Meta-analysis Of Previous Studies Research Articles

Association between body shape index and arterial stiffness: results of the EVasCu study and a meta-analysis.

The aim of this study was to analyse the association between body shape index (ABSI) and arterial stiffness in healthy subjects using data from the EVasCu study. In addition, a meta-analysis was performed to compare the association between ABSI and central, peripheral and systemic arterial stiffness in the general population. The EVasCu study included 390 healthy subjects. ABSI was calculated from waist circumference, body mass index and height, and arterial stiffness was assessed with aortic pulse wave velocity (a-PWv) and cardio-ankle vascular index (CAVI). A meta-analysis of previous studies, including data from the EVasCu study, was performed to obtain pooled estimates of correlation coefficients (r) and their respective 95% confidence intervals (95% CIs) for the association between ABSI and central, peripheral and systemic arterial stiffness. In addition, pooled OR estimates and their 95% CIs were calculated. In the EVasCu study, the correlation coefficient estimate was 0.458 (p < 0.01) for the association of a-PWv and ABSI and 0.408 (p < 0.01) for the association of CAVI and ABSI. In the meta-analysis, the pooled correlation coefficient estimate was 0.22 (95% CIs: 0.16, 0.28) for central arterial stiffness and ABSI, 0.21 (95% CIs: 0.14, 0.28) for peripheral arterial stiffness and ABSI, and 0.28 (95% CI: 0.21, 0.3) for systemic arterial stiffness and ABSI. When pooled ORs were calculated, the pooled OR estimate was 2.12 (95% CIs: 1.68, 2.56) for central arterial stiffness and ABSI, 2.21 (95% CIs: 1.81, 2.60) for peripheral arterial stiffness and ABSI, and 2.99 (95% CIs: 2.14, 3.85) for systemic arterial stiffness and ABSI. Based on both the results obtained in the EVasCu study and the meta-analysis, there is a positive association between ABSI and arterial stiffness, both in healthy subjects and in participants with comorbidities. For each unit of cm/kg/m²/m increase in ABSI, the risk of arterial stiffness increased by 112% for central arterial stiffness, 121% for peripheral arterial stiffness, and 199% for systemic arterial stiffness. However, further research is needed in this field of knowledge.

Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis.

Laser therapy has emerged to play a valuable role in the treatment of paediatric burn scars; however, there is heterogeneity in the literature, particularly concerning optimal timing for initiation of laser therapy. This study aims to investigate the effect of factors such as scar age, type of laser and laser treatment interval on burn scar outcomes in children by meta-analysis of previous studies. A literature search was conducted across seven databases in May 2022 to understand the effects of laser therapy on burn scar outcomes in paediatric patients by metanalysis of standardized mean difference (SMD) between pre- and post-laser intervention. Meta-analyses were performed using the Comprehensive Meta-Analysis software version 4.0. Fixed models were selected when there was no significant heterogeneity, and the random effects model was selected for analysis when significant heterogeneity was identified. For all analyses, a p-value < 0.05 was considered significant. Seven studies were included in the meta-analysis with a total of 467 patients. Laser therapy significantly improved Vancouver Scar Scale (VSS)/Total Patient and Observer Scar Assessment Scale (Total POSAS), vascularity, pliability, pigmentation and scar height of burn scars. Significant heterogeneity was found between the studies and thus subgroup analyses were performed. Early laser therapy (<12months post-injury) significantly improved VSS/POSAS scores compared to latent therapy (>12months post-injury) {SMD -1.97 [95% confidence interval (CI) = -3.08; -0.87], p < 0.001 vs -0.59 [95%CI = -1.10; -0.07], p = 0.03} as well as vascularity {SMD -3.95 [95%CI = -4.38; -3.53], p < 0.001 vs -0.48 [95%CI = -0.66; -0.30], p < 0.001}. Non-ablative laser was most effective, significantly reducing VSS/POSAS, vascularity, pliability and scar height outcomes compared to ablative, pulse dye laser and a combination of ablative and pulse dye laser. Shorter treatment intervals of <4 weeks significantly reduced VSS/POSAS and scar height outcomes compared to intervals of 4 to 6 weeks. Efficacy of laser therapy in the paediatric population is influenced by scar age, type of laser and interval between laser therapy application. The result of this study particularly challenges the currently accepted initiation time for laser treatment. Significant heterogeneity was observed within the studies, which suggests the need to explore other confounding factors influencing burn scar outcomes after laser therapy.

