Results Of Previous Meta-analyses Research Articles

Trends in smokeless tobacco use and attributable mortality and morbidity in the South-East Asia Region: implications for policy

ObjectivesTo describe the prevalence of smokeless tobacco (SLT) use and number of users by year, in addition to trends in mortality and attributable disease burden in countries of the WHO...

Effects of CPAP and Mandibular Advancement Devices on depressive symptoms in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials.

Studies show that patients with obstructive sleep apnea (OSA) are more likely than the general population to have psychological disorders such as depression. However, it is less clear how OSA treatment affects this association. This meta-analysis aimed to assess whether or not continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) reduce depression symptoms in patients with OSA. We searched Pubmed, Embase, Web of Science, and Cochrane Library from creating the databases until November 2022. Our analysis included RCTs that examined CPAP and MAD treatment effectiveness for depression in patients with OSA. We identified 17 CPAP studies comprising 1,931 patients for inclusion in the meta-analysis. The results of the meta-analysis using a fixed effects model found that CPAP improved depressed mood in patients with OSA relative to controls (SMD = 0.27;95% CI:0.18,0.36), with small heterogeneity among trials (I2 = 8.1% < 50%, P = 0.359). We performed subgroup analyses on three factors: the length of trial follow-up, patient adherence data, and depression assessment scales. The meta-analysis also identified six MAD studies involving 315 patients. According to this analysis, there was no heterogeneity between studies (I2 = 0%, P = 0.748). MADs did not significantly improve depression symptoms compared to controls, indicating a combined effect of SMD = 0.07 (95% CI: - 0.15,0.29), P > 0.05. The present findings confirm that CPAP may improve depressive symptoms inpatients with OSA. However, the review results suggest that MADs have no significant effect on depressive symptoms in patients with OSA, a finding that is different from the results of previous meta-analyses.

What can we learn about selective attention processes in individuals with chronic pain using reaction time tasks? A systematic review and meta-analysis.

Information-processing biases such as attentional, interpretation, and memory biases are believed to play a role in exacerbating and maintaining chronic pain (CP). Evidence suggests that individuals with CP show attentional bias toward pain-related information. However, the selective attentional processes that underpin this bias are not always well outlined in the literature. To improve current understanding, a systematic review was performed using a descriptive synthesis of reaction time-based studies. A random-effects meta-analysis was added to explore whether the results of previous meta-analyses would be confirmed using studies with a larger sample size. For this review, 2008 studies were screened from 4 databases, of which 34 (participant n = 3154) were included in the review and a subset of 15 (participant n = 1339) were included in the meta-analysis. Review results were summarised by producing a descriptive synthesis for all studies. Meta-analysis results indicated a mild significant attentional bias toward sensory pain-related information (k = 15, g = 0.28, 95% CI [0.16, 0.39], I 2 = 43.2%, P = 0.038), and preliminary evidence of significant moderate bias towards affective pain-related information (k = 3, g = 0.48, 95% CI [0.23, 0.72], I 2 = 7.1%, P = 0.341) for CP groups compared with control groups. We explored the main tasks, stimuli, and CP subtypes used to address attentional biases and related processes. However, variation across studies did not allow for a decisive conclusion about the role of stimulus, task type, or related attentional processes. In addition, a table of CP attention-related models was produced and tested for reliability. Finally, other results and recommendations are discussed.

Academic achievement of students without special educational needs and disabilities in inclusive education-Does the type of inclusion matter?

The main aim of the study, conducted in Poland, was to compare the academic achievement of 1552 (at Time 1) students without disabilities in three educational settings: general, without students with disabilities, inclusive (with co-teaching), with three to five students with disabilities, and inclusive (without co-teaching), with one to two students with disabilities. The study was longitudinal, with three waves eight months apart. The latent growth curve model was used for data analysis. The results have shown that changes in academic achievement (for language and for mathematics) over time were similar in all three groups; therefore, there were no differences between inclusive education (of the two types) and general education classrooms. These results mean that students neither lose nor benefit while learning in inclusive education classrooms. The findings are in line with the results of previous meta-analyses and are important for the future development of inclusive education.

