms (all studies: r = 0.170; experimental studies: SMD = 0.677), negative symptoms (all studies: r = 0.214; experimental studies: SMD = 0.838), and general psychopathology (all studies: r = 0.451; experimental studies: SMD = 1.511). The type of diagnosis (schizophrenia vs. other psychotic disorders) did not moderate these associations. Conclusions: We found a consistent pattern of associations between higher levels of PA and lower positive, negative, and general psychopathology symptoms in people with schizophrenia and those with other psychotic disorders.
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Burgoon LD, Borgert CJ. Comment on "Application of an in Vitro Assay to Identify Chemicals That Increase Estradiol and Progesterone Synthesis and Are Potential Breast Cancer Risk Factors". ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:58002. [PMID: 35507340 PMCID: PMC9067438 DOI: 10.1289/ehp11083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
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Systemic Complement Activation Profiles in Nonexudative Age-Related Macular Degeneration: A Meta-Analysis. J Clin Med 2022; 11:jcm11092371. [PMID: 35566495 PMCID: PMC9105289 DOI: 10.3390/jcm11092371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/18/2022] [Accepted: 04/22/2022] [Indexed: 12/04/2022] Open
Abstract
Although complement inhibition has emerged as a possible therapeutic strategy for age-related macular degeneration (AMD), there is not a clear consensus regarding what aspects of the complement pathway are dysregulated in AMD and when this occurs relative to disease stage. We recently published a systematic review describing systemic complement activation profiles in patients with early/intermediate AMD or geographic atrophy (GA) compared to non-AMD controls. Here, we sought to meta-analyze these results to estimate the magnitude of complement dysregulation in AMD using restricted maximum likelihood estimation. The seven meta-analyzed studies included 710 independent participants with 23 effect sizes. Compared with non-AMD controls, patients with early/intermediate nonexudative AMD (N = 246) had significantly higher systemic complement activation, as quantified by the levels of complement proteins generated by common final pathway activation, and significantly lower systemic complement inhibition. In contrast, there were no statistically significant differences in the systemic levels of complement common final pathway activation products or complement inhibition in patients with GA (N = 178) versus non-AMD controls. We provide evidence that systemic complement over-activation is a feature of early/intermediate nonexudative AMD; no such evidence was identified for patients with GA. These findings provide mechanistic insights and inform future clinical trials.
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Prevalence and genotype distribution of viral hepatitis B in Cambodia between 1990 and 2020: a systematic review and meta-analysis. Arch Public Health 2022; 80:119. [PMID: 35418163 PMCID: PMC9006504 DOI: 10.1186/s13690-022-00880-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Hepatitis B virus (HBV) infection is one of the major public health problems globally as well as in Cambodia. Continuous information on HBV infection burden is required to implement effective disease control strategies. This study aimed to determine the prevalence and genotype distribution of HBV infection in Cambodia through a systematic review with meta-analysis. Methods Four databases (PubMed, Web of Science, Scopus, and Google Scholar) were used to search published studies reporting either HBV prevalence or genotype distribution in Cambodia until August 21, 2020. Reviews, modeling studies, and studies conducted among Cambodian permanently living abroad were excluded. The Freeman–Tukey double arcsine transformation was implemented to achieve approximate normality. The DerSimonian and Laird method was used to compute pooled estimates based on the transformed values and their variance. Possible publication bias was assessed by the Egger test and the funnel plot. Results A total of 22 studies were included, covering 22,323 people. Ten studies reported HBV prevalence in the general population. The HBV infection prevalence was 4.73% (95%CI: 2.75–7.17%) in the general population and 19.87% (95%CI: 10.95–30.63%) in high-risk/co-infected groups. By sub-group analysis, the prevalence was 6.81% (95% CI: 4.43–9.66) in adults older than 15 years old, 2.37% (95% CI:0.04–7.05) in children 6–15 years old, and 2.47% (95% CI: 0.96–4.59) in children less than five years old. The prevalence of HBV infection decreased over time. Predominant HBV genotypes were genotypes C and B with 82.96% and 16.79%, respectively. Conclusions The decrease in HBV infection prevalence in Cambodia demonstrates the effects of national hepatitis B immunization, improved clinical hygiene, and the use of disposable devices. However, the estimated HBV prevalence among the general population indicates an intermediate endemicity level of HBV infection. Therefore, population screening and linkage to care, high vaccination coverage, health promotion, and HBV surveillance are essential to meet the WHO 2030 goal. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00880-9.
