Pooled Effect Research Articles

Reducing hyperuricemic events with SGLT2 inhibitors: An updated systematic review with meta-regression.

Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) were shown to lower hyperuricemic events in patients with type 2 diabetes mellitus (T2DM), the extent of this effect in the general population is yet to be elucidated. We performed an updated systematic review and meta-analysis on a large sample of patients with and without T2DM to evaluate the influence of SGLT2i therapy on clinically relevant hyperuricemic events, defined as the composite of acute gout flare episodes, acute anti-gout management or urate-lowering therapy initiation. Furthermore, we conducted a multivariate meta-regression to assess the relationship between different covariates and the pooled effect size. We systematically searched all reported outcomes of interest in patients on SGLT2i (PROSPERO: CRD42023442077) across PubMed, Scopus and Cochrane databases looking for randomized controlled trials, observational studies and post-hoc analyses since inception until August 2023. Data from seven randomized controlled trials and seven observational studies were included for a total of 464,009 patients, 13,370 of whom did not have T2DM. A total of 50% of the patients included were on SGLT2i. The pooled analysis demonstrated that SGLT2i reduce clinically relevant hyperuricemic events by 33% (HR, 0.67; 95% CI, 0.59-0.77; I2=83%) regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on chronic kidney disease (CKD) showed a positive correlation on the pooled effect size. SGLT2i reduce the risk of developing hyperuricemic events regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on CKD showed a significant impact on the main outcome. Further studies are essential to investigate more conclusively the extent of these beneficial effects.

Child- and Proxy-reported Differences in Patient-reported Outcome and Experience Measures in Pediatric Surgery: Systematic Review and Meta-analysis.

Pediatric health outcomes are often assessed using proxy reports, which may not fully capture children's experiences. Children with surgical conditions face unique, changing healthcare journeys, making accurate representation challenging. This review compares child-reported health status and treatment experiences from Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) with parent reports. A systematic search, designed by a librarian and adhering to PRISMA guidelines, was conducted across eight databases up to July 2023, targeting studies using PROMs and PREMs in pediatric surgery to capture both child and parent perspectives. Two reviewers independently screened abstracts, with conflicts resolved by senior authors. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment. A meta-analysis was also performed on Pediatric Quality of Life Inventory (PedsQL™) outcomes. Of 5415 screened studies, 53 met inclusion criteria: 50 used PROMs, two used PREMs, and one used both. PedsQL™ appeared in 30 studies, with 16 other quality of life measures used less frequently. Twenty-two studies with PedsQL™ data from 6691 child-parent pairs were included in the meta-analysis. The pooled effect size between child- and parent-reported PedsQL™ scores was 0.98 (95% CI: [-0.81, 2.77]), with high heterogeneity (I2=89%). This review revealed substantial variability but minimal systematic differences between child and parent reports, highlighting the need for future research to understand this variability and improve integration of child and parent perspectives in pediatric health assessments. I, Systematic Review or meta-analysis of RCTs (randomized control trials).

Effect of del Nido Cardioplegia on Isolated Coronary Artery Bypass Grafting: A Study-level Meta-analysis.

The purpose of this study was to evaluate the effect of del Nido cardioplegia versus conventional cardioplegic solutions on early outcomes of isolated coronary artery bypass grafting (CABG). PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched through July 2024 to conduct a meta-analysis for a comparison between del Nido and other cardioplegic solutions in isolated CABG. Major end points of the study included operative mortality and morbidities. A random effects model was used to estimate the pooled effect size. For subgroup analyses, meta-analyses were conducted for outcomes derived from either randomized controlled-trials, propensity score analysis, or multivariable analysis. Twenty-four studies met our eligibility criteria, including 4 randomized controlled trials and 5 propensity score-matched studies with a total of 34,737 patients. Operative mortality was not significantly associated with cardioplegic solutions (del Nido vs other solutions; p = 0.262). The incidence of postoperative stroke, reoperation, deep wound infection, and atrial fibrillation was also comparable between the 2 groups. The incidence of postoperative myocardial infarction and renal failure was significantly lower in the del Nido group with a pooled odds ratio of 0.43 (95% confidence interval, 0.24-0.77) and 0.61 (95% confidence interval, 0.45-0.81), respectively. Subgroup analyses also demonstrated these significant differences. In patients undergoing isolated CABG, del Nido cardioplegia provides comparable mortality compared with other cardioplegic solutions. Del Nido solution was significantly protective against myocardial infarction and renal failure.

