Meta-analysis Of Standardized Mean Difference Research Articles

Therapeutic success in fragmented coronoid process disease and other canine medial elbow compartment pathology: a systematic review with meta-analyses.

The correct treatment of elbow dysplasia is controversial in modern small animal orthopedics. The aim of this study was to compile all relevant literature of the therapy of fragmented coronoid process and other hereditary disorders of the medial elbow compartment and to statistically evaluate the therapeutic results in three meta-analyses. The basis for the systematic literature review was a comprehensive database search of Web of Science, PubMed and Medline. Studies on living patients with above mentioned degenerative joint disease were included in the initial literature search. The data from the final studies, selected according to the PRISMA guidelines, was subsequently extracted. Finally, the success of the different therapies was compared and analyzed by three meta-analyses: success rate, mean difference and standardized mean difference. Fourteen of 494 publications covered by the systematic literature search remained. Their overall truth was: In studies where surgery outcomes was determined by clinical examination and owner questionnaires, it was found that surgical intervention had a significant positive outcome in the presence of fragmented coronoid process and medial compartment disease. Surgical outcomes were also good in three cross-over studies that investigated treatment success using computerized gait analysis. In contrast, comparative studies between surgical and conservative management yielded controversial results. The meta-analysis found no significant difference between medical and surgical therapy. The positive results of studies investigating owner satisfaction and veterinary clinical examination of surgical therapy for medial compartment disease were confirmed by two meta-analyses. However, their study designs were susceptible to observer biases. A third meta-analysis of standardized mean difference differentiating computerized gait analysis results of surgical and conservative management found no evidence of significant superiority of each treatment modality. It however had a limited number of subjects. More comparative studies of high evidence are needed to better understand medial compartment disease and provide the clinician with more accurate diagnostics to separate pathology that should be treated surgically from pathology that can benefit from conservative therapy similarly. Given the invasiveness a more cautious approach might be warranted regarding generally recommending surgery for pathology of the medial elbow compartment.

Effect of Training on the Ability of Nurses to Provide Humanistic Care: Systematic Review and Meta-analysis.

This article describes a systematic review evaluating the effectiveness of training on the humanistic care abilities of nurses. The literature search was conducted in electronic databases to identify studies that evaluated the effect of training on the humanistic care abilities of nurses. Study selection was based on precise eligibility criteria. After the systematic review, a meta-analysis of standardized mean differences (SMDs) between posttraining and pretraining humanistic care scale scores was performed to evaluate the effect of training. A total of 11 studies were included (624 nurse participants; 97% women; weighted average age = 38.4 years; 95% confidence interval (CI) [31.5, 45.4]). Training schedules varied and ranged from a full-day workshop to brief weekly sessions for up to 2 months. The training framework involved compassion and empathy communication in most of the included studies. Training improved the humanistic care scale scores of the participants (SMD = 1.171; 95% CI [0.626, 1.716]; p < .0001), whereas no significant change was seen in the scores of control subjects (SMD = 0.588; 95% CI [-0.536, 1.713]; p = .305). The effect of training was observable for up to 1 year, although few studies carried out follow-up evaluations. Training has the potential to improve the humanistic care abilities of nurses. [J Contin Educ Nurs. 2023;54(9):430-436.].

Spit It Out: Is Caffeine Mouth Rinse an Effective Ergogenic Aid? A Systematic Review and Meta-Analysis

ABSTRACT The effects of caffeine mouth rinse (Caff-MR) on sports performance have been evaluated by recent studies presenting contrasting results. Therefore, this systematic review aimed to summarize the evidence regarding the effects of Caff-MR on sports performance. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, the search through PubMed, Web of Science, and Scopus databases was performed until December 2021. A random-effects meta-analysis of standardized mean differences was performed to assess the overall effect of Caff-MR on sports performance-related outcomes. Sixteen studies met the inclusion criteria (207 participants). The meta-analysis showed no significant overall effect of Caff-MR on sports performance (p = 0.09). Moreover, no effects were shown on maximal heart rate or ratings of perceived exertion. The risk of bias for the included studies assessed using the risk of bias in randomized trials Cochrane tool presented 87.5% (n = 14) of the studies as medium and 12.5% (n = 2) as high scores. These data do not support using Caff-MR for sports performance, although more consistent and well-controlled studies are warranted. Large heterogeneity in study designs precludes making practical recommendations for exercise performance. More research is warranted to elucidate the potential of Caff-MR, specifically focusing on determining the optimal dose.