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Haberstroh S, Schulte-Körne G. The Cognitive Profile of Math Difficulties: A Meta-Analysis Based on Clinical Criteria. Front Psychol 2022; 13:842391. [PMID: 35360597 PMCID: PMC8962618 DOI: 10.3389/fpsyg.2022.842391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/16/2022] [Indexed: 12/03/2022] Open
Abstract
Math difficulties (MD) manifest across various domain-specific and domain-general abilities. However, the existing cognitive profile of MD is incomplete and thus not applicable in typical settings such as schools or clinics. So far, no review has applied inclusion criteria according to DSM or ICD, summarized domain-specific abilities or examined the validity of response time scores for MD identification. Based upon stringent clinical criteria, the current meta-analysis included 34 studies which compared cognitive performances of a group with MD (n = 680) and a group without MD (n = 1565). Criteria according to DSM and ICD were applied to identify MD (percentile rank ≤ 16, age range 8–12 years, no comorbidities/low IQ). Effect sizes for 22 abilities were estimated and separated by their level and type of scoring (AC = accuracy, RT = response time). A cognitive profile of MD was identified, characterized by distinct weaknesses in: (a) computation (calculation [AC], fact retrieval [AC]), (b) number sense (quantity processing [AC], quantity-number linking [RT], numerical relations [AC]), and (c) visual-spatial short-term storage [AC]. No particular strength was found. Severity of MD, group differences in reading performance and IQ did not significantly moderate the results. Further analyses revealed that (a) effects are larger when dealing with numbers or number words than with quantities, (b) MD is not accompanied by any weakness in abilities typically assigned to reading, and (c) weaknesses in visual-spatial short-term storage emphasize the notion that number and space are interlinked. The need for high-quality studies investigating domain-general abilities is discussed.
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Cano-Cano F, Gómez-Jaramillo L, Ramos-García P, Arroba AI, Aguilar-Diosdado M. IL-1β Implications in Type 1 Diabetes Mellitus Progression: Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11051303. [PMID: 35268394 PMCID: PMC8910979 DOI: 10.3390/jcm11051303] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/16/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023] Open
Abstract
During Type 1 Diabetes Mellitus (T1DM) progression, there is chronic and low-grade inflammation that could be related to the evolution of the disease. We carried out a systematic review and meta-analysis to evaluate whether peripheral levels of pro-inflammatory markers such as interleukin-1 beta (IL-1β) is significantly different among patients with or without T1DM, in gender, management of the T1DM, detection in several biological fluids, study design, age range, and glycated hemoglobin. We searched PubMed, Embase, Web of Science, and Scopus databases, and 26 relevant studies (2186 with T1DM, 2047 controls) were included. We evaluated the studies’ quality using the Newcastle−Ottawa scale. Meta-analyses were conducted, and heterogeneity and publication bias were examined. Compared with controls, IL-1β determined by immunoassays (pooled standardized mean difference (SMD): 2.45, 95% CI = 1.73 to 3.17; p < 0.001) was significantly elevated in T1DM. The compared IL-1β levels in patients <18 years (SMD = 2.81, 95% CI = 1.88−3.74) was significantly elevated. The hemoglobin-glycated (Hbg) levels in patients <18 years were compared (Hbg > 7: SMD = 5.43, 95% CI = 3.31−7.56; p = 0.001). Compared with the study design, IL-1β evaluated by ELISA (pooled SMD = 3.29, 95% CI = 2.27 to 4.30, p < 0.001) was significantly elevated in T1DM patients. IL-1β remained significantly higher in patients with a worse management of T1DM and in the early stage of T1DM. IL-1β levels determine the inflammatory environment during T1DM.
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Affiliation(s)
- Fátima Cano-Cano
- Research Unit, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain; (F.C.-C.); (L.G.-J.); (M.A.-D.)
| | - Laura Gómez-Jaramillo
- Research Unit, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain; (F.C.-C.); (L.G.-J.); (M.A.-D.)
| | - Pablo Ramos-García
- Faculty of Dentistry, University of Granada, 18011 Granada, Spain
- Correspondence: (P.R.-G.); (A.I.A.)
| | - Ana I. Arroba
- Research Unit, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain; (F.C.-C.); (L.G.-J.); (M.A.-D.)