Stem Cell-Derived Exosomes as a Therapeutic Option for Spinal Cord Injuries; a Systematic Review and Meta-Analysis.

Exosomes function as cell signaling carriers and have drawn much attention to the cell-free treatments of regenerative medicine. This meta-analysis aimed to investigate the efficacy of mesenchymal stem cell-derived (MSC-derived) exosomes in animal models of spinal cord injuries (SCI). A comprehensive search was conducted in Medline, Embase, Scopus, and Web of Science to attain related articles published by January 31, 2023. The eligible keywords were correlated with the spinal cord injury and MSC-derived exosomes. The evaluated outcomes were locomotion, cavity size, cell apoptosis, inflammation, neuro-regeneration, and microglia activation. A standardized mean difference was calculated for each sample and a pooled effect size was reported. 65 papers fully met the inclusion criteria. Treatment with MSC-derived exosomes ultimately improved locomotion and shrunk cavity size (p<0.0001). The administration of MSC-derived exosomes enhanced the expression of beta-tubulin III, NF200, and GAP-43, and increased the number of NeuN-positive and Nissl-positive cells, while reducing the expression of glial fibrillary acidic protein (p<0.0001). The number of apoptotic cells in the treatment group decreased significantly (p<0.0001). Regarding the markers of microglia activation, MSC-derived exosomes increased the number of CD206- and CD68-positive cells (p=0.032 and p<0.0001, respectively). Additionally, MSC-derived exosome administration significantly increased the expression of the anti-inflammatory interleukin (IL)-10 and IL-4 (p<0.001 and p=0.001, respectively) and decreased the expression of the inflammatory IL-1b, IL-6, and TNF-a (p<0.0001). MSC-derived exosome treatment resulted in a significantly improved locomotion of SCI animals through ameliorating neuroinflammation, reducing apoptosis, and inducing neuronal regrowth by facilitating a desirable microenvironment.

Individual participant data (IPD) meta-analysis: An introduction – Narrative review

Systematic reviews and meta-analyses (MA) are accepted modalities for evidence synthesis in evidence-based medicine. However, as MA uses aggregate data that includes averaging patient characteristics and pooled effect estimates, it has limitations when considering personalised medicine. In contrast, individual participant data meta-analysis (IPD-MA) includes and segregates individual patient data to study new outcomes, identify outcome predictors, and analyse multiple covariate effects on treatments. IPD-MA requires data from multiple investigators, review board approvals, clear communication with collaborators, and statistical recalculation of cumulative data. IPD-MA can be performed as a single-stage process where data from all included studies is pooled and reanalysed or as a two-stage process where additionally the data from individual studies is re-analysed before being pooled. This review aims to orient clinicians about IPD-MA, including the process of performing it, comparing it with other types of meta-analyses and considering the potential barriers in conducting it.

Perinatal intimate partner violence and breastfeeding practices: A systematic review and meta-analysis protocol.

Intimate partner violence increases the risk of detrimental health, behaviors and psychological issues in mothers, affecting infant nutrition and development. However, the potential effects of maternal exposure to intimate partner violence on breastfeeding practices are understudied, and the results of individual studies are inconsistent and conflicting. The aims of this systematic review and meta-analysis are therefore to 1) estimate the prevalence of perinatal intimate partner violence and, 2) examine the relationship between perinatal intimate partner violence and breastfeeding outcomes. This systematic review and meta-analysis will investigate the association between perinatal intimate partner violence and breastfeeding outcomes, including early initiation within 1 hour after giving birth, exclusive breastfeeding under six months, and continued breastfeeding at two years or beyond. Comprehensive searches will be conducted in PsycInfo, Scopus, Web of Science, Medline, Cochrane, JBI EBP, CINAHL, Informit, and PubMed electronic databases. Data extraction will be performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analysis will be conducted using STATA/SE version 17, employing random-effects models to calculate pooled effect sizes and assess heterogeneity with I2 and Chi-square tests. Subgroup analyses and meta-regression will explore potential sources of heterogeneity. Evidence suggests that intimate partner violence is linked to poor breastfeeding outcomes. This systematic review and meta-analysis will update, compile, and critically review the evidence of the role of intimate partner violence on breastfeeding outcomes. This systematic review and meta-analysis will also inform effective strategies and interventions to support breastfeeding among IPV-affected women, thereby enhancing maternal and child health. As this review and meta-analysis involves secondary analysis of existing data, ethical approval is not required. Findings will be disseminated through peer-reviewed publications and scientific conferences, aiming to inform strategies to support breastfeeding among women affected by intimate partner violence. This protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42024555048.

