scholarly journals 10 Years of Pulsed-Xenon Ultraviolet Disinfection

2020 ◽  
Vol 41 (S1) ◽  
pp. s438-s438
Author(s):  
Mark Stibich ◽  
Sarah Simmons ◽  
Deborah Passey
Keyword(s):  
Relative Risk ◽  
Meta Analysis ◽  
Outcome Studies ◽  
Uv Disinfection ◽  
Clostridioides Difficile ◽  
Environmental Effectiveness ◽  
Meta Analyses ◽  
Hospital Acquired ◽  
And Control ◽  
Effectiveness Studies

Background: Ultraviolet light (UV) disinfection using low-pressure mercury lamps has been around since the 1940s. The advent of pulsed-xenon UV for hospital use in 2010 has provided a nontoxic and novel technology for hospital disinfection with the first data presented at the 2010 SHEA Decennial. The purpose of this systematic review and meta-analysis is to examine the current body of evidence for pulsed xenon UV disinfection. Methods: The literature search criteria included the following: research conducted in domestic and international settings using pulsed-xenon for surface disinfection, published between 2000 and 2019, and reporting on environmental effectiveness or hospital-acquired reductions (HAIs). We searched PubMed, Google Scholar, and Web of Science. The meta-analysis included 24 studies: 12 HAI outcome studies and 12 environmental effectiveness studies. Meta-analyses were conducted by calculating the percentage reductions for environmental effectiveness, and for the HAI outcome studies, we used a random-effects model to pool the relative risk of HAI. The outcome studies used 272 and 299 months of data for the experimental and control groups, respectively. Results: There was an overall benefit of using pulsed-xenon UV. The overall relative risk of infection decreased compared to the control arm (RR, 0.64; 95% CI, 0.54–0.76). The percentage reductions in environmental studies were as follows: Clostridioides difficile (94.8%), methicillin-resistant Staphylococcus aureus (91.5%), vancomycin-resistant Enterococcus (99.2%), and aerobic bacteria (94.2%). Conclusions: Overall, pulsed-xenon UV was effective for reducing environmental contamination and had the ability to significantly reduce HAIs.Funding: Xenex, Inc., funded this study.Disclosures: Mark Stibich receives a salary from Xenex and is a shareholder of Xenex. Deborah Passey receives a salary from Xenex Disinfection Services.

Interventions for Adolescents With ADHD to Improve Peer Social Functioning: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 108705472090651 ◽  
Author(s):  
Sarah Morris ◽  
Jade Sheen ◽  
Mathew Ling ◽  
Denise Foley ◽  
Emma Sciberras
Keyword(s):  
Social Functioning ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Parent Report ◽  
Self Report ◽  
Age Group ◽  
Control Groups ◽  
Social Interventions ◽  
Meta Analyses ◽  
And Control

Objective: Peer social functioning difficulties characteristic of ADHD persist into adolescence, but the efficacy of interventions for this age group remains unclear. Method: A systematic search of nonpharmacological interventions for adolescents with ADHD (10–18 years) identified 11 trials addressing social functioning, of which eight were included in meta-analyses. Results: Random effects meta-analyses of four randomized trials found no differences in social functioning between treatment and control groups by parent- ( g = −0.08 [−0.34, 0.19], k = 4, N = 354) or teacher-report ( g = 0.17 [−0.06, 0.40], k = 3, N = 301). Meta-analyses of nonrandomized studies indicated participants’ social functioning improved from baseline to postintervention by parent-report, but not teacher- or self-report. All trials had a high risk of bias. Conclusion: These results highlight the paucity of research in this age group. There is little evidence that current interventions improve peer social functioning. Clearer conceptualizations of developmentally relevant targets for remediation may yield more efficacious social interventions.

scholarly journals Impact of Non-Confinement Accommodation on Farrowing Performance: A Systematic Review and Meta-Analysis of Farrowing Crates Versus Pens

Animals ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 957 ◽  
Author(s):  
Dannielle Glencorse ◽  
Kate Plush ◽  
Susan Hazel ◽  
Darryl D’Souza ◽  
Michelle Hebart
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Web Of Science ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Literature Searches ◽  
Piglet Mortality ◽  
Partial Confinement ◽  
Meta Analyses ◽  
Piglet Survival

