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Background: Polycystic ovary syndrome (PCOS) is the most common metabolic disorder among women of reproductive age. Many factors are involved in the development of PCOS, among which genetic predisposition is probably the main contributor that is also influenced by lifestyle and environmental factors. This study aims to determine the prevalence of PCOS in different continents based on Rotterdam, AES and NIH diagnostic criteria. Methods: We conducted a systematic review and meta-analysis to evaluate the prevalence of polycystic ovary syndrome in women according to (Preferred Reporting Items for Systematic Review and Meta-Analysis) PRISMA guidelines. PubMed, Scopus, Science Direct, Web of Science and Google Scholar databases were comprehensively searched until February 2021 for relevant articles. Heterogeneity between the studies was assessed using the I2 index. Begg and Mazumdar's test was used to evaluate publication bias. Results: A total of 35 studies with 12,365,646 subjects were retrieved. The mean age ranged from 10–45 years. Global prevalence of PCOS was 9.2% (95% CI: 6.8–12.5%) based on meta-analysis, our results showed that the global prevalence of PCOS was 5.5% (95% CI: 3.9–7.7%) based on NIH criteria, 11.5 (95% CI: 6.6–19.4) based on Rotterdam criteria, and 7.1% (95% CI: 2.3–20.2%) based on AES criteria. According to self-report subgroup analysis, the prevalence of PCOS was found to be 11% (95% CI: 5.2–21.8%). Conclusion: Based on the results of the present study, the prevalence of PCOS in the world was 9.2% (95% CI: 6.8–12.5%). According to the results of the present study and the high prevalence of PCOS, especially in the Africa continent, it is necessary for health systems to implement measures to timely prevent and treat this syndrome. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI), encompassing stress urinary incontinence (SUI) and urge urinary incontinence (UUI), is a prevalent and debilitating condition in patients with multiple sclerosis (MS), profoundly impacting their quality of life. This systematic review and meta-analysis aimed to elucidate the worldwide prevalence rates of SUI and UUI among MS patients. This study was conducted by examining observational studies published between 2000 and 2023. An exhaustive literature search was conducted across databases such as PubMed, MEDLINE, Web of Science, Scopus, ProQuest, and Google Scholar. The Meta-prop method facilitated pooled prevalence estimation of UUI and SUI, while Egger tests assessed publication bias. In total, 27 studies with 15,052 participants were included in the meta-analysis. The findings revealed a high random effect pooled prevalence of UUI at 41.02% (95% Confidence Interval [CI]: 30.57–51.89; I2 = 99%, p < 0.001) and SUI at 25.67% (95% CI: 19.30–32.58%; I2 = 94.9%, P < 0.001). Additionally, the pooled prevalence of mixed urinary incontinence (MUI) was reported at 18.81% (95% CI: 7.55–33.48; I2:95.44%, p < 0.001). The high heterogeneity observed suggests variable prevalence across populations and highlights the intricate nature of UI in MS. These findings underscore the critical need for dedicated supportive, therapeutic, and rehabilitative interventions to manage this common complaint in MS patients effectively. [ABSTRACT FROM AUTHOR]

Rationale: Selective serotonin reuptake inhibitors (SSRIs) are the first choice of treatment for anxiety-like disorders. However, which aspects of anxiety are affected by SSRIs is not yet fully understood. Objective: We aimed to systematically review the effect of six clinically effective SSRIs on four aspects of unconditioned anxiety: approach-avoidance behaviour (elevated plus maze), repetitive behaviour (marble burying), distress behaviour (ultrasonic vocalization), and activation of the autonomous nervous system (stress-induced hyperthermia). Methods: We identified publications by searching Medline and Embase databases and assessed the risk of bias. A random effects meta-analysis was performed and moderator effects were analysed with Bayesian penalized meta-regression. Results: Our search yielded 105 elevated plus maze, 63 marble burying, 11 ultrasonic vocalization, and 7 stress-induced hyperthermia articles. Meta-analysis suggested that SSRIs reduce anxiety-like behaviour in the elevated plus maze, marble burying and ultrasonic vocalization test and that effects are moderated by pre-existing stress conditions (elevated plus maze) and dose dependency (marble burying) but not by duration of treatment or type of SSRI. The reporting quality was low, publication bias was likely, and heterogeneity was high. Conclusion: SSRIs seem to reduce a broad range of unconditioned anxiety-associated behaviours. These results should be interpreted with caution due to a high risk of bias, likely occurrence of publication bias, substantial heterogeneity and limited moderator data availability. Our review demonstrates the importance of including bias assessments when interpreting meta-analysis results. We further recommend improving the reporting quality, the conduct of animal research, and the publication of all results regardless of significance. [ABSTRACT FROM AUTHOR]

Purpose: Functional endoscopic sinus surgery (FESS) is a mainstay surgical intervention for chronic rhinosinusitis with nasal polyposis (CRSwNP). Nasal irrigation, particularly with normal saline, is a widely recommended postoperative care modality. This systematic review and meta-analysis aimed to assess the efficacy of various nasal irrigation solutions in postoperative FESS patients. Methods: A comprehensive search was conducted in multiple databases for randomized controlled trials investigating normal saline and various substances for nasal irrigation post-FESS. The systematic review followed PRISMA guidelines, and the meta-analysis used R software for data synthesis. Outcome measures included SNOT-22 and LKES scores. The Cochrane tool was employed to evaluate the potential for bias. Results: Results from 14 studies, focusing on six each for SNOT-22 and LKES, revealed a significant reduction in symptoms and endoscopic scores with various solutions compared to normal saline. The meta-analysis using the random-effects model indicated a negative standardized mean difference (SMD) of − 0.69(95% CI [− 1.64; 0.27], p = 0.157) for symptoms and endoscopic scores (SMD = − 0.48, 95% CI [− 1.32; 0.36], z = − 1.12, p = 0.264). Subgroup analyses highlighted budesonide's efficacy over normal saline, but substantial heterogeneity and potential publication bias were noted. Conclusion: Nasal irrigation with various solutions postoperative FESS patients demonstrated significant improvements in patient-reported symptoms and endoscopic scores compared to normal saline. Budesonide appeared particularly effective. However, high heterogeneity and potential publication bias warrant cautious interpretation. Standardized outcome measures and further research are needed to strengthen the evidence. [ABSTRACT FROM AUTHOR]

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This systematic review and meta-analysis aimed to examine the association between maternal education and completion of childhood vaccination among aged 12–23 months children in Ethiopia. Systematic review and meta-analysis. PubMed-Medline, EMBASE, SCOPUS, Global Health, and Google Scholar were searched for articles published from January 2010 to January 2020. The data extraction was reported based on the PRISMA guideline (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We performed the I2 test and a funnel plot to assess heterogeneity and check for publication bias. We assessed 841 studies for eligibility, of which 43 studies were included in the qualitative synthesis, and 28 studies were fully accessed for meta-analysis. The overall pooled effect of this systematic review and meta-analysis demonstrated a positive association between maternal education and completion of childhood vaccination. Having a primary level of maternal education was correlated with a 1.87 times higher likelihood (95% CI 1.76–1.98) of completing childhood vaccination compared to having no education. Furthermore, attending secondary education and above was associated with a 3.47 times higher likelihood (95% CI 3.18–3.78) of completing childhood vaccination compared to having no education. This systematic review and meta-analysis study revealed that as the level of maternal education increases, the completion of childhood vaccination accelerates. Therefore, investment in maternal education should be prioritized as an intervention. Empowering mothers through education can contribute to the reduction and prevention of vaccine-preventable diseases and associated risks. [ABSTRACT FROM AUTHOR]

Summary: Our review of 52 RCTs from 5 databases suggests a tendency for notable improvement in BMD when combining herbal medicine with supplements (calcium and vitamin D variants) compared to supplement monotherapy in primary osteoporosis. However, caution is needed in interpreting results due to substantial heterogeneity among included studies. Purpose: To conduct a systematic review and meta-analysis to determine whether herbal medicine (HM) plus supplements such as calcium (Ca) or vitamin D (Vit.D) improves bone mineral density (BMD) compared to supplements alone in primary osteoporosis (OP) patients. Methods: We searched 5 databases for randomized controlled trials (RCTs) using HMs with supplements (Ca or Vit.D variants) as interventions for primary OP patients published until August 31, 2022. Meta-analysis using BMD score as the primary outcome was performed using RevMan 5.4 version. Risk of bias in the included studies was assessed useing RoB 2.0 tool. Results: In total, 52 RCTs involving 4,889 participants (1,408 men, 3,481 women) were included, with average BMD scores of 0.690 ± 0.095 g/cm2 (lumbar) and 0.625 ± 0.090 g/cm2 (femoral neck). As a result of performing meta-analysis using BMD scores for all 52 RCTs included in this review, combination of HMs with Ca and Vit.D variants improved the BMD score by 0.08 g/cm2 (lumbar, 38 RCTs, 95% CI: 0.06–0.10, p < 0.001, I2 = 97%) and 0.06 g/cm2 (femoral neck, 19 RCTs, 95% CI: 0.04–0.08, p < 0.001, I2 = 92%)compared to controls. However, statistical significance of the lumbar BMD improvement disappeared after adjusting for potential publication bias. Conclusion: Our data suggest that combining of HM and supplements tends to be more effective in improving BMD in primary OP than supplements alone. However, caution is needed in interpretation due to the reporting bias and high heterogeneity among studies, and well-designed RCTs are required in the future. [ABSTRACT FROM AUTHOR]

