Previous Meta-analyses Research Articles

Circulating irisin levels in patients with MAFLD: an updated systematic review and meta-analysis

ObjectiveCurrent research suggests that irisin is closely linked to the pathogenesis and progression of metabolic dysfunction-associated fatty liver disease (MAFLD). This systematic review and meta-analysis updates our previous meta-analysis and further explores the relevance between circulating irisin levels and MAFLD.MethodsNine databases (PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, Weipu, CBM, Clinicaltrials.gov and gray literature) were retrieved as of 1st August, 2024. The standardized mean difference (SMD) and 95% confidence interval (CI) represent pooled effect size. We used the Newcastle–Ottawa Scale to evaluate the quality of articles and the certainty of evidence assessed by GRADE system. All statistical analyses were performed using RevMan 5.3 and Stata 12(Stata Corporation, yi TX).ResultsFifteen case-control studies were included. Circulating irisin levels in the MAFLD group were markedly lower than those in the healthy group (SMD=-1.04 [-1.93, -0.14]). Subgroup analyses by race, age, severity and T2DM revealed that circulating irisin levels were lower in the MAFLD group compared to those in the healthy controls in the Asian population (SMD=-1.38 [-2.44, -0.31], P<0.05) and in those above 50 years old (SMD=-2.23 [-3.64, -0.81], P<0.05) and higher in the mild MAFLD groups than those in moderate to severe MAFLD groups (SMD = 11.68 [9.05, 14.31], P<0.05). And the circulating irisin levels in MAFLD patients with T2DM were significantly lower than those in healthy group (SMD = -2.90 [-4.49, -1.30]). ELISA kits from different companies also presented different relationships.ConclusionsThere were significantly lower circulating irisin levels in the MAFLD group than in the healthy control group. Although these results differed from our previous results, there is no denying that circulating irisin levels are closely associated with the advancement of MAFLD.

Navigating agitation in neurodevelopmental disorders: A comparative study of pharmacotherapies via network meta-analysis in children and adults with autism spectrum disorder or intellectual disabilities.

Individuals with autism spectrum disorder (ASD) and intellectual disability often experience persistent challenges related to aggressive behaviour and agitation, highlighting the critical need for evidence-based pharmacological interventions among other strategies. Despite previous network meta-analyses (NMAs), the rapidly evolving landscape of treatment options necessitates ongoing and updated assessments. To evaluate the efficacy and tolerability of various pharmacotherapies in managing agitation in children and adults with ASD or intellectual disabilities (ID). Employing a systematic review and network meta-analysis methodology, we conducted an exhaustive search across multiple databases for double-blind, randomized controlled trials focusing on pharmacotherapies targeting agitation in these neurodevelopmental disorders. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, our assessment of study quality utilized the Cochrane Risk of Bias Tool to ensure methodological rigour and accuracy in data synthesis. Primary outcomes encompassed measures of reduced agitation, as indicated by treatment response on standardized agitation scales, alongside dropout rates, providing a comprehensive overview of treatment efficacy and tolerability. Our analysis included data from 38 eligible trials, involving 2503 participants across both pediatric and adult populations. Key pharmacological interventions, such as arbaclofen, risperidone plus buspirone, omega-3 fatty acids, risperidone plus palmitoylethanolamide, aripiprazole and risperidone, demonstrated significant efficacy in reducing agitation compared to placebo. Importantly, these treatments were generally well-tolerated, with no significant increase in all-cause dropouts compared to placebo, highlighting their suitability for clinical use in managing agitation in individuals with ASD or ID. This study underscores the efficacy and tolerability of several pharmacotherapies in managing agitation among children and adults with ASD or ID. Our findings provide robust evidence that specific treatments, such as arbaclofen, risperidone plus buspirone and omega-3 fatty acids, are both effective and well-tolerated, offering valuable therapeutic options for clinicians. The study emphasizes the need for ongoing research to ensure that treatment strategies remain aligned with the evolving clinical landscape, ultimately improving patient outcomes in this challenging population.

Association Between Parental Adverse Childhood Experiences and Offspring's Risk of Suboptimal Health: A Systematic Review and Meta-Analysis.

