Random-effects Model Analysis Research Articles

Impact of Temperature Variation on the Biological Traits and Lifecycle of Spodoptera exigua (Lepidoptera: Noctuidae): A Meta-Analysis Approach

Spodoptera exigua is a pest of considerable economic importance; however, detailed research into its ecological adaptability in newly invaded habitats is limited. This research performed a comprehensive analysis of the life history characteristics of S. exigua under varying temperature, photoperiod, and humidity conditions. A total of 264 studies that met the inclusion criteria were included in the analysis, and the data were examined using random-effects model, fixed-effects model, and meta-regression analysis techniques. The findings reveal that when temperatures exceed 20 °C, several biological parameters of S. exigua significantly increase, with the highest biological activity observed at 33 °C. As temperature rises, the duration of each developmental phase significantly decreases, accompanied by a reduction in the average number of eggs produced by females and a shorter pre-oviposition period. In addition, the pupal development period is shortened, resulting in a longer adult lifespan. By considering environmental variables such as temperature, photoperiod, and relative humidity, we identified the optimal conditions for the survival of each developmental stage of S. exigua. These results provide a foundation for predicting the population dynamics of this pest and contribute to the development of more effective pest control strategies.

Fluorescence-Guided Surgery to Detect Microscopic Disease in Ovarian Cancer: A Systematic Review with Meta-Analysis

Abstract: Background: The objective in epithelial ovarian cancer is to reach maximal cytoreduction with no visible residual tumor. Tumor detection during cytoreductive surgery depends on visual inspection, palpation, or blind biopsy, methods that lack reliability for identifying microscopic disease. Although the importance of microscopic disease in epithelial ovarian cancer is controversial, it may harbor chemoresistant cells and explain the high recurrence rates. Fluorescence-guided surgery (FGS) is an emerging approach. However, the potential in ovarian cancer remains underexplored; the majority of the existing evidence pertains to gastrointestinal tumors and a limited group of ovarian cancer patients. Their comparative effectiveness is still uncertain. Objective: To systematically review and evaluate the role of fluorescence-guided surgical techniques in detecting microscopic disease in ovarian cancer and compare their efficacy to total peritonectomy. Data Sources: A systematic search was made in three databases (PubMed, Web of Science, and Embase). The search was conducted from 1975 to 2024, including randomized controlled trials, observational studies, and conference abstracts in the last 25 years. Study Selection: Clinical studies published in English involving ovarian cancer patients undergoing FGS or total peritonectomy were included. Case reports, reviews, animal studies, and studies involving mixed cancer populations without ovarian cancer-specific data were excluded. Two independent reviewers screened 631 studies, yielding 12 eligible studies for final analysis. Data Extraction and Synthesis: Data were extracted and synthesized in accordance with PRISMA and MOOSE guidelines, using random-effects models for independent analysis. Sensitivity, specificity, positive predictive value (PPV), and odds ratios (ORs) were grouped, accompanied by subgroup analyses based on the fluorescence agent employed. For quality assessment, we utilized the NIH quality tool. Main Outcome(s) and Measure(s): The primary outcome was the rate of change in surgical management due to fluorescence guidance or total peritonectomy. Secondary outcomes comprised lesion-level sensitivity, specificity, and PPV. Safety outcomes included adverse events associated with fluorescence agents. Results: There were 12 studies involving 429 ovarian cancer patients. FGS improved the detection of microscopic disease compared to standard visualization methods, with a pooled sensitivity of 0.77. Folate receptor-targeted agents had high sensitivity (84%) but low specificity (26%). Aminolevulinic acid (5-ALA) showed superior diagnostic accuracy with a sensitivity of 84% and a specificity of 96%. Total peritonectomy showed no significant advantage over FGS for detecting microscopic disease. The adverse events were mild, with no serious events reported. We observed a high heterogeneity across studies and methodologies. Conclusions and Relevance: Fluorescence-guided surgery utilizing fluorescence tracers demonstrates potential in improving the detection of microscopic disease and may change surgical management in epithelial ovarian cancer, particularly with 5-ALA. Variability in performance and limited data on survival outcomes necessitates additional research. Total peritonectomy does not offer further advantage in the detection of microscopic disease. Future trials should focus on standardizing methodology and evaluating the effects of microscopic disease removal on survival outcomes. Registration: The study was registered to PROSPERO as CRD42024578274.

Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials

ObjectiveThe objective of this meta-analysis is to compare the perioperative surgical outcomes and cost-effectiveness of robotic ventral hernia repair (RVHR) versus laparoscopic ventral hernia repair (LVHR) with intraperitoneal mesh.MethodsRandomised control trials (RCTs) reporting perioperative outcomes and costs in patients undergoing RVHR versus LVHR were selected from medical electronic databases and meta-analysis was conducted in accordance with the guidelines of the Cochrane Collaboration using statistical software RevMan version 5.ResultsFour RCTs on 337 patients reporting perioperative outcomes and cost comparison were included. In the random effect model analysis, the duration of operation was shorter, and cost was lower in the LVHR group but with significant statistical heterogeneity [standardized mean difference (SMD) −48.07, 95%, CI (−78.06, −18.07), Z = 3.14, P = 0.002], [SMD 0.82, 95%, CI (−1.48, −0.16), Z = 2.45, P = 0.01]. However, the variables of hernia recurrence and surgical site complications were statistically similar in both groups without any statistical heterogeneity among the included studies [Risk Ratio (RR) 1.05, 95%, CI (0.22, 4.99), Z = 0.06, P = 0.95], [RR 0.85, 95%, CI (0.48, 1.50), Z = 0.55, P = 0.58].ConclusionThis systematic review demonstrates that RVHR does not offer any superiority among the compared perioperative variables (Duration of operation, hernia recurrence and surgical site complications) and it is not cost-effective when compared to LVHR. Due to the paucity of the RCTs and significant heterogeneity among the compared variables, a major multi-centre RCT is needed to validate these findings.

Evaluating the impact of ESG on financial risk: the moderating effects of operational ability and profitability in Indonesian infrastructure firms

Purpose This study aims to examine the impact of environmental, social, and governance (ESG) practices on financial risk, with operational ability and profitability as moderating variables, within the infrastructure sector in Indonesia. Design/methodology/approach The sample consists of 14 infrastructure companies listed on the Indonesia Stock Exchange over the period of 2020–2022, resulting in a total of 42 firm-year observations. The study employs a random-effects model for panel data regression analysis to test the hypotheses. ESG serves as the independent variable, financial risk as the dependent variable, and operational ability (measured by total asset turnover) and profitability (measured by return on assets) as moderating variables. Findings The results reveal that ESG practices have a significant positive impact on financial risk. Furthermore, operational ability negatively moderates the relationship between ESG and financial risk, while profitability positively moderates this relationship. These findings suggest that although higher ESG scores may elevate financial risk due to associated costs and uncertainties, firms with greater operational efficiency and profitability are better equipped to mitigate and manage these risks more effectively. Research limitations/implications This study focuses on infrastructure companies in Indonesia, which may limit the generalizability of the findings to other sectors or geographic regions. Future research could broaden the scope by incorporating diverse industries and cross-country contexts to enhance the robustness and applicability of the results. Practical implications The findings offer valuable insights for policymakers and corporate managers. Policymakers can develop frameworks to encourage sustainable practices without imposing excessive financial burdens on companies. Managers can leverage operational efficiency and profitability to integrate ESG practices effectively, thereby balancing sustainability goals with financial performance. Originality/value This study contributes to the scarce literature on the moderating effects of operational ability and profitability on the relationship between ESG practices and financial risk, particularly in the context of the infrastructure sector in Indonesia.

Pooled prevalence and associated factors of traditional uvulectom among children in Africa: A systematic review and meta-analysis.