Effects of Mental Fatigue on Strength Endurance: A Systematic Review and Meta-Analysis.

The purpose of the present systematic review and meta-analysis was to explore the effects of mental fatigue on upper and lower body strength endurance. Searches for studies were performed in the PubMed/MEDLINE and Web of Science databases. We included studies that compared the effects of a demanding cognitive task (set to induce mental fatigue) with a control condition on strength endurance in dynamic resistance exercise (i.e.,expressed as the number of performed repetitions at a given load). The data reported in the included studies were pooled in a random-effects meta-analysis of standardized mean differences. Seven studies were included in the review. We found that mental fatigue significantly reduced the number of performed repetitions for upper body exercises (standardized mean difference: -0.41; 95% confidence interval [-0.70, -0.12]; p = .006; I2 = 0%). Mental fatigue also significantly reduced the number of performed repetitions in the analysis for lower body exercises (standardized mean difference: -0.39; 95% confidence interval [-0.75, -0.04]; p = .03; I2 = 0%). Our results showed that performing a demanding cognitive task-which induces mental fatigue-impairs strength endurance performance. Collectively, our findings suggest that exposure to cognitive tasks that may induce mental fatigue should be minimized before strength endurance-based resistance exercise sessions.

Effect of periodontal therapy on insulin resistance in adults with dysglycemia and periodontitis: a systematic review and meta-analysis.

This systematic review and meta-analysis aimed to address whether non-surgical periodontal therapy (NSPT) can affect insulin resistance, estimated by the homeostasis model assessment (HOMA), in adults with prediabetes or type 2 diabetes mellitus and periodontitis. Six electronic databases and the gray literature were systematically searched for interventional studies reporting NSPT effect on insulin resistance. Seven studies met the eligibility criteria to be synthesized in the qualitative analysis, six reporting change in HOMA-IR, three reporting change in HOMA-%S, and two in HOMA-β. Among them, four were pooled in a meta-analysis of standardized mean difference (SMD) of HOMA-IR; comparing pre- and post-intervention values, three were pooled considering HOMA-%S as outcome, and two studies were summarized considering SMD of HOMA-%S between intervention and control groups. HOMA-β results were qualitatively synthetized. With low level of certainty, NSPT significantly reduced HOMA-IR, when compared with pre-intervention data (SMD, -0.35, 95% CI -0.63 to 0.07, p=0.02). There were no significant changes in HOMA-%S or in HOMA-β scores. The level of certainty was very low and moderate, respectively. Assertions about a causal link between NSPT and insulin resistance are weak and conflicting, although our more robust results point out to the absence of effect. . Because further high-quality studies assessing the relationship between periodontitis and insulin resistance are need, the findings of the current systematic review are limited to give recommendations for clinicians. However, while identifying a lack of research in humans with T2D concerning periodontitis and insulin resistance, this study reinforces the need of multicenter well-designed randomized clinical trials.

Heterogeneity estimation in meta-analysis of standardized mean differences when the distribution of random effects departs from normal: A Monte Carlo simulation study