There are conflicting reports regarding the effect of farrowing house accommodation on piglet performance. The aim of this investigation was to use a systematic review and meta-analyses to summarise the results of publications that focused on direct comparisons between full confinement conventional crates and various designs of loose-housed farrowing pens from loading until weaning. Literature searches in Scopus, BIOSIS Previews, Cab Abstracts, and Web of Science identified 6695 articles. Twenty-two publications were retained for the systematic review and individual meta-analyses after screening for inclusion criteria. The random effects meta-analyses were performed on crate versus pen for number of piglets born alive, number of stillborn piglets, pre-weaning mortality, and number of piglets weaned. Additionally, the modifiers of confinement length (no confinement from loading until weaning or partial confinement for shorter periods of time in the early stages post parturition), enrichment (no enrichment or enrichment provided), and pen size (small, medium, or large) were examined. There was a 14% increase in the relative risk of piglet mortality in farrowing pens when they were compared with crates (p = 0.0015). The number of stillborns per litter was not different between the pen and crate. However, when providing enrichment in the pens, there was an increase in stillborns within farrowing crates versus pens (p = 0.009). There was no overall effect on piglets that were born alive or number weaned. As there is no difference between piglets born alive and mortality is significantly higher in farrowing pens, a reduction in the number of piglets weaned was expected but not observed, which was possibly due to the lack of weaning details provided in the publications. This was the first systematic review and meta-analysis conducted on the performance of farrowing accommodation and identified that farrowing pens do compromise post-natal piglet survival. Future efforts should focus on improving sow comfort in the farrowing crate to maximize both piglet and sow welfare.

scholarly journals Estimation in meta-analyses of response ratios

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ilyas Bakbergenuly ◽  
David C. Hoaglin ◽  
Elena Kulinskaya
Keyword(s):  
Meta Analysis ◽  
Weighted Average ◽  
Effective Sample Size ◽  
Logarithmic Scale ◽  
Response Ratio ◽  
Effect Measure ◽  
Interval Estimators ◽  
Point Estimators ◽  
Meta Analyses ◽  
And Control

Abstract Background For outcomes that studies report as the means in the treatment and control groups, some medical applications and nearly half of meta-analyses in ecology express the effect as the ratio of means (RoM), also called the response ratio (RR), analyzed in the logarithmic scale as the log-response-ratio, LRR. Methods In random-effects meta-analysis of LRR, with normal and lognormal data, we studied the performance of estimators of the between-study variance, τ2, (measured by bias and coverage) in assessing heterogeneity of study-level effects, and also the performance of related estimators of the overall effect in the log scale, λ. We obtained additional empirical evidence from two examples. Results The results of our extensive simulations showed several challenges in using LRR as an effect measure. Point estimators of τ2 had considerable bias or were unreliable, and interval estimators of τ2 seldom had the intended 95% coverage for small to moderate-sized samples (n<40). Results for estimating λ differed between lognormal and normal data. Conclusions For lognormal data, we can recommend only SSW, a weighted average in which a study’s weight is proportional to its effective sample size, (when n≥40) and its companion interval (when n≥10). Normal data posed greater challenges. When the means were far enough from 0 (more than one standard deviation, 4 in our simulations), SSW was practically unbiased, and its companion interval was the only option.

scholarly journals A systematic review and meta-analysis of randomized controlled trials for the reduction of surgical site infection in closed incision management versus standard of care dressings over closed vascular groin incisions

Vascular ◽  
2020 ◽  
Vol 28 (3) ◽  
pp. 274-284 ◽  
Author(s):  
Alexander Gombert ◽  
Ellen Dillavou ◽  
Ralph D’Agostino ◽  
Leah Griffin ◽  
Julie M Robertson ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Surgical Site Infection ◽  
Meta Analysis ◽  
Site Infection ◽  
Infection Rates ◽  
Control Groups ◽  
Randomized Controlled ◽  
Risk Patients ◽  
Meta Analyses ◽  
And Control