Adolescent Idiopathic Scoliosis: Is the Feasible Option of Minimally Invasive Surgery using Posterior Approach?

The purpose of this systematic review and meta-analysis is to perform a systematic review and meta-analysis of previous studies on minimally invasive scoliosis surgery (MISS) in adolescents with idiopathic scoliosis (AIS). Some data on MISS in AIS compared with conventional open scoliosis surgery (COSS) are conflicting. A systematic literature search was conducted in Medline, Embase, and Cochrane Library, including studies reporting outcomes for MISS in AIS. The meta-analysis compared the operative, radiological, and clinical outcomes and complications between MISS and COSS in patients with AIS. Of the 208 records identified, 15 nonrandomized studies with 1,369 patients (reviews and case reports are excluded) were included in this systematic review and meta-analysis. The mean scale was 6.1, and eight of the 15 included studies showed satisfactory quality using the Newcastle-Ottawa scale. For operative outcomes, MISS had significant benefits in terms of estimated blood loss (standard mean difference [SMD], -1.87; 95% confidence interval [CI], -2.94 to -0.91) and hospitalization days (SMD, -2.99; 95% CI, -4.45 to -1.53) compared with COSS. However, COSS showed significantly favorable outcomes for operative times (SMD, 1.71; 95% CI, 0.92-2.51). No significant differences were observed in radiological outcomes, including Cobb's angle of the main curve and thoracic kyphosis. For clinical outcomes, MISS showed significant benefits on the visual analog scale score (SMD, -0.91; 95% CI, -1.36 to -0.47). The overall complication rates of MISS were similar to those of COSS (SMD, 0.96; 95% CI, 0.61-1.52). MISS using the posterior approach provides equivalent radiological and clinical outcomes and complication rates compared with COSS. Considering the lower estimated blood loss, shorter hospitalization days, and longer operative times in MISS, COSS is still the mainstay of surgical treatment in AIS; however, MISS using the posterior approach is also one of the surgical options of choice in the case of moderate AIS.

Genetic predisposition of LEPR (rs1137101) gene polymorphism related to type 2 diabetes mellitus – a meta-analysis

Background: Type 2 diabetes mellitus (T2DM) is a multifaceted disease appropriate to elevated blood glucose levels resulting from decreased insulin and beta-cell activity. Using a case–control methodology, researchers have examined the relationship between polymorphisms in LEPR and T2DM in a population from south India. Materials and Methods: We conducted a genetic analysis of 311 participants, and results were accomplished using a case-control study, a meta-analysis of previous studies on LEPR was conducted, and type 2 diabetes genotype distribution across various geographical regions Malaysians, Chinese Han, Kuwait, Iran, Mongolia, and Han Chinese, Greece, Saudi, India (North India, Punjabi), (South India, Tamilnadu). The study involved 254 prospective investigations, and nine association studies were preferred according to preset criteria. Studies were assessed for quality using the Hardy-Weinberg equilibrium (HWE) and the Newcastle–Ottawa Scale (NOS). An analysis of the genetic models was conducted to determine their relationship, statistical analysis was utilized to calculate odds ratios (ORs) and matching 95% confidence intervals (CIs). Results: The LEPR-rs1137101 polymorphism in the case-control study was associated with a significant increase in the risk of type 2 diabetes. A meta-analysis revealed a connection between LEPR gene polymorphism (rs1137101) and type 2 diabetes risk. Investigators might gain a more profound thought on the significance of the identified genetic variation and its impact on the chance of developing type 2 diabetes by verifying and strengthening previously reported findings. The model of fixed effects was chosen due to the low heterogeneity, and significant associations were observed in the allelic (OR = 0.79, 95% CI [0.70–0.87]), homozygote (OR = 0.58, 95% CI [0.46–0.72]), dominant (OR = 0.66, 95% CI [0.56–0.79]), and recessive (OR = 0.83, 95% CI [0.71–0.96]) genetic models. A Begg’s funnel plot and Egger’s test indicated no publication bias. These findings suggest that the rs1137101 variant in the LEPR gene has been linked to a higher risk of T2DM. Conclusions: A larger sample size, however, is required for further research, and consideration of potential confounding factors is needed to validate these associations. Understanding the implications of LEPR gene polymorphisms in T2DM susceptibility may contribute to personalized treatment strategies for patients with T2DM.

