scholarly journals Microplastic contamination of salt intended for human consumption: a systematic review and meta-analysis

2020 ◽  
Vol 2 (12) ◽  
Author(s):  
Evangelos Danopoulos ◽  
Lauren Jenner ◽  
Maureen Twiddy ◽  
Jeanette M. Rotchell
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Future Research ◽  
Human Consumption ◽  
Inclusion Criteria ◽  
Research Findings ◽  
Human Health Effects ◽  
Potential Human Health

Abstract Microplastics (MPs) are an emerging contaminant ubiquitous in the environment. There is growing concern regarding potential human health effects, a major human exposure route being dietary uptake. We have undertaken a systematic review (SR) and meta-analysis to identify all relevant research on MP contamination of salt intended for human consumption. Three thousand nine hundred and nineteen papers were identified, with ten fitting the inclusion criteria. A search of the databases MEDLINE, EMBASE and Web of Science, from launch date to September 2020, was conducted. MP contamination of salt varied significantly between four origins, sea salt 0–1674 MPs/kg, lake salt 8–462 MPs/kg, rock and well salt 0–204 MPs/kg. The majority of samples were found to be contaminated by MPs. Corresponding potential human exposures are estimated to be 0–6110 MPs per year (for all origins), confirming salt as a carrier of MPs. A bespoke risk of bias (RoB) assessment tool was used to appraise the quality of the studies, with studies demonstrating moderate to low RoB. These results suggest that a series of recurring issues need to be addressed in future research regarding sampling, analysis and reporting to improve confidence in research findings.

Should Levetiracetam or Phenytoin Be Used for Posttraumatic Seizure Prophylaxis? A Systematic Review of the Literature and Meta-analysis

Neurosurgery ◽  
2016 ◽  
Vol 79 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Nickalus R. Khan ◽  
Matthew A. VanLandingham ◽  
Tamara M. Fierst ◽  
Caroline Hymel ◽  
Kathryn Hoes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antiepileptic Drug ◽  
Random Effects ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Seizure Prophylaxis ◽  
Number Of Patients ◽  
Severe Tbi ◽  
Antiepileptic Drug Therapy

Abstract BACKGROUND: Posttraumatic seizure (PTS) is a significant complication of traumatic brain injury (TBI). OBJECTIVE: To perform a systematic review and meta-analysis to compare levetiracetam with phenytoin for seizure prophylaxis in patients diagnosed with severe TBI. METHODS: An inclusive search of several electronic databases and bibliographies was conducted to identify scientific studies that compared the effect of levetiracetam and phenytoin on PTS. Independent reviewers obtained data and classified the quality of each article that met inclusion criteria. A random effects meta-analysis was then completed. RESULTS: During June and July 2015, a systematic literature search was performed that identified 6097 articles. Of these, 7 met inclusion criteria. A random-effects meta-analysis was performed. A total of 1186 patients were included. The rate of seizure was 35 of 654 (5.4%) in the levetiracetam cohort and 18 of 532 (3.4%) in the phenytoin cohort. Our meta-analysis revealed no change in the rate of early PTS with levetiracetam compared with phenytoin (relative risk, 1.02; 95% confidence interval, 0.53-1.95; P = .96). CONCLUSION: The lack of evidence on which antiepileptic drug to use in PTS is surprising given the number of patients prescribed an antiepileptic drug therapy for TBI. On the basis of currently available Level III evidence, patients treated with either levetiracetam or phenytoin have similar incidences of early seizures after TBI.

scholarly journals Effectiveness of trauma centers verification: Protocol for a systematic review

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brice Batomen ◽  
Lynne Moore ◽  
Mabel Carabali ◽  
Pier-Alexandre Tardif ◽  
Howard Champion ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trauma Center ◽  
Assessment Tool ◽  
Meta Analysis ◽  
The Body ◽  
World Health ◽  
Trauma Patients ◽  
Assessment Development ◽  
Health Organization