Objective Surgical site infection after groin incision is a common complication and a financial burden to patients and healthcare systems. Closed incision negative pressure therapy (ciNPT) has been associated with decreased surgical site infection rates in published literature. This meta-analysis examines the effect of ciNPT (PREVENA™ Incision Management System; KCI, San Antonio, TX) versus traditional postsurgical dressing use in reducing surgical site infection rates over closed groin incisions following vascular surgery. Methods A systematic literature search using PubMed, OVID, EMBASE, and QUOSA was performed on 3 January 2019, by two independent researchers and focused on publications between 1 January 2005 and 31 December 2018. The review conformed to the statement and reporting check list of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Inclusion criteria included abstract or manuscript written in English, published studies, conference abstracts, randomized controlled trials (RCTs), ciNPT usage over closed groin incisions in vascular surgery, comparison of ciNPT use and traditional dressings, study endpoint/outcome of surgical site infection, and study population of >10. Characteristics of study participants, surgical procedure, type of dressing used, duration of treatment, incidence of surgical site infection, and length of follow-up were extracted. Weighted odds ratios and 95% confidence intervals were calculated to pool study and control groups in each publication for analysis. Treatment effects were combined using Mantel-Haenszel risk ratios, and the Chi-Square test was used to assess heterogeneity. Overall, high-risk patients, normal-risk patients, and Szilagyi I, II, III outcomes were assessed between ciNPT and control groups. The Cochrane Collaboration tool was utilized to assess the risk of bias for all studies included in the analysis. Results A total of 615 articles were identified from the literature search. After removal of excluded studies and duplicates, six RCT studies were available for analysis. In these studies, a total of 362 patients received ciNPT, and 371 patients received traditional dressings (control). Surgical site infection events occurred in 41 ciNPT patients and 107 control patients. The heterogeneity test was nonsignificant ( p > 0.05). The overall RCT meta-analysis showed a highly significant effect in favor of ciNPT (OR = 3.06, 95% CI [2.05, 4.58], p < 0.05). High-risk, normal-risk, Szilagyi I, and Szilagyi II meta-analyses were also statistically significant in favor of ciNPT use ( p < 0.05). The varying RCT inclusion/exclusion criteria, such as differences in procedure types, and patient populations form the major limitations of this study. Conclusions A statistically significant reduction in the incidence of surgical site infection was seen following ciNPT usage in patients undergoing vascular surgery with groin incisions.

Meta-analysis of Comparative Therapy Outcome Studies: a Reply to Wilson

1982 ◽  
Vol 10 (4) ◽  
pp. 307-310 ◽  
Author(s):  
David A. Shapiro ◽  
Diana Shapiro
Keyword(s):  
Meta Analysis ◽  
Outcome Studies ◽  
Therapy Outcome ◽  
Meta Analyses ◽  
Selection Of

Wilson's recent critique of the authors' appraisal of meta-analysis appears to misunderstand them as claiming more for meta-analysis than they intended. The present paper seeks to clarify consequent confusions concerning selection of studies, the quality of the literature reviewed, the classification of therapies, and the non-identical results of different meta-analyses. It is acknowledged that no single meta-analysis is definitive.

scholarly journals Elucidating the Role of Cerebellar Synaptic Dysfunction in C9orf72-ALS/FTD — a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Aleksandra Kaliszewska ◽  
Joseph Allison ◽  
Tarik-Tarkan Col ◽  
Christopher Shaw ◽  
Natalia Arias
Keyword(s):  
Meta Analysis ◽  
Neuronal Loss ◽  
Synaptic Dysfunction ◽  
Protein Levels ◽  
Hexanucleotide Repeat ◽  
Gene Dysregulation ◽  
Rna Foci ◽  
Synaptic Neurotransmission ◽  
Meta Analyses ◽  
And Control

AbstractA hexanucleotide repeat expansion in the C9orf72 gene is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) with synaptic dysfunction identified as an early pathological hallmark. Although TDP-43 pathology and overt neurodegeneration are largely absent from the cerebellum, the pathological hallmarks of RNA foci and dipeptide repeat protein (DPR) inclusions are most abundant. Here, we present a systematic literature search in the databases of PubMed, Scopus, Embase, Web of Science and Science Direct up until March 5, 2021, which yielded 19,515 publications. Following the exclusion criteria, 72 articles were included having referred to C9orf72, synapses and the cerebellum. Meta-analyses were conducted on studies which reported experimental and control groups with means and standard deviations extracted from figures using the online tool PlotDigitizer. This revealed dendritic defects (P = 0.03), reduced C9orf72 in human patients (P = 0.005) and DPR-related neuronal loss (P = 0.0006) but no neuromuscular junction abnormalities (P = 0.29) or cerebellar neuronal loss (P = 0.23). Our results suggest that dendritic arborisation defects, synaptic gene dysregulation and altered synaptic neurotransmission may drive cerebellar synaptic dysfunction in C9-ALS/FTD. In this review, we discuss how the chronological appearance of the different pathological hallmarks alters synaptic integrity which may have profound implications for disease progression. We conclude that a reduction in C9orf72 protein levels combined with the accumulation of RNA foci and DPRs act synergistically to drive C9 synaptopathy in the cerebellum of C9-ALS/FTD patients.