Association of current Schistosoma mansoni, Schistosoma japonicum, and Schistosoma mekongi infection status and intensity with periportal fibrosis: a systematic review and meta-analysis.

Periportal fibrosis is a severe morbidity caused by both current and past exposure to intestinal schistosomes. We aimed to assess the association between current infection status and intensity of Schistosoma mansoni, Schistosoma japonicum, or Schistosoma mekongi with periportal fibrosis. In this systematic review and meta-analysis, we searched the Cochrane Central Register of Controlled Trials, Embase, Global Health, Global Index Medicus, and MEDLINE from database inception to June 18, 2024. We applied methodological filters to limit our search to randomised controlled trials or observational studies, including before-and-after study designs. Animal studies were excluded, and no date or language limits were applied. We excluded reviews, editorials, personal opinions, and case reports. Self-reported infection status was an ineligible exposure. Two reviewers independently screened abstracts and full-text reports for eligibility. A third reviewer was consulted in cases of disagreement. The outcome of periportal fibrosis was recorded as reported by study authors to investigate variation in liver fibrosis definitions. For the key exposure of current infection, data were extracted for Schistosoma species, diagnostics, and author-provided infection status and intensity definitions. A meta-analysis was conducted for current schistosome infection status and intensity against author-defined current periportal fibrosis. Pooled effect sizes were derived using inverse-variance weighted random effects. Subgroup analyses included study characteristics and quality. The modified National Institute of Health risk of bias tool was used for assessing study quality. The protocol adhered to PRISMA reporting standards and was prospectively registered on PROSPERO, CRD42022333919. Our electronic search retrieved 2853 records, of which 1036 were duplicates. Nine records were identified in bibliographies of eligible full-text reports. We screened 1826 titles and abstracts to find 282 articles that met our inclusion criteria for full-text review. 41 studies were eligible for systematic review, 33 studies were eligible for infection status meta-analysis, and seven studies were eligible for infection intensity meta-analysis. Periportal fibrosis was heterogeneously defined with the Niamey ultrasound protocol most used. When findings were pooled, current schistosome infection status was associated with a higher likelihood of periportal fibrosis compared with no current infection (odds ratio [OR] 2·65, 95% CI 1·79-3·92; p<0·0001). Heterogeneity was high (I2=95·81%). In sub-Saharan Africa, before the widespread introduction of mass drug administration in 2003 there was a significant association between current infection status and periportal fibrosis (OR 5·38, 95% CI 2·03-14·25) but this association was no longer present after 2003 (1·19, 0·82-1·74). No association of current infection status was observed with periportal fibrosis in studies that used the Niamey protocol (1·57, 95% CI 0·95-2·59). Associations depended on moderate to high risk of bias studies. No significant differences in pooled effect sizes were observed between infection intensity categories and periportal fibrosis. WHO guidelines use current schistosome infection intensity as a proxy for schistosomiasis-related morbidity. Our findings support that current infection status is only tenuously associated with periportal fibrosis. Guidelines are needed to better monitor schistosomiasis-related morbidities. Nuffield Department of Population Health Pump Priming Fund, Wellcome Trust Institutional Strategic Support Fund, John Fell Fund, Robertson Foundation, and UK Research and Innovation Engineering and Physical Sciences Research Council.

The Influence of Resistance Training on Joint Flexibility in Healthy Adults: A Systematic Review, Meta-analysis, and Meta-regression.