Previous reviews and meta-analysis have not adequately explored the impact of specific parental adverse childhood experiences (ACEs) subtypes on offspring's health. This updated systematic review and meta-analysis aimed to investigate the association between parental ACE subtypes and various offspring health outcomes. A comprehensive search was conducted in electronic databases including PubMed, Web of Science, the Cochrane Library, WANFANG, and China National Knowledge Infrastructure for studies published in English and Chinese from January 1, 1998, until July 18, 2023. Two independent reviewers screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. A random-effects model was applied to generate pooled odds ratios (ORs) and 95% confidence interval (95% CI). A total of 47 eligible studies were included in the final analysis. Overall, parental ACEs were significantly associated with several offspring's health outcomes, including preterm birth (PTB), low birth weight (LBW), total developmental delay, social-emotional problems, and behavioral problems (total, externalizing and internalizing behaviors), with ORs ranging from 1.06 to 3.02. Specific subtypes of parental ACEs, such as household dysfunction, sexual abuse, and physical abuse (but not emotional abuse) were significantly associated with PTB. Household dysfunction was notably linked to delayed cognition ability in offspring. Parental sexual abuse, physical abuse, emotional abuse, and emotional neglect were significantly correlated with social-emotion problems, with the expception of household dysfunction. Regarding total behavioral problems, parental household dysfunction, physical abuse, emotional abuse, physical neglect, and peer bullying were all significantly associated with children's behavioral issues, except for emotional neglect. There is a positive correlation between parental household dysfunction, sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect, peer bullying, and neighborhood-related adversity and their children's externalizing behavior problems. These findings underscore the significant impacts of parental ACEs on multiple adverse health outcomes in children, with specific parental ACEs subtypes exerting unique effects. This highlight the significance of comprehending the intergenerational effects of different ACE subtypes, and emphasizes the urgency of interventions to address these issues.

Evaluation of the safety and effectiveness of easyEndo™ universal stapler compared with easyEndo™ E-lite in patients submitted to gastric surgery: a retrospective/prospective study including a large number of patients

Background: Staple line complications represent the most dangerous complication after gastric surgery. Better-formed staples could potentially reduce complications postoperatively. The newer motorized generation stapling system would lead to fewer intraoperative staple line complications compared to traditional stapling systems. Purpose was to evaluate the safety and efficacy of these two types of stapler models by determining its intraoperative performance and peri-operative complications. Methods: It was an observational cohort study including a total of 3613 patients submitted to gastric surgery for benign or malignant disease. The study was conducted within two periods: stage A using easyEndoTM universal (n=2359 patients, from January 2017 to December 2022) and stage B (n=1254 patients, from January 2023 to June 2024) using easyEndoTM E-lite motorized stapler including obese patients (n=3239), benign diseases with indication of surgical treatment (n=268) and patients with gastric cancer (n=106). Results: Although higher rate of leaks and postoperative complications were observed in patients submitted to sleeve gastrectomy or gastric bypass during stage A compared with stage B (p=0.0025), both type of staplers are safe and effective for performing gastric surgery. In patients submitted to gastric resections, no significates differences were demonstrated in terms of postoperative complications comparing the two groups (p=0.1). Conclusions: Patients operated on using motorized stapler presented less suture line interventions but no differences regarding postoperative complication. The results confirmed data published in previous reports and meta-analysis, but now including a big number of patients and complex procedures.

The Effect of Physical Exercise on Post-COVID-19 Survivors: A Scoping Review

Background: Post-COVID-19 survivors or patients show deterioration in respiratory function, physical symptoms, musculoskeletal strength, quality of life (QoL), and psychological problems due to persistent symptoms. These symptoms are associated with mitochondrial dysfunction, reduced antioxidants, and oxidative stress. Physical exercise has been proven to positively affect general and psychological health.Objective: This study intended to explore physical exercise's effect on post-COVID-19 survivors.Methods: Literature in this scoping review was searched from seven databases, including Embase, PubMed, CINAHL, Cochrane, Scopus, Ovid-MEDLINE, and Web of Science. A manual search from Google Scholar and citations from previous meta-analyses were also performed. The keywords are “physical exercise” OR “physical activity” AND “post-COVID” OR “Long COVID.” Studies were included if involving patients with post-COVID diagnosis. However, studies that did not focus on post-COVID-19 focused on respiratory rehabilitation and had no complete data were excluded from this review.Results: 33 studies from 1.909 were included (30 from databases and three citations from previous meta-analyses). Physical activity for post-COVID survivors can improve lung function, exercise capacity, functional capacity, physical symptoms (for instance, pain, fatigue), psychological or QoL, and also biochemical and hematological variables (for example, platelets, red blood cells, white blood cells, hemoglobin, hematocrit, creatinine, and urea).Conclusion: Physical activity programs may represent an important supportive therapy for post-COVID-19 survivors. Therefore, health workers are encouraged to closely monitor respiratory parameters or post-COVID-19 patient symptoms and motivate patients to perform physical exercise.

