The association between environmental exposures to chlordanes, adiposity and diabetes-related features: a systematic review and meta-analysis

AbstractChlordane compounds (CHLs) are components of technical chlordane listed in the Stockholm convention on persistent organic pollutants identified as endocrine disrupting chemicals (EDCs) and may interfere with hormone biosynthesis, metabolism or action resulting in an unbalanced hormonal function. There is increasing scientific evidence showing EDCs as risk factors in the pathogenesis and development of obesity and obesity-related metabolic syndromes such as type 2 diabetes, but there is no systematized information on the effect of CHLs in humans. Our aim is to identify the epidemiological data on the association between CHLs with adiposity and diabetes using a systematic approach to identify the available data and summarizing the results through meta-analysis. We searched PubMed and Web of Science from inception up to 15 February 2021, to retrieve original data on the association between chlordanes, and adiposity or diabetes. For adiposity, regression coefficients and Pearson or Spearman correlation coefficients were extracted and converted into standardized regression coefficients. Data were combined using fixed effects meta-analyses to compute summary regression coefficients and corresponding 95% confidence intervals (95% CI). For the association between chlordanes and diabetes, Odds ratios (ORs) were extracted and the DerSimonian and Laird method was used to compute summary estimates and respective 95% CI. For both, adjusted estimates were preferred, whenever available. Among 31 eligible studies, mostly using a cross-sectional approach, the meta-analysis for adiposity was possible only for oxychlordane and transchlordane, none of them were significantly associated with adiposity [(β = 0.04, 95% CI 0.00; 0.07, I2 = 89.7%)] and (β = 0.02, 95% CI − 0.01; 0.06), respectively. For diabetes, the estimates were positive for all compounds but statistically significant for oxychlordane [OR = 1.96 (95% CI 1.19; 3.23)]; for trans-nonachlor [OR = 2.43 (95% CI 1.64; 3.62)] and for heptachlor epoxide [OR = 1.88 (95% CI 1.42; 2.49)]. Our results support that among adults, the odds of having diabetes significantly increase with increasing levels of chlordanes. The data did not allow to reach a clear conclusion regarding the association with adiposity.

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Is Visual Pedagogy Effective in Improving Cooperation towards Oral Hygiene and Dental Care in Children with Autism Spectrum Disorder? A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020789 ◽

2021 ◽

Vol 18 (2) ◽

pp. 789

Author(s):

Araxi Balian ◽

Silvia Cirio ◽

Claudia Salerno ◽

Thomas Gerhard Wolf ◽

Guglielmo Campus ◽

...

Keyword(s):

Dental Care ◽

Oral Hygiene ◽

Meta Analysis ◽

Scientific Evidence ◽

Case Series ◽

Children With Autism ◽

Autism Spectrum ◽

Conclusive Evidence ◽

Cross Sectional ◽

Visual Pedagogy

Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during dental care in children with ASDs. The review protocol was registered on the PROSPERO Register (CRD42020183030). Prospective clinical studies, randomized trials, interruptive case series, before and after comparison studies, and cross-sectional studies following the PRISMA guideline were searched in PubMed, Embase, Scopus, and Google Scholar using ad hoc prepared search strings. The search identified 379 papers, of which 342 were excluded after title and abstract evaluation, and 37 full-text papers were analyzed. An additional four papers were added after consulting reference lists. Eighteen papers were disregarded; 23 were finally included, and their potential bias was assessed using ROB-2 and ROBINS-I tools. The wide heterogenicity of the studies included does not allow for conclusive evidence on the effectiveness of visual pedagogy in oral hygiene skills and dental care. Nevertheless, a significant and unilateral tendency of the overall outcomes was found, suggesting that visual pedagogy supports ASD children in improving both oral hygiene skills and cooperation during dental care.