Traditional childhood uvulectomy (TCU) is an unregulated cultural practice associated with significant health risks, including infections, anemia, aspiration, and oral or pharyngeal injuries. The reuse of unsafe tools such as blades, needles, or thread loops exacerbates the spread of infectious diseases like HIV and hepatitis B. Despite its clinical significance, the pooled prevalence and associated factors of TCU have not been adequately examined through systematic reviews or meta-analyses. This review and meta-analysis aimed to estimate the pooled prevalence and associated factors of TCU in some African countries. This systematic review and meta-analysis adhered to the PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including MEDLINE, ScienceDirect, Google Scholar, and African Journals Online, to identify relevant studies. A weighted inverse-variance random-effects model was employed to estimate the pooled prevalence and associated predictors of TCU. Heterogeneity among the included studies was assessed using a forest plot, I2 statistics, and Egger's test, ensuring the robustness and reliability of the findings. Missing data was handled by random effect model and sensitivity analysis. Data extraction was conducted fromNovember 6 to December 23, 2023. Included studies focused on children aged birth to under 15 years, examining TCU defined as the partial or complete removal of the uvula by traditional healers. Eleven primary studies comprising 7,231 children from some countries in Africa were included. Pooled estimate of TCU in some African countries was 40.98% (95% CI: 25.04-56.92; I2 = 99.61, P = 0.001). Mothers residing in rural areas were 2.45 times more likely to have a child experienced TCU compared to those in urban areas (AOR = 2.45; 95% CI: 1.59-3.32). Similarly, Mothers with a history of having a previous child who undergo TCU were 8.44 times more likely to seek the procedure for their other children compared to mothers without such a history (AOR = 8.44; 95% CI: 6.27-10.61). However, caution is warranted when interpreting these findings due to the significant heterogeneity reported across the included studies, which may influence the generalizability of the results. Nearly two-fifths of children in some African countries experienced TCU, which was influenced by maternal history and rural residency. While most procedures did not result in hospitalization, significant health risks remain. These findings underscore the urgent need for targeted interventions within maternal and child health programs to address TCU and mitigate its associated morbidity in the affected countries across Africa. CRD42024498699.

3DSlicer software-assisted neuroendoscopic surgery compared with traditional surgery on surgical effects, complications, and safety evaluation in patients with intracerebral hemorrhage: A systematic review and meta-analysis.

This study aims to comprehensively evaluate the complications, effectiveness, and safety of neuroendoscopic surgery (NS) assisted by 3DSlicer software, compared to traditional surgery in patients with intracerebral hemorrhage (IH). We searched for case-control trials from the Chinese Biomedical Literature data (CBM) online database, Wanfang Database, EMBASE, VIP Full-text Database, China National Knowledge Infrastructure (CNKI), Science Direct, Cochrane Library, and PubMed. The studies, published since January 2010, involved NS or traditional surgery for IH patients assisted by 3DSlicer software. Data were independently retrieved by two researchers, and the risk of bias in each study was evaluated using the Cochrane Handbook 5.3 standard. A total of 591 patients from seven controlled clinical studies were included. Fixed-effect model analysis revealed a significantly higher treatment effectiveness rate in the study group (SG) (P < 0.05). Random-effects model (REM) analysis indicated that the operation time in the SG was significantly shorter (P < 0.05). Furthermore, the SG group experienced significantly shorter hospitalization time (P < 0.05). NIHSS scores in the SG were notably lower (P < 0.05). Fixed-effect model analysis also showed that the incidence of postoperative complications in the SG was significantly lower (P < 0.05). Neuroendoscopic surgery assisted by 3DSlicer software is more effective in treating IH, enhancing prognosis, improving neurological function, and reducing complication rates. This approach appears to be a promising candidate for clinical adoption.

Comparison of efficacy and safety between palonosetron and ondansetron to prevent postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a systematic review and meta-analysis.