Abstract Background The implementation of trauma systems in many high-income countries over the last 50 years has led to important reductions in injury mortality and disability in many healthcare jurisdictions. Injury organizations including the American College of Surgeons and the Trauma Association of Canada as well as the World Health Organization provide consensus-based recommendations on resources and processes for optimal injury care. Many hospitals treating trauma patients seek verification to demonstrate that they meet these recommendations. This process may be labeled differently across jurisdictions. In Canada for example, it is called accreditation, but it has the same objective and very similar modalities. The objective of the study described in this protocol is to systematically review evidence on the effectiveness of trauma center verification for improving clinical processes and patient outcomes in injury care. Methods We will perform a systematic review of studies evaluating the association between trauma center verification and hospital mortality (primary outcome), as well as morbidity, resource utilization, and processes of care (secondary outcomes). We will search CINAHL, EMBASE, HealthStar, MEDLINE, and ProQuest databases, as well as key injury organization websites for gray literature. We will assess the methodological quality of studies using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool. We are planning to conduct a meta-analysis if feasible based on the number of included studies and their heterogeneity. We will evaluate the quality of cumulative evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group methodology. Discussion This review will provide a synthesis of the body of evidence on trauma center verification effectiveness. Results could reinforce current verification modalities and may suggest ways to optimize them. Results will be published in a peer-reviewed journal and presented at an international clinical conference. Systematic review registration PROSPERO CRD42018107083.

The incidence of military training-related injuries in Chinese new recruits: a systematic review and meta-analysis

2017 ◽  
Vol 164 (4) ◽  
pp. 309-313 ◽  
Author(s):  
Wei Hua ◽  
Q Chen ◽  
M Wan ◽  
J Lu ◽  
L Xiong
Keyword(s):  
Systematic Review ◽  
Military Service ◽  
Meta Analysis ◽  
Military Training ◽  
Inclusion Criteria ◽  
Random Effects Models ◽  
Premature Discharge ◽  
New Recruits

IntroductionTraining-related injuries are the main reason for disability, long-term rehabilitation, functional impairment and premature discharge from military service. The aim of this study was to identify the incidence of injuries in the training of Chinese new recruits via a systematic review of the literature.MethodA systematic review and meta-analysis was conducted to evaluate the combined incidence of military training-related injuries in Chinese new recruits. The electronic databases of full-text journals were searched, and the Loney criteria were used to assess the quality of eligible articles. Summary estimates were obtained using random-effects models. Subgroup analyses and publication bias tests were performed.ResultsFifty-five eligible articles representing 109 611 Chinese new recruits met the inclusion criteria, of which 21 253 recruits were clinically diagnosed with military training-related injuries. The combined incidence of military training-related injuries in Chinese new recruits was found to be 21.04%.ConclusionsAn increased incidence of training injuries was found in more recent years, underscoring the need for further research on the risk factors associated with their causation.

scholarly journals Evaluation of benefits and harms of surgical treatments for post-radical prostatectomy urinary incontinence: a systematic review and meta-analysis protocol

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1155
Author(s):  
Roselyne Choiniere ◽  
Patrick O. Richard ◽  
Melanie Morin ◽  
Le-Mai Tu ◽  
Gordon H. Guyatt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Future Research ◽  
Control Group ◽  
Bulking Agents

Background: Post-radical prostatectomy urinary incontinence (PPI) is a frequent and feared complication that can affect approximately 25% of patients. Between 1 and 10% of patients suffering from PPI will require surgery. The effectiveness of the available surgical interventions has only been compared in a few randomized controlled trials and the available reviews have important limitations regarding both benefits and harms that make them insufficient to inform decision-making. The aim of the study is to provide systematic summaries of benefits and harms of contemporary surgical treatment options for PPI through systematic review and meta-analysis using GRADE methodology and reporting in accord with the PRISMA-P statement. Methods: Studies pertaining to bulking agents, male synthetic slings, compressive balloon systems (ProACT) or artificial urinary sphincters (AUS) used for the treatment of patients suffering from PPI will be included. A systematic search will be conducted using the OVID and PubMED platforms in MEDLINE, Embase and Cochrane databases, and reference lists of relevant reviews and guidelines. Trained independent reviewers will conduct study selection and data extraction. Outcomes will include the number of pads used per day, the 24-h pad weight test, the Patient Global Impression of Improvement (PGI-I) and the Incontinence Quality of Life (IQOL) as possible benefits and the reoperations, the Clavien-Dindo complications and the other reported adverse events as the harms. When possible, pooled analyses will be completed. Risk of bias will be assessed using the CLARITY tools and a new tool for the before-and-after studies without a control group. Finally, study heterogeneity will be assessed, publication bias will be evaluated with funnel plots and quality of evidence rated for each outcome. Discussion: Our study will address patient-important outcomes and will be useful in clinical decision-making as well as identifying key elements for future research. Study registration: PROSPERO: CRD42018073923 05/12/2018

scholarly journals Effective maNagement of Depression among Patients witH cANCEr (ENHANCE): A Protocol for a Hybrid Systematic Review and Network Meta-Analysis of Randomized Controlled Trials of Interventions for Depressive Symptoms.

