Begg's Test Research Articles

Does orthodontic treatment using fixed appliances cause initial caries lesions?

Systematic review and meta-analysis of randomized clinical trials (RCTs), non-randomized studies of intervention (NRSIs), cohort and cross-sectional studies. The systematic review was registered in advance on PROSPERO, and was conducted following the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA checklist. An electronic search in three databases (PubMed, Scopus, and Embase) was conducted by two authors to evaluate studies published from 1990 until May 2023. The review question was defined in PICOS format as follows: Population (P), subjects with permanent dentition who having/had orthodontic therapy; Exposure (E), orthodontic therapy with fixed orthodontic appliance; Comparison/Control (C), no orthodontic treatment or intervention; Outcome (O), assessing incidence and/or prevalence of initial caries lesions (ICLs) at subject and teeth levels was the primary outcome, whereas evaluating the influence of demographics and treatment-related variables were secondary outcomes; studies (S), randomized clinical trials, non-randomized clinical studies, cohort and cross-sectional studies. Meta-analysis was conducted of three or more included studies had comparable findings. The following factors were calculated for each study; sample size, number of patients with ICLs, number of teeth with ICLs, number of teeth affected per patient, and number of surfaces affected. Statistical heterogeneity of effects among studies was assessed by means of the Cochran's test was used to evaluate the statistical heterogeneity of effects in the included studies. Funnel plot approach was used to assess publication bias, whereas Begg's and Egger's correlation test were used to identify asymmetry. Meta-analysis was conducted using a random effects model owing to high methodological and clinical heterogeneity. A descriptive analysis was presented when the meta-analyses appeared inappropriate. Statistical significance level was set at p < 0.05 for all statistical analyses. 21 studies were included in the qualitative synthesis (systematic review); 11 RCTs; 7 NRSIs, and 3 observation studies. Of the included studies, 19 studies were analyzed in the quantitative synthesis (meta-analysis). In regard to the prevalence rate of ICLs; 57% of patients had ICLs, with a mean of 2.24 lesions per patient and 22% of surfaces were affected. In regard to the incidence rate; 48% of patients developed new ICLs, with a mean of 2.29 new lesions per patient, and 15% of surfaces became affected. Both prevalence and incidence rates were positively associated with the duration of the orthodontic therapy (P = 0.01 and P < 0.01, respectively), illustrating an elevation in the ICLs numbers as the treatment duration (number of months) increases. There was no association between patients' age and ICLs numbers. Orthodontic therapy using fixed appliances can increase the risk of accumulating plaque and developing caries lesion. However, other risk factors may play a role in developing ICLs; thus, controlling for these factors is paramount to better evaluate the true influence of orthodontic therapy on the ICLs development. Implementing caries preventive measures during orthodontic treatment may be needed to minimize the potential risks.

Efficacy of intermittent pneumatic compression on breast cancer-related upper limb lymphedema: a systematic review and meta-analysis in clinical studies.

Complete decongestive therapy (CDT) and intermittent pneumatic compression (IPC) are the most common combination of treatments in breast cancer-related upper limb lymphedema. The effects of IPC as an addition to CDT are inconsistent in different studies. This meta-analysis aimed to explore whether IPC could bring additional benefits to CDT. Literatures were retrieved from databases with full-text publications ranging from January 1995 to March 2024. Fixed-effect models were applied to subsequent analysis if no heterogeneity was detected by using the Inverse formula. Publication bias was assessed using the Begg's test and Eagger's test. Twelve studies were finally included for further analysis. Results showed that additional application of IPC to CDT could further improve lymphedema within 4 weeks after the treatment period [standard mean difference (SMD) =-0.2 mL, 95% confidence interval (CI): -0.33 to -0.07 mL]. However, this additional benefit was weakened within about 9.4±2.6 weeks' follow-up duration after ceasing physical therapy (SMD =-0.15 mL, 95% CI: -0.33 to 0.04 mL). Periodically continuous treatment should be suggested to maintain the effect of CDT + IPC to promote lymph drainage and lymphedema improvement. Nonetheless, the treatment involved in the studies ranged from 4 to 12 weeks, therefore potential bias might exist.

Effect of SARS-CoV-2 on semen parameters: A meta-analysis of 39 articles from 15 countries.

