The association between lithium in drinking water and neuropsychiatric outcomes: A systematic review and meta-analysis from across 2678 regions containing 113 million

Background: Lithium in drinking water may have significant mental health benefits. We investigated the evidence on the association between lithium concentrations in drinking water and their neuropsychiatric outcomes. Methods: We conducted a systematic review and meta-analysis and searched Pubmed, Embase, Web of Science, PsycINFO and CINAHL up to 19 January 2020, for peer-reviewed research examining the association between lithium concentrations in drinking water and neuropsychiatric outcomes. We used a pairwise analysis and a random effects model to meta-analyse suicide rates and psychiatric hospital admissions. We assessed for publication bias using Egger’s test and Duval and Tweedie’s Trim and Fill analysis. Results: Twenty-seven studies including 113 million subjects were included in this systematic review. Meta-analysis of 14 studies including 94 million people found higher lithium concentrations were associated with reduced suicide rates ( r = −0.191, 95% confidence interval = [−0.287, −0.090], p < 0.001) and meta-analysis of two studies including 5 million people found higher lithium concentrations were associated with fewer hospital admissions ( r = −0.413, 95% confidence interval = [−0.689, −0.031], p = 0.035). We found significant heterogeneity between studies ( Q = 67.4, p < 0.001, I2 = 80.7%) and the presence of publication bias (Egger’s test; t value = 2.90, p = 0.013). Other included studies did not provide sufficient data to analyse other neuropsychiatric outcomes quantitatively. Conclusion: Higher lithium concentrations in drinking water may be associated with reduced suicide rates and inpatient psychiatric admissions. The relationship with other neuropsychiatric outcomes and complications remains unclear. Further research is required before any public health recommendations can be made. Trial registration number: The study was registered with PROSPERO, number CRD42018090145.

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Effects of the endocrine disruptor vinclozolin in male reproduction: a systematic review and meta-analysis†

Biology of Reproduction ◽

10.1093/biolre/ioab018 ◽

2021 ◽

Author(s):

Mariana Feijó ◽

Roberta V L Martins ◽

Sílvia Socorro ◽

Luísa Pereira ◽

Sara Correia

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Meta Analysis ◽

Endocrine Disrupting Chemicals ◽

Reproductive Organs ◽

Male Reproduction ◽

Mean Differences ◽

Trim And Fill ◽

Meta Analyses ◽

Q Statistic

Abstract Endocrine-disrupting chemicals have become an issue of scientific and public discussion. Vinclozolin (VNZ) is a fungicide that competitively antagonizes the binding of natural androgens to their receptor, disturbing the function of tissues that are sensitive to these hormones, as is the case of the male reproductive organs. A systematic review with meta-analyses of rodent studies was conducted to answer the following question: Does exposure to VNZ affect sperm parameters and testicular/epididymal weight? The methodology was prespecified according to the Cochrane Handbook for Systematic Reviews and PRISMA recommendations. Sixteen articles met the inclusion criteria, comprising a total of 1189 animals. The risk of publication bias was assessed using the Trim and Fill adjustment, funnel plot, and Egger regression test. Heterogeneity and inconsistency across the findings were tested using the Q-statistic and I2 of Higgins, respectively. Sensitivity was also analyzed. Statistical analysis was performed on Comprehensive Meta-Analysis software (Version 2.0), using random models and weighted mean differences along with a 95% confidence interval. Sperm motility, counts, daily sperm production (evidence of publication bias), and epididymis weight were decreased in VNZ-treated animals. Exposure length and dose, as well as the time point of exposure, influenced the obtained results. Despite the moderate/high heterogeneity observed, the sensitivity analysis overall demonstrated the robustness of the findings. The quality scores of the included studies were superior to 4 in a total of 9, then classified as good. The obtained data corroborate the capability of VNZ exposure to disrupt spermatogenic output and compromise male fertility.

