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A total of 23 studies were identified in a literature search performed in the Scopus, Science Direct and Google Scholar databases for meta‐analysis. The criteria used include studies that were published from 2015 to 2023 and those reporting the effects of insect meal utilisation in poultry diets. Data on live weight (LW), carcass weight (CW), moisture, meat pH, lightness (L*), redness (a*), yellowness (b*), proximate composition (protein, fat and ash content) and shear force in broilers were subjected to OpenMEE software, and data were pooled using a random‐effect model. Subgroup analysis and meta‐regression were performed to ascertain the influence of dietary insect meals on the response of meat aspects and the source of heterogeneity, respectively, using the following moderators (insect species, dosage level, feeding duration and age at slaughter). The results indicated that dietary insect meal did not affect LW, CW, meat L*, pH, shear force, moisture, fat and ash content. In contrast, dietary insect meal increased the a* of the meat (standardised mean differences (SMDs) = 1.03; 95% confidence intervals (CIs) = 0.484–1.578; p ≤ 0.001), b* (SMD = 1.117; 95% CI = 0.334–1.90; p = 0.005), and meat protein content (SMD = 0.365; 95% CI = 0.031–0.7; p = 0.032). The subgroup analysis showed that insect meal dosage of ≤10% and age at slaughtered ≤35 days had improved the LW, CW and meat L*. In addition, the meat a*, protein and ash content were also influenced by insect species, dosage levels and age at slaughter. In conclusion, ≤10% of either Hermetia illucens or Tenebrio molitor can be included in broiler diets without compromising the LW, CW, meat pH, colour, shear force, moisture, fat and ash content in broilers. The study therefore indicated that insect meals have a bright future as an alternative protein source in poultry diets. [ABSTRACT FROM AUTHOR]

Depression has been found to be associated with cognitive decline, but whether longer depressive durations lead to more severe cognitive declines has not been investigated. We aimed to estimate the association between depressive duration and cognitive decline in middle-aged and older Americans based on a large-scale representative population study. We included 27,886 participants from the Health and Retirement Study (HRS) in 2010–2018. Four datasets with 2-, 4-, 6-, and 8-year consecutive interviews were further derived which involving persistent depressed and persistent depression-free individuals. Multiple linear regressions were constructed to estimate the effects of each depressive duration on the decline in global cognition, memory and mental status. Meta-regressions were performed to test the linear trends and to explore the heterogeneity between sex, age and baseline cognitive function along with subgroup analyses. Depressive durations of 2, 4, 6, and 8 years were associated with reductions in global cognitive scores of 0.62 points (95% CI: 0.51–0.73), 0.77 points (95% CI: 0.60–0.94), 0.83 points (95% CI: 0.55–1.10), and 1.09 points (95% CI: 0.63–1.55), respectively, indicating a linear trend (P = 0.016). More pronounced associations were observed in middle-aged adults and females. Similar patterns were found in the associations between depressive duration and two subdomains, i.e., memory and mental health. This study is essentially a cross-sectional study and therefore cannot provide causal associations. Longer depressive durations were linearly related to more severe cognitive declines. Timely intervention for depression targeted middle-aged adults can more effectively alleviate cognition-related burdens. • This is the first study focusing on the association between depressive duration and cognition based on a large population. • Depressive durations were linearly associated with declines in global cognition, memory and mental status. • Significant linear trends between depressive duration and cognitive function persisted in females and adults aged 51-65. • Considering depressive duration, middle-aged adults showed greater cognitive decline due to depression than older adults. [ABSTRACT FROM AUTHOR]

Under the banner of evidence‐based policy, evidence reviews—summaries of existing studies on an intervention—have become an established form of policy analysis. Whereas evidence reviews have typically focused on studies of an intervention as delivered, interest is growing in examining the specific elements that comprise the intervention and that contribute to its success—broadly referred to as its core components. Understanding the core components of interventions allows policymakers to identify with greater precision what works, in which contexts, and for which populations. With the aim toward advancing core components analysis for policy design, this Research Note describes and compares four synthesis approaches for identifying core components in the context of evidence reviews: the distillation and matching model, meta‐regression, framework synthesis, and qualitative comparative analysis. The article then reflects on how to advance core components analysis in evidence reviews to better inform policy design and the policymaking process. [ABSTRACT FROM AUTHOR]

ABSTRACT Network meta‐analysis (NMA) combines evidence from multiple trials to compare the effectiveness of a set of interventions. In many areas of research, interventions are often complex, made up of multiple components or features. This makes it difficult to define a common set of interventions on which to perform the analysis. One approach to this problem is component network meta‐analysis (CNMA) which uses a meta‐regression framework to define each intervention as a subset of components whose individual effects combine additively. In this article, we are motivated by a systematic review of complex interventions to prevent obesity in children. Due to considerable heterogeneity across the trials, these interventions cannot be expressed as a subset of components but instead are coded against a framework of characteristic features. To analyse these data, we develop a bespoke CNMA‐inspired model that allows us to identify the most important features of interventions. We define a meta‐regression model with covariates on three levels: intervention, study, and follow‐up time, as well as flexible interaction terms. By specifying different regression structures for trials with and without a control arm, we relax the assumption from previous CNMA models that a control arm is the absence of intervention components. Furthermore, we derive a correlation structure that accounts for trials with multiple intervention arms and multiple follow‐up times. Although, our model was developed for the specifics of the obesity data set, it has wider applicability to any set of complex interventions that can be coded according to a set of shared features. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with the increasing prevalence of a modern sedentary lifestyle. Wearable technology‐based physical activity interventions (WT‐BPAI) might provide a channel to improve diabetic self‐management. The study aimed to (1) evaluate the effectiveness of WT‐BPAI on PA levels, glycemic levels, and other outcomes (blood pressure [BP], body mass index [BMI], and serum lipid profile) in adults with T2DM, and (2) investigate the potential covariates affecting aforementioned outcomes. Eight databases were searched thoroughly using three steps from inception until January 16, 2024. The quality of the studies and overall evidence were evaluated. The package meta of the R software program version 4.3.1. was utilized for meta‐analyses, subgroup analyses, and meta‐regression analyses. A total of 19 randomized controlled trials (RCTs) were found. Meta‐analyses revealed that WT‐BPAI significantly increased 1583 steps per day and decreased systolic BP (SBP) by 2.46 mmHg. Subgroup and meta‐regression analyses found that function, duration of intervention, and age were significant covariates. According to the risk of bias version 2, more than half of the trials raised some concerns about the randomization process, deviations from the intended intervention, and missing outcome data. The certainty of the evidence was very low for all outcomes based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. WT‐BPAI can be considered a supplementary intervention to increase the steps per day and decrease SBP, especially when used for short periods in young adults with T2DM. However, we need more well‐designed research with long‐term outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: A new estimate of swine needs in terms of amino acids seems necessary according to the factors influencing them and the current conditions within the pig industry. Using a meta-regression analysis, we found that the requirements of tryptophan, valine, isoleucine, and methionine were superior to previous recommendations regardless of the regression models and the animals' growth phases. Among the regression models used, two were selected as estimations of amino acid requirements for pigs under challenged conditions, whereas another one was chosen to estimate the amino acid requirements of genetically improved pigs under a modern housing system. These outcomes might serve as a foundation to build new standards in the assessment of pig requirements. Currently, the NRC amino acid (AA) requirements for pigs published in 2012 are used as a reference in variable swine industries. However, recent results in several articles suggest that the standardized ileal digestible (SID) AA–lysine (Lys) ratio significantly evolved over the last two decades, while some publications report inconsistent outcomes. Therefore, the present study used a meta-regression analysis to assess the relative ratio to lysine to maximize the feed efficiency of four essential amino acids (tryptophan, valine, isoleucine, and methionine) in pig diets. According to the PRISMA guidelines, articles examining the target AA requirement using a basal diet supplemented with varying levels of crystalline AA (tryptophan, valine, isoleucine, or methionine) were identified across Scopus, PubMed, and Science Direct. As a result, 23, 22, 16, and 9 articles using tryptophan, valine, isoleucine, and methionine were selected and categorized into experiments for inclusion in our meta-analysis. The results suggested that the requirements of tryptophan, valine, isoleucine, and methionine in our meta-regression analysis were superior to NRC recommendations, regardless of the regression models and the growth phases with significant RSQ values (RSQ ≈ 1). Also, the QUAD and CLP regression models emphasized higher requirements than the LP model for the great majority of amino acids and growth phases. The results of the QUAD and CLP models were selected as estimations of the amino acid requirements for pigs under challenged conditions, whereas the LP model was chosen to estimate the amino acid requirements of genetically improved pigs under a modern housing system. The results of this meta-regression analysis could be used to refresh the information on the NRC amino acids (AA) requirements for swine. [ABSTRACT FROM AUTHOR]