scholarly journals Association Between Sarcopenic Obesity and Metabolic Syndrome in Adults: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 16 (2) ◽  
pp. 153-162 ◽  
Author(s):  
Dima Khadra ◽  
Leila Itani ◽  
Yomna Chebaro ◽  
May Obeid ◽  
Miryam Jaber ◽  
...  
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Relative Risk ◽  
Meta Analysis ◽  
Sarcopenic Obesity ◽  
Narrative Synthesis ◽  
Inclusion Criteria ◽  
Meta Analyses ◽  
Overweight Or Obesity

Background: In the last two decades, a new phenotype termed Sarcopenic Obesity (SO), in which sarcopenia and obesity coexist, has emerged. Objective: The aim of this systematic review and meta-analysis was first to assess the prevalence of Metabolic syndrome (Mets) among individuals with and without SO, and second, to determine if SO may increase the relative risk of Mets. Methods: This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the data were collated by means of metaanalysis and narrative synthesis. Results: Twelve studies including a total of 11,308 adults with overweight or obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, a similar overall prevalence of Mets in individuals with SO (61.49%; 95% CI: 52.19-70.40) when compared to those without SO (56.74%; 95% CI: 47.32-65.93) was identified. Second, the presence of SO appears not to increase the risk of Mets with respect to those without SO (RR = 1.08, 95% CI: 0.99- 1.17, p = 0.07). Conclusion: No higher prevalence of Mets among individuals with SO when compared to those with obesity only, nor a significant association between SO and a higher risk of Mets was found.

scholarly journals Paclitaxel-Coated or Uncoated Devices: Significant Differences in Patient Populations and Mortality Led to Study Incomparability

2021 ◽  
Author(s):  
Chenyang Zhang ◽  
Guosheng Yin
Keyword(s):  
Relative Risk ◽  
Interim Analysis ◽  
Meta Analysis ◽  
Credible Interval ◽  
Mortality Rates ◽  
Control Groups ◽  
Random Effects Models ◽  
And Control

AbstractThe SWEDEPAD trial reported an unplanned interim analysis to show no difference in the mortality rate between the paclitaxel-coated and uncoated groups (Nordanstig et al., 2020), which contradicts the long-term risk of paclitaxel-coated devices claimed by a meta-analysis (Katsanos et al., 2018). However, there existed significant differences in mortality rates between the SWEDEPAD trial and the trials included in the meta-analysis, which were caused by significant differences in the patient populations. As a result, the SWEDEPAD trial and meta-analysis results are not directly comparable. An updated meta-analysis including the SWEDPEPAD trial and all studies in the meta-analysis (Katsanos et al., 2018) shows marginal differences in mortality rates between the paclitaxel-coated and control groups at two years with Bayesian relative risk (RR) 1.39 (95% credible interval (CrI) [1.01, 2.39]) and frequentist RR 1.16 (95% confidence interval (CI) [0.99, 1.36]) and differences in mortality rates during the entire follow-up period with Bayesian RR 1.29 (95% CrI [1.01, 1.72]) and frequentist RR 1.13 (95% CI [0.99, 1.28]) under random-effects models. Given the relatively short follow-up thus far in the SWEDEPAD trial (with a mean follow-up of 2.49 years) and the paclitaxel-coated risk being long-term (e.g., 4 or 5 years), the interim results on the risk of paclitaxel-coated devices reported by the SWEDEPAD trial warrant further investigation.

scholarly journals Blood-Based ATN Biomarkers of Alzheimer’s Disease: A Meta-Analysis

2021 ◽  
Vol 79 (1) ◽  
pp. 177-195
Author(s):  
Ivan Koychev ◽  
Katrin Jansen ◽  
Alina Dette ◽  
Liu Shi ◽  
Heinz Holling
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Single Molecule ◽  
Meta Analysis ◽  
Random Effect ◽  
Neurofilament Light ◽  
Meta Analyses ◽  
And Control ◽  
T Tau ◽  
Biological State

