Prevalence and Risk Factors for Retinopathy of Prematurity in China: A Systematic Review and Meta-Analysis

Abstract Background The etiology of retinopathy of prematurity (ROP) is thought to be related to genetic susceptibility and environmental exposure factors. The purpose of this article was to estimate the prevalence of ROP in mainland China and to attempt to summarize the environmental risk factors for ROP in Chinese infants. Method We searched 9 databases for articles that were published before May 29, 2021, and studies describing the prevalence and risk factors for ROP in Chinese infants were included. The fixed-effects model and the random-effects model were applied to the effect sizes (ES) and their 95% confidence intervals (CIs) with I2≤50% and I2>50% in the heterogeneity tests, respectively. Results Twenty-two separate populations were included in the meta-analysis of the prevalence of ROP. The prevalence of ROP in mainland China was 9.284% (95% CI: 6.546-12.022%). It was negatively correlated with birth weight (BW) and gestational age (GA). Fifty independent meta-analyses were observed to be related to environmental exposure factors of ROP. Thirty of the 50 meta-analyses had results that were significant at p values less than 0.05. The first three risk factors with the largest combined effect size were GA≤34 w, bronchopulmonary dysplasia (BPD) and BW≤2,000 g. Conclusions Approximately one in ten immature infants suffered from ROP. More studies need to be included. Premature babies with diseases that cause hypoxia and irregular oxygen use should be paid more attention for ROP screening.

Download Full-text

Clinical symptoms, comorbidities and complications features in severe and non-severe patients with COVID-19: a systematic review and meta-analysis without cases duplication

10.21203/rs.3.rs-30787/v1 ◽

2020 ◽

Author(s):

Zhufeng Wang ◽

Hongsheng Deng ◽

Changxing Ou ◽

Jingyi Liang ◽

Yingzhi Wang ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Observational Studies ◽

Fixed Effects ◽

Clinical Symptoms ◽

Meta Analysis ◽

Mortality Rates ◽

Fixed Effects Model ◽

Review Of The Literature ◽

Q Statistic

Abstract Background: The pandemic of COVID-19 posed a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 31.8%, and it is particularly important to identify risk factors that aggravate the disease.Methods: We performed a systematic review of the literature with meta-analysis, using 7 databases to assess clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% CI. Measure of heterogeneity was estimated by Cochran’s Q statistic, I2 index and P value.Results: 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension (severe: 33.4%, 95% CI: 25.4% - 41.4%; non-severe 21.6%, 95% CI: 9.9% - 33.3%), followed by diabetes (severe: 14.4%, 95% CI: 11.5% - 17.3%; non-severe: 8.5%, 95% CI: 6.1% - 11.0%). The prevalence of ARDS, AKI and shock were all higher in severe cases, with 41.1% (95% CI: 14.1% - 68.2%), 16.4% (95% CI: 3.4% - 29.5%) and 19.9% (95% CI: 5.5% - 34.4%), rather than 3.0% (95% CI: 0.6% - 5.5%), 2.2% (95% CI: 0.1% - 4.2%) and 4.1% (95% CI -4.8% - 13.1%) in non-severe patients, respectively. The death rate was higher in severe cases (30.3%, 95% CI: 13.8% - 46.8%) than non-severe cases (1.5%, 95% CI: 0.1% - 2.8%).Conclusions: Hypertension, diabetes and cardiovascular diseases may be risk factors for COVID-19 patients to develop into severe cases.

Download Full-text

Reappraisal With Meta-Analysis of the Addition of Gram-Positive Prophylaxis to Fluoroquinolone in Neutropenic Patients

Journal of Clinical Oncology ◽

10.1200/jco.2003.01.234 ◽

2003 ◽

Vol 21 (22) ◽

pp. 4127-4137 ◽

Cited By ~ 62

Author(s):

Mario Cruciani ◽

Marina Malena ◽

Oliviero Bosco ◽

Stefano Nardi ◽

Giovanni Serpelloni ◽

...