There is a strong association between total hip bone mineral density (THBMD) changes after 24 mo of treatment and reduced fracture risk. We examined whether changes in THBMD after 12 and 18 mo of treatment are also associated with fracture risk reduction. We used individual patient data (n = 122 235 participants) from 22 randomized, placebo-controlled, double-blind trials of osteoporosis medications. We calculated the difference in mean percent change in THBMD (active-placebo) at 12, 18, and 24 mo using data available for each trial. We determined the treatment-related fracture reductions for the entire follow-up period, using logistic regression for radiologic vertebral fractures and Cox regression for hip, non-vertebral, "all" (combination of non-vertebral, clinical vertebral, and radiologic vertebral) fractures and all clinical fractures (combination of non-vertebral and clinical vertebral). We performed meta-regression to estimate the study-level association (r2 and 95% confidence interval) between treatment-related differences in THBMD changes for each BMD measurement interval and fracture risk reduction. The meta-regression revealed that for vertebral fractures, the r2 (95% confidence interval) was 0.59 (0.19, 0.75), 0.69 (0.32, 0.82), and 0.73 (0.33, 0.84) for 12, 18, and 24 mo, respectively. Similar patterns were observed for hip: r2 = 0.27 (0.00, 0.54), 0.39 (0.02, 0.63), and 0.41 (0.02, 0.65); non-vertebral: r2 = 0.27 (0.01, 0.52), 0.49 (0.10, 0.69), and 0.53 (0.11, 0.72); all fractures: r2 = 0.44 (0.10, 0.64), 0.63 (0.24, 0.77), and 0.66 (0.25, 0.80); and all clinical fractures: r2 = 0.46 (0.11, 0.65), 0.64 (0.26, 0.78), and 0.71 (0.32, 0.83), for 12-, 18-, and 24-mo changes in THBMD, respectively. These findings demonstrate that treatment-related THBMD changes at 12, 18, and 24 mo are associated with fracture risk reductions across trials. We conclude that BMD measurement intervals as short as 12 mo could be used to assess fracture efficacy, but the association is stronger with longer BMD measurement intervals. Lay Summary: In this study, we looked at how changes in hip bone density over time relate to the risk of fractures in people taking osteoporosis medications. We analysed data from over 122 000 participants across 22 different clinical trials. We found that the increase in bone density measured after 12, 18, and 24 mo of treatment was linked to the risk of fractures. Specifically, greater improvements in bone density were associated with fewer fractures in the spine, hips, and other bones. Using statistical methods, we calculated the strength of this association. We discovered that the later, we measured BMD in people taking the medication, the stronger the link between improved bone density and reduced fracture risk became. Our findings suggest that bone density measurements after 12 mo of treatment could help predict how well a medication will prevent fractures. However, the best predictions came from bone density changes measured over longer periods. Graphical Abstract [ABSTRACT FROM AUTHOR]

Purpose: Transarterial radioembolization (TARE) has emerged as a promising therapeutic approach for unresectable intrahepatic cholangiocarcinoma (ICCA). We updated our previous meta-analysis with meta-regression to explore the efficacy of TARE in the context of ICCA. Methods: We searched PubMed and Scopus for studies published up to September 1, 2023. The primary outcome was overall survival. Secondary outcomes were tumor overall response rate, severe adverse events, and downstaging to surgery. Meta-analysis employed a random-effects model, and meta-regression was utilized to explore sources of heterogeneity. Results: We included 27 studies, involving 1365 patients. Pooled survival estimates at 1, 2, and 3 years were 52.6%, 27%, and 16.8%, respectively. Meta-regression revealed that the proportion of patients naïve to treatment was the only pre-TARE predictor of survival (1-, 2-, and 3-year survival of 70%, 45%, and 36% for treatment-naïve patients, mean survival 19.7 months vs. 44%, 18%, and 7% for non-naïve patients, mean survival 12.2 months). Overall response according to RECIST 1.1 and mRECIST was 19.6% and 67%, respectively. Effective downstaging to surgery was possible in varying rates (3–54%); the mean survival in these patients was 34.8 months (1-, 2-, and 3-year survival of 100%, 87%, and 64%). About 45.7% of patients experienced adverse events, but only 5.9% were severe. Conclusions: Our study benchmarked the survival rates of patients undergoing TARE for unresectable ICCA and showed that this is a valid option in these patients, especially if naïve to previous treatments. Downstaging to surgery is feasible in selected patients with promising results. [ABSTRACT FROM AUTHOR]

Background: Eye Movement Desensitization and Reprocessing (EMDR) therapy has gained attention for its potential effectiveness in treating depression beyond its initial use for PTSD. This systematic review and meta-analysis aims to evaluate the efficacy of EMDR in treating depression and to identify the variables influencing its effectiveness. Methods: A comprehensive search was conducted across databases, including MEDLINE, PubMed, and EMBASE, covering studies up to January 2023. A total of 521 studies were screened, and 25 studies with 1042 participants (522 EMDR, 520 control) met the inclusion criteria and were included in the meta-analysis. The inclusion criteria involved randomized controlled trials (RCTs) comparing EMDR to control conditions such as usual care or waitlist groups, with outcomes focused on changes in depression symptoms. Results: The results show that EMDR had a significant effect on reducing depression symptoms (Hedges' g = 0.75), with moderate heterogeneity being observed. The meta-regression indicated that the severity of depression was a significant predictor of EMDR's effectiveness, with greater effects in severe cases. Additionally, the systematic review analyzed and evaluated various theoretical models and related studies that explain how EMDR works for the treatment of depression, reporting on neurobiological models proposed in previous research. Conclusions: This study confirms that EMDR is effective in treating depression, particularly in severe cases, and highlights its potential as a non-pharmacological intervention. However, this study highlights the need for more standardized research and long-term evaluations to assess EMDR's lasting impact. Integrating EMDR into multimodal treatment plans and primary care, especially for treatment-resistant depression, could significantly improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: This study aimed to synthesize and quantitatively examine Health State Utility Values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for selecting appropriate HSUV estimates. Method: We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing various influencing factors. Relevant literature was sourced from a review spanning 2000-2020, supplemented by literature from PubMed, Embase, and the Web of Science (up to March 2024). Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical and demographic variables on HSUVs. Results: Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated the significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in diabetic foot, was quantified. Age <70 was linked to increased HSUVs, while longer illness duration, hypertension, overweight and obesity correlated with reduced HSUVs. Conclusion: Accurate HSUVs are vital for the optimization of T2DM management strategies. This study provided a comprehensive data pool for HSUVs selection, and quantified the influence of various factors on HSUVs, informing analysts and policymakers in understanding the utility variations associated with T2DM and its complications. [ABSTRACT FROM AUTHOR]

This study used a meta-analytic approach to evaluate the effects of dietary supplementation with seaweed on milk yield, milk composition, nutrient digestibility, ruminal fermentation, and enteric methane (CH4) emissions of dairy cows. Data used in statistical analyses were obtained from 23 peer-reviewed scientific articles. Effect size was assessed using weighted mean differences (WMD) between seaweed-supplemented and control treatments. Dietary supplementation with seaweed decreased (p < 0.05) dry matter intake, milk protein content, milk urea nitrogen, and somatic cell count. In contrast, milk fat content, milk lactose content, and milk iodine increased (p < 0.05) in response to dietary supplementation with seaweed. Dietary supplementation with seaweed did not affect (p > 0.05) nutrient digestibility, total volatile fatty acids, acetate, and propionate. Dietary supplementation with seaweeds increased (p < 0.05) ruminal pH and ruminal concentration of butyrate and valerate. In contrast, lower (p < 0.05) ruminal ammonia nitrogen concentration, acetate/propionate ratio, daily CH4 emission, CH4 yield, and CH4 intensity were observed in response to dietary supplementation with seaweeds. In conclusion, dietary supplementation with seaweed modifies milk composition, improves ruminal fermentation, and decreases enteric methane emissions without negatively affecting milk yield or feed efficiency. [ABSTRACT FROM AUTHOR]