Declining birth rates during the pandemic have led to concerns about the potential impact of the of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on fertility among men. As previous studies have had inconsistent conclusions, we conducted a meta-analysis to evaluate the effects of SARS-CoV-2 on semen parameters. We searched several databases for articles published between 1 January 2020 and 25 July 2023. We performed a robust screening process based on predetermined inclusion and exclusion criteria and, following quality assessment, extracted data from high-quality studies for the meta-analysis. We determined the P-values and 95% confidence intervals (CIs) for both continuous and dichotomous variables, which we described using mean differences (MDs) and odds ratios (ORs), respectively. Lastly, we used the leave-one-out approach for our sensitivity analysis, and Begg's and Egger's tests to determine publication bias. We included 39 articles with 1887 cases and 2097 controls. In patients infected with SARS-CoV-2, the sperm volume (MD = -0.29; 95% CI = -0.50, -0.07; P = 0.008) and concentration (MD = -8.71; 95% CI = -16.94, -0.48; P = 0.04) were decreased, which increased oligospermia risk (OR = 2.49; 95% CI = 1.04, 5.99; P = 0.04). Furthermore, we observed reduced sperm motility (MD = -8.18; 95% CI = -12.19, -4.17; P < 0.001) and increased immotility (MD = 4.06; 95% CI = 1.57, 6.54; P = 0.001) in infected patients, which increased asthenospermia risk (OR = 3.86; 95%CI = 1.83, 8.14; P = 0.0004). We also saw a decreased proportion of semen with normal sperm morphology (MD = -1.67; 95% CI = -2.68, -0.66; P = 0.001) and an increased proportion of semen with abnormal sperm morphology (MD = -1.31; 95% CI = -2.14, -0.49; P = 0.002,), along with increases in teratospermia (OR = 1.98; 95% CI = 1.00, 3.92; P = 0.05) in infected compared non-infected patients. Although we found consistency within most subgroups, we observed differences in severity, follow-up time, and country of origin. The results of the main meta-analysis results remained stable in the sensitivity analysis, while Begg's and Egger's tests showed no publication bias. Based on sufficient evidence, we see that the effects of SARS-CoV-2 on semen parameters resulted in a decline in male fertility. The increased severity and shorter duration of the SARS-CoV-2 infection increased the likelihood of altering of semen parameters. INPLASY: INPLASY202420083.

Prognostic significance of CRLF2 in patients with acute lymphoblastic leukemia: a meta-analysis and systematic review.

The association between cytokine receptor-like factor 2 (CRLF2) and clinical outcomes in acute lymphoblastic leukemia (ALL) has been a topic of ongoing debate, with divergent findings. This article intended to investigate the influence of CRLF2 alterations on ALL prognosis. Following the PRISMA 2020 guidelines, this meta-analysis was conducted. Hazard ratio (HR) values and confidence intervals (CIs) were the primary statistical measures used. Data heterogeneity was judged using the chi-square test and I2 statistic. Publication bias was appraised with funnel plots, Begg's test, and Egger's test. 16 studies with 6771 patients were finally screened out. CRLF2 over-expression (CRLF2 OE) was associated with poorer event-free survival (EFS) (HR = 1.70, 95% CI = 1.18-2.44, P = 0.004) and relapse-free survival (RFS) (HR = 1.70, 95% CI = 1.28-2.24, P = 0.000) in pediatric ALL. Patients with CRLF2-deregulation (CRLF2-d), also known as CRLF2 rearrangement, exhibited shorter overall survival (OS) (HR = 2.22, 95% CI = 1.49-3.32, P = 0.000), EFS (HR = 1.93, 95% CI = 1.43-2.60, P = 0.000), and RFS (HR = 2.2, 95% CI = 1.53-3.18, P = 0.000) compared to those without CRLF2-d. Subgroup analysis of multivariate HRs and corresponding CIs indicated that childhood with CRLF2 OE had a shorter RFS (HR = 1.70, 95% CI = 1.28-2.24, P = 0.006), and CRLF2-d was identified as an independent prognostic biomarker for OS (HR = 2.22, 95% CI = 1.49-3.32, P = 0.000), EFS (HR = 1.95, 95% CI = 1.44-2.64, P = 0.000), and RFS (HR = 2.2, 95% CI = 1.53-3.18, P = 0.000) in pediatric ALL patients. Both CRLF2 OE and CRLF2-d are associated with poor prognosis in ALL patients.

Patterns of single and multiple HPV infections in female: A systematic review and meta-analysis

BackgroundData on the patterns of single and multiple HPV infections are largely limited to small size studies, and the regional difference have not been systematically examined. MethodsA literature search was conducted using PubMed, Embase, and Web of Science databases up to Sept 22, 2023. The pooled prevalence of HPV infection were calculated using random-effects meta-analysis. Subgroup analysis was used to explore the heterogeneity, and publication bias was evaluated by Egger's test and Begg's test. ResultsThere were 121 studies included with 1,682,422 participants. Globally, the most common genotypes of single HPV infection were HPV16 (7.05 %), 18 (1.94 %), 52 (1.93 %), 58 (1.68 %), and 31 (1.53 %), as well as HPV 16 (4.91 %), 31 (2.68 %), 52 (2.20 %), 51 (1.99 %), and 18 (1.96 %) in multiple HPV infections. Apart from HPV16 and 18, HPV52 and 58 were common in Asia, HPV31 and 51 was in Europe, North and South America, and HPV35 and 45 were in Africa. The prevalence of HPV infection among different age groups (<30, 30–50, >50 years age groups) was 20.93 %, 16.27 %, and 18.69 %, respectively. The single HPV infection prevalence in the No-ILs, LSILs, HSILs, and cervical cancer groups were 16.17 %, 51.60 %, 57.12 %, and 62.88 %, respectively, as well as in multiple infections were 5.09 %, 30.93 %, 32.86 %, and 21.26 % ConclusionDeveloping local HPV vaccines is necessary based on the HPV infection pattern. It is essential to educate young women to get vaccinated and encourage elderly women to have regular cervical cancer screenings to reduce the danger of cervical cancer.

