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Clinical and Experimental Dental... Jun 2024The present systematic review explored the involvement of enzymatic and nonenzymatic antioxidants in periodontitis, drawing from established literature. (Meta-Analysis)
Meta-Analysis Review
The assessment of glutathione, glutathione peroxidase, glutathione reductase, and oxidized glutathione in patients with periodontitis-A systematic review and meta-analysis.
OBJECTIVE
The present systematic review explored the involvement of enzymatic and nonenzymatic antioxidants in periodontitis, drawing from established literature.
MATERIALS AND METHODS
The research approach encompassed an extensive electronic search from 2000 to 2023 across databases such as PubMed, Science Direct, and Wiley Online Library and cross-referencing using specific keywords.
RESULTS
The initial literature exploration generated a total of 766 articles. After thoroughly examining the abstracts, 693 articles were excluded from consideration due to duplication and lack of relevance to the central research inquiry. Following that, 73 articles were left for in-depth evaluation. Following a qualitative assessment, 35 studies that satisfied the inclusion criteria were chosen, while 38 were removed for not meeting the necessary standards. Within this selection, a meta-analysis was conducted on 11 articles that provided consistent data for quantitative synthesis. Specifically, the analysis of glutathione (GSH) levels in serum samples revealed a standardized mean difference (SMD) of -5.552 µg/mL (CI 95%: -9.078 to -2.026; P-0.002). In contrast, the analysis of glutathione peroxidase (GPx) enzymes in gingival crevicular fluid (GCF) samples displayed an overall SMD of 2.918 ng/µL (CI 95%: 0.372-5.465; P-0.025), while salivary samples exhibited an overall SMD value of 0.709 U/l (95% CI: -1.907-3.325; P-0.596) which is of insignificant.
CONCLUSION
The systematic review findings suggest a notable decrease in antioxidant enzymes across various systemic biological samples among patients with periodontitis, contrasting with the results from gingival tissue samples meta-analysis of GPx enzyme.
Topics: Humans; Periodontitis; Glutathione Peroxidase; Glutathione; Glutathione Reductase; Glutathione Disulfide; Gingival Crevicular Fluid; Antioxidants
PubMed: 38881240
DOI: 10.1002/cre2.907 -
Scientific Reports Jun 2024To elucidate the correlation of HIF1A with clinicopathologic characteristics in patients with gastric cancer (GC), we conducted a systematic review and meta-analysis. We... (Meta-Analysis)
Meta-Analysis
To elucidate the correlation of HIF1A with clinicopathologic characteristics in patients with gastric cancer (GC), we conducted a systematic review and meta-analysis. We searched PubMed, Embase and Web of Science for studies on GC and HIF1A, covering studies published until January 31st, 2022. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for clinical characteristics based on high and low HIF1A protein levels. We used random-effects and fixed-effects meta-analysis methods to determine mean effect sizes of ORs and evaluated publication heterogeneity with τ, I, and Q values. Additionally, we generated funnel plots to inspect publication bias. Our meta-analysis included 20 publications with 3416 GC patients to estimate the association between high or low HIF1A expression and clinical characteristics. Positive HIF1A expression was significantly associated with T stage progression (OR: 2.46; 95% CI 1.81-3.36; P < 0.01), TNM stage progression (OR: 2.50; 95% CI 1.61-3.87; P < 0.01), lymph node metastasis (OR: 2.06; 95% CI 1.44-2.94; P < 0.01), undifferentiated status (OR: 1.83; 95% CI 1.45-2.32; P < 0.01), M stage progression (OR: 2.34; 95% CI 1.46-3.77; P < 0.01), Borrmann stage progression (OR: 1.48; 95% CI 1.02-2.15; P = 0.04), larger tumor size (OR: 1.27; 95% CI 1.06-1.52; P < 0.01), vascular invasion (OR: 1.94; 95% CI 1.38-2.72; P < 0.01), and higher vascular endothelial growth factor (VEGF) protein expression (OR: 2.61; 95% CI 1.79-3.80; P < 0.01) in our meta-analysis. GC Patients highly expressing HIF1A protein might be prone to tumor progression, poorly differentiated GC cell types, and a high VEGF expression.