Influence of scar age, laser type and laser treatment intervals on adult burn scars: A systematic review and meta-analysis.

The study aims to identify whether factors such as time to initiation of laser therapy following scar formation, type of laser used, laser treatment interval and presence of complications influence burn scar outcomes in adults, by meta-analysis of previous studies. A literature search was conducted in May 2022 in seven databases to select studies on the effects of laser therapy in adult hypertrophic burn scars. The study protocol was registered with PROSPERO (CRD42022347836). Eleven studies were included in the meta-analysis, with a total of 491 patients. Laser therapy significantly improved overall VSS/POSAS, vascularity, pliability, pigmentation and scar height of burn scars. Vascularity improvement was greater when laser therapy was performed >12 months (-1.50 [95%CI = -2.58;-0.42], p = 0.01) compared to <12 months after injury (-0.39 [95%CI = -0.68; -0.10], p = 0.01), the same was true for scar height ((-1.36 [95%CI = -2.07; -0.66], p<0.001) vs (-0.56 [95%CI = -0.70; -0.42], p<0.001)). Pulse dye laser (-4.35 [95%CI = -6.83; -1.86], p<0.001) gave a greater reduction in VSS/POSAS scores compared to non-ablative (-1.52 [95%CI = -2.24; -0.83], p<0.001) and ablative lasers (-0.95 [95%CI = -1.31; -0.59], p<0.001). Efficacy of laser therapy is influenced by the time lapse after injury, the type of laser used and the interval between laser treatments. Significant heterogeneity was observed among studies, suggesting the need to explore other factors that may affect scar outcomes.

Preoperative HbA1c and Postoperative Outcomes in Spine Surgery: A Systematic Review and Meta-Analysis.

Systematic review and meta-analysis. To perform a systematic review and meta-analysis of previous studies on HbA1c in preoperative risk stratification in patients undergoing spinal procedures and provide an overview of the consensus recommendations. Diabetes mellitus (DM) and hyperglycemia have been shown to be independent risk factors for increased surgical complications. Glycated Hemoglobin A1C (HbA1c), a surrogate for long term glycemic control, is an important preoperative parameter that may be optimized to reduce surgical complications and improve patient-reported outcomes. However, comprehensive systematic reviews on preoperative HbA1c and postoperative outcomes in spine surgery have been limited. We systematically searched PubMed, EMBASE, Scopus, and Web-of-Science for English-language studies from inception through April 5 th , 2022, including references of eligible articles. The search was conducted according to PRISMA guidelines. Only studies in patients undergoing spine surgery with preoperative HbA1c values and postoperative outcomes available were included. A total of 22 articles (18 retrospective cohort studies, 4 prospective observational studies) were identified with level of evidence III or greater. The majority of studies (n=17) found that elevated preoperative HbA1c was associated with inferior outcomes or increased risk of complications. Random-effect meta-analysis demonstrated that patients with preoperative HbA1c >8.0% had increased risk(s) of postoperative complications (RR: 1.85, 95% CI: [1.48, 2.31], P <0.01) and that patients with surgical site infection (SSI) had higher preoperative HbA1c (Mean Difference: 1.49%, 95% CI: [0.11, 2.88], P =0.03). The findings of this study suggest that HbA1c >8.0% is associated with an increased risk of complications. HbA1c was higher by 1.49% on average among patients with SSI when compared to patients who did not experience SSI. These results suggest that elevated HbA1c is associated with less favorable outcomes following spine surgery. IV.

Cardiovascular telerehabilitation improves functional capacity, cardiorespiratory fitness and quality of life in older adults: A systematic review and meta-analysis