This paper reports a meta‐analysis of the relationship between unemployment and health. Our meta‐dataset consisted of 327 study results taken from 65 articles published in peer‐reviewed journals between 1990 and 2021. We found that publication bias is important, but only for those study results obtained by means of difference‐in‐differences or instrumental variables estimators. On average, the effect of unemployment on health is negative, but quite small in terms of partial correlation coefficients. We investigated whether the findings were heterogeneous across several research dimensions. We found that unemployment has the strongest impact on the psychological domains of health and long‐term unemployment spells are more detrimental than short‐term ones. Furthermore, women are less affected, studies dealing with endogeneity issues find smaller effects and the health penalty is increasing with unemployment rate. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to synthesize and quantitatively examine Health State Utility Values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for selecting appropriate HSUV estimates. Method We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing various influencing factors. Relevant literature was sourced from a review spanning 2000-2020, supplemented by literature from PubMed, Embase, and the Web of Science (up to March 2024). Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical and demographic variables on HSUVs. Results Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated the significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in diabetic foot, was quantified. Age

Objective The present study aimed to investigate the effectiveness of dietary β-mannanase supplementation on growth performance, intestinal morphology, digesta viscosity, and dietary nutrient utilization in broiler chickens through a meta-analysis. The effects were further examined by a meta-regression analysis with activity levels of β-mannanase in broiler diets. Methods A total of 23 studies, which were conducted in 11 countries and completed between December 2003 and August 2023, were selected for this meta-analysis. The standardized mean difference and its 95% confidence interval were calculated as the effect size metrics using random effect model, with I2 value being utilized to measure heterogeneity. Investigated measurements included body weight gain (BWG), feed intake, feed conversion ratio (FCR), villus height (VH), crypt depth (CD), VH:CD ratio, digesta viscosity, nitrogen-corrected metabolizable energy (AMEn), apparent ileal digestibility (AID), and apparent total tract retention (ATTR) of dry matter (DM), gross energy (GE), and nitrogen (N). All statistical analyses were performed using R version 4.3.3. Results Results revealed significant positive effects of dietary β-mannanase supplementation on BWG (p = 0.005), FCR (p

This study used a meta-analytic approach to evaluate the effects of dietary supplementation with seaweed on milk yield, milk composition, nutrient digestibility, ruminal fermentation, and enteric methane (CH4) emissions of dairy cows. Data used in statistical analyses were obtained from 23 peer-reviewed scientific articles. Effect size was assessed using weighted mean differences (WMD) between seaweed-supplemented and control treatments. Dietary supplementation with seaweed decreased (p < 0.05) dry matter intake, milk protein content, milk urea nitrogen, and somatic cell count. In contrast, milk fat content, milk lactose content, and milk iodine increased (p < 0.05) in response to dietary supplementation with seaweed. Dietary supplementation with seaweed did not affect (p > 0.05) nutrient digestibility, total volatile fatty acids, acetate, and propionate. Dietary supplementation with seaweeds increased (p < 0.05) ruminal pH and ruminal concentration of butyrate and valerate. In contrast, lower (p < 0.05) ruminal ammonia nitrogen concentration, acetate/propionate ratio, daily CH4 emission, CH4 yield, and CH4 intensity were observed in response to dietary supplementation with seaweeds. In conclusion, dietary supplementation with seaweed modifies milk composition, improves ruminal fermentation, and decreases enteric methane emissions without negatively affecting milk yield or feed efficiency.

Objective: To explore the relationship between Hashimoto's autoimmune hypothyroidism (HT) and male fertility, focusing on hormonal and seminal factors. Methods: A systematic literature search was conducted across databases such as PubMed, Web of Science, EMBASE, Scopus, Cochrane, and Google Scholar, covering studies published from January 2000 to March 2024. Studies investigating the impact of HT on semen quality parameters and reproductive hormones were included. Pooled effect estimates were calculated using standard mean difference (SMD) and 95% confidence intervals (CI). Results: A total of 8 studies with 8965 participants were included. HT significantly affected semen quality and reproductive hormone levels. Specifically, there was a notable decrease in progressive morphology (SMD= -0.78; 95% CI: -1.40 to -0.17; P=0.01) and sperm motility (SMD= -1.151; 95% CI: -1.876 to -0.425; P=0.002). In addition, there were no significant changes in reproductive hormones, although there were elevated levels of luteinizing hormone (SMD=0.437; 95% CI: 0.000 to 0.874; P=0.050) and follicle-stimulating hormone (SMD=0.293; 95% CI: -0.171 to 0.758; P=0.216), with a slight impact on testosterone levels (SMD= -1.143; 95% CI: -2.487 to 0.200; P=0.095). Conclusions: This systematic review and meta-analysis provides robust evidence of the detrimental effects of HT on semen quality and reproductive hormones, underscoring the necessity for thorough evaluation and management of thyroid function in male infertility assessments.

Objectives: We aimed to assess the prevalence of long COVID-19 and estimate the average time to its diagnosis and meta-regression for covariates. Methods: We conducted a systematic review, meta-analysis, and meta-regression from 43 studies (367,236 patients) (June 2020–August 2022). With the random-effects model, the pooled prevalence of long COVID-19 was measured. Publication bias was ascertained, and meta-regression analysis was performed on predetermined covariates. The trial was registered with PROSPERO (CRD42022328509). Results: The pooled prevalence of long COVID-19 was 42.5% (95% CI 36% to 49.3%), with 25% and 66% at four and two months, respectively. Mostly, long COVID-19 signs and symptoms occurred at three (54.3%) to six (57%) months (p < 0.0001), further increasing at 12 months (57.9%, p = 0.0148). Hypertension was significantly associated with long COVID-19 at 32% (0.322 (95% CI 0.166, 0.532) (p < 0.001) and hospital re-admission contributed to 17% (Q = 8.70, df = 1, p = 0.0032) (R2 = 0.17). All the covariates explained at least some of the variance in effect size on long COVID-19 at 53% (Q = 38.81, df = 19, p = 0.0047) (R2 analog = 0.53). Conclusion: The prevalence of long COVID-19 was 42.5% when linked with a cardiovascular disorder. Hospital re-admission majorly predicted the incidence of long COVID-19. Clinical and methodological characteristics in a specific study contributed to over 50% of long COVID-19 events, with most signs and symptoms occurring between 3 and 6 months and increasing at 12 months.

Abstract Background Baseline imbalances have been identified in randomized trials of evolocumab and alirocumab. Our aim was to quantitatively assess (1) the presence of systematic baseline differences, and (2) the relationship of baseline differences with effects on low-density lipoprotein-cholesterol (LDL-c) and clinical outcomes in the trials. Methods We performed a meta-epidemiological study. PubMed, Embase, regulatory reports, ClinicalTrials.gov and company websites were searched for trials. Seven baseline characteristics (mean age, LDL-c, BMI, percentage males, diabetics, smokers, and hypertensives) and five outcomes (LDL-c, major adverse cardiac events, serious adverse events, any adverse events, all-cause mortality) were extracted. We calculated (1) range and distribution of baseline imbalances (sign-test), (2) pooled baseline differences and heterogeneity (meta-analysis), (3) differences in SDs around continuous variables (sign-test and pooling), and (4) the relationship of baseline differences with outcomes (meta-regression). The comparisons of PCSK9-inhibitor groups with either placebo or ezetimibe were analysed separately and combined. Results We identified 43 trials with 63,193 participants. Baseline characteristics were frequently missing. Many trials showed small baseline imbalances, but some large imbalances. Only baseline BMI showed a statistically significant lower pooled mean for the drug versus placebo groups (MD -0.16; 95% CI -0.24 to -0.09). Heterogeneity in baseline imbalances was present in six placebo- and five ezetimibe-comparisons. Heterogeneity was statistically significant for BMI, males, diabetics and hypertensives in the combined comparisons. There was a statistically significant preponderance for larger SDs in the PCSK9-inhibitor versus control groups (sign-test age 0.014; LDL-c 0.014; BMI 0.049). Meta-regression showed clinically relevant relationships of baseline imbalances in age, BMI and diabetics with the risk of any adverse events and the risk of mortality. Two relationships were statistically significant: A higher mean BMI in the drug versus control group with a decreased risk of mortality (beta − 0.56; 95% CI -1.10 to -0.02), and a higher proportion of diabetics with an increased risk of any adverse events (beta 0.02; 95% 0.01 to 0.04). Conclusions Heterogeneous baseline imbalances and systematically different SDs were present in evolocumab and alirocumab trials, so study groups cannot be assumed to be comparable. These findings raise concerns about the design and conduct of the randomization procedures.