Topics: Stomach Neoplasms; Humans; Hypoxia-Inducible Factor 1, alpha Subunit; Lymphatic Metastasis; Biomarkers, Tumor; Neoplasm Staging; Vascular Endothelial Growth Factor A; Gene Expression Regulation, Neoplastic
PubMed: 38877062
DOI: 10.1038/s41598-024-63019-6 -
Campbell Systematic Reviews Jun 2024Many intervention studies of summer programmes examine their impact on employment and education outcomes, however there is growing interest in their effect on young... (Review)
Review
REVIEW RATIONALE AND CONTEXT
Many intervention studies of summer programmes examine their impact on employment and education outcomes, however there is growing interest in their effect on young people's offending outcomes. Evidence on summer employment programmes shows promise on this but has not yet been synthesised. This report fills this evidence gap through a systematic review and meta-analysis, covering summer education and summer employment programmes as their contexts and mechanisms are often similar.
RESEARCH OBJECTIVE
The objective is to provide evidence on the extent to which summer programmes impact the outcomes of disadvantaged or 'at risk' young people.
METHODS
The review employs mixed methods: we synthesise quantitative information estimating the impact of summer programme allocation/participation across the outcome domains through meta-analysis using the random-effects model; and we synthesise qualitative information relating to contexts, features, mechanisms and implementation issues through thematic synthesis. Literature searches were largely conducted in January 2023. Databases searched include: Scopus; PsychInfo; ERIC; the YFF-EGM; EEF's and TASO's toolkits; RAND's summer programmes evidence review; key academic journals; and Google Scholar. The review employed PICOSS eligibility criteria: the was disadvantaged or 'at risk' young people aged 10-25; were either summer education or employment programmes; a valid group that did not experience a summer programme was required; studies had to estimate the summer programme's impact on violence and offending, education, employment, socio-emotional and/or health ; eligible were experimental and quasi-experimental; eligible were high-income countries. Other eligibility criteria included publication in English, between 2012 and 2022. Process/qualitative evaluations associated with eligible impact studies or of UK-based interventions were also included; the latter given the interests of the sponsors. We used standard methodological procedures expected by The Campbell Collaboration. The search identified 68 eligible studies; with 41 eligible for meta-analysis. Forty-nine studies evaluated 36 summer education programmes, and 19 studies evaluated six summer employment programmes. The number of participants within these studies ranged from less than 100 to nearly 300,000. The PICOSS criteria affects the external applicability of the body of evidence - allowances made regarding study design to prioritise evidence on UK-based interventions limits our ability to assess impact for some interventions. The risk of bias assessment categorised approximately 75% of the impact evaluations as low quality, due to attrition, losses to follow up, interventions having low take-up rates, or where allocation might introduce selection bias. As such, intention-to-treat analyses are prioritised. The quality assessment rated 93% of qualitative studies as low quality often due to not employing rigorous qualitative methodologies. These results highlight the need to improve the evidence.