BackgroundAdvantages of meta-analysis depend on the assumptions underlying the statistical procedures used being met. One of the main assumptions that is usually taken for granted is the normality underlying the population of true effects in a random-effects model, even though the available evidence suggests that this assumption is often not met. This paper examines how 21 frequentist and 24 Bayesian methods, including several novel procedures, for computing a point estimate of the heterogeneity parameter ({tau }^{2}) perform when the distribution of random effects departs from normality compared to normal scenarios in meta-analysis of standardized mean differences.MethodsA Monte Carlo simulation was carried out using the R software, generating data for meta-analyses using the standardized mean difference. The simulation factors were the number and average sample size of primary studies, the amount of heterogeneity, as well as the shape of the random-effects distribution. The point estimators were compared in terms of absolute bias and variance, although results regarding mean squared error were also discussed.ResultsAlthough not all the estimators were affected to the same extent, there was a general tendency to obtain lower and more variable {tau }^{2} estimates as the random-effects distribution departed from normality. However, the estimators ranking in terms of their absolute bias and variance did not change: Those estimators that obtained lower bias also showed greater variance. Finally, a large number and sample size of primary studies acted as a bias-protective factor against a lack of normality for several procedures, whereas only a high number of studies was a variance-protective factor for most of the estimators analyzed.ConclusionsAlthough the estimation and inference of the combined effect have proven to be sufficiently robust, our work highlights the role that the deviation from normality may be playing in the meta-analytic conclusions from the simulation results and the numerical examples included in this work. With the aim to exercise caution in the interpretation of the results obtained from random-effects models, the tau2() R function is made available for obtaining the range of {tau }^{2} values computed from the 45 estimators analyzed in this work, as well as to assess how the pooled effect, its confidence and prediction intervals vary according to the estimator chosen.

Effects of Concurrent Resistance and Endurance Training Using Continuous or Intermittent Protocols on Muscle Hypertrophy: Systematic Review With Meta-Analysis.

Monserdà-Vilaró, A, Balsalobre-Fernández, C, Hoffman, JR, Alix-Fages, C, and Jiménez, SL. Effects of concurrent resistance and endurance training using continuous or intermittent protocols on muscle hypertrophy: Systematic review with meta-analysis. J Strength Cond Res 37(3): 688-709, 2023-The purpose of this systematic review with meta-analysis was to explore the effects of concurrent resistance and endurance training (CT) incorporating continuous or intermittent endurance training (ET) on whole-muscle and type I and II muscle fiber hypertrophy compared with resistance training (RT) alone. Randomized and nonrandomized studies reporting changes in cross-sectional area at muscle fiber and whole-muscle levels after RT compared with CT were included. Searches for such studies were performed in Web of Science, PubMed, Scopus, SPORTDiscus, and CINAHL electronic databases. The data reported in the included studies were pooled in a random-effects meta-analysis of standardized mean differences (SMDs). Twenty-five studies were included. At the whole-muscle level, there were no significant differences for any comparison (SMD < 0.03). By contrast, RT induced greater type I and type II muscle fiber hypertrophy than CT when high-intensity interval training (HIIT) was incorporated alone (SMD > 0.33) or combined with continuous ET (SMD > 0.27), but not compared with CT incorporating only continuous ET (SMD < 0.16). The subgroup analyses of this systematic review and meta-analysis showed that RT induces greater muscle fiber hypertrophy than CT when HIIT is included. However, no CT affected whole-muscle hypertrophy compared with RT.

The Effects of Sprint Interval Training on Physical Performance: A Systematic Review and Meta-Analysis.

Hall, AJ, Aspe, RR, Craig, TP, Kavaliauskas, M, Babraj, J, and Swinton, PA. The effects of sprint interval training on physical performance: a systematic review and meta-analysis. J Strength Cond Res 37(2): 457-481, 2023-The present study aimed to synthesize findings from published research and through meta-analysis quantify the effect of sprint interval training (SIT) and potential moderators on physical performance outcomes (categorized as aerobic, anaerobic, mixed aerobic-anaerobic, or muscular force) with healthy adults, in addition to assessing the methodological quality of included studies and the existence of small study effects. Fifty-five studies were included (50% moderate methodological quality, 42% low methodological quality), with 58% comprising an intervention duration of ≤4 weeks and an array of different training protocols. Bayesian's meta-analysis of standardized mean differences (SMD) identified a medium effect of improved physical performance with SIT (ES 0.5 = 0.52; 95% credible intervals [CrI]: 0.42-0.62). Moderator analyses identified overlap between outcome types with the largest effects estimated for anaerobic outcomes (ES 0.5 = 0.61; 95% CrI: 0.48-0.75). Moderator effects were identified for intervention duration, sprint length, and number of sprints performed per session, with larger effects obtained for greater values of each moderator. A substantive number of very large effect sizes (41 SMDs > 2) were identified with additional evidence of extensive small study effects. This meta-analysis demonstrates that short-term SIT interventions are effective for developing moderate improvements in physical performance outcomes. However, extensive small study effects, likely influenced by researchers analyzing many outcomes, suggest potential overestimation of reported effects. Future research should analyze fewer a priori selected outcomes and investigate models to progress SIT interventions for longer-term performance improvements.