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Depression and risk of disability pension: A systematic review and meta-analysis

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217419837412 ◽

2019 ◽

pp. 009121741983741 ◽

Cited By ~ 4

Author(s):

Sohrab Amiri ◽

Sepideh Behnezhad

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Publication Bias ◽

Risk Ratio ◽

Disability Pension ◽

Common Mental Disorder ◽

Meta Analysis ◽

Psychological Consequences ◽

Treatment Of Depression

Background and objective Depression is a common mental disorder that leads to undesirable consequences. The study of the role of depression in disability pension can provide valuable insights. This study was conducted with the goal of systematic review and meta-analysis of the relationship between depression and disability pension. Methods PubMed, Scopus, PsycInfo, and Google Scholar databases were systematically searched until March 2018. Fifteen prospective cohort studies were selected and included in the meta-analysis. The random-effects method was used to combine the studies. Subgroup analysis was performed, and publication bias was also examined. Results Depression was a risk factor for disability pension (pooled risk ratio =1.68 and 95% confidence interval = 1.50–1.88). In men, pooled risk ratio was 1.82 for the effect of depression on the risk of disability pension (95% confidence interval = 1.45–2.28). In women, pooled risk ratio was 1.62 (95% confidence interval = 1.31–2.02). The results showed that there is publication bias. Conclusions Depression is a factor for retirement due to disability. Therefore, the prevention and treatment of depression can reduce socioeconomic and psychological consequences imposed on society.

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Toxoplasmosis in immunocompromised patients in Iran: a systematic review and meta-analysis

The Journal of Infection in Developing Countries ◽

10.3855/jidc.4796 ◽

2014 ◽

Vol 8 (12) ◽

pp. 1503-1510 ◽

Cited By ~ 55

Author(s):

Ehsan Ahmadpour ◽

Ahmad Daryani ◽

Mahdi Sharif ◽

Shahabeddin Sarvi ◽

Mohsen Aarabi ◽

...

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Meta Analysis ◽

Scientific Information ◽

Control Measures ◽

Significant Heterogeneity ◽

Seroprevalence Rate ◽

Immunocompromised Patients ◽

Toxoplasma Infection ◽

Hiv Aids

Although toxoplasmosis in immunocompetent individuals is generally asymptomatic, in immunocompromised patients (HIV/AIDS, cancer, and transplant patients), it can lead to serious pathological effects. This study included a systematic review and meta-analysis to comprehensively assess the seroprevalence rate of Toxoplasma infection in immunocompromised patients in Iran. Electronic English and Persian databases (PubMed, Google Scholar, ScienceDirect, Scopus, Magiran, Scientific Information Database [SID], IranMedex, and IranDoc), parasitology congresses, and projects and theses of Iranian medical universities, were systematically searched from 1997 to 2013 (published or unpublished data). In this paper, several studies that used serological methods for diagnosis of toxoplasmosis were selected. Analysis of seroprevalence estimates was pooled using a random-effects meta-analysis. Twenty-two studies, comprising 2,805 individuals, were included in the meta-analysis. Overall seroprevalence rate of Toxoplasma infection in Iranian immunocompromised patients was 50.01% (95% confidence interval, 43.85 to 56.17); however, there was significant heterogeneity among study groups. The results showed that seroprevalence rate of toxoplasmosis among transplant recipients, HIV/AIDS, and cancer patients in Iran was 55.1%, 50.05%, and 45.06%, respectively. In addition, IgM seroprevalence rate was estimated to be 4.85% (95% confidence interval, 2.22 to 8.41). This systematic review and meta-analysis identified a high seroprevalence rate of Toxoplasma infection among immunocompromised patients (50%).Consideration of management , design and provision of appropriate control measures of toxoplasmosis is highly recommended.

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The impact of time to adjuvant chemotherapy (AC) on survival in colorectal cancer (CRC): A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.364 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 364-364 ◽

Cited By ~ 4

Author(s):