RESULTS AND CONCLUSIONS
The quantitative synthesis examined impact estimates across 34 outcomes, through meta-analysis (22) or in narrative form (12). We summarise below the findings where meta-analysis was possible, along with the researchers' judgement of the security of the findings (high, moderate or low). This was based on the number and study-design quality of studies evaluating the outcome; the consistency of findings; the similarity in specific outcome measures used; and any other specific issues which might affect our confidence in the summary findings.Below we summarise the findings from the meta-analyses conducted to assess the impact of allocation to/participation in summer education and employment programmes (findings in relation to other outcomes are also discussed in the main body, but due to the low number of studies evaluating these, meta-analysis was not performed). We only cover the pooled results for the two programme types where there are not clear differences in findings between summer education and summer employment programmes, so as to avoid potentially attributing any impact to both summer programme types when this is not the case. We list the outcome measure, the average effect size type (i.e., whether a standardised mean difference (SMD) or log odds ratio), which programme type the finding is in relation to and then the average effect size along with its 95% confidence interval and the interpretation of the finding, that is, whether there appears to be a significant impact and in which direction (positive or negative, clarifying instances where a negative impact is beneficial). In some instances there may be a discrepancy between the 95% confidence interval and whether we determine there to be a significant impact, which will be due to the specifics of the process for constructing the effect sizes used in the meta-analysis. We then list the statistic and the -value from the homogeneity test as indications of the presence of heterogeneity. As the sample size used in the analysis are often small and the homogeneity test is known to be under-powered with small sample sizes, it may not detect statistically significant heterogeneity when it is in fact present. As such, a 90% confidence level threshold should generally be used when interpreting this with regard to the meta-analyses below. The presence of effect size heterogeneity affects the extent to which the average effects size is applicable to all interventions of that summer programme type. We also provide an assessment of the relative confidence we have in the generalisability of the overall finding (low, moderate or high) - some of the overall findings are based on a small sample of studies, the studies evaluating the outcome may be of low quality, there may be wide variation in findings among the studies evaluating the outcome, or there may be specific aspects of the impact estimates included or the effect sizes constructed that affect the generalisability of the headline finding. These issues are detailed in full in the main body of the review. -Engagement with/participation in/enjoyment of education (SMD):∘Summer education programmes: +0.12 (+0.03, +0.20); positive impact; = 48.76%, = 0.10; moderate confidence.-Secondary education attendance (SMD):∘Summer education programmes: +0.26 (+0.08, +0.44); positive impact; = N/A; = N/A; low confidence.∘Summer employment programmes: +0.02 (-0.03, +0.07); no impact; = 69.98%; = 0.03; low confidence.-Passing tests (log OR):∘Summer education programmes: +0.41 (-0.13, +0.96); no impact; = 95.05%; = 0.00; low confidence.∘Summer employment programmes: +0.02 (+0.00, +0.04); positive impact; = 0.01%; = 0.33; low confidence.-Reading test scores (SMD):∘Summer education programmes: +0.01 (-0.04, +0.05); no impact; = 0.40%; = 0.48; high confidence.-English test scores (SMD):∘Summer education programmes: +0.07 (+0.00, +0.13); positive impact; = 27.17%; = 0.33; moderate confidence.∘Summer employment programmes: -0.03 (-0.05, -0.01); negative impact; = 0.00%; = 0.76; low confidence.-Mathematics test scores (SMD):∘All summer programmes: +0.09 (-0.06, +0.25); no impact; = 94.53%; = 0.00; high confidence.∘Summer education programmes: +0.14 (-0.09, +0.36); no impact; = 94.15%; = 0.00; moderate confidence.∘Summer employment programmes: +0.00 (-0.04, +0.05); no impact; = 0.04%; = 0.92; moderate confidence.-Overall test scores (SMD):∘Summer employment programmes: -0.01 (-0.08, +0.05); no impact; = 32.39%; = 0.20; high confidence.