The urinary and sexual outcomes of buccal mucosal graft urethroplasty versus end-to-end anastomosis: a systematic review with meta-analysis.

The urinary and sexual outcomes after urethroplasty may be a concern for patients, but there are still some controversies regarding the consequences of buccal mucosal graft urethroplasty (BMG) in terms of erectile dysfunction (ED). This meta-analysis aimed to compare urinary and sexual outcomes of BMG and end-to-end urethroplasty (EE). The PubMed, Web of Science, Cochrane, and Embase databases were searched until February 31, 2023. Data extraction and quality assessment were performed by 2 designated researchers. Dichotomous data were analyzed as odds ratios with 95% confidence intervals (CIs). Heterogeneity across studies was assessed by the I2 quantification, and publication bias using Begg's and Egger's tests. Meta-analysis was performed using RevMan software. Outcomes included stricture recurrence, ED, penile complications, and voiding symptoms. Eighteen studies, including 1648 participants, were included in our meta-analysis. The meta-analysis revealed that there was no significant difference in stricture recurrence (OR = 0.74; 95% CI, 0.48-1.13; P = .17) and voiding symptoms (OR = 1.12; 95% CI, 0.32-3.88; P = .86) between the BMG group and the EE group. BMG was associated with lower risk of penile complications (OR = 0.40; 95% CI, 0.24-0.69; P = .001) and ED (OR = 0.53, 95% CI, 0.32-0.90, P = .02). The study may help clinicians choose procedures that achieve better recovery of the urological and sexual function in the treatment of urethral stricture. This meta-analysis is the first to evaluate the urinary and sexual outcomes of BMG vs EE. A limitation is that most of the included studies were retrospective cohort studies. BMG is as effective as EE in the treatment of bulbar urethral stricture, but BMG has fewer complications and ED than EE.

The association between road traffic accidents and visual functions: A systematic review and meta-analysis.

Poor visual functions have been reported to be related to the occurrence of road traffic accidents. To review the association between visual function and road traffic accidents (RTAs) from published relevant empirical studies. Worldwide. A random effects (RE) model meta-analysis was conducted using STATA 18. Statistical tests conducted include meta-summary statistics, RE meta-analysis (forest plot), meta-regression (relationship between mean age and effect sizes), funnel plots, Egger's and Begg's tests for publication bias and small study effects. A total of 17 relevant studies, which were either cross-sectional or observational by design, were included in the meta-analysis. Reported effect sizes were within computed confidence intervals (CI) at 95%. The computedQtest of homogeneity was 61.94. The overall mean effect size of 1.43 (95% CI of 0.985-1.883) was statistically significant at a 5% level (Z= 6.26;p 0.001). TheI-squared = 62.17% (p= 0.00) confirmed moderate heterogeneity and theQ-value of 61.94 (p= 0.00) rejected the null hypothesis that the effect size was the same in all the studies. The funnel plot showed that the remaining majority of 13 studies were within the funnel plot on the right-hand side of the line of no effect. These results provide evidence of associations between visual functions and RTAs, and highlight the need for targeted interventions and further research to address the challenges associated with impaired visual functions and road safety.Contributions:The study contributes to the understanding of the implications of visual functions for road safety.

Effect of astragalus injection on left ventricular remodeling in HFmrEF: a systematic review and meta-analysis.