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Epidemiological evidence relating environmental smoke to COPD in lifelong non-smokers: a systematic review

F1000Research ◽

10.12688/f1000research.13887.1 ◽

2018 ◽

Vol 7 ◽

pp. 146 ◽

Cited By ~ 3

Author(s):

Peter N. Lee ◽

Barbara A. Forey ◽

Katharine J. Coombs ◽

Jan S. Hamling ◽

Alison J. Thornton

Keyword(s):

Meta Analysis ◽

Middle Eastern ◽

Epidemiological Data ◽

Case Control ◽

Chronic Obstructive ◽

Exposure Index ◽

Bias Estimation ◽

Case Control Studies ◽

Cross Sectional ◽

Main Index

Background: Some evidence suggests environmental tobacco smoke (ETS) might cause chronic obstructive pulmonary disease (COPD). We reviewed available epidemiological data in never smokers. Methods: We identified epidemiological studies providing estimates of relative risk (RR) with 95% confidence interval (CI) for various ETS exposure indices. Confounder-adjusted RRs for COPD were extracted, or derived using standard methods. Meta-analyses were conducted for each exposure index, with tests for heterogeneity and publication bias. For the main index (spouse ever smoked or nearest equivalent), analyses investigated variation in RR by location, publication period, study type, sex, diagnosis, study size, confounder adjustment, never smoker definition, and exposure index definition. Results: Twenty-eight relevant studies were identified; nine European or Middle Eastern, nine Asian, eight American and two from multiple countries. Five were prospective, seven case-control and 16 cross-sectional. The COPD definition involved death or hospitalisation in seven studies, GOLD stage 1+ criteria in twelve, and other definitions in nine. For the main index, random-effects meta-analysis of 33 heterogeneous (p<0.001) estimates gave a RR of 1.20 (95%CI 1.08-1.34). Higher estimates for females (1.59,1.16-2.19, n=11) than males (1.29,0.94-1.76, n=7) or sexes combined (1.10,0.99-1.22, n=15 where sex-specific not available), and lower estimates for studies of 150+ cases (1.08,0.97-1.20, n=13) partly explained the heterogeneity. Estimates were higher for Asian studies (1.34,1.08-1.67, n=10), case-control studies (1.55,1.04-2.32, n=8), and COPD mortality or hospitalisation (1.40,1.12-1.74, n=11). Some increase was seen for severer COPD (1.29,1.10-1.52, n=7). Dose-response evidence was heterogeneous. Evidence for childhood (0.88,0.72-1.07, n=2) and workplace (1.12,0.77-1.64, n=4) exposure was limited, but an increase was seen for overall adulthood exposure (1.20,1.03-1.39, n=17). We discuss study weaknesses that may bias estimation of the association of COPD with ETS. Conclusions: Although the evidence suggests ETS increases COPD, study weaknesses and absence of well-designed large studies precludes reliable inference of causality. More definitive evidence is required.

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Total Dairy, Cheese and Milk Intake and Arterial Stiffness: A Systematic Review and Meta-Analysis of Cross-sectional Studies.

Nutrients ◽

10.3390/nu11040741 ◽

2019 ◽

Vol 11 (4) ◽

pp. 741 ◽

Cited By ~ 8

Author(s):

Ana Diez-Fernández ◽

Celia Álvarez-Bueno ◽

Vicente Martínez-Vizcaíno ◽

Mercedes Sotos-Prieto ◽

José Recio-Rodríguez ◽

...

Keyword(s):

Systematic Review ◽

Arterial Stiffness ◽

Dairy Products ◽

Fixed Effects ◽

Meta Analysis ◽

Dairy Product ◽

Milk Intake ◽

Cross Sectional ◽

Product Consumption ◽

Dairy Product Consumption

The aim of this review was to determine the relationship between dairy product consumption and arterial stiffness, measured by pulse wave velocity (PWV). We systematically searched the Medline, Embase and Web of Science databases until 30th January 2019 for cross-sectional data from studies addressing the association between dairy product consumption and PWV. This study was registered with PROSPERO (CRD42018110528). Both the inverse-variance fixed effects method and the DerSimonian and Laird method were used to compute pooled estimates of effect size (ES) and the respective 95% confidence intervals (CIs). Seven studies were included in the meta-analysis, with a total of 16,443 patients. Total dairy product (ES = −0.03; 95% CI [−0.04, −0.01]) and cheese (ES = −0.04; 95% CI [−0.07, −0.01]) consumption were weak, but significantly associated with lower PWV levels. Conversely, milk intake showed no significant association with PWV (ES = 0.02; 95% CI [−0.01, 0.05]). Heterogeneity in the ES was not important for the three groups of dairy products assessed. This systematic review and meta-analysis of seven studies found no detrimental effects of dairy product consumption on arterial stiffness measured by PWV. Due to the scarcity of studies, further investigations are warranted to clarify the role of dairy products on arterial stiffness.