Background: Although selective serotonin reuptake inhibitors (SSRIs) are usually considered safe to use in patients with Parkinson's disease (PD), there are mixed data about their effectiveness, and only a few investigations have led to a total improvement of depressive symptoms in patients with PD. Objectives: We aimed to conduct a comprehensive systematic review and meta-analysis of all studies that investigated the effectiveness of SSRIs in treating depression in the context of PD. Methods: From its commencement to June 2024, the databases of MEDLINE via PubMed, Scopus, Embase, and Google Scholar were electronically searched for the relevant papers. All full-text journal articles assessing the effectiveness of SSRIs in treating depression in patients with PD were included. The tool developed by the Cochrane Collaboration was utilized to evaluate the bias risk. Data were analyzed utilizing a pair-wise comparison meta-analysis using the standardized mean difference. Results: A total of 19 articles and 22 separate interventions were included. We found that SSRI treatment attenuated depression in patients with PD (1.242 standardized mean difference, 95% confidence interval 0.956, 1.529, p < 0.001). The general heterogeneity of the studies was medium (ϰ2 = 72.818, T2 = 0.317, df = 21, I2 = 71.15%, p < 0.001). The funnel plot was reasonably symmetrical. However, three studies were trimmed to the left of the mean. Begg's test (p = 0.080), Egger's test (p = 0.121), and funnel plot showed no significant risk of publication bias. The meta-regression showed that the treatment effect increased as a function of paroxetine treatment duration (slope p = 0.001) but decreased as a function of sertraline treatment duration (slope p = 0.019). Conclusions: There are few controlled antidepressant trials on the PD population, even though patients with PD frequently experience depression and use antidepressants. Clinical studies that are larger and better structured are needed in the future to determine if antidepressants are useful for treating patients with PD with depression. [ABSTRACT FROM AUTHOR]

Curcumin, a polyphenol derived from the herb turmeric, has emerged as a prospective potential therapy in the treatment of Alzheimer's disease (AD). However, the efficacy of curcumin treatment in improving cognitive decline caused controversy recently. We aimed to systematically review the effect of curcumin on cognitive impairment in an animal model of AD. We conducted an exhaustive database search of related studies. Two investigators identified studies and independently extracted data. Stratified meta-analyses and meta-regression analyses were carried out to explore the sources of heterogeneity. Publication bias was assessed using funnel plots and Egger's test. Our systematic review included 33 articles. A meta-analysis of 29 publications showed that curcumin exerts significant positive effects on cognitive performance. For acquisition, the global estimated effect of curcumin was − 2.027 (95% CI − 2.435 to − 1.619, p < 0.001); for retention, the global estimated effect of curcumin was 1.606 (95% CI 1.101 to 2.111, p < 0.001). The stratified meta-analysis demonstrated that an increased effect size depended on diverse study characteristics. Additionally, publication bias was detected. We conclude that curcumin may reduce cognitive deficits in experimental AD. Furthermore, we emphasize that additional well-designed and well-reported animal studies are needed to inform further clinical studies. [ABSTRACT FROM AUTHOR]

Purpose: To obtain performance values of PET/CT for determining the nodal status of rectal cancer. Materials: A comprehensive literature search was performed on PubMed and Embase for original diagnostic accuracy studies on the diagnostic performance of PET-CT for detection of LN metastasis in rectal cancer. The QUADAS-2 was used to evaluate the methodological quality of each study. Pooled sensitivity, specificity, and AUC were calculated to estimate the diagnostic role of PET/CT using a random-effects model. A subgroup analysis was performed to investigate the influence of different parameters on diagnostic performance. Results: A total of 15 studies and 1209 patients were included. A publication bias was observed. The pooled sensitivity, specificity, and AUC for PET/CT was 0.62 (95% CI 0.49, 0.74), 0.94 (95% CI 0.87, 0.97), and 0.87 (95% CI 0.83–0.89), respectively. Per-node basis yields higher accuracy than per-patient basis, with pooled sensitivities of 0.65 (95% CI 0.50–0.79) vs. 0.56 (95% CI 0.36–0.77) and specificities of 0.96 (95% CI 0.92–1.00) vs. 0.88 (95% CI 0.76–1.00), but there were no significant differences in diagnostic accuracy. Conclusion: PET/CT has high specificity but moderate sensitivity for the detection of LN metastasis in rectal cancer. The current data suggests that the diagnostic capabilities of this method is limited due to its moderate sensitivity. [ABSTRACT FROM AUTHOR]

The present analysis reports on the robustness of preclinical cardioprotection studies with infarct size as endpoint which were published in Basic Research in Cardiology, Cardiovascular Research, and Circulation Research between January 2013 and December 2023. Only 26 out of 269 papers with technically robust analysis of infarct size by triphenyltetrazolium chloride staining, magnetic resonance imaging or single photon emission tomography applied a prospective power analysis. A retrospective power calculation revealed that only 75% of the reported data sets with statistically significant positive results from all these studies had a statistical power of ≥ 0.9, and an additional 9% had a statistical power ≥ 0.8. The remaining 16% of all significant positive data sets did not even reach the 0.8 threshold. Only 13% of all analyzed data sets were neutral. We conclude that neutral studies are underreported and there is indeed a significant lack of robustness in many of the published preclinical cardioprotection studies which may contribute to the difficulties of translating cardioprotection to patient benefit. [ABSTRACT FROM AUTHOR]

Background and Objective: Despite the significant burden of Plasmodium falciparum (Pf) malaria and the licensure of two vaccines for use in infants and young children that are partially effective in preventing clinical malaria caused by Pf, a highly effective vaccine against Pf infection is still lacking. Live attenuated vaccines using Pf sporozoites as the immunogen (PfSPZ Vaccines) hold promise for addressing this gap. Here we review the safety and efficacy of two of the most promising PfSPZ approaches: PfSPZ Vaccine (radiation attenuated PfSPZ) and PfSPZ-CVac (chemo-attenuated PfSPZ). Methods: We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, SCOPUS, CENTRAL, and WOS until 22nd December 2021. We included randomized controlled trials (RCTs) of these two vaccine approaches that measured protection against parasitaemia following controlled human malaria infection (CHMI) in malaria-naive and malaria-exposed adults or following exposure to naturally transmitted Pf malaria in African adults and children (primary outcome) and that also measured the incidence of solicited and unsolicited adverse events as indicators of safety and tolerability after vaccination (secondary outcome). We included randomized controlled trials (RCTs) that measured the detected parasitaemia after vaccination (primary outcome) and the incidence of various solicited and unsolicited adverse events (secondary outcome). The quality of the included RCTs using the Cochrane ROB 1 tool and the quality of evidence using the GRADE system were evaluated. We pooled dichotomous data using the risk ratio (RR) for development of parasitemia in vaccinees relative to controls as a measure of vaccine efficacy (VE), including the corresponding confidence interval (CI). This study was registered with PROSPERO (CRD42022308057). Results: We included 19 RCTs. Pooled RR favoured PfSPZ Vaccine (RR: 0.65 with 95% CI [0.53, 0.79], P = 0.0001) and PfSPZ-table (RR: 0.42 with 95% CI [0.27, 0.67], P = 0.0002) for preventing parasitaemia, relative to normal saline placebo. Pooled RR showed no difference between PfSPZ Vaccine and the control in the occurrence of any solicited adverse event (RR: 1.00 with 95% CI [0.82, 1.23], P = 0.98), any local solicited adverse events (RR: 0.73 with 95% CI [0.49, 1.08], P = 0.11), any systemic solicited adverse events (RR: 0.94 with 95% CI [0.75, 1.17], P = 0.58), and any unsolicited adverse event (RR: 0.93 with 95% CI [0.78, 1.10], P = 0.37). Conclusion: PfSPZ and PfSPZ-CVacs showed comparable efficacy. Therefore, they can introduce a promising strategy for malaria prophylaxis, but more large-scale field trials are required to sustain efficacy and yield clinically applicable findings. [ABSTRACT FROM AUTHOR]