The aim of this meta-analysis is to evaluate the effect of astragalus injection (AI) on left ventricular remodeling (LVR) in patients with heart failure with mildly reduced ejection fraction (HFmrEF). The randomized controlled trials (RCTs) of AI in treating HFmrEF were retrieved from 8 major English and Chinese electronic databases, up until November 30, 2023. To evaluate the methodological quality of the included studies, the Cochrane bias risk tool and the Modified Jadad Scale were employed. Stata 17.0 software was utilized for statistical analysis, sensitivity analysis, and assessment of publication bias. Ten RCTs with 995 patients (562 males and 433 females) were identified. Meta-analysis indicated that compared to conventional treatment (CT), AI significantly improved LVR, specifically increasing left ventricular ejection fraction (LVEF, MD = 4.56, 95% CI: 3.68-5.44, p < 0.00001), decreasing left ventricular end-diastolic volume (LVEDV, MD = -7.89, 95% CI: -11.13 to -4.64, p < 0.00001), left ventricular end-diastolic diameter (LVEDD, MD = -4.18, 95% CI: -5.79 to -2.56, p < 0.00001), left ventricular end-systolic volume (LVESV, MD = -8.11, 95% CI: -11.79 to -4.43, p < 0.00001), and left ventricular end-systolic diameter (LVESD, MD = -3.42, 95% CI: -4.90 to -1.93, p < 0.00001). AI also improved clinical efficacy (RR = 4.62, 95% CI: 3.11-6.88, p < 0.00001), reduced N-terminal pro-brain natriuretic peptide (NT-pro BNP, MD = -27.94, 95% CI: -43.3 to -12.36) level, without increasing the incidence of adverse reactions (RR = 1.60, 95% CI: 0.59-4.29, p = 0.35). Sensitivity analysis confirmed the reliability of the merged results, and Begg's and Egger's tests showed no significant publication bias. The systematic review and meta-analysis revealed that combining AI with CT improves LVR without increasing adverse events in HFmrEF patients. However, caution is needed in interpreting the results due to limited evidence. Future high-quality RCTs are needed to support these conclusions. https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42022347248].

Associations between dietary antioxidant vitamins and risk of glioma: an updated systematic review and meta-analysis of observational studies.

Epidemiological studies investigating the potential associations between antioxidant vitamins intake and risk of glioma have yielded inconsistent results. To address this, we carried out a systematic review and updated meta-analysis to explore the relationship between dietary antioxidant vitamins intake and risk of glioma. We comprehensively searched electronic databases including PubMed, Web of Science, Embase, Scopus, China National Knowledge Infrastructure (CNKI) and Wan fang Data from their inception to March 2024. We employed fixed-effects or random-effects models to estimate the pooled relative risks (RRs) and 95% confidence intervals (CIs) for the associations between dietary antioxidant vitamins intake and risk of glioma. Publication bias was assessed through the visual inspection of the funnel plots and quantified by the Begg's and Egger's tests. Heterogeneity across studies was assessed using the Cochran's Q test and I-square (I2). Additionally, subgroup and sensitivity analyses were performed to explore potential sources of heterogeneity and evaluate the robustness of the results. Overall, a total of 15 articles involving 3,608 glioma cases and 771,930 participants were included in the final analysis. The pooled analyses revealed that the highest intake of vitamin C significantly reduced the risk of glioma (RR = 0.78; 95%CI: 0.63-0.96; P = 0.022), compared to the lowest intake. However, no significant associations were observed between vitamin A and vitamin E intake and the risk of glioma (P>0.05). Subgroup analyses revealed the inverse association between vitamin C intake and risk of glioma in the population-based case-control studies (RR = 0.82; 95%CI: 0.68-1.00, P = 0.049) and study quality <7(RR = 0.52, 95%CI: 0.29-0.92, P = 0.025). Our findings show that higher intake of vitamin C is strongly associated with a reduced risk of glioma, although a dose-response relationship was not evident. Future large-scale prospective studies are warranted to confirm these findings.

The Association between Statins Intake and Risk of Post Stroke Pneumonia: A Systematic Review and Meta-Analysis.

This research aimed to examine the relationship between the intake of statins and the risk of post-stroke pneumonia in a systematic review and meta-analysis study. An extensive search of published articles on March 21st, 2023, was done in several databases, like Web of Science (ISI), PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. The Newcastle Ottawa Scale (NOS) checklist was employed to evaluate the quality of observational studies. Statistical tests (Chi-square test and I2) and graphical techniques (Forest plot) were used to determine whether heterogeneity existed in the meta-analysis studies. Funnel plots and Begg and Egger's tests were used to assess the publication bias. Seven studies (5 cohort and 2 case-control studies) were retrieved to examine the association between statins and post-stroke pneumonia. The sample size of the studies compiled in the meta- analysis was obtained to be 68,966 participants. Meta-analysis demonstrated that the overall odds of post-stroke pneumonia in the statin group was equal to 0.87 (95% CI: 0.67 - 1.13; p-value 0.458). Subgroup analysis indicated that the odds of post-stroke pneumonia in the statin group was equal to 0.93 (95% CI: 0.73-1.18; p-value = 0.558) in the cohort studies, and equal to 0.92 (95% CI: 0.37-2.26; p-value = 0.857) in the case-control studies. The examination of the association between the intake of statins and post-stroke pneumonia showed no evidence of publication bias (Begg's test, p-value = 0.368; Eggers test, p-value = 0.282). In this study, no relationship has been observed between receiving statins and the risk of post-stroke pneumonia.

A Systematic Review and Meta-analysis of the Relationship between Statin Intake and Esophageal Cancer.