Keyword(s):

Fixed Effects ◽

Antimicrobial Agents ◽

Meta Analysis ◽

Fixed Effects Model ◽

Inclusion Criteria ◽

Gram Positive ◽

Relative Risks ◽

Unexplained Fever ◽

Neutropenic Patients ◽

Meta Analyses

Purpose: Past reports and meta-analyses indicate that fluoroquinolones are highly effective in preventing Gram-negative infections in neutropenic cancer patients, but offer inadequate coverage for Gram-positive infections. We evaluated by meta-analysis the efficacy of the addition of antimicrobial agents with enhanced Gram-positive activity to prophylaxis with quinolones. Materials and Methods: Randomized trials comparing fluoroquinolones alone (ciprofloxacin, ofloxacin, pefloxacin, or norfloxacin) with fluoroquinolone in combination with Gram-positive prophylaxis (rifampin, vancomycin, amoxicillin, roxithromycin, or penicillin) were retrieved. We pooled relative risks (RRs) using a fixed-effects model. Results: Nine trials (1,202 patients) published between 1993 and 2000 meet inclusion criteria. Compared with fluoroquinolone alone, Gram-positive prophylaxis reduced total bacteremic episodes (RR, 1.54; 95% CI, 1.26 to 1.88), streptococcal infections (RR, 2.20; 95% CI, 1.44 to 3.37), coagulase-negative staphylococcal infections (RR, 1.46; 95% CI, 1.04 to 2.04), and rate of febrile patients (RR 1.08; 95% CI, 1.00 to 1.16). Occurrence of clinically documented infections, unexplained fever, and infectious mortality was similar in the two groups. The addition of Gram-positive prophylaxis, however, significantly increased side effects (RR, 0.46; 95% CI, 0.28 to 0.76). Rifampin use resulted in a higher incidence of undesirable effects. Conclusion: Considering the lack of cut-clear benefit on some parameters of morbidity and mortality, routine use of Gram-positive prophylaxis is not advisable. This strategy, however, should be particularly valuable in subgroups of patients at high risk of streptococcal infection (eg, those with severe and prolonged neutropenia or mucositis, and those receiving cytarabine). Problems of tolerability and the potential for the emergence of resistant microorganisms should be considered when prescribing prophylaxis with enhanced Gram-positive activity to neutropenic patients.

Download Full-text

Norms Across Cultures: A Cross-Cultural Meta-Analysis of Norms Effects in the Theory of Planned Behavior (corrected & updated)

10.31234/osf.io/v2wz6 ◽

2020 ◽

Author(s):

Ronald Fischer ◽

Johannes Alfons Karl

Keyword(s):

Fixed Effects ◽

Cultural Psychology ◽

Meta Analysis ◽

Relative Strength ◽

Cross Cultural ◽

Fixed Effects Model ◽

Central Concept ◽

Meta Analyses ◽

And Behavior ◽

Behavior Domain

This paper presents a corrected version of a manuscript published in the Journal of Cross-Cultural Psychology. Norms have emerged as a central concept across various fields of psychology. In social psychology, norms have been important to predict intentions and behavior, but cultural variability has not been examined. In cultural psychology, norms have also played a central role in explained cultural differences. In contrast, to date, variability in norm-intention and norm-behavior relationships has not been systematically investigated. Any systematic variability may be challenging to both social and cultural psychology. We re-analyzed effect sizes taken from five previously published meta-analyses using a fixed-effects model and demonstrate that the relative strength of norm-intention and norm-behavior correlations in this sample of previously published studies are systematically higher in less economically developed societies. We also found significant, but weaker, effects for individualism, tightness–looseness and monumentalism vs flexibility. Meanwhile, behavior domain effects also emerged, which suggests that norms are behavior specific. Norms effects systematically vary across previously published studies, implying that more attention is needed to investigate culturally conditioned domain and behavior effects.