Combination Therapy with Korean Medicine and Filgrastim on Neutropenia: A Retrospective Study

Objectives: Neutropenia is a complication due to chemotherapy or radiotherapy that can limit clinical outcomes. Previous systematic reviews and meta-analysis have suggested that traditional Asian medicine may relieve neutropenia. This study investigated the effect of the combination therapy of Korean Medicine (KM) and filgrastim on neutropenia.Methods: A total of 336 subjects were included, with 167 in the only filgrastim treatment group and 169 in the filgrastim with KM treatment group. Absolute neutrophil count (ANC) was calculated by multiplying the white blood cell count by the total percentage of neutrophils. ANC was observed on the day of filgrastim and up to 6 days with hospital medical records.Results: The clinical characteristics of the participants in the filgrastim with KM treatment group tended to have higher age. Comparing the two groups, by the linear mixed-effects model, ANC mean was significantly different on the 3rd day. A linear mixed effect model was performed to estimate difference in slope of ANC over time after treatment between the two groups. The slope difference was significant in neutropenia grade 3 patients. The mean of ANC increment after initial treatment tends to increase with the number of days of KM treatment but not statistically significant. During the follow-up period, the average blood levels of patients in the filgrastim with KM treatment group were within the normal range.Conclusions: The combination treatment with filgrastim and KM can be effective for patients with neutropenia.

Umbrella-Review, Evaluation, Analysis and Communication Hub (U-REACH): a novel living umbrella review knowledge translation approach

Systematic reviews and meta-analyses have become crucial for evidence-based decision-making in recent decades. However, it is common for the results of multiple reviews on the same topic to be inconsistent,...

Contraception with levonorgestrel-releasing intrauterine system versus copper intrauterine device: a meta-analysis of randomized controlled trials

Globally, approximately 19.4% of women of reproductive age use intrauterine contraception, encompassing both copper intrauterine devices (Cu-IUDs) and levonorgestrel intrauterine devices (LNG-IUDs). Despite current guidelines endorsing intrauterine contraception as a primary method, there remains debate regarding device selection. Notably, the lack of data regarding reasons for discontinuation has limited previous meta-analyses. This study aims to comprehensively evaluate the potential differences between intrauterine devices using available multinational data, thereby providing a basis for global policy and healthcare services. We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library for primary studies published from inception to January 13, 2024, with no language or geographic restrictions. The study was registered on PROSPERO (CRD42024496400). We included only randomized controlled trials comparing Cu-IUDs and LNG-IUDs. Data extraction was independently conducted by two reviewers, with unresolved discrepancies referred to a third senior reviewer for consultation. The primary outcome was pregnancy, with secondary outcomes encompassing continuation, reasons for discontinuation, expulsion, satisfaction, and other adverse events. Data were synthesized using a random-effects model. Risk of bias was evaluated with the Cochrane Collaboration's tool, and evidence quality was assessed using the GRADE framework. An analysis of 20 trials showed that compared to Cu-IUDs, LNG-IUDs were associated with lower risks of pregnancy (Risk Ratio 0.22, 95% confidence interval 0.12-0.39), ectopic pregnancy (RR 0.12, 95% CI 0.03-0.47), discontinuation due to increased bleeding (RR 0.49, 95% CI 0.28-0.85), increased bleeding (RR 0.42, 95% CI 0.25-0.7), heavy bleeding (RR 0.41, 95% CI 0.22-0.75), and dysmenorrhea (RR 0.41, 95% CI 0.34-0.48), but they carried a higher risk of discontinuation due to amenorrhea (RR 21.05, 95% CI 8.83-50.00). When comparing LNG (52mg) IUD with copper (380mm2) IUD, The LNG-IUD showed a lower risk of discontinuation due to increased bleeding (RR 0.68, 95% CI 0.55-0.58) and dysmenorrhea (RR 0.42, 95% CI 0.34-0.53), but a higher risk of discontinuation due to bleeding issues (RR 2.83, 95% CI 2.47-3.25) and amenorrhea (RR 5.92, 95% CI 2.81-12.49). There were no significant differences between the two terms of continuation, expulsion, non-medical reasons for discontinuation, satisfaction, and other adverse outcomes. LNG-IUDs and Cu-IUDs are both highly effective contraceptive methods. Compared to Cu-IUDs, LNG-IUDs were associated with a lower risk of pregnancy and adverse reactions. However, LNG-IUDs carry a higher risk of amenorrhea. When recommending contraceptive methods, healthcare providers should fully inform patients of these potential risks and consider patient preferences. The research was funded by Hunan Provincial Natural Foundation of China (2021JJ30040), the National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University (2021KFJJ06), and the National Natural Science Foundation of China (No. 81672225).