Purpose: Evidence-based medicine requires evaluation of the medical literature to guide clinical reasoning and treatment recommendations. The presence of publication bias towards exclusion of non-statistically significant clinical trials may be leading to an incomplete evaluation of the literature and cause potentially incomplete guidance for patients. We aimed to compare publication rates and impact of publications of positive and negative outcome clinical trials. Methods: We queried the US National Library of Medicine Clinical Trials database identifying clinical trials with reported results on the topics of pancreatic, liver, and gastric cancer. A "positive" trial was defined as having a statistically significant difference between the treatment arms, while a "negative" did not. Data collected included termination cause, intervention, funding type, publication rates, and journal characteristics. Results: In total, 535 clinical trials were examined, across all pathologies clinical trials with significant findings for the primary outcome were published at a higher rate (99%) compared to those with non-significant findings (77%) (p < 0.01). Significantly, more studies with significant findings reached at least 80% of their estimated enrollment goal versus non-significant studies, 72% and 53% respectively (p < 0.01). Three of four metrics for impact of publication showed no difference between significant and non-significant studies once they reached publication. Conclusion: These findings suggest that clinical trials of three of the most common upper gastrointestinal malignancies have a publication bias towards studies with significant primary outcome findings. This study has implications to the way evidence-based medicine is practiced as the medical literature appears to be failing to capture important data for consideration of clinical decision making. [ABSTRACT FROM AUTHOR]

Empirical research usually takes place in a space of available external information, like results from single studies, meta-analyses, official statistics or subjective (expert) knowledge. The available information ranges from simple means and proportions to known relations between a multitude of variables or estimated distributions. In psychological research, external information derived from the named sources may be used to build a theory and derive hypotheses. In addition, techniques do exist that use external information in the estimation process, for example prior distributions in Bayesian statistics. In this paper, we discuss the benefits of adopting generalized method of moments with external moments, as another example for such a technique. Analytical formulas for estimators and their variances in the multiple linear regression case are derived. An R function that implements these formulas is provided in the supplementary material for general applied use. The effects of various practically relevant moments are analyzed and tested in a simulation study. A new approach to robustify the estimators against misspecification of the external moments based on the concept of imprecise probabilities is introduced. Finally, the resulting externally informed model is applied to a dataset to investigate the predictability of the premorbid intelligence quotient based on lexical tasks, leading to a reduction of variances and thus to narrower confidence intervals. [ABSTRACT FROM AUTHOR]

We analyze diverse and heterogeneous literature to grasp the general effect size of financial development on economic growth on a world scale. For that, we perform by far the largest available meta-analysis of the finance–growth nexus using 3561 estimates collected from 177 studies. Our meta-synthesis results show that large heterogeneity in empirical evidence is, in fact, driven by only a limited number of variables (moderators). By using advanced techniques, we also document the existence of the publication selection bias that is propagated in the literature in a nonlinear fashion. We account for uncertainty in moderator selection by employing model-averaging techniques. After adjusting for the publication bias, the results of our meta-regression provide evidence of a small but genuine positive effect of the financial development on growth that very mildly declines over time. Finance channeled via capital markets seems to be more beneficial for economic growth than that provided in the form of private credit. Our evidence goes against arguments about the damaging role of financial development and is in line with century-old theoretical foundations that favor the positive role of finance on economic growth. [ABSTRACT FROM AUTHOR]

Dural Arteriovenous Fistulas (dAVFs) of the anterior cranial fossa (ACF) are uncommon but carry a high risk of hemorrhage and pose substantial treatment challenges. Recent advancements in endovascular treatment (EVT), including the introduction of novel liquid embolic agents, have markedly bolstered EVT's role in managing ACF-dAVFs, with notable series published in the last five years. We aimed to assess the feasibility, safety, and efficacy of EVT for ACF-dAVFs. We searched Medline, Scopus, Web of Science, and Cochrane Library databases following PRISMA guidelines. Eligible studies included those with ≥ 5 patients undergoing embolization of ACF-dAVFs, detailing both angiographic and clinical outcomes. We used single proportion analysis with 95% confidence intervals under a random-effects model, I2 to assess heterogeneity, and Baujat and sensitivity analysis to address high heterogeneity. Publication bias was assessed by funnel-plot analysis and Egger's test. Outcomes included complete occlusion following embolization, unsuccessful endovascular embolization attempts, incomplete occlusion following embolization, symptom resolution or clinical improvement following embolization, recurrence; procedure-related complications, morbidity, and mortality. Additionally, a subanalysis for studies exclusively utilizing Onyx™ embolic system was done. Eighteen studies comprising 231 ACF-dAVF were included. Unsuccessful endovascular embolization attempts rate was 2%. Complete occlusion rate was 85%, with 4% of complications. Incomplete occlusion rate was 10%. Successfully embolized patients experienced either symptom resolution or clinical improvement in 94% of cases. Morbidity and mortality rates were 1% and 0%, respectively. Onyx subanalyses showed an overall rate of 0% for unsuccessful attempts, 95% for complete occlusion, and 5% for incomplete occlusion. Symptom resolution or clinical improvement was 98% and recurrence rate was 0%. EVT for ACF-dAVF is highly feasible, effective, and safe, with a low rate of complications, morbidity, and mortality. The subanalyses focusing on Onyx embolizations revealed superior efficacy and safety outcomes compared to the findings of the primary analyses involving all included studies. [ABSTRACT FROM AUTHOR]

Aim: To conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that evaluated the efficacy of low-dose aspirin (LDA, ≤ 160 mg/day) on preventing preterm birth (PB). Methods: Five databases were screened from inception until June 25, 2023. The RCTs were assessed for quality according to Cochrane's risk of bias tool. The endpoints were summarized as risk ratio (RR) with 95% confidence interval (CI). Results: Overall, 40 RCTs were analyzed. LDA significantly decreased the risk of PB < 37 weeks (RR: 0.91, 95% CI 0.87, 0.96, p < 0.001, moderate certainty of evidence) with low between-study heterogeneity (I2 = 23.2%, p = 0.11), and PB < 34 weeks (RR: 0.78, 95% CI 0.61, 0.99, p = 0.04, low certainty of evidence) with high between-study heterogeneity (I2 = 58.3%, p = 0.01). There were no significant differences between both groups regarding the risk of spontaneous (RR: 0.94, 95% CI 0.83, 1.07, p = 0.37) and medically indicated (RR: 1.28, 95% CI 0.87, 1.88, p = 0.21) BP < 37 weeks. Sensitivity analysis revealed robustness for all outcomes, except for the risk of PB < 34 weeks. For PB < 37 weeks and PB < 34 weeks, publication bias was detected based on visual inspection of funnel plots for asymmetry and statistical significance for Egger's test (p = 0.009 and p = 0.0012, respectively). Conclusion: LDA can significantly reduce the risk of PB < 37 and < 34 weeks. Nevertheless, further high-quality RCTs conducted in diverse populations, while accounting for potential confounding factors, are imperative to elucidate the optimal aspirin dosage, timing of initiation, and treatment duration for preventing preterm birth and to arrive at definitive conclusions. [ABSTRACT FROM AUTHOR]

Despite the current increase in revisional bariatric surgery (RBS), data on the sustainability of weight loss remain unclear. A systematic review and meta-analysis were performed to assess weight loss outcomes in adult patients undergoing RBS with follow-up > 2 years. Twenty-eight observational studies (n = 2213 patients) were included. The %TWL was 27.2 (95%CI = 23.7 to 30.6), and there was a drop in BMI of 10.2 kg/m2 (95%CI = − 11.6 to − 8.7). The %EWL was 54.8 (95%CI = 47.2 to 62.4) but with a high risk of publication bias (Egger's test = 0.003). The overall quality of evidence was very low. Our data reinforce that current evidence on RBS is mainly based on low-quality observational studies, and further higher-quality studies are needed to support evidence-based practice. [ABSTRACT FROM AUTHOR]

Gastroesophageal reflux disease (GERD) is a common concern following laparoscopic sleeve gastrectomy (LSG). This paper aimed to assess the incidence of reflux disease following these bariatric procedures. A literature search was conducted to identify observational studies and clinical trials reporting patients developed GERD disease after LSG. Twenty-two studies included in the analysis, involve 20,495 participants, indicated that the estimated proportion of patients who developed post-surgery GERD was 0.35 (95% CI 0.30–0.41). Subgroup analysis revealed a proportion of 0.33 (95% CI 0.27–0.38) in observational studies and 0.58 (95% CI 0.39–0.75) in clinical trials. High heterogeneity was noted across studies (I2 = 98%). Sensitivity analyses and publication bias assessments were performed to enhance the robustness of the results. Our findings highlight a moderate to high risk of developing GERD following LSG surgery. [ABSTRACT FROM AUTHOR]