Postoperative nausea and vomiting (PONV) is a prevalent and distressing complication, especially in laparoscopic surgeries. This review compares the efficacy and safety of palonosetron and ondansetron in preventing PONV after laparoscopic surgery. A systematic review was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library to identify comparative studies that reported the efficacy (nausea and vomiting) at three postoperative time points T1 (0-2 hours), T2 (2-6 hours), T3 (6-24 hours) and safety (incidence of adverse effects). Meta-analysis of relative risk was performed using a random effect model and subgroup analysis based on factors such as antiemetic dose and timing of administration, type of surgery, and anesthetic agents. Twenty-one randomized controlled trials were published between 2011 and 2022, involving 2,043 participants. Nineteen trials were included in the meta-analysis (efficacy, 17; safety, 11). The pooled risk ratio revealed that patients receiving palonosetron demonstrated significantly less likelihood of developing nausea and vomiting at various postoperative time points. Subgroup analysis indicated significantly less PONV when palonosetron was administered before intubation and in combination with isoflurane anesthesia. Headache, dizziness, constipation, and drowsiness were the most commonly reported. The safety profiles of palonosetron and ondansetron were comparable. Palonosetron exhibits superior efficacy within the first 24 hours postoperatively and requires less rescue antiemetic intervention compared to ondansetron in laparoscopic surgery patients. Both demonstrate nearly comparable safety profiles. Future trials focusing on cardiac safety (QT interval) and cost consideration are needed.

Adjuvant immunotherapy in high-risk muscle-invasive urothelial cancer: an updated meta-analysis of randomized controlled trials

Introduction: Neoadjuvant cisplatin-based chemotherapy followed by radical surgery is the standard treatment for muscle-invasive urothelial carcinoma (MIUC). The Checkmate-274 and AMBASSADOR trials have demonstrated improvements in disease-free survival (DFS) with adjuvant immunotherapy. Consequently, this meta-analysis aimed to assess the effectiveness of strategies involving checkpoint inhibitors in managing high-risk MIUC. Patients and Methods: We searched PubMed, Embase, Cochrane, ClinicalTrials.gov, EAU24, and ASCO GU abstracts for randomized controlled trials (RCTs) comparing adjuvant PD-1 and PD-L1 inhibitors against control (placebo or observation) for MIUC. Outcomes included DFS, grade ≥ 3 adverse events (AEs), and overall survival (OS). Heterogeneity was assessed using I2 statistics, employing a random-effects model for analysis. Results: In a cohort of 2,220 patients from three RCTs, 1,113 (50.14%) underwent adjuvant immunotherapy. This treatment significantly increased DFS (HR 0.76; 95% CI 0.65-0.90; p < 0.01), particularly in lower tract tumors (HR 0.71; 95% CI 0.56-0.91; p < 0.01). No substantial DFS improvement surfaced in the upper tract subgroup (p = 0.28) (p-interaction = 0.01). PD-L1 status (p-interaction = 0.83) and previous neoadjuvant chemotherapy (p-interaction = 0.11) did not significantly affect outcomes. However, immunotherapy correlated with higher grade ≥ 3 AEs (RR 1.47; p<0.01), with no notable difference in OS (p=0.07). Conclusions: Adjuvant PD-1/PD-L1 inhibitors notably enhance MIUC DFS, particularly in lower tract tumors, regardless of PD-L1 status. These findings support immunotherapy, especially anti-PD1, as a valuable adjuvant treatment strategy for high-risk MIUC patients. Micro abstractThis meta-analysis investigates the use of adjuvant anti-PD1/PDL1 therapy for high-risk muscle-invasive urothelial cancer (MIUC). By analyzing data from three randomized controlled trials involving 2,220 patients, the study demonstrates that immune checkpoint inhibitors, particularly PD1 inhibitors, significantly improve disease-free survival, regardless of PD-L1 status. These findings support considering ICIs as a viable adjuvant treatment option for patients with MIUC.

Effects of Integrated Care Approaches to Address Co-occurring Depression and Diabetes: A Systematic Review and Meta-analysis.