Predictive value of MRI for identifying symptomatic neurovascular compressions in classical trigeminal neuralgia: a PRISMA-compliant meta-analysis

BackgroundPatients with trigeminal neuralgia frequently undergo magnetic resonance imaging (MRI) prior to surgery. In patients without the signs and symptoms of face discomfort, MRI has shown the presence of neurovascular contact (NVC) in humans. Therefore, its capacity to accurately exclude NVC of the trigeminal nerve is not properly understood. A meta-analysis of the literature satisfied the criteria to further explore the value of MRI for the diagnosis of classical trigeminal neuralgia (CTN).Study designThe association between the symptomatic and asymptomatic trigeminal nerves, NVC, root entry zone (REZ), non-REZ, and anatomical variation was measured by a comprehensive review and meta-analysis of 13 observational studies using MRI for CTN neurovascular compression diagnosis.ObjectivesThis study aimed to evaluate the effectiveness of MRI in detecting the neurovascular compression that causes symptoms in individuals with classic trigeminal neuralgia.SettingThis study was conducted at the Department of Neurosurgery, Yantai Yuhuangding Hospital, Qingdao University.MethodsDigital searches of PubMed, Embase, and the Cochrane Library were performed to identify studies published until December 31, 2023. The following were evaluated: (1) MRI evidence of NVC in symptomatic and asymptomatic trigeminal nerves; (2) MRI indication of NVC at the REZ in symptomatic and asymptomatic trigeminal nerves; (3) MRI substantiation of non-REZ neurovascular contact in patients with CTN; and (4) asymptomatic and symptomatic anatomical changes at the NVC site of the trigeminal nerves. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the fixed effects models.ResultsWe identified 13 observational studies (1 prospective and 12 retrospective studies) with data collected from 1770 nerves (728 symptomatic and 1042 asymptomatic) were meta-analyzed. First, MRI of 649/728 (88.2%) symptomatic versus 378/1042 (36.3%) asymptomatic trigeminal nerves revealed marked differences in NVC in the REZ (OR = 16.3; CI 95%=12.2–21.8; p < 0.00001). Second, pooled data showed that REZ NVC was detected in 206/262 (78.6%) symptomatic and in 129/340 (37.9%) asymptomatic nerves (OR = 5.0; CI 95% = 3.4–7.3; p < 0.00001); Third, no significant differences were detected between 44/267 (16.5%) symptomatic and 23/189 (12.1%) asymptomatic nerves on MRI examination of NVC in the NON-REZ (OR = 0.9; CI 95% 0.5–1.6) (p = 0.77); Finally, MRI revealed marked differences in 302/567 (53.2%) symptomatic and 73/919 (7.9%) asymptomatic anatomic changes (atrophy, dislocation, distorsion, flattening or indentation) at the NVC site of the trigeminal segments (OR = 11.9; CI 95% = 8.8–16.2; p < 0.00001).LimitationsDespite the systematic evaluation of 13 observational studies, large-scale randomized controlled trials should be conducted, focusing on the specificity of MRI for the diagnosis of trigeminal neuralgia and evaluating the specificity of the imaging findings and the impact of the patient’s postoperative treatment.ConclusionsA previous meta-analysis showed that patients with CTN were more likely to have NVC-specific anatomical changes. MRI of patients with CTN can detect anatomical changes in the REZ NVC with higher sensitivity.

Reassessing the Neural Correlates of Social Exclusion: A Replication Study of the Cyberball Paradigm Using Arterial Spin Labeling.