- Department of Endocrinology and Metabolism, University Hospital Puerta del Mar, 11009 Cadiz, Spain
- Correspondence: (P.R.-G.); (A.I.A.)
| | - Manuel Aguilar-Diosdado
- Research Unit, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain; (F.C.-C.); (L.G.-J.); (M.A.-D.)
- Department of Endocrinology and Metabolism, University Hospital Puerta del Mar, 11009 Cadiz, Spain
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Wang Y, Lin L, Thompson CG, Chu H. A penalization approach to random-effects meta-analysis. Stat Med 2022; 41:500-516. [PMID: 34796539 PMCID: PMC8792303 DOI: 10.1002/sim.9261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 11/06/2022]
Abstract
Systematic reviews and meta-analyses are principal tools to synthesize evidence from multiple independent sources in many research fields. The assessment of heterogeneity among collected studies is a critical step when performing a meta-analysis, given its influence on model selection and conclusions about treatment effects. A common-effect (CE) model is conventionally used when the studies are deemed homogeneous, while a random-effects (RE) model is used for heterogeneous studies. However, both models have limitations. For example, the CE model produces excessively conservative confidence intervals with low coverage probabilities when the collected studies have heterogeneous treatment effects. The RE model, on the other hand, assigns higher weights to small studies compared to the CE model. In the presence of small-study effects or publication bias, the over-weighted small studies from a RE model can lead to substantially biased overall treatment effect estimates. In addition, outlying studies may exaggerate between-study heterogeneity. This article introduces penalization methods as a compromise between the CE and RE models. The proposed methods are motivated by the penalized likelihood approach, which is widely used in the current literature to control model complexity and reduce variances of parameter estimates. We compare the existing and proposed methods with simulated data and several case studies to illustrate the benefits of the penalization methods.
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Affiliation(s)
- Yipeng Wang
- Department of Statistics, Florida State University, FL,
USA
- Department of Biostatistics, University of Florida, FL,
USA
| | - Lifeng Lin
- Department of Statistics, Florida State University, FL,
USA
| | | | - Haitao Chu
- Division of Biostatistics, University of Minnesota School
of Public Health, MN, USA
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90
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Sun Y, Ji M, Leng M, Li X, Zhang X, Wang Z. Comparative efficacy of 11 non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia: A systematic review and network meta-analysis. Int J Nurs Stud 2022; 129:104204. [DOI: 10.1016/j.ijnurstu.2022.104204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/21/2022]
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91
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Osugo M, Whitehurst T, Shatalina E, Townsend L, O’Brien O, Mak TLA, McCutcheon R, Howes O. Dopamine partial agonists and prodopaminergic drugs for schizophrenia: systematic review and meta-analysis of randomized controlled trials. Neurosci Biobehav Rev 2022; 135:104568. [DOI: 10.1016/j.neubiorev.2022.104568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/16/2021] [Accepted: 02/02/2022] [Indexed: 10/19/2022]
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92
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Serrano-Ripoll MJ, Zamanillo-Campos R, Fiol-DeRoque MA, Castro A, Ricci-Cabello I. Impact of Smartphone App-Based Psychological Interventions for Reducing Depressive Symptoms in People With Depression: Systematic Literature Review and Meta-analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2022; 10:e29621. [PMID: 35084346 PMCID: PMC8832272 DOI: 10.2196/29621] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/16/2021] [Accepted: 11/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depression is a serious, disabling mental disorder that severely affects quality of life. Patients with depression often do not receive adequate treatment. App-based psychotherapy is considered to have great potential to treat depression owing to its reach and easy accessibility. OBJECTIVE We aim to analyze the impact of app-based psychological interventions for reducing depressive symptoms in people with depression. METHODS We conducted a systematic literature review and meta-analysis. We searched Medline, Embase, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials from inception to December 23, 2020. We selected randomized controlled trials to examine the impact of app-based psychological interventions for reducing depressive symptoms in people with depression. Study selection, data extraction, and critical appraisal (using the Cochrane Risk of Bias tool for randomized studies and the ROBINS-I tool for nonrandomized studies) were conducted independently by 2 reviewers. Where possible, we pooled data using random effects meta-analyses to obtain estimates of the effect size of the intervention. We conducted post