-All test scores (SMD):∘Summer education programmes: +0.14 (+0.00, +0.27); positive impact; = 91.07%; = 0.00; moderate confidence.∘Summer employment programmes: -0.01 (-0.04, +0.01); no impact; = 0.06%; = 0.73; high confidence.-Negative behavioural outcomes (log OR):∘Summer education programmes: -1.55 (-3.14, +0.03); negative impact; = N/A; = N/A; low confidence.∘Summer employment programmes: -0.07 (-0.33, +0.18); no impact; = 88.17%; = 0.00; moderate confidence.-Progression to HE (log OR):∘All summer programmes: +0.24 (-0.04, +0.52); no impact; = 97.37%; = 0.00; low confidence.∘Summer education programmes: +0.32 (-0.12, +0.76); no impact; = 96.58%; = 0.00; low confidence.∘Summer employment programmes: +0.10 (-0.07, +0.26); no impact; = 76.61%; = 0.02; moderate confidence.-Complete HE (log OR):∘Summer education programmes: +0.38 (+0.15, +0.62); positive impact; = 52.52%; = 0.06; high confidence.∘Summer employment programmes: +0.07 (-0.19, +0.33); no impact; = 70.54%; = 0.07; moderate confidence.-Entry to employment, short-term (log OR):∘Summer employment programmes: -0.19 (-0.45, +0.08); no impact; = 87.81%; = 0.00; low confidence.∘Entry to employment, full period (log OR)∘Summer employment programmes: -0.15 (-0.35, +0.05); no impact; = 78.88%; = 0.00; low confidence.-Likelihood of having a criminal justice outcome (log OR):∘Summer employment programmes: -0.05 (-0.15, +0.05); no impact; = 0.00%; = 0.76; low confidence.-Likelihood of having a drug-related criminal justice outcome (log OR):∘Summer employment programmes: +0.16 (-0.57, +0.89); no impact; = 65.97%; = 0.09; low confidence.-Likelihood of having a violence-related criminal justice outcome (log OR):∘Summer employment programmes: +0.03 (-0.02, +0.08); no impact; = 0.00%; = 0.22; moderate confidence.-Likelihood of having a property-related criminal justice outcome (log OR):∘Summer employment programmes: +0.09 (-0.17, +0.34); no impact; = 45.01%; = 0.18; low confidence.-Number of criminal justice outcomes, during programme (SMD):∘Summer employment programmes: -0.01 (-0.03, +0.00); no impact; = 2.17%; = 0.31; low confidence.-Number of criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.01 (-0.03, +0.00); no impact; = 23.57%; = 0.37; low confidence.-Number of drug-related criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.01 (-0.06, +0.06); no impact; = 55.19%; = 0.14; moderate confidence.-Number of violence-related criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.02 (-0.08, +0.03); no impact; = 44.48%; = 0.18; low confidence.-Number of property-related criminal justice outcomes, post-programme (SMD):∘Summer employment programmes: -0.02 (-0.10, +0.05); no impact; = 64.93%; = 0.09; low confidence. We re-express instances of significant impact by programme type where we have moderate or high confidence in the security of findings by translating this to a form used by one of the studies, to aid understanding of the findings. Allocation to a summer education programme results in approximately 60% of individuals moving from never reading for fun to doing so once or twice a month (engagement in/participation in/enjoyment of education), and an increase in the English Grade Point Average of 0.08. Participation in a summer education programme results in an increase in overall Grade Point Average of 0.14 and increases the likelihood of completing higher education by 1.5 times. Signs are positive for the effectiveness of summer education programmes in achieving some of the education outcomes considered (particularly on test scores (when pooled across types), completion of higher education and STEM-related higher education outcomes), but the evidence on which overall findings are based is often weak. Summer employment programmes appear to have a limited impact on employment outcomes, if anything, a negative impact on the likelihood of entering employment outside of employment related to the programme. The evidence base for impacts of summer employment programmes on young people's violence and offending type outcomes is currently limited - where impact is detected this largely results in substantial reductions in criminal justice outcomes, but the variation in findings across and within studies affects our ability to make any overarching assertions with confidence. In understanding the effectiveness of summer programmes, the order of outcomes also requires consideration - entries into education from a summer employment programme might be beneficial if this leads towards better quality employment in the future and a reduced propensity of criminal justice outcomes.