Introduction The aim was to identify whether cardiovascular telerehabilitation programs (CV-T-REHAB) can improve functional capacity, cardiorespiratory fitness and quality of life (QoL) to the same extent of presential rehabilitation (CV-P-REHAB) in older adults, by meta-analysis of previous studies. Methods Literature search was conducted in October 2020 in four databases to select controlled trials of CV-T-REHAB effects on functional capacity (six-minute walk test [6MWT]), cardiorespiratory fitness (maximal oxygen consumption [ V ˙ O2max]), and QoL in older adults (> 50 years) and included new articles in April 2022. Results CV-T-REHAB improved 6MWT (11.14 m [CI95% = 8.03; 14.26], p < 0.001), V ˙ O2max (1.18 ml/kg/min [CI95% = 0.70; 1.66], p < 0.001), and QoL (standardized mean difference [SMD] = 0.36 [CI95% = 0.05; 0.67], p = 0.02). CV-T-REHAB increased V ˙ O2max to a greater extent than CV-P-REHAB (1.08 ml/kg/min [0.39; 1.76], p = 0.002). Although the 6MWT and V ˙ O2max analyses proved consistent and homogeneous, the QoL analysis showed considerable inconsistency (I2 = 92.90%), suggesting the need for studies exploring the effect of CV-T-REHAB on QoL in this population. Part of the heterogeneity was explained by age differences, as CV-T-REHAB improved QoL in adults >65 years, but not in adults <64 years. Conclusion CV-T-REHAB improved cardiorespiratory fitness to a level equal to or higher than CV-P-REHAB and improved functional capacity and QoL; being mainly effective for QoL in older adults >65 years. Thus, CV-T-REHAB can be a good alternative, when not the best option and might be considered especially for individuals with limited access to participate in face-to-face programs.

What are gender differences in lower limb muscle activity during jump\u2013landing tasks? A systematic review and meta-analysis

BackgroundGender differences in muscle activity during landing have been proposed as a possible contributing factor to the greater incidence of anterior cruciate ligament injuries in women. Conflicting results among a few studies in this regard makes it impossible to reach correct conclusions.ObjectivesThe aim of this study was systematic review and the meta-analysis of previous studies which have compared the electromyographic activity of lower limb muscles in gluteus muscles (maximus and medius), quadriceps (rectus femoris, vastus medialis and lateralis), hamstrings (biceps femoris and semimembranosus), and gastrocnemius in men and women in jump–landing task.MethodsA systematic search of the PubMed, SCOPUS, Science Direct databases was performed for eligible articles in October 2020. Cross-sectional studies that compared the muscle activity of male and female athletes without a history of previous injury in the jump–landing task were included. Unisex and non-athlete's studies were extracted from the included studies. The data were synthesized using a fixed and random effects model.ResultsEight studies involving 145 participants were included. All participants were people who participated in regular exercises. The meta-analysis of timing and muscle activity was performed in the feedforward (pre contact) and feedback (post contact) stages. There were no significant differences in the muscle activity of biceps femoris (MD = −12.01; 95% CI − 51.49 to 27.47; p = 0.55; I2 = 87%), vastus medialis (MD = −53.46; 95% CI − 129.73 to 22.81; p = 0.17; I2 = 91%), semimembranosus (MD = 1.81; 95% CI − 6.44 to 10.07; p = 0.67; I2 = 0%), gluteus medius (MD = −3.14; 95% CI − 14.24 to 7.96; p = 0.58; I2 = 48%), and rectus femoris (MD = −5.83; 95% CI − 14.57 to 2.92; p = 0.19; I2 = 87%) in the pre contact phase between two sexes. There was a significant difference between men and women in the activity of vastus lateralis muscle in the post contact phase (MD = −34.90; 95% CI − 48.23 to − 21.57). No significant difference was observed between the men and women in the timing of semimembranosus (MD = 23.53; 95% CI − 14.49 to 61.54; p = 0.23; I2 = 56%) and biceps femoris muscle activity (MD = −46.84; 95% CI − 97.50 to 3.83; p = 0.07; I2 = 82%).ConclusionThe results showed that in all lower limb muscles except vastus lateralis there were no significant differences between muscle activity and muscle contraction timing in both sexes before and after foot contact. Therefore, it can be concluded that the reason for the greater susceptibility of ACL injuries in women than men is maybe related to other factors such as biomechanical and hormonal. Additional good quality research in this regard is required to strengthen these conclusions.