Esophageal cancer is a malignant tumor with a low survival rate. Statins, commonly prescribed for their lipid-lowering effects, have been suggested to possess potential chemopreventive properties against various cancers, including esophageal cancer. This systematic review studied the association between statin intake and esophageal cancer. To conduct this systematic review and meta-analysis, we reviewed studies published between 1980 and June 2023 in Web of Science (WOS), Embase, MEDLINE/PubMed, Scopus, and Cochrane Library databases according to the PRISMA guidelines. Data extraction, quality assessment, and statistical analyses were performed using predefined protocols. We used various statistical tests conducted by Stata statistical software. Statistical significance was considered significant at p < 0.05. Twenty-one studies were collected and analyzed. The meta-analysis demonstrated that the odds ratio (OR) of esophageal cancer in patients treated with statins was 0.65 (95% CI: 0.57-0.75, p < 0.001) compared to the non-receiving group. The ORs for case-control and cohort studies were 0.67 (95% CI:0.54-0.83, p < 0.001) and 0.62 (95% CI:0.55-0.71, p < 0.001), respectively. The investigation into the relationship between the statins intake and the incidence of esophageal cancer did not reveal any indication of publication bias according to both Begg's test (p = 0.966) and Egger's test (p = 0.113). The results revealed that the odds of esophageal cancer in patients treated with statins decreased by 35% compared to patients not treated with statins. However, further well-designed prospective studies are needed to validate these findings and understand the underlying mechanisms of statins in preventing esophageal cancer.

Effects of Electronic Serious Games on Older Adults With Alzheimer's Disease and Mild Cognitive Impairment: Systematic Review With Meta-Analysis of Randomized Controlled Trials.

Serious games (SGs) are nonpharmacological interventions that are widely applied among older adults. To date, no evidence has been published regarding the effect of digital SGs on cognitive ability, daily behavioral capacity, or depression in older adults with Alzheimer's disease (AD) and mild cognitive impairment (MCI). This study aimed to assess the effect of SGs on older adults with AD and MCI by summarizing and pooling the results of previous studies. This meta-analysis examined the effectiveness of digital SGs in improving cognitive ability, enhancing daily behavioral capacity, and alleviating depression in older adults with AD and MCI. We searched the following databases up to December 31, 2023, to identify relevant high-quality randomized controlled trials (RCTs): PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Stata 15.1 and Review Manager 5.3 were used to screen the 14 studies, extract data, code the data, and perform meta-analysis. Mean differences and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Eligibility criteria were developed in accordance with the Population, Intervention, Comparison, Outcomes, and Study Design framework: (1) population (older adults with AD and MCI), (2) intervention (digital SG intervention), (3) comparison (digital SG intervention vs routine health care), (4) outcomes (cognitive ability, daily behavioral capacity, and depression), and (5) study or research design (RCT). Sensitivity analysis was performed, and a funnel plot was constructed. From January 2017 to December 2023, we enrolled 714 individuals across 14 RCTs, with 374 (52.4%) in the severe game group using digital SGs and 340 (47.6%) in the control group using traditional methods. The results of our meta-analysis indicated that using digital SGs in older adults with AD and MCI is more effective than traditional training methods in several key areas. Specifically, digital SG therapy significantly increased cognitive ability, as found in the Mini-Mental State Examination (SMD 2.11, 95% CI 1.42-2.80; P<.001) and the Montreal Cognitive Assessment (SMD 2.75, 95% CI 1.98-3.51; P<.001), significantly increased daily behavioral capacity (SMD 0.53, 95% CI 0.06-0.99; P=.03), and significantly reduced depression (SMD -2.08, 95% CI -2.94 to -1.22; P<.001) in older adults with AD and MCI. No publication bias was detected based on the results of Begg and Egger tests. Digital SGs offer a viable and effective nonpharmacological approach for older adults with AD and MCI, yielding better results compared to traditional formats. However, caution is warranted in interpreting these findings due to limited RCTs, small sample sizes, and low-quality meta-analyzed evidence. PROSPERO International Prospective Register of Systematic Reviews: CRDCRD42023486090; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=486090.

The effects of ACSM-based exercise on breast cancer-related lymphoedema: a systematic review and meta-analysis.

