1
|
Peng Q, Zhang L. Assessing the Evidence for Erector Spinae Plane Block in Spine Surgery. Clin J Pain 2024; 40:560-561. [PMID: 38863200 DOI: 10.1097/ajp.0000000000001228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Affiliation(s)
- Qing Peng
- Department of Orthopedics, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | | |
Collapse
|
2
|
Villacura-Herrera C, Pérez J, Jones PB, Núñez D. Internal consistency and temporal stability of the Community Assessment of Psychic Experiences (CAPE): A reliability generalization meta-analysis. Psychiatry Res 2024; 338:115988. [PMID: 38850889 DOI: 10.1016/j.psychres.2024.115988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
Psychotic experiences (PE) are prevalent in general and clinical populations and can increase the risk for mental disorders in young people. The Community Assessment of Psychic Experiences (CAPE) is a widely used measure to assess PE in different populations and settings. However, the current knowledge on their overall reliability is limited. We examined the reliability of the CAPE-42 and later versions, testing the role of age, sex, test scores, and clinical status as moderators. A systematic search was conducted on the Scopus, Web of Science, PubMed, EBSCOhost, ProQuest, and GoogleScholar databases. Internal consistency and temporal stability indices were examined through reliability generalization meta-analysis (RGMA). Moderators were tested through meta-regression analysis. From a pool of 1,015 records, 90 independent samples were extracted from 71 studies. Four versions showed quantitative evidence for inclusion: CAPE-42, CAPE-20, CAPE-P15, and CAPE-P8. Internal consistency indices were good (α/ω≈.725-0.917). Temporal stability was only analyzed for the CAPE-P15, yielding a moderate but not-significant effect (r=0.672). The evidence for temporal stability is scant due to the limited literature, and definitive conclusions cannot be drawn. Further evidence on other potential moderators such as adverse experiences or psychosocial functioning is required.
Collapse
Affiliation(s)
- César Villacura-Herrera
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile
| | - Jesús Pérez
- Prevention and Early Intervention (PRINT) in Mental Health, Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), University of Salamanca, Spain; Cambridgeshire and Peterborough NHS Foundation Trust, UK; Department of Psychiatry, University of Cambridge, UK
| | - Peter B Jones
- Cambridgeshire and Peterborough NHS Foundation Trust, UK; Department of Psychiatry, University of Cambridge, UK
| | - Daniel Núñez
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile; Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Chile.
| |
Collapse
|
3
|
Fang CS, Chang SL, Kang YN, Fang CJ, Chou FH. Response to letter to the editor: Evaluating meta-analysis robustness with trial sequential analysis. J Clin Nurs 2024. [PMID: 38932476 DOI: 10.1111/jocn.17349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Chiu-Shu Fang
- Department of Nursing, Chi-Mei Medical Center, Tainan, Taiwan
| | - Shih-Lun Chang
- Department of Otorhinolaryngology, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Pet Care and Grooming, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Yi-No Kang
- Evidence-Based Medicine Centre, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ching-Ju Fang
- Department of Secretariat, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Medical Library, National Cheng Kung University, Tainan, Taiwan
| | - Fan-Hao Chou
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
4
|
Kitaw TA, Abate BB, Yilak G, Tilahun BD, Faris AM, Walle GT, Haile RN. Virological outcomes of third-line antiretroviral therapy in a global context: a systematic reviews and meta-analysis. AIDS Res Ther 2024; 21:43. [PMID: 38918866 PMCID: PMC11197289 DOI: 10.1186/s12981-024-00630-7] [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: 01/30/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Despite remarkable progress, HIV's influence on global health remains firm, demanding continued attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral therapy vary from study to study, highlighting the need for robust global estimates. METHODS A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web of Science, and Google Scholar, was conducted. STATA version 17 statistical software was used for analysis. A random-effects model was applied to compute the pooled estimates. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future study will fall. The GRADE tool was also used to determine the quality of the evidence. RESULTS In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95% CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore, third-line therapy effectively suppressed viral RNA copy numbers to ≤ 50 copies/mL, ≤ 200 copies/mL, and ≤ 400 copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively. CONCLUSION More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression. Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life for those with second-line treatment failure.
Collapse
Affiliation(s)
- Tegene Atamenta Kitaw
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gizachew Yilak
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Befkad Derese Tilahun
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abebe Merchaw Faris
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Getachew Tesfaw Walle
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Ribka Nigatu Haile
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| |
Collapse
|
5
|
McGrady ME, Keenan-Pfeiffer ME, Lang AC, Noser AE, Tyagi AP, Herriott JK, Ramsey RR. Systematic review and meta-analysis of interventions to promote medication adherence among children, adolescents, and young adults with medical conditions. J Pediatr Psychol 2024:jsae036. [PMID: 38905019 DOI: 10.1093/jpepsy/jsae036] [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: 12/12/2023] [Revised: 04/11/2024] [Accepted: 05/05/2024] [Indexed: 06/23/2024] Open
Abstract
OBJECTIVE This meta-analysis examined the efficacy of adherence-promotion interventions for children, adolescents, and young adults prescribed a medication for > 90 days as part of a treatment regimen for a medical condition. METHODS A systematic literature review was conducted to identify randomized controlled trials of adherence-promotion interventions published between 2013 and 2023 and including children, adolescents, and/or young adults with a medical condition. A total of 38 articles representing 39 trials met inclusion criteria. A narrative synthesis was conducted to summarize included trials and a random-effects model was used to compute an overall intervention effect. Effect sizes by adherence outcome assessment methodology, participant age, and technology use were also computed. RESULTS Pediatric adherence-promotion interventions demonstrate a medium effect with those randomized to an intervention displaying greater improvements in medication adherence than those randomized to a comparator condition (SMD = 0.46, 95% CI: 0.31, 0.60, n = 37; 95% Prediction Interval: -0.32, 1.23). CONCLUSIONS Adherence interventions for children, adolescents, and young adults with medical conditions increase adherence.
Collapse
Affiliation(s)
- Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Mary E Keenan-Pfeiffer
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Amy C Lang
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Amy E Noser
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Anshul P Tyagi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Julia K Herriott
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Rachelle R Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| |
Collapse
|
6
|
Bassalov H, Yakirevich-Amir N, Reuveni I, Monk C, Florentin S, Bonne O, Matok I. Prenatal cannabis exposure and the risk for neuropsychiatric anomalies in the offspring: a systematic review and meta-analysis. Am J Obstet Gynecol 2024:S0002-9378(24)00682-3. [PMID: 38908654 DOI: 10.1016/j.ajog.2024.06.014] [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: 03/02/2024] [Revised: 06/04/2024] [Accepted: 06/14/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To evaluate the association between cannabis use during pregnancy and the risk for long-term neuropsychiatric pathology in the offspring. DATA SOURCES MEDLINE, EMBASE, and Cochrane library databases were systematically searched until January 22, 2024, with no language or date restrictions. STUDY ELIGIBILITY CRITERIA Studies were eligible for inclusion if they reported quantitative data on any long-term neuropsychiatric outcome in offspring whose mothers used cannabis during pregnancy for medical or recreational use, by any route and at any trimester, in comparison to offspring of women who abstained from cannabis use during pregnancy. All observational study designs were included in the analysis. STUDY APPRAISAL AND SYNTHESIS METHODS A systematic review and meta-analysis were performed according to the PRISMA and MOOSE guidelines. The data was extracted independently by 2 reviewers. The following offspring outcomes were of interest: attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression, anxiety, psychotic disorders, as well as cannabis and other substance use. Odds ratios (OR) and 95% confidence intervals (CI) were pooled for each neuropsychiatric outcome in the offspring of women exposed to cannabis during pregnancy compared with nonexposed. Data were pooled using random-effects models. RESULTS Eighteen eligible observational studies were included in the systematic review, and 17 were included in the final quantitative analysis, representing 534,445 participants. After adjusting for confounders, the pooled OR for ADHD was 1.13 (95% CI 1.01-1.26); for ASD, the pooled OR was 1.04 (95% CI 0.74-1.46); for psychotic symptoms, the pooled OR was 1.29 (95% CI 0.97-1.72); for anxiety, the pooled OR was 1.34 (95% CI 0.79-2.29); for depression, the pooled OR was 0.72 (95% CI 0.11-4.57); and for offspring's cannabis use, the pooled OR was 1.20 (95% CI 1.01-1.42). CONCLUSION Prenatal cannabis exposure is not associated with an increased risk of ASD, psychotic symptoms, anxiety, or depression in offspring. However, it may slightly elevate the risk of ADHD and predispose offspring to cannabis consumption. Despite these findings, caution is warranted regarding cannabis use during pregnancy. Further research is imperative, especially given the increasing potency of cannabis in recent years.
Collapse
Affiliation(s)
- Hely Bassalov
- Department of Clinical Pharmacy, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel
| | - Catherine Monk
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY; New York State Psychiatric Institute, New York, NY
| | - Sharon Florentin
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel
| | - Omer Bonne
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel
| | - Ilan Matok
- Department of Clinical Pharmacy, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| |
Collapse
|
7
|
Metaxa AM, Clarke M. Efficacy of psilocybin for treating symptoms of depression: systematic review and meta-analysis. BMJ 2024; 385:e078084. [PMID: 38692686 PMCID: PMC11062320 DOI: 10.1136/bmj-2023-078084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE To determine the efficacy of psilocybin as an antidepressant compared with placebo or non-psychoactive drugs. DESIGN Systematic review and meta-analysis. DATA SOURCES Five electronic databases of published literature (Cochrane Central Register of Controlled Trials, Medline, Embase, Science Citation Index and Conference Proceedings Citation Index, and PsycInfo) and four databases of unpublished and international literature (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, ProQuest Dissertations and Theses Global, and PsycEXTRA), and handsearching of reference lists, conference proceedings, and abstracts. DATA SYNTHESIS AND STUDY QUALITY Information on potential treatment effect moderators was extracted, including depression type (primary or secondary), previous use of psychedelics, psilocybin dosage, type of outcome measure (clinician rated or self-reported), and personal characteristics (eg, age, sex). Data were synthesised using a random effects meta-analysis model, and observed heterogeneity and the effect of covariates were investigated with subgroup analyses and metaregression. Hedges' g was used as a measure of treatment effect size, to account for small sample effects and substantial differences between the included studies' sample sizes. Study quality was appraised using Cochrane's Risk of Bias 2 tool, and the quality of the aggregated evidence was evaluated using GRADE guidelines. ELIGIBILITY CRITERIA Randomised trials in which psilocybin was administered as a standalone treatment for adults with clinically significant symptoms of depression and change in symptoms was measured using a validated clinician rated or self-report scale. Studies with directive psychotherapy were included if the psychotherapeutic component was present in both experimental and control conditions. Participants with depression regardless of comorbidities (eg, cancer) were eligible. RESULTS Meta-analysis on 436 participants (228 female participants), average age 36-60 years, from seven of the nine included studies showed a significant benefit of psilocybin (Hedges' g=1.64, 95% confidence interval (CI) 0.55 to 2.73, P<0.001) on change in depression scores compared with comparator treatment. Subgroup analyses and metaregressions indicated that having secondary depression (Hedges' g=3.25, 95% CI 0.97 to 5.53), being assessed with self-report depression scales such as the Beck depression inventory (3.25, 0.97 to 5.53), and older age and previous use of psychedelics (metaregression coefficient 0.16, 95% CI 0.08 to 0.24 and 4.2, 1.5 to 6.9, respectively) were correlated with greater improvements in symptoms. All studies had a low risk of bias, but the change from baseline metric was associated with high heterogeneity and a statistically significant risk of small study bias, resulting in a low certainty of evidence rating. CONCLUSION Treatment effects of psilocybin were significantly larger among patients with secondary depression, when self-report scales were used to measure symptoms of depression, and when participants had previously used psychedelics. Further research is thus required to delineate the influence of expectancy effects, moderating factors, and treatment delivery on the efficacy of psilocybin as an antidepressant. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023388065.
Collapse
Affiliation(s)
- Athina-Marina Metaxa
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Mike Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, ICS-A Royal Hospitals, Belfast, Ireland, UK
| |
Collapse
|
8
|
Tang S, Chen R, Ma Z, Li X, Chen J, Zhao J. Associations of problematic smartphone use with depressive symptoms and suicidal ideation in university students before and after the COVID-19 outbreak: A meta-analysis. Addict Behav 2024; 152:107969. [PMID: 38290322 DOI: 10.1016/j.addbeh.2024.107969] [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: 08/30/2023] [Revised: 01/06/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND AND AIM Problematic smartphone use (PSU) has been suggested to present with depressive symptoms and suicidal ideation (SI) as well as sleep disturbance, lack of social support, and emotional isolation. The aim of this systematic review and meta-analysis was to evaluate the association between PSU with depressive symptoms and SI in university students, and to determine the potential influence of the coronavirus disease 2019 (COVID-19) outbreak. METHODS Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, Cochrane Library, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings. RESULTS Eighteen datasets from 17 case-control studies, including 24,019 university students, were included. Among them, 8,775 (36.5 %) had PSU. A higher prevalence of depressive symptoms (odds ratio [OR]: 2.40, 95 % confidence interval [CI]: 2.19 to 2.63, p < 0.001; prediction interval: 1.95 to 2.96) was observed in university students with higher scores for PSU measures. A subgroup analysis showed a stronger association between PSU and depressive symptoms after the COVID-19 outbreak as compared to that before the outbreak (OR: 2.76 versus 2.16, p for subgroup difference = 0.002), which explained the heterogeneity. The association between PSU and depressive symptoms in university students was similar to those reported in studies from China and other countries, and in studies with different quality scores. Finally, a meta-analysis of three studies suggested that PSU was also associated with the prevalence of SI (OR: 2.18, 95 % CI: 1.77 to 2.68, p < 0.001; I2 = 0 %). CONCLUSION In university students, PSU may be a risk factor for depressive symptoms and SI, and the association between PSU and depressive symptoms became stronger after the COVID-19 outbreak.
Collapse
Affiliation(s)
- Siyao Tang
- Mental Health Center, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Rongning Chen
- Mental Health Center, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Zijie Ma
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xueguo Li
- Mental Health Center, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jianbin Chen
- Mental Health Center, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jingbo Zhao
- Mental Health Center, School of Public Health, Southern Medical University, Guangzhou 510515, China.
| |
Collapse
|
9
|
Rißmayer M, Kambeitz J, Javelle F, Lichtenstein TK. Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health. Schizophr Bull 2024; 50:615-630. [PMID: 38394386 DOI: 10.1093/schbul/sbae015] [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] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND HYPOTHESIS Exercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes. STUDY DESIGN PubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities. STUDY RESULTS Of 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01). CONCLUSIONS A minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.