Download Full-text

Effects of dutasteride on prostate cancer incidence: A systematic review and meta-analysis

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3860 ◽

2020 ◽

Vol 11 (4) ◽

pp. 7266-7270

Author(s):

Gyeong-Eun Min ◽

Haesoo Kim ◽

Da Eun Lee ◽

Kisok Kim

Keyword(s):

Prostate Cancer ◽

Random Effects ◽

Fixed Effects ◽

Meta Analysis ◽

Adult Males ◽

Fixed Effects Model ◽

Random Effects Models ◽

Benign Prostate Hypertrophy ◽

Fixed And Random Effects ◽

Meta Analyses

5-Alpha-reductase inhibitors (5-ARIs) are used in the treatment of benign prostate hypertrophy (BPH). 5-ARIs, such as finasteride and dutasteride, suppress the biosynthesis of dihydrotestosterone (DHT), a precursor of androgen, which is closely related to the incidence of prostate cancer (PCa). A previous meta-analysis demonstrated a relationship between finasteride use and the incidence of PCA. However, there have been no meta-analyses on the relationship between PCa and dutasteride alone. This meta-analysis was performed to examine the prevalence of PCa in adult males taking dutasteride. We searched PubMed for reports regarding PCa risk and dutasteride use. The study was conducted according to the PRISMA guidelines for systematic reviews and meta-analyses. The analytic hierarchy process (AHP) method was used to weight the studies. Odds ratios (ORs), 95% confidence intervals (CIs), and P-values were calculated using fixed- and random-effects models. A total of eight articles were included in the meta-analysis. The overall OR for both the fixed- and random-effects models was 0.669 and the 95% CI for the random-effects model (0.526–0.851; P = 0.006) was wider than that for the fixed effects model (0.548–0.817; P < 0.001). This study confirmed that the incidence of PCa was significantly reduced by taking dutasteride.

Download Full-text

Risk factors of flare in patients with systemic lupus erythematosus after glucocorticoids withdrawal. A systematic review and meta-analysis

Lupus Science & Medicine ◽

10.1136/lupus-2021-000603 ◽

2022 ◽

Vol 9 (1) ◽

pp. e000603

Author(s):

Lanlan Ji ◽

Wenhui Xie ◽

Serena Fasano ◽

Zhuoli Zhang

Keyword(s):

Risk Factors ◽

Lupus Erythematosus ◽

Fixed Effects ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Final Analysis ◽

Cochrane Library ◽

Fixed Effects Model ◽

Increased Risk ◽

Potential Risk Factors

ObjectiveGlucocorticoids (GC) withdrawal is part of the targets in current recommendations for SLE, but relapse is the most worrying issue. We aimed to investigate the predictors for flare in patients with SLE after GC withdrawal.MethodsWe systematically searched PubMed, EMBASE and Cochrane Library as well as Scopus databases up to 9 July 2021 for studies concerning predictive factors of relapses in patients with SLE after GC cessation. Pooled OR and 95% CI were combined using a random-effects or fixed-effects model.Results635 patients with SLE with GC discontinuation in 9 publications were eligible for the final analysis. Of them, 99.5% patients were in clinical remission before GC withdrawal. Serologically active yet clinically quiescent (SACQ) was associated with an increased risk of flare after GC withdrawal (OR 1.78, 95% CI (1.00 to 3.15)). Older age and concomitant use of hydroxychloroquine (HCQ) trended towards decreased risk of flare (weighted mean difference (WMD) −2.04, 95% CI (−4.15 to 0.06) for age and OR 0.50, 95% CI (0.23 to 1.07) for HCQ), yet not statistically significant. No significant association was observed regarding gender (pooled OR 1.75; 95% CI (0.59 to 5.20)), disease duration (WMD −11.91, 95% CI (−27.73 to 3.91)), remission duration (WMD −8.55, 95% CI (−33.33 to 16.23)), GC treatment duration (WMD −10.10, 95% CI (−64.09 to 43.88)), concomitant use of immunosuppressant (OR 0.86, 95% CI (0.48 to 1.53)).ConclusionYounger age and SACQ were potential risk factors of SLE flare among patients who discontinued GC. HCQ, but not immunosuppressant might prevent flare. GC withdrawal should be done with caution in this subgroup of patients.