Favro, F, Roma, E, Gobbo, S, Bullo, V, Di Blasio, A, Cugusi, L, and Bergamin, M. The influence of resistance training on joint flexibility in healthy adults: A systematic review, meta-analysis, and meta-regression. J Strength Cond Res XX(X): 000-000, 2024-Joint flexibility is a key component of physical fitness. Despite the large body of evidence regarding the effectiveness of muscle stretching exercises, little is known about the effect of resistance training on flexibility. A systematic search was conducted on 9 academic search instruments; inclusion criteria were as follows: healthy adult participants (age ≥18 years); resistance training intervention (duration ≥4 weeks); at least one flexibility outcome. Risk of bias was assessed using the RoB-2 and ROBINS-I tools. A 3-level meta-analysis was conducted, with multiple outcomes nested within each study. A moderator analysis was conducted by fitting a meta-regression model. Significance level was set at p < 0.05. We included 36 studies (1,469 participants). None of the included papers resulted at a low risk of bias. The pooled effect size for resistance training on flexibility was g = 0.6325, with 95% CI: 0.4762 to 0.7888 (p < 0.0001). There was a substantial amount of heterogeneity between studies. Exercise intensity was a significant moderator (p < 0.0225, high vs low), based on 129 and unique effect sizes, and sex (p = 0.0429). Activity level and age were nonsignificant moderators. Resistance training could be implemented as a strategy to improve joint flexibility, with high-intensity protocols resulting in a magnified effect. However, the high overall risk of bias and substantial heterogeneity limit our ability to draw definitive conclusions.

ASSOCIATIONS OF PROTEIN INTAKE WITH THE RISK OF ALL-CAUSE, CARDIOVASCULAR, AND CANCER MORTALITY: A META-ANALYSIS

Abstract The association of the amount and sources of protein consumption with mortality for cardiovascular diseases (CVD) and cancer has been extensively studied. However, the outcomes remains controversial. The present meta-analysis was conducted to synthesize findings on the associations between total, animal, and plant protein intake and the risk of mortality from all causes, and cancer. Pubmed and Web of Science were searched to identify prospective cohort studies published up to November 2022. Random effects models were used to calculate pooled effect sizes and 95% confidence intervals for the highest versus lowest categories of protein intake. Heterogeneity were evaluated with I2 statistic, and publication bias was evaluated with funnel plots and Egger’s test. A total of 28 cohort studies were identified. The results showed that total protein (HR=0.99, 95%CI: 0.93, 1.04; HR=0.95, 95%CI: 0.87, 1.02; HR=0.97, 95%CI: 0.84, 1.11), animal protein (HR=1.02, 95% CI: 0.98, 1.07; HR=1.05, 95% CI: 0.99, 1.12; HR=1.00, 95% CI: 0.98, 1.02) were not associated with the all-cause, CVD and cancer mortality. However, the intake of plant protein was inversely associated with the risk of all-cause (HR=0.92, 95% CI: 0.87, 0.96) and CVD mortality (HR=0.87, 95% CI:0.81, 0.93), but not cancer mortality (HR=0.98, 95% CI: 0.94, 1.01). This study demonstrates that higher plant protein intake is associated with a reduced risk of all-cause and CVD mortality. Increasing plant protein intake is a potential way to decrease the risk of death.

Effect of Aerobic Exercise on Blood Glucose Among Those with Prediabetes: A Systematic Review and Meta-Analysis.

Prediabetes, a state between normoglycemia and diabetes, is increasingly affecting population health; thus, it should not be overlooked. This systematic review and meta-analysis aimed to explore the efficacy of aerobic exercise on blood glucose indicators among those with prediabetes. Five databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL, were searched up to September 2024 to identify randomized controlled trials measuring the effect of aerobic exercise on blood glucose levels among individuals with prediabetes. Data on fasting blood glucose (FBG), 2-h postprandial plasma glucose (2hPG), and hemoglobin A1c (HbA1c) were extracted. Subgroup analyses were conducted based on intervention duration, weekly exercise duration, and volume. In total, 2518 relevant records were initially retrieved, and 16 studies were included in this systematic review, with 14 providing sufficient data for meta-analysis. Compared to the control group, the weighted mean difference (MD) for FBG, 2hPG, and HbA1c was -1.33 (95%CI: -1.87, -0.89), -1.00 (95%CI: -1.60, -0.39), and -1.05 (95%CI: -1.49, -0.61), respectively. Subgroup analysis showed that pooled effect size for FBG, 2hPG, and HbA1c was greater in the subgroup subjected to ≥48 weeks of intervention compared to the subgroup subjected to ≤24 weeks of intervention, although only the difference in FBG was significant (p < 0.05). Weekly exercise longer than 180 min/week led to greater reductions in FBG, 2hPG, and HbA1c compared to weekly exercise shorter than 150 min/week, and only differences in 2hPG were not significant (p > 0.05). Total weekly exercise of 1314-1323 MET·min/week led to greater reductions in FBG and HbA1c levels compared to 975-1080 MET·min/week (p > 0.05). Aerobic exercise effectively decreases FBG, 2hPG, and HbA1c and controls blood glucose levels. The volume and duration of aerobic exercise are important factors affecting the reduction in blood glucose levels, exhibiting a positive correlation within a specific range. Aerobic exercise can serve as a viable therapeutic approach for reducing the risk of diabetes among individuals with prediabetes.