In Vivo Antibacterial Efficacy of Antimicrobial Peptides Modified Metallic Implants─Systematic Review and Meta-Analysis.

Biomaterial-associated infection is difficult to detect and brings consequences that can lead to morbidity and mortality. Bacteria can adhere to the implant surface, grow, and form biofilms. Antimicrobial peptides (AMPs) can target and kill bacterial cells using a plethora of mechanisms of action such as rupturing the cell membrane by creating pores via depolarization with their cationic and amphipathic nature. AMPs can thus be coated onto metal implants to prevent microbial cell adhesion and growth. The aim of this systematic review was to determine the potential clinical applications of AMP-modified implants through in vivo induced infection models. Following a database search recently up to 22 January 2022 using PubMed, Web of Science and Cochrane databases, and abstract/title screening using the PRISMA framework, 24 studies remained, of which 18 were used in the random effects meta-analysis of standardized mean differences (SMD) to get effect sizes. Quality of studies was assessed using SYRCLE’s risk of bias tool. The data from these 18 studies showed that AMPs carry antibacterial effects, and the meta-analysis confirmed the favorited antibacterial efficacy of AMP-coated groups over controls (SMD −1.74, 95%CI [−2.26, −1.26], p < 0.00001). Subgroup analysis showed that the differences in effect size are random, and high heterogeneity values suggested the same. HHC36 and vancomycin were the most common AMPs for surface modification and Staphylococcus aureus, the most tested bacterium in vivo. Covalent binding with polymer brush coating and physical layer-by-layer incorporation of AMPs were recognized as key methods of incorporation to achieve desired densities. The use of fusion peptides seemed admirable to incorporate additional benefits such as osteointegration and wound healing and possibly targeting more microbe strains. Further investigation into the incorporation methods, AMP activity against different bacterial strains, and the number of AMPs used for metal implant surface modification is needed to progress toward potential clinical application.

Does Acute Caffeine Supplementation Improve Physical Performance in Female Team-Sport Athletes? Evidence from a Systematic Review and Meta-Analysis.

Introduction: Recent original research and meta-analyses suggest that acute caffeine supplementation improves exercise performance in team-sport athletes (TSA). Nonetheless, most of the studies testing the effects of caffeine on TSA included samples of male athletes, and there is no meta-analysis of the performance-enhancing effects of caffeine on female TSA. The aim of the present study was to synthesize the existing literature regarding the effect of caffeine supplementation on physical performance in adult female TSA. Methods: A search was performed in Pubmed/Medline, SPORTDiscus and Scopus. The search was performed from the inception of indexing until 1 September 2021. Crossover randomized controlled trials (RCT) assessing the effects of oral caffeine intake on several aspects of performance in female TSA were selected. The methodological quality and risk of bias were assessed for individual studies using the Physiotherapy Evidence Database scale (PEDro) and the RoB 2 tool. A random-effects meta-analysis of standardized mean differences (SMD) was performed for several performance variables. Results: The search retrieved 18 articles that fulfilled the inclusion/exclusion criteria. Overall, most of the studies were of excellent quality with a low risk of bias. The meta-analysis results showed that caffeine increased performance in specific team-sport skills (SMD: 0.384, 95% confidence interval (CI): 0.077–0.691), countermovement jump (SMD: 0.208, CI: 0.079–0.337), total body impacts (SMD: 0.488; 95% CI: 0.050, 0.927) and handgrip strength (SMD: 0.395, CI: 0.126–0.665). No effects were found on the ratings of perceived exertion, squat jumps, agility, repeated sprint ability or agility tests performed after fatigue. Conclusions: The results of the meta-analysis revealed that acute caffeine intake was effective in increasing some aspects of team-sports performance in women athletes. Hence, caffeine could be considered as a supplementation strategy for female athletes competing in team sports.

