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Korean Journal of Anesthesiology Apr 2018Systematic reviews and meta-analyses present results by combining and analyzing data from different studies conducted on similar research topics. In recent years,...
Systematic reviews and meta-analyses present results by combining and analyzing data from different studies conducted on similar research topics. In recent years, systematic reviews and meta-analyses have been actively performed in various fields including anesthesiology. These research methods are powerful tools that can overcome the difficulties in performing large-scale randomized controlled trials. However, the inclusion of studies with any biases or improperly assessed quality of evidence in systematic reviews and meta-analyses could yield misleading results. Therefore, various guidelines have been suggested for conducting systematic reviews and meta-analyses to help standardize them and improve their quality. Nonetheless, accepting the conclusions of many studies without understanding the meta-analysis can be dangerous. Therefore, this article provides an easy introduction to clinicians on performing and understanding meta-analyses.
PubMed: 29619782
DOI: 10.4097/kjae.2018.71.2.103 -
Journal of Cognition Oct 2020There is an ongoing debate in the scientific community regarding whether a state of mental fatigue may have a negative effect upon a range of objective and subjective... (Review)
Review
There is an ongoing debate in the scientific community regarding whether a state of mental fatigue may have a negative effect upon a range of objective and subjective measures of human performance. This issue has attracted attention from several fields, including sport and exercise sciences. In fact, a considerable body of literature in the sport science field has suggested that performing a long and demanding cognitive task might lead to a state of mental fatigue, impairing subsequent exercise performance, although research in this field has shown contradictory results. Here, we performed a meta-analysis to investigate these inconsistent findings. The analysis yielded small-to-medium effects of mental fatigue on exercise performance, = 0.50, and RPE, = 0.21. However, a three-parameter selection model also revealed evidence of publication or reporting biases, suggesting that the bias-corrected estimates might be substantially lower (0.08 and 0.10, respectively) and non-significant. In sum, current evidence does not provide conclusive support for the claim that mental fatigue has a negative influence on exercise performance.
PubMed: 33103052
DOI: 10.5334/joc.126 -
Diagnostics (Basel, Switzerland) Aug 2022We aimed to evaluate and compare the diagnostic performances of ultrasonography (US) and magnetic resonance enterography (MRE) in assessing active bowel lesions in... (Review)
Review
Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn's Disease: A Systematic Review and Meta-Analysis.
UNLABELLED
We aimed to evaluate and compare the diagnostic performances of ultrasonography (US) and magnetic resonance enterography (MRE) in assessing active bowel lesions in patients with Crohn's disease (CD).
MATERIALS AND METHODS
We searched PubMed and EMBASE for studies in which US and MRE were used to assess active bowel lesions in CD patients. Bivariate random effect meta-analytic methods were used to estimate pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves. We performed a meta-regression analysis to explore the source of study heterogeneity.
RESULTS
Eleven studies involving 752 patients were included. US exhibited a pooled sensitivity of 86% (95% confidence interval (CI) 72-94), pooled specificity of 88% (95% CI 78-94), and HSROC of 0.93 in 10 studies. MRE exhibited a pooled sensitivity of 88% (95% CI 76-95), pooled specificity of 87% (95% CI 73-95), and an HSROC of 0.94 in eight studies. In seven studies comparing the diagnostic performances of US and MRE, the summary sensitivity of US and MRE were 86% (95% CI 65-96, I = 92.1) and 86% (95% CI 72-93, I = 88.1) ( = 0.841), respectively. The summary specificity of US and MRE were 87% (95% CI 78-93, I = 79.8%) and 84% (72-90, I = 72.5%) ( = 0.431), respectively, which showed no statistical differences. On meta-regression analysis, studies from Europe ( = 0.002), those that used linear US probes ( = 0.012), those on small bowel lesions ( = 0.01), and those with outcomes as combined features (active inflammation) reported higher US sensitivity than those from other regions, those that used both linear and convex US probes, those on small and large bowels, and those with outcome as one feature (bowel wall thickening or ulcer). Studies with pediatric patients ( = 0.001), those with reference standards including US ( = 0.001), and outcomes as combined features ( = 0.01) reported higher MRE specificity than those with adult populations, reference standards other than the US, and outcomes as one feature.
CONCLUSIONS
In spite of considerable heterogeneity in the included studies, both US and MRE can diagnose active bowel lesions with comparable diagnostic accuracy in patients with CD. The study region, type of US probe, lesion location, investigated outcome for US sensitivity and study population, reference standards, and investigated outcomes for MRE specificity were potential sources of heterogeneity.