J. J. Biagi ◽

M. Raphael ◽

W. D. King ◽

W. Kong ◽

W. J. Mackillop ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Adjuvant Chemotherapy ◽

Publication Bias ◽

Meta Analysis ◽

Disease Free Survival ◽

Significant Heterogeneity ◽

Risk Of Death ◽

The Impact ◽

The Relationship

364 Background: The optimal timing from CRC surgery to initiation of AC is unknown. We report a systematic review and meta-analysis to determine the relationship between time to adjuvant chemotherapy (TTAC) and survival. Methods: A systematic review of literature was done to identify studies that described the relationship between TTAC and survival. Studies were only included if the distribution of relevant prognostic factors was adequately described, and either comparative groups were balanced or results adjusted for the prognostic factors. Hazard ratio (HR) and TTAC for overall survival (OS) and disease free survival (DFS) from each study were converted to a regression coefficient (β) and standard error (SE) corresponding to a continuous representation per 4 weeks of TTAC. The adjusted β from individual studies were combined using a fixed-effect model. Inverse-variance (1/SE2) was used to weight individual studies. The possible effect of publication bias was investigated using the trim and fill approach. Results: We identified 9 eligible studies involving 14,357 patients (4 published articles, 5 abstracts). Two studies were randomized trials and 7 were cohort studies. Six studies reported TTAC as a binary variable and 3 reported TTAC as ≥3 categories. An estimate of HR for OS was derived from all 9 studies and estimate for DFS was derived from 5 studies. Meta-analysis demonstrated that a 4-week increase in TTAC was associated with a significant decrease in both OS (HR = 1.12, 95% CI 1.09-1.15), and DFS (HR = 1.15, 95% CI 1.11-1.20). The analysis showed no significant heterogeneity among studies. These TTAC associations remained significant after analysis for potential publication bias, and when the analysis was repeated excluding the two studies of largest weight. Conclusions: This study demonstrates a 12% increase in the risk of death for each 4 week of delay in the start of AC for CRC. These findings indicate the need for clinicians and health systems managers to take the steps necessary to keep TTAC as short as reasonably achievable. In addition, our results suggest there may be some benefit to AC after a 3-month TTAC delay. No significant financial relationships to disclose.

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Undernutrition and its determinants among Ethiopian adolescent girls: a protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-026718 ◽

2019 ◽

Vol 9 (5) ◽

pp. e026718 ◽

Cited By ~ 1

Author(s):

Wubet Worku Takele ◽

Achenef Asmamaw Muche ◽

Zeleke Abebaw Mekonnen ◽

Yehualashet Fikadu Ambaw ◽

Fasil Wagnew

Keyword(s):

Systematic Review ◽

Adolescent Girls ◽

Meta Analysis ◽

Health Concern ◽

Forest Plot ◽

P Value ◽

Pooled Prevalence ◽

Registration Number ◽

Trim And Fill ◽

Meta Analyses

IntroductionIn Ethiopia, undernutrition is the common public health concern, swaying the lives of lots of adolescent girls. Its sequelae are not only limited to them, but rather their upcoming offspring are vulnerable too. Even though some studies have been carried out in different parts of the country, the national pooled prevalence and determinants of undernutrition are not known. Therefore, this study is aimed at determining the pooled prevalence and determinants of undernutrition among adolescent girls in Ethiopia.MethodsPublished articles will be retrieved from databases such as Medline and PubMed. Electronic search engines such as Google Scholar and Google will be used. To identify eligible studies, the Joanna Briggs Institute quality appraisal checklists prepared for different study designs will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to maintain the scientific robustness of the study. The presence of heterogeneity among studies will be examined by forest plot as well as I2heterogeneity test. Potential causes of heterogeneity will be explored by carrying out sensitivity and subgroup analyses. The DerSimonian and Laird random-effects model will be used provided that heterogeneity is observed. Publication bias will be examined by observing funnel plots, and objectively by Egger’s regression test. If the funnel plot is asymmetric and/or Egger’s test was found to be statistically significant (p<0.05), the trim and fill (Duval and Tweedie’s) analysis will be performed. The presence of a statistical association between independent and dependent variables will be declared if the p value is <0.05 with the 95% CI.Ethics and disseminationSince this is a systematic review and meta-analysis, ethical clearance will not be a concern. The results of the study will be published in a peer-reviewed reputable journal and presented at different scientific research conferences.Trial registration numberCRD42018106180.

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Systematic review and meta-analysis determining the benefits of in vivo genetic therapy in spinal muscular atrophy rodent models

Gene Therapy ◽

10.1038/s41434-021-00292-4 ◽

2021 ◽

Author(s):

Ellie M. Chilcott ◽

Evalyne W. Muiruri ◽

Theodore C. Hirst ◽

Rafael J. Yáñez-Muñoz

Keyword(s):