The association of neurodevelopmental abnormalities, congenital heart and renal defects in a tuberous sclerosis complex patient cohort

BackgroundTuberous sclerosis complex (TSC) is a rare multi-system genetic disorder characterised by the presence of benign tumours throughout multiple organs including the brain, kidneys, heart, liver, eyes, lungs and skin, in addition to neurological and neuropsychiatric complications. Intracardiac tumour (rhabdomyoma), neurodevelopmental disorders (NDDs) and kidney disorders (KD) are common manifestations of TSC and have been linked with TSC1 and TSC2 loss-of-function mutations independently, but the dynamic relationship between these organ manifestations remains unexplored. Therefore, this study aims to characterise the nature of the relationship specifically between these three organs’ manifestations in TSC1 and TSC2 mutation patients.MethodsClinical data gathered from TSC patients across South Wales registered with Cardiff and Vale University Health Board (CAV UHB) between 1990 and 2020 were analysed retrospectively to evaluate abnormalities in the heart, brain and kidney development. TSC-related abnormalities such as tumour prevalence, location and size were analysed for each organ in addition to neuropsychiatric involvement and were compared between TSC1 and TSC2 mutant genotypes. Lastly, statistical co-occurrence between organ manifestations co-morbidity was quantified, and trajectories of disease progression throughout organs were modelled.ResultsThis study found a significantly greater mutational frequency at the TSC2 locus in the cohort in comparison to TSC1. An equal proportion of male and female patients were observed in this group and by meta-analysis of previous studies. No significant difference in characterisation of heart involvement was observed between TSC1 and TSC2 patients. Brain involvement was seen with increased severity in TSC2 patients, characterised by a greater prevalence of cortical tubers and communication disorders. Renal pathology was further enhanced in TSC2 patients, marked by increased bilateral angiomyolipoma prevalence. Furthermore, co-occurrence of NDDs and KDs was the most positively correlated out of investigated manifestations, regardless of genotype. Analysis of disease trajectories revealed a more diverse clinical outcome for TSC2 patients: however, a chronological association of rhabdomyoma, NDD and KD was most frequently observed for TSC1 patients.ConclusionsThis study marks the first empirical investigation of the co-morbidity between congenital heart defects (CHD), NDDs, and KDs in TSC1 and TSC2 patients. This remains a unique first step towards the characterisation of the dynamic role between genetics, heart function, brain function and kidney function during the early development in the context of TSC.

502 Benefits of Rivaroxaban over Enoxaparin in Trauma and Orthopaedics

Abstract Aim Our Aim was to show what the benefits of Rivaroxaban over Enoxaparin post-operatively in trauma and orthopaedics. Doing a meta-analysis of previous studies and comparing post-op thrombotic risk in both rivaroxaban and Enoxaparin. To compare costs of using Enoxaparin vs Rivaroxaban in the major trauma centre. Method Meta-analysis of four studies conducted;Lassen 2008, Turpie 2005, Turpie 2009, Xie 2017 and Zou 2014. Gathered data from the British national formulary about Rivaroxaban cost and enoxaparin cost. Results This illustrated that rivaroxaban after TKA(Total knee Arthroplasty) had a significantly lower rate of symptomatic VTE, symptomatic DVT, asymptomatic DVT, distal DVT, and proximal DVT (shown in figure 1). The study shows that rivaroxaban after TKA is more effective than enoxaparin and did not increase major bleeding or cause increased mortality Major venous thromboembolism occurred in 9 of 908 patients (1.0%) given rivaroxaban and 24 of 925 (2.6%) given enoxaparin in a study done by Lassen et al Rivaroxaban requires less training for the patient, enoxaparin requires the patient to be taught proper administration. Rivaroxaban is considerably cheaper compared to enoxaparin. Enoxaparin provided by both Inhixa and Clexane cost £30.27 for a batch of 10 pre-filled disposable injections of 40mg, whilst rivaroxaban costs £18 for 10 tablets of the dose 10mg. Conclusions Rivaroxaban is cheaper to use for post-op anticoagulation, less resource intensive as patient is not required to be taught optimal administration method. Rivaroxaban has significantly reduced occurrence of thrombus compared to that of enoxaparin (based of the meta-analysis).

