Possible predictors of phenoconversion in isolated REM sleep behaviour disorder: a systematic review and meta-analysis

2021 ◽  
pp. jnnp-2021-328062
Author(s):  
Chunyi Wang ◽  
Fangzheng Chen ◽  
Yuanyuan Li ◽  
Jun Liu
Keyword(s):  
Fixed Effects ◽  
Large Scale ◽  
Comprehensive Evaluation ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Motor Dysfunction ◽  
Electromyographic Activity ◽  
Behaviour Disorder ◽  
Sleep Behaviour ◽  
Mean Differences

BackgroundA number of promising biomarkers for predicting imminent α-synucleinopathies have been suggested in isolated rapid eye movement sleep behaviour disorder (iRBD). However, existing evidence is conflicting without quantitative evaluation.MethodsPubMed, Web of Science and ClinicalTrials.gov were searched through June 2021 to identify possible predictors of phenoconversion from iRBD to Parkinson’s disease (PD). The pooled HRs and standardised mean differences (SMDs) with 95% CIs were calculated using fixed-effects or random-effects model.ResultsA total of 123 studies were included in the meta-analysis. Significant motor dysfunction (HR 1.83, 95% CI 1.33 to 2.51, I2=86.8%, p<0.001), constipation (HR 1.52, 95% CI 1.26 to 1.84, I2=8.3%, p=0.365), orthostatic hypotension (HR 1.93, 95% CI 1.05 to 3.53, I2=54.9%, p=0.084), hyposmia (HR 2.78, 95% CI 1.83 to 4.23, I2=23.9%, p=0.255), mild cognitive impairment (HR 2.27, 95% CI 1.58 to 3.27, I2=0%, p=0.681) and abnormal colour vision (SMD −0.34, 95% CI −0.63 to −0.05, I2=45.6%, p=0.087) correlated with susceptibility to PD. The process can also be traced by putaminal dopamine transporter imaging (HR 2.60, 95% CI 1.94 to 3.48, I2=0%, p=0.781) and tonic electromyographic activity (HR 1.50, 95% CI 1.04 to 2.15, I2=70%, p=0.018).ConclusionsThe predictive value of each biomarker was initially highlighted with comprehensive evaluation. Combining specific predictors with high sensitivity is promising for detecting phenoconversion in the prodromal stage. Large-scale and multicentre studies are pivotal to extend our findings.

Serum Copper Level and Polycystic Ovarian Syndrome: A Meta-Analysis

2021 ◽  
pp. 1-8
Author(s):  
Qingtao Jiang ◽  
Feng Zhang ◽  
Lei Han ◽  
Baoli Zhu ◽  
Xin Liu
Keyword(s):  
Large Scale ◽  
Polycystic Ovarian Syndrome ◽  
Meta Analysis ◽  
Serum Copper ◽  
Copper Level ◽  
Serum Copper Level ◽  
Copper Status ◽  
Plasma Copper ◽  
Mean Differences ◽  
Ovarian Syndrome

<b><i>Introduction:</i></b> The association of serum copper with polycystic ovarian syndrome (PCOS) has been studied for years, but no definite conclusion is drawn. Therefore, we conducted a meta-analysis to investigate serum copper concentrations in PCOS subjects compared with healthy controls. <b><i>Methods:</i></b> Electronic search was performed in PubMed, Google Scholar, and Scopus up to June 30, 2020, without any restriction. Standardized mean differences (SMDs) with corresponding 95% CIs in serum copper levels were employed with random-effects model. <i>I</i><sup>2</sup> was applied to evaluate heterogeneity among studies. <b><i>Results:</i></b> Nine studies, measuring plasma copper levels in 1,168 PCOS patients and 1,106 controls, were included. Pooled effect size suggested serum copper level was significantly higher in women with PCOS (SMD = 0.51 μg/mL, 95% CI = [0.30, 0.72], <i>p</i> &#x3c; 0.0001). The overall heterogeneity was not connected with subgroups of the country, but derived from the opposite result of 1 study. <b><i>Conclusion:</i></b> Our research generally indicated circulating copper level in PCOS sufferers was significantly higher than normal controls. Large-scale studies are still needed to elucidate the clear relation between copper status and etiology of PCOS.

scholarly journals A Systematic Review and Meta-Analysis of Molecular Biomarkers Associated with Early Neurological Deterioration Following Acute Stroke

2018 ◽  
Vol 46 (5-6) ◽  
pp. 230-241 ◽  
Author(s):  
Alexander J. Martin ◽  
Christopher I. Price
Keyword(s):  
Ischaemic Stroke ◽  
Acute Stroke ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Neurological Status ◽  
Neurological Deterioration ◽  
Increased Risk ◽  
Early Neurological Deterioration