Breast cancer-related lymphedema (BCRL) frequently occurs after axillary lymph node dissection and remains incurable even with lymphaticovenular anastomosis. Exercise interventions have emerged as a potential non-pharmacological management approach. However, standardized exercise recommendations tailored to BCRL patients are lacking. This study evaluated the impact of high and low compliance exercise interventions, aligned with ACSM recommendations, on quality of life (QOL), shoulder range of motion (ROM), and arm volume in BCRL patients. It further aimed to determine the optimal exercise dosage, assessed via the FITT (frequency, intensity, time, type) principle, that maximizes health benefits for BCRL patients. Adhering to the PRISMA guidelines for systematic reviews and meta-analyses, we conducted a comprehensive literature search in various databases, including PubMed, Embase, Cochrane Library, and Web of Science, encompassing the period from the inception of these databases to December 2023. We extracted data on exercise form, frequency, intensity, duration, repetitions, and sets from the identified studies. Subsequently, a meta-analysis and review were conducted. The exercise interventions were evaluated based on ACSM recommendations and categorized as either high or low compliance with ACSM standards. Fixed or random effects models were employed to compare outcomes across study subgroups with comparable results. Additionally, funnel plot analyses, sensitivity analyses, and Egger's and Begg's tests were conducted to evaluate the potential for bias. 15 studies encompassing 863 patients with BCRL were analyzed. Eleven studies exhibited high ACSM compliance, while four demonstrated low ACSM compliance. Regarding QOL, the overall standard mean difference (SMD) was 0.13 (95% CI: -1.07, 1.33). Specifically, the SMD for the high-adherence subgroup was 0.91 (95% CI: 0.33, 1.49; p = 0.002). For ROM, the overall SMD was 1.21 (95% CI: -0.19, 2.61). For arm volume, the overall SMD was -0.06 (95% CI: -0.22, 0.10). QOL results differed significantly in the high-adherence subgroup, whereas no significant effect on ROM or arm volume was observed. The study revealed significant QOL improvements in patients with high ACSM compliance, contrasted with those with low compliance. Conversely, no notable changes in ROM or arm volume were observed. Notably, the high adherence group tended to show better ROM during exercise and stable arm volume. Future research is needed to validate these findings.

Subclinical rejection and allograft survival in kidney transplantation: protocol for a systematic review and meta-analysis

IntroductionSubclinical rejection (SCR) refers to the presence of acute rejection without accompanying kidney allograft dysfunction. The impact of SCR on long-term graft survival remains a subject of ongoing debate.Methods and...

Association between UCP2 gene 3'UTR I/D and A55V polymorphisms and neural tube defects susceptibility: systematic review, meta-analysis, and trial sequential analysis.

Our study aimed to assess the association between UCP2 gene 3' untranslated region insertion/deletion (3'UTR I/D) and A55V (alanine/valine) polymorphisms and neural tube defects (NTDs) susceptibility. According to pre-determined inclusion and exclusion criteria, the article search was conducted to search articles published before October 2023. Two authors independently screened the included articles and extracted their basic characteristics. After quality evaluation, the meta-analysis and trial sequential analysis (TSA) were conducted using RevMan 5.4, Stata/MP 17, and TSA 0.9.5.10 Beta. Subgroup analysis was conducted based on country and case group composition. Sensitivity analysis was conducted using a one-by-one exclusion method. Begg's and Egger's tests were used to evaluate publication bias. A total of seven articles were included. Overall meta-analysis revealed significant heterogeneity among the included studies for 3'UTR I/D polymorphism of the UCP2 gene. Significant statistical data indicated that those with the DD genotype and D allele had higher chances of NTD compared to those with the II genotype and the I allele, respectively. The combined result of II vs. ID was not statistically significant. A55V variation showed no statistical significance in the risk of NTD, despite the absence of significant heterogeneity across the included studies. Most of the heterogeneity was resolved after subgrouping, and a higher risk of the ID genotype was found than the II genotype for Chinese people. Genotyping NTD patients or their mothers was not a factor affecting the heterogeneity. Sensitivity analysis and publication bias analysis suggested that positive findings supported our results. The UCP2 gene 3'UTR I/D polymorphism increased the likelihood of developing NTDs in the Chinese population, with the D allele being the risk factor, which contributed to the understanding of the genetic basis of NTDs. TSA indicated that more high-quality original studies were needed in the future for further validation.

Practices for preventing Hepatitis B infection among health science students in Ethiopia: Systematic review and meta-analysis.

Hepatitis B virus infection remains a significant public health concern globally, particularly among healthcare workers, including health science students who are at high risk due to their exposure to infected patients and contaminated medical equipment. In Ethiopia, where the burden of HBV infection is substantial, preventive practices among health science students are critical for minimizing transmission and ensuring a healthy workforce. However, there is a lack of comprehensive evidence regarding the effectiveness of these practices specifically among this population in Ethiopia. Therefore, this study aimed to provide a systematic review and meta-analysis of preventive measures for Hepatitis B infection among Health Science Students in Ethiopia. This study followed the guidelines outlined in the PRISMA checklist and focused on research conducted within Ethiopia. Seven relevant studies were identified through comprehensive searches across various databases including Google, Medline, PubMed, and Scholar. Data retrieval was systematically conducted using a checklist, and analysis was performed using STATA version 14. Heterogeneity was assessed using both the Cochrane Q test and the I2 statistic. Additionally, publication bias was evaluated using Egger's weighted regression, a funnel plot, and Begg's test. In this meta-analysis and systematic review, we identified a total of 515 research articles, of which seven studies met the eligibility criteria for analysis. The overall pooled magnitude of practices aimed at preventing Hepatitis B infection among Health Science Students in Ethiopia was 41.21% (95% CI: 30.81-51.62). Factors significantly associated with these practices included better understanding of Hepatitis B infection prevention (OR = 1.99, 95% CI: 1.20-3.29), age group 20-24 years (OR = 5.79, 95% CI: 2.43-13.78), needle stick injury exposure (OR = 3.43, 95% CI: 1.10-10.70), and students enrolled in medicine or public health officer departments (OR = 4.20, 95% CI: 2.65-6.65). Our analysis indicates that only 41.21% of Health Science students in Ethiopia adhere to Hepatitis B prevention practices. To improve these practices, it is essential to mandate vaccination, provide targeted training on infection prevention, and increase awareness of vaccine uptake. Tailored educational programs should equip students with practical strategies. Additionally, intelligent interventions must address factors influencing preventive practices. Collaboration between institutions and ongoing monitoring is crucial to ensuring success.