Effects of Prebiotics and Probiotics on Symptoms of Depression and Anxiety in Clinically Diagnosed Samples: Systematic Review and Meta-analysis of Randomized Controlled Trials.

The use of prebiotics and probiotics as a treatment for psychiatric conditions has gained interest due to their potential to modulate the gut-brain axis. This review aims to assess the effectiveness of these interventions in reducing symptoms of depression and anxiety in psychiatric populations. The aim was to comprehensively review and appraise the effectiveness of prebiotic, probiotic, and synbiotic interventions in reducing clinical depression and anxiety symptoms. Systematic searches were conducted across Embase, Medline, PsycINFO, CINAHL, Cochrane Library, and Science Citation Index from database inception to May 22, 2023. Randomized controlled trials investigating prebiotic, probiotic, or synbiotic interventions for treating clinical depression or anxiety symptoms in clinical samples were included. Data were extracted on study characteristics, intervention details, and outcome measures. The Cochrane Collaboration Tool was used to assess the risk of bias. The standardized mean difference (SMD) was calculated using Hedge's g as the metric of effect size. A random-effects model was applied to estimate pooled effect sizes with 95% CIs. Subgroup analyses were performed based on study characteristics, methodological factors, and intervention types. Sensitivity analyses excluded studies with a high risk of bias. Twenty-three RCTs involving 1401 patients met the inclusion criteria, with 20 trials providing sufficient data for meta-analysis. Of these, 18 trials investigated probiotics for depression, 9 trials assessed probiotics for anxiety, and 3 trials examined prebiotics for depression. Probiotics demonstrated a significant reduction in depression symptoms (SMD: -0.96; 95% CI: -1.31, -0.61) and a moderate reduction in anxiety symptoms (SMD: -0.59; 95% CI: -0.98, -0.19). Prebiotics did not show a significant effect on depression (SMD: -0.28; 95% CI: -0.61, 0.04). High heterogeneity was observed across studies, and subgroup analyses indicated that study duration and probiotic formulations contributed to the variation in effect sizes. Probiotics showed substantial reductions in depression symptoms and moderate reductions in anxiety symptoms. Prebiotics showed a nonsignificant trend toward reducing depression. An adjunctive mental health treatment approach that diagnoses, monitors, and treats the gut microbiome alongside traditional pharmacological treatment holds promise for clinical practice. PROSPERO registration no. CRD42023424136.

Dental Implant Failure Risk in Patients with Bruxism-A Systematic Review and Meta-Analysis of the Literature.

Background/Objectives: Recent research has indicated that placing dental implants in patients diagnosed with bruxism has led to higher rates of implant failure. This study aimed to provide more accurate knowledge about the relationship between bruxism and implant loss in patients (number, age, gender) with different numbers of implants and prosthetic restorations, considering the follow-up time, compared to non-bruxers. Methods: A systematic search was conducted in PubMed and Cochrane Library using the keyword combination "dental implant", "bruxism", and "implant failure". This search had no language or time restrictions. Results: The review included 15 papers, which were divided into four groups. The first group focused on studies regarding implant loss regardless of the superstructure. In the second group, research on implant-supported removable prostheses was examined. The third group consisted of a single study specifically addressing implant-supported single crowns. Lastly, the fourth group comprised two studies investigating implant-supported single crowns and fixed partial dentures. Only three out of the fifteen studies failed to find a correlation between bruxism and implant failure. The meta-analysis shows a significant pooled effect across the included studies, with an odds ratio of 4.68. Conclusions: Bruxism is a probable risk factor for mechanical issues in implant-supported prostheses and implant-supported crowns. Additionally, elevated failure rates have been documented in patients with bruxism.