hoc meta-regression analyses to explore the factors associated with intervention success. RESULTS After screening 3468 unique references retrieved from bibliographic searches and assessing the eligibility of 79 full texts, we identified 12 trials (2859 participants) evaluating 14 different interventions. Of 14 trials, 7 (58%) were conducted in the United States; 3 (25%) trials, in Asia (Japan, South Korea, and China); 1 (8%) trial, in Australia; and 1 (8%) trial, in Germany. Of the 12 trials, 5 (42%) trials presented a low risk of bias. The mean duration of the interventions was 6.6 (SD 2.8) weeks. Two-thirds of the interventions were based on cognitive behavioral therapy alone or included it in combination with cognitive control therapy, positive psychology, brief behavioral activation, or mindfulness- and acceptance-based therapy. With no evidence of publication bias, a pooled analysis of 83% (10/12) of the trials and 86% (12/14) of the interventions showed that app-based interventions, compared with a control group receiving usual care or minimal intervention, produced a moderate reduction in depressive symptoms (standardized mean difference [SMD] -0.51, 95% CI -0.69 to -0.33; 2018/2859, 70.58% of the participants; I2=70%). Our meta-regression analyses indicated that there was a greater reduction in symptoms of depression (P=.04) in trials that included participants with moderate to severe depression (SMD -0.67, 95% CI -0.79 to -0.55), compared with trials with participants exhibiting mild to moderate depression (SMD -0.15, 95% CI -0.43 to -0.12). CONCLUSIONS App-based interventions targeted at people with depression produce moderate reductions in the symptoms of depression. More methodologically robust trials are needed to confirm our findings, determine which intervention features are associated with greater improvements, and identify those populations most likely to benefit from this type of intervention. TRIAL REGISTRATION PROSPERO CRD42019145689; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=145689.
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Affiliation(s)
- Maria J Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Network, RedIAPP, Barcelona, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain
| | - Maria A Fiol-DeRoque
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain
| | - Adoración Castro
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain
- Centro de Investigación Biomedica en Red (CIBERESP), Madrid, Spain
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93
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Díaz LA, García-Salum T, Fuentes-López E, Reyes D, Ortiz J, Chahuan J, Levican J, Almonacid LI, Valenzuela GH, Serrano E, Budnik S, Gandara V, Gallardo A, Seydewitz MF, Ferrés M, Cofré C, Álvarez M, Pavez C, Candia R, Monrroy H, Espino A, Rada G, Ortiz L, Valderrama S, Salinas E, Toro A, Ortega M, Pizarro M, Medina RA, Riquelme A. High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A Systematic Review and Cohort Study. GASTROENTEROLOGIA Y HEPATOLOGIA 2022; 45:593-604. [PMID: 35077722 PMCID: PMC8783395 DOI: 10.1016/j.gastrohep.2021.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/02/2021] [Accepted: 12/29/2021] [Indexed: 10/25/2022]
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The effect of metformin on body mass index and metabolic parameters in non-diabetic HIV-positive patients: a meta-analysis. J Diabetes Metab Disord 2021; 20:1901-1911. [PMID: 34900832 DOI: 10.1007/s40200-021-00869-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
We sought to evaluate the effetc of metformin on body mass index (BMI) and metabolic parameters in HIV-positive patients. We performed a comprehensive search through five major indexing databases, using keywords ("metformin" OR "dimethylguanylguanidine" OR "biguanide" OR "Glucophage") AND ("HIV" OR "human immunodeficiency virus" OR "AIDS" OR "Acquired immunodeficiency syndrome"), and all possible combinations until January 15, 2021. We measured standardized mean differences (SMD) and 95% confidence intervals (CI) for each outcome. We finally included 12 RCTs (577 participants, 274 in the metformin group and 303 in the comparators). Metformin did not significantly change BMI index compared to various comparators. Metformin generally improve LDL levels (SMD = 0.29, 95% CI: - 1.00 1.57, P = 0.01), HDL levels (SMD = - 0.15, 95% CI: - 0.72 0.41, P = 0.001), triglycerides values (SMD = 0.46, 95% CI: - 0.36 1.27, P < 0.00001), fasting glucose (SMD = - 0.82, 95% CI: - 1.80 0.15, P < 0.00001), insulin 120 min (SMD = - 0.82, 95% CI: - 1.59-0.04, P = 0.02), and glucose 120 min (SMD = - 1.24, 95% CI: - 2.57 0.10, P < 0.0001), but worsened total cholesterol values (SMD = 1.24, 95% CI: - 0.98 3.46, P = 0.0001). Metformin is safe for weight loss in obese people; however, this drug may not be suitable for everyone, especially those who are not overweight. Nevertheless the body of evidences may suggest that metformin had promising impacts on metabolic parameters in patients with both HIV, it is still unknown that such surrogate changes will translate to long-standing clinical advantages. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00869-1.