QUALITATIVE SYNTHESIS
Various shared features among different summer education programmes emerged from the review, allowing us to cluster specific types of these interventions which then aided the structuring of the thematic synthesis. The three distinct clusters for summer education programmes were: catch-up programmes addressing attainment gaps, raising aspirations programmes inspiring young people to pursue the next stage of their education or career, and transition support programmes facilitating smooth transitions between educational levels. Depending on their aim, summer education programme tend to provide a combination of: additional instruction on core subjects (e.g., English, mathematics); academic classes including to enhance specialist subject knowledge (e.g., STEM-related); homework help; coaching and mentoring; arts and recreation electives; and social and enrichment activities. Summer employment programmes provide paid work placements or subsidised jobs typically in entry-level roles mostly in the third and public sectors, with some summer employment programmes also providing placements in the private sector. They usually include components of pre-work training and employability skills, coaching and mentoring. There are a number of mechanisms which act as facilitators or barriers to engagement in summer programmes. These include tailoring the summer programme to each young person and individualised attention; the presence of well-prepared staff who provide effective academic/workplace and socio-emotional support; incentives of a monetary (e.g., stipends and wages) or non-monetary (e.g., free transport and meals) nature; recruitment strategies, which are effective at identifying, targeting and engaging participants who can most benefit from the intervention; partnerships, with key actors who can help facilitate referrals and recruitment, such as schools, community action and workforce development agencies; format, including providing social activities and opportunities to support the formation of connections with peers; integration into the workplace, through pre-placement engagement, such as through orientation days, pre-work skills training, job fairs, and interactions with employers ahead of the beginning of the summer programme; and skill acquisition, such as improvements in social skills. In terms of the causal processes which lead from engagement in a summer programme to outcomes, these include: skill acquisition, including academic, social, emotional, and life skills; positive relationships with peers, including with older students as mentors in summer education programmes; personalised and positive relationships with staff; location, including accessibility and creating familiar environments; creating connections between the summer education programme and the students' learning at home to maintain continuity and reinforce learning; and providing purposeful and meaningful work through summer employment programmes (potentially facilitated through the provision of financial and/or non-financial incentives), which makes participants more likely to see the importance of education in achieving their life goals and this leads to raised aspirations. It is important to note that no single element of a summer programme can be identified as generating the causal process for impact, and impact results rather from a combination of elements. Finally, we investigated strengths and weaknesses in summer programmes at both the design and implementation stages. In summer education programmes, design strengths include interactive and alternative learning modes; iterative and progressive content building; incorporating confidence building activities; careful lesson planning; and teacher support which is tailored to each student. Design weaknesses include insufficient funding or poor funding governance (e.g., delays to funding); limited reach of the target population; and inadequate allocation of teacher and pupil groups (i.e., misalignment between the education stage of the pupils and the content taught by staff). Implementation strengths include clear programme delivery guidance and good governance; high quality academic instruction; mentoring support; and strong partnerships. Implementation weaknesses include insufficient planning and lead in time; recruitment challenges; and variability in teaching quality. In summer employment programmes, design strengths include use of employer orientation materials and supervisor handbooks; careful consideration of programme staff roles; a wide range of job opportunities; and building a network of engaged employers. Design weaknesses are uncertainty over funding and budget agreements; variation in delivery and quality of training between providers; challenges in recruitment of employers; and caseload size and management. Implementation strengths include effective job matching; supportive relationships with supervisors; pre-work training; and mitigating attrition (e.g., striving to increase take up of the intervention among the treatment group). Implementation weaknesses are insufficient monitors for the number of participants, and challenges around employer availability.
PubMed: 38873396
DOI: 10.1002/cl2.1406 -
Frontiers in Endocrinology 2024Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving patient outcomes. However, data on the prevalence and factors associated with unmet drug-related needs in patients with diabetes in Ethiopia is limited. This systematic review and meta-analysis aims to provide a comprehensive analysis of the prevalence of unmet drug-related needs among patients with diabetes mellitus in Ethiopia.
METHODS
A thorough exploration of databases, including PubMed, Scopus, Hinari, and Embase and Google Scholar, was conducted to identify pertinent studies. Inclusion criteria involved observational studies that reported the prevalence of unmet drug-related needs in Ethiopian patients with diabetes. The quality of the studies was assessed using Joanna Briggs Institute (JBI) checklists. A random-effects meta-analysis was employed to amalgamate data on study characteristics and prevalence estimates, followed by subsequent subgroup and sensitivity analyses. Graphical and statistical assessments were employed to evaluate publication bias.
RESULTS
Analysis of twelve studies involving 4,017 patients revealed a pooled prevalence of unmet drug-related needs at 74% (95% CI 63-83%). On average, each patient had 1.45 unmet drug-related needs. The most prevalent type of unmet need was ineffective drug therapy, 35% (95% CI 20-50). Type 2 diabetes, retrospective study designs, and studies from the Harari Region were associated with a higher prevalence. Frequently reported factors associated with the unmet drug-related needs includes multiple comorbidities, older age, and polypharmacy. Notably, the results indicated significant heterogeneity (I = 99.0%; p value < 0.001), and Egger's regression test revealed publication bias with p<0.001.
