Effect of Interventions on Learning Burnout: A Systematic Review and Meta-Analysis

Objectives: This study aimed to provide a comprehensive understanding of all intervention for learning burnout by meta-analyzing their effects.Methods: Relevant studies that had been published up to September 18, 2020, were identified through a systematic search of the PubMed, Web of Science, the China National Knowledge Infrastructure (CNKI), and Wan Fang databases. Eligible studies included randomized control trials of any learning burnout intervention conducted among students. The Jadad scale was used to evaluate the quality of the study. Random-effect meta-analyses, subgroup analyses, meta-regression analysis, and sensitivity analysis were conducted. Funnel plots and Egger's tests were used to evaluate publication bias. Duval and Tweedie's non-parametric trim-and-fill method was used to adjust the effect of publication bias.Results: Of the 5,245 articles found, 39 met the inclusion criteria for the systematic review. There were 3,400 students, including 1,847 students in the intervention group and 1,553 in the control group. A meta-analysis of 44 studies showed that the interventions were effective. Subgroup analyses were conducted according to education, scales, intervention measures, and intervention time. The results showed that, compared with the control group, the learning burnout scores of undergraduates, secondary vocational students, and middle school students were significantly lower. Based on different scales, all interventions were also effective. The funnel plot was asymmetric and consistent with the results of Egger's test. The trim-and-fill method was used, and seven missing studies were merged to obtain a symmetric funnel plot.Conclusions: This meta-analysis indicated that learning burnout interventions are effective. The subgroup analyses showed that group counseling is the most widely used, exercise intervention is probably the most effective, and 8 weeks or more is the appropriate intervention time. An integrated intervention study based on the factors of learning burnout adds value. More studies are needed to supplement the results in the future.

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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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Sofosbuvir with daclatasvir and the outcomes of patients with COVID-19: a systematic review and meta-analysis with GRADE assessment

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140287 ◽

2021 ◽

pp. postgradmedj-2021-140287

Author(s):

Ahmad Fariz Malvi Zamzam Zein ◽

Catur Setiya Sulistiyana ◽

Wilson Matthew Raffaello ◽

Arief Wibowo ◽

Raymond Pranata

Keyword(s):

Systematic Review ◽

Absolute Risk ◽

Controlled Trial ◽

Meta Analysis ◽

Invasive Mechanical Ventilation ◽

Intervention Group ◽

Control Group ◽

Reduce Mortality Rate ◽

Icu Admission ◽

Clinical Recovery

PurposeThis systematic review and meta-analysis aimed to evaluate the effect of sofosbuvir/daclatasvir (SOF/DCV) on mortality, the need for intensive care unit (ICU) admission or invasive mechanical ventilation (IMV) and clinical recovery in patients with COVID-19.MethodsWe performed a systematic literature search through the PubMed, Scopus and Embase from the inception of databases until 6 April 2021. The intervention group was SOF/DCV, and the control group was standard of care. The primary outcome was mortality, defined as clinically validated death. The secondary outcomes were (1) the need for ICU admission or IMV and (2) clinical recovery. The pooled effect estimates were reported as risk ratios (RRs).ResultsThere were four studies with a total of 231 patients in this meta-analysis. Three studies were randomised controlled trial, and one study was non-randomised. SOF/DCV was associated with lower mortality (RR: 0.31 (0.12, 0.78); p=0.013; I2: 0%) and reduced need for ICU admission or IMV (RR: 0.35 (0.18, 0.69); p=0.002; I2: 0%). Clinical recovery was achieved more frequently in the SOF/DCV (RR: 1.20 (1.04, 1.37); p=0.011; I2: 21.1%). There was a moderate certainty of evidence for mortality and need for ICU/IMV outcome, and a low certainty of evidence for clinical recovery. The absolute risk reductions were 140 fewer per 1000 for mortality and 186 fewer per 1000 for the need for ICU/IMV. The increase in clinical recovery was 146 more per 1000.ConclusionSOF/DCV may reduce mortality rate and need for ICU/IMV in patients with COVID-19 while increasing the chance for clinical recovery.Protocol registrationPROSPERO: CRD42021247510.