Comparison between Early Results of Laparoscopic Mini Gastric Bypass and Sleeve Gastrectomy regarding Weight Loss, Remission of Type II Diabetes Mellitus and Hypertension

Abstract Background Bariatric Surgery leads to a dramatic improvement in morbid obesity and associated type 2 Diabetes Mellitus (T2DM) and hypertension. Objectives The aim of the study was to compare between early results of Laparoscopic Mini Gastric Bypass and Sleeve gastrectomy regarding excess weight loss, remission of Type II diabetes mellitus and hypertension. Patients and Methods Type of the study, retrospective study. study setting, Our study was carried out at The General Surgery Department Ain Shams University Hospitals. study period,. All cases were operated during the period February and march 2019. Follow up of patients 6 months after operation was done (retrospective study). Last follow up was done on September 2019. The study included 50 patients aged 18-60 years with Type II Diabetes Mellitus and hypertension of at least 6 months duration, BMI 35 65 kg/m2 for at least 5 years. Results In this study There was no statistical significant difference between studied groups as regard age,gender,and baseline clinical data. there was a statistical significant difference between patients in LMGB group as well as between patients in LGS group before and six months after surgery as regard weight in kg, BMI and HbA1C and.remission of hypertention (P value 0.000). there was high statistical significant difference between studied groups as regard percentage of change of weight and BMI(P value 0.000) However, there was no statistical significant difference between studied groups as regard percent of change of HbA1C. (P value 0.613),remission of T2DM.(p value 0.123 ) and control of hypertension. (p value 0.136 ). Further results and data could be reached on long-term follow up of patients involved in this study. Conclusion Patients receiving mini-gastric bypass had more advantageous indexes than patients receiving sleeve gastrectomy, such as higher six months EWL% (excess weight loss), higher T2DM remission rate and higher hypertension remission rate. Especially on long term follow up and that was proved by meta analysis of previous studies but on short term follow up there is no statistical singnificant difference between both studied groups except in percentage of change of weight and BMI. Mini-gastric bypass is simple, safe and more effective bariatric procedure than laparoscopic sleeve gastrectomy.

ANA-positive primary immune thrombocytopaenia: a different clinical entity with increased risk of connective tissue diseases

ObjectivePrimary immune thrombocytopaenia (ITP) is highly heterogeneous. ANA-positive primary ITP may resemble the preclinical stage of connective tissue diseases (CTDs), but is still considered primary ITP due to a controversial...

Related factors with orolingual angioedema after intravenous alteplase in acute ischemic stroke: results from a single-center cohort and meta-analysis.

Orolingual angioedema (OA) after intravenous thrombolysis (IVT) with alteplase in acute stroke can be a life-threatening complication. Our aim was to describe its incidence, clinical features, and related factors. We analyzed a single-center cohort of stroke patients treated with IVT in an 8-year period. We compared patients with (OA+) and without OA (OA-). A meta-analysis of previous studies was performed to identify factors related with OA. OA occurred in 7 out of 512 patients (1.37%; 95% CI 0.86-1.88%). Previous hypertension, diabetes, and treatment with ACE inhibitors were more frequent in OA+ compared to OA- patients (100% vs 58%, p = 0.045; 71.4% vs 21.8%, p = 0.008; and 71.4% vs. 16.6%, p = 0.002). Three out of 4 cases with unilateral OA had a contralateral insular infarct. The meta-analysis included 13 studies: 5720 stroke patients treated with IVT and 209 cases of OA. Factors related with OA were ACE inhibitor treatment (RR 5.33 [95% CI 3.07-9.26]) female sex (RR 1.94 [95% CI 1.24-3.03]), hypertension (RR 2.64 [95% CI 1.79-3.90]), diabetes (RR 1.60 [95% CI 1.16-2.21]), and dyslipidemia (RR 1.46 [95% CI 1.00-2.12]). The effect of insular infarct was inconclusive: positive when considering complete infarcts (RR 1.97 [95% CI 1.18-3.29]) and absent when partial infarcts were also included. OA occurred in 1.37% of the IVT-treated stroke patients. Previous treatment with ACE inhibitors, hypertension, diabetes, dyslipidemia, and female sex were associated with OA. The effect of insular infarct needs to be clarified in further studies.

Meta-Analisis Pengaruh Model Example Non Example dalam Pembelajaran IPA di Sekolah Dasar

The purpose of this study was to analyze the effectivenees of the effect od the example non example model on science learning. The research method used is a meta-analysis of previous studies that apply the example non example learning model in science learning. The research begins with formulating a research problem, tracing the relevant research results for analysisi. Data is collected by browsing electronic journals via google scholar. Form the search, it was obtained 8 scientific articles that have been published, the instrument was in the form of coding based on predetermined criteria. Data were analyzed using the effect size. The research findings reveal that overall the studies conductes are effective and effective on science learning in elementary scools with an effect size of 1,323132 or in the high efficiency category. The example non example model also has an effect and is effective at the grade level, namely in grade 4,5 and 6 and the application of learnin to improve learning outcomes, critical thinking skills, and the ability to explain. The conclusion of this study is that the example non example model is more effective in science learning compared to other learning models from this study.