Dietary Lutein and Cognitive Function in Adults: A Meta-Analysis of Randomized Controlled Trials.

Emerging literature suggests that dietary lutein may have important functions in cognitive health, but there is not enough data to substantiate its effects in human cognition. The current study was intended to determine the overall effect of lutein on the main domains of cognition in the adult population based on available placebo randomized-controlled trials. Literature searches were conducted in PubMed, AGRICOLA, Scopus, MEDLINE, and EMBASE on 14 November 2020. The effect of lutein on complex attention, executive function and memory domains of cognition were assessed by using an inverse-variance meta-analysis of standardized mean differences (SMD) (Hedge’s g method). Dietary lutein was associated with slight improvements in cognitive performance in complex attention (SMD 0.02, 95% CI −0.27 to 0.31), executive function (SMD 0.13, 95% CI −0.26 to 0.51) and memory (SMD 0.03, 95% CI −0.26 to 0.32), but its effect was not significant. Change-from-baseline analysis revealed that lutein consumption could have a role in maintaining cognitive performance in memory and executive function. Although dietary lutein did not significantly improve cognitive performance, the evidence across multiple studies suggests that lutein may nonetheless prevent cognitive decline, especially executive function. More intervention studies are needed to validate the role of lutein in preventing cognitive decline and in promoting brain health.

Intralymphatic immunotherapy for allergic rhinitis: A systematic review and meta-analysis.

Background: Only a fraction of patients with allergic rhinitis receive allergen-specific immunotherapy (AIT). AIT is most commonly delivered subcutaneously in a series of injections over 3-5 years. Common obstacles to completing this therapy include cost and inconvenience. Intralymphatic immunotherapy (ILIT) has been proposed as a faster alternative, which requires as few as three injections spaced 4 weeks apart. Objective: This systematic review and meta-analysis evaluated the current evidence that supports the use of ILIT for allergic rhinitis. Methods: Clinical trials were identified in the published literature by using an electronic search strategy and were evaluated by using a risk of bias tool. Treatment outcome (symptom scores, medication scores, and combined symptom and medication scores) and provocation testing results (nasal provocation and skin-prick testing) were included in a meta-analysis of standardized mean difference with subgrouping by using a random-effects model. Overall adverse event rates were tabulated, and overall risk ratios were calculated by using a random-effects model. Results: We identified 17 clinical trials that met eligibility criteria. The standardized mean difference of ILIT on the symptom and medication score was -0.72 (95% confidence interval [CI], -0.98 to -0.46; p < 0.0001) (n = 10). The standardized mean difference of ILIT on nasal provocation and skin-prick testing was -1.00 (95% CI, -1.38 to -0.61; p < 0.0001) (n = 7) and -0.73 (95% CI, -0.99 to -0.47; p < 0.0001) (n = 7), respectively. No statistically significant heterogeneity was detected. The overall adverse event rate was 39.5% for ILIT and 23.5% for placebo. Also, 98.4% of adverse events were mild. Conclusion: Our meta-analysis demonstrated that ILIT was safe, conferred desensitization to seasonal and nonseasonal allergens, alleviated allergic rhinitis symptoms, and reduced medication use. A larger randomized, double-blind, placebo controlled trial will be necessary for wider adaptation of this form of AIT.

Ergogenic Effects of Acute Caffeine Intake on Muscular Endurance and Muscular Strength in Women: A Meta-Analysis

This meta-analysis aimed to explore the effects of caffeine ingestion on muscular endurance and muscular strength in women. Five databases were searched to find relevant studies. A random-effects meta-analysis of standardized mean differences (SMD) was performed for data analysis. Subgroup meta-analyses explored the effects of caffeine on upper-body and lower-body muscular endurance and muscular strength. Eight crossover placebo-controlled studies were included in the review. In the main meta-analysis that considered data from all included studies, there was a significant ergogenic effect of caffeine on muscular endurance (SMD = 0.25; p = 0.027) and muscular strength (SMD = 0.18; p < 0.001). In a subgroup analysis that considered only upper-body exercises, there was a significant ergogenic effect of caffeine on muscular endurance (SMD = 0.20; p = 0.007) and muscular strength (SMD = 0.17; p < 0.001). In a subgroup analysis that considered only lower-body exercises, there was no significant difference between caffeine and placebo for muscular endurance (SMD = 0.43; p = 0.092) or muscular strength (SMD = 0.16; p = 0.109). The main finding of this meta-analysis is that caffeine ingestion has a significant ergogenic effect on muscular endurance and muscular strength in women. The effects reported in this analysis are similar to those previously observed in men and suggest that women may use caffeine supplementation as an ergogenic aid for muscular performance. Future research is needed to explore the effects of caffeine on lower-body muscular endurance and muscular strength in this population.