Testing an HPV Vaccine Decision Aid for 27- to 45-Year-Old Adults in the United States: A Randomized Trial.

In the United States, human papillomavirus (HPV) vaccination among 27- to 45-y-olds (mid-adults) is recommended based on shared clinical decision making with a health care provider. We developed a patient decision aid tool to support the implementation of this mid-adult HPV vaccination guideline. The purpose of this study was to evaluate the effect of a patient decision aid tool for HPV vaccination, HPV DECIDE, compared with an information fact sheet among mid-adults who have not received the HPV vaccine. Participants were recruited between December 2023 and January 2024. We used a randomized Solomon, 4-group, pretest/posttest design with mid-adults aged 27 to 45 y who were unvaccinated for HPV and balanced based on sex (n = 612). The primary outcome was decisional conflict. Intermediate outcomes included knowledge, behavioral expectancies, self-efficacy, and perceived risk. Variables were measured using validated scales. Pretest sensitization was not present; intervention and control groups were compared. Fixed-effects inverse-variance weighting was used to pool effect estimates and determine meta-analytic statistical significance across tests with and without pretest controls. Participants in the intervention group had significantly lower total decisional conflict scores (B = -3.58, P = 0.007) compared with the control group. Compared with the control group, participants in the intervention group showed higher knowledge (B = 0.48, P = 0.020), greater intention to receive (B = 0.196, P = 0.049) and discuss the HPV vaccine (B = 0.324, P ≤ 0.001), and greater self-efficacy about HPV vaccine decision making (B = 3.28, P = 0.043). There were no statistically significant results for perceived risks of HPV infection. The HPV DECIDE tool for mid-adult HPV vaccination shows promise for immediate reductions in decisional conflict and improvement in knowledge, intentions, and self-efficacy about the HPV vaccine. Future studies are warranted to evaluate the effectiveness of this patient decision aid tool in real-world settings. Shared clinical decision making is recommended for HPV vaccination with mid-adults.A patient decision aid for HPV vaccination reduced decisional conflict for mid-adults.The HPV vaccine patient decision aid was acceptable to mid-adults.

Evaluating Community of Inquiry's effectiveness in online Science Instruction

The Community of Inquiry (CoI) framework has emerged as a pivotal model for online science instruction during the global shift to remote learning from 2020–2022. This meta-analysis evaluated its impact on academic achievement and students' behavior by systematically examining published articles (N=798) using Harzing's Publish or Perish© adhering to PRISMA© protocol. Effect sizes were calculated through Hedges' g and Random Effects Models, with heterogeneity evaluated using τ² and Q-statistics. The findings revealed a significant pooled random effect size (ES = 1.188, p &lt; .0001), demonstrating a significant effect on academic achievement (ES = 2.026, p = .097) and a medium effect on students' behavior (ES = .611, p = .0001). CoI demonstrated significant potential in fostering meaningful academic and behavioral improvements in online learning, highlighting the need for targeted strategies to optimize its benefits and further explore its varied impact across diverse educational contexts.

Dopaminergic Treatment and Episodic Memory in Parkinson's Disease: A Meta-analysis of the Literature.

To date, few studies have focused on the benefits of dopaminergic treatment on episodic memory functions in patients affected by Parkinson's disease (PD). We conducted a meta-analysis to determine the effects of pharmacological therapy with dopamine in alleviating episodic memory deficits in Parkinson's patients. A secondary aim was to evaluate the role of dopamine in episodic memory circuits and thus in different memory systems. We conducted a comprehensive literature search in PubMed (1971-2022) to find studies that met specific inclusion criteria. The studies had to provide sufficient data (means and standard deviations) to evaluate performance on neuropsychological tests of episodic memory. A total of k = 36 measures were included in the analysis. A statistically significant difference suggested better performance following dopaminergic therapy assumption (ON condition) than following dopaminergic withdrawal (OFF condition), specifically the estimated pooled effect calculated through a random-effects restricted maximum likelihood model was log ratio of means (RoM) = 0.047 (p = 0.011). The back-transformed RoM, indicating a 4.8% improvement, provides an interpretable measure of the effect size, as it reflects the multiplicative change in performance associated with the ON condition. A meta-regression analysis was also performed to assess the influence of specific memory tasks and relevant covariates/factors on the overall meta-analytic effect: four memory contrasts (verbal/visual, immediate/delayed, recall/recognition, word-list/short-story), age of participants, years of education, severity of illness, duration of illness in years, country of study, proportion of women in the sample, type of medication, counterbalancing. Word list/short story and proportion of women in the sample were the only two statistically significant predictors in the model, both associated with a positive higher pooled effect size. The present study revealed a significant overall difference between the results obtained in the ON and OFF conditions. We also found a significantly greater pharmacological effect in the recall of short stories than word lists, which supports the hypothesis of a beneficial effect of dopamine on the hippocampal circuit rather than on prefrontal cortical areas.