The cyberball paradigm has been used in numerous neuroimaging studies to elicit activation in neural substrates of social exclusion, which have been interpreted in terms of activity associated with "social pain". The objectives of the study were to assess not only the replicability but also the specificity of the areas activated by this paradigm. Functional imaging with arterial spin labeling, an approach to image longer mental states. We replicated findings of previous meta-analyses of this paradigm in the inferior frontal gyrus and ventral cingular cortex. However, these areas were also active in a watch condition (in which participants were not excluded), although less so. These findings relativize a simple and specific interpretation of these areas as the neural substrates of social exclusion and social pain, as in previous studies. In a broader experimental context, similar activations have been reported by neuroimaging studies when semantic disambiguation and evaluation of action goals are required, an interpretation that may also apply to the effects elicited by this paradigm.

The Association Between Cadmium Exposure and Prostate Cancer: An Updated Systematic Review and Meta-Analysis.

Prostate cancer (PCa) is a common cancer among men, and it has a multifactorial etiology. Cadmium (Cd), a toxic heavy metal classified as a carcinogen by the IARC, can cause various acute and chronic effects. This systematic review and meta-analysis aims to update previous findings on the association between Cd exposure and PCa. We carried out a literature search in PubMed, Web of Science, and Scopus up to May 2024, identifying eight new articles. The effect size from the highest and lowest exposure categories were extracted and analyzed using a random-effects model. Heterogeneity was assessed with the I2 test, and publication bias was evaluated using funnel plot asymmetry. Overall, the effect size for PCa associated with Cd exposure, combining previous and new articles, was 1.11 (95% CI 0.85-1.45). Heterogeneity was high, but no significant publication bias was detected. For studies from Europe, the effect size was 1.47 (95% CI 1.00-2.17). Notably, 11 articles from the previous systematic review and meta-analysis highlighted that higher Cd exposure is significantly associated with more aggressive histopathological types of PCa (OR 1.50, 95% CI 1.08-2.07). These findings suggest a potential public health concern, indicating the need for further research to clarify the risk associated with Cd exposure.

A comprehensive meta-analysis of the impact of intervention programmes on psychological capital development: post-intervention and longer-term effects

PurposeThis paper presents the most up-to-date comprehensive meta-analysis of the effectiveness of interventions to enhance psychological capital (PsyCap). It also reports the first meta-analytic examination of longer-term effects (beyond the immediate post-intervention period).Design/methodology/approachThis meta-analysis followed PRISMA 2020 guidelines and utilised the methodologies of Hunter and Schmidt (2004) and Borenstein et al. (2009). The search period was from 2006 until February 2023. A total of 40 studies (N = 4,207) were included in the meta-analyses. The analyses were performed using the Comprehensive Meta-Analysis (CMA) Version 4 software programme.FindingsThe results indicate that the impacts of interventions on PsyCap and each of its component resources are greater than those reported in a previous meta-analysis (Lupșa et al., 2020), with the strongest impacts on hope and optimism. Interventions had sustained positive effects on PsyCap, hope, resilience and optimism, but not efficacy, and the frequency of intervention sessions influenced the effectiveness of interventions on hope, efficacy and optimism. Interestingly, specific PsyCap-focussed interventions did not have the greatest impact on PsyCap or its component resources.Originality/valueThis study contributes to emerging research on wellbeing-oriented HRM and provides valuable insights into more effective design and implementation of interventions to enhance PsyCap and its component resources. These interventions are a promising form of investment in employees which may bring mutual gains for individuals and organisations. The present findings extend those of previous studies and specifically respond to the call for further research on the persistence of PsyCap intervention effects.

The effects of mindfulness therapy on infertile female patients: A meta-analysis.