PubMed: 36010359
DOI: 10.3390/diagnostics12082008 -
AJNR. American Journal of Neuroradiology Jan 2017Ultrasound has become widely accepted as the first imaging technique used for the assessment of cervical lymph node metastasis in patients with papillary thyroid cancer.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
Ultrasound has become widely accepted as the first imaging technique used for the assessment of cervical lymph node metastasis in patients with papillary thyroid cancer. In this systematic review and meta-analysis, we evaluate the performance of CT for the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer compared with ultrasound.
MATERIALS AND METHODS
Ovid-MEDLINE and EMBASE data bases were searched for studies regarding the use of CT to diagnose cervical lymph node metastasis. The diagnostic performance of CT, ultrasound, and combined CT/ultrasound was assessed by using level-by-level and patient-based analyses. We also performed meta-analyses on the basis of the central and lateral neck levels.
RESULTS
Nine eligible studies, including a total sample size of 1691 patients, were included. CT showed a summary sensitivity of 62% (95% CI, 52%-70%) and specificity of 87% (95% CI, 80%-92%) for diagnosing cervical lymph node metastasis when using level-by-level analysis. There was a positive correlation between the sensitivity and the false-positive rate (correlation coefficient, 0.807) because of the threshold effect. The summary sensitivity of combined CT/ultrasound (69%; 95% CI, 61%-77%) was significantly higher than ultrasound (51%; 95% CI, 42%-60%), though the summary specificity did not differ.
CONCLUSIONS
The diagnostic performances of CT and ultrasound are similar, though CT and ultrasound combined are superior to ultrasound only. CT may be used as a complementary diagnostic method in addition to ultrasound for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer.
Topics: Adult; Carcinoma, Papillary; Female; Humans; Lymphatic Metastasis; Sensitivity and Specificity; Thyroid Cancer, Papillary; Thyroid Neoplasms; Tomography, X-Ray Computed
PubMed: 27789450
DOI: 10.3174/ajnr.A4967 -
International Journal of Nursing... Dec 2022Nurse-surgeons have been performing surgeries for decades. Yet, their impact on perioperative clinical outcomes has not been explored in detail. (Review)
Review
BACKGROUND
Nurse-surgeons have been performing surgeries for decades. Yet, their impact on perioperative clinical outcomes has not been explored in detail.
OBJECTIVE
To investigate the impact of nurse-surgeons on patient-centred outcomes.
DESIGN
Systematic review.
METHOD
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram and checklist for systematic reviews were used as the screening and reporting guideline. CINAHL, Cochrane Library, MEDLINE, and PubMed databases were searched for articles that fit the review's eligibility criteria. A combination of Medical Subject Headings, keywords and filters for each database were used. Following screening and full text review, the Mixed Methods Appraisal Tool was used for quality assessment and the Grading of Recommendations, Assessment, Development and Evaluations framework for certainty and confidence assessment. Narrative synthesis was used to report the findings due to the design heterogeneity of the included studies.
RESULTS
Forty-eight ( = 48) patient-centred outcomes were identified from 25 included studies. These outcomes were grouped into four categories: patient satisfaction and experience; waiting list; perioperative complications; and quality of surgical care. Patient satisfaction and experience was rated high to very high in 16 studies; none reported patient dissatisfaction. Waiting lists improved in eight studies. Perioperative complications were none to very low in nine studies. Mortality rates in the nurse-surgeon group were better than the physician group in three studies. The quality of care in the performance of surgeries by nurse-surgeons was either similar or better than physicians in ten studies.
CONCLUSIONS
Nurse-surgeons performed safe, satisfactory, and high-quality surgeries with minimal perioperative complications similar to physicians. The use of nurse-surgeons has significantly reduced waiting lists regardless of surgical speciality. Policies around nurse-surgeon practice needs to be developed at national and international levels to streamline the delivery of much needed surgical services amidst the coronavirus pandemic in the areas of cancer diagnostic surgeries, emergency surgeries, minor surgeries, and remote and rural health.