2021 ◽  
Author(s):  
Maria Margareta Pertl ◽  
Perez ◽  
Sonya Collier ◽  
Emer Guinan ◽  
Garret Monahan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Future Research ◽  
Controlled Trials ◽  
Systematic Review Methodology ◽  
Patients With Cancer

Abstract Background: Depression is common among patients with cancer and is associated with lower treatment participation, lower satisfaction with care, poorer quality of life, greater symptom burden, and higher healthcare costs. Various types of interventions (e.g., pharmacological, psychotherapy) are used for the treatment of depression. However, evidence for these among patients with cancer is limited. Furthermore, the relative effectiveness and acceptability of different approaches is unknown because a direct comparison between all available treatments has not been carried out. We will address this by conducting a network meta-analysis (NMA) of interventions for depression among people with cancer using a hybrid overview of reviews and systematic review methodology. Methods: We will search for and extract data from systematic reviews of randomised controlled trials (RCTs) of depression interventions for patients with cancer from inception, before performing a supplemental search for more recent RCTs. We will include RCTs comparing pharmacological, psychotherapy, exercise, combination therapy, collaborative care, or complementary and alternative medicine interventions with pill placebo, no treatment, waitlist, treatment as usual, or minimal treatment control groups, or directly in head-to-head trials, among adults who have a current or previous diagnosis of cancer and elevated depressive symptoms (scores above a cut-off on validated scales or meeting diagnostic criteria). Our primary outcomes will be change in depressive symptoms (standardised mean difference) and intervention acceptability (% who withdrew). Our secondary outcomes will be 6-month change in depressive symptoms, health-related quality of life, adverse events and mortality. We will independently screen for eligibility, extract data, and assess risk of bias using the RoB2 tool. We will use frequentist random-effects multivariate NMA in Stata, Rankograms and surface under the cumulative ranking curves to synthesize evidence and obtain a ranking of intervention groups. We will explore heterogeneity and inconsistency using local and global measures and evaluate the credibility of results using the Confidence in NEtwork Meta-Analysis (CINeMA) framework.Discussion: Our findings will provide the best available evidence for managing depression among patients with cancer. Such information will help to inform clinical guidelines, evidence-based treatment decisions and future research by identifying gaps in the current literature. Systematic review registration: Submitted to PROSPERO (record number: 290145), awaiting registration

Efficacy of acupuncture in the management of fatigue related to breast cancer antineoplastic treatment: a systematic review

2019 ◽  
Vol 9 (2) ◽  
pp. 264-272
Author(s):  
Ana Carolina Moraes Costa ◽  
Alena Peixoto Medrado
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Total Sample ◽  
Inclusion Criteria ◽  
Antineoplastic Treatment

INTRODUCTION: Breast cancer is the most prevalent cancer among women worldwide. Similar to chemotherapy, antineoplastic treatment is associated with many side effects, with fatigue being one of the most common. It is important to investigate potential treatments, especially non-pharmacological alternatives, to control symptoms that directly affect women’s quality of life. OBJECTIVE: The objective of this study was to provide scientific evidence to verify the efficacy of acupuncture in the management of fatigue in patients with breast cancer. METHODS: This study involved a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. Randomized clinical trials published in indexed scientific journals were compiled. The literature search was performed using the electronic databases, PubMed, PEDro, and BIREME, using the descriptors ‘breast cancer’, ‘fatigue’, ‘acupuncture’, and ‘randomized trial’. Inclusion criteria included fully available online articles that were classified as randomised clinical trials published from 2012 to 2017 in either English or Portuguese. Study eligibility was based on the Population, Intervention, Control, Outcome, and Study (PICO) design criteria, in which the (1) population included women 18–65 years of age with breast cancer, (2) intervention was acupuncture, (3) comparison referred to standard care or sham acupuncture, and (4) outcome was the evaluation of fatigue. The PEDro scale was applied to evaluate the quality of the studies. WebQualis was also used to evaluate the quality of the journals of the selected articles. RESULTS: In total, 66 articles were selected, but only four fulfilled all inclusion criteria, giving a total sample size of 620 women. All trials evaluated the effect of acupuncture on fatigue and other symptoms related to the treatment of breast cancer with different treatment durations. Three articles reported statistically significant results, and all articles described clinical improvement in fatigue after the application of acupuncture. The average PEDro score of the manuscripts was 6.25. All articles were published in non-Brazilian journals with WebQualis scores that ranged from B2 to A1. CONCLUSION: Scientific evidence confirms the efficacy of acupuncture in the management of fatigue reported by women with breast cancer. Acupuncture was effective in reducing fatigue in the studies selected for this review.