Background: Early neurological deterioration (END) following acute stroke is associated with poorer long-term outcomes. Identification of patients at risk could assist early monitoring and treatment decisions. This review summarised the evidence describing non-radiological biomarkers for END. Summary: Electronic searches from January 1990 to March 2017 identified studies reporting a blood/cerebrospinal fluid (CSF)/urine biomarker measurement within 24 h of acute stroke and at least 2 serial assessments of clinical neurological status (< 24 h and < 7 days). Out of 12,895 citations, 82 studies were included, mostly focusing on ischaemic stroke. Using higher neurological thresholds, the n-weighted END incidence for ischaemic stroke was 11.9% (95% CI 11.4–12.4%) and 18.6% (17.9–19.2%) for lower thresholds. Incidence decreased with advancing study publication year (Pearson r-squared 0.23 and 0.15 for higher and lower threshold studies). After classification into 3 broad categories, meta-analysis showed that biomarkers associated with increased END risk (n; fixed-effects mean difference; 95% CI) were “metabolic” (glucose [n = 9,481; 0.90 mmol/L; 0.74–1.06], glycosylated haemoglobin [n = 3,146; 0.33%; 0.19–0.46], low-density lipoprotein [n = 4,839; 0.13 mmol/L; 0.06–0.21], total cholesterol [n = 4,762; 0.21 mmol/L; 0.11–0.31], triglycerides [n = 4,820; 0.11 mmol/L; 0.06–0.17], urea [n = 1,351; 0.55 mmol/L; 0.14–0.96], decreasing albumin [n = 513; 0.33 g/dL; 0.05–0.61]); “inflammatory and excitotoxic” (plasma glutamate [n = 688; 60.13 µmol/L; 50.04–70.22], CSF glutamate [n = 369; 7.50 µmol/L; 6.76–8.23], homocysteine [n = 824; 2.15 µmol/L; 0.68–3.61], leucocytes [n = 3,766; 0.54 × 109/L; 0.34–0.74], high-sensitivity C-reactive protein [n = 1,707; 3.79 mg/L; 1.23–6.35]); and “coagulation/haematological” (fibrinogen [n = 3,132; 0.32 g/L; 0.25–0.40]; decreasing haemoglobin [n = 3,586; 2.38 g/L; 0.15–4.60]). Key Messages: Declining incidence of END may represent improving care standards; however, it remains a frequent occurrence. Although statistical associations exist between biomarkers and an increased risk of END, the most promising still need prospective evaluation to determine their additional value relative to baseline radiological and clinical characteristics.

scholarly journals Curative Effects of Fuzheng Huayu on Liver Fibrosis and Cirrhosis: A Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Shu Dong ◽  
Qi-Long Chen ◽  
Shi-Bing Su
Keyword(s):  
Hyaluronic Acid ◽  
Liver Fibrosis ◽  
Fixed Effects ◽  
Total Bilirubin ◽  
Meta Analysis ◽  
Life Quality ◽  
Alanine Transaminase ◽  
Random Effects Model ◽  
Type Iv ◽  
Mean Differences

The Fuzheng Huayu (FZHY) formula is being used in antiliver fibrosis treatment in China. For systemic evaluation of the curative effects of FZHY on liver fibrosis and cirrhosis progress, a total of 1392 subjects (714 cases and 678 controls) were found to be eligible for meta-analysis in this study. Standard mean differences (SMDs) with 95% confidence interval (CI) were calculated for changes between FZHY groups and controls by employing fixed effects or random effects model. In the overall analysis, alanine transaminase (ALT) (P=0.003, SMD = −0.87, 95% CI: −1.46 to −0.29), total bilirubin (TBil) (P=0.001, SMD = −1.30, 95% CI: −2.10 to −0.50), hyaluronic acid (HA) (P=0.000, SMD = −0.94, 95% CI: −1.30 to −0.58), laminin (LN) (P=0.000, SMD = −0.80, 95% CI: −1.20 to −0.41), type III procollagen (PC-III) (P=0.000, SMD = −1.27, 95% CI: −1.93 to −0.60), and type IV procollagen (IV-C) (P=0.000, SMD = −0.78, 95% CI: −1.05 to −0.51) were decreased after FZHY treatment; however, albumin (ALB) was increased (P=0.037, SMD = 1.10, 95% CI: 0.07 to 2.12) significantly. Furthermore, the Child-Pugh score was reduced significantly and the life quality was improved after FZHY treatment in cirrhosis patients. The results of this meta-analysis indicated that FZHY effectively improves the liver function, alleviates hepatic fibrosis, decreases Child-Pugh score, and relieves TCM symptoms caused by liver dysfunction, indicating that FZHY may contribute to the alleviation of liver fibrosis and cirrhosis.