Systematic Review ◽

Experimental Design ◽

Spinal Muscular Atrophy ◽

Publication Bias ◽

Median Survival ◽

Muscular Atrophy ◽

Meta Analysis ◽

Significant Heterogeneity ◽

Rodent Models ◽

Genetic Therapy

AbstractSpinal muscular atrophy (SMA) is a severe childhood neuromuscular disease for which two genetic therapies, Nusinersen (Spinraza, an antisense oligonucleotide), and AVXS-101 (Zolgensma, an adeno-associated viral vector of serotype 9 AAV9), have recently been approved. We investigated the pre-clinical development of SMA genetic therapies in rodent models and whether this can predict clinical efficacy. We have performed a systematic review of relevant publications and extracted median survival and details of experimental design. A random effects meta-analysis was used to estimate and compare efficacy. We stratified by experimental design (type of genetic therapy, mouse model, route and time of administration) and sought any evidence of publication bias. 51 publications were identified containing 155 individual comparisons, comprising 2573 animals in total. Genetic therapies prolonged survival in SMA mouse models by 3.23-fold (95% CI 2.75–3.79) compared to controls. Study design characteristics accounted for significant heterogeneity between studies and greatly affected observed median survival ratios. Some evidence of publication bias was found. These data are consistent with the extended average lifespan of Spinraza- and Zolgensma-treated children in the clinic. Together, these results support that SMA has been particularly amenable to genetic therapy approaches and highlight SMA as a trailblazer for therapeutic development.

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Cardiac Arrhythmias in Patients with COVID-19: A Systematic review and Meta-analysis

10.1101/2020.10.09.20209379 ◽

2020 ◽

Author(s):

Omar Hamam ◽

Ahmed Goda ◽

Moustafa Eldalal ◽

Amr Ussama ◽

Mostafa Fahmy ◽

...

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Cardiac Arrhythmia ◽

Cardiac Arrhythmias ◽

Early Identification ◽

Web Of Science ◽

Meta Analysis ◽

Great Influence ◽

Cochrane Library ◽

Significant Heterogeneity

Background: Cardiac arrhythmia cannot be overlooked in patients with coronavirus disease 2019 (COVID-19) as it carries a great influence on the outcomes. Hence, this study aimed to build concrete evidence regarding the incidence of cardiac arrhythmia in patients with COVID-19. Methods: We performed a systematic search for trusted databases/search engines including PubMed, Scopus, Cochrane library and web of science. After screening, the relevant data were extracted and the incidences from the different included studies were pooled for meta-analysis. Results: Nine studies were finally included in our study consisting of 1445 patients. The results of meta-analysis showed that the incidence of arrhythmia in patients with COVID-19 was 19.7% with 95% confidence interval (CI) ranging from 11.7 to 27.6%. There was also a significant heterogeneity (I2 = 94.67%). Conclusion: Cardiac arrhythmias were highly frequent in patients with COVID-19 and observed in 19.7% of them. Appropriate monitoring by electrocardiogram with accurate and early identification of arrhythmias is important for better management and outcomes.

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Inverse Association of Coffee with Liver Cancer Development: An Updated Systematic Review and Meta-analysis

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-805 ◽

2020 ◽

Author(s):

Abhishek Bhurwal ◽

Puru Ratta ◽

Sho Yoshitake ◽

Lauren Pioppo ◽

Debashish Reja ◽

...

Keyword(s):

Systematic Review ◽

Liver Cancer ◽

Publication Bias ◽

Meta Analysis ◽

Coffee Consumption ◽

Cancer Development ◽

Significant Heterogeneity ◽

Inverse Association ◽

Coffee Drinking ◽

Higher Doses

Background and Aims: Coffee consumption has been suggested to reduce the risk for hepatocellular carcinoma (HCC). While several studies report inverse correlation with coffee drinking, others have suggested more than 2 cups of coffee every day decrease the risk of liver cancer or HCC. However, controversy exists about the exact dose that would provide protective benefit. Therefore, we aimed to carry out a systematic review and meta-analysis of all studies that investigated the association of coffee consumption and risk of HCC and/or liver cancer. Our outcomes were the evaluation of the association of coffee with HCC or liver cancer development along with the amount of coffee needed to prevent HCC or liver cancer. Methods: We performed a PubMed/MEDLINE/EMBASE/Ovid/Google Scholar search of original articles published in English from 1996 to June 2019, on case-control or cohort or prospective studies that associated coffee with liver cancer or HCC. We calculated the relative risk (RR) of the two conditions for coffee drinking and then stratified this into increments of one cup of coffee per day. Twenty studies were identified. The analysis was performed using random effects models from the methods of DerSimonian and Laird with inverse variance weighting. The Cochrane Q and the I 2 statistics were calculated to assess heterogeneity between studies. A p<0.10 value for chi-square test and I 2 <20% were interpreted as low-level heterogeneity. Probability of publication bias was assessed using funnel plots and with the Egger’s test. Results: The overall RR was 0.69 (95%CI 0.56-0.85; p<0.001) with significant heterogeneity between the studies. We performed subgroup analysis over the increments of 1 cup of coffee. Higher doses of coffee consumption were associated with a significant decrease in the risks of developing HCC or liver cancer. The funnel plot did not show significant publication bias. Conclusions: Our systematic review and meta-analysis suggests that drinking coffee provides benefits with a reduction in the risk of HCC or liver cancer. Higher doses of coffee have higher benefits in terms of risk reduction. However, further biological and epidemiological studies are required to determine the exact mechanism and to study specific subgroups such as viral hepatitis B or C related HCC.