Download Full-text

A Systematic Review and Meta-Analysis about the Effect of Bisphosphonates on the Risk of Skeletal-Related Event in Men with Prostate Cancer

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520620666200521114815 ◽

2020 ◽

Vol 20 (13) ◽

pp. 1604-1612

Author(s):

Congcong Wu ◽

Hua Jiang ◽

Jianghua Chen

Keyword(s):

Prostate Cancer ◽

Fixed Effects ◽

Data Extraction ◽

Controlled Trial ◽

Meta Analysis ◽

Control Group ◽

Fixed Effects Model ◽

Related Event ◽

Mineral Density ◽

Skeletal Related Event

Background: Although the adjuvant therapy of bisphosphonates in prostate cancer is effective in improving bone mineral density, it is still uncertain whether bisphosphonates could decrease the risk of Skeletal- Related Event (SRE) in patients with prostate cancer. We reviewed and analyzed the effect of different types of bisphosphonates on the risk of SRE, defined as pathological fracture, spinal cord compression, radiation therapy to the bone, surgery to bone, hypercalcemia, bone pain, or death as a result of prostate cancer. Methods: A systemic literature search was conducted on PubMed and related bibliographies. The emphasis during data extraction was laid on the Hazard Ratio (HR) and the corresponding 95% Confidence Interval (CI) from every eligible Randomized Controlled Trial (RCT). HR was pooled with the fixed effects model, and preplanned subgroup analyses were performed. Results: 5 RCTs (n = 4651) were included and analyzed finally after screening 51 articles. The meta-analysis of all participants showed no significant decrease in the risk of SRE when adding bisphosphonates to control group (HR = 0.968, 95% CI = 0.874 - 1.072, p = 0.536) with low heterogeneity (I2 = 0.0% (d.f. = 4) p = 0.679). There was no significant improvement on SRE neither in the subgroups with Metastases (M1) or Castration-Sensitive Prostate Cancer (CSPC) (respectively HR = 0.968, 95% CI = 0.874 - 1.072, p = 0.536, I2 = 0.0% (d.f. = 4) p = 0.679; HR = 0.954, 95% CI = 0.837 - 1.088, p = 0.484, I2 = 0.0% (d.f. = 3) p = 0.534). Conclusion: Our study demonstrated that bisphosphonates could not statistically significantly reduce the risk of SRE in patients with prostate cancer, neither in the subgroups with M1 or CSPC.

Download Full-text

Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139172 ◽

2021 ◽

pp. postgradmedj-2020-139172

Author(s):

Rimesh Pal ◽

Mainak Banerjee ◽

Urmila Yadav ◽

Sukrita Bhattacharjee

Keyword(s):

Clinical Outcomes ◽

Observational Studies ◽

Fixed Effects ◽

Controlled Trial ◽

Meta Analysis ◽

Adverse Outcomes ◽

Fixed Effects Model ◽

Adjusted Risk ◽

Risk Estimates ◽

Statin Use

PurposeObservations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.MethodsPubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.ResultsWe included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).ConclusionsStatin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

Download Full-text

Risk Factors for Retinopathy of Prematurity in the Netherlands: A Comparison of Two Cohorts

Neonatology ◽

10.1159/000517247 ◽

2021 ◽

pp. 1-8

Author(s):