Introduction: Currently, the cause of psoriatic arthritis (PsA) is unknown, and the effectiveness of current drug treatments is unsatisfactory. In March 2019, the US Food and Drug Administration (FDA) approved risankizumab, a humanized immunoglobulin G1 (IgG1) monoclonal antibody targeting the p19 subunit of interleukin (IL)-23, for the treatment of PsA in adults. This study aimed to conduct a meta-analysis of double-blind, randomized, placebo-controlled trials to evaluate the effectiveness and safety of risankizumab in moderate-to-severe PsA. Methods: We conducted a thorough search of relevant databases from the establishment of the databases to October 1, 2023. We conducted a meta-analysis using Stata 12.0 and utilized I2 and Egger tests to assess heterogeneity and publication bias among the studies. Bias assessment was performed using the risk bias map and bias risk summary diagram generated by Revman5.4 software. The review protocols were registered on PROSPERO (CRD42023451894) and adhered to the preferred reporting item of system evaluation (PRISMA) guideline. Results: Six randomized controlled trials (RCTs) involving 5038 patients with PsA treated with either risankizumab or placebo were included in the analysis. At 24 weeks, the risankizumab group demonstrated a significantly higher American College of Rheumatology-20 (ACR20) response rate compared to the placebo group (RR 1.760, 95% CI 1.568–1.977, P < 0.001). Additionally, the risankizumab group showed a significantly higher Minimal Disease Activity (MDA) response rate compared to the placebo group (RR 1.827, 95% CI 1.048–3.184, P < 0.05). The risankizumab group also exhibited improvement in Short Form 36 Questionnaire (SF-36) score (SMD 0.51, 95% CI 0.33–0.69, P < 0.001), with significantly lower Health Assessment Questionnaire Disability Index (HAQ-DI) score (SMD − 0.27, 95% CI − 0.37 to − 0.17, P < 0.001) and higher Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) score (SMD 0.27, 95% CI 0.20–0.35, P < 0.001) compared to the placebo group. Moreover, the risankizumab group had a significantly lower Psoriasis Area and Severity Index (PASI) score (SMD − 6.12, 95% CI − 10.02 to 2.23, P < 0.001). A study by Mease et al. indicated that patients receiving risankizumab generally demonstrated numerical improvements in the Leeds Enthesitis Index (LEI), although the small sample size limits the evidence. Further research is necessary to provide evidence-based guidelines. There were no significant differences in the incidence of serious adverse events (SAE) and serious treatment-emergent adverse events (STEAE) between the risankizumab and placebo groups (RR 0.76, 95% CI 0.45–1.28, P = 0.31; RR 0.99, 95% CI 0.49–1.99, P = 0.97, respectively), and the overall incidence of adverse events (AE) was not comparable (RR 1.10, 95% CI 0.63–1.94, P = 0.73). Conclusion: Risankizumab showed superior efficacy across multiple outcome measures compared to placebo, with no significant increase in adverse events. Our findings endorse risankizumab as an excellent treatment option for PsA, offering valuable insights for clinicians and patients when choosing appropriate therapeutic interventions. Trial Registration: Retrospectively registered (CRD42023451894, 16 August 2023). [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the efficacy and safety of acupressure on nausea and vomiting during pregnancy. Methods: PubMed, Embase, Springer, Web of Science, and the Cochrane Library were searched for all randomized controlled trials (RCT) of treating nausea and vomiting during pregnancy by acupressure from the inception date of database to July 31st, 2023. Study selection, data extraction, and risk of bias assessment were conducted independently by researchers. The methodological quality of included studies was evaluated by the Cochrane Collaboration's bias risk assessment tool, meta-analysis by Stata 17.0 software, and publication bias by Begg's test. Results: A total of 11 RCTs involving 1378 pregnant women were included in this review, which was assessed to be moderate quality. 10 RCTs involving 1298 pregnant women were assessed for the meta-analysis. The results revealed that acupressure showed significant difference on improvement in symptom score compared with sham acupressure (pooled MD, − 1.33; 95%CI [− 2.06, − 0.61]; P < 0.001) or control group (pooled MD, − 0.73; 95%CI [− 1.08, − 0.39]; P < 0.001), and incidence of effective rate compared with sham acupressure group (pooled RR, 1.78; 95%CI [1.03, 3.07]; P = 0.039). However, no statistical significance was found between acupressure and control group (pooled RR, 4.53; 95%CI [0.67, 30.48]; P = 0.120) on effective rate. On comparing acupressure with sham acupressure, there was no beneficial effect on preventing nausea and vomiting during pregnancy (pooled RR, 0.83; 95%CI [0.50, 1.38]; P = 0.476), shortening the duration of hospital stay (pooled MD, − 0.78; 95%CI [− 1.98, 0.41]; P = 0.199) and improving patient satisfaction (pooled RR, 1.36; 95%CI [0.47, 3.91]; P = 0.570). Begg's test did not reveal any publication bias. Only one RCT reported minimal acupressure-related adverse events. Conclusion: Acupressure may have potential favorable or encouraging effect on treating nausea and vomiting during pregnancy, but strong supportive data are not yet available. Well-designed and large-scale RCTs should be conducted for assessing and confirming the efficacy and safety of acupressure in nausea and vomiting during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Running economy is defined as the energy demand at submaximal running speed, a key determinant of overall running performance. Strength training can improve running economy, although the magnitude of its effect may depend on factors such as the strength training method and the speed at which running economy is assessed. Aim: To compare the effect of different strength training methods (e.g., high loads, plyometric, combined methods) on the running economy in middle- and long-distance runners, over different running speeds, through a systematic review with meta-analysis. Methods: A systematic search was conducted across several electronic databases including Web of Science, PubMed, SPORTDiscus, and SCOPUS. Using different keywords and Boolean operators for the search, all articles indexed up to November 2022 were considered for inclusion. In addition, the PICOS criteria were applied: Population: middle- and long-distance runners, without restriction on sex or training/competitive level; Intervention: application of a strength training method for ≥ 3 weeks (i.e., high loads (≥ 80% of one repetition maximum); submaximal loads [40–79% of one repetition maximum); plyometric; isometric; combined methods (i.e., two or more methods); Comparator: control group that performed endurance running training but did not receive strength training or received it with low loads (< 40% of one repetition maximum); Outcome: running economy, measured before and after a strength training intervention programme; Study design: randomized and non-randomized controlled studies. Certainty of evidence was assessed with the GRADE approach. A three-level random-effects meta-analysis and moderator analysis were performed using R software (version 4.2.1). Results: The certainty of the evidence was found to be moderate for high load training, submaximal load training, plyometric training and isometric training methods and low for combined methods. The studies included 195 moderately trained, 272 well trained, and 185 highly trained athletes. The strength training programmes were between 6 and 24 weeks' duration, with one to four sessions executed per week. The high load and combined methods induced small (ES = − 0.266, p = 0.039) and moderate (ES = − 0.426, p = 0.018) improvements in running economy at speeds from 8.64 to 17.85 km/h and 10.00 to 14.45 km/h, respectively. Plyometric training improved running economy at speeds ≤ 12.00 km/h (small effect, ES = − 0.307, p = 0.028, β1 = 0.470, p = 0.017). Compared to control groups, no improvement in running economy (assessed speed: 10.00 to 15.28 and 9.75 to 16.00 km/h, respectively) was noted after either submaximal or isometric strength training (all, p > 0.131). The moderator analyses showed that running speed (β1 = − 0.117, p = 0.027) and VO2max (β1 = − 0.040, p = 0.020) modulated the effect of high load strength training on running economy (i.e., greater improvements at higher speeds and higher VO2max). Conclusions: Compared to a control condition, strength training with high loads, plyometric training, and a combination of strength training methods may improve running economy in middle- and long-distance runners. Other methods such as submaximal load training and isometric strength training seem less effective to improve running economy in this population. Of note, the data derived from this systematic review suggest that although both high load training and plyometric training may improve running economy, plyometric training might be effective at lower speeds (i.e., ≤ 12.00 km/h) and high load strength training might be particularly effective in improving running economy (i) in athletes with a high VO2max, and (ii) at high running speeds. Protocol Registration: The original protocol was registered (https://osf.io/gyeku) at the Open Science Framework. [ABSTRACT FROM AUTHOR]

Assessing the impact of the nonprofit sector on society has been one of the most fundamental yet challenging questions in public and nonprofit management scholarship. Built on a recent systematic literature review published in VOLUNTAS (Cheng and Choi in Int J Volunt Nonprofit Organ 33:1245–1255, 2022), our meta-analysis synthesizes the existing literature from multiple disciplines and fills this critical knowledge gap. Using 357 effects from 29 studies, our moderation analysis shows that a larger nonprofit sector has a more positive impact on society especially when the impact is political and measured at the city/county level. Studies that used fixed-effects models and quasi-experimental designs also found a more positive societal impact of the nonprofit sector. However, the choice of sector size measure, the selection of impact measure, the use of lagged explanatory variables, publication bias, and publication time seem not to matter. [ABSTRACT FROM AUTHOR]