About 186 million people in the world suffer from infertility, and there is one infertile couple in every 4-6 couples. It is thus essential to find effective psychological treatment. To conduct a systematic review of previous meta-analyses on mindfulness-based therapy outcomes in infertile female patients and a meta-analysis of studies nested within these meta-analyses. Randomized controlled trials (RCTS) on the efficacy of mindset-based interventions in infertile female patients were retrieved from PubMed, The Cochrane Library, Embase, Web of Science, CNI, VIP Database, and Wanfang Database until March 1, 2023. Two researchers screened the literature, extracted data according to inclusion and exclusion criteria, and conducted quality control according to Cochrane Handbook 5.1.0. When there was ambiguity, a third party determined it. The meta-analysis was performed using RevMan 5.3 software. 14 randomized controlled trials involving 1784 patients were included. Meta-analysis showed that compared with conventional care, mindfulness-based intervention can effectively relieve anxiety in female infertility patients [SMD =-2.25, 95% CI (-2.90, -1.60), P< 0.00001], depression [SMD =-2.25, 95% CI (-2.99, -1.52), P< 0.00001], perceived stress [SMD =-0.99, 95% CI (-1.27, -0.71), P< 0.00001], improved quality of life, physiological function [MD = 14.03, 95% CI (11.98, 16.07), P< 0.00001], Role limitations due to physical problems [MD = 11.30, 95% CI (5.71, 16.90), P< 0.0001], vitality [MD = 11.55, 95% CI (9.46, 13.65), P< 0.00001], mental health [MD = 17.32, 95% CI (15.29, 19.35), P< 0.00001]. Existing evidence shows that mindfulness therapy can effectively relieve the anxiety and depression of infertile women, reduce the level of stress, and improve the quality of life and sleep quality. However, due to the limited quantity and quality of the literature, multi-center, large-sample, and high-quality randomized controlled studies should be conducted in the future.

Upstaging Prediction Model to Guide the Application of Sentinel Lymph Node Biopsy in Patients With Ductal Carcinoma In Situ: A Retrospective Comparative Study.

Indication for sentinel lymph node (SLN) biopsy in ductal carcinoma in situ (DCIS) patients with high-upstaging risk remains inconsistent. Our previous systematic review and meta-analysis had reported five variables that were significantly higher in the upstaging group. We developed the "high-risk upstaging model" and investigated its predictivity and accuracy. The study included patients initially diagnosed with DCIS in a medical center between 2011 and 2020. Patients' clinicopathological data were obtained through web-based surgical medical record database. Two prediction models were built, in which patients who met at least one (Model A) or two (Model B) of the predictors would be predicted to upstage in the final pathology. We compared the accuracy of our models with National Comprehensive Cancer Network (NCCN) guideline and original data. The analyses included 249 patients, of which 67 DCIS patients upstaged in final pathology. The excess treatment in Model A (70%) was lower than the original data (80.2%). The incomplete treatment in Model A (3%) was lower than the NCCN guideline model (38.8%) and the original data (7.5%). Both Model A and Model B yielded a higher receiver operating characteristic (AUC) curve compared with original data. Our Model A derived from the systematic review of the real-world data reduced the incomplete treatment rate of SLNB. Our Model B also showed the highest predictive value. With the two models, we provided a clearer indication for surgeons to perform SLNB in DCIS patients and demonstrated proof of concept, allowing ready input of patient data.

Effect of resting heart rate on the risk of metabolic syndrome in adults: a dose-response meta-analysis.

Given the notable rise in the prevalence of metabolic syndrome (MS) in China, it is urgent to identify early screening indicators. Extensive dose-response meta-analyses have been conducted to investigate the association between resting heart rate (RHR) and MS, and additional relevant studies have been updated in the last five years. Therefore, this paper aims to update the results of previous meta-analyses. PubMed, Cochrane Library, Web of Science, and Embase databases were searched from the inception to 25th May 2023. Additional relevant references were manually screened. Quality assessment was performed independently by authors using the Newcastle-Ottawa Scale. Stata 15.0 software was applied for data analysis. A random-effects model was adopted to pool the effect size of hazard ratio (HR) and 95% confidence interval (CI). A restricted cubic spline function was utilized to assess dose-response relationships. The protocol was prospectively registered in PROSPERO (number CRD42023458979). 35 studies from 21 reports were included, with 433,365 adults and 84,354 events of MS and/or diabetes mellitus. The highest RHR tertile was positively associated with the risk of MS [HR = 1.80, 95% CI (1.60, 2.04)]. Dose-response analysis suggested a non-linear correlation between RHR and MS, with a 3.5% increase in risk per unit increase in RHR, at a RHR of 42.5. Both high RHR and its increasing rate are significantly associated with the risk of MS. Therefore, RHR might be a non-invasive and convenient community-based screening tool for the management and monitoring of MS.

Bias-accounting meta-analyses overcome cerebellar neglect to refine the cerebellar behavioral topography.