Depressive symptoms frequently co-occur with diabetes and, when unaddressed, can function to worsen diabetes control and increase the risk of diabetes-related morbidity. Integrated care (IC) approaches aim to improve outcomes among people with diabetes and depression, but there are no current meta-analyses examining their effects. In our study we summarize the effects of IC approaches to address depression and diabetes and examine moderating effects of IC approaches (e.g., behavioral intervention used; type of IC approach). A systematic search was conducted of PubMed, PsycInfo, CINAHL, and ProQuest. Two reviewers triaged abstracts and full-text articles to identify relevant articles. Randomized controlled trials with enrollment of participants with diabetes and depressive symptoms and with provision of sufficient data on depression scores and hemoglobin A1c were included. Two reviewers extracted demographic information, depression scores, diabetes outcomes, intervention details, and the risk of bias for each study. From 517 abstracts, 75 full-text reports were reviewed and 31 studies with 8,843 participants were analyzed. Among 26 studies with reporting of HbA1c, IC approaches were associated with a significant between-group difference regarding the percent decrease of HbA1c (d = -0.36, 95% CI -0.52 to -0.21). Studies that included a combination of behavioral interventions (behavioral activation with cognitive behavioral therapy) showed greater reductions in HbA1c. Among 23 studies with reporting of depressive symptoms, the pooled effect of IC approaches lowered depressive scores by 0.72 points (95% CI -1.15 to -0.28). The inclusion of a wide range of IC approaches increased study heterogeneity. A random effects model and sensitivity analyses mitigated this limitation. IC approaches are associated with improved glycemia and depressive symptoms in comparison with treatment as usual.

The Effect of Interest Rates and Inflation on Economic Growth in ASEAN-5 Countries

This study aims to empirically test the effect of interest rates and inflation on economic growth, with gross capital formation as a control variable. This research uses panel data from 5 ASEAN countries, namely Indonesia, Malaysia, the Philippines, Singapore, and Thailand in 2004 – 2021 and was tested using the Random Effect Model (REM) analysis technique. The results of this study explain that interest rates and inflation have a simultaneous effect on economic growth. Another finding from this study is that interest rates have a significantly negative effect on economic growth and inflation has a significant positive effect on economic growth. However, this study is subject to several limitations. First, it solely focuses on ASEAN-5 countries, thus limiting the generalizability of the findings to other developed and developing nations. Second, the study’s reliance on annual data from 2004 to 2021 excludes more recent data, potentially overlooking current economic trends. Third, the static panel method utilized with the REM analysis only provides a broad overview of the relationships between interest rates, inflation, and economic growth, lacking deeper insights into long-term and short-term dynamics. Fourth, while the study covers the period including the COVID-19 pandemic, it fails to thoroughly explore its impact and provide detailed explanations. Thus, future research should consider expanding the scope beyond ASEAN-5, incorporating more recent data, employing dynamic panel methods, and thoroughly investigating the implications of significant events such as the COVID-19 pandemic on the examined relationships.

Effectiveness of ethnomathematics-based learning on students’ mathematical literacy: a meta-analysis study

This study aims to determine the effectiveness of ethnomathematics-based learning on students’ mathematical literacy through a meta-analysis study. Primary studies were collected from Google Scholar and ERIC databases based on the inclusion criteria. The results of the literature review obtained 16 studies, either from theses, proceedings, or journal articles. Furthermore, the effect sizes were combined according to the Random Effects Model (REM) and data analysis using CMA v3 and R Studio (Meta Package). The calculation results obtained an overall effect size which indicates that ethnomathematics-based learning has a “strong” effect on students’ mathematical literacy when compared to conventional learning. As a result of the moderator category analysis, it was found that the effect sizes differed significantly according to students’ regional demographics, independent variables, and subject matter. However, it does not show significant differences when based on the duration of the meeting, education level, sample size, experimental design, type and year of publication. Thus, it can be said that ethnomathematics-based learning can be an effective learning model for increasing students’ understanding of mathematical literacy, especially in the Kalimantan Island region, recommended to be integrated with the Ethnomathematics Pop Up Book and Visual Thinking learning model, and Probability & Sets and Transformation Geometry materials, using Nonequivalent Control Group Design are recommended to be taught through this learning model.