scholarly journals Music Therapy in Pain and Anxiety Management during Labor: A Systematic Review and Meta-Analysis

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 526
Author(s):  
Rocio Santiváñez-Acosta ◽  
Elena de las Nieves Tapia-López ◽  
Marilina Santero
Keyword(s):  
Music Therapy ◽  
Pain Intensity ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Final Analysis ◽  
Beneficial Effects ◽  
Quasi Experimental ◽  
Vas Scores ◽  
Mean Differences

Background and Objective: The study of music therapy in labor is unknown. The main objective of this research was to evaluate the effectiveness of music therapy to manage pain and anxiety during labor. Materials and Methods: A search strategy was used with PubMed/MEDLINE, LILACS, Cochrane, TRIPDATABASE, and Google Scholar. The selection criteria were based on randomized clinical trials; quasi-experimental research on pain intensity and anxiety during labor was evaluated. The primary outcomes were measured by the Visual Analogue Scale (VAS). A meta-analysis of the fixed effects was performed using mean differences (MD). Twelve studies were included for the final analysis, six (778 women) of which were meta-analyzed. Results: Decreased VAS scores for pain intensity associated with music therapy were found in the latent (MD: −0.73; 95% CI −0.99; −0.48) and active (MD: −0.68; 95% CI −0.92; –0.44) phases of labor. VAS scores for anxiety decreased both in the latent (MD: −0.74; 95% CI −1.00; −0.48) and active (MD: −0.76; 95% CI −0.88; −0.64) phases. Conclusion: Music therapy seems to have beneficial effects on pain intensity and anxiety during labor, especially for women giving birth for the first time. However, the evidence is qualified as low.

scholarly journals Identifying small-effect genetic associations overlooked by the conventional fixed-effect model in a large-scale meta-analysis of coronary artery disease

2019 ◽  
Author(s):  
Lerato E Magosi ◽  
Anuj Goel ◽  
Jemma C Hopewell ◽  
Martin Farrall
Keyword(s):  
Random Effects ◽  
Complex Traits ◽  
Large Scale ◽  
Meta Analysis ◽  
Genetic Effect ◽  
High Sensitivity ◽  
Fixed Effect Model ◽  
Fixed Effect ◽  
Supplementary Information ◽  
Genetic Associations

Abstract Motivation Common small-effect genetic variants that contribute to human complex traits and disease are typically identified using traditional fixed-effect (FE) meta-analysis methods. However, the power to detect genetic associations under FE models deteriorates with increasing heterogeneity, so that some small-effect heterogeneous loci might go undetected. A modified random-effects meta-analysis approach (RE2) was previously developed that is more powerful than traditional fixed and random-effects methods at detecting small-effect heterogeneous genetic associations, the method was updated (RE2C) to identify small-effect heterogeneous variants overlooked by traditional fixed-effect meta-analysis. Here, we re-appraise a large-scale meta-analysis of coronary disease with RE2C to search for small-effect genetic signals potentially masked by heterogeneity in a FE meta-analysis. Results Our application of RE2C suggests a high sensitivity but low specificity of this approach for discovering small-effect heterogeneous genetic associations. We recommend that reports of small-effect heterogeneous loci discovered with RE2C are accompanied by forest plots and standardized predicted random-effects statistics to reveal the distribution of genetic effect estimates across component studies of meta-analyses, highlighting overly influential outlier studies with the potential to inflate genetic signals. Availability and implementation Scripts to calculate standardized predicted random-effects statistics and generate forest plots are available in the getspres R package entitled from https://magosil86.github.io/getspres/. Supplementary information Supplementary data are available at Bioinformatics online.

scholarly journals Irreversible Electroporation in Patients with Pancreatic Cancer: How Important Is the New Weapon?