Purpose: The prevention of mechanical complications (MC) is a major concern in adult spinal deformity (ASD) correction surgery; thus, the global alignment and proportion (GAP) score was developed to assess MC risk. Numerous studies have clarified the validity of the GAP score, but their contradictory results have prevented researchers from reaching compelling conclusions. This study aimed to analyze the predictive power of the GAP score on MC via a meta-analysis. Methods: A total of 1,617 patients were included in the meta-analysis. Studies relevant to the GAP score and MC were identified in PubMed, EMBASE, and Cochrane CENTRAL and screened according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The GAP score categories of the patients and their MC/revision surgery status were collected. The data collected for the meta-analysis of odds ratios (OR) included the number of patients in the GAP score subgroups and their MC/revision surgery status. To calculate the OR, three GAP score subgroups were combined into two groups; hence, the analysis was conducted twice (gap proportioned [GAP-P] and higher groups, and gap severely disproportioned [GAP-SD] and lower groups). Results: Eleven studies were collected; of them, revision surgery data were available for seven. The proportion of MC in the studies was 27.7–60.6%, while that of revision surgery was 11.7–34.9%. In the meta-analysis of the GAP-P and higher score groups, the difference in MC ratio was significant (OR = 2.83; 95% confidence interval [CI] = 1.20–6.67; P = 0.02), whereas that for revision surgery was not. For the GAP-SD and lower score groups, the GAP-SD group had significantly higher proportions of both MC (OR = 2.65; 95% CI = 1.57–4.45; P < 0.001) and revision surgery (OR = 2.27; 95% CI = 1.33–3.88; P = 0.003). Publication bias was significant only in the latter MC analysis. Conclusion: The GAP score offers predictive value for the risk of mechanical complications. [ABSTRACT FROM AUTHOR]

Although many studies in recent years have examined the use of gamification as a motivational strategy in education, evidence regarding its effects on intrinsic motivation is inconsistent. To make the case for or against the adoption of gamification in education, this study examines its effects on students' intrinsic motivation and the underlying motivational factors: perceived competence, autonomy, and relatedness. In this review, we analyzed the results of studies comparing gamified learning with non-gamified learning published between 2011 and 2022. The results of our meta-analysis of 35 independent interventions (involving 2500 participants) indicated an overall significant but small effect size favoring gamified learning over learning without gamification (Hedges' g = 0.257, 95% CI [0.043, 0.471], p =.019) with no evidence of publication bias. Gamification also exerted a positive and significant effect on the students' perceptions of autonomy (Hedges' g = 0.638, 95% CI [0.139, 1.136], p =.012) and relatedness (Hedges' g = 1.776, 95% CI [0.737, 2.814], p =.001), but minimal impact on competence (Hedges' g = 0.277, 95% CI [0.001, 0.553], p =.049). To further investigate the possible reasons for the small impact on intrinsic motivation, a systematic review of 31 studies was conducted. The findings revealed two major challenges encountered in the adoption of gamification to increase students' intrinsic motivation: students' lack of perceived competence and lack of perceived autonomy in gamified classes. [ABSTRACT FROM AUTHOR]

Learning new categories is a fundamental human skill. In the present article, we report the first comprehensive meta-analysis of category learning in autism. Including studies comparing groups of autistic and nonautistic individuals, we investigated whether autistic individuals differ in category learning from nonautistic individuals. In addition, we examined moderator variables accounting for variability between studies. A multilevel meta-analysis of k = 50 studies examining n = 1,220 autistic and n = 1,445 nonautistic individuals based on 112 effect sizes in terms of the standardized mean difference revealed lower-level category learning skills for autistic compared with nonautistic individuals, g = −0.55, 95% CI = [−0.73, −0.38], p <.0001. According to moderator analyses, the significant amount of heterogeneity, Q(111) = 617.88, p <.0001, was explained by only one of the moderator variables under investigation—namely, study language. For the remaining variables—namely, age, year of publication, risk of bias, type of control group, IQ of autistic group, percentage of male autistic participants, type of category, type of task, and type of dependent measure—there were no significant effects. Although hat values and Cook's distance statistics confirmed the robustness of findings, results of Egger's test and a funnel plot suggested the presence of publication bias reflecting an overrepresentation of disadvantageous findings for autistic groups. Objectives for future work include identifying additional moderator variables, examining downstream effects of suboptimal category learning skills, and developing interventions. [ABSTRACT FROM AUTHOR]

Although the number of journals that have adopted the registered report format has increased rapidly in recent years, they still account for only a tiny portion of academic journals. This article provides a summary and overview of the number and proportion of journals that accept the registered report format in the various scientific domains. The Center for Open Science was searched for journals that have adopted the registered report as a regular submission option. The numbers of such journals in each scientific domain were then counted based on their group and category classification in the Journal Citation Reports (JCR). In July 2023, 278 journals had adopted the registered report format, with 186 of these journals included in the JCR. The percentage of journals that had adopted the registered report format ranged from 0 to 7% across the different major research fields (groups in JCR) and from 0 to 34% across the research subfields (categories in JCR). The group "Psychiatry/Psychology" and category "Psychology, Experimental" had the highest percentage of journals that had adopted registered reports. Four large-scale replication projects have been published, focusing on psychology, social science, medicine, and economics, respectively. Although all four studies showed unsatisfactory replication success rates, ≤ 1% of the journals in the corresponding scientific domains had adopted registered reports, with the exception of psychology (7%). To improve research reliability and transparency, it is critical to increase the use of the registered report publishing format. [ABSTRACT FROM AUTHOR]

Objective: To systematically analyze the accuracy of ultrasonic techniques in assessing the nature of gastric contents and their volume. Methods: English-language articles that used ultrasonic techniques to assess the nature of gastric contents and their volume in patients were selected. In eligible studies, data were recalculated and analyzed for forest plots and subject summary curves of operating characteristics (SROC). Study quality was assessed using the diagnostic accuracy study quality assessment tool QUADAS-2. Publication bias was tested using funnel plots. Results: Nine articles with a total of 523 study subjects were identified for this review. All studies were feasibility studies. The sensitivity of ultrasound assessment of gastric contents ranged from 53 to 100% and the specificity from 48 to 99%. The combined analysis yielded an area under the working characteristic curve for subjects of 97% (95% confidence interval (CI), 95–98%), a sensitivity of 95% (95% CI, 84–99%), and a specificity of 88% (95% CI, 72–95%). There was a high degree of heterogeneity among the studies due to inter-operator differences and small sample sizes. Conclusion: Ultrasound techniques have high diagnostic accuracy in assessing the nature of gastric contents and their volume in patients. However, most of the studies were feasibility studies with small sample sizes, lacked standardization, and had high risk of bias. More studies are needed in the future to investigate the diagnostic performance of gastric ultrasound assessment techniques. Critical relevance statement: Ultrasonography can be used to assess gastric contents, but standardized data integration and reporting are needed to account for the diagnostic capabilities of this technology. Key points: • Ultrasound is a safe and feasible tool for assessing gastric contents. • Ultrasound has good diagnostic performance for gastric contents. • There is still a certain heterogeneity within our analysis process; more research is needed in the future to improve our results. [ABSTRACT FROM AUTHOR]

Pathologic Technology Use (PTU) has emerged as a prominent public health and educational concern due to the rapid global advancements in technology. Cognitive Behavior Therapy (CBT) has been extensively studied as a primary approach to mitigate PTU. The objective of this study was to draw a comprehensive conclusion by conducting a systematic review and meta-analysis of experimental studies that utilized CBT for PTU, including conditions such as Internet addiction, internet use disorder, and game addiction. Through a literature search, we identified 15 relevant studies for inclusion in our meta-analysis, conducted using Comprehensive Meta-Analysis (CMA). A moderator analysis was performed to compare the impact of CBT on different types of PTU and to assess its effectiveness across various age groups. Our analysis revealed the presence of publication bias in the included studies, and we discussed potential reasons for this bias based on existing literature. [ABSTRACT FROM AUTHOR]

Due to the long-term separation from their parents, the physical and mental health development of left-behind children is not optimal. Among many psychological problems, loneliness is the most significant. We searched all publicly published literature related to the loneliness of left-behind children from its establishment to September 30, 2022 in Chinese and English databases. Forest plots and funnel plots were drawn to examine the heterogeneity and publication bias of the included studies, and the loneliness status of left-behind children was analyzed by meta-analysis. A total of 23 studies with 6,678 left-behind children were included in the analysis. The meta results showed that the loneliness level of left-behind children was higher than that of non-left-behind children. Subgroup analysis showed that there was no significant difference in total effect size among different grades. However, different guardian types could affect the loneliness level of left-behind children, for example, single-parent monitoring was associated with lower loneliness than other relative monitoring. [ABSTRACT FROM AUTHOR]