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Do early life “non-cognitive skills” matter? A systematic review and meta-analysis of early life effects on academic achievement, psychosocial, language and cognitive, and health outcomes

10.1101/115691 ◽

2017 ◽

Cited By ~ 1

Author(s):

Lisa G. Smithers ◽

Alyssa C. P. Sawyer ◽

Catherine R. Chittleborough ◽

Neil Davies ◽

George Davey Smith ◽

...

Keyword(s):

Systematic Review ◽

Academic Achievement ◽

Study Design ◽

Early Life ◽

Cognitive Skills ◽

Fixed Effects ◽

Meta Analysis ◽

Self Regulation ◽

Sample Type ◽

Cross Sectional

AbstractBackgroundSuccess in school and the labour market is due to more than just high intelligence. Associations between traits such as attention, self-regulation, and perseverance in childhood, and later outcomes have been investigated by psychologists, economists, and epidemiologists. Such traits have been loosely referred to as “non-cognitive” skills. There has been no attempt to systematically assess the relative importance of non-cognitive skills in early life on later outcomes.MethodsThe systematic review protocol was registered with the International Prospective Register for Systematic Reviews (PROSPERO, CRD42013006566) in December 2013. We systematically reviewed electronic databases covering psychology, education, health and economics for articles published from database conception until September 2015. Titles and abstracts were screened for eligibility, and from eligible articles data was extracted on study design, sample type and size, age of participants at exposure and outcome, loss to follow up, measurement of exposure and outcome, type of intervention and comparison group, confounding adjustment and results. Where possible we extracted a standardised effect size. We reviewed all studies and rated their evidence quality as ‘better, weak, or poor’ on the basis of study design and potential for confounding, selection and measurement bias.ResultsWe reviewed 375 studies and provided interpretation of results from 142 (38%) better quality studies comprising randomised controlled trials, quasi-experimental, fixed effects including twin studies, longitudinal and some cross-sectional designs that made reasonable attempts to control confounding. In the academic achievement category outcomes were reported in 78 publications of better quality studies which were consistent with 0.1-0.2 SD effects.Psychosocial outcomes were reported in 65 better quality studies consistent with effects of 0.3-0.4 SD. For the language and cognitive category there were 42 publications reporting better quality studies consistent with effects of 0.3-0.4 SD. For physical health, results across only eight better quality studies were inconsistent but centred around zero. Analysis of funnel plots consistently showed asymmetric distributions, raising the potential of small study bias which may inflate these observed effects.ConclusionsThe evidence under-pinning the importance of non-cognitive skills for life success is diverse and inconsistent. Nevertheless, there is tentative evidence from published studies that non-cognitive skills associate with modest improvements in academic achievement, psychosocial, and language and cognitive outcomes with effects in the range of 0.2-0.4 SD. The quality of evidence under-pinning this field is generally low with more than a third of studies making little or no attempt to control even the most basic confounding (endogeneity) bias. The evidence could be improved by adequately powering studies, and using procedures and tools that improve the conduct and reporting of RCTs and observational studies. Interventions designed to develop children’s non-cognitive skills could potentially improve opportunities, particularly for disadvantaged children. The inter-disciplinary researchers interested in these skills should take a more rigorous approach to determine which interventions are most effective.