Collapse
Affiliation(s)
- Matthias Rißmayer
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, NeuroPsychoImmunology Research Unit, German Sport University Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Florian Javelle
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, NeuroPsychoImmunology Research Unit, German Sport University Cologne, Cologne, Germany
| | - Theresa Katharina Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
10
|
Zhang J, Jiang N, Xu H, Wu Y, Cheng S, Liang B. Efficacy of cognitive functional therapy in patients with low back pain: A systematic review and meta-analysis. Int J Nurs Stud 2024; 151:104679. [PMID: 38219428 DOI: 10.1016/j.ijnurstu.2023.104679] [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: 10/19/2022] [Revised: 11/19/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Low back pain is a major public health problem worldwide, and there exists evidence that cognitive functional therapy may help improve patients' health condition. However, the utilization of cognitive functional therapy for low back pain is limited, and its clinical efficacy remains unclear. OBJECTIVES To determine the efficacy of cognitive functional therapy in the management of disability, pain intensity, and fear-avoidance beliefs in low back pain patients. DESIGN Systematic review and meta-analysis. METHOD A comprehensive study search of Pubmed, Web of Science, Medline, CINAHL, Embase, PsycINFO, and the Cochrane Library databases was conducted from their inception to August 14th, 2023. Two researchers independently conducted the literature search and data extraction. All statistical analysis was performed using Stata Version 17.0. RESULTS A total of eight randomized controlled trials were included. In the short-term, cognitive functional therapy significantly improved disability (7 studies, SMD = -1.05, 95 % CI = -1.74 to -0.35, I2 = 95.37 %, GRADE = very low), pain intensity (7 studies, SMD = -1.02, 95 % CI = -1.89 to -0.15, I2 = 97.21 %, GRADE = very low), and fear-avoidance beliefs (4 studies, SMD = -0.89, 95 % CI = -1.30 to -0.47, I2 = 82.49 %, GRADE = very low). In the medium-term, cognitive functional therapy also significantly improved disability (3 studies, SMD = -0.48, 95 % CI = -0.82 to -0.14, I2 = 77.97 %, GRADE = very low), pain intensity (3 studies, SMD = -0.34, 95 % CI = -0.58 to -0.10, I2 = 55.55 %, GRADE = very low), and fear-avoidance beliefs (2 studies, SMD = -0.62, 95 % CI = -1.19 to -0.04, I2 = 88.24 %, GRADE = very low). In the long-term, cognitive functional therapy significantly improved disability (4 studies, SMD = -0.54, 95 % CI = -0.95 to -0.13, I2 = 85.87 %, GRADE = very low) and fear-avoidance beliefs (3 studies, SMD = -0.76, 95 % CI = -1.17 to -0.34, I2 = 80.34 %, GRADE = very low). CONCLUSION Cognitive functional therapy might be effective in reducing disability and fear-avoidance beliefs at any of short-, medium- and long-term follow-ups, and reducing pain at short- and medium-term follow-ups. No definitive conclusions can be drawn about the impact of cognitive functional therapy on low back pain patients due to the very low certainty evidence base. Additional rigorous randomized controlled trials are needed to further confirm these findings. REGISTRATION NUMBER CRD42022287123 (PROSPERO).
Collapse
Affiliation(s)
- Jiaxin Zhang
- Department of Nursing, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, China
| | - Nan Jiang
- School of Nursing, Jilin University, Changchun 130021, China
| | - Huiying Xu
- Department of Ultrasound, The First Hospital of Jilin University, Changchun 130000, China
| | - Yi Wu
- School of Nursing, Peking University, 100191, China
| | - Siming Cheng
- Jilin General Aviation Vocational and Technical College, Jilin 132000, China
| | - Bing Liang
- School of Nursing, Jilin University, Changchun 130021, China.
| |
Collapse
|
11
|
Chaabane S, Chaabna K, Khawaja S, Aboughanem J, Mittal D, Mamtani R, Cheema S. Sleep disorders and associated factors among medical students in the Middle East and North Africa: a systematic review and meta-analysis. Sci Rep 2024; 14:4656. [PMID: 38409132 PMCID: PMC10897338 DOI: 10.1038/s41598-024-53818-2] [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: 04/19/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of medically defined sleep disorders (SDs) remains unclear. This meta-analysis determines SD prevalence and identifies associated factors among medical students in the MENA. PubMed, Web of Science, Google Scholar, and reference lists of included studies were searched (latest search: June 2022). Meta-analyses included 22 studies and were performed using random-effect models. Included studies used self-reported screening tools for assessing SDs and then estimated the proportion of participants at high risk of developing a SD. Central disorders of hypersomnolence were the most prevalent SD [prevalencepooled range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia disorders [prevalencepooled range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm sleep-wake disorders [prevalencepooled range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], sleep-related breathing disorders [prevalencepooled range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalencepooled range: 5.9% (Egypt) to 30.6% (Saudi Arabia)], and parasomnias [prevalencepooled range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. Female sex, studying in the latter academic years, having anxiety, excessive internet use, and poor academic performance were significantly associated with SDs. SDs are prevalent among MENA medical students. Implementing student-centered interventions targeting high risk groups in medical schools should be considered to improve students' health and wellbeing.
Collapse
Affiliation(s)
- Sonia Chaabane
- Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar.
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar
| | - Salina Khawaja
- Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar
| | - Jasmine Aboughanem
- Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar
| | - Dhruv Mittal
- Intern, Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, P.O. Box. 24144, Doha, Qatar
| |
Collapse
|
12
|
Faggion CM, Atieh MA, Tsagris M, Seehra J, Pandis N. A case study evaluating the effect of clustering, publication bias, and heterogeneity on the meta-analysis estimates in implant dentistry. Eur J Oral Sci 2024; 132:e12962. [PMID: 38030576 DOI: 10.1111/eos.12962] [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: 12/11/2022] [Accepted: 11/08/2023] [Indexed: 12/01/2023]
Abstract
Meta-analyses may provide imprecise estimates when important meta-analysis parameters are not considered during the synthesis. The aim of this case study was to highlight the influence of meta-analysis parameters that can affect reported estimates using as an example pre-existing meta-analyses on the association between implant survival and sinus membrane perforation. PubMed was searched on 7 July 2021 for meta-analyses comparing implant failure in perforated and non-perforated sinus membranes. Primary studies identified in these meta-analyses were combined in a new random-effects model with odds ratios (ORs), confidence intervals (CIs), and prediction intervals reported. Using this new meta-analysis, further meta-analyses were then undertaken considering the clinical, methodological, and statistical heterogeneity of the primary studies, publication bias, and clustering effects. The meta-analyses with the greatest number and more homogeneous studies provided lower odds of implant failure in non-perforated sites (OR 0.49, 95 % CI = [0.26, 0.92]). However, when considering heterogeneity, publication bias, and clustering (number of implants), the confidence in these results was reduced. Interpretation of estimates reported in systematic reviews can vary depending on the assumptions made in the meta-analysis. Users of these analyses need to carefully consider the impact of heterogeneity, publication bias, and clustering, which can affect the size, direction, and interpretation of the reported estimates.
Collapse
Affiliation(s)
- Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University Hospital Münster, Münster, Germany
| | - Momen A Atieh
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
- School of Dentistry, University of Jordan, Amman, Jordan
| | - Michail Tsagris
- Department of Economics, University of Crete, Rethimnon, Greece
| | - Jadbinder Seehra
- Centre for Craniofacial Development & Regeneration, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| |
Collapse
|
13
|
Chen IW, Kao CL, Hung KC. Association Between Bariatric Surgery and Pelvic Organ Prolapse. Obes Surg 2024; 34:262-263. [PMID: 37962779 DOI: 10.1007/s11695-023-06937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023]
Affiliation(s)
- I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - Chia-Li Kao
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No.901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan.
| |
Collapse
|
14
|
Garg PK, Bhatia HS, Allen TS, Grainger T, Pouncey AL, Dichek D, Virmani R, Golledge J, Allison MA, Powell JT. Assessment of Subclinical Atherosclerosis in Asymptomatic People In Vivo: Measurements Suitable for Biomarker and Mendelian Randomization Studies. Arterioscler Thromb Vasc Biol 2024; 44:24-47. [PMID: 38150519 PMCID: PMC10753091 DOI: 10.1161/atvbaha.123.320138] [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] [Indexed: 12/29/2023]
Abstract
BACKGROUND One strategy to reduce the burden of cardiovascular disease is the early detection and treatment of atherosclerosis. This has led to significant interest in studies of subclinical atherosclerosis, using different phenotypes, not all of which are accurate reflections of the presence of asymptomatic atherosclerotic plaques. The aim of part 2 of this series is to provide a review of the existing literature on purported measures of subclinical disease and recommendations concerning which tests may be appropriate in the prevention of incident cardiovascular disease. METHODS We conducted a critical review of measurements used to infer the presence of subclinical atherosclerosis in the major conduit arteries and focused on the predictive value of these tests for future cardiovascular events, independent of conventional cardiovascular risk factors, in asymptomatic people. The emphasis was on studies with >10 000 person-years of follow-up, with meta-analysis of results reporting adjusted hazard ratios (HRs) with 95% CIs. The arterial territories were limited to carotid, coronary, aorta, and lower limb arteries. RESULTS In the carotid arteries, the presence of plaque (8 studies) was independently associated with future stroke (pooled HR, 1.89 [1.04-3.44]) and cardiac events (7 studies), with a pooled HR, 1.77 (1.19-2.62). Increased coronary artery calcium (5 studies) was associated with the risk of coronary heart disease events, pooled HR, 1.54 (1.07-2.07) and increasing severity of calcification (by Agaston score) was associated with escalation of risk (13 studies). An ankle/brachial index (ABI) of <0.9, the pooled HR for cardiovascular death from 7 studies was 2.01 (1.43-2.81). There were insufficient studies of either, thoracic or aortic calcium, aortic diameter, or femoral plaque to synthesize the data based on consistent reporting of these measures. CONCLUSIONS The presence of carotid plaque, coronary artery calcium, or abnormal ankle pressures seems to be a valid indicator of the presence of subclinical atherosclerosis and may be considered for use in biomarker, Mendelian randomization and similar studies.
Collapse
Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California, Keck School of Medicine, Los Angeles (G.P.)
| | - Harpreet S Bhatia
- Division of Cardiovascular Medicine, University of California San Diego (B.H., A.T., A.M.A.)
| | - Tara S Allen
- Division of Cardiovascular Medicine, University of California San Diego (B.H., A.T., A.M.A.)
| | - Tabitha Grainger
- Department of Surgery & Cancer, Imperial College London (G.T., P.A.-L., P.J.T.)
| | - Anna L Pouncey
- Department of Surgery & Cancer, Imperial College London (G.T., P.A.-L., P.J.T.)
| | - David Dichek
- Division of Cardiology, Department of Medicine, University of Washington, Seattle (D.D.)
| | | | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University and Townsville University Hospital, Australia (G.J.)
| | - Matthew A Allison
- Division of Cardiovascular Medicine, University of California San Diego (B.H., A.T., A.M.A.)
| | - Janet T Powell
- Department of Surgery & Cancer, Imperial College London (G.T., P.A.-L., P.J.T.)
| |
Collapse
|
15
|
Lewkowitz AK, Whelan AR, Ayala NK, Hardi A, Stoll C, Battle CL, Tuuli MG, Ranney ML, Miller ES. The effect of digital health interventions on postpartum depression or anxiety: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol 2024; 230:12-43. [PMID: 37330123 PMCID: PMC10721728 DOI: 10.1016/j.ajog.2023.06.028] [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: 03/13/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE This study aimed to examine the effect of digital health interventions compared with treatment as usual on preventing and treating postpartum depression and postpartum anxiety. DATA SOURCES Searches were conducted in Ovid MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. STUDY ELIGIBILITY REQUIREMENTS The systematic review included full-text randomized controlled trials comparing digital health interventions with treatment as usual for preventing or treating postpartum depression and postpartum anxiety. STUDY APPRAISAL AND SYNTHESIS METHODS Two authors independently screened all abstracts for eligibility and independently reviewed all potentially eligible full-text articles for inclusion. A third author screened abstracts and full-text articles as needed to determine eligibility in cases of discrepancy. The primary outcome was the score on the first ascertainment of postpartum depression or postpartum anxiety symptoms after the intervention. Secondary outcomes included screening positive for postpartum depression or postpartum anxiety --as defined in the primary study --and loss to follow-up, defined as the proportion of participants who completed the final study assessment compared with the number of initially randomized participants. For continuous outcomes, the Hedges method was used to obtain standardized mean differences when the studies used different psychometric scales, and weighted mean differences were calculated when studies used the same psychometric scales. For categorical outcomes, pooled relative risks were estimated. RESULTS Of 921 studies originally identified, 31 randomized controlled trials-corresponding to 5532 participants randomized to digital health intervention and 5492 participants randomized to treatment as usual-were included. Compared with treatment as usual, digital health interventions significantly reduced mean scores ascertaining postpartum depression symptoms (29 studies: standardized mean difference, -0.64 [95% confidence interval, -0.88 to -0.40]; I2=94.4%) and postpartum anxiety symptoms (17 studies: standardized mean difference, -0.49 [95% confidence interval, -0.72 to -0.25]; I2=84.6%). In the few studies that assessed screen-positive rates for postpartum depression (n=4) or postpartum anxiety (n=1), there were no significant differences between those randomized to digital health intervention and treatment as usual. Overall, those randomized to digital health intervention had 38% increased risk of not completing the final study assessment compared with those randomized to treatment as usual (pooled relative risk, 1.38 [95% confidence interval, 1.18-1.62]), but those randomized to app-based digital health intervention had similar loss-to-follow-up rates as those randomized to treatment as usual (relative risk, 1.04 [95% confidence interval, 0.91-1.19]). CONCLUSION Digital health interventions modestly, but significantly, reduced scores assessing postpartum depression and postpartum anxiety symptoms. More research is needed to identify digital health interventions that effectively prevent or treat postpartum depression and postpartum anxiety but encourage ongoing engagement throughout the study period.