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Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis

10.1101/2020.05.08.20095968 ◽

2020 ◽

Cited By ~ 2

Author(s):

Mostaured Khan ◽

Md Nuruzzaman Khan ◽

Md. Golam Mustagir ◽

Juwel Rana ◽

Md Saiful Islam ◽

...

Keyword(s):

Systematic Review ◽

Publication Bias ◽

English Language ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Healthcare Providers ◽

Cerebrovascular Diseases ◽

Reference List ◽

Trim And Fill

Abstract Background: Coronavirus disease 2019 (COVID-19), the most hectic pandemic of the era, is increasing exponentially and taking thousands of lives worldwide. This study aimed to assess the prevalence of pre-existing morbidities among COVID-19 infected patients and their mortality risks against each type of pre-existing morbidity category. Methods: To conduct this systematic review and meta-analysis, Medline, Web of Science, Scopus, and CINAHL databases were searched using specified relavent keywords. Further searches were conducted using the reference list of the selected studies, renowned pre-print servers (e.g., medRxiv, bioRixv, SSRN), and relevant journal websites. Studies written in the English language included if those were conducted among COVID-19 patients with and without comorbidities and presented survivor vs. non-survivor counts or hazard/odds of deaths or survivors against types of pre-existing morbidities. Comorbidities reported in the selected studies were grouped into eight categories. The pooled likelihoods of deaths in each category were estimated using a fixed or random-effect model, based on the heterogeneity assessment. Publication bias was assessed by visual inspection of the funnel plot asymmetry and Eggers regression test. Trim and Fill method was used if there any publication bias was found. Results: A total of 42 studies included in this study comprised of 39,398 samples. The most common pre-existing morbidities in COVID-19 infected patients were hypertension (36.5%), cardiovascular disease (11.9%), and diabetes (22.0%). The higher likelihood of deaths was found among COVID-19 patients who had pre-existing cardiovascular diseases (OR: 3.32, 95% CI: 2.79-3.95), immune and metabolic disorders (OR: 2.39, 95% CI: 2.00-2.85), respiratory diseases (OR: 2.02, 95% CI: 1.80-2.26), cerebrovascular diseases (OR: 4.12, 95% CI: 3.04-5.58), any types of cancers (OR: 2.22, 95% CI: 1.63-3.03), renal (OR: 3.02, 95% CI: 2.60-3.52), and liver diseases (OR: 1.44, 95% CI: 1.21-1.71). Conclusions: This study provides evidence of a higher likelihood of deaths among COVID-19 patients against morbidity categories. These findings could potentially help healthcare providers to sort out the most endangered COVID-19 patients by comorbidities, take precautionary measures during hospitalization, assess susceptibility to death, and prioritize their treatment, which could potentially reduce the number of fatalities in COVID-19.

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Loneliness and sleep: A systematic review and meta-analysis

Health Psychology Open ◽

10.1177/2055102920913235 ◽

2020 ◽

Vol 7 (1) ◽

pp. 205510292091323 ◽

Cited By ~ 2

Author(s):

Sarah C Griffin ◽

Allison B Williams ◽

Scott G Ravyts ◽

Samantha N Mladen ◽

Bruce D Rybarczyk

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Sleep Disturbance ◽

Publication Bias ◽

Meta Analysis ◽

Potential Mechanism

Despite the mounting evidence linking loneliness with health, the mechanisms underlying this relationship remain obscure. This systematic review and meta-analysis on the association between loneliness and one potential mechanism—sleep—identified 27 relevant articles. Loneliness correlated with self-reported sleep disturbance ( r = .28, 95% confidence interval (.24, .33)) but not duration, across a diverse set of samples and measures. There was no evidence supporting age or gender as moderators or suggesting publication bias. The longitudinal relationship between loneliness and sleep remains unclear. Loneliness is related to sleep disturbance, but research is necessary to determine directionality, examine the influence of other factors, and speak to causality.

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