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Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1093 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Giacchetta ◽

M Chiavarini ◽

G Naldini ◽

R Fabiani

Keyword(s):

Systematic Review ◽

Malignant Melanoma ◽

Publication Bias ◽

Oral Contraceptives ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cutaneous Malignant Melanoma ◽

Hormonal Factors ◽

Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

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Is Routine Preoperative Esophagogastroduodenoscopy Prior to Bariatric Surgery Mandatory? Systematic Review and Meta-analysis of 10,685 Patients

Obesity Surgery ◽

10.1007/s11695-020-04672-4 ◽

2020 ◽

Vol 30 (8) ◽

pp. 3073-3083 ◽

Cited By ~ 1

Author(s):

Walid El Ansari ◽

Ayman El-Menyar ◽

Brijesh Sathian ◽

Hassan Al-Thani ◽

Mohammed Al-Kuwari ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Publication Bias ◽

Surgical Approach ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Background This systematic review and meta-analysis searched, retrieved and synthesized the evidence as to whether preoperative esophagogastroduodenoscopy (p-EGD) should be routine before bariatric surgery (BS). Methods Databases searched for retrospective, prospective, and randomized (RCT) or quasi-RCT studies (01 January 2000–30 April 2019) of outcomes of routine p-EGD before BS. STROBE checklist assessed the quality of the studies. P-EGD findings were categorized: Group 0 (no abnormal findings); Group 1 (abnormal findings that do not necessitate changing the surgical approach or postponing surgery); Group 2 (abnormal findings that change the surgical approach or postpone surgery); and Group 3 (findings that signify absolute contraindications to surgery). We assessed data heterogeneity and publication bias. Random effect model was used. Results Twenty-five eligible studies were included (10,685 patients). Studies were heterogeneous, and there was publication bias. Group 0 comprised 5424 patients (56%, 95% CI: 45–67%); Group 1, 2064 patients (26%, 95% CI: 23–50%); Group 2, 1351 patients (16%, 95% CI: 11–21%); and Group 3 included 31 patients (0.4%, 95% CI: 0–1%). Conclusion For 82% of patients, routine p-EGD did not change surgical plan/ postpone surgery. For 16% of patients, p-EGD findings necessitated changing the surgical approach/ postponing surgery, but the proportion of postponements due to medical treatment of H Pylori as opposed to “necessary” substantial change in surgical approach is unclear. For 0.4% patients, p-EGD findings signified absolute contraindication to surgery. These findings invite a revisit to whether p-EGD should be routine before BS, and whether it is judicious to expose many obese patients to an invasive procedure that has potential risk and insufficient evidence of effectiveness. Further justification is required.

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Comparison of problem-based learning and traditional teaching methods in medical psychology education in China: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0243897 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243897

Author(s):

Junwei Gao ◽

Ling Yang ◽

Jinghui Zhao ◽

Lian Wang ◽

Jiao Zou ◽

...

Keyword(s):

Systematic Review ◽

Teaching Method ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Medical Psychology ◽

Psychology Education ◽

Subgroup Analyses ◽

Psychology Curriculum ◽

Education In China

Background PBL approach has been widely used in many Chinese universities over the past decade. However, the effects of PBL approach on medical psychology education in China are inconsistent. The purpose of this study was to ascertain whether the PBL approach was superior to the lecture-based teaching method in the context of the medical psychology curriculum in China. Methods A systematic review and meta-analysis was performed to confirm the effectiveness of PBL in Chinese medical psychology. Corresponding databases were searched for available studies, where data were extracted to calculated Hedges’ g and its 95% confidence interval in total and subgroup analyses. Subgroup analyses were also carried out. Results Nine studies with 551 cases and 496 controls were identified. The total examination scores of students in the PBL approach group were significantly higher compared with students in the traditional lecture-based teaching group under the random effect model (Hedges’ g = 1.510, 95%CI 0.792–2.227, p<0.001). Subgroup analyses based on major and school system exhibited similar results. Conclusions Our study supported the notion that the PBL approach may be applicable to Chinese medical psychology education.

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Association of Toxoplasmosis with suicide: A systematic review and meta-analysis

10.21203/rs.2.14031/v1 ◽

2019 ◽

Author(s):

Eissa Soleymani ◽

Fariba Faizi ◽

Rashid Heidarimoghadam ◽

Lotfollah Davoodi ◽

Younes Mohammadi

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Publication Bias ◽

Potential Risk ◽

Meta Analysis ◽

Random Effect ◽

Potential Risk Factor ◽

Analysis Phase ◽

Analysis Methods ◽

And Control

Abstract Background findings on association of Toxoplasmosis and suicide is contradictory. This paper aimed to resolve this uncertainty with help of Meta-analysis. Methods using keywords include “Toxoplasmosis” and “suicide” and the relayed synonyms in international databases such as ISI, Medline and Scopus, we found the relevant studies. The eligible studies included into Meta-analysis phase. Random effect approach was used to combine the results. Results out of 150 initial studies, 16 were included into meta-analysis. Odds of suicide in person with toxoplasmosis was 47% (OR: 1.47, 95%CI; 1.20 to 1.79) higher than of that without toxoplasmosis. Test for publication bias was not statistically significant, which indicate absence of likely publication bias. Conclusion This study confirm which toxoplasmosis is a potential risk factor for suicide. To reduce cases of suicide attributable to Toxoplasmosis, it deserving the measures to prevent and control of transmission of toxoplasmosis should be taken.