Background and objectivesMethodsResultsConclusionsVirtual reality exposure therapy offers a unique opportunity to treat social anxiety disorder. This meta-analysis aims to evaluate the effectiveness of virtual reality exposure therapy compared to waitlist comparators or other interventions for individuals with social anxiety disorder in alleviating anxiety symptoms.A three-step comprehensive search for the randomized controlled trials of virtual reality exposure therapy was conducted from inception to 7 December 2023. The overall effect was measured using Hedges’ g and determined using t-statistics at a significance level of p < 0.05. Sensitivity, subgroup, and meta-regression analyses were carried out.A total of 17 randomized control trials were retrieved from nine electronic databases. Virtual reality exposure therapy has greater efficacy than waitlist comparators in reducing anxiety symptoms at post-intervention and follow-up assessment. Virtual reality exposure therapy demonstrates a similar effect to other interventions at post-intervention and follow-up assessment. We observed a greater effect for participants with symptomatic social anxiety when we combined the intervention with cognitive behavioral therapy compared to its counterpart. Meta-regression analyses found no significant covariate.Overall, virtual reality exposure therapy can provide supplementary therapy for improving anxiety symptoms. Additional high-quality and large-scale trials with long-term follow-up are needed. [ABSTRACT FROM AUTHOR]

It is not clear whether the amount and frequency of psychotherapy is associated with treatment effects for adult depression. We investigated whether a number of indicators of the amount and frequency of psychotherapy were related to the treatment effects in randomized controlled trials (RCTs) comparing individual, face-to-face psychotherapy to a control group (e.g., care-as-usual [CAU] or waitlist condition [WL]). Four databases were systematically searched, and meta-regression analyses conducted to assess the relationship between the effect size (Hedges' g) of the treatment and number of sessions, duration of psychotherapy, total contact time with the therapist, and number of sessions per week. We included 176 studies (210 comparisons) with 15,158 participants. We did not find a relationship between the effect size, and number of sessions, or total contact time. There was a small negative association between duration of treatment and the effect size, an additional week of treatment was related to a 0.014 decrease in the effect size. In addition, there was a strong association between number of sessions per week and the effect size, an increase from one to two sessions per week was related to an effect size higher by 0.596. Both associations were no longer significant when controlling for characteristics of studies. The current findings are correlational, future research should thus address this question in an RCT. We should deliver brief therapies, and thus shorten waiting lists. More sessions, if necessary, should be delivered with higher frequency and over a shorter period of time. • Number of sessions is not associated with treatment effects in adult depression. • Contact time between therapists and clients is not related to treatment effects. • An extra week of treatment is related to a small decrease in treatment effects. • Delivering 2 instead of 1 treatment session per week increases treatment effects. • Associations are not significant when characteristics of studies are considered. [ABSTRACT FROM AUTHOR]

Network meta-analysis has been used to answer a range of clinical questions about the preferred intervention for a given condition. Although the effectiveness and safety of pharmacological agents depend on the dose administered, network meta-analysis applications typically ignore the role that drugs dosage plays in the results. This leads to more heterogeneity in the network. In this paper, we present a suite of network meta-analysis models that incorporate the dose–effect relationship using restricted cubic splines. We extend existing models into a dose–effect network meta-regression to account for study-level covariates and for groups of agents in a class-effect dose–effect network meta-analysis model. We apply our models to a network of aggregate data about the efficacy of 21 antidepressants and placebo for depression. We find that all antidepressants are more efficacious than placebo after a certain dose. Also, we identify the dose level at which each antidepressant's effect exceeds that of placebo and estimate the dose beyond which the effect of antidepressants no longer increases. When covariates were introduced to the model, we find that studies with small sample size tend to exaggerate antidepressants efficacy for several of the drugs. Our dose–effect network meta-analysis model with restricted cubic splines provides a flexible approach to modelling the dose–effect relationship in multiple interventions. Decision-makers can use our model to inform treatment choice. [ABSTRACT FROM AUTHOR]

Rescue workers (policemen, firefighters, emergency medical staff, etc.) experience intense stress due to rescuing and helping victims of accidents, terrorist attacks, violent crimes, and natural disasters. Overexposure and ineffective coping with such stressful events may lead to developing Post‐Traumatic Stress Disorder (PTSD). Meta‐regression procedures were applied to examine moderators such as the sample sex composition, age, working experience, occupation, country, or type of PTSD evaluation. The 9.8% PTSD prevalence found here was virtually the same compared with earlier findings from 10 years ago. There was a large heterogeneity, however, associated with geographical location and the instrument used to evaluate PTSD. The main findings revealed that rescue workers are a high‐risk group with increased levels of Post‐traumatic Stress Disorder (PTSD). Moreover, PTSD prevalence could depend on a great extent on geographical and cultural factors, and on the type of PTSD evaluation. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the levels of serum, gingival crevicular fluid (GCF), and salivary adipokines and their possible relationship with periodontitis and obesity. An electronic search was conducted in the following databases: PubMed/ Medline, Scopus, and EBSCOhost through February 2023. Two independent reviewers screened the titles, abstracts, and full text of all the studies. Studies comparing the levels of adipokines in GCF, serum, and/or saliva in subjects with obesity and periodontitis (group 1), subjects with normal weight and periodontitis (group 2), and subjects with obesity and gingival health (group 3) were included. Meta‐analyses and meta‐regression were performed on the data from included studies. Seventeen studies with study participants ranging from 30 to 120 were included with subjects in each group ranging from 10 to 40. There was a significant increase in levels of serum TNF‐α, leptin, IL‐6, and CRP between groups 1 and 2 (p <.05). In GCF, TNF‐α and resistin levels were significantly higher (p <.05) in Group 1 vs. 2. Serum level of leptin was higher for group 1 vs. 3 (p <.05). Meta‐regression analysis revealed that the obesity definition (body mass index (BMI) cut‐off value >25 or >30) was significant for serum resistin (p <.05) and GCF resistin (p <.05) between group 1 and 2. The current analysis indicates that both periodontitis and obesity can modulate the pro‐inflammatory cytokines at systemic and local levels. This bidirectional interaction of periodontitis and obesity via the inflammation pathway seems likely plausible. Further studies are required to elucidate this mechanism in more detail. [ABSTRACT FROM AUTHOR]

Introduction: Transcranial direct current stimulation (tDCS) administers lowintensity direct current electrical stimulation to brain regions via electrodes arranged on the surface of the scalp. The core promise of tDCS is its ability to modulate brain activity and affect performance on diverse cognitive functions (affording causal inferences regarding regional brain activity and behavior), but the optimal methodological parameters for maximizing behavioral effects remain to be elucidated. Here we sought to examine the effects of 10 stimulation and experimental design factors across a series of five cognitive domains: motor performance, visual search, working memory, vigilance, and response inhibition. The objective was to identify a set of optimal parameter settings that consistently and reliably maximized the behavioral effects of tDCS within each cognitive domain. Methods: We surveyed tDCS effects on these various cognitive functions in healthy young adults, ultimately resulting in 721 effects across 106 published reports. Hierarchical Bayesian meta-regression models were fit to characterize how (and to what extent) these design parameters differentially predict the likelihood of positive/negative behavioral outcomes. Results: Consistent with many previous meta-analyses of tDCS effects, extensive variability was observed across tasks and measured outcomes. Consequently, most design parameters did not confer consistent advantages or disadvantages to behavioral effects--a domain-general model suggested an advantage to using within-subjects designs (versus between-subjects) and the tendency for cathodal stimulation (relative to anodal stimulation) to produce reduced behavioral effects, but these associations were scarcely-evident in domainspecific models. Discussion: These findings highlight the urgent need for tDCS studies to more systematically probe the effects of these parameters on behavior to fulfill the promise of identifying causal links between brain function and cognition. [ABSTRACT FROM AUTHOR]