Collapse
Affiliation(s)
- Adam K Lewkowitz
- Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI; Center for Digital Health, Brown University School of Public Health, Providence, RI.
| | - Anna R Whelan
- Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Nina K Ayala
- Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Angela Hardi
- Becker Medical Library, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Carrie Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Methodius G Tuuli
- Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI
| | - Megan L Ranney
- Center for Digital Health, Brown University School of Public Health, Providence, RI; Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI
| |
Collapse
|
16
|
Schröder D, Wrona KJ, Müller F, Heinemann S, Fischer F, Dockweiler C. Impact of virtual reality applications in the treatment of anxiety disorders: A systematic review and meta-analysis of randomized-controlled trials. J Behav Ther Exp Psychiatry 2023; 81:101893. [PMID: 37453405 DOI: 10.1016/j.jbtep.2023.101893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/15/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Anxiety disorders are the most prevalent mental disorders worldwide. Virtual reality (VR) treatment approaches have increasingly been studied. Before clinical implementation, it is necessary to evaluate the treatment effect of VR applications. The objective is to evaluate the treatment effect of virtual reality applications in the treatment of anxiety disorders compared to conventional therapy. METHODS A systematic literature review with meta-analysis was conducted. Four databases were used to identify randomized controlled trials published between April 2011 and April 2021 which compare VR applications with non-VR interventions or waiting lists. Study characteristics, pre- and post-treatment data were extracted. Hedges g was calculated as effect size. Primary outcome was anxiety symptoms. RESULTS Data from 17 studies from 827 participants was extracted. The studies examined specific phobia (n = 9), social anxiety disorder (n = 4), agoraphobia (n = 2) and panic disorder (n = 2). 16 out of 17 studies used head-mounted displays as VR application. A non-significant effect size with significant heterogeneity was observed in favor of the use of VR applications in anxiety symptoms (g, 0.33; 95%-CI, -0.20-0.87). Compared to passive control groups, VR applications are associated significant with lower anxiety symptoms (g, 1.29; 95%-CI, 0.68-1.90). LIMITATIONS The study and patient characteristics varied between the individual studies which is reflected in a high statistical heterogeneity of the effect sizes. CONCLUSIONS The added value of VR applications over waiting-list or psychoeducation only control groups is obvious. VR applications can be used as part of the treatment of anxiety disorders, especially when conventional therapy is unavailable.
Collapse
Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.
| | - Kamil J Wrona
- Hochschule Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany; Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany; Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Bavarian Research Center for Digital Health and Social Care, Kempten University, Kempten, Germany
| | - Christoph Dockweiler
- Department Digital Biomedicine and Health Sciences, School of Life Sciences, University Siegen, Siegen, Germany; School of Public Health, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
17
|
Drumond VZ, de Arruda JAA, Bernabé E, Mesquita RA, Abreu LG. Burden of dental caries in individuals experiencing food insecurity: a systematic review and meta-analysis. Nutr Rev 2023; 81:1525-1555. [PMID: 37040617 DOI: 10.1093/nutrit/nuad031] [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] [Indexed: 04/13/2023] Open
Abstract
CONTEXT Food insecurity affects approximately 2.37 billion people worldwide. Individuals experiencing food insecurity are more likely to exhibit poor health-related endpoints. Dental caries, a highly prevalent noncommunicable disease, is modulated by an interplay between biological, behavioral, and environmental factors. OBJECTIVE This systematic review and meta-analysis aimed to assess whether individuals experiencing food insecurity were more likely to exhibit dental caries than individuals facing food security. DATA SOURCES The Web of Science, PubMed, Scopus, Embase, Ovid, CINAHL, LILACS, and APA PsycINFO databases were checked from inception to November 2021. Grey literature and Google Scholar were also examined. An updated search was conducted in August 2022. Observational studies were included if they evaluated the association between dental caries and food insecurity status. DATA EXTRACTION Data extraction was performed by two reviewers. DATA ANALYSIS Random-effects meta-analyses were conducted using R language. In total, 514 references were retrieved from databases, of which 14 articles were included in qualitative synthesis and 7 were merged into meta-analysis. The results of an inverse-variance meta-analysis (OR = 1.62; 95%CI, 1.01-2.60) and a meta-analysis of binary data (OR = 1.66; 95%CI, 1.36-2.02) demonstrated that food-insecure individuals were more likely to exhibit dental caries than food-secure individuals. Inverse-variance meta-analyses appraising multiple strata of food security also showed that individuals experiencing marginal food security (OR = 1.48; 95%CI, 1.28-1.72), individuals experiencing low food security (OR = 1.26; 95%CI, 1.01-1.57), and those experiencing very low food security (OR = 1.33; 95%CI, 1.04-1.71) were more likely to exhibit dental caries than individuals experiencing full food security. CONCLUSION Dental caries is associated with food insecurity. Individuals living with food insecurity are more likely to exhibit dental caries than those who have food security. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021268582.
Collapse
Affiliation(s)
| | - José Alcides A de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Bernabé
- Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ricardo A Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas G Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
18
|
Yadav VS, Gumber B, Makker K, Gupta V, Tewari N, Khanduja P, Yadav R. Global prevalence of gingival recession: A systematic review and meta-analysis. Oral Dis 2023; 29:2993-3002. [PMID: 35735236 DOI: 10.1111/odi.14289] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/11/2022] [Accepted: 06/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to estimate the global prevalence of gingival recession (GR) in the general population. MATERIALS AND METHODS Population-based observational studies reporting the prevalence of GR and published from 1991 to 2021 were identified from five electronic databases and manual searches. Risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Studies. The pooled prevalence of GR was calculated by using a random-effect model. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to summarize the overall certainty of evidence. RESULTS A total of 15 studies involving 37,460 participants were included. The overall pooled prevalence was 78.16% at the minimal reported threshold values and 84.92% at ≥1 mm "cut-off" with high heterogeneity among studies. A separate analysis for the buccal GR revealed a pooled prevalence of 75.42%. The risk of bias was found to be high for 10 and low for 5 studies. The overall certainty of the evidence was assessed to be very low. CONCLUSION More than two-thirds of the population worldwide was found to be affected by GR. Studies with standard case definition and less heterogeneity are required to accurately estimate the prevalence of GR.
Collapse
Affiliation(s)
- Vikender Singh Yadav
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Bhumika Gumber
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kanika Makker
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Gupta
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Khanduja
- Public Health Consultant, MicroSave Consulting, New Delhi, India
| | - Renu Yadav
- Department of Prosthodontics, Surendera Dental College and Research Institute, Sri Ganganagar, India
| |
Collapse
|
19
|
Lin LH, Lin TY, Chang KV, Wu WT, Özçakar L. Muscle energy technique to reduce pain and disability in cases of non-specific neck pain: A systematic review and meta-analysis of randomized controlled trials. Heliyon 2023; 9:e22469. [PMID: 38034677 PMCID: PMC10687238 DOI: 10.1016/j.heliyon.2023.e22469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023] Open
Abstract
Background To investigate the effectiveness of muscle energy technique (MET) for treatment of non-specific neck pain (NSNP). Methods A literature search was performed using electronic databases from their inception until October 2023 for randomized controlled trials (RCTs) that investigated the effects of MET on NSNP. A change in pain intensity and reduced disability were the primary and secondary outcomes, respectively, standardized using Hedges' g. A random effects model was used for data pooling. Results This study included 26 RCTs comprising 1170 participants. The results showed that MET significantly reduced pain intensity (Hedges' g = -0.967 95 % CI = -1.417 to -0.517, p < 0.001). However, subgroup analysis revealed that this significant benefit was observed only when MET was combined with other treatments and not with MET monotherapy. MET also reduced disability (Hedges' g = -0.545, 95 % CI = -1.015 to - 0.076, p = 0.023). Meta-regression analysis showed that an increase in treatment duration/session per week contributed to greater pain reduction. No adverse events were reported following the MET. Conclusions In conclusion, our meta-analysis suggests MET's potential effectiveness within a combined treatment for NSNP. However, the evidence's low certainty is likely influenced by bias and study variations. To strengthen these findings, future research should focus on higher-quality clinical trials, longer follow-up periods, and prediction interval presentations.
Collapse
Affiliation(s)
- Long-Huei Lin
- Kaohsiung Rukang Physiotherapy Clinic, Kaohsiung, Taiwan
| | - Ting-Yu Lin
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| |
Collapse
|
20
|
Packheiser J, Papadatou-Pastou M, Koufaki A, Paracchini S, Stein CC, Schmitz J, Ocklenburg S. Elevated levels of mixed-hand preference in dyslexia: Meta-analyses of 68 studies. Neurosci Biobehav Rev 2023; 154:105420. [PMID: 37783301 DOI: 10.1016/j.neubiorev.2023.105420] [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: 08/01/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023]
Abstract
Since almost a hundred years, psychologists have investigated the link between hand preference and dyslexia. We present a meta-analysis to determine whether there is indeed an increase in atypical hand preference in dyslexia. We included studies used in two previous meta-analyses (Bishop, 1990; Eglinton & Annett, 1994) as well as studies identified through PubMed MEDLINE, PsycInfo, Google Scholar, and Web of Science up to August 2022. K = 68 studies (n = 4660 individuals with dyslexia; n = 40845 controls) were entered into three random effects meta-analyses using the odds ratio as the effect size (non-right-handers; left-handers; mixed-handers vs. total). Evidence of elevated levels of atypical hand preference in dyslexia emerged that were especially pronounced for mixed-hand preference (OR = 1.57), although this category was underdefined. Differences in (direction or degree) of hand skill or degree of hand preference could not be assessed as no pertinent studies were located. Our findings allow for robust conclusions only for a relationship of mixed-hand preference with dyslexia.
Collapse
Affiliation(s)
- Julian Packheiser
- Social Brain Lab, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Marietta Papadatou-Pastou
- School of Education, National and Kapodistrian University of Athens, Athens, Greece; BioMedical Research Foundation of the Academy of Athens, Athens, Greece.
| | - Angeliki Koufaki
- School of Education, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Clara C Stein
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy, and Preventive Medicine, LWL-University Hospital Bochum, Bochum, Germany
| | - Judith Schmitz
- Biological Personality Psychology, Georg-August-University Goettingen, Goettingen, Germany
| | - Sebastian Ocklenburg
- Department of Psychology, Medical School Hamburg, Hamburg, Germany; ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany; Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
21
|
Makridis KL, Kaindl AM. Real-world experience with cenobamate: A systematic review and meta-analysis. Seizure 2023; 112:1-10. [PMID: 37713961 DOI: 10.1016/j.seizure.2023.09.006] [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: 04/05/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/17/2023] Open
Abstract
PURPOSE Despite many new ASM, the rate of patients with drug-resistant epilepsy (DRE) has not changed. Cenobamate (CNB) is a novel ASM for the treatment of focal-onset seizures in adults with high seizure freedom rates in randomized controlled trials (RCT). Although CNB appears to be effective, it is not commonly prescribed to patients with DRE, resulting in a lack of "real-world data". METHODS To evaluate the real-world effect of CNB and to assess the generalizability of RCT data, a systematic review and meta-analysis was conducted. Pooled proportions were calculated using a random intercept logistic regression model. RESULTS The analysis included seven studies with a total of 229 patients with DRE, 77.3 % of whom were adults and 91.5 % had focal-onset seizures. Seizure reduction >50 % was achieved in 68 % of patients [54.54; 79.07], with seizure freedom in 16.2 % [8.38; 28.97]. There was no difference between pediatric and adult patients. CNB was discontinued in 10 % [6.74; 14.6] of patients, mostly due to lack of efficacy (39 %) or adverse effects (AE, 43 %). AE, observed in 57.3 % [39.7; 73.2] of patients, included fatigue and vertigo. A comparison of the rates calculated in this meta-analysis to the active arm of equivalent RCTs revealed no significant difference. CONCLUSION CNB achieves a good treatment response in patients with DRE in real-world settings, like the effect reported in RCTs. The high heterogeneity between studies calls for studies focusing on specific DRE subpopulations.
Collapse
Affiliation(s)
- Konstantin L Makridis
- Charité - Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Center for Chronically Sick Children, Berlin, Germany; Charité - Universitätsmedizin Berlin, German Epilepsy Center for Children and Adolescents, Berlin, Germany; Charité - Universitätsmedizin Berlin, Institute of Cell Biology and Neurobiology, Berlin, Germany
| | - Angela M Kaindl
- Charité - Universitätsmedizin Berlin, Department of Pediatric Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Center for Chronically Sick Children, Berlin, Germany; Charité - Universitätsmedizin Berlin, German Epilepsy Center for Children and Adolescents, Berlin, Germany; Charité - Universitätsmedizin Berlin, Institute of Cell Biology and Neurobiology, Berlin, Germany.
| |
Collapse
|
22
|
Rossano F, Caiazza C, Zotti N, Viacava L, Irano A, Solini N, Pistone L, Pezone R, Cilmi F, Ricci C, De Prisco M, Iasevoli F, Kishi T, Solmi M, de Bartolomeis A, Fornaro M. The efficacy, safety, and adverse events of azapirones in anxiety disorders: A systematic review and meta-analysis of randomized controlled trials. Eur Neuropsychopharmacol 2023; 76:23-51. [PMID: 37544075 DOI: 10.1016/j.euroneuro.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Abstract
Azapirones have been proposed as anxiety and mood modulators. We assessed azapirones' viability in anxiety disorders via systematic review and random-effects meta-analysis, inquiring PubMed/MEDLINE/CENTRAL/WHO-ICTRP/WebOfScience/VIP up-to 05/01/2023. We conducted sensitivity, and subgroup analyses assessing heterogeneity, publication bias, risk of bias, and confidence in the evidence within the GRADE framework. Symptom reduction (mean difference/MD), study-defined response (risk ratios/RRs), and acceptability were co-primary outcomes. Adverse events and withdrawal were secondary. Seventy studies were included. In generalized anxiety disorder (GAD), azapirones largely outperformed placebo (MD=-4.91, 95%C.I.[-5.91, -3.90], Hedges'g -1.37 [-1.02, -0.73]), k = 22, n = 2,567; RR=1.64, 95%C.I.[1.45, 1.86], k = 9, n = 1,346). While azapirones overlapped benzodiazepines in symptom reduction (MD=-0.12, 95%C.I.[-0.70, 0.45], k = 34, n = 3,160), they were slightly outperformed in response rate (RR=0.94, 95%C.I.[0.90, 0.99], k = 18, n = 2,423). Azapirones overlapped SRIs (MD=0.09, 95%C.I.[-0.49, 0.67], k = 8, n = 747; RR=0.97, 95%C.I.[0.89, 1.07], k = 7, n = 737). Confidence in estimates was high/moderate vs. placebo, moderate/low vs. benzodiazepine, very-low vs. SRIs. Azapirones failed to outperform the placebo in panic and social anxiety disorders. Azapirones overlapped placebo and SRIs in drop-out rates, while they showed higher treatment discontinuation rates than benzodiazepines (RR=1.33, 95%C.I.[1.16, 1.53], k = 23, n = 2,768). Azapirones caused less sedation/fatigue/drowsiness/weakness/cognitive issues than benzodiazepines, resembling placebo. They caused more nausea and dizziness than placebo, more headache and nausea than benzodiazepines, and less nausea and xerostomia than SRIs. Azapirones proved effective and relatively well-tolerated for GAD. They should be preferred over benzodiazepines, especially in the long-term, considering their lower sedation and addiction potential, representing a potential SRI alternative. Further research is warranted to prove efficacy in panic and social anxiety.