Experience With Early Sorafenib Treatment With mTOR Inhibitors in Hepatocellular Carcinoma Recurring After Liver Transplantation.

Sorafenib (SOR) is currently used for hepatocellular carcinoma (HCC) recurring after liver transplantation (LT) when HCC is unsuitable for surgical/locoregional treatments. We evaluated safety and effectiveness of early introduction of SOR after HCC-recurrence. All patients with HCC-recurrence after LT treated with SOR in 2 centers were included (January 2008 to June 2018). Baseline and on-treatment data were collected. Fifty patients early treated with SOR for HCC-recurrence after LT (74% mammalian target of rapamycin inhibitor [mTORi], 54% HCC-treated at baseline) were enrolled. During 7.3 (0.3-88) months of SOR, all patients had at least one adverse event (AE), 56% graded 3-4. SOR was reduced in 68%, being AEs the main cause of reduction, and discontinued in 84% (60% symptomatic progression, 33% AE). Objective response was obtained in 16% and stable disease in 50%. Median time to radiological progression was 6 months (95% confidence Interval [CI], 4-8). Thirty-three patients (69%) died, 94% for HCC progression. Median overall survival (OS) was 18 months (95% CI, 8-27); 5-year OS was 18% (95% CI, 4%-32%). Baseline predictors of OS were SOR+mTORi (hazard ratio [HR], 0.4; 95% CI, 0.2-0.9; P = 0.04), previous curative treatments (HR, 0.3; 95% CI, 0.2-0.7; P = 0.003) and alpha-fetoprotein > 100 ng/mL (HR, 2.5; 95% CI, 1.1-5.0, P = 0.02). At multivariate analysis, HCC curative treatment was the only independent predictor (HR, 0.4; 95% CI 0.2-1.0; P = 0.04). Early and combined treatment with SOR and mTORi resulted in a favorable safety profile, while its effectiveness should be confirmed by meta-analysis of previous studies or by larger studies. Curative treatment for HCC resulted the only independent predictor of OS.

Clinicopathological and Prognostic Role of STAT3/p-STAT3 in Breast Cancer Patients in China: A Meta-Analysis

In order to explore the important factors in the diagnosis of breast cancer in China, meta-analysis of previous studies was performed to understand the association between STAT3/p-STAT3 and breast cancer. Information about STAT3/p-STAT3 expression and clinical data about breast cancer in China in particular were gathered from PubMed, Web of Science, CNKI and WanFang databases. RevMan 5.3 and STATA 14.0 were used to analyze the occurrence, development and metastasis of breast cancer for 2818 patients in 18 studies. STAT3/p-STAT3 expression was higher in breast cancer tissue than in normal ones (OR = 7.48, 95% CI = 5.64–9.94), in highly differentiated breast cancer tissue than in lowly differentiated cancer tissues (OR = 2.13, 95% CI = 1.53–2.98), in III/IV stage breast cancer than in I/II stage breast cancer (OR = 3.58, 95% CI = 2.44–5.25), and in tissue with lymphatic metastasis than in normal tissues (OR = 3.72, 95% CI = 2.59–5.35), respectively. Thus, the expression of STAT3/p-STAT3 plays a clinicopathological and prognostic role in the diagnosis and treatment of Chinese breast cancer patients.

Diagnostic accuracy of ROMA index in diagnosing ovarian malignancy in pelvic mass patients

Objective: To evaluate ROMA in assessing malignancy risk of pelvic mass with Meta-analysis. Methods: PubMed, ISI Web of Science, and Cochrane literature were searched until December 2017. Combine and analyse sensitivity, specificity, positive likelihoodratio, negative likelihood ratio, diagonistic odd ratio and AUC. Results: Data of ROMA was retrieved from 8 studies, sensitivity and specificity were 86% and 77% respectively, and AUC was 0.899. Conclusion: According to Meta analysis of previous studies, sensitivity and specificity of ROMA are high enough to be used as an index in setting of ovarian cancer diagnosis.