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Nicotine products relative risk assessment: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.26762.1 ◽

2020 ◽

Vol 9 ◽

pp. 1225

Author(s):

Rachel Murkett ◽

Megyn Rugh ◽

Belinda Ding

Keyword(s):

Systematic Review ◽

Relative Risk ◽

Electronic Cigarettes ◽

Meta Analysis ◽

Scientific Evidence ◽

Final Analysis ◽

Epidemiological Data ◽

Risk Scores ◽

Chewing Tobacco ◽

Relative Risk Assessment

Background: Nicotine products have been the subject of considerable innovation over the past few decades. While the health risks of combustible cigarettes and most tobacco-based products are well characterized, there is less clarity regarding newer nicotine products, and how they compare with the traditional forms. Methods: In this study, we have developed a relative risk hierarchy (RRH) of 13 nicotine products based on systematic review of the scientific literature and analysis of the best available evidence. In total, 3980 publications were identified and screened, with 320 studies being carried through to the final analysis. The health risk data for each product was extracted and the level assessed. The products were analyzed in terms of their toxin emissions and epidemiological data, which were combined on an arbitrary scale from 0 to 100 (low to high risk) to derive a combined risk score for each nicotine product. Results: Combustible tobacco products dominate the top of the RRH, with combined risk scores ranging from 40 to 100. The most frequently consumed products generally score highest. Dipping and chewing tobacco place considerably lower on the hierarchy than the combustible products with scores of 10 to 15, but significantly above heat-not-burn devices and snus, which score between 3 and 4. The lowest risk products have scores of less than 0.25 and include electronic cigarettes, non-tobacco pouches and nicotine replacement therapy. Conclusions: The RRH provides a framework for the assessment of relative risk across all categories of nicotine products based on the best available evidence regarding their toxin emissions and the observed risk of disease development in product users. As nicotine products continue to evolve, and more data comes to light, the analyses can be updated to represent the best available scientific evidence.

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Association between Body Composition and Bone Mineral Density in Children and Adolescents: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182212126 ◽

2021 ◽

Vol 18 (22) ◽

pp. 12126

Author(s):

Kai-Li Deng ◽

Wan-Yu Yang ◽

Jin-Li Hou ◽

Hui Li ◽

Hao Feng ◽

...

Keyword(s):

Bone Mineral Density ◽

Systematic Review ◽

Body Composition ◽

Children And Adolescents ◽

Bone Mineral ◽

Meta Analysis ◽

Correlation Coefficients ◽

Regression Coefficients ◽

Mineral Density ◽

Total Body

Background: Bone mass acquisition during growth is a major determinant of the risk of developing osteoporosis later in life. Body composition is an anthropometric determinant of bone mineral density (BMD) and significantly influences its development during childhood and adolescence. Objective: This study aimed to systematically examine the association between body composition and bone mineral density in children and adolescents. Methods: Observational studies addressing this association were identified from PubMed (MEDLINE), Embase, Scopus and the Cochrane Library (up to January 2021). The study populations consisted of healthy children and adolescents. The DerSimonian and Laird method was used to compute pooled estimates of effect size and the respective 95% confidence intervals for upper limbs, femoral neck (FN), lumbar spine (LS) and total body, respectively. Subgroup analyses were further performed based on age, sex and ethnicity. Results: Thirty-one published studies were eligible for inclusion in this systematic review and meta-analysis, including three longitudinal studies. The combined population from all the studies amounted to 21,393 (11,205 males and 10,188 females). The pooled estimates of the correlation coefficients for lean mass (LM) and BMD ranged from 0.53 to 0.74 (p < 0.050), and the pooled regression coefficients ranged from 0.23 to 0.79 for FN, LS and total body (p < 0.050). For fat mass (FM), the pooled correlation coefficients ranged from 0.10 to 0.50 (p < 0.050) and the pooled regression coefficient was only significant for FN BMD with a weak strength (pooled β = 0.07, p < 0.050). The pooled regression coefficients for body fat percentage (BF%) were between −0.54 and −0.04 (p < 0.050). The subgroup analysis revealed a stronger association in Asians than in Caucasians for LM and in males compared to females for BF% (p < 0.050). Conclusions: This systematic review and meta-analysis supports a positive association between LM and BMD. BF% appears to have a deleterious effect on bone acquisition in children and adolescents.