The cerebellum plays important roles in motor, cognitive, and emotional behaviors. Previous cerebellar coordinate-based meta-analyses and mappings have attributed different behaviors to cerebellar subareas, but an accurate behavioral topography is lacking. Here, we show overrepresentation of superior activation foci, which may be exacerbated by historical cerebellar neglect. Unequal foci distributions render the null hypothesis of standard activation likelihood estimation unsuitable. Our new method, cerebellum-specific activation-likelihood estimation (C-SALE), finds behavioral convergence beyond baseline activation rates. It does this by testing experimental foci versus null models sampled from a data-driven, biased probability distribution of finding foci at any cerebellar location. Cerebellar mappings were made across five BrainMap task domains and thirty-five subdomains, illustrating improved specificity of the new method. Twelve of forty (sub)domains reached convergence in specific cerebellar subregions, supporting dual motor representations and placing cognition in posterior-lateral regions. Repeated subsampling revealed that whereas action, language and working memory were relatively stable, other behaviors produced unstable meta-analytic maps. Lastly, meta-analytic connectivity modeling in the same debiased framework was used to reveal coactivation networks of cerebellar behavioral clusters. In sum, we created a new method for cerebellar meta-analysis that accounts for data biases and can be flexibly adapted to any part of the brain. Our findings provide a refined understanding of cerebellar involvement in human behaviors, highlighting regions for future investigation in both basic and clinical applications.

Absolute and relative outcomes of cognitive behavior therapy for eating disorders in adults: a meta-analysis

ABSTRACT Cognitive–behavioral therapy (CBT) is the best examined treatment for eating disorders. However, previous meta-analyses of cognitive–behavioral therapy have not examined absolute outcomes, which are important from a clinical perspective. We updated a meta-analysis and conducted new searches in PubMed, Embase, PsycINFO and CINAHL. We included randomized trials comparing CBT with control conditions in adults with a diagnosed eating disorder. We used random effects models in all analyses. We included 36 trials with 44 comparisons between CBT and controls (2,809 participants), 22 trials on binge eating disorder (BED), 11 on bulimia nervosa (BN), and three on anorexia nervosa and mixed disorders. The overall effect of CBT compared to controls was g = 0.88 (95% CI: 0.71; 1.04), with high heterogeneity (I 2 = 74; 95% CI: 65; 81; PI: −0.06; 1.81) and no significant difference between BED and BN. Effects were smaller studies with low risk of bias. The absolute abstinence rate was 0.36 (95% CI: 0.31; 0.43) for CBT and 0.10 (95% CI: 0.08; 0.12) in controls. ly effective in the treatment of bulimia nervosa and binge-eating disorder, but there is also a large group of patients who do not respond sufficiently.

Association of NTRK2 gene with suicidality: a meta-analysis.

Previous studies have shown that genes in brain development pathways may have important roles in affecting risk of suicidal behaviors, with our previous meta-analysis supporting a role of the brain-derived neurotrophic factor (BDNF) gene. NTRK2 is a gene that encodes the neurotrophic receptor tyrosine kinase 2, which is a receptor for BDNF. In the current study, we aim to examine the potential association between NTRK2 single nucleotide polymorphism (SNPs) and suicidal ideation/behaviors. We first conducted a literature search using keywords like 'NTRK2', 'TRKB', and 'suicid*' to identify papers on NTRK2 SNPs and suicidal ideation/behaviors. In addition, we have individual-level genotype data for all the identified SNPs in literature search. We used the R meta package to perform meta-analyses on both the genotype count and the allele count data. Moreover, we performed meta-analyses on specific haplotypes within each haplotype block. Following our literature search and meta-analyses on 20 NTRK2 SNPs across up to 8467 samples, we found three SNPs, rs10868235 [N = 5,318, odds ratio (OR) = 1.34, P = 0.02], rs1867283 (N = 5,134, OR = 0.73, P = 0.04), and rs1147198 (N = 5,132, OR = 1.36, P = 0.03) to be nominally associated with suicidal attempts. Those three findings, however, did not survive multiple-testing corrections. Also, none of the haplotype blocks showed significant involvement in suicidality. Our results suggest that the NTRK2 gene may not have a major role in suicidality. Future efforts, however, should explore gene-gene interaction and pathway analyses.

Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care

Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. Although previous meta-analyses have explored the correlates of nurse burnout, none have estimated their association with health care quality and safety and patient morbidity and mortality. To evaluate the magnitude and moderators of the association between nurse burnout and patient safety, patient satisfaction, and quality of care. The Web of Science, Scopus, MEDLINE, Embase, PsycINFO, CINAHL, and ProQuest databases were searched from January 1, 1994, to February 29, 2024. Two reviewers independently identified studies that reported a quantifiable association between nurse burnout and any of the outcomes of patient safety, patient satisfaction, or quality of health care. The PRISMA 2020 guideline was followed. Two reviewers independently extracted the standardized mean difference (SMD) (Cohen d) estimates for a random-effects meta-analysis. Subgroup analyses and meta-regressions were conducted using prespecified variables. Any measure of patient safety, patient satisfaction, or quality of health care previously associated with nurse burnout. A total of 85 studies (81 cross-sectional and 4 longitudinal) involving 288 581 nurses from 32 countries (mean [SD] age, 33.9 (2.1) years; 82.7% female; mean [SD] burnout prevalence rate with study-specific ascertainments, 30.7% [9.7%]) were included. Nurse burnout was associated with a lower safety climate or culture (SMD, -0.68; 95% CI, -0.83 to -0.54), lower safety grade (SMD, -0.53; 95% CI, -0.72 to -0.34), and more frequent nosocomial infections (SMD, -0.20; 95% CI, -0.36 to -0.04), patient falls (SMD, -0.12; 95% CI, -0.22 to -0.03), medication errors (SMD, -0.30; 95% CI, -0.48 to -0.11), adverse events or patient safety incidents (SMD, -0.42; 95% CI, -0.76 to -0.07), and missed care or care left undone (SMD, -0.58; 95% CI, -0.91 to -0.26) but not with the frequency of pressure ulcers. Nurse burnout was also associated with lower patient satisfaction ratings (SMD, -0.51; 95% CI, -0.86 to -0.17) but not with the frequencies of patient complaints or patient abuse. Finally, nurse burnout was associated with lower nurse-assessed quality of care (SMD, -0.44; 95% CI, -0.57 to -0.30) but not with standardized mortality rate. The associations were consistent across nurses' age, sex, work experience, and geography and persistent over time. For patient safety outcomes, the association was smaller for the low personal accomplishment subcomponent of burnout than for emotional exhaustion or depersonalization, as well as for nurses with a college education. In this systematic review and meta-analysis, nurse burnout was found to be associated with lower health care quality and safety and lower patient satisfaction. This association was consistent across nurse and study characteristics.

Client-identified outcomes of individual psychotherapy: a qualitative meta-analysis

Psychotherapy outcomes are typically measured in terms of symptom relief. However, this method might overlook important changes from clients' perspectives when they are asked to report on them. A more client-centred approach might bring a deeper understanding of psychotherapy outcomes. We aimed to evaluate the outcomes identified by clients within qualitative psychotherapy research. The PsycArticles, PsycInfo, and MEDLINE Complete databases were searched for English language studies published until Nov 11, 2023. Additional studies were identified through references in the primary studies and previous meta-analyses or systematic reviews. Search terms were related to psychotherapy and counselling, clients' or patients' experiences, psychotherapy outcomes and changes, post-treatment perspectives, and types of qualitative methods. Qualitative studies on client-identified outcomes of individual psychotherapy were included. Findings related to clients' perceptions of psychotherapy outcomes were extracted (by ML and checked by TR and LT) and analysed (by all authors) using the descriptive-interpretative meta-analytic approach. All authors have personally experienced psychotherapy as clients. This study was pre-registered with PROSPERO (CRD42021277330). We included 177 studies in the qualitative meta-analysis, from 24 countries, including descriptions from 2908 clients. Most of the studies were of good quality; they covered a wide range of therapeutic approaches and diagnoses. The descriptions of psychotherapy outcomes were classified into 60 meta-categories and grouped into ten clusters. These clusters related to clients' relational and social functioning; their emotional functioning; self-awareness, self-understanding, and more adaptive cognitive processing; behavioural functioning; developing their own resources; clients' attitudes towards themselves; generally embracing life; symptom and problem change; and more general wellbeing. The tenth cluster was outcomes that could not be clearly attributed to psychotherapy, which was considered outside the scope of this study. The meta-analysis showed that clients value outcome dimensions beyond symptom reduction, such as deeper self-understanding, enhanced self-agency, and greater social engagement. By examining psychotherapy outcomes across various diagnoses and therapeutic approaches, we highlight limitations in traditional outcome measures, showing the need for more comprehensive, client-centred assessment tools and the value of incorporating qualitative methods into understanding dimensions of change. European Union.