Postpartum depression during the COVID-19 pandemic: an umbrella review and meta-analyses.

The COVID-19 pandemic has significantly increased anxiety, stress, and depression, which could have harmful consequences for pregnant women. Therefore, this study aimed to investigate the prevalence of postpartum depression during COVID-19 using an umbrella review and meta-analysis. The current study followed the PRISMA guideline and utilized data from various sources such as PubMed, Scopus, Web of Science, and Google Scholar. The searches were conducted without a time limit until the end of May 2023. Meta-analysis was performed using the random effects model, heterogeneity was assessed using the I2 index, and publication bias was evaluated using Begg's test. Data analysis was carried out using STATA software (version 15). In this study, 243 articles were initially identified. Only meta-analysis studies that reported PPD during COVID-19 were included. After quality assessment, nine papers were selected for the meta-analysis stage. The study found that the prevalence postpartum depression (PPD) was 25.27% (95% CI = 23.66-27.86, I2 = 0.0%, p = 0.549). The findings of this study revealed that the incidence of PPD during the COVID-19 pandemic was relatively high. To decrease mental health issues among pregnant and postpartum women, healthcare professionals should implement community programs aimed at preventing, promptly identifying, and providing appropriate intervention for pregnant women. This is crucial as pregnant women are particularly vulnerable to psychological distress during infectious disease outbreaks.

Intratumoral high endothelial venules in solid tumors: a pooled study.

We performed this pooled analysis for the first time to comprehensively explore the prognostic value of tumor-associated high endothelial venules (TA-HEVs) and determine their relationships with clinicopathological features in solid tumors. Four online databases, including PubMed, Web of Science, Embase, and Cochrane Library, were comprehensively searched to identify studies assessing the effect of TA-HEVs on prognosis or clinicopathological features. Hazard ratios (HRs) with 95% confidence intervals (CIs) were applied to evaluate survival outcomes, including overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS). The association between TA-HEV status and clinicopathological characteristics was assessed by odds ratios (ORs) combined with 95% CIs. Subgroup analysis was conducted to explore sources of heterogeneity. The sensitivity analysis was performed to evaluate the stability of our findings. Meanwhile, Funnel plots were employed to visually evaluate potential publication bias, and both Begg's and Egger's tests were adopted to quantitatively determine publication bias. A total of 13 retrospective cohort studies, involving 1,933 patients were finally included in this meta-analysis. Effect-size pooling analysis showed that the positivity of TA-HEVs was related to improved OS (pooled HR: 0.75, 95% CI: 0.62-0.93, P<0.01), and DFS (pooled HR = 0.54, 95% CI = 0.41-0.72, P< 0.01). However, TA-HEV positivity in solid tumors was not linked to PFS (pooled HR = 0.75, 95% CI 0.34-1.64, P = 0.47) or CSS (pooled HR: 0.58, 95% CI: 0.04-7.58, P= 0.68). Further subgroup analysis demonstrated that ethnicity and source of HR were the main factors contributing to heterogeneity. Moreover, TA-HEVs were inversely associated with lymph node metastasis and distant metastasis, but were positively related to worse tumor differentiation. However, TA-HEVs were not significantly correlated with sex, LVI, clinical stage, and depth of invasion. Sensitivity analysis suggested that the pooled results were stable and reliable, with no significant publication bias in all included articles. This is the first comprehensive analysis of the prognostic value of TA-HEVs in solid tumors using existing literature. Overall, our study demonstrated a significant correlation between TA-HEVs and prognosis as well as clinicopathological features. TA-HEVs may serve as novel immune-related biomarkers for clinical assessments and prognosis prediction in solid tumors. https://www.crd.york.ac.uk/prospero/display_record.php, identifier CRD42023394998.