End-stage ankle osteoarthritis: arthroplasty offers better quality of life than arthrodesis with similar complication and re-operation rates—an updated meta-analysis of comparative studies

Ankle arthrodesis (AA) has traditionally been the surgical standard for patients with an end-stage ankle osteoarthritis, with total ankle arthroplasty (TAA) recently becoming an alternative. The aim of this study was to update evidence in terms of functional outcomes, complications, and quality of life between AA and TAA by analyzing comparative studies. PubMed, MEDLINE, Scopus, and Cochrane Central databases were used to search keywords. A total of 21 studies entered our qualitative and quantitative analysis. Demographics, functional outcomes, and complications were extracted. Random and fixed-effect models were used for the meta-analysis of standardized mean differences (SMDs) and odds ratios (ORs). A total of 18,448 patients were identified, with a mean age of 57.3 ± 11.3years. TAA showed significantly greater post-operative range of motion (SMD - 0.883, 95% CI - 1.175 to - 0.590; I2 < 0.001) and Ankle Osteoarthritis Scale scores (SMD - 1.648, 95% CI - 3.177 to - 0.118; I2 = 97.67), but no differences in other patient-reported outcome scores were found. Patients undergoing TAA showed higher post-operative SF-36 (SMD - 0.960, 95% CI - 1.584 to - 0.336; I2 = 68.77). The total complication rate was similar between the two procedures (OR 0.936, 95% CI 0.826 to 1.060; I2 = 87.44), including the incidence of re-operations (OR 1.720, 95% CI 0.892 to 3.316; I2 = 77.65). While TAA and AA showed no differences in most post-operative functional outcomes, our review demonstrates that patients undergoing TAA show better health-related quality of life than AA. We found no evidence to suggest that TAA carries a higher risk of complications and re-operations compared to AA.

Effects of beta-alanine supplementation on Yo-Yo test performance: A meta-analysis.

The aim of this meta-analysis was to explore the effects of beta-alanine supplementation on Yo-Yo test performance. Nine databases were searched to find relevant studies. A random-effects meta-analysis of standardized mean differences (SMD) was performed for data analysis. Subgroup meta-analyses were conducted to explore the effects of beta-alanine supplementation duration on Yo-Yo test performance, and the effects of beta-alanine supplementation on performance only in Yo-Yo level 2 test variants. Ten study groups were included in the meta-analysis. All studies included athletes as study participants. When considering all available studies, there was no significant difference between the placebo/control and beta-alanine groups (SMD: 0.68; 95% confidence interval [CI]:-0.30, 1.67). When considering only the studies that used supplementation protocols lasting between 6 and 12 weeks, there was a significant ergogenic effect of beta-alanine (SMD: 1.02; 95% CI: 0.01, 2.05). When considering only the studies that used the level 2 variants of the Yo-Yo test, there was a significant ergogenic effect of beta-alanine (SMD: 1.41; 95% CI: 0.35, 2.48). This meta-analysis found that beta-alanine is ergogenic for Yo-Yo test performance in athletes when the supplementation protocol lasts between 6 and 12 weeks and when using the level 2 variants of the Yo-Yo test.