PubMed: 38745634
DOI: 10.1016/j.ijnsa.2022.100086 -
Acta Psychologica May 2022Cognitive resources contribute to balance control. There is evidence that mental fatigue reduces cognitive resources and impairs balance performance, particularly in... (Meta-Analysis)
Meta-Analysis
Cognitive resources contribute to balance control. There is evidence that mental fatigue reduces cognitive resources and impairs balance performance, particularly in older adults and when balance tasks are complex, for example when trying to walk or stand while concurrently performing a secondary cognitive task. We conducted a systematic literature search in PubMed (MEDLINE), Web of Science and Google Scholar to identify eligible studies and performed a random effects meta-analysis to quantify the effects of experimentally induced mental fatigue on balance performance in healthy adults. Subgroup analyses were computed for age (healthy young vs. healthy older adults) and balance task complexity (balance tasks with high complexity vs. balance tasks with low complexity) to examine the moderating effects of these factors on fatigue-mediated balance performance. We identified 7 eligible studies with 9 study groups and 206 participants. Analysis revealed that performing a prolonged cognitive task had a small but significant effect (SMDwm = -0.38) on subsequent balance performance in healthy young and older adults. However, age- and task-related differences in balance responses to fatigue could not be confirmed statistically. Overall, aggregation of the available literature indicates that mental fatigue generally reduces balance in healthy adults. However, interactions between cognitive resource reduction, aging and balance task complexity remain elusive.
Topics: Aged; Aging; Cognition; Health Status; Humans; Mental Fatigue; Postural Balance
PubMed: 35245722
DOI: 10.1016/j.actpsy.2022.103540 -
F1000Research 2023A systematic literature review was conducted to summarize the overall thermal performance of different gasified cooking stoves from the available literature. For this...
A systematic literature review was conducted to summarize the overall thermal performance of different gasified cooking stoves from the available literature. For this purpose, available studies from the last 14 years (2008 to 2022) were searched using different search strings. After screening, a total of 28 articles were selected for this literature review. Scopus, Google Scholar, and Web of Science databases were used as search strings by applying "Gasifier cooking stove" AND "producer gas cooking stove" AND "thermal performance" keywords. This review uncovers different gasified cooking stoves, cooking fuels, and fabrication materials besides overall thermal performances. The result shows that the overall thermal performance of different gasified cooking stoves was 5.88% to 91% depending on the design and burning fuels. The premixed producer gas burner with a swirl vane stove provided the highest overall thermal performance range, which was 84% to 91%, and the updraft gasified stove provided the lowest performance, which was 5.88% to 8.79%. The result also demonstrates that the wood pellets cooking fuel provided the highest thermal performance and corn straw briquette fuel provided the lowest for gasified cooking stoves. The overall thermal performance of wood pellets was 38.5% and corn straw briquette was 10.86%.
Topics: Air Pollution, Indoor; Cooking; Household Articles; Particulate Matter
PubMed: 37484517
DOI: 10.12688/f1000research.126890.2 -
Journal of Psychiatry & Neuroscience :... Nov 2013Endophenotypes in genetic psychiatry may increase our understanding of the molecular mechanisms underlying disease risk and its manifestations. We sought to investigate... (Review)
Review
BACKGROUND
Endophenotypes in genetic psychiatry may increase our understanding of the molecular mechanisms underlying disease risk and its manifestations. We sought to investigate the link between neuropsychological impairments and brain structural abnormalities associated with the COMT Val(158)Met polymorphism in patients with schizophrenia to improve understanding of the pathophysiology of this disorder.
METHODS
We performed a systematic review using studies identified in PubMed and MEDLINE (from the date of the first available article to July 2012). Our review examined evidence of an association between the COMT Val(158)Met polymorphism and both neuropsychological performance and brain structure in patients with psychosis, in their relatives and in healthy individuals (step 1). The review also explored whether the neuropsychological tasks and brain structures identified in step 1 met the criteria for an endophenotype (step 2). Then we evaluated evidence that the neuropsychological endophenotypes identified in step 2 are associated with the brain structure endophenotypes identified in that step (step 3). Finally, we propose a neurobiological interpretation for this evidence.
RESULTS
A poorer performance on the n-back task and the Continuous Performance Test (CPT) and smaller temporal and frontal brain areas were associated with the COMT Val allele in patients with schizophrenia and their relatives and met most of the criteria for an endophenotype. It is possible that the COMT Val(158)Met polymorphism therefore contributes to the development of these neuropsychological and brain structural endophenotypes of schizophrenia, in which the prefrontal cortex may represent the neural substrate underlying both n-back and CPT performances.
LIMITATIONS
The association between a single genetic variant and an endophenotype does not necessarily imply a causal relationship between them.
CONCLUSION
This evidence and the proposed interpretation contribute to explain, at least in part, the biological substrate of 4 important endophenotypes that characterize schizophrenia.