Does unicompartmental knee arthroplasty have worse outcomes in spontaneous osteonecrosis of the knee than in medial compartment osteoarthritis? A systematic review and meta-analysis.

The role of unicompartmental knee arthroplasty (UKA) in spontaneous osteonecrosis of the knee (SONK) remains controversial, even though SONK involves only one compartment of the knee joint. We aimed to compare the survival rate and clinical outcomes of UKA in SONK and medial compartment osteoarthritis (MOA) via a meta-analysis of previous studies. MEDLINE, Embase, and Cochrane Library were searched up to January 2018 with keywords related to SONK and knee arthroplasty. Studies were selected with predetermined inclusion criteria: (1) medial UKA as the primary procedure, (2) reporting implant survival or clinical outcomes of osteonecrosis and osteoarthritis, and (3) follow-up period > 1year. Quality assessment was performed using the risk of bias assessment tool for non-randomized studies. A random-effects model was used to estimate the pooled relative risk (RR) and standardized mean difference. The incidence of UKA revision for any reason was significantly higher in SONK than in MOA group (pooled RR = 1.83, p = 0.009). However, the risk of revision due to aseptic loosening was not significantly different between the groups. Moreover, when stratified by the study quality, high-quality studies showed similar risk of overall revision in SONK and MOA (p = 0.71). Subgroup analysis revealed no significant difference in failure between SONK and MOA after cemented mobile and fixed bearing UKA. Results of uncemented UKA were reported only in one study, which showed higher failure of SONK compared to MOA. Clinical outcomes after UKA were similar between SONK and MOA (p = 0.66). Cemented UKA has similar survival and clinical outcomes in SONK and MOA. Prospective studies designed specifically to compare the UKA outcomes in SONK and MOA are necessary.

MiR-146a rs2910164 Polymorphism and Risk of Papillary Thyroid Carcinoma: A Meta-Analysis.

Aims: The presence of single nucleotide polymorphisms contributes to genetic diversity, and some are associated with cancer progression. Recent studies concerning the relationship between polymorphisms in miR-146a and the risk of papillary thyroid carcinoma (PTC) have produced conflicting results. Here, a meta-analysis of previous studies was performed to evaluate this relationship. Materials and Methods: Electronic databases, including PubMed, China National Knowledge Infrastructure, Cochrane Library, Embase, and Web of Science, were searched for studies concerning miR-146a and PTC published between January 1, 2000 and January 1, 2018. Fixed/random-effects models were used to calculate the pooled odds ratios (ORs) estimated in each study according to the level of heterogeneity. Results: Eight studies involving 3993 cases and 9919 controls were assessed. Pooled results showed no association between the miR-146a rs2910164 polymorphism and PTC (OR = 1.001, 95% confidence interval [CI] 0.893-1.121). Subgroup analysis showed that the GG/GC genotype did not significantly increase PTC risk versus CC among Asians (OR = 0.939; 95% CI 0.828-1.066). Similarly, the combination of the GG and GC genotypes did not increase the risk of PTC for Caucasians (OR = 1.571, 95% CI 0.949-2.601). Conclusions: The results of our meta-analysis indicated that the miR-146a rs2910164 variant genotype has no effect on susceptibility to PTC.

The Impact of Revenue Diversification on Nonprofit Financial Health: A Meta-analysis

This study reviews the influence of revenue stream diversification on financial health. It is a meta-analysis of previous studies that have studied the relationship. This literature variously demonstrates that nonprofit financial health is improved, not influenced or harmed by diversifying reliance on different revenue streams. Our analysis of 40 original studies reporting 296 statistical effects demonstrates a small, positive, yet statistically significant association between revenue diversification and nonprofit financial health. In addition, we show that granularity of measurement of revenue diversification influences effect size, that this effect has shifted over time, and that studies on U.S. nonprofits demonstrate weaker (or more negative) effects. However, few other prominent suspects, including diversity of financial health measure or methodology choices, explain variations in effects across the literature on revenue diversification. Overall, the study supports the contention that both analysts and practitioners should make strategic considerations that have generally escaped scholarship on revenue diversification or shift attention to revenue optimization considerations that have been raised by portfolio theory.