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A systematic review and meta-analysis for association of Helicobacter pylori colonization and celiac disease

PLoS ONE ◽

10.1371/journal.pone.0241156 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0241156

Author(s):

Fazel Isapanah Amlashi ◽

Zahra Norouzi ◽

Ahmad Sohrabi ◽

Hesamaddin Shirzad-Aski ◽

Alireza Norouzi ◽

...

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Celiac Disease ◽

Publication Bias ◽

Meta Analysis ◽

Protective Role ◽

Negative Association ◽

Risk Of Bias ◽

Control Group ◽

Synthesis Methods

Background and objectives Based on some previous observational studies, there is a theory that suggests a potential relationship between Helicobacter pylori (H. pylori) colonization and celiac disease (CeD); however, the type of this relationship is still controversial. Therefore, we aimed to conduct a systematic review and meta-analysis to explore all related primary studies to find any possible association between CeD and human H. pylori colonization. Data sources Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After screening, the quality and risk of bias assessment of the selected articles were evaluated. Synthesis methods Meta-analysis calculated pooled odds ratio (OR) on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed. Results Twenty-six studies were included in this systematic review, with a total of 6001 cases and 135512 control people. The results of meta-analysis on 26 studies showed a significant and negative association between H. pylori colonization and CeD (pooled OR = 0.56; 95% CI = 0.45–0.70; P < 0.001), with no publication bias (P = 0.825). The L’Abbé plots also showed a trend of having more H. pylori colonization in the control group. Among subgroups, ORs were notably different only when the data were stratified by continents or risk of bias; however, subgroup analysis could not determine the source of heterogeneity. Conclusions According to the meta-analysis, this negative association might imply a mild protective role of H. pylori against celiac disease. Although this negative association is not strong, it is statistically significant and should be further considered. Further investigations in both molecular and clinic fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of H. pylori colonization in CeD patients. Systematic review registration number (PROSPERO) CRD42020167730 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=167730.

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Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291718002003 ◽

2018 ◽

Vol 49 (4) ◽

pp. 685-696 ◽

Cited By ~ 7

Author(s):

Martin Taylor-Rowan ◽

Oyiza Momoh ◽

Luis Ayerbe ◽

Jonathan J. Evans ◽

David J. Stott ◽

...

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Meta Analysis ◽

Assessment Method ◽

Self Report ◽

Funnel Plot ◽

Strength Of Evidence ◽

Post Stroke ◽

Depression Assessment ◽

Post Stroke Depression

AbstractBackgroundDepression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with post-stroke depression.MethodsWe searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via ‘GRADE’.ResultsOf 11 884 studies identified, 29 were included (total participantsn= 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2–14.7]; range: 0.4–24% (I295.8). Prevalence of pre-stroke depression varied by assessment method (p= 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3–4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was ‘very low’.ConclusionsOne in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression.Protocol identifierPROSPERO identifier: CRD42017065544

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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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Biological effects of amniotic membrane on diabetic foot wounds: a systematic review

Journal of Wound Care ◽

10.12968/jowc.2018.27.sup2.s19 ◽

2018 ◽

Vol 27 (Sup2) ◽

pp. S19-S25 ◽

Cited By ~ 9

Author(s):

André Oliveira Paggiaro ◽

Andriws Garcia Menezes ◽

Alexandra Donizetti Ferrassi ◽

Viviane Fernandes De Carvalho ◽

Rolf Gemperli

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Amniotic Membrane ◽

Diabetic Foot ◽

Biological Effects ◽

Meta Analysis ◽

Healing Process ◽

Intervention Group ◽

Risk Of Bias ◽

Control Group

Objective: The amniotic membrane has biological properties that are beneficial to the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse the scientific evidence found in literature on the use of the amniotic membrane to stimulate DFU healing. Method: A systematic review of amniotic membrane's influence was undertaken, using the search terms ‘placenta’ ‘diabetic foot’ ‘amnion’ and biological dressing’, assessing the outcomes ‘wound healing’ and ‘wound healing time’, in DFU. Following the inclusion and exclusion criteria, randomised controlled trials (RCT) were identified, and the risk of bias was analysed according to the Cochrane risk of bias tool. We conducted a meta-analysis of the two outcomes to evaluate the level of evidence. Results: We identified six clinical trials, with a total of 331 patients. The most common risks of bias in the studies were selection, attrition, and detection biases. From the meta-analysis, the difference of the intervention group (amnion) in relation to the control group was statistically significant. We found that wound healing in the group treated with amniotic membrane occurs 2.32 times more often and is 32 days faster in comparison with the group that used conventional dressings. Conclusion: There is statistical evidence to support the effectiveness of amniotic membrane in comparison with other conventional dressings. In addition, there is a clear tendency for the use of amniotic membrane treatment to result in a larger number of DFUs healing at a quicker rate.

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