What is Known about the Intervention with Gender Abusers? A Meta-analysis on Intervention Effectiveness

In this research, a meta-analytic study is proposed with the aim of determining the state of the art of the efficacy of treatment programs for gender aggressors across different variables. Doing so is relevant in view of the inconsistency in the results of previous meta-analyses and the proliferation of new intervention programs for gender aggressors. The results of general meta-analysis show a positive, though not significant, effect of the intervention. The analysis of moderating variables shows a positive, significant, and close-to-moderate effect size for interventions lasting fewer than 16 weeks/sessions (δw = .39) and follow-up periods greater than or equal to 12 months (δw = .38), and a positive, significant and moderate size for interventions using cognitive-behavioral therapy (δw = .57). However, along the same lines, as previous meta-analyses, no definite conclusions can be drawn about the effectiveness of this type of program.

Night work during pregnancy and preterm birth-A large register-based cohort study.

BackgroundMelatonin stimulates the production of progesterone, which is essential for the maintenance of pregnancy. Since melatonin in blood is reduced due to work under illuminated conditions during night work, it has been hypothesized that night work may increase the risk of preterm birth. Previous meta-analyses have not revealed increased risk of preterm birth in women working night shifts during pregnancy. Still, these studies might have been limited by inaccurate self-reports of timing, intensity and duration of night work most likely causing bias towards the null. The aim of this is study was to investigate if the frequency and duration of night work during the first (week 1–12) and second (week 13–22) trimester of pregnancy were associated with risk of preterm birth when objective and prospective data on night work are used.MethodIn a register-based prospective cohort study, we obtained individual day-to-day information on working hours from The Danish Working Hour Database (DWHD, a payroll database including all public service employees in administrative Danish Regions from 2007–2013) and information on preterm birth from the Danish Medical Birth Registry. Night-shift was defined as at least three working hours between 23:00 and 06:00. Preterm birth was defined as giving birth during gestational weeks 23–37. Odds of preterm birth according to working night shifts were analysed by logistic regression.ResultsWe identified 16,501 pregnant women eligible for the study, of which 10,202 women (61.8%) had at least one night-shift during the first 22 gestational weeks. The risk of preterm birth was not elevated among women working night shifts compared to women working only day shifts during either the first or second trimester. Within night-shift workers, the risk was not related to the number of night shifts, the duration of night shifts, consecutive night shifts or quick returns defined as short intervals between shifts. Odds of preterm birth was not related to change of working schedule from the first to second trimester, although women changing from night shifts in the first trimester to day work only in the second trimester displayed a weak increased odds of preterm birth (OR 1.21, 95%CI 0.98–1.49) compared to women working night shifts in both trimesters.ConclusionOur results, which are without bias from self-report of either exposure or outcome, are in line with the results of previous meta-analyses. Due to the detailed information on hours worked during pregnancy, we were able to investigate several dimensions of night work not previously investigated, of which none were associated with elevated risk of preterm birth.

The Relationship Between Digit Independence and Digital Sesamoids in Humans and a Proposal of a New Digital Sesamoid Evolutionary Hypothesis.