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Association between eczema and major cardiovascular outcomes in population-based studies: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2017-017979 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017979 ◽

Cited By ~ 1

Author(s):

Anna Ascott ◽

Ashley M Yu ◽

Morten Schmidt ◽

Katrina Abuabara ◽

Liam Smeeth ◽

...

Keyword(s):

Systematic Review ◽

Inflammatory Diseases ◽

Data Extraction ◽

Meta Analysis ◽

Epidemiological Data ◽

Epidemiological Studies ◽

Cardiovascular Death ◽

Population Based ◽

Cardiovascular Outcomes ◽

Cross Sectional

IntroductionChronic inflammatory diseases such as eczema (also known as atopic dermatitis) have been inconsistently linked to cardiovascular disease and stroke in both mechanistic and epidemiological studies. There is a need to review the existing epidemiological data examining the association between eczema and major cardiovascular outcomes, including angina, myocardial infarction, coronary revascularisation, heart failure, cardiac arrhythmias, stroke and cardiovascular death, in order to improve our understanding of the comorbidities of eczema.Methods and analysisWe will systematically review population-based studies, including cohort, case–control and cross-sectional studies, reporting on the association between eczema and cardiovascular outcomes. We will search Medline, Embase and Global Health, from their date of inception to April 2017, using a comprehensive search strategy formulated with the help of a librarian. Two reviewers will independently screen titles and abstracts in duplicate, followed by independent data extraction and quality assessment. We will group studies by the cardiovascular outcome under study and synthesise them narratively. If sufficient numbers of homogeneous studies are returned, we will perform meta-analyses to obtain pooled effect estimates. Preferred Reporting Items for Systematic Review and Meta-Analysis will be used to inform the reporting of this study.Trial registration numberCRD42017060359.

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Meta-analytic Gaussian Network Aggregation

Psychometrika ◽

10.1007/s11336-021-09764-3 ◽

2021 ◽

Author(s):

Sacha Epskamp ◽

Adela-Maria Isvoranu ◽

Mike W.-L. Cheung

Keyword(s):

Graphical Models ◽

Fixed Effects ◽

Large Scale ◽

Meta Analysis ◽

Correlation Coefficients ◽

Likelihood Estimation ◽

Post Traumatic Stress ◽

Modeling Framework ◽

Network Aggregation ◽

Gaussian Network

AbstractA growing number of publications focus on estimating Gaussian graphical models (GGM, networks of partial correlation coefficients). At the same time, generalizibility and replicability of these highly parameterized models are debated, and sample sizes typically found in datasets may not be sufficient for estimating the underlying network structure. In addition, while recent work emerged that aims to compare networks based on different samples, these studies do not take potential cross-study heterogeneity into account. To this end, this paper introduces methods for estimating GGMs by aggregating over multiple datasets. We first introduce a general maximum likelihood estimation modeling framework in which all discussed models are embedded. This modeling framework is subsequently used to introduce meta-analytic Gaussian network aggregation (MAGNA). We discuss two variants: fixed-effects MAGNA, in which heterogeneity across studies is not taken into account, and random-effects MAGNA, which models sample correlations and takes heterogeneity into account. We assess the performance of MAGNA in large-scale simulation studies. Finally, we exemplify the method using four datasets of post-traumatic stress disorder (PTSD) symptoms, and summarize findings from a larger meta-analysis of PTSD symptom.

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Association between hormonal therapy and craniofacial development in subjects between 10 and 18 years of age. Systematic review

Revista Estomatología ◽

10.25100/re.v22i2.5779 ◽

2017 ◽

Vol 22 (2) ◽

pp. 27-34

Author(s):