CONCLUSION
The prevalence of unmet drug-related needs among diabetes patients with diabetes in Ethiopia is high with the most prevalent issue being ineffective drug therapy. Targeted interventions are needed; especially patients on multiple medications, advanced age, with comorbidities, and prolonged illness duration to improve diabetes management and outcomes.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero, identifier CRD42024501096.
Topics: Humans; Ethiopia; Diabetes Mellitus; Hypoglycemic Agents; Health Services Needs and Demand; Prevalence; Diabetes Mellitus, Type 2
PubMed: 38872966
DOI: 10.3389/fendo.2024.1399944 -
Frontiers in Public Health 2024Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.
METHODS
A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.
RESULT
A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity ( = 81%, < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity ( = 79%, < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity ( = 30%, -value = 0.18).
CONCLUSION
This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.
Topics: Humans; Asthma; Respiratory Sounds; Pesticides; Respiratory Tract Infections; Child; Environmental Exposure; Child, Preschool; Adolescent; Infant
PubMed: 38868160
DOI: 10.3389/fpubh.2024.1402908 -
BMC Medical Imaging Jun 2024Esophageal cancer, a global health concern, impacts predominantly men, particularly in Eastern Asia. Lymph node metastasis (LNM) significantly influences prognosis, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Esophageal cancer, a global health concern, impacts predominantly men, particularly in Eastern Asia. Lymph node metastasis (LNM) significantly influences prognosis, and current imaging methods exhibit limitations in accurate detection. The integration of radiomics, an artificial intelligence (AI) driven approach in medical imaging, offers a transformative potential. This meta-analysis evaluates existing evidence on the accuracy of radiomics models for predicting LNM in esophageal cancer.
METHODS
We conducted a systematic review following PRISMA 2020 guidelines, searching Embase, PubMed, and Web of Science for English-language studies up to November 16, 2023. Inclusion criteria focused on preoperatively diagnosed esophageal cancer patients with radiomics predicting LNM before treatment. Exclusion criteria were applied, including non-English studies and those lacking sufficient data or separate validation cohorts. Data extraction encompassed study characteristics and radiomics technical details. Quality assessment employed modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and Radiomics Quality Score (RQS) tools. Statistical analysis involved random-effects models for pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC). Heterogeneity and publication bias were assessed using Deek's test and funnel plots. Analysis was performed using Stata version 17.0 and meta-DiSc.
RESULTS
Out of 426 initially identified citations, nine studies met inclusion criteria, encompassing 719 patients. These retrospective studies utilized CT, PET, and MRI imaging modalities, predominantly conducted in China. Two studies employed deep learning-based radiomics. Quality assessment revealed acceptable QUADAS-2 scores. RQS scores ranged from 9 to 14, averaging 12.78. The diagnostic meta-analysis yielded a pooled sensitivity, specificity, and AUC of 0.72, 0.76, and 0.74, respectively, representing fair diagnostic performance. Meta-regression identified the use of combined models as a significant contributor to heterogeneity (p-value = 0.05). Other factors, such as sample size (> 75) and least absolute shrinkage and selection operator (LASSO) usage for feature extraction, showed potential influence but lacked statistical significance (0.05 < p-value < 0.10). Publication bias was not statistically significant.
CONCLUSION
Radiomics shows potential for predicting LNM in esophageal cancer, with a moderate diagnostic performance. Standardized approaches, ongoing research, and prospective validation studies are crucial for realizing its clinical applicability.
Topics: Humans; Esophageal Neoplasms; Lymphatic Metastasis; Sensitivity and Specificity; Artificial Intelligence; Radiomics
PubMed: 38867143
DOI: 10.1186/s12880-024-01278-5 -
Hypertension (Dallas, Tex. : 1979) Jun 2024Alcohol consumption has been associated with higher blood pressure and an increased risk of hypertension. However, the possible exposure thresholds and effect-modifiers... (Review)
Review
BACKGROUND
Alcohol consumption has been associated with higher blood pressure and an increased risk of hypertension. However, the possible exposure thresholds and effect-modifiers are uncertain.