Collapse
Affiliation(s)
- Flavia Rossano
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Claudio Caiazza
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Nicolas Zotti
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Luca Viacava
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Antonella Irano
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Niccolò Solini
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Luca Pistone
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Rosanna Pezone
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Flavia Cilmi
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Claudio Ricci
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, C. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Felice Iasevoli
- Unit of Treatment-Resistant Psychosis, Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, University School of Medicine of Naples Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine of Naples Federico II, Naples, Italy
| | - Taro Kishi
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada; On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Andrea de Bartolomeis
- Unit of Treatment-Resistant Psychosis, Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology, University School of Medicine of Naples Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine of Naples Federico II, Naples, Italy
| | - Michele Fornaro
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy.
| |
Collapse
|
23
|
Teixeira JMM, Roever L, Ramasamy A, Pereira R, Carneiro I, Krustrup P, Póvoas SCA. Statistical heterogeneity in meta-analysis of hypertension and exercise training: A meta-review. J Sports Sci 2023; 41:2033-2044. [PMID: 38341865 DOI: 10.1080/02640414.2024.2309055] [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: 07/14/2023] [Accepted: 01/16/2024] [Indexed: 02/13/2024]
Abstract
We aim to evaluate the prevalence of reporting and the extent of statistical heterogeneity of systematic reviews with meta-analyses (SRMAs) of exercise training for hypertension and to provide practical recommendations for dealing with statistical heterogeneity. We systematically searched on four databases (from 2002 to September of 2023) for SRMAs comparing exercise interventions vs. a non-exercise control on blood pressure (BP) control in adults with hypertension. Fifty-nine SRMAs, with a median of 14 studies, were analysed. Cochran's Q (41%), I2 (24%), forest plots (44%), and particularly τ2 (54%) and prediction intervals (96.6%) frequently were not reported for the hypertension subgroup. The recalculated prediction intervals were discrepant (i.e., crossed the null effect) of significant 95% confidence intervals of most meta-analyses (systolic BP: 65%; diastolic BP: 92%). This suggests substantial heterogeneity across studies, which was often not acknowledged by authors' conclusions (78%). Consequently, downgrading the certainty of the available evidence may be justified alone due to heterogeneity across studies. Finally, we illustrate areas for improving I2 interpretation and provide practical recommendations on how to address statistical heterogeneity across all stages of a SRMA.
Collapse
Affiliation(s)
- Jorge M M Teixeira
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Leonardo Roever
- Department of Clinical Research, Brazilian Evidence-Based Health Network, Uberlândia, Brazil
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Akilesh Ramasamy
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Karaikal Campus, Kovilpathu, Karaikal, Puducherry, India
| | - Rita Pereira
- Laboratory of Metabolism and Exercise, Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Ivone Carneiro
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Sport and Health Sciences, College of Life and Environment Sciences, University of Exeter, Exeter, UK
- Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
| | - Susana C A Póvoas
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
| |
Collapse
|
24
|
Hooten WM, Eberhart ND, Cao F, Gerberi DJ, Moman RN, Hirani S. Preoperative Epidural Steroid Injections and Postoperative Infections After Lumbar or Cervical Spine Surgery: A Systematic Review and Meta-Analysis. Mayo Clin Proc Innov Qual Outcomes 2023; 7:349-365. [PMID: 37655233 PMCID: PMC10466430 DOI: 10.1016/j.mayocpiqo.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Objective To determine the risk difference and 95% prediction intervals (PIs) for postoperative infections (POIs) associated with preoperative epidural steroid injections (ESIs) in adults undergoing lumbar or cervical spine surgery. Methods Comprehensive database searches were conducted from inception dates through December 2023. Inclusion criteria included all study designs involving adults receiving a preoperative ESI before lumbar or cervical decompression or fusion spine surgery. Risk of bias was assessed using a modified tool developed for uncontrolled studies. The summary estimates of risk difference and the corresponding PIs were reported. Results A total of 12 studies were included in the systematic review, of which 9 were included in the meta-analysis. Preoperative ESIs within 1 month of lumbar spine decompression or fusion surgery were associated with a 0.6% and 2.31% greater risk of a POI, respectively. In adults ≥65 years of age, ESIs within 1 or 1-3 months of lumbar spine decompression or fusion surgery were associated with a 1.3% and 0.6% greater risk of a POI, respectively. Preoperative ESIs within 3 months of cervical spine fusion were not associated with an increased risk of a POI. The bounds of all corresponding 95% PIs were nonsignificant. Conclusion The observations of this study provide summary estimates of risk difference and 95% PIs, which could be used to support shared decision-making about the use of ESIs before cervical or lumbar spine surgery.
Collapse
Affiliation(s)
- W. Michael Hooten
- Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Nathan D. Eberhart
- Department of Anesthesiology and Perioperative Medicine, Anesthesiology Systematic Review Group, Mayo Clinic, Rochester, MN
| | - Fei Cao
- Department of Psychiatry, Division of Pain Medicine, University of Missouri at Kansas City, Kansas City, MO
| | | | | | - Salman Hirani
- Comprehensive Pain Center, Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science Center, Portland, OR
| |
Collapse
|
25
|
O'Sullivan R, Bissell S, Hamilton A, Bagshaw A, Richards C. Concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions: A systematic review and meta-analysis. Sleep Med Rev 2023; 71:101814. [PMID: 37422998 DOI: 10.1016/j.smrv.2023.101814] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
The purpose of this systematic review and meta-analysis is to delineate the concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions (NDCs). A systematic literature search identified 31 studies that compare objective and subjective estimates of sleep parameters in autism, ADHD or rare genetic syndromes associated with intellectual disability. The meta-analyses revealed smaller mean differences and larger correlations indicative of greater concordance for parameters associated with sleep scheduling compared to parameters associated with sleep duration and night awakenings. Relative to objective measures, subjective measures produced: 1) greater estimates of total sleep time, sleep efficiency and time in bed; and 2) lower estimates of wake after sleep onset and number of night awakenings. Subgroup analyses also revealed differences in concordance between measurement comparison types (e.g., stronger correlations between actigraphy and sleep diaries, compared to actigraphy and questionnaires) and NDC diagnostic groups. The results predominantly replicate concordance trends observed in typically-developing samples, although some NDC-specific patterns of concordance were identified. This indicates that objective and subjective sleep measures retain broadly similar properties across populations, although researchers and clinicians should be cautious of the impact of NDC-related characteristics on sleep parameter estimates. These findings should inform sleep assessment design and the interpretation of sleep parameter estimates in NDCs, increasing the rigour of sleep parameter description across research and clinical settings.
Collapse
Affiliation(s)
- Rory O'Sullivan
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK.
| | - Stacey Bissell
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Anna Hamilton
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Andrew Bagshaw
- School of Psychology, University of Birmingham, UK; Centre for Human Brain Health, University of Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| |
Collapse
|
26
|
Phua DY, Chew CSM, Tan YL, Ng BJK, Lee FKL, Tham MMY. Differential effects of prenatal psychological distress and positive mental health on offspring socioemotional development from infancy to adolescence: a meta-analysis. Front Pediatr 2023; 11:1221232. [PMID: 37780045 PMCID: PMC10536167 DOI: 10.3389/fped.2023.1221232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
The impact of prenatal maternal mental health on offspring socioemotional development is substantial and enduring. Existing literature primarily focuses on the effects of psychological distress during pregnancy, emphasizing adverse child outcomes. Recent studies, however, highlight the unique impact of positive maternal mental health on child outcomes. To elucidate the differential associations of maternal psychological distress and positive mental health during pregnancy with child outcomes, we conducted a systematic literature search and random-effects meta-analyses on studies investigating the associations of prenatal maternal mental health with child socioemotional development. Our analyses, comprising 74 studies with 321,966 mother-child dyads across 21 countries, revealed significant associations of prenatal psychological distress with both adverse and positive child socioemotional outcomes. Notably, the effect sizes for the association of psychological distress with positive child outcomes were smaller compared to adverse outcomes. Positive prenatal mental health, on the other hand, was significantly associated with positive socioemotional outcomes but not adverse outcomes. This meta-analysis highlights the independence of negative and positive prenatal mental health constructs and their distinct relationships with child socioemotional development. The findings underscore the importance of considering the positive spectrum of maternal mental health and developmental outcomes to enhance our understanding of prenatal influences on child development. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335227, identifier CRD42022335227.
Collapse
Affiliation(s)
- Desiree Y. Phua
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chermaine S. M. Chew
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yang Lik Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Benjamin J. K. Ng
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Florence K. L. Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Megan M. Y. Tham
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| |
Collapse
|
27
|
Pahari S, Barman D, Talukdar R. Tobacco usage in India: A meta-analysis of evidence drawn from regional studies between 2010 and 2022. Trop Med Int Health 2023; 28:699-709. [PMID: 37583260 DOI: 10.1111/tmi.13924] [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] [Indexed: 08/17/2023]
Abstract
OBJECTIVES To generate a national and zonal pooled estimate of current tobacco usage (CTU) in any form, as well as stratified gender and tobacco type (smokeless and smoke) specific estimates among the Indian population, utilising evidence from 2010 to 2022. METHOD PubMed, Scopus, ScienceDirect, CINAHL and Google Scholar databases were searched for articles on tobacco use among Indian adults published between January 2010 and October 2022. The NIH Quality Assessment Tool was used to assess study quality, and a random-effects inverse-variance method was used to attain a pooled estimate of usage. Heterogeneity was estimated through I2 statistics and prediction intervals, and further subgroup analysis and meta-regression were conducted. A leave-one-out analysis was done to establish the sensitivity of the pooled estimate. RESULTS CTU prevalence of any form among the adult Indian population was 35.2% [confidence interval (CI) 25.27-45.92, I2 = 99.7, p < 0.001] between 2010 and 2022 with a wide Prediction interval between 3.19 to 78.74. The regionally drawn estimate for the years 2016-2022 was 44.3% (CI 30.57-58.64, I2 = 99.8, p < 0.01). Highest prevalence was found in the East zone (55.4%) followed by the northeast with 51.8% tobacco consumption. Although residual heterogeneity persisted after subgroup analysis, the variability in estimates showed statistical significance when considering disaggregated estimates across administrative zones and gender-wise consumption. The estimated CTU among males was 54.1%, whereas in females it was 15%. Leave-one-out analysis indicated the findings are reliable and are not dependent on any one study. CONCLUSION This review highlights differences in tobacco usage estimates from national-level surveys and regional studies. More regionally representative surveys of tobacco usage to tailormade prevention efforts alongside increased regional efforts improved community-level advocacy and more coordinated and stringent tobacco prevention policy implementation at national and state levels are warranted.
Collapse
Affiliation(s)
| | - Diplina Barman
- Division of Epidemiology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Rounik Talukdar
- Division of Epidemiology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| |
Collapse
|
28
|
Hasani WSR, Muhamad NA, Hanis TM, Maamor NH, Chen XW, Omar MA, Cheng Kueh Y, Abd Karim Z, Hassan MRA, Musa KI. The global estimate of premature cardiovascular mortality: a systematic review and meta-analysis of age-standardized mortality rate. BMC Public Health 2023; 23:1561. [PMID: 37587427 PMCID: PMC10429077 DOI: 10.1186/s12889-023-16466-1] [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: 03/24/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is a lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled age-standardized mortality rate (ASMR) of premature CVD mortality. METHODS We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the "meta" and "metafor" packages. RESULTS A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20-64 years and 30-74 years had a higher ASMR than the age group of 0-74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time. CONCLUSIONS This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.
Collapse
Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia.
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia.
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Tengku Muhammad Hanis
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Nur Hasnah Maamor
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam, Selangor, Malaysia
| | - Xin Wee Chen
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Setia Alam 40170, Selangor, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Zulkarnain Abd Karim
- Office of The Manager to Biomedical Research Policy & Strategic Planning Unit, Institutes for Medical Research, Setia Alam 40170, Selangor, Malaysia
| | | | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
| |
Collapse
|
29
|
Zahl-Olsen R, Severinsen L, Stiegler JR, Fernee CR, Simhan I, Rekdal SS, Bertelsen TB. Effects of emotionally oriented parental interventions: a systematic review and meta-analysis. Front Psychol 2023; 14:1159892. [PMID: 37519350 PMCID: PMC10374204 DOI: 10.3389/fpsyg.2023.1159892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Objective This systematic review and meta-analysis investigates the effects of emotionally oriented parental interventions. Background Several emotionally oriented parental interventions have been developed during the last decade. Some of these have gained popularity and spread across several continents. The literature is growing and consists of qualitative studies; intervention only, quasi-experimental, case-control studies; and randomized controlled trials. They indicate effects for parents and children. However, no systematic review or meta-analysis has, to our knowledge, summarized the results. Method Using several search engines, we located 8,272 studies. After abstract and full-text screening, 33 studies were assessed for bias and included in the study. Outcomes for parents and children were extracted and combined into three constructs for parents and two for children. Meta-analyses were conducted for each construct to estimate the effect of the interventions using a robust Bayes meta-analysis. Results The results indicate the presence of a small to medium effect on parents' mental health, behavior, and use of emotionally oriented parenting, as well as on children's internalizing and externalizing difficulties. Most participants were recruited from the general population, and clinical settings were rare. The results show little evidence of publication bias. Conclusion There is evidence of a small to medium effect of emotionally oriented interventions on parents and children. Systematic review registration https://osf.io/un3q4/.