Potentially toxic elements (PTEs), including heavy metal exposures, have been associated with numerous negative pregnancy and birth outcomes. However, the association between PTE exposure and gestational diabetes mellitus (GDM) has not yet undergone a comprehensive systematic review. Consequently, this study undertook the first-ever systematic review and meta-analysis of observational studies concerning this association. All relevant articles published in English were searched in Scopus, PubMed, and Web of Science until November 6, 2023, adhering to the MOOSE guidelines. The quality of retrieved studies was evaluated based on the Gascon et al. method. The meta-analysis of association estimates was performed using random effects meta-analysis. Egger's regression was employed to evaluate publication bias. In total, 16 articles (n = 116,728 participants) were included in our review, with 11 eligible for meta-analysis. Quality assessment categorized five studies (31%) as excellent, nine studies (56%) as good, and two studies (13%) as fair. Maternal high levels of Hg during pregnancy were associated with an increased risk of GDM (for each one-quartile increase in Hg: 1.20, 95% CI 1.08, 1.31), while serum Cd levels during the second trimester were associated with a lower risk of GDM (for each one-quartile increase in Cd: 0.76, 95% CI 0.65, 0.87). Furthermore, exposure to Pb was not associated with higher risk of GDM. In summary, our comprehensive review and meta-analysis underscore the possible negative influence of Hg exposure on GDM. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the effect of cognitive behavioural therapy intervention on sleep and health improvement in patients with cardiometabolic syndrome and sleep problems. This study also aimed to assess the effect of different study designs to explain the overall intervention effect through subgroup analysis. Relevant randomized controlled trial studies were searched through six online databases. The PEDro scale was used to assess the quality of the included studies. The random effects model was used to assess the mean difference, effect size, and standard deviation of the outcome variables. The heterogeneity of the included studies was assessed using I2 and Q tests. Publication bias was assessed by the Egger test. Cognitive behavioural therapy intervention provided a significant effect in improving the Pittsburgh Sleep Quality Index, Insomnia Severity Index, total sleep time, sleep efficiency, depression, fatigue, and HbA1c. The effect of cognitive behavioural therapy is more significant when relaxation training and education components are included. Cognitive behavioural therapy is suitable for the treatment of sleep problems in patients with cardiometabolic syndrome. Cognitive behavioural therapy is also effective on depression and fatigue but has a limited effect on blood pressure and biomedical indicators related to cardiometabolic syndrome. [ABSTRACT FROM AUTHOR]

Objective: The aim was to conduct a systematic review and meta-analysis to study the association between night work and the development of prostate cancer. Methods: A systematic literature search was conducted in CINAHL, Embase, MEDLINE, and Web of Science. Studies were included based on a PECOS; the population included men in/above the working age, exposure defined as night work, outcome defined as prostate cancer, and study design restricted to cohort studies. The exclusion of articles, risk-of-bias assessment, and data extraction were performed by two reviewers. A meta-analysis was conducted using a random-effects model, including a sensitivity analysis stratified based on the risk-of-bias assessment. We evaluated publication bias using a funnel plot and Egger´s test, and the level of evidence was assessed using GRADE. Results: A total of 528 articles were identified, and eight cohort studies were included. Three studies had a moderate risk of bias, while five studies had a high risk of bias. The meta-analysis showed a pooled hazard ratio (HR) of 1.0 (95% CI 0.6–1.7). In the sensitivity analysis, moderate vs. high risk-of-bias studies showed a pooled HR of 1.2 (95% CI 0.3–4.1) and 0.9 (95% CI 0.6–1.3), respectively. Based on GRADE, the level of evidence was rated low. Conclusion: We found no association between night work and the development of prostate cancer. The evidence was assessed as limited and inconsistent. Future studies encompassing consistent definitions of night work, including objective exposure data, are highly warranted. [ABSTRACT FROM AUTHOR]

Purpose: Diesel exhaust (DE) is an established lung carcinogen. The association with leukemia is not well established. We conducted a systematic review and meta-analysis of cohort studies to determine the association between occupational DE exposure and risk of leukemia. Methods: A systematic literature review was performed to identify all cohort studies on occupational exposure to DE and associated risk of leukemia. STROBE guidelines and PECOS criteria were followed. Meta-analyses with fixed effects (and random-effects model in cases of high heterogeneity) were performed to calculate summary relative risks (RR) and 95% confidence intervals (CI), including subgroup analyses by outcome (mortality or incidence), sex, geographic region, industry type, and study quality. Study quality was assessed using the the Joanna Briggs Institute (JBI) critical appraisal checklist for cohort studies. Results: Of the 30 studies retained, 20 (8 from North America, 12 from Europe) reported a total of 33 estimates of the risk of leukemia. Overall, the relative risk (RR) of leukemia was 1.01 (95% CI = 0.97–1.05, I2 = 21.2%, n = 33); corresponding results for leukemia incidence and mortality were RR = 1.02 (95% CI = 0.98–1.06, I2 = 27.9%, n = 19) and RR = 0.91 (95% CI = 0.81–1.02, I2 = 0.0%, n = 15), respectively. The main results were confirmed in analyses by sex and geographic area. A statistically significant association was detected for miners (RR = 1.58, 95% CI = 1.15–2.15, I2 = 77.0%, n = 2) but not for other occupational groups. Publication bias was not detected (p = 0.7). Conclusion: Our results did not indicate an association between occupational DE exposure and leukemia, with the possible exception of miners. Residual confounding cannot be excluded. [ABSTRACT FROM AUTHOR]

The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults. [ABSTRACT FROM AUTHOR]

Clinical populations with basal ganglia pathologies may present with language production impairments, which are often described in combination with comprehension measures or attributed to motor, memory, or processing-speed problems. In this systematic review and meta-analysis, we studied word production in four (vascular and non-vascular) pathologies of the basal ganglia: stroke affecting the basal ganglia, small vessel disease, Parkinson's disease, and Huntington's disease. We compared scores of these clinical populations with those of matched cognitively unimpaired adults on four well-established production tasks, namely picture naming, category fluency, letter fluency, and past-tense verb inflection. We conducted a systematic search in PubMed and PsycINFO with terms for basal ganglia structures, basal ganglia disorders and language production tasks. A total of 114 studies were included, containing results for one or more of the tasks of interest. For each pathology and task combination, effect sizes (Hedges' g) were extracted comparing patient versus control groups. For all four populations, performance was consistently worse than that of cognitively unimpaired adults across the four language production tasks (p-values < 0.010). Given that performance in picture naming and verb inflection across all pathologies was quantified in terms of accuracy, our results suggest that production impairments cannot be fully explained by motor or processing-speed deficits. Our review shows that while language production difficulties in these clinical populations are not negligible, more evidence is necessary to determine the exact mechanism that leads to these deficits and whether this mechanism is the same across different pathologies. [ABSTRACT FROM AUTHOR]

Purpose: There remains a lack of consensus around autograft selection in anterior cruciate ligament reconstruction (ACLR), though there is a large body of overlapping systematic reviews and meta‐analyses. Systematic reviews and their methodological quality were aimed to be further assessed, using a validated tool known as assessing the methodological quality of systematic reviews (AMSTAR‐2). Methods: MEDLINE, Embase and CENTRAL were searched from inception to 23 April 2023 for systematic reviews (with/without meta‐analysis) comparing primary ACLR autografts. A final quality rating from AMSTAR‐2 was provided for each study ('critically low', 'low', 'moderate' or 'high' quality). Correlational analyses were conducted for ratings in relation to study characteristics. Results: Two thousand five hundred and ninety‐eight studies were screened, and 50 studies were ultimately included. Twenty‐four studies (48%) were rated as 'critically low', 17 (34%) as 'low', seven (14%) as 'moderate' and two (4%) as 'high' quality. The least followed domains were reporting on sources of funding (1/50 studies), the impact of risk of bias on results of meta‐analyses (11/36 studies) and publication bias (17/36 studies). There was a significant increase in the frequency of studies graded as 'moderate' compared to 'low' or 'critically low' quality over time (p = 0.020). Conclusion: The methodological quality of systematic reviews comparing autografts in ACLR is low, with many studies being rated lower due to commonly absent aspects of systematic review methodology such as investigating sources of funding and publication bias. More recent studies were generally more likely to be of higher quality. Authors are advised to consult AMSTAR‐2 prior to conducting systematic reviews in ACLR. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