Topics: Atrophy; Brain; Catechol O-Methyltransferase; Endophenotypes; Frontal Lobe; Genetic Predisposition to Disease; Humans; Neuropsychological Tests; Polymorphism, Single Nucleotide; Psychomotor Performance; Schizophrenia; Schizophrenic Psychology; Temporal Lobe
PubMed: 23527885
DOI: 10.1503/jpn.120178 -
European Journal of Sport Science May 2023The aim of this systematic review with meta-analysis was to determine the effect of caffeine gum (Caff-gum) on exercise performance-related outcomes. Several databases... (Meta-Analysis)
Meta-Analysis
The aim of this systematic review with meta-analysis was to determine the effect of caffeine gum (Caff-gum) on exercise performance-related outcomes. Several databases were searched for studies assessing the effect of Caff-gum in placebo-controlled protocols involving healthy adults. Random-effects meta-analyses using standardized mean differences (SMD) were performed to determine the effect of Caff-gum on exercise outcomes with several sub-analyses (training status, exercise type, timing and dose) for potential modifying factors. 14 studies were included, totalling 200 participants. There was a significant overall effect of Caff-gum compared to placebo (SMD = 0.21, 95%CI: 0.10-0.32; = 0.001). Subgroup analysis showed improved performance for trained (SMD = 0.23, 95%CI: 0.08-0.37; = 0.004), but not for untrained (SMD = 0.14, 95%CI: -0.02-0.29; = 0.07) individuals. Caff-gum improved both endurance (SMD = 0.27, 95%CI: 0.12-0.42; = 0.002) and strength/power (SMD = 0.20, 95%CI: 0.03-0.37; = 0.03) performance outcomes. Caff-gum was ergogenic when consumed within 15 min prior to initiating exercise (SMD = 0.27, 95%CI: 0.07-0.4; = 0.01), but not when provided >15 min prior (SMD = -0.48, 95%CI = -1.7-0.82; = 0.25). There was no significant effect of Caff-gum with doses <3 mg/kg body mass (BM) (SMD = 0.20, 95%CI: -0.03-0.43; = 0.07), but there was a significant effect when the dose was ≥3 mg/kg BM (SMD = 0.22, 95%CI: 0.07-0.37; = 0.01). Caff-gum supplementation may be an effective ergogenic strategy for trained athletes involved in both endurance and strength/power exercise, using a recommended dose of ≥3 mg/kg BM consumed within 15 min of initiating exercise.This study determined the effect of Caff-gum on exercise performance, using a systematic review and meta-analysis. Fourteen studies, totalling 200 participants performing a variety of endurance and strength/power exercise tests were included. The relative Caff-gum dose ranged from 1.27-4.26 mg/kg BM and timing ranged from 120 min prior to exercise up to intra-test application.Caff-gum was shown to be an effective ergogenic aid for trained individuals involved in both endurance and strength/power exercise.Supplement dose and timing modified the efficacy of Caff-gum. Supplementation with Caff-gum was effective when provided in doses ≥3 mg/kg BM and within 15 min prior to initiating exercise.Trained endurance or strength/power athletes seeking to benefit from caffeine in the form of chewing gum should supplement within 15 min prior to initiating an exercise task, in doses ≥3 mg/kg BM.
Topics: Adult; Humans; Caffeine; Chewing Gum; Exercise; Exercise Test; Performance-Enhancing Substances; Dietary Supplements
PubMed: 35239468
DOI: 10.1080/17461391.2022.2049885 -
Cell and Tissue Banking Dec 2016For successful transplantation, allografts should be free of microorganisms that may cause harm to the allograft recipient. Before or during recovery and subsequent... (Review)
Review
For successful transplantation, allografts should be free of microorganisms that may cause harm to the allograft recipient. Before or during recovery and subsequent processing, tissues can become contaminated. Effective tissue recovery methods, such as minimizing recovery times (<24 h after death) and the number of experienced personnel performing recovery, are examples of factors that can affect the rate of tissue contamination at recovery. Additional factors, such as minimizing the time after asystole to recovery and the total time it takes to perform recovery, the type of recovery site, the efficacy of the skin prep performed immediately prior to recovery of tissue, and certain technical recovery procedures may also result in control of the rate of contamination. Due to the heterogeneity of reported recovery practices and experiences, it cannot be concluded if the use of other barriers and/or hygienic precautions to avoid contamination have had an effect on bioburden detected after tissue recovery. Qualified studies are lacking which indicates a need exists for evidence-based data to support methods that reduce or control bioburden.
Topics: Allografts; Cell Culture Techniques; Decontamination; Humans; Specimen Handling; Sterilization; Tissue Banks; Transplantation, Homologous
PubMed: 27761677
DOI: 10.1007/s10561-016-9590-5