METHODS
We assessed the dose-response relationship between usual alcohol intake and hypertension incidence in nonexperimental cohort studies. After performing a systematic literature search through February 20, 2024, we retrieved 23 eligible studies. We computed risk ratios and 95% CI of hypertension incidence using a nonlinear meta-analytic model based on restricted cubic splines, to assess the dose-response association with alcohol consumption.
RESULTS
We observed a positive and almost linear association between alcohol intake and hypertension risk with risk ratios of 0.89 (0.84-0.94), 1.11 (1.07-1.15), 1.22 (1.14-1.30), and 1.33 (1.18-1.49) for 0, 24, 36 and 48 g/d, respectively, using 12 g alcohol/d as the reference value. In sex-specific analyses, the association was almost linear in men over the entire range of exposure but only observed above 12 g/d in women, although with a steeper association at high levels of consumption compared with men. The increased risk of hypertension above 12 to 24 g alcohol/d was similar in Western and Asian populations and considerably greater in Whites than in Blacks, mainly due to the positive association in women at moderate-to-high intake.
CONCLUSIONS
Overall, our results lend support to a causal association between alcohol consumption and risk of hypertension, especially above an alcohol intake of 12 g/d, and are consistent with recommendations to avoid or limit alcohol intake. Sex and ethnicity appear to be major effect-modifiers of such association.
PubMed: 38864208
DOI: 10.1161/HYPERTENSIONAHA.124.22703 -
Frontiers in Psychiatry 2024Anti-inflammatory agents have emerged as a potential new therapy for major depressive disorder (MDD). In this meta-analysis, our aim was to evaluate the antidepressant... (Review)
Review
BACKGROUND
Anti-inflammatory agents have emerged as a potential new therapy for major depressive disorder (MDD). In this meta-analysis, our aim was to evaluate the antidepressant effect of anti-inflammatory agents and compare their efficacy.
METHODS
We conducted a comprehensive search across multiple databases, including PubMed, Embase, Web of Science, Cochrane Review, Cochrane Trial, and ClinicalTrials.gov, to identify eligible randomized clinical trials. The primary outcome measures of our meta-analysis were efficacy and acceptability, while the secondary outcome measures focused on remission rate and dropout rate due to adverse events. We used odds ratio (OR) and 95% confidence interval (95% CI) to present our results.
RESULTS
A total of 48 studies were included in our analysis. In terms of efficacy, anti-inflammatory agents demonstrated a significant antidepressant effect compared to placebo (OR = 2.04, 95% CI: 1.41-2.97, p = 0.0002). Subgroup analyses revealed that anti-inflammatory agents also exhibited significant antidepressant effects in the adjunctive therapy subgroup (OR = 2.17, 95% CI: 1.39-3.37, p = 0.0006) and in MDD patients without treatment-resistant depression subgroup (OR = 2.33, 95% CI: 1.53-3.54, p < 0.0001). Based on the surface under the cumulative ranking curve (SUCRA) value of network meta-analysis, nonsteroidal anti-inflammatory drugs (NSAIDs) (SUCRA value = 81.6) demonstrated the highest acceptability among the included anti-inflammatory agents.
CONCLUSION
In summary, our meta-analysis demonstrates that anti-inflammatory agents have significant antidepressant effects and are well-accepted. Furthermore, adjunctive therapy with anti-inflammatory agents proved effective in treating MDD. Among the evaluated anti-inflammatory agents, NSAIDs exhibited the highest acceptability, although its efficacy is comparable to placebo.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=422004), identifier CRD42023422004.
PubMed: 38863604
DOI: 10.3389/fpsyt.2024.1407529 -
BMC Public Health Jun 2024To solve the problem of workplace bullying among nurses, it is necessary to review the effects of interventions and generalize the findings. We conducted a systematic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To solve the problem of workplace bullying among nurses, it is necessary to review the effects of interventions and generalize the findings. We conducted a systematic literature review and meta-analysis to evaluate the effects of cognitive rehearsal programs on workplace bullying among hospital nurses.