Digital sesamoids are found in the metapodial-phalangeal joints of most mammals and quadrupedal tetrapods, yet their functional significance is still unclear. During primate evolution, a slight decline in their frequency has been associated with brachiation in gibbons, followed by a quasi-complete absence in orangutans then a slight resurgence occurred in gorillas and chimpanzees. Simultaneously, forearm muscles showed a progressive division in hominoid evolution towards a more "individualistic" musculature yielding more mobility and independence to some fingers. In humans, sesamoids are consistently observed in thumbs and big toes and frequently in other hypermobile digits such as the index and little fingers. Using a simple mathematical equation, this paper attempted to quantify a presumed association between hypermobile fingers and sesamoid frequency and distribution in humans. To this, an anatomic definition of digital independence has been formulated which includes three variables; (1) number and (2) frequency of independent flexor/extensor forearm muscles destined to a single finger, (3) and number of free/absent webspace. Results of previous meta-analyses and means of big sample studies were used to evaluate the frequency of such muscles. The expected values obtained via this model were found to be very close to the observed (published) values of the ossified sesamoids in human hands, and that in terms of frequency and distribution. The findings in humans showed a quasi-linear association between the degree of mobility and sesamoid frequency. The more the number of independent muscles destined to a finger, the more its metacarpo-phalangeal joint is likely to bear sesamoids. Based on our results and on a new analysis of primates' forearm/hand muscles and sesamoid evolution, a new hypothesis is proposed to answer two questions; the evolution of digital sesamoid frequency in primates and its sesamoid distribution in human digits. It claims that the number/frequency of independent forearm/hand muscles, and particularly the independent extensors, is likely to be a major factor in sesamoid reversion in hominoids. The argument is based on the link between the metatarsal break induced by the digitigrade locomotion observed in quadrupedal mammals and tetrapods and the amount of extra-extension of the metacarpo-phalangeal joints conferred by the individualization of some forearm extensors. The same rationale yielded similar conclusions when applied to both the hand and foot. The manipulative function of the hand and the plantigrade locomotion of the foot required such extra-extension in specific digits and consequently, a higher frequency of digital sesamoids was associated with these two different functions. The new evolutionary analysis suggests evolutionary pathways for both, the sesamoids of the hands and feet, and speculates that muscle individualization would have induced a very slow re-acquisition of digital sesamoids when compared to their rapid decline after brachiation. It is the first hypothesis offering a plausible explication on the recent evolution of digital sesamoids; specifically, the progression of sesamoid frequency in African apes and its resurgence, prevalence and distribution in humans. Anat Rec, 301:1046-1060, 2018. © 2018 Wiley Periodicals, Inc.

Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies

BACKGROUND For a number of reasons, the results of previous meta-analyses may not fully reflect the mental health status of the average woman suffering from polycystic ovary syndrome (PCOS), or the causes of this distress. Our objective was to examine emotional distress and its associated features in women with PCOS. METHODS A comprehensive meta-analysis of comparative studies reporting measures of depression, anxiety or emotional-subscales of quality of life (emoQoL) was performed. PubMed, Embase, PsychInfo and the Cochrane trial register databases were searched up to November 2011 (see Supplementary Data for PUBMED search string). Unpublished data obtained through contact with authors were also included. The standardized mean difference (SMD) of distress scores was calculated. Subgroup analyses and meta-regression analysis of methodological and PCOS-related features were performed. RESULTS Twenty-eight studies (2384 patients and 2705 control women) were included. Higher emotional distress was consistently found for women with PCOS compared with control populations [main outcomes: depression: 26 studies, SMD 0.60 (95% confidence interval (CI) 0.47-0.73), anxiety: 17 studies, SMD of 0.49 (95% CI 0.36-0.63), emoQoL: 8 studies, SMD -0.66 (95% CI -0.92 to -0.41)]. However, heterogeneity was present (I(2) 52-76%). Methodological and clinical aspects only partly explained effect size variation. CONCLUSIONS Women with PCOS exhibit significantly more emotional distress compared with women without PCOS. However, distress scores mostly remain within the normal range. The cause of emotional distress could only partly be explained by methodological or clinical features. Clinicians should be aware of the emotional aspects of PCOS, discuss these with patients and refer for appropriate support where necessary and in accordance with patient preference.