Long-term outcomes of glued (sutureless) amniotic membrane transplantation in acute Stevens-Johnson syndrome/toxic epidermal necrolysis: a comparative study

PurposeTo compare the effectiveness and efficiency of a glued (sutureless) technique for amniotic membrane transplantation (AMT) with a traditional sutured one in the setting of acute Stevens-Johnson syndrome/toxic epidermal necrolysis...

Association of endometrial cancer risk with hypertension- an updated meta-analysis of observational studies

Endometrial cancer is one of the most common gynaecological cancers in the developed countries. The aim of this study was to determine the impact of hypertension on endometrial cancer risk. Databases: PubMed, Embase and the Cochrane Library were searched from January 2000 to June 2024. We used DerSimonian-Laird random-effects model for analysis. Risk estimates were extracted by two authors and summarized using meta-analytic methods. A total of 26 observational studies with 207,502 endometrial cancer cases were included in the study. Overall meta-analysis demonstrates significant association between hypertension and endometrial cancer risk (RR = 1.37, 95% CI: 1.27–1.47, p < 0.001). Subgroup analysis of the risk of endometrial cancer shows statistically significant higher risk in patients with BMI ≥ 30 kg/m2, diabetics, women who had their first menstrual period at the age of 11 years or earlier, and who had never given birth. Findings of this comprehensive review and meta-analysis indicate that hypertension is associated with higher overall risk of endometrial cancer.

Meal replacements on obesity and leptin: a systematic review and meta-analysis.

The global prevalence of obesity and overweight is a significant concern in the field of public health. Numerous interventional studies have been conducted to assess the possible meal replacements (MRs) effect on anthropometric indicators and indices and laboratory test that reflect obesity. However, there are no comprehensive results in this field. The study aim was to understand the possible effects of MRs on body weight, body mass index (BMI), fat mass, waist circumferences (WC), and leptin levels. A systematic search was conducted in five electronic databases in order to find randomized clinical trials (RCTs) that examined the possible MRs effect on obesity. Analyses were performed in R software, version 4.2.1. The random-effects model analysis was used to provide pooled mean difference and 95% confidence intervals (95% CI). Seventy studies were included. Body weight (WMD: -3.35 kg, 95% CI: -4.28 to -2.42), BMI (WMD: -1.12 kg/m2, 95% CI: -1.51 to -0.72), fat mass (WMD: -2.77 kg, 95% CI: -3.59 to -1.6), WC (WMD: -2.82 cm, 95% CI: -3.51 to -2.12) were significantly reduced after MRs compared to control. No significant effect was observed on leptin (WMD: -3.37 ng/ml, 95% CI: -8.23 to 1.49). Subgroup analyses indicated that impact of total MRs on anthropometric factors was greater in comparison to partial MRs. Considering other lifestyle factors, MRs can lead to anthropometric indicators and indices reduction.

A Systematic Review and Meta-Analysis of the Efficacy of Antimicrobial Chemoprophylaxis for Recurrent Acute Otitis Media in Children.

Acute otitis media (AOM) is a common childhood infection. Recurrent AOM affects a subset of children, resulting in an adverse impact on quality of life, socioeconomic disadvantage, and risk of long-term sequelae. Antimicrobial chemoprophylaxis is used in some settings but is increasingly controversial due to an awareness of adverse long-term effects and contribution to global antibiotic resistance. A comprehensive literature search was undertaken using Medline (1946-October 2023) and Embase (1974-October 2023). The primary aim was to assess the efficacy of antimicrobial chemoprophylaxis on AOM episodes in children < 18 years of age. Bias and quality assessment was performed. Dichotomous data were analysed using risk ratio with 95% confidence intervals. Meta-analysis was carried out using random-effects models for pooled analysis, independent of heterogeneity. Heterogeneity was assessed using the I 2 statistic. The effect of antimicrobial chemoprophylaxis in children with rAOM on the number of individual AOM episodes. assessment of antimicrobial agents and outcomes in children with risk factors. Assessment of qualitative data was performed on 20 studies (n = 2210). No controlled trials were identified post-multivalent pneumococcal conjugate vaccine (PCV) introduction, restricting current generalisability. Quantitative meta-analysis on nine pre-PCV studies (n = 1087) demonstrated antimicrobial chemoprophylaxis reduced any episode of AOM with a risk ratio 0.59 (95% CI 0.45-0.77). Families and clinicians must balance marginal short-medium term benefit (based on pre-PCV data), and the potential for adverse effects to that individual, and the societal risk of antimicrobial resistance with prolonged antibiotic use.