Kasia Trzcionkowska ◽

Floris Groenendaal ◽

Peter Andriessen ◽

Peter H. Dijk ◽

Frank A.M. van den Dungen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

The Netherlands ◽

Retinopathy Of Prematurity ◽

Screening Guideline ◽

Potential Risk Factors ◽

Second Period ◽

Perinatal Database ◽

Rop Screening

Introduction: Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP. Methods: Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians. Ophthalmologists provided data of screened infants, which were combined with risk factors from the national perinatal database (Perined). Clinical data and potential risk factors were compared to the first national ROP inventory (NEDROP-1, 2009). During the second period, more strict risk factor-based screening inclusion criteria were applied. Results: Of 1,287 eligible infants, 933 (72.5%) were screened for ROP and matched with the Perined data. Any ROP was found in 264 infants (28.3% of screened population, 2009: 21.9%) and severe ROP (sROP) (stage ≥3) in 41 infants (4.4%, 2009: 2.1%). The risk for any ROP is decreased with a higher GA (odds ratio [OR] 0.59 and 95% confidence interval [CI] 0.54–0.66) and increased for small for GA (SGA) (1.73, 1.11–2.62), mechanical ventilation >7 days (2.13, 1.35–3.37) and postnatal corticosteroids (2.57, 1.44–4.66). For sROP, significant factors were GA (OR 0.37 and CI 0.27–0.50), SGA (OR 5.65 and CI 2.17–14.92), postnatal corticosteroids (OR 3.81 and CI 1.72–8.40), and perforated necrotizing enterocolitis (OR 7.55 and CI 2.29–24.48). Conclusion: In the Netherlands, sROP was diagnosed more frequently since 2009. No new risk factors for ROP were determined in the present study, apart from those already included in the current screening guideline.

Download Full-text

Association between early bronchiolitis and the development of childhood asthma: a meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-043956 ◽

2021 ◽

Vol 11 (5) ◽

pp. e043956

Author(s):

Guizuo Wang ◽

Dong Han ◽

Zhengdong Jiang ◽

Manxiang Li ◽

Shumei Yang ◽

...

Keyword(s):

Early Life ◽

Fixed Effects ◽

Late Onset ◽

Meta Analysis ◽

Later Life ◽

Analysis Data ◽

Fixed Effects Model ◽

Case Control Studies ◽

Increased Risk ◽

Registration Number

ObjectiveEarly life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma.DesignSystematic review and meta-analysis.MethodsPubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case–control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies.Results32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant.ConclusionsThe meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis.PROSPERO registration numberCRD42018089453.

Download Full-text

Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-82161-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jing Li ◽

Yinzi Chen ◽

Xiling Wang ◽

Hongjie Yu

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Fixed Effects ◽

Disease Burden ◽

Outpatient Visit ◽

Meta Analysis ◽

Age Groups ◽

Mainland China ◽

Mortality And Morbidity ◽

All Cause Mortality

AbstractInfluenza causes substantial morbidity and mortality. Many original studies have been carried out to estimate disease burden of influenza in mainland China, while the full disease burden has not yet been systematically reviewed. We did a systematic review and meta-analysis to assess the burden of influenza-associated mortality, hospitalization, and outpatient visit in mainland China. We searched 3 English and 4 Chinese databases with studies published from 2005 to 2019. Studies reporting population-based rates of mortality, hospitalization, or outpatient visit attributed to seasonal influenza were included in the analysis. Fixed-effects or random-effects model was used to calculate pooled estimates of influenza-associated mortality depending on the degree of heterogeneity. Meta-regression was applied to explore the sources of heterogeneity. Publication bias was assessed by funnel plots and Egger’s test. We identified 30 studies eligible for inclusion with 17, 8, 5 studies reporting mortality, hospitalization, and outpatient visit associated with influenza, respectively. The pooled influenza-associated all-cause mortality rates were 14.33 and 122.79 per 100,000 persons for all ages and ≥ 65 years age groups, respectively. Studies were highly heterogeneous in aspects of age group, cause of death, statistical model, geographic location, and study period, and these factors could explain 60.14% of the heterogeneity in influenza-associated mortality. No significant publication bias existed in estimates of influenza-associated all-cause mortality. Children aged < 5 years were observed with the highest rates of influenza-associated hospitalizations and ILI outpatient visits. People aged ≥ 65 years and < 5 years contribute mostly to mortality and morbidity burden due to influenza, which calls for targeted vaccination policy for older adults and younger children in mainland China.

Download Full-text