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BCG Vaccination in Early Childhood and Risk of Atopic Disease: A Systematic Review and Meta-Analysis. Can Respir J 2021; 2021:5434315. [PMID: 34868440 PMCID: PMC8635936 DOI: 10.1155/2021/5434315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/19/2021] [Accepted: 10/23/2021] [Indexed: 01/15/2023] Open
Abstract
Background Several large-scale studies suggest that Bacille Calmette–Guerin (BCG) vaccination in early childhood may reduce the risk of atopic diseases, but the findings remain controversial. Here, we aimed to investigate the potential correlation between early childhood BCG vaccination and the risk of developing atopic diseases. Methods Eligible studies published on PubMed, EMBASE, and Cochrane CENTRAL were systematically sourced from 1950 to July 2021. Studies with over 100 participants and focusing on the association between BCG vaccine and atopic diseases including eczema, asthma, and rhinitis were included. Preliminary assessment of methods, interventions, outcomes, and study quality was performed by two independent investigators. Odds ratio (OR) with 95% confidence interval (CI) was calculated. Random effects of the meta-analysis were performed to define pooled estimates of the effects. Results Twenty studies with a total of 222,928 participants were selected. The quantitative analysis revealed that administering BCG vaccine in early childhood reduced the risk of developing asthma significantly (OR 0.77, 95% CI 0.63 to 0.93), indicating a protective efficacy of 23% against asthma development among vaccinated children. However, early administration of BCG vaccine did not significantly reduce the risk of developing eczema (OR 0.94, 95% CI 0.76 to 1.16) and rhinitis (OR 0.99, 95% CI 0.81 to 1.21). Further analysis revealed that the effect of BCG vaccination on asthma prevalence was significant especially in developed countries (OR 0.73, 95% CI 0.58 to 0.92). Conclusion BCG vaccination in early childhood is associated with reduced risk of atopic disease, especially in developed countries.
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96
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Wong SH, Tan ZYA, Cheng LJ, Lau ST. Wearable technology-delivered lifestyle intervention amongst adults with overweight and obese: A systematic review and meta-regression. Int J Nurs Stud 2021; 127:104163. [DOI: 10.1016/j.ijnurstu.2021.104163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 02/08/2023]
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97
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Piscopo A, Seaman SC, Beer MA, Torner JC, Greenlee JD. A meta-analysis of proportions of single arm observational series for anterior skull base meningiomas comparing supraorbital craniotomy to the endoscopic endonasal approach. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Deng J, Zhou F, Hou W, Heybati K, Ali S, Chang O, Silver Z, Dhivagaran T, Ramaraju HB, Wong CY, Zuo QK, Lapshina E, Mellett M. Efficacy of lopinavir-ritonavir combination therapy for the treatment of hospitalized COVID-19 patients: a meta-analysis. Future Virol 2021; 17:10.2217/fvl-2021-0066. [PMID: 35145560 PMCID: PMC8815807 DOI: 10.2217/fvl-2021-0066] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 12/08/2021] [Indexed: 12/15/2022]
Abstract
Aim: To evaluate the efficacy and safety of lopinavir-ritonavir (LPV/r) therapy in treating hospitalized COVID-19 patients. Materials & methods: Data from randomized and observational studies were included in meta-analyses. Primary outcomes were length of stay, time for SARS-CoV-2 test conversion, mortality, incidence of mechanical ventilation, time to body temperature normalization and incidence of adverse events. Results: Twenty-four studies (n = 10,718) were included. LPV/r demonstrated no significant benefit over the control groups in all efficacy outcomes. The use of LPV/r was associated with a significant increase in the odds of adverse events. Conclusion: Given the lack of efficacy and increased incidence of adverse events, the clinical use of LPV/r in hospitalized COVID-19 patients is not recommended.