This review aims to examine the ceiling effects of EQ-5D-3L (3L) and EQ-5D-5L (5L) in general adult populations and identify the factors influencing these effects. We searched 8 databases for observational studies published in English from inception to 24 July 2023. Ceiling effects were calculated by dividing the number of participants reporting full health at dimension or profile level by the total sample size. Subgroup analysis and meta-regression using the metafor package in R software were performed. We identified 94 studies from 70 articles, including 4 543 647 adults across 37 countries. The global pooled proportion of individuals reporting full health ("11111") was 56% (95% CI 51%-62%) for 3L and 49% (95% CI 44%-54%) for 5L. The self-care dimension showed the highest ceiling effects (3L: 97%; 5L: 94%), whereas pain/discomfort had the lowest (3L: 69%; 5L: 60%). The ceiling effects in East/South-East Asia were higher than in Europe by 25% (95% CI 18%-32%) in 3L and 9% (95% CI −2%-20%) in 5L. Adjusting for mean age and proportion of males, significant regional differences persisted in the overall profile level of 3L, in all 3L dimensions (except for self-care), and 5L dimensions (except for pain/discomfort and anxiety/depression). This review highlights significant ceiling effects in the EQ-5D, especially in Asian populations. The 5L version exhibited fewer ceiling effects than the 3L, indicating its superiority for general population surveys. Further research is crucial to understand the disparities in self-reported health outcomes between Asians and other populations. • EQ-5D 5L version shows fewer ceiling effects than the 3L version, suggesting increased sensitivity, therefore supporting its use in surveys of the general population. • This review uncovers pronounced regional disparities, with Asian studies exhibiting higher ceiling effects than European ones, underscoring the need for careful cross-cultural application in international health surveys and clinical trials. • The review supports the switch from 3L to 5L version for general population health surveys when the EQ-5D is chosen as a health-related quality of life instrument because of its lower ceiling effects and greater sensitivity. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to assess the prevalence of long COVID-19 and estimate the average time to its diagnosis and meta-regression for covariates. Methods: We conducted a systematic review, meta-analysis, and meta-regression from 43 studies (367,236 patients) (June 2020–August 2022). With the random-effects model, the pooled prevalence of long COVID-19 was measured. Publication bias was ascertained, and meta-regression analysis was performed on predetermined covariates. The trial was registered with PROSPERO (CRD42022328509). Results: The pooled prevalence of long COVID-19 was 42.5% (95% CI 36% to 49.3%), with 25% and 66% at four and two months, respectively. Mostly, long COVID-19 signs and symptoms occurred at three (54.3%) to six (57%) months (p < 0.0001), further increasing at 12 months (57.9%, p = 0.0148). Hypertension was significantly associated with long COVID-19 at 32% (0.322 (95% CI 0.166, 0.532) (p < 0.001) and hospital re-admission contributed to 17% (Q = 8.70, df = 1, p = 0.0032) (R2 = 0.17). All the covariates explained at least some of the variance in effect size on long COVID-19 at 53% (Q = 38.81, df = 19, p = 0.0047) (R2 analog = 0.53). Conclusion: The prevalence of long COVID-19 was 42.5% when linked with a cardiovascular disorder. Hospital re-admission majorly predicted the incidence of long COVID-19. Clinical and methodological characteristics in a specific study contributed to over 50% of long COVID-19 events, with most signs and symptoms occurring between 3 and 6 months and increasing at 12 months. [ABSTRACT FROM AUTHOR]

There are inconsistent results on the effect of dietary lactobacillus supplementation on laying performance. Therefore, this study ascertained the effect of lactobacillus supplementation on laying hen performance. A total of 348 publications were identified from a methodical search done in five databases, of which 12 met the eligibility conditions for the meta-analysis. Eligibility criteria were information on feed intake (FI), feed conversion ratio (FCR), egg production (EP), egg weight (EW), egg mass (EM), Haugh unit (HU), eggshell thickness (EST), egg yolk, blood cholesterol, and moderators (i.e., treatment duration, Lactobacillus spp. and supplementation dose, hen age, and strains). Data obtained were analyzed in OpenMEE software, and pooled results showed that FCR, EP, EM, HU, EST, egg yolk, blood and egg yolk cholesterol levels were better in the lactobacillus-supplemented group than the controls, taking significant heterogeneity into consideration. Furthermore, results indicate that studied moderators influenced the results of the meta-analysis and explained the variabilities across studies utilized for the meta-analysis. In conclusion, dietary lactobacillus supplementation improved feed conversion ratio, egg production, aspects of egg quality, and blood cholesterol levels in laying hens and could be added to chicken feed to boost laying performance and egg quality. [ABSTRACT FROM AUTHOR]

Hyaluronic acid, in the form of a gel or viscoelastic colloidal solution, is currently used for the viscosupplementation of joints affected by osteoarthritis, but its effectiveness is under debate in relation to newer alternatives. Based on meta-analytical arguments, the present article reinforces the opinion that there are still no decisive arguments for its complete replacement but for its use adapted to the peculiarities of the disease manifestation and of the patients. A "broad" comparison is first made with almost all alternatives studied in the last decade, and then a meta-regression study is performed to compare and predict the effect size induced by viscosupplementation therapy and its main challenger of clinical interest, the platelet-rich plasma treatment. If they are computerized, the developed models can represent tools for clinicians in determining the appropriateness of the option or not for viscosupplementation in a manner adapted to the pain felt by the patients, to their age, or to other clinical circumstances. The models were generated using algorithms implemented in the R language and assembled in different R packages. All primary data and necessary R scripts are provided in accordance with the philosophy of reproducible research. Finally, we adhere in a documented way to the opinion that HA-based products, currently under circumspection, are still clinically useful. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effects of the microalgae (MIAs) Schizochytrium sp. as a dietary supplement for dairy cows with respect to the yield, composition, and fatty acid profile of milk using a meta-analytical method. The data used in the statistical analyses were obtained from 11 peer-reviewed scientific publications. The effect size was assessed using the weighted mean differences (WMDs) between MIA-supplemented and control treatments. Dry matter intake, milk fat yield, and milk fat content decreased (p < 0.001) in response to the dietary inclusion of Schizochytrium sp. MIAs. However, Schizochytrium sp. MIAs supplementation increased (p = 0.029) milk yield. The dietary inclusion of Schizochytrium sp. MIAs decreased (p < 0.05) the content of the fatty acids (FAs) butyric, caproic, caprylic, capric, undecanoic, lauric, pentadecanoic, palmitic, heptadecanoic, stearic, arachidic, and total saturated FAs, and it resulted in a ω-6/ω-3 ratio in milk. In contrast, Schizochytrium sp. MIAs supplementation increased (p < 0.05) the content of linoleic, conjugated linoleic, eicosapentaenoic, behenic, docosahexaenoic, total monounsaturated FAs, total polyunsaturated FAs, and total omega-3 FAs in milk. The results showed that Schizochytrium sp. MIAs could be used as a dietary supplement to improve the milk yield and fatty acid profile of milk obtained from dairy cows. [ABSTRACT FROM AUTHOR]

Background: Baseline imbalances have been identified in randomized trials of evolocumab and alirocumab. Our aim was to quantitatively assess (1) the presence of systematic baseline differences, and (2) the relationship of baseline differences with effects on low-density lipoprotein-cholesterol (LDL-c) and clinical outcomes in the trials. Methods: We performed a meta-epidemiological study. PubMed, Embase, regulatory reports, ClinicalTrials.gov and company websites were searched for trials. Seven baseline characteristics (mean age, LDL-c, BMI, percentage males, diabetics, smokers, and hypertensives) and five outcomes (LDL-c, major adverse cardiac events, serious adverse events, any adverse events, all-cause mortality) were extracted. We calculated (1) range and distribution of baseline imbalances (sign-test), (2) pooled baseline differences and heterogeneity (meta-analysis), (3) differences in SDs around continuous variables (sign-test and pooling), and (4) the relationship of baseline differences with outcomes (meta-regression). The comparisons of PCSK9-inhibitor groups with either placebo or ezetimibe were analysed separately and combined. Results: We identified 43 trials with 63,193 participants. Baseline characteristics were frequently missing. Many trials showed small baseline imbalances, but some large imbalances. Only baseline BMI showed a statistically significant lower pooled mean for the drug versus placebo groups (MD -0.16; 95% CI -0.24 to -0.09). Heterogeneity in baseline imbalances was present in six placebo- and five ezetimibe-comparisons. Heterogeneity was statistically significant for BMI, males, diabetics and hypertensives in the combined comparisons. There was a statistically significant preponderance for larger SDs in the PCSK9-inhibitor versus control groups (sign-test age 0.014; LDL-c 0.014; BMI 0.049). Meta-regression showed clinically relevant relationships of baseline imbalances in age, BMI and diabetics with the risk of any adverse events and the risk of mortality. Two relationships were statistically significant: A higher mean BMI in the drug versus control group with a decreased risk of mortality (beta − 0.56; 95% CI -1.10 to -0.02), and a higher proportion of diabetics with an increased risk of any adverse events (beta 0.02; 95% 0.01 to 0.04). Conclusions: Heterogeneous baseline imbalances and systematically different SDs were present in evolocumab and alirocumab trials, so study groups cannot be assumed to be comparable. These findings raise concerns about the design and conduct of the randomization procedures. [ABSTRACT FROM AUTHOR]