Prevalence and associated factors of post-traumatic stress disorder in pediatric populations in Africa: a systematic review and meta-analysis

IntroductionPost-traumatic stress disorder (PTSD) is a prevalent challenge faced by individuals following traumatic events. Given the substantial impact of PTSD on the well-being of young people, comprehensive assessment of the available evidence can inform more effective prevention and intervention strategies to support the mental health and resilience of children in the African context. Despite its high incidence, there has been no up-to-date systematic synthesis of evidence to measure the magnitude of PTSD in pediatric populations in Africa. This systematic review and meta-analysis aim to quantify the prevalence of PTSD and identify associated factors in this vulnerable population.MethodsA systematic search was conducted across multiple databases, including PubMed, Embase, Scopus, Science Direct, and the search engines Google Scholar and Google, covering the period from 2014 up to May 15, 2024. The primary objective of this search was to identify relevant studies. Subsequently, a meta-analysis was performed using random-effects models to estimate the pooled effect size for each outcome of interest. Additionally, subgroup analysis was conducted to explore potential sources of heterogeneity, with study characteristics considered as covariates.ResultsThe pooled prevalence estimate for post-traumatic stress disorder (PTSD) among pediatric individuals was 36% (95% CI: 28–44%). Notably, significant heterogeneity existed among the studies (I2 = 98.41%, p value < 0.001), prompting us to employ a random effect model analysis. Furthermore, our meta-analysis revealed that children above 14 years of age and those who experienced family deaths due to traumatic events were significantly associated with PTSD.ConclusionThis systematic review and meta-analysis revealed that the prevalence of PTSD among pediatric individuals aged 0–18 years in Africa was high. Notably, older children and those who experienced family deaths due to traumatic events were at a significantly higher risk of developing PTSD. These findings underscore the need for early intervention, age-specific support, and trauma-informed care to address the mental health challenges faced by pediatric populations.

Prevalence of stroke in Bangladesh: A systematic review and meta-analysis

BackgroundStroke is a major health concern in Bangladesh due to its high incidence and effect on rates of morbidity and death. The morbidity due to stroke in Bangladesh is indeed increasing. This study aimed to find the pooled prevalence of stroke in Bangladesh. MethodsAn extensive search was conducted using PubMed, MEDLINE, and Google Scholar databases. I2 and Q-tests were employed to evaluate the heterogeneity. A random-effects model and subgroup analysis were performed due to the significant heterogeneity. We used Egger's test and funnel plot to look at publication bias. Meta-regression was carried out to analyze how different study variables influenced the effect estimates and to explore sources of heterogeneity across studies. The GRADE approach was used to evaluate the overall quality of the evidence, and the Joanna Briggs Institute tool was used to assess the risk of bias. Sensitivity analysis was conducted to evaluate the robustness of the meta-analysis results. STATA version 17 was used for analysis. ResultsWe selected eleven (n = 1577293) studies that met the inclusion criteria for the final synthesis. In Bangladesh, the overall pooled prevalence of stroke was 1.10 % (95 % CI: 0.70–1.51). Subgroup analysis showed that the prevalence of stroke was 1.14 % (95 % CI: 0.58–1.70) from 2005 to 2014 and 1.04 % (95 % CI: 0.40–1.68) from 2015 to 2024. ConclusionStroke prevalence in Bangladesh is significantly high. The country's healthcare system faces adequate stroke prevention and treatment challenges. Improving healthcare services and public health education are crucial to addressing this increasing public health issue.