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Affiliation(s)
- Jiawen Deng
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Fangwen Zhou
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Wenteng Hou
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Kiyan Heybati
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Mayo Clinic Alix School of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Saif Ali
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Oswin Chang
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Zachary Silver
- Faculty of Science, Carleton University, 1125 Colonel By Dr, Ottawa, ON, K1S 5B6, Canada
| | - Thanansayan Dhivagaran
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Integrated Biomedical Engineering & Health Sciences Program, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | | | - Chi Yi Wong
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Qi Kang Zuo
- Department of Anesthesiology, Rutgers, New Jersey Medical School, 185 S Orange Ave, Newark, NJ 07103, USA
- Faculty of Science, McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G4, Canada
| | - Elizabeth Lapshina
- Faculty of Science, McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G4, Canada
| | - Madeline Mellett
- Faculty of Science, McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G4, Canada
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Chen YH, Chou CH, Su HH, Tsai YT, Chiang MH, Kuo YJ, Chen YP. Correlation between neutrophil-to-lymphocyte ratio and postoperative mortality in elderly patients with hip fracture: a meta-analysis. J Orthop Surg Res 2021; 16:681. [PMID: 34794459 PMCID: PMC8600895 DOI: 10.1186/s13018-021-02831-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/04/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction The neutrophil-to-lymphocyte ratio (NLR) is a crucial prognosis predictor following several major operations. However, the association between NLR and the outcome after hip fracture surgery is unclear. In this meta-analysis, we investigated the correlation between NLR and postoperative mortality in geriatric patients following hip surgery.
Method PubMed, Embase, Cochrane library, and Google Scholar were searched for studies up to June 2021 reporting the correlation between NLR and postoperative mortality in elderly patients undergoing surgery for hip fracture. Data from studies reporting the mean of NLR and its 95% confidence interval (CI) were pooled. Both long-term (≥ 1 year) and short-term (≤ 30 days) mortality rates were included for analysis. Result Eight retrospective studies comprising a total of 1563 patients were included. Both preoperative and postoperative NLRs (mean difference [MD]: 2.75, 95% CI: 0.23–5.27; P = 0.03 and MD: 2.36, 95% CI: 0.51–4.21; P = 0.01, respectively) were significantly higher in the long-term mortality group than in the long-term survival group. However, no significant differences in NLR were noted between the short-term mortality and survival groups (MD: − 1.02, 95% CI: − 3.98 to 1.93; P = 0.5). Conclusion Higher preoperative and postoperative NLRs were correlated with a higher risk of long-term mortality following surgery for hip fracture in the geriatric population, suggesting the prognostic value of NLR for long-term survival. Further studies with well-controlled confounders are warranted to clarify the predictive value of NLR in clinical practice in geriatric patients with hip fracture. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-021-02831-6.
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Affiliation(s)
- Yu-Hang Chen
- Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ching-Hsin Chou
- Department of General Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsin-Hsien Su
- Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu-Ting Tsai
- Department of General Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Ming-Hsiu Chiang
- Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei City, 116, Taiwan.,Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Wenshan Dist., Taipei City, 116, Taiwan. .,Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Guerra-Londono CE, Privorotskiy A, Cozowicz C, Hicklen RS, Memtsoudis SG, Mariano ER, Cata JP. Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2133394. [PMID: 34779845 PMCID: PMC8593761 DOI: 10.1001/jamanetworkopen.2021.33394] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE The use of intercostal nerve block (ICNB) analgesia with local anesthesia is common in thoracic surgery. However, the benefits and safety of ICNB among adult patients undergoing surgery is unknown. OBJECTIVE To evaluate the analgesic benefits and safety of ICNB among adults undergoing thoracic surgery. DATA SOURCES A systematic search was performed in Ovid MEDLINE, Ovid Embase, Scopus, and the Cochrane Library databases using terms for ICNB and thoracic surgery (including thoracic surgery, thoracoscopy, thoracotomy, nerve block, intercostal nerves). The search and results were not limited by date, with the last search conducted on July 24, 2020. STUDY SELECTION Selected studies were experimental or observational and included adult patients undergoing cardiothoracic surgery in which ICNB was administered with local anesthesia via single injection, continuous infusion, or a combination of both techniques in at least 1 group of patients. For comparison with ICNB, studies that examined systemic analgesia and different forms of regional analgesia (such as thoracic epidural analgesia [TEA], paravertebral block [PVB], and other techniques) were included. These criteria were applied independently by 2 authors, and discrepancies were resolved by consensus. A total of 694 records were selected for screening. DATA EXTRACTION AND SYNTHESIS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data including patient characteristics, type of surgery, intervention analgesia, comparison analgesia, and primary and secondary outcomes were extracted independently by 3 authors. Synthesis was performed using a fixed-effects model. MAIN OUTCOMES AND MEASURES The coprimary outcomes were postoperative pain intensity (measured as the worst static or dynamic pain using a validated 10-point scale, with 0 indicating no pain and 10 indicating severe pain) and opioid consumption (measured in morphine milligram equivalents [MMEs]) at prespecified intervals (0-6 hours, 7-24 hours, 25-48 hours, 49-72 hours, and >72 hours). Clinically relevant analgesia was defined as a 1-point or greater difference in pain intensity score at any interval. Secondary outcomes included 30-day postoperative complications and pulmonary function. RESULTS Of 694 records screened, 608 were excluded based on prespecified exclusion criteria. The remaining 86 full-text articles were assessed for eligibility, and 20 of those articles were excluded. All of the 66 remaining studies (5184 patients; mean [SD] age, 53.9 [10.2] years; approximately 59% men and 41% women) were included in the qualitative analysis, and 59 studies (3325 patients) that provided data for at least 1 outcome were included in the quantitative meta-analysis. Experimental studies had a high risk of bias in multiple domains, including allocation concealment, blinding of participants and personnel, and blinding of outcome assessors. Marked differences (eg, crossover studies, timing of the intervention [intraoperative vs postoperative], blinding, and type of control group) were observed in the design and implementation of studies. The use of ICNB vs systemic analgesia was associated with lower static pain (0-6 hours after surgery: mean score difference, -1.40 points [95% CI, -1.46 to -1.33 points]; 7-24 hours after surgery: mean score difference, -1.27 points [95% CI, -1.40 to -1.13 points]) and lower dynamic pain (0-6 hours after surgery: mean score difference, -1.66 points [95% CI, -1.90 to -1.41 points]; 7-24 hours after surgery: mean score difference, -1.43 points [95% CI, -1.70 to -1.17 points]). Intercostal nerve block analgesia was noninferior to TEA (mean score difference in worst dynamic panic at 7-24 hours after surgery: 0.79 points; 95% CI, 0.28-1.29 points) and marginally inferior to PVB (mean score difference in worst dynamic pain at 7-24 hours after surgery: 1.29 points; 95% CI, 1.16 to 1.41 points). The largest opioid-sparing effect of ICNB vs systemic analgesia occurred at 48 hours after surgery (mean difference, -10.97 MMEs; 95% CI, -12.92 to -9.02 MMEs). The use of ICNB was associated with higher MME values compared with TEA (eg, 48 hours after surgery: mean difference, 48.31 MMEs; 95% CI, 36.11-60.52 MMEs) and PVB (eg, 48 hours after surgery: mean difference, 3.87 MMEs; 95% CI, 2.59-5.15 MMEs). CONCLUSIONS AND RELEVANCE In this study, single-injection ICNB was associated with a reduction in pain during the first 24 hours after thoracic surgery and was clinically noninferior to TEA or PVB. Intercostal nerve block analgesia had opioid-sparing effects; however, TEA and PVB were associated with larger decreases in postoperative MMEs, suggesting that ICNB may be most beneficial for cases in which TEA and PVB are not indicated.
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Affiliation(s)
- Carlos E. Guerra-Londono
- Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, University of Texas, Houston
| | | | - Crispiana Cozowicz
- Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Rachel S. Hicklen
- Research Medical Library, MD Anderson Cancer Center, University of Texas, Houston
| | | | - Edward R. Mariano
- Department of Anesthesia, School of Medicine, Stanford University, Stanford, California
| | - Juan P. Cata
- Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, University of Texas, Houston
- Anesthesiology and Surgical Oncology Research Group, Houston, Texas
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