Few studies have acknowledged and quantified the economic contribution in expenditures of recreational fisheries. Additional economic value attributed to fishers' willingness to pay (WTP) for recreational fisheries in excess of expenses was estimated for 33 countries in Europe. Benefit transfer was used in a meta‐regression analysis of 184 studies and 1001 observations of WTP per day for recreational fisheries. Most studies of fishing were in the USA, but also in Europe, Australia, New Zealand, South America and Canada. Mixed‐effects regression models were estimated with income, climate variables, population density and study characteristics as explanatory variables. Income and temperature positively affected WTP per day. Benefit transfers with these variables and different transfer methods among European countries showed that the estimated total WTP could amount to 11.4 billion USD (purchasing power parity corrected to 2020 prices). Variation in WTP per day was large, and ranged 9–62 USD among countries and transfer methods. For several countries, WTP for recreational fisheries exceeded 0.1% of gross domestic product. [ABSTRACT FROM AUTHOR]

Background: Although, several studies have assessed the association of the phospholipase A2 receptor (PLA2R) and HLA-DQA1 SNPs with primary membranous nephropathy (PMN), results were inconsistent and between-studies heterogeneity needs to be investigated. Objectives: The aim of this review was to summarize existing data on the contribution of 10 SNPs in the PLA2R and HLA-DQA1 genes to PMN susceptibility and to investigate the between-studies heterogeneity by subgroup analyses and meta-regressions. Design: This study was performed according to the PRISMA guidelines for systematic reviews and meta-analyses. Data sources and methods: An electronic literature search for eligible studies among all papers published prior to January 10, 2024, was conducted through PubMed, EMBASE, Web of science and Scopus databases. Meta-analyses together with subgroup analyses and meta-regressions were performed for the 10 following SNPs: rs4664308, rs3749117, rs3749119, rs35771982, rs3828323, rs16844715, rs1511223, rs6757188, rs2715918, and rs2187668. Results: Combined analyses revealed a significant increase in PMN risk conferred by the following alleles: rs4664308*A, rs3749117*T, rs3749119*C, rs35771982*G, rs3828323*C, rs16844715*C, rs1511223*A, rs2715918*A, and rs2187668*A, all P -values <.001. Moreover, the PLA2R-rs4664308/HLA-DQA1-rs2187668 interaction was significantly associated with an increased PMN risk, P <.001. However, there was a substantial between-studies heterogeneity for some SNPs. Subgroup analyses by ethnicity for the 9 PLA2R SNPs did not show any cross-ethnic disparity. Inversely, the risk conferred by the HLA-DQA1 rs2187668*A allele was significantly higher in Caucasians (OR [95% CI] = 3.929 [3.251–4.748]) than in Asians (OR [95% CI] = 2.537 [1.94–3.318], P =.007. Besides, meta-regressions revealed for the majority of investigated SNPs significant correlations of the effect size with albumin, 24-hours proteinuria, serum creatinine, and eGFR levels. Hence, the influence on PMN risk conferred by the PLA2R and HLA-DQA1 SNPs was rather noted in patients with a severe disease. Conclusion: This meta-analysis showed that 9 out of the 10 investigated SNPs in PLA2R and HLA-DQA1 genes were associated with increased PMN risk. Heterogeneity could be due to disparate patient groups in terms of disease presentation for almost all SNPs, and ethnicity for the HLA-DQA1 rs2187668 SNP. Registration: This review has been registered on PROSPERO: CRD42024506729. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024506729 Plain language summary: Genetic factors in primary membranous nephritis Why was the study done? Primary membranous nephritis (PMN) is the most common etiology of adult-onset nephrotic syndrome. Understanding risk factors, particularly genetic ones, would provide a better understanding of its pathophysiological mechanisms in order to prevent and treat patients more effectively. What did the researchers do? The research team summarized published data on genetic factors associated with PMN including phospholipase A2 receptor (PLA2R) and HLA-DQA1 genes. What did the researchers find? The total number of included studies was 27. Nine out of ten genetic factors were found to be associated with PMN risk. Moreover, we noted significant interaction between PLA2R and HLA-DQA1 in potentializing PMN risk. Nevertheless, there was a significant between-studies heterogeneity which was found to be explained in part by disease severity. What do the findings mean? This study has identified some important some genetic factors associated with PMN together with confounding factors that could influence the aforementioned association. [ABSTRACT FROM AUTHOR]

Aim: We aimed to determine the macrovascular and microvascular outcomes of intensive versus standard glucose‐lowering strategies in type 2 diabetes (T2D) and investigate the relationships between these outcomes and trial arm glycated haemoglobin (HbA1c) reduction. Materials and Methods: In this systematic review and meta‐analysis, we identified relevant trials from MEDLINE, Embase, the Cochrane Library, and bibliographies up to August 2023. Macrovascular and microvascular outcomes, along with safety outcomes, were evaluated. Pooled study‐specific hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated, and meta‐regression was employed to analyse the relationships between outcomes and HbA1c reduction. Results: We included 11 unique RCTs involving 51 469 patients with T2D (intensive therapy, N = 26 691; standard therapy, N = 24 778). Intensive versus standard therapy reduced the risk of non‐fatal myocardial infarction (MI) (HR 0.84; 95% CI 0.75‐0.94) with no difference in the risk of major adverse cardiovascular events (HR 0.97; 95% CI 0.92‐1.03) and other adverse cardiovascular outcomes. Intensive versus standard therapy reduced the risk of retinopathy (HR 0.85; 0.78‐0.93), nephropathy (HR 0.71; 0.58‐0.87) and composite microvascular outcomes (HR 0.88; 0.77‐1.00). Meta‐regression analyses showed modest evidence of inverse linear relationships between HbA1c reduction and the outcomes of major adverse cardiovascular events, non‐fatal MI, stroke and retinopathy, but these were not statistically significant. Conclusions: In people with T2D, intensive glucose control was associated with a reduced risk of non‐fatal MI and several microvascular outcomes, particularly retinopathy and nephropathy. The lack of an effect of intensive glucose‐lowering on most macrovascular outcomes calls for a more comprehensive approach to managing cardiovascular risk factors alongside glycaemic control. [ABSTRACT FROM AUTHOR]

Low back disorder (LBD) is a major cause of disability worldwide. Inflammation results in proliferation of cytokines or consequent degradation products (collectively known as inflammatory biomarkers) that activate pain pathways which can result in non-specific LBD. This systematic review and meta-analysis aim to evaluate the relationship between inflammatory biomarkers and clinical outcomes in patients with LBD. The PRISMA guideline was followed for the systematic reivew. Three online databases were searched. Four RCTs and sixteen observational studies with 1142 LBD patients were analysed. The primary outcomes were back and leg pain scores, back-specific disability scores and expression of inflammatory biomarkers. Standardized mean difference (SMD) and their 95% confidence intervals (CI) were evaluated. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to summarize the strength of evidence. Four RCTs and sixteen observational studies were included in the analysis of 1142 patients with LBD. There was a statistically significant reduction in back pain score and IL-1 beta and increase in the expression of CTX-1 and IL-10 levels post treatment. There was a significant relationship between increase in the expression of MCP- and reduction in the expression of hsCRP with increase in back pain. Significant relationship was also observed between increase in the expression of MCP-1 and reduction in the expression of IL-6 with increase in leg pain. Increase in the expression of IL-8 and reduction in the expression of hsCRP was also associated with increased disability score. Inflammatory biomarkers play a significant role in the pathogenesis of LBD. CTX-1, IL-10 and IL-1 beta may be responsible for the decrease in back pain scores post treatment. There is a relationship between MCP-1, IL-6, IL-8 and hsCRP with clinical and functional assessments for LBD. Further studies will improve understanding of the pathogenesis of LBD and aid in targeted management strategies. [ABSTRACT FROM AUTHOR]