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Guo Tian ◽  
Xueping Liu ◽  
Qiyu Zhao ◽  
Danxia Xu ◽  
Tian’an Jiang
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Fixed Effects ◽  
Large Scale ◽  
Meta Analysis ◽  
Irreversible Electroporation ◽  
Complete Response ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
Secondary Outcomes

Background. Pancreatic cancer (PC) is a deadly disease with poor prognosis in the general population. We aimed to quantitate overall survival of patients with PC after irreversible electroporation (IRE) and the incidence of relevant complications. Methods. We performed a literature search via five electronic databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases) up to August 2017. The primary outcomes were overall survival and prognosis. Secondary outcomes included the response of post-IRE complications. Fixed-effects or random-effects meta-analysis was conducted to pool these data. Results. A total of 15 eligible articles involving 535 patients were included. The primary outcomes showed that the pooled prevalence estimates of overall survival were 94.1% (95% CI: 90.7–97.5), 80.9% (95% CI: 72.5–89.4), 54.5% (95% CI: 38.3–70.6), and 33.8% (95% CI: 14.2–53.5) at 3, 6, 12, and 24 months, and the pooled prevalence data of complete response (CR) at 2 months, partial response (PR) at 3 months, and progression at 3 months were 12.5% (95% CI: 2.9–22.2), 48.5% (95% CI: 39.4–57.6), and 19.7% (95% CI: 7.3–32.2), respectively. The secondary outcomes showed that the pooled prevalence values of post-IRE complications were abscess 6.6% (95% CI: 0.2–13), fistula 10.6% (95% CI: 2.5–18.7), pain 33.5% (95% CI: 14.5–52.5), infection 16.1% (95% CI: 3.9–28.4), thrombosis 4.9% (95% CI: 1.2–8.5), pancreatitis 7.2% (95% CI: 3.1–11.2), bleeding 4.2% (95% CI: −0.5–8.9), cholangitis 4.2% (95% CI: −0.5–8.9), nausea 9.6% (95% CI: 4.4–14.8), biliary obstruction 13.8% (95% CI: 4.2–23.3), chest tightness 7.6% (95% CI: 0.5–14.6), and hypoglycemia 5.9% (95% CI: −0.4–12.2). Conclusions. This meta-analysis indicated a clear survival benefit for PC patients who received irreversible electroporation therapy, although future safety and effectivity monitoring from more large-scale studies will be needed.

scholarly journals Efficacy of Monocyte Distribution Width in the Early Diagnosis of Sepsis: A Diagnostic Meta-Analysis

2021 ◽  
Author(s):  
Jiahao Chen ◽  
Qiang Guo
Keyword(s):  
Early Diagnosis ◽  
Large Scale ◽  
Meta Analysis ◽  
Delayed Diagnosis ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Inexpensive Method ◽  
Diagnostic Efficacy ◽  
Distribution Width ◽  
Non Invasive

Abstract Background: Delayed diagnosis of sepsis urgently requires a fast, convenient, and inexpensive method to improve the early diagnosis of sepsis. Increasing evidence showed that monocyte distribution width (MDW) could be used as a non-invasive biomarker with high sensitivity and specificity for the early diagnosis of sepsis. However, the accuracy and reliability of its diagnosis are still controversial in different studies. Method: A meta-analysis of all available studies regarding the association between MDW and the diagnosis of sepsis was performed to systematically evaluate the diagnostic efficacy of MDW in the prediction of sepsis. Results: The estimated results of all eight studies are as follows: sensitivity, 0.84 (95% CI 0.77, 0.90); specificity, 0.68 (95% CI 0.54, 0.80); PLR, 2.7 (95% CI 1.8, 4.1); NLR, 0.23 (95% CI 0.15, 0.35); DOR is 12 (95% CI 5, 25). The corresponding overall area under the curve is 0.85 (95% CI 0.82, 0.88). Conclusion: In conclusion, this meta-analysis demonstrates that MDW has high accuracy in distinguishing patients with sepsis from healthy controls for early diagnosis of sepsis. However, large-scale prospective studies and joint diagnosis with other indicators are urgently required to confirm our findings and their utilization for routine clinical diagnosis in the future.

scholarly journals PSVIII-10 Effects of enzyme supplementation in corn distiller’s dried grains with solubles (DDGS) diets on growth performance in broilers: a meta-analysis

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 211-211
Author(s):  
Jae-Cheol Jang ◽  
Zhikai Zeng ◽  
Pedro E Urriola ◽  
Gerald C Shurson
Keyword(s):  
Growth Performance ◽  
Fixed Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Growth Responses ◽  
Exogenous Enzymes ◽  
The Mean ◽  
Enzyme Supplementation ◽  
Mean Differences