The purpose of this meta-analysis was to assess the overall effects of automaticity training of fundamental literacy component skills (i.e., letter names/sounds, individual words) on reading fluency and comprehension. Another purpose was to assess if the effects of automaticity training varied for reading fluency and comprehension. We identified 11 research studies involving students in Grades 1–6 that met the inclusion criteria for this meta-analysis. A total of 83 effect sizes (Hedges g, corrected for sample size bias) were extracted from these studies. These studies were double-coded for specific features (e.g., student age, student grade, type of automaticity training). We meta-analyzed the effect sizes using a multi-level meta-analytic model and examined whether the outcome measure type (comprehension or fluency) moderated the effects of automaticity training. We also analyzed for publication bias. The overall effect size for automaticity training of fundamental literacy component skills on reading fluency and comprehension was 0.28, although it was not statistically significant. Shifting units of analysis approach indicated there was a statistically significant effect found for reading fluency outcomes [g = 0.48 (CI =.23,.72)] but not for reading comprehension (ES = 0.17 ns). Limitations and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Stereotactic radiosurgery (SRS) is a well-established treatment option for Koos stage I–III vestibular schwannomas (VS), often used as the first line of treatment or after subtotal resection. However, the optimal treatment for Koos-IV VS remains unclear. Therefore, our study aimed to evaluate the effectiveness of SRS as a primary treatment for large VS classified as Koos-IV. Methods: A systematic search was performed on December 28th, 2022, based on PubMed, Web of Science, and Scopus according to the PRISMA statement. The review was updated on September 7th, 2023. The risk of bias was assessed using the NIH Quality Assessment Tool. The R software (ver. 4.3.2) was used for all quantitative analyses and preparation of the forest plots. Publication bias and sensitivity analysis were performed to evaluate the reliability of the obtained results. Results: Among 2941 screened records, ten studies (1398 patients) have been included in quantitative synthesis. The overall tumor control rate was 90.7% (95%CI 86.3–94.4). Kaplan–Meier estimates of tumor control at 2, 6, and 10 years were 96.0% (95% CI 92.9–97.6%), 88.8% (95% CI 86.9–89.8%), and 84.5% (95% CI, 81.2–85.8%), respectively. The overall hearing preservation rate was 56.5% (95%CI 37–75.1). Kaplan–Meier estimates of hearing preservation rate at 2, 6, and 10 years were 77.1% (95% CI 67.9–82.5%), 53.5% (95% CI 44.2–58.5%), and 38.1% (95% CI 23.4–40.7%), respectively. The overall facial nerve preservation rate was 100% (95%CI 99.9–100.0). The overall trigeminal neuropathy rate reached 5.7% (95%CI 2.9–9.2). The overall rate of new-onset hydrocephalus was 5.6% (95%CI 3–9). The overall rates of worsening or new-onset tinnitus and vertigo were 6.8% (95%CI 4.2–10.0) and 9.1% (95%CI 2.1–19.6) respectively. No publication bias was detected according to the used methods. Conclusions: Our systematic review and meta-analysis demonstrated a high overall tumor control rate, excellent facial nerve preservation, and low incidence of new-onset or worsened tinnitus and vertigo. However, several drawbacks associated with SRS should be noted, such as the presence of post-SRS hydrocephalus risk, mediocre long-term hearing preservation, and the lack of immediate tumor decompression. Nevertheless, the use of SRS may be beneficial in appropriately selected cases of Koos-IV VS. Moreover, further prospective studies directly comparing SRS with surgery are necessary to determine the optimal treatment for large VS and verify our results on a higher level of evidence. Registration and protocol: CRD42023389856. [ABSTRACT FROM AUTHOR]

Identification, the experience of a psychological merging between the self and a character, is a key mechanism underlying the power of narratives to influence attitudes, beliefs, intentions, and behaviors in story-consistent ways. Similarity between audience members and characters has been intuitively thought to be an antecedent of identification, but experimental studies have yielded inconsistent findings regarding the effectiveness of manipulating similarity on eliciting identification. The current meta-analysis synthesized and quantified the evidence from 39 studies (k = 50, N = 11,077) and investigated several potential causes of heterogeneity at both the narrative and study levels. The data revealed a small but significant and robust overall effect of similarity on identification (g = 0.19, 95% CI [0.10, 0.28], p <.001), with little evidence of publication bias. A notable narrative-level moderator was type of similarity, with manipulations of psychological similarity yielding larger effects than manipulations of objective similarity. In addition, study design emerged as a significant study-level moderator, with the similarity–identification effect being stronger in studies that manipulated similarity using a within-subjects design than those that used a between-subjects design. Insights gained from this meta-analysis can help to address some ill-defined aspects of the similarity–identification hypothesis, contributing to a better understanding of involvement with narrative characters. Practically, the results can inform the design of more effective targeted and tailored narrative messages that are intended to engage and persuade audiences using the tactic of incorporating similar characters. [ABSTRACT FROM AUTHOR]

Objectives: Self-compassion interventions are becoming popular, with demonstrated effects in reducing psychological distress and cultivating well-being. However, in case of university student populations these interventions can be less efficient. This review integrates the available evidence to determine the extent to which self-compassion interventions improve affects among university students. Methods: Seven databases were systematically searched, and randomized trials that evaluated self-compassion interventions among university students were included in this meta-analysis. Outcomes included positive affect, negative affect and self-compassion. Post-intervention between group effect sizes (Hedges' g) were calculated and synthesized using the random effects model. Sensitivity and moderator analyses were conducted and publication bias was assessed. Results: The aggregate effect size was very small for measures of negative (k = 15; g =.28) and positive affect (k = 15; g =.14), and was moderate for self-compassion outcomes (k = 11; g =.49). Effect sizes for negative and positive affect were moderated by control used. Effects for self-compassion were stronger in face-to-face format over online delivery methods, and the instrument for assessing self-compassion can also moderate the effect size. Results also indicated that publication bias may be present. Conclusions: This review supported the effectiveness of the self-compassion interventions for self-compassion, but not for negative affect. Limited evidence of effectiveness exists for students' positive affect. Trial registration: The registration identifier: CRD42022309920. [ABSTRACT FROM AUTHOR]

Background: Assessing certainty of evidence is a key element of any systematic review. The aim of this meta-epidemiology study was to understand the frequency and ways with which certainty of evidence is assessed in contemporary systematic reviews published in high-impact sports science journals. Methods: We searched PubMed and relevant journal web sites from 1 August 2016 to 11 October 2022 for systematic reviews published in the top-ten highest-impact journals within the 2020 Journal Citation Report for the Sports Sciences category. Pairs of independent reviewers screened items using a priori established criteria. Results: Of 1250 eligible documents, 258 (20.6%) assessed the certainty of evidence, defined as using two or more distinct domains to provide an overall rating of the trustworthiness of findings across studies. Nine methods were cited for assessing certainty, with the most common being the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach (61.6%). The proportion of systematic reviews assessing certainty of evidence appeared to increase over the 6-year timeframe analyzed. Across all reviews analyzed, a large majority addressed the domains of risk of bias, imprecision, and inconsistency of the results. Other certainty domains including indirectness/applicability were less commonly assessed. Discussion: Only one in five recent contemporary systematic reviews in the field of exercise and sports science assessed certainty of evidence. Organizational and institutional education on methods for assessing evidence may help further increase uptake of these methods and improve both the quality and clinical impact of systematic reviews in the field. [ABSTRACT FROM AUTHOR]

Publication bias refers to a systematic deviation from the truth in the results of a meta-analysis due to the higher likelihood for published studies to be included in meta-analyses than unpublished studies. Publication bias can lead to misleading recommendations for decision and policy making. In this education review, we introduce, explain, and provide solutions to the pervasive misuses and misinterpretations of publication bias that afflict evidence syntheses in sport and exercise medicine, with a focus on the commonly used funnel-plot based methods. Publication bias is more routinely assessed by visually inspecting funnel plot asymmetry, although it has been consistently deemed unreliable, leading to the development of statistical tests to assess publication bias. However, most statistical tests of publication bias (i) cannot rule out alternative explanations for funnel plot asymmetry (e.g., between-study heterogeneity, choice of metric, chance) and (ii) are grossly underpowered, even when using an arbitrary minimum threshold of ten or more studies. We performed a cross-sectional meta-research investigation of how publication bias was assessed in systematic reviews with meta-analyses published in the top two sport and exercise medicine journals throughout 2021. This analysis highlights that publication bias is frequently misused and misinterpreted, even in top tier journals. Because of conceptual and methodological problems when assessing and interpreting publication bias, preventive strategies (e.g., pre-registration, registered reports, disclosing protocol deviations, and reporting all study findings regardless of direction or magnitude) offer the best and most efficient solution to mitigate the misuse and misinterpretation of publication bias. Because true publication bias is very difficult to determine, we recommend that future publications use the term "risk of publication bias". [ABSTRACT FROM AUTHOR]

Background: Gastric band erosion may be seen in up to 3% of patients. Endoscopic intervention has become increasingly utilized due to its minimally invasive nature. The purpose of this study was to perform a systematic review and meta-analysis to examine the role of endoscopic removal for eroded gastric bands. Methods: Individualized search strategies were developed for PubMed, EMBASE, Web of Science, and Cochrane Library databases in accordance with PRISMA and MOOSE guidelines. Outcomes included technical success, clinical success, procedure duration, adverse events, and surgical conversion. Pooled proportions were analyzed using random effects models. Heterogeneity and publication bias was assessed with I2 statistics and funnel plot asymmetry using Egger and Begg tests. Meta-regression was also performed comparing outcomes by endoscopic tools. Results: Ten studies (n=282 patients) were included in this meta-analysis. Mean age was 40.68±7.25 years with average duration of band placement of 38.49±19.88 months. Pre-operative BMI was 42.76±1.06 kg/m2 with BMI of 33.06±3.81 kg/m2 at time of band erosion treatment. Endoscopic removal was attempted in 240/282 (85.11%) of cases. Pooled technical and clinical success of the endoscopic therapy was 86.08% (95% CI: 79.42–90.83; I2=28.62%) and 85.34% (95% CI: 88.70–90.62; I2=38.56%), respectively. Mean procedure time for endoscopic removal was 46.47±11.52 min with an intra-operative adverse event rate of 4.15% (95% CI: 1.98–8.51; I2=0.00%). Post-procedure-associated adverse events occurred in 7.24% (CI: 4.46–11.55; I2=0.00%) of patients. Conversion to laparotomy/laparoscopy occurred in 10.54% (95% CI: 6.12–17.54) of cases. Conclusion: Endoscopic intervention is a highly effective and safe modality for the treatment of gastric band erosion. [ABSTRACT FROM AUTHOR]