Preventing Staphylococcus aureus stainless steel‐associated infections in orthopedics. A systematic review and meta‐analysis of animal literature

Surgical site infection in the presence of orthopedic implants poses significant healthcare and socioeconomic burden. To assess the potential of various prevention strategies against Staphylococcus-induced stainless steel-associated infections, a review of animal evidence wasdesigned. The databases of PubMed, Embase, and CENTRAL were searched until March 10, 2020, for articles including animal models with stainless steel instrumentation and techniques to prevent Staphylococcus infection. We conducted a random-effects meta-analysis of standardized mean differences (SMD) with subgroup analysis linked to various protection strategies and we recorded complications. Quality was assessed with the SYRCLE's risk of bias tool. Twenty-five studies were included. Combined active coating (featuring organic antibacterial compound release) and degradable passive finishing (lipid- or polymer-based structure modification reducing bacterial adhesion) was favored over untreated controls (SMDs for methicillin-sensitive Staphylococcus aureus [MSSA] and methicillin-resistant Staphylococcus aureus [MRSA] were -3.46, 95% CI [-4.53 to -2.4], p < .001 [n = 4 head-to-head comparisons]; and -6.67, 95% CI [-10.53 to -3], p < .001 [n = 5 head-to-head comparisons], respectively). Systemic vitamin D supplementation and systemic antibiotic administration with or without local antibiotics demonstrated favorable outcomes against MSSA infection. On the contrary, no benefit was seen following vaccination. Of note, no side effects were documented. On thebasis ofdata gathered from eight studies, which comprised 294 animals, a bioresorbable polymer- or lipid-based surface modification supplemented with organic coating yielded improved infection-related outcomes against MSSA and MRSA stainless steel infections, and therefore, this strategy could be further investigated in human research.

Effects of n-3 Polyunsaturated Fatty Acid Supplementation in the Prevention and Treatment of Depressive Disorders-A Systematic Review and Meta-Analysis.

N-3 polyunsaturated fatty acids (PUFAs) have been suggested to affect depressive disorders. This review aims to determine the effect of n-3 PUFAs on depressive symptoms in people with or without diagnosed depression. Medline, PsycINFO, and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) assessing the association between n-3 PUFAs and depressive symptoms or disorders as outcomes. A random-effects meta-analysis of standardized mean difference (SMD) with 95% confidence intervals (CI) was performed. Twenty-five studies (7682 participants) were included. Our meta-analysis (20 studies) indicated that n-3 PUFA supplementation lowered depressive symptomology as compared with placebo: SMD = −0.34, 95% CI: −0.55, −0.12, I2 = 86%, n = 5836, but a possible publication bias cannot be ruled out. Subgroup analyses indicated no statistically significant difference by treatment duration of <12 vs. ≥12 weeks, presence of comorbidity, or severity of depressive symptoms. Nevertheless, beneficial effects were seen in the subgroups of studies with longer treatment duration and with no depression and mild to moderate depression. Subgroup analysis by eicosapentaenoic acid (EPA) dosage revealed differences in favor of the lower EPA dosage. Sensitivity analysis including studies with low risk of bias seems to confirm the overall result. Supplementation of n-3 PUFA appears to have a modest beneficial effect on depressive symptomology, although the quality of evidence is still insufficient.

Major Depressive Disorder Is Associated With Differential Expression of Innate Immune and Neutrophil-Related Gene Networks in Peripheral Blood: A Quantitative Review of Whole-Genome Transcriptional Data From Case-Control Studies

BackgroundWhole-genome transcription has been measured in peripheral blood samples as a candidate biomarker of inflammation associated with major depressive disorder. MethodsWe searched for all case-control studies on major depressive disorder that reported microarray or RNA sequencing measurements on whole blood or peripheral blood mononuclear cells. Primary datasets were reanalyzed, when openly accessible, to estimate case-control differences and to evaluate the functional roles of differentially expressed gene lists by technically harmonized methods. ResultsWe found 10 eligible studies (N = 1754 depressed cases and N = 1145 healthy controls). Fifty-two genes were called significant by 2 of the primary studies (published overlap list). After harmonization of analysis across 8 accessible datasets (n = 1706 cases, n = 1098 controls), 272 genes were coincidentally listed in the top 3% most differentially expressed genes in 2 or more studies of whole blood or peripheral blood mononuclear cells with concordant direction of effect (harmonized overlap list). By meta-analysis of standardized mean difference across 4 studies of whole-blood samples (n = 1567 cases, n = 954 controls), 343 genes were found with false discovery rate <5% (standardized mean difference meta-analysis list). These 3 lists intersected significantly. Genes abnormally expressed in major depressive disorder were enriched for innate immune-related functions, coded for nonrandom protein-protein interaction networks, and coexpressed in the normative transcriptome module specialized for innate immune and neutrophil functions. ConclusionsQuantitative review of existing case-control data provided robust evidence for abnormal expression of gene networks important for the regulation and implementation of innate immune response. Further development of white blood cell transcriptional biomarkers for inflamed depression seems warranted.