Collapse
Affiliation(s)
- Rune Zahl-Olsen
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
| | - Linda Severinsen
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Carina Ribe Fernee
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Indra Simhan
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
| | - Sondre Sverd Rekdal
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, Kristiansand, Norway
| | | |
Collapse
|
30
|
Rossano F, Caiazza C, Sobrino A, Solini N, Vellucci A, Zotti N, Fornaro M, Gillman K, Cattaneo CI, Van den Eynde V, Birkenhager TK, Ruhé HG, Stahl S, Iasevoli F, de Bartolomeis A. Efficacy and safety of selegiline across different psychiatric disorders: A systematic review and meta-analysis of oral and transdermal formulations. Eur Neuropsychopharmacol 2023; 72:60-78. [PMID: 37087864 DOI: 10.1016/j.euroneuro.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/23/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023]
Abstract
Selegiline is an irreversible, selective type-B monoamine oxidase inhibitor (MAOI) approved for Parkison's disease-oral and major depressive disorder-transdermal formulation) resulting in non-selective MAOI activity at oral doses≥20 mg/day. The present systematic review and meta-analysis appraises the evidence of different formulations/dosages of selegiline across different psychiatric conditions. We inquired PubMed/MEDLINE/Cochrane-Central/WHO-ICTRP/Clarivate-WebOfScience and the Chinese-Electronic-Journal Database from inception to 10/26/2022 for selegiline trials involving psychiatric patients. Random-effects meta-analyses assessed heterogeneity, publication/risk biases, and confidence in the evidence, followed by sensitivity, subgroup, and meta-regression analyses. Co-primary outcomes were: changes in symptom score (standardized mean difference=SMD) and author-defined response (risk ratios=RRs). RRs of adverse events and all-cause discontinuation were secondary and acceptability outcomes, respectively. Systematic-review included 42 studies; meta-analysis, 23. Selegiline outperformed placebo in depressive symptom reduction (SMD=-0.96, 95%C.I.=-1.78, -0.14, k = 10, n = 1,308), depression (RR=1.61, 95%C.I.=1.20, 2.15, k = 9, n = 1,238) and atypical-depression response (RR=2.23, 95%C.I.=1.35, 3.68, k = 3, n = 136). Selegiline failed to outperform the placebo in negative (k = 4) or positive symptoms of schizophrenia (k = 4), attention-deficit-hyperactivity disorder (ADHD) symptoms reduction (k = 2), and smoking abstinence rate (k = 4). Selegiline did not differ from methylphenidate and ADHD scores (k = 2). No significant difference emerged in acceptability, incident diarrhea, headache, dizziness, and nausea RRs, in contrast to xerostomia (RR=1.58, 95%C.I. =1.03, 2.43, k = 6, n = 1,134), insomnia (RR=1.61, 95%C.I.=1.19, 2.17, k = 10, n = 1,768), and application-site reaction for transdermal formulation (RR=1.81, 95%C.I.=1.40, 2.33, k = 6, n = 1,662). Confidence in findings was low/very-low for most outcomes; moderate for depressive symptoms reduction (transdermal). Selegiline proved effective, safe, and well-tolerated for depressive disorders, yet further evidence is warranted about specific psychiatric disorders.
Collapse
Affiliation(s)
- Flavia Rossano
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Claudio Caiazza
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Andrea Sobrino
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Niccolò Solini
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Alessandro Vellucci
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Nicolas Zotti
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy
| | - Michele Fornaro
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy.
| | | | - Carlo Ignazio Cattaneo
- Brain Stimulation Italia, Cavaglietto, Italy; ASL NOVARA - Dept. Mental Health - Borgomanero
| | - Vincent Van den Eynde
- PsychoTropical Research, QLD, Australia; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tom K Birkenhager
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, the NetherlandsCollaborative Antwerp Psychiatric Research Institue (CAPRI), Department of Biomedical Sciences, University of Antwerp, Belgium
| | - Henricus G Ruhé
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stephen Stahl
- Department of Psychiatry and Neuroscience, University of California, Riverside, Riverside, CA, United States
| | - Felice Iasevoli
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine Federico II, Naples, Italy
| | - Andrea de Bartolomeis
- Clinical Section of Psychiatry and Psychology - Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University School of Medicine Federico II, Naples, Italy; Laboratory of Molecular and Translational Psychiatry, University School of Medicine Federico II, Naples, Italy
| |
Collapse
|
31
|
Ostoros G, Hettle R, Georgoulia N, Berktas M, Chander P, Diaz Perez I, Couto AM, Eichinger C, Field P, Morten P. Association between event-free survival and overall survival after neoadjuvant treatment for non-small cell lung cancer: a systematic review and meta-analysis. Expert Rev Anticancer Ther 2023; 23:1305-1313. [PMID: 37850939 DOI: 10.1080/14737140.2023.2272645] [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: 05/16/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND We wanted to evaluate if event-free survival (EFS) is a reliable surrogate for overall survival (OS) in patients with resectable non-small cell lung cancer (r-NSCLC) receiving neoadjuvant therapy. We conducted a systematic literature review and meta-analysis to investigate the statistical association between EFS and OS. RESEARCH DESIGN AND METHODS Electronic databases were searched on 30 July 2021 to identify sources reporting both EFS and OS data in patients with stage I-IIIB r-NSCLC receiving neoadjuvant therapy. Correlation and regression analyses evaluated the association between the effect of treatment on EFS and OS using log-hazard ratios (HRs). Sources in which the entire population had epidermal growth factor receptor mutations were excluded from the analyses. RESULTS We identified 74 sources, of which 8 reported EFS and OS HRs from randomized controlled trials. Based on these, we found a positive linear correlation and a strong association between EFS and OS log-HRs (weighted Pearson's correlation coefficient r = 0.864; 95% confidence interval 0.809-0.992; P = 0.006; random-effects meta-regression, R2 = 0.777). CONCLUSIONS We found a strong association between treatment effects for EFS and OS, indicating that improvements in EFS are likely to be predictive of improvements in OS. EFS may therefore be a reliable surrogate for OS after neoadjuvant therapy in r-NSCLC.
Collapse
Affiliation(s)
- Gyula Ostoros
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Rani I, Goyal A, Shamim MA, Satapathy P, Pal A, Squitti R, Goswami K, Sah R, Barboza JJ, Padhi BK. Prevalence of mpox viral DNA in cutaneous specimens of monkeypox-infected patients: a systematic review and meta-analysis. Front Cell Infect Microbiol 2023; 13:1179885. [PMID: 37457957 PMCID: PMC10349178 DOI: 10.3389/fcimb.2023.1179885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/05/2023] [Indexed: 07/18/2023] Open
Abstract
Background Human monkeypox (mpox) disease is a multicountry outbreak driven by human-human transmission which has resulted in an international public health emergency. However, there is limited evidence on the positivity rate of skin lesions for mpox viral DNA. We aim to fill this gap by estimating the pooled positivity rate of skin samples with mpox viral DNA from mpox patients globally. Methods In this systematic review and meta-analysis, seven databases and several preprint servers have been extensively searched until 17 January 2023 according to a prospectively registered protocol (PROSPERO: CRD42023392505). Articles including the positivity rate of skin samples with mpox viral DNA in mpox-confirmed patients were considered eligible. After a quality assessment, a random-effect meta-analysis was used for pooled prevalence. To explore and resolve heterogeneity, we used statistical methods for outlier detection, influence analysis, and sensitivity analysis. Findings Among the 331 articles retrieved after deduplication, 14 studies were finally included. The pooled positivity rate of the skin samples was 98.77% (95% CI: 94.74%-99.72%). After the removal of an influential outlier, I 2 for heterogeneity dropped from 92.5% to 10.8%. Meta-regression did not reveal any significant moderator. Conclusion/interpretation The present findings reinforce that skin lesions act as a reservoir of mpox viral DNA and contribute to a high infectivity risk. This may be a prevailing basis of prompt transmission during the current multicountry outbreak and also needs further investigation. The present imperative outcome may benefit in producing valuable preventive and management procedures in an appropriate health strategy.
Collapse
Affiliation(s)
- Isha Rani
- Department of Biochemistry, Maharishi Markandeshwar College of Medical Sciences and Research (MMCMSR), Sadopur, Ambala, India
| | - Anmol Goyal
- Department of Community Medicine, Maharishi Markandeshwar College of Medical Sciences and Research (MMCMSR), Sadopur, Ambala, India
| | - Muhammad Aaqib Shamim
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prakasini Satapathy
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Pal
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, India
| | - Rosanna Squitti
- Department of Laboratory Science, Research and Development Division, Fatebenefratelli Isola Tiberina, Gemelli Isola, Rome, Italy
| | - Kalyan Goswami
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, India
| | - Ranjit Sah
- Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
- Department of Microbiology, Dr. D.Y Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | | | - Bijaya K. Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
33
|
Glisic M, Raguindin PF, Gemperli A, Taneri PE, Salvador DJ, Voortman T, Marques Vidal P, Papatheodorou SI, Kunutsor SK, Bano A, Ioannidis JPA, Muka T. A 7-Step Guideline for Qualitative Synthesis and Meta-Analysis of Observational Studies in Health Sciences. Public Health Rev 2023; 44:1605454. [PMID: 37260612 PMCID: PMC10227668 DOI: 10.3389/phrs.2023.1605454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/14/2023] [Indexed: 06/02/2023] Open
Abstract
Objectives: To provide a step-by-step, easy-to-understand, practical guide for systematic review and meta-analysis of observational studies. Methods: A multidisciplinary team of researchers with extensive experience in observational studies and systematic review and meta-analysis was established. Previous guidelines in evidence synthesis were considered. Results: There is inherent variability in observational study design, population, and analysis, making evidence synthesis challenging. We provided a framework and discussed basic meta-analysis concepts to assist reviewers in making informed decisions. We also explained several statistical tools for dealing with heterogeneity, probing for bias, and interpreting findings. Finally, we briefly discussed issues and caveats for translating results into clinical and public health recommendations. Our guideline complements "A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research" and addresses peculiarities for observational studies previously unexplored. Conclusion: We provided 7 steps to synthesize evidence from observational studies. We encourage medical and public health practitioners who answer important questions to systematically integrate evidence from observational studies and contribute evidence-based decision-making in health sciences.
Collapse
Affiliation(s)
- Marija Glisic
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Faculty of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland
- Institute of Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Petek Eylul Taneri
- HRB-Trials Methodology Research Network, National University of Ireland, Galway, Ireland
| | - Dante Jr. Salvador
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Pedro Marques Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | | | - Setor K. Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom
- Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, United Kingdom
| | - Arjola Bano
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - John P. A. Ioannidis
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
- Department of Statistics, Stanford University, Stanford, CA, United States
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, United States
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, United States
- Epistudia, Bern, Switzerland
| |
Collapse
|
34
|
Samore T, Fessler DMT, Sparks AM, Holbrook C, Aarøe L, Baeza CG, Barbato MT, Barclay P, Berniūnas R, Contreras-Garduño J, Costa-Neves B, Del Pilar Grazioso M, Elmas P, Fedor P, Fernandez AM, Fernández-Morales R, Garcia-Marques L, Giraldo-Perez P, Gul P, Habacht F, Hasan Y, Hernandez EJ, Jarmakowski T, Kamble S, Kameda T, Kim B, Kupfer TR, Kurita M, Li NP, Lu J, Luberti FR, Maegli MA, Mejia M, Morvinski C, Naito A, Ng'ang'a A, de Oliveira AN, Posner DN, Prokop P, Shani Y, Solorzano WOP, Stieger S, Suryani AO, Tan LKL, Tybur JM, Viciana H, Visine A, Wang J, Wang XT. Greater traditionalism predicts COVID-19 precautionary behaviors across 27 societies. Sci Rep 2023; 13:4969. [PMID: 37041216 PMCID: PMC10090070 DOI: 10.1038/s41598-023-29655-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/08/2023] [Indexed: 04/13/2023] Open
Abstract
People vary both in their embrace of their society's traditions, and in their perception of hazards as salient and necessitating a response. Over evolutionary time, traditions have offered avenues for addressing hazards, plausibly resulting in linkages between orientations toward tradition and orientations toward danger. Emerging research documents connections between traditionalism and threat responsivity, including pathogen-avoidance motivations. Additionally, because hazard-mitigating behaviors can conflict with competing priorities, associations between traditionalism and pathogen avoidance may hinge on contextually contingent tradeoffs. The COVID-19 pandemic provides a real-world test of the posited relationship between traditionalism and hazard avoidance. Across 27 societies (N = 7844), we find that, in a majority of countries, individuals' endorsement of tradition positively correlates with their adherence to costly COVID-19-avoidance behaviors; accounting for some of the conflicts that arise between public health precautions and other objectives further strengthens this evidence that traditionalism is associated with greater attention to hazards.