Meta‐analysis: banding ligation and medical interventions for the prevention of rebleeding from oesophageal varices

In patients with oesophageal varices, the combination of endoscopic variceal ligation (EVL) and medical therapy is recommended as standard of care for prevention of rebleeding. The results of previous meta-analyses on this topic are equivocal. To assess the effects of EVL plus medical therapy vs. monotherapy (EVL or medical therapy alone) for secondary prevention in oesophageal varices. Electronic and manual searches were combined. The primary outcome measures were overall rebleeding (variceal and nonvariceal) and mortality. Random-effects meta-analyses were performed with subgroup, sensitivity, regression and sequential analyses to identify sources of intertrial heterogeneity and the robustness of the results. Nine randomised trials were included. In total, 442 patients were randomised to combination therapy and 513 to monotherapy. Combination therapy reduced rebleeding (RR = 0.68; 95% CI = 0.54-0.85; number needed to treat eight patients). The result was confirmed in sequential and regression analyses, but not when limiting the analysis to trials with adequate selection bias control. No effect on overall mortality was identified (RR = 0.89; 95% CI = 0.65-1.21). Combination therapy reduced bleeding-related mortality (RR = 0.52; 95% CI 0.27-0.99; number needed to treat 33 patients) and the risk of rebleeding from oesophageal varices. Combination therapy increased the risk of serious adverse events in fixed, but not in random-effects meta-analyses. The combination of endoscopic variceal ligation and medical therapy reduce the risk of rebleeding, but not overall mortality. Additional research is needed to determine why reduced rebleeding rates do not lead to reduced mortality.

Meta‐Analysis of Susceptibility of Woody Plants to Loss of Genetic Diversity through Habitat Fragmentation

Shrubs and trees are assumed less likely to lose genetic variation in response to habitat fragmentation because they have certain life-history characteristics such as long lifespans and extensive pollen flow. To test this assumption, we conducted a meta-analysis with data on 97 woody plant species derived from 98 studies of habitat fragmentation. We measured the weighted response of four different measures of population-level genetic diversity to habitat fragmentation with Hedge's d and Spearman rank correlation. We tested whether the genetic response to habitat fragmentation was mediated by life-history traits (longevity, pollination mode, and seed dispersal vector) and study characteristics (genetic marker and plant material used). For both tests of effect size habitat fragmentation was associated with a substantial decrease in expected heterozygosity, number of alleles, and percentage of polymorphic loci, whereas the population inbreeding coefficient was not associated with these measures. The largest proportion of variation among effect sizes was explained by pollination mechanism and by the age of the tissue (progeny or adult) that was genotyped. Our primary finding was that wind-pollinated trees and shrubs appeared to be as likely to lose genetic variation as insect-pollinated species, indicating that severe habitat fragmentation may lead to pollen limitation and limited gene flow. In comparison with results of previous meta-analyses on mainly herbaceous species, we found trees and shrubs were as likely to have negative genetic responses to habitat fragmentation as herbaceous species. We also found that the genetic variation in offspring was generally less than that of adult trees, which is evidence of a genetic extinction debt and probably reflects the genetic diversity of the historical, less-fragmented landscape.

Thickened Formula Reduces Reflux in Infants

Results of previous meta-analyses have suggested that thickening infant formula (e.g., with rice cereal or carob bean gum) does not reduce

Reversal of Left Ventricular Hypertrophy

Regression of left ventricular hypertrophy (LVH) is an important intermediate target for antihypertensive therapy. Thus, several trials and meta-analyses have attempted to compare the effects of different antihypertensive agents on LVH, but flawed study designs and methodologic problems have limited the utility of these studies. PRESERVE (Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement), LIVE (LVH: Indapamide Sustained Release Versus Enalapril) and LIFE (Losartan Intervention For Endpoint reduction in hypertension) represent a new generation of large well designed trials with the power to compare different antihypertensive drugs. These studies have shown that treatment regimens based on enalapril and a nifedipine gastrointestinal therapeutic system are of similar efficacy (PRESERVE), that indapamide sustained release (SR) is superior to enalapril (LIVE), and that a regimen based on losartan is superior to a regimen based on atenolol (LIFE) in reversing hypertensive LVH. LIVE incorporated on-treatment echocardiographic quality control, with centralized readers blinded for both treatment and sequence of recording. The findings of these rigorous studies, to some extent in disagreement with results of previous meta-analyses, support the notion that antihypertensive drugs need to be judged on their individual effects on important intermediate endpoints such as LVH in well designed and adequately sized studies. However, extrapolation of the results of these studies in terms of class effects could be misleading and should be made with caution.