Juliana Isabel Ceballos ◽

Sebastián Pineda ◽

Zulma Vanesa Rueda ◽

María Clara Lema ◽

Natalia Johnson

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Scientific Evidence ◽

Hormonal Treatment ◽

Hormone Treatment ◽

Hormone Deficiency ◽

Case Control Studies ◽

Hormone Substitution ◽

Cross Sectional ◽

Long Term Treatment

Background: Hormone deficiency could affect craniofacial complex during esqueletal growth and development. Objective: Determine whether there is scientific evidence of the association between hormonal treatment and craniofacial growth measured by cephalometry films, in subjects of 10 to 18 years with hormonaltreatment. Materials and Methods: A systematic review. For the articles published in PubMed, Google Scholar, Lilacs, Embase and Science Direct databases, without restriction of publication year was performed. Clinicaltrials, case control studies, cohort, systematic reviews and meta analysis studies were included. Reading f the abstracts and the complete articles were made by two researchers. Results: Among 1085 articles found, 1074 were excluded because did not meet the inclusion criteria. After complete reading of the articles, five were excluded because they were cross-sectional studies and one was not recovered in the full text. In total, 6 articles were included. These studies report that patients who were treated with hormone substitution therapy showed favorable changes in their craniofacial structures, especially in mandibular total length, ramus length and mandibular body length. These positive changes led to an improvement in profile, inter-maxillary relations, and other osseous body structures. Conclusions: Despite the heterogeneity of the studies it was found that early replacement with hormone treatment, regardless of the dose and long-term treatment, accelerates the development of craniofacial structures, mainly the mandible, to reach the skeletal patterns genetically established. Studies are required to evaluate replacehormone treatment in patients without additional systemic compromises.

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Epidemiological evidence relating environmental smoke to COPD in lifelong non-smokers: a systematic review

F1000Research ◽

10.12688/f1000research.13887.3 ◽

2020 ◽

Vol 7 ◽

pp. 146

Author(s):

Peter N. Lee ◽

Barbara A. Forey ◽

Katharine J. Coombs ◽

Jan S. Hamling ◽

Alison J. Thornton

Keyword(s):

Meta Analysis ◽

Middle Eastern ◽

Epidemiological Data ◽

Case Control ◽

Chronic Obstructive ◽

Exposure Index ◽

Bias Estimation ◽

Case Control Studies ◽

Cross Sectional ◽

Main Index

Background: Some evidence suggests environmental tobacco smoke (ETS) might cause chronic obstructive pulmonary disease (COPD). We reviewed available epidemiological data in never smokers. Methods: We identified epidemiological studies providing estimates of relative risk (RR) with 95% confidence interval (CI) for various ETS exposure indices. Confounder-adjusted RRs for COPD were extracted, or derived using standard methods. Meta-analyses were conducted for each exposure index, with tests for heterogeneity and publication bias. For the main index (spouse ever smoked or nearest equivalent), analyses investigated variation in RR by location, publication period, study type, sex, diagnosis, study size, confounder adjustment, never smoker definition, and exposure index definition. Results: Twenty-eight relevant studies were identified; nine European or Middle Eastern, nine Asian, eight American and two from multiple countries. Five were prospective, seven case-control and 16 cross-sectional. The COPD definition involved death or hospitalisation in seven studies, GOLD stage 1+ criteria in twelve, and other definitions in nine. For the main index, random-effects meta-analysis of 33 heterogeneous (p<0.001) estimates gave a RR of 1.20 (95%CI 1.08-1.34). Higher estimates for females (1.59,1.16-2.19, n=11) than males (1.29,0.94-1.76, n=7) or sexes combined (1.10,0.99-1.22, n=15 where sex-specific not available), and lower estimates for studies of 150+ cases (1.08,0.97-1.20, n=13) partly explained the heterogeneity. Estimates were higher for Asian studies (1.34,1.08-1.67, n=10), case-control studies (1.55,1.04-2.32, n=8), and COPD mortality or hospitalisation (1.40,1.12-1.74, n=11). Some increase was seen for severer COPD (1.29,1.10-1.52, n=7). Dose-response evidence was heterogeneous. Evidence for childhood (0.88,0.72-1.07, n=2) and workplace (1.12,0.77-1.64, n=4) exposure was limited, but an increase was seen for overall adulthood exposure (1.20,1.03-1.39, n=17). We discuss study weaknesses that may bias estimation of the association of COPD with ETS. Conclusions: Although the evidence strongly suggests that ETS increases COPD, study weaknesses and absence of well-designed large studies preclude reliable effect estimation. More definitive evidence is required.

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