Transition to home after very preterm birth: improving outcomes of children and their families—a systematic review protocol

IntroductionMedical progress has significantly improved the survival rates of very preterm-born infants in recent decades. Nevertheless, these infants are still at increased risk for long-term impairments as compared with term-born...

A protocol and analysis of year-long simulations of global storm-resolving models and beyond

We propose a protocol to evaluate and analyze year-long simulations of global storm-resolving models (GSRMs). The proposed protocol complements an earlier 40-day simulation protocol under the DYAMOND (DYnamics of the Atmospheric general circulation Modeled On Non-hydrostatic Domains) project to allow the analysis of the seasonal cycle and associated climatic relevant phenomena. This intercomparison aims to reveal how GSRMs, which can simulate mesoscale convective systems (MCSs) in the global domain, reproduce atmospheric large-scale structures related to convection beyond month-long simulations. The intercomparison for one-year simulations is conducted by either atmosphere-only models or atmosphere–ocean coupled models with atmospheric horizontal mesh sizes less than 5 km. We recommend the continuous four seasons from March 2020 to February 2021 as a target period for the intercomparison but with options for many groups to join more flexibly. The output variables are collected at 0.25° resolution, and archives of a small set of native grid variables are encouraged to analyze tropical cyclones and MCSs. Through the proposed global storm-resolving simulation, we will evaluate the climatological distributions of the atmospheric large-scale circulations, such as the Intertropical Convergence Zone (ITCZ), monsoon, midlatitude jets, their time evolution, and the upscale impacts on them. We present sample analyses from a one-year simulation using the 3.5 km mesh Nonhydrostatic Icosahedral Atmospheric Model (NICAM), revealing the realistic zonal contrast of tropical precipitation, no double ITCZ structure, the reasonable midlatitude jet position and intensity but a weak bias of storm track activities, and a warm bias over the Eurasia during boreal winter. We also clarify the cross-scale interaction, such as the effects of cold pools on mean precipitation over the Maritime Continent through the precipitation diurnal cycle and the effects of resolved gravity waves on midlatitude mean flows. The proposed one-year simulation protocol is referred to as the “Sendai Protocol.” This protocol is not unique or definite for evaluating GSRMs; we prospect a hierarchical set of experiments from short-term to multi-year simulations as GSRM intercomparisons.A protocol and analysis of year-long simulations of global storm-resolving models. Daisuke Takasuka, Masaki Satoh, Tomoki Miyakawa, Chihiro Kodama, Daniel Klocke, Bjorn Stevens, Pier Luigi Vidale, Christopher R. Terai. Progress in Earth and Planetary Science. Sample analysis of a one-year experiment with the global storm-resolving model, Nonhydrostatic Icosahedral Atmospheric Model (NICAM). Top: seasonal mean precipitation obtained from the (left) the Global Precipitation Climatology Project (GPCP) product and (right) 3.5-km NICAM simulation for (a, b) March-April-May, (c, d) June-July-August, (e, f) September-October-November, and (g, h) December-January-February in 2011-2012. Bottom: time-latitude diagrams of the monthly mean precipitation averaged from 160°E to 140°W over the Pacific for the (left) GPCP product and (right) 3.5-km NICAM simulation

Association Between Systemic Immune-Inflammation Index and Outcomes of Acute Myocardial Infarction: A Systemic Review and Meta-Analysis.