Methylphenidate (MPH), a first-line treatment for attention-deficit hyperactivity disorder (ADHD) management, has been the focus of debate for decades regarding its effect on growth. The aim of this PRISMA meta-analysis was to determine the effect of MPH on height in children/adolescents with ADHD and its predictive factors based on literature reports. Available full-text articles were systematically reviewed to identify clinical studies of pediatric ADHD patients with height Z-score (HZS) data for monotherapy MPH-treated and non-treated groups. We estimated standardized mean differences (SMDs) of HZS or its changes from baseline (ΔHZS) between groups, then identified associated factors through subgroup analyses and meta-regression. For before–after treatment studies, the paired standard errors of ΔHZS were re-estimated to demonstrate in the forest plot. Risk of bias was analyzed using the Newcastle–Ottawa Scale. Among the 29 eligible studies, 26 reported ΔHZS with self-control groups, and ΔHZS or absolute HZS were compared to other external controls in 11 studies. A significant reduction was observed between post-MHP and pre-MPH use, with high heterogeneity (SMD = – 0.40; 95% confidence interval = [ – 0.54, – 0.27]; I2 = 91%). The study region, ADHD subtype, and stimulant-naïve status of patients at baseline may modify the effect on HZS. Because of the high clinical heterogeneity in observational studies, clinicians should consider the negative effect of MPH on height in ADHD patients by determining whether patients fulfill appropriate high-risk criteria. Further well-designed longitudinal studies are required to better quantify this effect, especially with prolonged treatment. [ABSTRACT FROM AUTHOR]

Purpose: The increase in thyroid cancer incidence has inevitably led to an increase in thyroid cancer surgeries. This meta-regression analysis aimed to determine if the rate of post-thyroidectomy complications changes by year. Materials and Methods: PubMed and Embase databases were used to perform a systematic literature search of studies published from January 1, 2005, using the keywords "thyroidectomy" and "complication." A meta-regression was performed for post-thyroidectomy hypocalcemia and bleeding. Results: This meta-analysis included 25 studies involving 927751 individuals. Through the years of publications in this study, there was no significant difference in the proportion of post-thyroidectomy hypocalcemia and bleeding (p=0.9978, 0.6393). Conclusion: Although the number of thyroid surgeries has recently increased, the incidence of post-thyroidectomy hypocalcemia and bleeding did not significantly increase. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effects of dietary supplementation with 3-nitrooxypropanol (3-NOP) on growth performance, ruminal fermentation, and enteric methane emissions of beef cattle using a meta-analytic approach. The final meta-analysis database included results from 15 scientific articles. The response variables were analyzed through random effects models, where the results were reported as weighted mean differences (WMD) between the treatments without 3-NOP and those supplemented with 3-NOP. The dietary inclusion of 3-NOP decreased (p < 0.001) dry matter intake but did not affect (p > 0.05) average daily gain and increased (p < 0.05) feed efficiency. In the rumen, 3-NOP supplementation increased (p < 0.01) the pH and ruminal concentration of propionate, butyrate, valerate, isobutyrate, and isovalerate. In contrast, dietary supplementation with 3-NOP decreased (p < 0.001) the rumen concentration of ammonia nitrogen, total volatile fatty acids, acetate, and the acetate/propionate ratio. Furthermore, daily methane (CH4) emission, CH4 yield, and CH4 emission as a percentage of gross energy ingested decreased (p < 0.001) in response to 3-NOP dietary supplementation. In conclusion, dietary supplementation with 3-nitrooxypropanol can be used as a nutritional strategy to improve feed efficiency and ruminal fermentation in beef cattle and, at the same time, reduce enteric methane emissions. [ABSTRACT FROM AUTHOR]

Purpose: It is unclear which triceps tendon repair constructs and techniques produce the strongest biomechanical performance while minimizing the risk of gap formation and repair failure. We aimed to determine associations of construct and technique variables with the biomechanical strength of triceps tendon repairs. PubMed, Embase, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov were systematically searched for peer-reviewed studies on biomechanical strength of triceps tendon repairs in human cadavers. 6 articles met the search criteria. Meta-regression was performed on the pooled dataset (123 specimens). Outcomes of interest included gap formation, failure mode, and ultimate failure load. Covariates were fixation type; number of implants; and number of sutures. Stratification by covariates was performed. We found no association between fixation type and ultimate failure load; however, suture anchor fixation was associated with less gap formation compared with transosseous direct repair (β = − 1.1; 95% confidence interval [CI]:− 2.2, − 0.04). A greater number of implants was associated with smaller gap formation (β = − 0.77; 95% CI: − 1.3, − 0.28) while a greater number of sutures was associated with higher ultimate failure load (β= 3; 95% CI: 21, 125). In human cadaveric models, the number of sutures used in triceps tendon repairs may be more important than the fixation type or number of implants for overall strength. If using a transosseous direct repair approach to repair triceps tendon tears, surgeons may choose to use more sutures in their repair in order to balance the risk of larger gap formation when compared to indirect repair techniques. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Purpose: The burden of herpes zoster (HZ) is substantial and numerous chronic underlying conditions are known as predisposing risk factors for HZ onset. Thus, a comprehensive study is needed to synthesize existing evidence. This study aims to comprehensively identify these risk factors. Methods: A systematic literature search was done using MEDLINE via PubMed, EMBASE and Web of Science for studies published from January 1, 2003 to January 1, 2023. A random-effects model was used to estimate pooled Odds Ratios (OR). Heterogeneity was assessed using the I2 statistic. For sensitivity analyses basic outlier removal, leave-one-out validation and Graphic Display of Heterogeneity (GOSH) plots with different algorithms were employed to further analyze heterogeneity patterns. Finally, a multiple meta-regression was conducted. Results: Of 6392 considered records, 80 were included in the meta-analysis. 21 different conditions were identified as potential risk factors for HZ: asthma, autoimmune disorders, cancer, cardiovascular disorders, chronic heart failure (CHF), chronic obstructive pulmonary disorder (COPD), depression, diabetes, digestive disorders, endocrine and metabolic disorders, hematological disorders, HIV, inflammatory bowel disease (IBD), mental health conditions, musculoskeletal disorders, neurological disorders, psoriasis, renal disorders, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and transplantation. Transplantation was associated with the highest risk of HZ (OR = 4.51 (95% CI [1.9–10.7])). Other risk factors ranged from OR = 1.17–2.87, indicating an increased risk for all underlying conditions. Heterogeneity was substantial in all provided analyses. Sensitivity analyses showed comparable results regarding the pooled effects and heterogeneity. Conclusions: This study showed an increased risk of HZ infections for all identified factors. [ABSTRACT FROM AUTHOR]

The replacement of fish oil with plant oils is a common practice in aquaculture to compensate for the shortage of fish oil supply and has been thoroughly studied. However, because the experimental conditions vary in many aspects, the results are usually inconsistent quantitatively. Therefore, a meta‐analysis was conducted based on a dataset containing 328 articles to systematically model the influence of plant oils on the main aquaculture fish. In addition to demonstrating the species‐specific dose‐dependent impact of plant oils on fish growth, feed utilization efficiency, lipid deposition and health parameters, we have also investigated the role of other factors in this process. We found that the adverse effects caused by plant oils worsen as the experimental duration extends for Atlantic salmon, while Gilthead seabream and European seabass gradually adapt to the change. Further, water temperature could be a decisive factor for Rainbow trout, and early adaptation to plant oils would be helpful for Gilthead seabream. Moreover, sufficient fishmeal supply could alleviate the adverse effects caused by plant oils for most species, but for Gilthead seabream and European seabass, the growth suppression effect of plant oil was larger when fed high‐fishmeal diets. Besides, by comprehensively considering the effects of plant oils, we matched the potential optimal plant oil for each fish species. Our article quantitatively modelled the adverse effects of replacing fish oil with plant oils, investigated the influences of assistant factors and offered a panorama of the research status with emphasis on potential breakthrough orientations. [ABSTRACT FROM AUTHOR]