scholarly journals Efficacy of Acupuncture for Treating Opioid Use Disorder in Adults: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-15
Author(s):  
Zhihan Chen ◽  
Yitong Wang ◽  
Rui Wang ◽  
Jin Xie ◽  
Yulan Ren
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Opioid Use Disorder ◽  
Cochrane Central Register ◽  
Opioid Use ◽  
Link Type ◽  
Registration Number

Objectives. To assess the efficacy of acupuncture in treating opioid use disorder (OUD). Design. Systematic review and meta-analysis. Methods. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, ProQuest Dissertation and Theses, Allied and Complementary Medicine Database (AMED), Clinicaltrials.gov, and who.int/trialsearch were searched from inception to 23 December 2017. The methodological quality of selected studies and the quality of evidence for outcomes were assessed, respectively, by the Cochrane risk of bias assessment tool and the GRADE approach. Statistical analyses were conducted by RevMan 5.3. Results. A total of nine studies involving 1063 participants fulfilled the inclusion criteria. The results showed that acupuncture could be more beneficial than no treatment/sham acupuncture in terms of changes in craving for opioid (MD -2.18, 95% CI -3.10 to -1.26), insomnia (MD 2.31, 95% CI 1.97 to 2.65), and depression (SMD -1.50, 95% CI -1.85 to -1.15). In addition, these findings showed that, compared to sham electroacupuncture (EA), EA had differences in alleviating symptoms of craving (SMD -0.50, 95% CI -0.94 to -0.05) and depression (SMD -1.07, 95% CI -1.88 to -0.25) and compared to sham transcutaneous acupoint electrical stimulation (TEAS), TEAS had differences in alleviating symptoms of insomnia (MD 2.31, 95% CI 1.97 to 2.65) and anxiety (MD -1.26, 95% CI -1.60 to -0.92) compared to no treatment/sham TEAS. Conclusions. Acupuncture could be effective in treating OUD. Moreover, EA could effectively alleviate symptoms of craving for opioid and depression, and TEAS could be beneficial in improving symptoms of insomnia and anxiety. Nevertheless, the conclusions were limited due to the low-quality and small number of included studies. PROSPERO registration number is CRD42018085063.

scholarly journals Chemical venous thromboembolism prophylaxis in neurosurgical patients: an updated systematic review and meta-analysis

2018 ◽  
Vol 129 (4) ◽  
pp. 906-915 ◽  
Author(s):  
Nickalus R. Khan ◽  
Prayash G. Patel ◽  
John P. Sharpe ◽  
Siang Liao Lee ◽  
Jeffrey Sorenson
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Meta Analysis ◽  
Bleeding Complications ◽  
Minor Bleeding ◽  
Inclusion Criteria ◽  
Thromboembolism Prophylaxis ◽  
Neurosurgical Patients ◽  
Chemical Prophylaxis

OBJECTIVEVenous thromboembolism (VTE) is a common and potentially life-threatening complication. The risk of serious hemorrhagic complications when starting chemical prophylaxis for VTE prevention is a substantial concern for neurosurgeons. The objective of this study was to perform an updated systematic review and meta-analysis to determine if the rates of VTE and bleeding complications are different in patients undergoing chemoprophylaxis compared with placebo or mechanical prophylaxis alone following cranial or spinal procedures.METHODSIn February 2016 a systematic literature review was performed identifying 3944 articles from 4 different databases. A random-effects meta-analysis was performed after identifying the articles that met inclusion criteria.RESULTSNine articles that met the inclusion criteria were included. The quality of the studies was good, with all of them being classified as Level 2 evidence, with moderate Jadad scores. A meta-analysis comparing chemoprophylaxis with placebo in the prevention of deep venous thrombosis showed a significant benefit to chemical prophylaxis (OR 0.51, 95% CI 0.37–0.71; p < 0.0001). No significant increase in major intracranial hemorrhage (p = 0.60), major extracranial hemorrhage (p = 0.98), or minor bleeding complications (p = 0.60) was found.CONCLUSIONSBased on moderate-to-good quality of evidence, chemoprophylaxis is beneficial in preventing VTE, with no significant increase in either major or minor bleeding complications in patients undergoing cranial and spinal procedures. Further research is needed to determine whether this conclusion holds true for more specific subpopulations.