Background: The Amyloid Tau Neurodegeneration (ATN) framework was proposed to define the biological state underpinning Alzheimer’s disease (AD). Blood-based biomarkers offer a scalable alternative to the costly and invasive currently available biomarkers. Objective: In this meta-analysis we sought to assess the diagnostic performance of plasma amyloid (Aβ40, Aβ42, Aβ42/40 ratio), tangle (p-tau181), and neurodegeneration (total tau [t-tau], neurofilament light [NfL]) biomarkers. Methods: Electronic databases were screened for studies reporting biomarker concentrations for AD and control cohorts. Biomarker performance was examined by random-effect meta-analyses based on the ratio between biomarker concentrations in patients and controls. Results: 83 studies published between 1996 and 2020 were included in the analyses. Aβ42/40 ratio as well as Aβ42 discriminated AD patients from controls when using novel platforms such as immunomagnetic reduction (IMR). We found significant differences in ptau-181 concentration for studies based on single molecule array (Simoa), but not for studies based on IMR or ELISA. T-tau was significantly different between AD patients and control in IMR and Simoa but not in ELISA-based studies. In contrast, NfL differentiated between groups across platforms. Exosome studies showed strong separation between patients and controls for Aβ42, t-tau, and p-tau181. Conclusion: Currently available assays for sampling plasma ATN biomarkers appear to differentiate between AD patients and controls. Novel assay methodologies have given the field a significant boost for testing these biomarkers, such as IMR for Aβ, Simoa for p-tau181. Enriching samples through extracellular vesicles shows promise but requires further validation.

scholarly journals Diabetes as a risk factor for incident peripheral arterial disease in women compared to men: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Alyssa Z. Chase-Vilchez ◽  
Isaac H. Y. Chan ◽  
Sanne A. E. Peters ◽  
Mark Woodward
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Relative Risk ◽  
Meta Analysis ◽  
Arterial Disease ◽  
Excess Risk ◽  
Newcastle Ottawa Scale ◽  
Peripheral Arterial ◽  
Meta Analyses ◽  
Ottawa Scale

Abstract Aims/hypothesis Previous meta-analyses have suggested that diabetes confers a greater excess risk of coronary heart disease, stroke, vascular dementia, and heart failure in women compared to men. While the underlying mechanism that explains such greater excess risk is unknown, in the current meta-analysis we hypothesized that we would find a similar sex difference in the relationship between diabetes and peripheral arterial disease (PAD). Methods PubMed MEDLINE, the Cochrane Database of Systematic Reviews, and Embase were systematically searched for prospective population-based cohort studies, with no restriction on publication date, language, or country. We included studies that reported the relative risk (RR), and its variability, for incident PAD associated with diabetes in both sexes. We excluded studies that did not adjust at least for age, and in which participants had pre-existing PAD. In cases where sex-specific results were not reported, study authors were contacted. Random-effects meta-analyses with inverse variance weighting were used to obtain summary sex-specific RRs and the women: men ratio of RRs for PAD. The Newcastle–Ottawa scale was used to assess study quality. Results Data from seven cohorts, totalling 2071,260 participants (49.8% women), were included. The relative risk for incident PAD associated with diabetes compared with no diabetes was 1.96 (95% CI 1.29–2.63) in women and 1.84 (95% CI 1.29–2.86) in men, after adjusting for potential confounders. The multiple-adjusted RR ratio was 1.05 (95% CI 0.90–1.22), with virtually no heterogeneity between studies (I2 = 0%). All studies scored 6–8, on the Newcastle–Ottawa scale of 0–9, indicating good quality. Eleven of the 12 studies that met review inclusion criteria did not report sex-specific relative risk, and these data were collected through direct correspondence with the study authors. Conclusion/interpretation Consistent with other studies, we found evidence that diabetes is an independent risk factor for PAD. However, in contrast to similar studies of other types of cardiovascular disease, we did not find evidence that diabetes confers a greater excess risk in women compared to men for PAD. More research is needed to explain this sex differential between PAD and other forms of CVD, in the sequelae of diabetes. In addition, we found that very few studies reported the sex-specific relative risk for the association between diabetes and PAD, adding to existing evidence for the need for improved reporting of sex-disaggregated results in cardiovascular disease research.

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