Is the buccal alveolar bone less affected by mini-implant assisted rapid palatal expansion than by conventional rapid palatal expansion?-A systematic review and meta-analysis.

To systematically review the existing literature comparing mini-implant assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) regarding the effect on the buccal alveolar bone thickness (BT) and marginal bone level (BL). PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library, Virtual Health Library, Embase, Ovid, LIVIVO, CINAHL, the Portal de Periódicos da CAPES, Google Scholar and SIGLE were searched up to January 2020. Risk of bias (RoB) assessments were performed using the Cochrane Collaboration and ROBINS-I tools. Fixed-effects meta-analysis of standardized mean differences (SMD) was implemented to assess the pooled estimates for the BT outcome. The analyses were performed adopting a significance level of 5%. A narrative synthesis was performed to summarize the results on the BL. The GRADE tool was used to assess the quality of the evidence. Three randomized clinical trials and one retrospective study were included. Only one study was rated as with low RoB, while the others were scored as with moderate to serious RoB. Limited evidence indicated that patients using conventional RPE had a greater loss of the BT compared to patients using MARPE (SMD=0.55; 95% CI: 0.29-0.80; P<.0001). Subgroup analyses showed that differences were significant in both premolars' regions, right (SMD=0.75; 95% CI: 0.24-1.25; P=.004) and left (SMD=1.05; 95% CI: 0.52-1.57; P<.0001), and these were not significant for the molars' regions (P>.05) (Low quality of evidence). Limited amount of selected papers, methodological issues that could lead to bias and high clinical heterogeneity among the studies. Due to the statistical model applied for the quantitative synthesis of the results, no generalization to any other population is recommended. Limited evidence suggests that MARPE could decrease the loss of the buccal alveolar bone when compared to conventional RPE.

Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research

BackgroundS-Nitrosoglutathione (GSNO) is a nitric oxide donor that has been investigated for neuroprotective and neuro-recovery effect. We aimed to conduct a systematic review on the published literatures using GSNO in both pre-clinical and clinical stroke studies. MethodsWe searched PubMed up to June 30, 2019, using the following keywords: S-Nitrosoglutathione, GSNO, stroke, cerebrovascular, carotid arteries, middle cerebral artery, and middle cerebral artery occlusion. Only studies published in the English language providing efficacy results of GSNO on ischemic stroke were included. Stroke Therapy Academic Industry Roundtable (STAIR) score was used to assess the quality of pre-clinical studies and PEDro score for clinical trials. A meta-analysis was conducted to compare the effect size. ResultsOf 39 articles identified, 10 (6 for pre-clinical and 4 for clinical studies) met the eligibility criteria and were included. The median STAIR score across the pre-clinical studies was 5.5 (range: 4–7), and the median PEDro score for the 4 clinical trials was 10 (ranged: 6 to 10). Among the 6 pre-clinical studies, GSNO reduced infarct size in 6 studies and improved neurological behavior scales in 5 studies compared to placebo. Inverse-variance weighted linear meta-analysis of standardized mean difference (Hedge's g) on 4 human studies revealed a big effect size (Hedge's g = −0.82, 95% CI: [−1.26, −0.38], P = .0003) favoring the GSNO group in term of reducing embolic signals. I2 value was 0 across the included clinical studies in the meta-analysis. ConclusionsPre-clinical studies showed positive benefit of GSNO in animal stroke models. The meta-analysis of clinical studies demonstrated that GSNO is effective in reducing embolic signals in patients with symptomatic internal carotid artery stenosis undergoing carotid endarterectomy or stenting. Further investigation of this molecule is warranted.