Stevia rebaudiana Bertoni, a no-calorie natural sweetener, contains a plethora of polyphenols that exert antioxidant properties with potential medicinal significance. Due to the variety of functional groups, polyphenols exhibit varying solubility depending on the nature of the extraction solvents (water, organic, or their mixtures, defined further on as hydroalcoholic extracts). In the present study, we performed a systematic review, following PRISMA guidelines, and meta-analysis, synthesizing all available data from 45 articles encompassing 250 different studies. Our results showed that the total phenolic content (TPC) of hydroalcoholic and aqueous extracts presents higher values (64.77 and 63.73 mg GAE/g) compared to organic extracts (33.39). Total flavonoid content (TFC) was also higher in aqueous and hydroalcoholic extracts; meta-regression analysis revealed that outcomes in different measuring units (mg QE/g, mg CE/g, and mg RUE/g) do not present statistically significant differences and can be synthesized in meta-analysis. Using meta-regression analysis, we showed that outcomes from the chemical-based ABTS, FRAP, and ORAC antioxidant assays for the same extract type can be combined in meta-analysis because they do not differ statistically significantly. Meta-analysis of ABTS, FRAP, and ORAC assays outcomes revealed that the antioxidant activity profile of various extract types follows that of their phenolic and flavonoid content. Using regression meta-analysis, we also presented that outcomes from SOD, CAT, and POX enzymatic antioxidant assays are independent of the assay type (p-value = 0.905) and can be combined. Our study constitutes the first effort to quantitatively and statistically synthesize the research results of individual studies using all methods measuring the antioxidant activity of stevia leaf extracts. Our results, in light of evidence-based practice, uncover the need for a broadly accepted, unified, methodological strategy to perform antioxidant tests, and offer documentation that the use of ethanol:water 1:1 mixtures or pure water can more efficiently extract stevia antioxidant compounds. [ABSTRACT FROM AUTHOR]

Abstract Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with the increasing prevalence of a modern sedentary lifestyle. Wearable technology‐based physical activity interventions (WT‐BPAI) might provide a channel to improve diabetic self‐management. The study aimed to (1) evaluate the effectiveness of WT‐BPAI on PA levels, glycemic levels, and other outcomes (blood pressure [BP], body mass index [BMI], and serum lipid profile) in adults with T2DM, and (2) investigate the potential covariates affecting aforementioned outcomes. Eight databases were searched thoroughly using three steps from inception until January 16, 2024. The quality of the studies and overall evidence were evaluated. The package meta of the R software program version 4.3.1. was utilized for meta‐analyses, subgroup analyses, and meta‐regression analyses. A total of 19 randomized controlled trials (RCTs) were found. Meta‐analyses revealed that WT‐BPAI significantly increased 1583 steps per day and decreased systolic BP (SBP) by 2.46 mmHg. Subgroup and meta‐regression analyses found that function, duration of intervention, and age were significant covariates. According to the risk of bias version 2, more than half of the trials raised some concerns about the randomization process, deviations from the intended intervention, and missing outcome data. The certainty of the evidence was very low for all outcomes based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. WT‐BPAI can be considered a supplementary intervention to increase the steps per day and decrease SBP, especially when used for short periods in young adults with T2DM. However, we need more well‐designed research with long‐term outcomes.

Vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and insulin-like growth factor-1 (IGF-1) may help the brain resist both functional and structural neurodegeneration, which is critical for maintaining cognitive and neurological health in older adults. This meta-analysis and meta-regression seek to elucidate the impact of physical activity on these biomarker levels in healthy seniors, as well as to examine the influence of several moderator factors, including age, sex, period length, and time, for the first time. The standardized mean effect metric was used to assess the influence of weights, which reflected each group's relative importance in comparison to baseline data. The study looked at potential moderating factors including age, gender, and physical activity levels. The analysis of 11 studies indicated no significant effect of physical activity on VEGF levels [0.328, CI 95 % (−0.871 to 1.52); I2 = 0.00; p = 0.592; Q = 4.14]. Physical activity had a substantial impact on brain-derived neurotrophic factor (0.827, 95 % confidence interval: 0.487 to 1.16; I2 = 0.00; p = 0.00; Q = 78.46), with females showing particularly notable effects (Tau2 = 0.327, Tau = 0.571, I2 = 80.90 %, Q = 68.05, df = 15, p = 0.00). Physical activity also had a substantial effect on insulin-like growth factor 1 (0.276, 95 % confidence interval: 0.065 to 0.487; I2 = 0.00; p = 0.10; Q = 8.35), indicating that it positively influences IGF-1 levels. Overall, while physical exercise has a significant effect on BDNF and IGF-1, more research is needed to fully understand its impact on vascular endothelial growth factor and to investigate how individual characteristics may influence exercise outcomes.

Emotion-related impulsivity, the trait-like tendency toward regrettable behavior during states of high emotion, is a robust predictor of internalizing and externalizing psychopathology. Despite substantial evidence that emotion-related impulsivity is important transdiagnostically, relatively little is known about its cognitive correlates. This systematic review and meta-regression investigates one such candidate, risky decision-making. We analyzed 195 effect sizes from 51 studies of 14,957 total participants, including 105 newly calculated effect sizes that were not reported in the original publications. The meta-regression demonstrated evidence for a small, positive relationship of emotion-related impulsivity with behavioral indices of risky decision-making (ß = 0.086). Effects generalized across sample age, gender, Positive versus Negative Urgency, and clinical versus nonclinical samples. The average effect size varied by task type, with stronger effects for the Iowa Gambling Task and Delay Discounting Task. Experimental arousal manipulation was nearly a significant moderator, with stress and pharmacological manipulations yielding significant effect sizes. Analyses indicated that publication bias did not skew the current findings. Notwithstanding limitations, the data suggest that risky decision-making is a cognitive domain that relates to emotion-related impulsivity. We conclude with recommendations regarding the specific types of tasks and arousal inductions that will best capture emotion-related impulsivity in future experimental research.

Abstract Background Practitioners’ enrollment, adherence, and retention rates influence estimates of effectiveness in knowledge translation (KT) studies and remain important concerns for implementation researchers. This review aimed to systematically summarize the current evidence on feasibility measures as gauged by enrollment, adherence, and retention rates in KT evaluation studies targeting rehabilitation practitioners treating musculoskeletal disorders (MSDs). Methods We searched five electronic databases from the inception to October 2022. We included KT studies that 1) had designs recommended by the Effective Practice and Organisation of Care, 2) targeted rehabilitation practitioners managing patients with MSDs, 3) delivered KT interventions according to the Expert Recommendations for Implementing Change classification, and 4) reported on the feasibility measures (e.g., enrollment, adherence, and retention). Descriptive statistics were conducted to report on study-, practitioners- and intervention-related factors influencing enrollment, adherence, and retention rates. Meta-regression weighted by the sample size of included studies was used to estimate the effect of factors on overall enrollment, adherence, and retention rates. Results Findings from 33 KT studies reported weighted enrolment, adherence, and retention rate of 82% (range: 32%-100%), 74% (range: 44%-100%), and 65% (range: 36%-100%) respectively for both intervention and control groups. Factors positively influencing enrollment, adherence, and retention rates included designing short study period with short duration intervention. Conclusions Intense (e.g., high frequency, short duration) single KT intervention was more appealing for practitioners. Future evaluation studies should clearly report follow-up data, and practitioners’ prior training, Results may not apply to non-MSD healthcare providers.

ABSTRACT: Although postruminal glucose infusion into dairy cows has increased milk protein yield in some past experiments, the same trend has not been observed in others. A meta-regression of 64 sets of observations from 29 previously published glucose and propionate infusion studies in dairy cattle, treating study and experiment (study) as random effects, was performed to establish the general effects of glucose equivalent (GlcE) infusion rate on milk true protein (MTP) yield and content, if any, and to identify independent, fixed-effect variables that accounted for the changes in MTP yield and content that were observed. Candidate explanatory variables included rate and site of infusion, diet composition and intake, body weight and lactation stage of the cows, and the change in nutrient intake between GlcE and control treatments. Across all studies, according to a model containing only the random effects of study and experiment, GlcE infusion at an average of 954 g/d increased MTP yield by 26 g/d, on average, whereas mean MTP content was not affected. Backward stepwise elimination of potential explanatory variables from a full mixed model produced a final, reduced model for MTP yield that retained a positive, second-order quadratic effect of infusion rate of GlcE and a positive, linear effect of the change in crude protein intake (CPI) between GlcE treatment and control. This change in CPI due to GlcE infusion ranged from −0.546 to 0.173 kg/d in the dataset. The model fit indicated that when CPI was allowed to drop during GlcE infusion, the effect of GlcE on MTP yield was smaller than when CPI was maintained or increased, in a manifestation of the classic protein:energy interaction. The final reduced model for MTP content contained the same explanatory variables as for MTP yield, plus a negative effect of intravenous compared with gastrointestinal infusion. Overall, the meta-analysis revealed that both MTP yield, and content were positively related to GlcE infusion rate and to the change in CPI between glucose treatment and control.