Introduction: Fundoplication sleeve gastrectomy (FSG) is a novel bariatric procedure that combines anti-reflux fundoplication with sleeve gastrectomy (SG) to simultaneously address gastroesophageal reflux disease (GERD) and obesity. We performed a systematic review and meta-analysis to quantify the prevalence of postoperative GERD and amount of weight loss after FSG. Methods: We searched PubMed, Embase, and Web of Science Core Collection in May 2023 for full-text reports of case series, registries, cohort studies, and randomized clinical trials that reported postoperative GERD and percent excess weight loss (%EWL) after FSG for patients with preoperative GERD and obesity, excluding reports including patients with previous history of bariatric procedures. We used random effects models to estimate postoperative GERD prevalence and %EWL. Risk of bias and evidence quality were assessed with the ROBINS-I and GRADE frameworks (PROSPERO CRD42023420067). Results: Of the 935 records initially identified, 13 studies from 8 countries met our inclusion criteria. The prevalence of postoperative GERD pooled from 418 patients was 4.8% (95% CI: 2.8 to 8.4%). Pooled %EWL, available for 225 patients from 7 studies, was 67.8% (95% CI: 55.2 to 80.5). The overall quality of evidence was low, largely due to observational study design, lack of blinded outcome assessment, and evidence of publication bias. Conclusion: Fundoplication sleeve gastrectomy is an emerging surgical approach for patients with obesity and GERD with promising initial outcomes. Additional studies of efficacy and safety are needed to compare FSG and its technical variations with other weight loss procedures. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study is to assess the effectiveness of serotonin-norepinephrine reuptake inhibitors (SNRIs) in managing ADHD symptoms compared to placebo, stimulants, or compared as pre- and post-treatment. Methods: Clinical trials assessing the potency of SNRIs in treating ADHD patients were imported from PubMed, Web of Science, and Scopus (until February 2023). Data were extracted by two independent researchers. Random- and fixed- effect meta-analysis was performed to pool the data. Publication bias and study heterogeneity were assessed. The Cochrane Collaboration tool was utilized to determine the risk of bias. The certainty of outcomes was evaluated by the Grade criteria. Results: Of the initial 830 studies, 13 were finally imported after two screening stages which two separate researchers carried out. The pooled standardized mean difference (95% CI) of reducing the score of different ADHD questionnaires (showing reduction in total inattentive and hyperactivity/impulsivity symptoms) by SNRIs, venlafaxine, and duloxetine were − 2.20 [− 3.00, − 1.40], − 1.86 [− 2.69, − 1.02], − 2.65 [− 3.35, − 1.96], respectively. While the most reported side effects were nausea, abdominal pain, and sedation, all studies reported that side effects were not serious and were well tolerated. Outcomes for the effectiveness of venlafaxine and duloxetine got high and moderate certainty, respectively. Conclusions: Duloxetine and venlafaxine can be administered to treat symptoms of ADHD while being well tolerated. It seems that duloxetine is more potent in reducing ADHD symptoms. It can also be concluded that venlafaxine is more effective in females, and is more effective on inattentive symptoms of ADHD rather than hyperactive symptoms. [ABSTRACT FROM AUTHOR]

Randomized controlled trials are essential for evaluating clinical interventions; however, selective reporting and publication bias in medical journals have undermined the integrity of the clinical evidence system. ClinicalTrials.gov serves as a valuable and complementary repository, yet synthesizing information from it remains challenging. This study introduces a curated dataset that extends beyond the traditional PICO framework. It links efficacy with safety results at the experimental arm group level within each trial, and connects them across all trials through a knowledge graph. This novel representation effectively bridges the gap between generally described searchable information and specifically detailed yet underutilized reported results, and promotes a dual-faceted understanding of interventional effects. Adhering to the "calculate once, use many times" principle, the structured dataset will enhance the reuse and interpretation of ClinicalTrials.gov results data. It aims to facilitate more systematic evidence synthesis and health technology assessment, by incorporating both positive and negative results, distinguishing biomarkers, patient-reported outcomes, and clinical endpoints, while also balancing both efficacy and safety outcomes for a given medical intervention. [ABSTRACT FROM AUTHOR]

Background: Osteonecrosis of the humeral head (ONHH) is a severe complication after the internal fixation of proximal humeral fractures (IFPHF). The risk factors remain controversial though many studies have reported. In this research, meta-analysis was used to evaluate which surgeon-level factors can be modified to lower the risk and we hope to provide evidence-based support for preventing ONHH. Methods: Literature was retrieved from PubMed, Cochrane Library, Embase, Web of Science, and Scopus for eligible studies published up to January 2023. The pooled odds ratios (ORs) were calculated with their corresponding 95% confidence intervals (CIs) to evaluate. STATA 15.1 software was applied for data synthesis, sensitivity synthesis, and publication bias. Results: 45 articles were published between 2000 and 2022, and 2482 patients were finally included. All articles were observational research, with 7 case–control studies and 38 cohort studies, and the Newcastle Ottawa Scale (NOS) score ranged from 7 to 9. The pooled results suggested that age (OR 0.32, 95% CI 0.14–0.74, P = 0.01), reduction quality (OR 0.08, 95% CI 0.01–0.44, P = 0.00), fracture type (OR 0.44, 95% CI 0.25–0.78, P = 0.01), surgical approach (OR: 4.06, 95% CI 1.21–13.61, P = 0.02) and fixation implant (OR = 0.68, 95% CI = 0.34–1.33, P = 0.02) were risk factors for ONHH after IFPHF. According to sensitivity analysis, Begg (P = 0.42) and Egger (P = 0.68) tests, the results were stable and exhibited no publication bias. Conclusions: The study showed that age, reduction quality, fracture type, surgical approach and fixation implant were risk factors for ONHH after IFPHF, while gender, varus or valgus, timely operation, injured side, and the existence of medial support have little influence on ONHH, as they could not be considered risk factors and still need further investigations. [ABSTRACT FROM AUTHOR]

A key concern for property owners about the set up of proximate wind turbines is the potential devaluation of their property. However, there is no consensus in the empirical hedonic literature estimating this price-distance relationship. It remains unclear if the proximity to wind turbines reduces, increases, or has no significant effect on property values. This article addresses this ambiguity, combining 720 estimates from 25 hedonic pricing studies in a first comprehensive meta-analysis on this topic. Using Bayesian model averaging techniques and novel publication bias correction methods, I calculate an average of the reported estimates that is free from misspecification and publication bias. In economic terms, I find an average reduction in property values of - 0.68 % for properties 1.89 miles away, which turns to zero beyond 2.8 miles. Next to publication selection, the studies' ability to control for confounding factors such as pre-existing price differentials and spatial effects explains the variance in reported effect sizes. [ABSTRACT FROM AUTHOR]

Recovery after spinal cord injury (SCI) may be propagated by plasticity-enhancing treatments. The myelin-associated nerve outgrowth inhibitor Nogo-A (Reticulon 4, RTN4) pathway has been shown to restrict neuroaxonal plasticity in experimental SCI models. Early randomized controlled trials are underway to investigate the effect of Nogo-A/Nogo-Receptor (NgR1) pathway blockers. This systematic review and meta-analysis of therapeutic approaches blocking the Nogo-A pathway interrogated the efficacy of functional locomotor recovery after experimental SCI according to a pre-registered study protocol. A total of 51 manuscripts reporting 76 experiments in 1572 animals were identified for meta-analysis. Overall, a neurobehavioral improvement by 18.9% (95% CI 14.5–23.2) was observed. Subgroup analysis (40 experiments, N = 890) revealed SCI-modelling factors associated with outcome variability. Lack of reported randomization and smaller group sizes were associated with larger effect sizes. Delayed treatment start was associated with lower effect sizes. Trim and Fill assessment as well as Egger regression suggested the presence of publication bias. Factoring in theoretically missing studies resulted in a reduced effect size [8.8% (95% CI 2.6–14.9)]. The available data indicates that inhibition of the Nogo-A/NgR1pathway alters functional recovery after SCI in animal studies although substantial differences appear for the applied injury mechanisms and other study details. Mirroring other SCI interventions assessed earlier we identify similar factors associated with outcome heterogeneity. [ABSTRACT FROM AUTHOR]