Effect of deep brain stimulation on postoperative body mass index: A systematic review and meta-analysis.

Deep Brain Stimulation (DBS) is FDA-approved for several movement disorders; such as Parkinson's disease, dystonia, and neuropsychiatric disorders. There are various reports of Body mass index (BMI) changes following different DBS targets in various disorders. A comprehensive systematic review and meta-analysis were conducted to investigate the impact of DBS on patients' Body Mass Index (BMI) and provide an in-depth overview of its underlying mechanisms. We conducted research according to PRISMA guidelines. Our study assessed comprehensively electronic databases, including Pubmed, Scopus, Embase, web of science, and the Cochrane Library, up to May 2024. The random-effect model analysis was performed by the Comprehensive Meta-analysis software (CMA) version 3.0. As well, Cochran's Q test was used to determine the statistical heterogeneity of included studies. This systematic review ultimately included 49 studies, 46 of which entered the meta-analysis. The total number of patients was 1478, consisting of Parkinson's disease (PD), dystonia, and the obsessive compulsive disorder (OCD) patients. The most common DBS target was subthalamic nucleus, followed by globus pallidus internus (GPi). Our meta-analysis depicted the BMI of participants significantly mount after DBS electrode implantation (SMD = -0.542, 95%CI: -0.678 to -0.406, and P-value < 0.001). However, moderate to high heterogeneity was detected among the studies (I2 = 67.566%). Additionally, the Daily energy intake (DEI) of patients significantly decreased after DBS (SMD: 0.457, 95%CI; 0.205 to 0.709, and P-value < 0.001). STN and GPi DBS can lead to weight gain through distinct central pathways in various movement and neuropsychiatric disorders, posing a potential risk for obesity, insulin resistance, and metabolic syndrome.

Financial Inclusion, Environmental Quality, and Economic Development in Asian Economies: A Panel Data Analysis

The objective of this study is to explore the effect of Financial Inclusion and Environmental Quality on Economic Development of some selected Asian economies. For this purpose, panel data of some Asian economies has been taken from 2004 to 2023 from the World Development Indicators. The results are estimated by using the Fixed Effect Model and Random Effect Model, descriptive statistics, correlation, and causality analysis. The results of Fixed Effect model reveal that GDP is significantly increased by Internet Subscribers &amp; Mobile users (Financial Inclusion variables), FDI, Government expenditure and Carbon dioxide emission while GDP is insignificantly increased by energy use in the Asian economies. The Fixed Effect model suggests policy implications for Asian economies, focusing on digital connectivity, FDI attraction, targeted public expenditure, sustainable growth practices, and energy efficiency.

ThP3.5 - A systematic review of comparing the outcomes of per-oral endoscopic myotomy vs pneumatic dilation in patients diagnosed with achalasia

Abstract Objective The objective of this meta-analysis is to compare the success rate of per-oral endoscopic myotomy (POEM) versus pneumatic dilation (PD) for patients with achalasia. Methods Studies reporting success rates and symptoms in patients undergoing POEM versus PD were selected from medical electronic databases and meta-analysis was conducted by following the guidelines of the Cochrane Collaboration using statistical software RevMan version 5. Results Four studies on 319 patients reporting success rates and Eckardt scores were included. In the random effect model analysis, the success rate [odds ratio (OR) 6.22, 95%, CI (3.23, 11.97), Z = 5.47, p = 0.00001] favoured the PD and there was no heterogeneity (Tau2 = 0; Chi2 = 1.29, df = 2 (P = 0.53; I2 = 0 %) among included studies. Eckardt scores [mean difference -0.36, 95%, CI (-0.76, 0.03), Z = 1.79, p = 0.07] suggesting the achalasia symptoms severity was also similar in both interventions. There was moderate heterogeneity (Tau2 = 0.10; Chi2 = 7.47, df = 3 (P = 0.06; I2 = 60 %) among the included studies. Conclusion The POEM seems to be more successful when compared to the PD for patients with achalasia. On comparison of Eckardt score, there was no statistical difference seen between the two groups.