Abstract The objective of this study was to conduct a meta-analysis to quantitatively summarize the growth responses of broilers fed cDDGS and the efficacy of various types of dietary enzyme supplementation. A total of 12 publications with 69 observations were included in the database. Individual observations were analyzed using a multivariable linear mixed model. The mean differences (MD) of BWG, FI, and gain efficiency (G/F) were calculated by subtracting either the enzyme response in corn-soybean meal (CSB) or CSB+cDDGS based diets to the control, and was expressed as a percentage (MD = (enzyme – control)/control ×100%). A type of exogenous enzymes (xylanase; protease; carbohydrases; cocktail = proteases + carbohydrases), and feeding phase (starter = d 0 to d 21; finisher = d 21 to d 42 or 49; overall = d 0 to d 42 or more) were included as fixed effects. Dietary enzyme inclusion showed significant improvement on BWG (3.19%, P &lt; 0.01) and G/F (5.69%, P &lt; 0.01) in broilers fed cDDGS diet. However, no significant enzyme responses were observed in broilers fed CSB diet on growth performance. Broilers fed cDDGS diet had increased (P &lt; 0.01) BWG with the addition of protease (3.32 %) and cocktail (3.27 %), whereas addition of xylanased improved (P &lt; 0.01) G/F by (3.56 %) and carbohydrases (1.90 %). Broilers fed cDDGS diet with enzyme supplementation showed greater improvement in BWG (3.71 %, P &lt; 0.01) and G/F (3.78 %, P &lt; 0.01) at finisher phase compared with starter phase. Likewise, Broilers fed CSB diet with enzyme supplementation increased BWG (9.40 %, P &lt; 0.01) and G/F (3.11 %, P &lt; 0.01) at finisher phase. In conclusion, supplementation of xylanase and carbohydrases in cDDGS diet improved G/F, and the enzyme response can be maximized when fed during the finisher phase diet compared with the starter phase diet.

Abstract MP84: Trans-ethnic Meta-analysis of Exome Chip Data Reveals Novel Low-frequency Variants Contributing to Central Adiposity

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Kristin L Young ◽  
Anne Justice ◽  
Tugce Karaderi ◽  
Heather Highland ◽  
Mariaelisa Graff ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Large Scale ◽  
Blood Glucose Concentration ◽  
Meta Analysis ◽  
Low Frequency ◽  
Fat Distribution ◽  
Central Adiposity ◽  
Single Nucleotide Variants ◽  
Chip Data ◽  
Exome Chip

Central adiposity is a leading risk factor for cardiovascular disease, and genetic factors contribute both to fat distribution, measured as waist-to-hip ratio adjusted for BMI (WHRa), and to differences in central adiposity prevalence. To date, 49 loci have been associated with WHRa, based on studies of common [minor allele frequency (MAF) ≥5%] single nucleotide variants (SNVs), primarily in European descent populations. Our aim was to identify low frequency (LFV: MAF <5%) and rare (RV: MAF <1%) coding variants associated with WHRa using Exome-Chip data from 344,369 individuals of European (84%), South Asian (8%), African (5%), East Asian(2%), and Hispanic/Latino (1%) ancestry. We performed fixed effects meta-analyses of study-specific WHRa associations stratified by sex and ancestry and then combined across strata for both SNV and gene-based results. We used a strict definition of variants annotated as damaging by 5 algorithms to perform gene-based analyses using the sequence kernel association test (SKAT). Analyses included up to 284,499 SNVs (218,195 with MAF<5%), and 15,063 genes with at least one SNV that met our inclusion criteria. Five LFVs reached chip-wide significance (CWS: P<2.5E-7) in our all ancestry sex-combined analyses, including one novel non-synonymous LFV in RAPGEF3 [MAF=0.01, β (SE) = -0.09 (0.012), P=1.28E-13]. In addition, one novel RV reached CWS in men for UGGT2 [MAF<0.01, β (SE) = -0.142 (0.025), P=9.71E-9], and one RV reached CWS in women for ACVR1C [MAF<0.01, β (SE) = -0.09 (0.018), P=1.09E-7]. Gene-based analyses identified RAPGEF3 (P=1.18E-11) as significantly associated with WHRa in the all ancestry sex combined analyses after correction for multiple tests (P<2.5E-6), though conditional analysis revealed that this result is driven by the top SV identified in this region. RAPGEF3 also shows a significant association (p=4.68E-12) in all ancestry, sex combined gene-based analysis of BMI. RAPGEF3 is expressed in subcutaneous and visceral adipose tissue, and has been implicated in insulin regulation. RAPGEF3 plays a role in the GLP1 pathway, which controls insulin secretion in response to blood glucose concentration. Our results highlight the importance of large-scale genomic studies for identifying LFV and RV influencing central fat distribution. Understanding these genetic effects may provide insights into the progression of central adiposity and highlight potential population-specific variants that increase susceptibility.

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