scholarly journals HIV incidence among men who have sex with men in mainland China: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Wenting Huang ◽  
Liming Wang ◽  
Mi Guodong ◽  
Ryan J. Zahn ◽  
Jennifer Taussig ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Temporal Trends ◽  
Mainland China ◽  
Hiv Infections ◽  
Future Research ◽  
Hiv Incidence ◽  
Geographic Variations ◽  
Sex With Men

Abstract Background Men who have sex with men (MSM) are disproportionately affected by HIV in China. Globally, younger MSM are at higher risk for incident HIV infections, but there has been substantial variation in the estimates of age-stratified HIV incidence among MSM in mainland China, potentially due to regional differences in the nature of the epidemic. Given the need for quality epidemiological data to meet the global goal of ending new HIV infections by 2030, this systematic review and meta-analysis aims to determine age-stratified HIV incidence in mainland China, including consideration by geographic region and time. Methods This review will include longitudinal studies, cross-sectional surveys, and surveillance reports among MSM in mainland China that have reported HIV incidence. We will search studies and reports published from January 1, 2003, to April 30, 2020, in both English and Chinese language literature databases. For each study considered, two reviewers will independently screen, determine eligibility, and extract relevant data, with discrepancies resolved by consensus of a third reviewer. The methodological quality of included studies will be assessed by the Quality Assessment Tool for Systematic Reviews of Observational Studies Score (QATSO). We will develop age-stratified estimates of HIV incidence with geographic variations and temporal trends. Heterogeneity will be examined using statistical techniques appropriate to the dataset. For subgroup analyses, we will conduct mixed-effects meta-analysis models. Discussion This review will contribute to a better understanding of the HIV epidemic among MSM in mainland China by providing age-stratified estimates of HIV incidence with a portrayal of geographic and temporal variations. Findings will reflect epidemic dynamics, informing local and national intervention programs and policies for HIV prevention, and providing estimation data to inform future research among MSM in China. Systematic review registration PROSPERO ID 154834

scholarly journals Impact of multimorbidity on healthcare costs and utilisation: a systematic review of the UK literature

2020 ◽  
Vol 71 (702) ◽  
pp. e39-e46
Author(s):  
Marina Soley-Bori ◽  
Mark Ashworth ◽  
Alessandra Bisquera ◽  
Hiten Dodhia ◽  
Rebecca Lynch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dental Care ◽  
Healthcare Costs ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Grey Literature ◽  
Healthcare Utilisation ◽  
Future Research ◽  
Healthcare Provision ◽  
The Uk

BackgroundManaging multimorbidity is complex for both patients and healthcare systems. Patients with multimorbidity often use a variety of primary and secondary care services. Country-specific research exploring the healthcare utilisation and cost consequences of multimorbidity may inform future interventions and payment schemes in the UK.AimTo assess the relationship between multimorbidity, healthcare costs, and healthcare utilisation; and to determine how this relationship varies by disease combinations and healthcare components.Design and settingA systematic review.MethodThis systematic review followed the bidirectional citation searching to completion method. MEDLINE and grey literature were searched for UK studies since 2004. An iterative review of references and citations was completed. Authors from all articles selected were contacted and asked to check for completeness of UK evidence. The National Institutes of Health National Heart, Lung, and Blood Institute quality assessment tool was used to assess risk of bias. Data were extracted, findings synthesised, and study heterogeneity assessed; meta-analysis was conducted when possible.ResultsSeventeen studies were identified: seven predicting healthcare costs and 10 healthcare utilisation. Multimorbidity was found to be associated with increased total costs, hospital costs, care transition costs, primary care use, dental care use, emergency department use, and hospitalisations. Several studies demonstrated the high cost of depression and of hospitalisation associated with multimorbidity.ConclusionIn the UK, multimorbidity increases healthcare utilisation and costs of primary, secondary, and dental care. Future research is needed to examine whether integrated care schemes offer efficiencies in healthcare provision for multimorbidity.

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