Comparison of the efficacy and safety of ciprofol and propofol in sedating patients in the operating room and outside the operating room: a meta-analysis and systematic review

BackgroundAs a new type of intravenous anesthetic, ciprofol has the advantages of fast onset of action, fast recovery and high clearance rate. This study aimed to investigate the effectiveness and safety of ciprofol versus traditional propofol for anesthesia and sedation in and out of the operating room.MethodsWe searched the literature in PubMed, Web of Science, Cochrane Library, and Embase databases from January 2021 to December 2023. All clinical studies comparing the sedative effects of propofol and ciprofol, both inside and outside the operating room, were included in our trial. The main outcome measures were induction time and incidence of injection-site pain. Data are merged using risk ratio and standardized mean difference with 95% confidence interval. Subgroup analysis, meta-regression, sensitivity analysis, and publication bias were performed. The study protocol was prospectively registered with PROSPERO (CRD42023447747).ResultsA total of 15 randomized, controlled trials involving 2002 patients were included in this study. Compared with propofol, ciprofol has a longer induction time in the operating room but a shorter induction time in non-operating room settings. Ciprofol can effectively reduce the risk of injection-site pain and respiratory depression both inside and outside the operating room. In addition, the risk of drug-related hypotension induced with ciprofol in the operating room is lower, but the awakening time is also longer. Meta-regression analysis showed that neither age nor BMI were potential sources of heterogeneity. Funnel plot, egger and begg tests showed no significant publication bias. Sensitivity analyzes indicate that our results are robust and reliable.ConclusionCiprofol has absolute advantages in reducing the risk of injection-site pain and respiratory depression, both in and outside operating room. Intraoperative use of ciprofol reduces the risk of drug-related hypotension and may also reduce the risk of intraoperative physical movements. However, ciprofol may have longer induction and awakening time than propofol.

Dietary Diversity and Associated Factors among Children 6-23 Months Old in Ethiopia: Systematic Review and Meta-Analysis.

Feeding diversified food for children is the major indicator of nutritional quality and adequacy that is crucial during the complementary feeding period for infants and young children aged 6-23 months. Ensuring diversified food is highly essential for the normal growth and development of the infant and young children. In Ethiopia, malnutrition and food insecurity remain prevalent, underscoring the need to understand and improve dietary diversity among children. The primary objective of this review was to determine the pooled prevalence of dietary diversity and its associated factors among children aged 6-23 months in Ethiopia. We thoroughly searched some electronic databases, including Pub Med, Africa Index Medicus, Science Direct, Hinari, and Google Scholar, to perform a meta-analysis. Excel was used to extract and combine the data, while Stata 17 was used for statistical analysis. To estimate pooled prevalence rates and related associated factors, we used a random-effect model and the Der Simonian-Laird technique. The I2-test was utilized to examine heterogeneity, and funnel plots, in conjunction with Egger's and Begg's tests, were employed to investigate publication bias. This review analyzed 42 full-text studies, finding a pooled prevalence of 26.78% (95% confidence interval (CI): 23.35-30.21) with significant heterogeneity (I2 = 98.95%). Maternal education levels-college & above Adjusted Odds Ratio (AOR: 5.377, 95% CI: 3.116-9.279), secondary and above (AOR: 3.324, 95% CI: 1.939-5.700), primary (AOR: 3.065, 95% CI: 2.275-3.129), and formal education (AOR: 2.484, 95% CI: 1.722-3.583)-showed higher odds than counterparts. Similarly, fathers' education-secondary and above (AOR: 2.837, 95% CI: 1.981-4.065) and primary (AOR: 2.082, 95% CI: 1.016-4.266)-and father's occupation as merchant (AOR: 2.739, 95% CI: 1.355-5.539), and mother's occupation as housewife (AOR: 3.636, 95% CI: 2.457-5.381) showed higher odds. Additionally, male child sex (AOR: 1.877, 95% CI: 1.185-2.972), child age 18-23 months (AOR: 2.470, 95% CI: 1.568-3.987), and 12-17 months (AOR: 2.460, 95% CI: 1.914-3.163) indicated higher odds than counterparts. Having Postnatal Care (PNC) follow-up, counseling on infant and young child feeding (IYCF) practices, and no history of child illness were associated with higher odds (AOR: 3.155, 95% CI: 2.104-4.732), (AOR: 2.960, 95% CI: 2.288-3.829), and (AOR: 2.420, 95% CI: 1.765-3.318), respectively. Maternal knowledge of dietary diversity, urban residency, Antenatal Care (ANC) follow-up, child growth monitoring, and media exposure also showed higher odds. Similarly, maternal age groups 25-34 years and 35-44 years had higher odds compared to those aged 15-24 years. Other factors associated with higher odds included home grading, food security, institutional delivery, availability of cow milk, and household wealth index. Among Ethiopian children aged 6-23 months, the prevalence of recommended dietary diversity feeding practices was remarkably low, with only about 25% meeting the minimum recommended diversified food. The scientific predictors factor affecting dietary diversity included maternal media exposure, place of delivery, food security, urban residency, availability of cow milk, child growth monitoring, age, and knowledge of IYCF practices; paternal factors like education and occupation; child-related variables like age, sex, and history of illness; and history of ANC and PNC.