METHODS
Data were collected from March 30 to April 11, 2021, and 11,048 journal articles published in South Korea and internationally were examined across eight databases. Nine articles were selected for inclusion in the systematic literature review; five of the nine studies were included in the meta-analysis. For randomized controlled trials, the risk of bias was evaluated, and for non-randomized controlled trials, the study quality was evaluated using the Risk of Bias for Non-randomized Studies version 2.0. Egger's regression test was performed to determine publication bias.
RESULTS
Of the nine articles selected for this study, two were randomized controlled trials and seven were non-randomized controlled trials. The I value was 18.9%, indicating non-significant heterogeneity. The overall effect size of the cognitive rehearsal programs was -0.40 (95% confidence interval: -0.604 to -0.196; Z = -3.85; p = .0001) in a random-effects model, indicating a large effect size with statistical significance.
CONCLUSIONS
Therefore, cognitive rehearsal programs that address workplace bullying among hospital nurses are effective. Health policymakers must implement cognitive rehearsal programs in a policy manner to address the problems of bullying in the workplace.
Topics: Humans; Bullying; Nursing Staff, Hospital; Workplace; Program Evaluation; Republic of Korea; Cognitive Behavioral Therapy; Randomized Controlled Trials as Topic
PubMed: 38862940
DOI: 10.1186/s12889-024-18969-x -
PloS One 2024Intradialytic hypertension (IDHTN) is a common but less frequently recognised complication of haemodialysis. However, it is associated with increased overall mortality... (Meta-Analysis)
Meta-Analysis
The prevalence and risk of mortality associated with intradialytic hypertension among patients with end-stage kidney disease on haemodialysis: A systematic review and meta-analysis.
INTRODUCTION
Intradialytic hypertension (IDHTN) is a common but less frequently recognised complication of haemodialysis. However, it is associated with increased overall mortality in patients on haemodialysis. This systematic review and meta-analysis aimed to determine the prevalence of IDHTN and associated mortality risk in the global haemodialysis population.
METHOD
A systematic search of PubMed and EMBASE was undertaken to identify articles with relevant data published between 1990 and 2023. The pooled prevalence of IDHTN in the global haemodialysis population was determined using the DerSimonian-Laird random-effects meta-analysis. The pooled hazards ratio for mortality in patients with IDHTN was also computed from the studies that reported mortality among haemodialysis patients with IDHTN. The study protocol was registered with PROSPERO (CRD42023388278).
RESULTS
Thirty-two articles from 17 countries were included, with a pooled population of 127,080 hemodialysis patients (median age 55.1 years, 38.2% females). Most studies had medium methodological quality (53.1%, n = 17). The overall pooled prevalence of IDHTN was 26.6% [(95% CI 20.2-33.4%), n = 27 studies, I2 = 99.3%, p<0.001 for heterogeneity], with significant differences depending on the definition used. The pooled proportion of haemodialysis sessions with IDHTN was 19.9% [(95% 12.5-28.6%, n = 8 studies, I2 = 99.3%, p<0.001 for heterogeneity)] with significant differences across the different definition criteria. The p-value for the Begg test was 0.85. The median pre-dialysis blood pressure was not significantly associated with IDHTN. The pooled hazard ratio for mortality was 1.37 (95% CI 1.09-1.65), n = 5 studies, I2 = 13.7%, and p-value for heterogeneity = 0.33.
CONCLUSION
The prevalence of IDHTN is high and varies widely according to the definition used. A consensus definition of IDHTN is needed to promote uniformity in research and management. The increased mortality risk forecasted by IDHTN highlights the need for optimal blood pressure control in patients on hemodialysis.
Topics: Humans; Renal Dialysis; Kidney Failure, Chronic; Prevalence; Hypertension; Female; Risk Factors; Male; Middle Aged
PubMed: 38861528
DOI: 10.1371/journal.pone.0304633