Objective: To assess the link between systemic immune-inflammation index (SII) and risk of major adverse cardiovascular events (MACE), contrast-induced nephropathy (CIN), and overall mortality in patients with acute myocardial infarction (AMI). Patients and Methods: Electronic search of PubMed, EMBASE, Web of Science, and Scopus databases was done for observational studies with the data on the association of SII and outcomes, such as MACE, and CIN in adult (≥18 y) patients with AMI. A random-effects model was used, and the pooled effect sizes were expressed as relative risk (RR) with corresponding 95% confidence intervals (CI). Subgroup analysis was conducted on the basis of the type of AMI (ST elevation myocardial infarction and non-ST elevation myocardial infarction), sample size (≥500 and <500), and study design. GRADE assessment was used to evaluate the certainty of the evidence. Results: The analysis included 23 studies. Most studies were conducted in China (n = 13), followed by Turkey (n = 10). Majority of the studies (n = 20) had a retrospective cohort design. Patients with high SII had increased risk of MACE (RR 2.95, 95% CI: 1.25, 6.99; n = 5, I2 = 97.5%), overall mortality (RR 2.59, 95% CI: 1.64, 4.07; n = 6, I2 = 58.0%), and CIN (RR 4.58, 95% CI: 3.44, 6.10; n = 4, I2 = 0.0%), compared with patients with lower SII. Egger's test detected publication bias for MACE (p = 0.047) and overall mortality (p = 0.012) but not for CIN. These associations remained valid in subgroup analysis. Conclusion: Findings suggest that higher SII in patients with AMI is associated with increased risks of MACE, CIN, and overall mortality. This underscores SII's potential as a prognostic marker in AMI.

Comparing Medical Record Abstraction (MRA) error rates in an observational study to pooled rates identified in the data quality literature

BackgroundMedical record abstraction (MRA) is a commonly used method for data collection in clinical research, but is prone to error, and the influence of quality control (QC) measures is seldom and inconsistently assessed during the course of a study. We employed a novel, standardized MRA-QC framework as part of an ongoing observational study in an effort to control MRA error rates. In order to assess the effectiveness of our framework, we compared our error rates against traditional MRA studies that had not reported using formalized MRA-QC methods. Thus, the objective of this study was to compare the MRA error rates derived from the literature with the error rates found in a study using MRA as the sole method of data collection that employed an MRA-QC framework.MethodsA comparison of the error rates derived from MRA-centric studies identified as part of a systematic literature review was conducted against those derived from an MRA-centric study that employed an MRA-QC framework to evaluate the effectiveness of the MRA-QC framework. An inverse variance-weighted meta-analytical method with Freeman-Tukey transformation was used to compute pooled effect size for both the MRA studies identified in the literature and the study that implemented the MRA-QC framework. The level of heterogeneity was assessed using the Q-statistic and Higgins and Thompson’s I2 statistic.ResultsThe overall error rate from the MRA literature was 6.57%. Error rates for the study using our MRA-QC framework were between 1.04% (optimistic, all-field rate) and 2.57% (conservative, populated-field rate), 4.00–5.53% points less than the observed rate from the literature (p < 0.0001).ConclusionsReview of the literature indicated that the accuracy associated with MRA varied widely across studies. However, our results demonstrate that, with appropriate training and continuous QC, MRA error rates can be significantly controlled during the course of a clinical research study.

Psychotherapeutic Interventions for Depressive Symptoms in Community-Dwelling Older Adults: A Systematic Review with Meta-Analysis.

This review investigates psychotherapeutic interventions for reducing depressive symptoms in older adults in a community setting. RCTs were assessed using Joanna Briggs Institute tools. The following databases were searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and the Psychology and Behavioral Sciences Collection. A meta-analysis of 13 studies with 1528 participants showed a medium, significant pooled effect size at post-intervention (Hedges' g = -0.36, p < 0.001) and substantial heterogeneity. Follow-up analysis of studies indicated a small, non-significant effect (Hedges' g = -0.17, p = 0.27). Group interventions, particularly the "reminiscence protocol", had the largest significant effect. This systematic review and meta-analysis found that in community-dwelling older adults' group psychotherapeutic interventions, particularly the "reminiscence protocol" and "modified behavioral activation treatment" are most effective for reducing depressive symptoms. Individual psychotherapeutic interventions like "prevention of suicide in primary care elderly" and "behavioral activation" also show effectiveness, with group psychotherapeutic interventions being generally more effective than when these treatments are offered in individual psychotherapeutic interventions. Group and individual psychotherapeutic interventions reduce depressive symptoms in community-dwelling older adults, with group psychotherapeutic interventions being more effective.