Collapse
Affiliation(s)
- Theodore Samore
- Department of Anthropology, Center for Behavior, Evolution, and Culture, University of California, Los Angeles, CA, 90095, USA.
| | - Daniel M T Fessler
- Department of Anthropology, Center for Behavior, Evolution, and Culture, Bedari Kindness Institute, University of California, Los Angeles, CA, 90095, USA
| | | | - Colin Holbrook
- Department of Cognitive and Information Sciences, University of California, Merced, CA, 95343, USA
| | - Lene Aarøe
- Department of Political Science, Aarhus University, 8000, Aarhus C, Denmark
| | - Carmen Gloria Baeza
- Laboratorio de Evolución y Relaciones Interpersonales, Universidad de Santiago de Chile, Santiago, Chile
| | - María Teresa Barbato
- Laboratorio de Evolución y Relaciones Interpersonales, Universidad de Santiago de Chile, Santiago, Chile
| | - Pat Barclay
- Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | | | - Jorge Contreras-Garduño
- Escuela Nacional de Estudio Superiores, Universidad Nacional Autónoma de México, Unidad Morelia, 58190, Morelia, Michoacán, Mexico
| | - Bernardo Costa-Neves
- Lisbon Medical School, University of Lisbon, 1649-028, Lisbon, Portugal
- Centro Hospitalar Psiquiátrico de Lisboa, 1749-002, Lisbon, Portugal
| | - Maria Del Pilar Grazioso
- Centro Integral de Psicología Aplicada, Universidad del Valle de Guatemala, Guatemala City, 01015, Guatemala
- Proyecto Aiglé Guatemala, Guatemala City, Guatemala
| | - Pınar Elmas
- Department of Psychology, Adnan Menderes University, Aydın, Turkey
| | - Peter Fedor
- Department of Environmental Ecology and Landscape Management, Faculty of Natural Sciences, Comenius University, 842 15, Bratislava, Slovakia
| | - Ana Maria Fernandez
- Laboratorio de Evolución y Relaciones Interpersonales, Universidad de Santiago de Chile, Santiago, Chile
| | - Regina Fernández-Morales
- Facultad de Humanidades, Universidad Rafael Landivár, Guatemala City, 01016, Guatemala
- Departamento de Psicología, Universidad Francisco Marroquín, Guatemala City, Guatemala
| | - Leonel Garcia-Marques
- CICPsi Research Center for Psychological Science, Universidade de Lisboa, Lisbon, Portugal
- School of Psychology, Universidade de Lisboa, Lisbon, Portugal
| | - Paulina Giraldo-Perez
- The School of Biological Sciences, The University of Auckland, Auckland, 1010, New Zealand
| | - Pelin Gul
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Groningen, The Netherlands
| | - Fanny Habacht
- Division of Psychological Methodology, Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Youssef Hasan
- Psychology Program, Department of Social Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar
| | - Earl John Hernandez
- College of Arts and Sciences, Partido State University, Goa, 4422, Camarines Sur, Philippines
| | - Tomasz Jarmakowski
- Institute of Psychology, Nicolaus Copernicus University in Toruń, 87-100, Toruń, Poland
| | - Shanmukh Kamble
- Department of Psychology, Karnatak University, Dharwad, Karnataka, 580003, India
| | - Tatsuya Kameda
- Department of Social Psychology, The University of Tokyo, Tokyo, 113-0033, Japan
- Brain Science Institute, Tamagawa University, Tokyo, 194-8610, Japan
- Center for Experimental Research in Social Sciences, Hokkaido University, Sapporo, 060-0810, Japan
| | - Bia Kim
- Department of Psychology, Pusan National University, Busan, South Korea
| | - Tom R Kupfer
- Department of Psychology, Nottingham Trent University, Nottingham, NG1 4FQ, UK
| | - Maho Kurita
- Department of Social Psychology, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Norman P Li
- School of Social Sciences, Singapore Management University, Singapore, 188065, Singapore
| | - Junsong Lu
- School of Humanities and Social Science, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, China
| | - Francesca R Luberti
- Department of Psychology, Nipissing University, North Bay, ON, P1B 8L7, Canada
| | - María Andrée Maegli
- Department of Psychology, Universidad del Valle de Guatemala, Guatemala City, 01015, Guatemala
| | | | - Coby Morvinski
- Department of Management, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Aoi Naito
- Department of Social Psychology, The University of Tokyo, Tokyo, 113-0033, Japan
- Japan Society for the Promotion of Science, Tokyo, 102-0083, Japan
| | - Alice Ng'ang'a
- Lazaridis School of Business and Economics, Wilfrid Laurier University, Waterloo, ON, N2L 3C5, Canada
| | | | - Daniel N Posner
- Department of Political Science, University of California, Los Angeles, CA, 90095, USA
| | - Pavol Prokop
- Department of Environmental Ecology and Landscape Management, Faculty of Natural Sciences, Comenius University, 842 15, Bratislava, Slovakia
- Institute of Zoology, Slovak Academy of Sciences, 845 06, Bratislava, Slovakia
| | - Yaniv Shani
- Coller School of Management, Tel Aviv University, Tel Aviv, Israel
| | | | - Stefan Stieger
- Division of Psychological Methodology, Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | | | - Lynn K L Tan
- School of Social Sciences, Singapore Management University, Singapore, 188065, Singapore
| | - Joshua M Tybur
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Hugo Viciana
- Departamento de Filosofía y Lógica y Filosofía de la Ciencia, Universidad de Sevilla, 41018, Seville, Spain
| | | | - Jin Wang
- School of Humanities and Social Science, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, China
| | - Xiao-Tian Wang
- School of Humanities and Social Science, The Chinese University of Hong Kong (Shenzhen), Shenzhen, 518172, China
| |
Collapse
|
35
|
Sabeena S, Ravishankar N, Robin S, Pillai SS. The impact of coronavirus disease 2019 pandemic on bronchiolitis (lower respiratory tract infection) due to respiratory syncytial virus: A systematic review and meta-analysis. Indian J Public Health 2023; 67:284-291. [PMID: 37459026 DOI: 10.4103/ijph.ijph_1334_22] [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] [Indexed: 07/20/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has changed the epidemiology of respiratory syncytial virus (RSV) infection which accounts for most bronchiolitis and viral pneumonias in infants. This systematic review and meta-analysis aimed to quantitatively assess the effect of the COVID-19 pandemic on RSV-associated bronchiolitis among hospitalized infants. The study protocol was registered in the PROSPERO database (CRD42022314000) and was designed based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines updated in May 2020. The meta-analysis component was modified appropriately to synthesize the pooled proportion of infants having RSV-associated bronchiolitis before the COVID-19 pandemic in 2019 and during the pandemic with 95% confidence interval (CI). We identified and screened 189 articles and systematically reviewed 50 full texts. Eight qualified studies from Europe and China, including 109,186 symptomatic cases of bronchiolitis before the pandemic in 2019 and 61,982 cases in 2020-2021 were pooled by random-effects meta-analysis. The quantitative analysis included laboratory-confirmed RSV infection in 7691 infants with bronchiolitis reported before the pandemic in 2019. Meanwhile, during the pandemic, 4964 bronchiolitis cases were associated with RSV infection. The pooled proportion of RSV-associated bronchiolitis cases before the pandemic in 2019 was 16.74% (95% CI 11.73, 22.43%, 95% prediction interval 0.032, 34.16). The pooled proportion of confirmed RSV cases during the pandemic in 2020/2021 was 19.20% (95% CI 12.01, 27.59%, 95% prediction interval 0.046, 42.35). There was an increase in RSV activity after the relaxation of stringent public health measures during the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Nagaraja Ravishankar
- Assistant Professor, Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
| | - Sudandiradas Robin
- Research Officer, Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sabitha Sasidharan Pillai
- Paediatric Endocrinology Fellow, Warren Alpert Medical School of Brown University, Providence, RI, USA
| |
Collapse
|
36
|
González-Roz A, Martínez-Loredo V, Aston ER, Metrik J, Murphy J, Balodis I, Secades-Villa R, Belisario K, MacKillop J. Concurrent validity of the marijuana purchase task: a meta-analysis of trait-level cannabis demand and cannabis involvement. Addiction 2023; 118:620-633. [PMID: 36305652 PMCID: PMC10020890 DOI: 10.1111/add.16075] [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: 02/11/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta-analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement. METHODS Electronic databases and pre-print repositories were searched for MPT studies that examined the cross-sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta-analyses of cross-sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta-regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples. RESULTS The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax , and elasticity showed the most robust concurrent validity (|r's| = 0.147-325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity-quantity and Pmax -problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed. CONCLUSIONS The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax , and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis.
Collapse
Affiliation(s)
- Alba González-Roz
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | - Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
- Providence VA Medical Center, Providence, RI, USA
| | - James Murphy
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Iris Balodis
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Roberto Secades-Villa
- Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| |
Collapse
|
37
|
Beaufort I, Akkerman E, van Munster S, Weusten B. Effect of biopsy protocol adherence vs non-adherence on dysplasia detection rates in Barrett's esophagus surveillance endoscopies: a systematic review and meta-analysis. Endosc Int Open 2023; 11:E221-E229. [PMID: 36910844 PMCID: PMC9995180 DOI: 10.1055/a-1967-1589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/13/2022] [Indexed: 03/14/2023] Open
Abstract
Background Barrett's esophagus (BE) surveillance endoscopies are advised for early diagnosis of esophageal adenocarcinoma (EAC). Current guidelines recommend obtaining four-quadrant random biopsies every 2 centimeters of BE length alongside with targeted biopsies if visible lesions are present. Low adherence rates for this random biopsy protocol are widely reported. The aim of this systematic review and meta-analysis was to assess the effect of adherence versus non-adherence to the four-quadrant biopsy protocol on detection of dysplasia in BE patients. Methods We searched for studies that reported effects of adherence and non-adherence to the four-quadrant biopsy protocol on dysplasia detection rates in BE patients. Adherence was defined as taking a minimum of 4 quadrant random biopsies per 2 cm of BE segment. Studies with low risk of bias and without applicability concerns were included in a good quality synthesis. Pooled relative risks (RRs) with 95% confidence interval (CI) of dysplasia detection rates were calculated. Results A total of 1,570 studies were screened and 8 studies were included. Four studies were included in the good quality synthesis. In the pooled good quality analysis, four-quadrant biopsy protocol adherence significantly increased detection of dysplasia compared to non-adherence (RR 1.90, 95 % CI = 1.36-2.64; I2 = 45 %). Pooled RRs for LGD and HGD/EAC were 2.00 (95 % CI = 1.49-2.69; I2 = 0 %) and 2.03 (95 % CI = 0.98-4.24; I2 = 28 %), respectively. Conclusion This systematic review and meta-analysis demonstrates that four-quadrant biopsy protocol adherence is associated with increased detection of dysplasia in BE patients. Efforts should be made to increase biopsy protocol adherence rates.
Collapse
Affiliation(s)
- Ilse Beaufort
- Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands.,Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Elisabeth Akkerman
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Sanne van Munster
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Bas Weusten
- Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands.,Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht University, the Netherlands
| |
Collapse
|
38
|
Chatwin H, Broadley M, de Galan B, Bazelmans E, Speight J, Pouwer F, Nefs G. Effectiveness of educational and behavioural interventions for reducing fear of hypoglycaemia among adults with type 1 diabetes: Systematic review and meta-analyses. Diabet Med 2023; 40:e15071. [PMID: 36807935 DOI: 10.1111/dme.15071] [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: 08/15/2022] [Revised: 02/02/2023] [Accepted: 02/16/2023] [Indexed: 02/20/2023]
Abstract
AIMS To summarize and critically appraise evidence regarding the effectiveness of educational and/or behavioural interventions in reducing fear of hypoglycaemia among adults with type 1 diabetes. METHODS Systematic searches of medical and psychology databases were conducted. Risk-of-bias was assessed using the Joanna Briggs Institute Critical Appraisal Tools. Data were synthesized using random-effects meta-analyses for randomized controlled trials (RCTs) and narrative synthesis for observational studies. RESULTS Five RCTs (N = 682) and seven observational studies (N = 1519) met the inclusion criteria, reporting on behavioural, structured education and cognitive-behavioural therapy (CBT) interventions. Most studies assessed fear of hypoglycaemia using the Hypoglycaemia Fear Survey Worry (HFS-W) and Behaviour (HFS-B) subscales. Mean fear of hypoglycaemia at baseline was relatively low across studies. Meta-analyses showed a significant effect of interventions on HFS-W (SMD = -0.17, p = 0.032) but not on HFS-B scores (SMD = -0.34, p = 0.113). Across RCTs, Blood Glucose Awareness Training (BGAT) had the largest effect on HFS-W and HFS-B scores, and one CBT-based program was as effective as BGAT in reducing HFS-B scores. Observational studies showed that Dose Adjustment for Normal Eating (DAFNE) was associated with significant fear of hypoglycaemia reductions. CONCLUSIONS Current evidence suggests that educational and behavioural interventions can reduce fear of hypoglycaemia. However, no study to date has examined these interventions among people with high fear of hypoglycaemia.
Collapse
Affiliation(s)
- Hannah Chatwin
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Melanie Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Bastiaan de Galan
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands
| | - Ellen Bazelmans
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Jane Speight
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Giesje Nefs
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg, Netherlands
- Diabeter, Center for Type 1 Diabetes Care and Research, Rotterdam, Netherlands
| |
Collapse
|
39
|
Portale G, Bartolotta P, Azzolina D, Gregori D, Fiscon V. Laparoscopic right hemicolectomy with 2D or 3D video system technology: systematic review and meta-analysis. Int J Colorectal Dis 2023; 38:34. [PMID: 36773133 DOI: 10.1007/s00384-023-04342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Standard laparoscopic colorectal surgery relies on 2D image systems in most centers. However, 3D vision has gained popularity and is used nowadays in a constantly rising number of units. Right hemicolectomy with intracorporeal anastomosis and lymph node dissection represents a surgical procedure that may benefit the most from 3D vision. The aim of the study was to summarize the available literature on the use of 2D vs. 3D video imaging in patients undergoing laparoscopic right hemicolectomy. METHODS A comprehensive literature review was conducted including Medline/PubMed, Embase, and Scopus (PROSPERO registration number CRD 42022344764) through October 2022. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The risk of bias was evaluated using the ROBINS-I tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines and GRADEpro to develop a summary of evidence tables. Random-effects meta-analyses were conducted. RESULTS Five observational retrospective studies (496 patients, 275 2D and 216 3D) were included. One study was rated as having a critical risk of bias; the remaining had low to moderate risk. 2D laparoscopic right hemicolectomy patients showed longer anastomotic time in 3/3 studies (MD = 3.32; 95%CI, 1.58-5.05; p = 0.002) and an upward trend in operative time in 4/5 studies (MD = 9.98; 95%CI, -1.42, 21.37; p = 0.086) compared to 3D. The two image video systems had similar short-term outcomes, including the number of lymph nodes harvested (MD = -0.67; 95%CI, -2.47, 1.13; p = 0.47), morbidity (OR post-operative complications = 1.12; 95%CI, 0.71-1.77; p = 0.62), and length of stay (MD = 0.27; 95%CI, -0.59, 1.13; p = 0.9). CONCLUSIONS 2D and 2D laparoscopic right hemicolectomy had similar complications rate, with a shorter anastomotic time along with a downward trend in overall operative time for 3D. Larger prospective randomized trials are awaited before definitive conclusions can be drawn.
Collapse
Affiliation(s)
- Giuseppe Portale
- Department of General Surgery, Azienda Euganea ULSS 6, Cittadella, Padova, Italy.
| | - Patrizia Bartolotta
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35121, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35121, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35121, Padova, Italy
| | - Valentino Fiscon
- Department of General Surgery, Azienda Euganea ULSS 6, Cittadella, Padova, Italy
| |
Collapse
|
40
|
Craige EA, Memon AR, Belavy DL, Vincent GE, Owen PJ. Effects of non-pharmacological interventions on sleep in chronic low back pain: A systematic review and meta-analysis of randomised controlled trials. Sleep Med Rev 2023; 68:101761. [PMID: 36805590 DOI: 10.1016/j.smrv.2023.101761] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/29/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023]
Abstract
Low back pain is a leading cause of disability worldwide and adults with chronic low back pain (≥12weeks) commonly experience sleep impairments (e.g., insomnia, sleep disturbance). This study examined the effects of non-pharmacological interventions on sleep in adults with chronic low back pain. Six databases (PubMed, CINAHL, SPORTDiscus, PsycINFO, EMBASE, CENTRAL) were searched from inception to 2 June 2021 for randomised controlled trials. Pairwise random-effect meta-analysis estimated standardised mean difference (Hedges' g) at end-of-intervention follow-up. Nineteen studies (participants: 1348) were included. When compared to control, non-pharmacological interventions improved sleep (g [95%CI]: -0.33 [-0.56, -0.11], p = 0.004, small effect, I2 = 59.3%; n = 879; studies: n = 13; GRADE: low). This small improvement in sleep was associated with a moderate reduction in pain intensity (-0.69 [-1.00, -0.38], p < 0.001, I2 = 75.3%; n = 812; studies: n = 12; GRADE: very low) and no changes in back-related disability (-0.50 [-1.13, 0.14], p = 0.129, I2 = 91.4%; n = 517; studies: n = 6; GRADE: low). Notably, all eligible studies reported interventions primarily aimed to reduce pain, although our search criteria were not limited to pain interventions. Key limitations were data paucity and high risk of bias. Future research should investigate sleep-based interventions (i.e., those purposely designed to improve sleep) using subjective and objective measures across a range of sleep domains (CRD42021275227).
Collapse
Affiliation(s)
- Emma A Craige
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, South Australia, Australia.
| | - Aamir R Memon
- Institute of Physiotherapy & Rehabilitation Sciences, Peoples University of Medical & Health Sciences for Women, Pakistan.
| | - Daniel L Belavy
- Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Gesundheitscampus 6-8, 44801, Bochum, Germany.
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, South Australia, Australia.
| | - Patrick J Owen
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia.
| |
Collapse
|
41
|
Craige EA, Tagliaferri SD, Ferguson SA, Scott H, Belavy DL, Easton DF, Buntine P, Memon AR, Owen PJ, Vincent GE. Effects of pharmacotherapy on sleep-related outcomes in adults with chronic low back pain: A systematic review and meta-analysis of randomised controlled trials. EClinicalMedicine 2023; 55:101749. [PMID: 36425870 PMCID: PMC9678954 DOI: 10.1016/j.eclinm.2022.101749] [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: 08/25/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background Adults with chronic low back pain (CLBP) suffer impaired sleep. Medications for CLBP can impact sleep which in turn may influence treatment outcomes. This systematic review and meta-analysis examined the effects of pharmacotherapy (any type) on sleep in adults with CLBP. Methods In this systematic review and meta-analysis, we searched PubMed, CINAHL, SPORTDiscus, PsycINFO, EMBASE, and CENTRAL from inception to 10 July 2022. Randomised controlled trials that investigated the effects of pharmacotherapy on sleep in adults with CLBP were included. Manual citation search of relevant systematic reviews and included studies were also conducted. Mean change from baseline for sleep outcomes (e.g., sleep quality, total sleep time, wake after sleep onset) was the effect of interest. Pairwise inverse-variance random effect meta-analysis was performed to impute pooled estimates (Hedges' g or risk ratios). The Hartung-Knapp-Sidik-Jonkman method was used where there were ≤5 studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for evaluating the certainty of evidence. This study was registered with PROSPERO (CRD42022309419). Findings Assessment of 3959 records resulted in nine studies (n = 2927) being included. Pharmacotherapy for CLBP management had a small, yet unlikely clinically significant, effect on improving sleep in adults with CLBP, when compared to placebo (g [95% CI]: -0.23 [-0.37, -0.09], p = .0009; I 2 = 30.1%; n = 1433; studies: n = 8; GRADE: low). Notably, no eligible studies investigated the effect of sleep medications in this population, despite being within the scope of this review. Interpretation Pharmacotherapy used to manage CLBP provided improvements in sleep in adults with CLBP. Given that these effects were small and unlikely clinically significant, clinicians could consider alternative treatments (e.g., non-pharmacological interventions) for managing sleep in adults with CLBP. However, low to very low certainty of evidence precluded strong conclusions. To improve certainty of evidence and confidence in the effect estimates, future research needs to use robust method to minimise bias. Additional research evaluating multiple sleep characteristics, using both validated objective and subjective measures, is also warranted to further investigate the influence of distinct sleep parameters. Funding The Summer Research Scholarship from the Appleton Institute, Central Queensland University, Australia.
Collapse
Affiliation(s)
- Emma A. Craige
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Scott D. Tagliaferri
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Sally A. Ferguson
- Appleton Institute, School of Medical and Applied Sciences, Central Queensland University, South Australia, Australia
| | - Hannah Scott
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
| | - Daniel L. Belavy
- Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
| | - Dayna F. Easton
- Appleton Institute, School of Medical and Applied Sciences, Central Queensland University, South Australia, Australia
| | - Paul Buntine
- Eastern Health Clinical School, Monash University, Melbourne, Australia
- Eastern Health Emergency Medicine Program, Melbourne, Australia
| | - Aamir R. Memon
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Patrick J. Owen
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Grace E. Vincent
- Appleton Institute, School of Medical and Applied Sciences, Central Queensland University, South Australia, Australia
| |
Collapse
|
42
|
Kaiser Pinotti L, Castro ADS, de Oliveira Garcia GH, Alvim PHP, Roza TH, Andrade FA, Kowacs PA, Massuda R. Executive functions in migraine patients: a systematic review with meta-analysis. Cogn Neuropsychiatry 2023; 28:52-66. [PMID: 36420996 DOI: 10.1080/13546805.2022.2149390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction: Migraine, a common neurological disease, is known to impact the quality of life of individuals with this condition.Methods: We performed a systematic review with meta-analysis to investigate the abnormalities associated with executive functions of migraineurs as compared with healthy controls. In addition, we investigated the differences between patients with and without aura.Results: A total of 25 studies were included in the systematic review and 19 in the meta-analysis. Meta-analysis was conducted using random effects models, with the unit of analysis as the standardised mean difference (calculated as Hedges'g). Patients with migraine had worse performance in the trail making test A (g = 0.40; 95% confidence interval [CI] 0.05-0.74; p = 0.0271) and B (g = 0.40; 95% CI 0.16-0.64; p = 0.0026), and digit span backward test (g = -0.20; 95% CI - 0.31, - 0.09; p = 0.0105). Subgroup analysis revealed no difference between migraine with and without aura.Conclusion: These results suggest that migraine patients may present worse performance for specific executive functional domains, including attention, working memory, and mental flexibility.
Collapse
Affiliation(s)
- Luciane Kaiser Pinotti
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Anderson da Silva Castro
- Complexo Hospital de Cllínicas do Paraná (CHC), Neurology Service, Federal University of Paraná (UFPR), Curitiba, Brazil
| | | | - Pedro Henrique Pereira Alvim
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil.,Department of Psychiatry, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Thiago Henrique Roza
- Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fabiana Antunes Andrade
- Laboratory of Molecular Immunopathology, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Pedro André Kowacs
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil.,Complexo Hospital de Cllínicas do Paraná (CHC), Neurology Service, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Raffael Massuda
- Postgraduate Program in Internal Medicine and Health Sciences (PPGMICS), Federal University of Paraná (UFPR), Curitiba, Brazil.,Department of Psychiatry, Federal University of Paraná (UFPR), Curitiba, Brazil
| |
Collapse
|
43
|
Pfeifer LO, De Nardi AT, da Silva LXN, Botton CE, do Nascimento DM, Teodoro JL, Schaan BD, Umpierre D. Association Between Physical Exercise Interventions Participation and Functional Capacity in Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Controlled Trials. SPORTS MEDICINE - OPEN 2022; 8:34. [PMID: 35244804 PMCID: PMC8897547 DOI: 10.1186/s40798-022-00422-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
Background The prevalence of type 2 diabetes mellitus increases with age, and people with type 2 diabetes are more affected by reductions in functional performance. Although exercise interventions are recommended for people with diabetes, it is relevant to assess the effects of different training modes on the available functional outcomes. Therefore, our purpose was to systematically assess the effect of different physical exercise modalities in patients with type 2 diabetes with an average age of 45 years or older on outcomes used to measure functional capacity.
Methods A systematic review and meta-analysis of controlled trials was conducted. Seven databases were searched from January 1987 to December 2021 (PubMed, Physiotherapy Evidence Database, Cochrane Library, SPORTDiscus, and in grey literature: Open Grey and Google Scholar). Eligible studies should last 8 weeks or longer, comparing structured exercise training and non-exercise control for one out of six pre-specified functional capacity outcomes (Timed Up and Go test, chair stands, walking performance, upper-limb muscle strength, lower-limb muscle strength, physical fitness parameter), in patients with type 2 diabetes, aged ≥ 45 years. The risk of bias was assessed with the Downs & Black checklist. Pooled mean differences were calculated using a random-effects model, followed by sensitivity and meta-regression analyses. Results Of 18,112 references retrieved, 29 trials (1557 patients) were included. Among these, 13 studies used aerobic training, 6 studies used combined training, 4 studies used resistance training, 3 studies had multiple intervention arms and 3 studies used other types of training. Exercise training was associated with an increase in functional capacity outcomes, as reflected by changes in 6-min walk test (n = 8) [51.6 m; 95% CI 7.6% to 95.6%; I2 92%], one-repetition maximum leg-press (n = 3) [18.0 kg; 95% CI 4.0% to 31.9%; I2 0%], and maximum oxygen consumption (VO2max) (n = 20) [2.41 mL/kg·min; 95% CI 1.89% to 2.92%; I2 100%] compared with control groups. In sensitivity and subgroup analyses using VO2max as outcome and stratified by type of study (randomized and non-randomized controlled clinical trials), duration of diabetes diagnosis, and sex, we observed overlapping confidence intervals. Meta-regression showed no association between glycated hemoglobin (HbA1C) levels and VO2max [p = 0.34; I2 99.6%; R2 = 2.6%]. In addition, the quality of the included studies was mostly low. Conclusion The results indicate that structured physical exercise programs might improve functional capacity in patients with type 2 diabetes, except for the upper-limb muscle strength. However, we could not identify potential effect predictors associated with directional summary estimates. Trial registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews (CRD42020162467); date of registration: 12/15/2019. The review protocol is hosted at the Open Science Framework (OSF) (Preprint https://doi.org/10.31219/osf.io/kpg2m). Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00422-1.
Collapse
|
44
|
Mheissen S, Daraqel B, Alzoubi EE, Khan H. Effectiveness of platelet-rich concentrates on the rate of orthodontic tooth movement: a systematic review and meta-analysis. Eur J Orthod 2022; 45:196-207. [PMID: 36056906 DOI: 10.1093/ejo/cjac049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Autologous platelet-rich concentrates (PRCs) are recently used as a local biological substance in orthodontics to accelerate the rate of tooth movement. OBJECTIVES This systematic review aimed to evaluate the effects of PRCs on the rate of orthodontic tooth movement (OTM). SEARCH METHODS Unrestricted search of five electronic databases supplemented by the manual and gray literature search were undertaken in March 2022. SELECTION CRITERIA Randomized controlled trials (RCTs) evaluating the effect of PRCs on the rate of OTM with their side effect were included in this systematic review. DATA COLLECTION AND ANALYSIS Data items were extracted by two authors using a pre-piloted extraction form. Similar outcomes within a comparable time frame were synthesized in a meta-analysis. RESULTS Fourteen studies were deemed eligible for inclusion and seven RCTs were pooled in a meta-analysis. Canine retraction rate was higher in the side of PRCs injection than the control side by 0.28 mm/month (95% CI: 0.16-0.40, I2 = 95.6 per cent, P < 0.001, 345 patients) in the first 4 months after PRCs injection. There was no statistically significant difference between the PRCs side and the control side regarding molar anchorage loss (MAL) (MD = 0.03 mm, 95% CI: -0.18 to 0.24, I2 = 46.3 per cent, P = 0.78, 44 patients), canine rotation (MD = -0.19o, 95% CI: -1.95 to 1.57, I2 = 45.4 per cent, P = 0.96, 48 patients), or en-masse retraction. Likewise, there was no difference between both groups in terms of the duration of de-crowding. The mandibular canine retraction was statistically higher on the PRCs side than on the control side by 0.17 mm/month (P < 0.001, one trial). Regarding root resorption, there was no statistically significant difference between the experimental and control sides within the follow-up time. Mild pain scores were reported by the patients in the first 24 hours after injections. CONCLUSIONS Low-level evidence indicates that the effect of PRCs on OTM is minor and clinically insignificant. The findings should be interpreted with caution due to the inherent limitations in the included RCTs. REGISTRATION PROSPERO (CRD42022300026).
Collapse
Affiliation(s)
- Samer Mheissen
- DDS, Syrian Board in Orthodontics, Private Practice, Damascus, Syria
| | - Baraa Daraqel
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, China
| | | | - Haris Khan
- CMH Institute of Dentistry Lahore, National University of Medical Sciences, Punjab, Pakistan
| |
Collapse
|
45
|
Farouki L, El-Dirani Z, Abdulrahim S, Akl C, Akik C, McCall SJ. The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies. PLoS Med 2022; 19:e1004061. [PMID: 36048881 PMCID: PMC9436112 DOI: 10.1371/journal.pmed.1004061] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Female genital mutilation/cutting (FGM/C) is a nonmedical procedure entailing the modification of the external female genitalia. A description of the prevalence and distribution of FGM/C allows the tracking of progress toward ending FGM/C by 2030 (Sustainable Development Goal (SDG): target 5.3). This systematic review aimed to examine FGM/C prevalence and types, by World Health Organization (WHO) region and country. METHODS AND FINDINGS A systematic search using Medical Subject Headings (MeSH) and keywords from 2009 to March 24, 2022 was undertaken in MEDLINE, PubMED, PsycINFO, Web of Science, and Embase to identify studies presenting FGM/C prevalence. Abstract and full-text screening, quality assessment, and data extraction were undertaken by 2 reviewers. Only nationally representative studies were included in the meta-analysis. Pooled FGM/C prevalence was estimated by random-effects meta-analysis using generalized linear mixed models (GLMMs). FGM/C prevalence with 95% confidence intervals (CIs), prediction intervals (PIs), and FGM/C type were presented separately by women aged 15 to 49 years and girls aged 0 to 14 years. A total of 163 studies met the inclusion criteria and 30 were included in the meta-analysis, of which 23 were from the WHO African Region (AFR), 6 from the Eastern Mediterranean Region (EMR), and 1 from the South East Asian Region (SEAR). These studies included data from 406,068 women across 30 countries and 296,267 girls across 25 countries; the pooled prevalence estimate of FGM/C among women aged 15 to 49 years was 36.9% (95% CI: 19.6% to 58.3%; PI: 0.4% to 99.0%), and 8.27% (95% CI: 3.7% to 17.3%; PI: 0.1% to 89.3%) among girls aged 0 to 14 years. Among included countries, this gave a total estimated prevalence of 84,650,032 women (95% CI: 45,009,041 to 133,834,224) and 13,734,845 girls with FGM/C (95% CI: 6,211,405 to 28,731,901). Somalia had the highest FGM/C prevalence among women (99.2%), and Mali had the highest among girls (72.7%). The most common type of FGM/C among women was "flesh removed" (Type I or II) in 19 countries. Among girls, "not sewn closed" (Type I, II, or IV) and "flesh removed" (Type I or II) were the most common types in 8 countries, respectively. Among repeated nationally representative studies, FGM/C decreased for both women and girls in 26 countries. The main limitation of the study methodology is that estimates were based on available published data, which may not reflect the actual global prevalence of FGM/C. CONCLUSIONS In this study, we observed large variation in FGM/C prevalence between countries, and the prevalence appears to be declining in many countries, which is encouraging as it minimizes physical and physiological harm for a future generation of women. This prevalence estimate is lower than the actual global prevalence of FGM/C due to data gaps, noncomparable denominators, and unavailable surveys. Yet, considerable policy and community-level interventions are required in many countries to meet the SDG target 5.3. TRIAL REGISTRATION Registration: CRD42020186937.
Collapse
Affiliation(s)
- Leen Farouki
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zeinab El-Dirani
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Sawsan Abdulrahim
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Stephen J. McCall
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
46
|
Arechvo A, Nikolaidi DA, Gil MM, Rolle V, Syngelaki A, Akolekar R, Nicolaides KH. Maternal Race and Stillbirth: Cohort Study and Systematic Review with Meta-Analysis. J Clin Med 2022; 11:3452. [PMID: 35743521 PMCID: PMC9224577 DOI: 10.3390/jcm11123452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 12/10/2022] Open
Abstract
Accurate identification of independent predictors of stillbirth is needed to define preventive strategies. We aim to examine the independent contribution of maternal race in the risk of stillbirth after adjusting for maternal characteristics and medical history. There are two components to the study: first, prospective screening in 168,966 women with singleton pregnancies coordinated by the Fetal Medicine Foundation (FMF) and second, a systematic review and meta-analysis of studies reporting on race and stillbirth. In the FMF study, logistic regression analysis found that in black women, the risk of stillbirth, after adjustment for confounders, was higher than in white women (odds ratio 1.78, 95% confidence interval 1.50 to 2.11). The risk for other racial groups was not significantly different. The literature search identified 20 studies that provided data on over 6,500,000 pregnancies, but only 10 studies provided risks adjusted for some maternal characteristics; consequently, the majority of these studies did not provide accurate contribution of different racial groups to the prediction of stillbirth. It is concluded that in women of black origin, the risk of stillbirth, after adjustment for confounders, is about twofold higher than in white women. Consequently, closer surveillance should be granted for these women.
Collapse
Affiliation(s)
- Anastasija Arechvo
- Harris Birthright Research Centre of Fetal Medicine, King’s College Hospital, London SE5 8BB, UK; (M.M.G.); (A.S.); (K.H.N.)
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences Lund, Lund University, 22100 Lund, Sweden
| | | | - María M. Gil
- Harris Birthright Research Centre of Fetal Medicine, King’s College Hospital, London SE5 8BB, UK; (M.M.G.); (A.S.); (K.H.N.)
- Department of Obstetrics and Gynecology, Hospital Universitario de Torrejón, 28850 Torrejón de Ardoz, Spain
- School of Medicine, Universidad Francisco de Vitoria (UFV), 28223 Madrid, Spain
| | - Valeria Rolle
- Bioestatistics and Epidemiology Platform at Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain;
| | - Argyro Syngelaki
- Harris Birthright Research Centre of Fetal Medicine, King’s College Hospital, London SE5 8BB, UK; (M.M.G.); (A.S.); (K.H.N.)
| | - Ranjit Akolekar
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham ME7 5NY, UK;
- Institute of Medical Sciences, Canterbury Christ Church University, Chatham ME4 4UF, UK
| | - Kypros H. Nicolaides
- Harris Birthright Research Centre of Fetal Medicine, King’s College Hospital, London SE5 8BB, UK; (M.M.G.); (A.S.); (K.H.N.)
| |
Collapse
|
47
|
Figliozzi S, Georgiopoulos G, Pateras K, Sianis A, Previtero M, Tondi L, Petropoulos Ι, Bragato RM, Papachristidis A, Condorelli G, Takeuchi M. Normal ranges of left atrial volumes and ejection fraction by 3D echocardiography in adults: a systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:1329-1340. [PMID: 34994882 DOI: 10.1007/s10554-021-02520-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/30/2021] [Indexed: 11/05/2022]
Abstract
Increased sizes and dysfunction of the left atrium have been related to adverse outcomes. 3D-echocardiography is more accurate than 2D-echocardiography in estimating LA volumes and ejection fraction. However, the use of 3DE for LA analysis is limited by the absence of established reference values. We performed a systematic review and meta-analysis to provide reference ranges of LA maximum and minimum volumes indexed for body surface area (LAVi max and LAVi min, respectively), and LA-EF assessed by 3DE in healthy adults. Data search was conducted from inception through September 15, 2021, using the following Medical Subject Heading terms: left atrial/atrium, three-dimensional/3D echocardiography. The study protocol was registered in the PROSPERO database (CRD42021252428). 15 studies including 4,226 healthy adults (51% males) and reporting 3DE values of LAVi max, LAVi min and LA-EF were selected. LAVi max, LAVi min and LA-EF mean and reference values were equal to 25.18 ml/m2 (95% CI 23.10, 27.26), 11.10 ml/m2 (10.01, 12.18) and 55.94% (51.92, 59.96), respectively. No influential studies were identified. Pooled estimates per age group- and sex were also estimated. By meta-regression analyses, we identified variability in LA volumes and LA-EF depending on participants' age, ethnicity and number of heart cycles at 3D multi-beat acquisition. At individual patient data analysis conducted on 374 subjects, a software effect on LA-EF was shown. This systematic review and meta-analysis provides reference values of LAVi max, LAVi min and LA-EF assessed by 3DE in healthy adults, encouraging 3DE evaluation of the LA evaluation in daily practice.
Collapse
Affiliation(s)
- Stefano Figliozzi
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy.
| | - Georgios Georgiopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Kostantinos Pateras
- Department of Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Faculty of Public Health, University of Thessaly, Volos, Greece
| | - Alexandros Sianis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Marco Previtero
- Cardiology Unit, Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Lara Tondi
- Multimodality Imaging Section IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Ιoannis Petropoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Renato Maria Bragato
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy
| | | | - Gianluigi Condorelli
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| |
Collapse
|
48
|
Chen Z, Yuan M, Aro AL, Tse G, Li G, Liu T. Association between electrocardiographic QRS transition zone and mortality from all causes and cardiovascular diseases: A systematic review and meta-analysis. J Electrocardiol 2022; 73:62-67. [PMID: 35667214 DOI: 10.1016/j.jelectrocard.2022.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/02/2022] [Accepted: 05/22/2022] [Indexed: 11/29/2022]
Abstract
AIMS To investigate whether clockwise rotation (CWR) and counterclockwise rotation (CCWR) of electrocardiographic QRS transition zone is associated with mortality from all causes and cardiovascular diseases (CVD). METHODS Studies were identified from searching of PubMed, EMBASE and the reference lists of relevant papers. Summary multivariate-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) and 95% prediction intervals (PIs) were computed through meta-analysis. RESULTS A total of five observational cohort studies fulfilled the inclusion criteria, which included 47,252 participants from the general population (8.8% CWR; 44.1% CCWR). Pooling data revealed that CWR was significantly associated with the increased risk of all-cause mortality (HR, 1.18; 95% CI: 1.12-1.24; 95% PI: 1.03-1.37) and CVD mortality (HR, 1.18; 95% CI: 1.08-1.29; 95% PI: 0.98-1.42) compared to NR pattern, with low heterogeneity among studies (P = 0.29, I2 = 20%; P = 0.37; I2 = 7%; respectively). However, CCWR was inversely associated with the risk of all-cause mortality (HR, 0.92; 95% CI: 0.89-0.95; 95% PI: 0.80-1.05) with low heterogeneity (P = 0.14; I2 = 43%), while no significant association existed between CCWR and CVD mortality (HR, 0.89; 95% CI: 0.77-1.02; 95% PI: 0.53-1.48) with high heterogeneity (P < 0.01; I2 = 78%). CONCLUSION Our meta-analysis demonstrated CWR was positively associated with higher risk of mortality from all-cause and CVD, while CCWR was negatively associated with the risk of all-cause mortality and no significant association with CVD mortality. These findings suggested that QRS transition zone carries important prognostic value, more attention should be paid in clinical practice.
Collapse
Affiliation(s)
- Ziliang Chen
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China
| | - Ming Yuan
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China
| | - Aapo L Aro
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Finland
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, PR China.
| |
Collapse
|
49
|
Arechvo A, Voicu D, Gil MM, Syngelaki A, Akolekar R, Nicolaides KH. Maternal race and pre-eclampsia: Cohort study and systematic review with meta-analysis. BJOG 2022; 129:2082-2093. [PMID: 35620879 DOI: 10.1111/1471-0528.17240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/14/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the association between race and pre-eclampsia and gestational hypertension after adjustment for factors in maternal characteristics and medical history in a screening study from the Fetal Medicine Foundation (FMF) in England, and to perform a systematic review and meta-analysis of studies on pre-eclampsia. DESIGN Prospective observational study and systematic review with meta-analysis. SETTING Two UK maternity hospitals. POPULATION A total of 168 966 women with singleton pregnancies attending for routine ultrasound examination at 11-13 weeks of gestation without major abnormalities delivering at 24 weeks or more of gestation. METHODS Regression analysis examined the association between race and pre-eclampsia or gestational hypertension in the FMF data. Literature search to December 2021 was carried out to identify peer-reviewed publications on race and pre-eclampsia. MAIN OUTCOME MEASURE Relative risk of pre-eclampsia and gestational hypertension in women of black, South Asian and East Asian race by comparison to white women. RESULTS In black women, the respective risks of total-pre-eclampsia and preterm-pre-eclampsia were 2-fold and 2.5-fold higher, respectively, and risk of gestational hypertension was 25% higher; in South Asian women there was a 1.5-fold higher risk of preterm pre-eclampsia but not of total-pre-eclampsia and in East Asian women there was no statistically significant difference in risk of hypertensive disorders. The literature search identified 19 studies that provided data on several million pregnancies, but 17 were at moderate or high-risk of bias and only three provided risks adjusted for some maternal characteristics; consequently, these studies did not provide accurate contributions on different racial groups to the prediction of pre-eclampsia. CONCLUSION In women of black and South Asian origin the risk of pre-eclampsia, after adjustment for confounders, is higher than in white women.
Collapse
Affiliation(s)
- Anastasjja Arechvo
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.,Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Diana Voicu
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK
| | - María M Gil
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.,Department of Obstetrics and Gynaecology, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid and School of Medicine, Universidad Francisco de Vitoria, UFV, Madrid, Spain
| | - Argyro Syngelaki
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK
| | - Ranjit Akolekar
- Fetal Medicine Unit, Medway Maritime Hospital, Gillingham, UK.,Institute of Medical Sciences, Canterbury Christ Church University, Chatham, UK
| | - Kypros H Nicolaides
- Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK
| |
Collapse
|
50
|
Gambarota F, Tsuchiya N, Pastore M, Di Polito N, Sessa P. Unconscious Visual Working Memory: A critical review and Bayesian meta-analysis. Neurosci Biobehav Rev 2022; 136:104618. [PMID: 35289273 DOI: 10.1016/j.neubiorev.2022.104618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022]
Abstract
The relationship between consciousness and working memory (WM) has been recently debated both at the theoretical and methodological levels (Persuh et al., 2018; Velichkovsky, 2017). While there is behavioral and neural evidence that argues for the existence of unconscious WM, several methodological concerns have been raised, rendering this issue highly controversial. To address the robustness of the previous findings, here we adopt a meta-analytic approach to estimate the effect size and heterogeneity of the previously reported unconscious WM results, also including unpublished results. We used meta-regression to isolate relevant experimental variables, in particular, consciousness manipulation and the WM paradigm to identify the source of the heterogeneity in the reported effect size of the unconscious WM. Our meta-analysis supports the existence of the unconscious WM effect and critically reveals several experimental variables that contribute to relevant heterogeneity. Our analysis clarifies several theoretical and methodological issues. We recommend that future studies explicitly operationalize the definition of consciousness, standardize the methodology and systematically explore the role of critical variables for the unconscious WM effect.
Collapse
Affiliation(s)
- Filippo Gambarota
- Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy; Padova Neuroscience Center, University of Padova, Via Giuseppe Orus, 2, 35131 Padova, Italy.
| | - Naotsugu Tsuchiya
- Turner Institute for Brain and Mental Health & School of Psychological Sciences, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, Victoria, Australia; Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Suita, Osaka 565-0871, Japan; Advanced Telecommunications Research Computational Neuroscience Laboratories, 2-2-2 Hikaridai, Seika-cho, Soraku-gun, Kyoto 619-0288, Japan.
| | - Massimiliano Pastore
- Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.
| | - Nicola Di Polito
- Medical Neurosciences Program, Charité Universitätsmedizin, Charitépl 1, 10117, Berlin, Germany.
| | - Paola Sessa
- Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy; Padova Neuroscience Center, University of Padova, Via Giuseppe Orus, 2, 35131 Padova, Italy.
| |
Collapse
|