scholarly journals Examining the Effects of Diet Composition, Soluble Fiber, and Species on Total Fecal Excretion of Bile Acids: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Julia Guazzelli Pezzali ◽  
Anna K. Shoveller ◽  
Jennifer Ellis
Keyword(s):  
Bile Acids ◽  
Diet Composition ◽  
Meta Analysis ◽  
Random Effect ◽  
Fixed Effect ◽  
Information Criteria ◽  
Dietary Factors ◽  
Fecal Excretion ◽  
Dietary Carbohydrate ◽  
Soluble Fiber

Bile acids (BA) are produced in the liver and conjugated with glycine or taurine before being released into the small intestine to aid with lipid digestion. However, excessive BA losses through feces can occur due to several dietary factors that in turn require greater production of BA by the liver due to a reduction in BA recycling. Consequently, net utilization of taurine and/or glycine is increased. To quantify this impact, we conducted a meta-analysis to investigate the effect of soluble fiber, diet composition, and species on fecal excretion of BA. After a systematic review of the literature, twelve studies met all inclusion criteria. Dietary carbohydrate, protein, fat, cellulose, cholesterol, soluble fiber and animal species were tested as independent variables. Mixed models were developed treating study as a random effect, and fixed effect variables were retained at P < 0.05 significance and where collinearity was absent between multiple X variables. A total of ten studies comprised of four species [(rat = 5), hamster (n = 1), guinea pig (n = 3) and dog (n = 1)], and 30 observations were evaluated in the final models after outlier removal. Model evaluation was based on the corrected Akaike Information Criteria, the concordance correlation coefficient and the root mean square prediction error. Three base models were developed, examining carbohydrate, protein and fat impacts separately. The best fitting models included the fixed effect of species and the interaction between soluble fiber (yes/no) and dietary carbohydrate, protein or fat (%, as-fed). Increased concentrations of dietary protein and fat resulted in greater fecal excretion of BA (P < 0.05). Conversely, increasing levels of dietary carbohydrate led to lower excretions of BA (P < 0.05). Increased dietary soluble fiber containing ingredients resulted in greater excretion of BA in all models (P < 0.05). Rats had greater excretion of BA compared to hamsters and guinea pigs (P < 0.05) in all models, and also compared to dogs (P < 0.05) in the carbohydrate model. The findings from this meta-analysis indicate that not only soluble fiber, but also increasing levels of dietary fat and protein may result in greater fecal excretion of BA, potentially altering taurine and/or glycine metabolism and affecting the need for diet delivery of these AA.

scholarly journals Comparative efficacy between ketamine, memantine, riluzole and d-cycloserine in patients diagnosed with drug resistant depression: a meta-analysis

2019 ◽  
Vol 8 (6) ◽  
pp. 1132
Author(s):  
Nishita H. Darji ◽  
Devang A. Rana ◽  
Supriya D. Malhotra
Keyword(s):  
Rating Scale ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect ◽  
P Value ◽  
Drug Resistant ◽  
Effect Model ◽  
Resistant Depression ◽  
Glutamate Modulators

Background: Glutamate modulators are having immense potential and are newer entities for treating drug resistant depression. The objectives were to generate statistical evidence on basis of existing data of ketamine, memantine, riluzole and d-cycloserine in resistant depression.Methods: A total of 14 RCTs following PRISMA guidelines and matching inclusion and exclusion criteria were collected of ketamine (5), memantine (3), riluzole (2) and d-cycloserine (4) vs placebo in drug resistant depression. Only RCTs with primary diagnosis of drug resistant depression (Previously on two standard antidepressant therapy) were included. Studies with treatment response rate, 50% reduction in total score of the depression rating scale-Montgomery-Åsberg Depression Rating Scale or the Hamilton Depression Rating Scale or Beck Depression Inventory was chosen as clinical outcome measure. RevMan 5.3 software was used for the analysis.Results: In ketamine group using random effect model SMD was 2.122 (95% CI 0.659-3.584). P-value was statistically significant (random effect p <0.005 and in fixed effect <0.001). In memantine group, using random effect model -0.963 was SMD and (95% CI -1.958-0.0324). P-value was <0.001, significant in fixed effect. In riluzole group, SMD was -0.564 with (95% CI -3.927-2.799) in random effect. P-value was 0.741. In d-cycloserine group SMD was 0.316 with (95% CI -1.252-1.885) in random effect. P-value was 0.690.Conclusions: Ketamine showed best efficacy followed by memantine. Riluzole and DCS as such have no efficacy although its acts by same glutamate pathway. More molecular based research is required in use of glutamate modulators in resistant depression.

scholarly journals 465. Comparative Efficacy of Double vs. Single Antibiotic Regimens for the Empiric Treatment of MRSA-Induced Acute Bacterial Skin and Skin Structure Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S227-S228
Author(s):  
Abdullah A Alhifany ◽  
Nisrin Bifari ◽  
Yasser Alatawi ◽  
Saad Ullah Malik ◽  
Thamer Almangour
Keyword(s):  
Clinical Cure ◽  
Meta Analysis ◽  
Random Effect ◽  
Fixed Effect ◽  
Skin Structure Infection ◽  
Effect Analysis ◽  
Gram Negative ◽  
Skin Structure ◽  
Structure Infection ◽  
Random Effect Analysis

Abstract Background The initial management of Acute bacterial skin and skin structure infection (ABSSSI) is burdensome. It requires empirical antibiotic therapy that covers both gram-positive and gram-negative bacteria. Vancomycin plus aztreonam are the most commonly used antibiotic combination, nonetheless, they have many limitations which limits their use. Hence, many new single agents with MRSA and gram-negative coverage, oral options, and/or good safety profile have been developed to be a potential alternative such as: ceftaroline, ceftobiprole, tigecycline and the recent FDA approved antibiotic (delafloxacin). In the absence of head-to-head trials comparing these agents, we decided to conduct a network meta-analysis for these therapeutic regimens. Methods A Bayesian network meta-analysis of randomized clinical trials identified in PubMed/Medline and Embase databases was conducted. We performed both fixed and random effect models for clinical cure as the primary outcome of interest. Additionally, rankograms were generated using the surface under the cumulative ranking curve (SUCRA) to obtain the treatment ranking probabilities in relation to their relative effect. Results We identified 10 eligible studies involving 4,914 patients. The indirect comparison demonstrated that delafloxacin showed no difference in terms of clinical cure compared with ceftaroline (OR, 0.82, 95% Cr.I 0.39–1.8), ceftobiprole (OR, 0.79, 95% Cr.I 0.32–1.9), SOC (OR, 1.2, 95% Cr.I 0.62–2.4) and tigecycline (OR, 1.0, 95% Cr.I 0.45–2.2) in the fixed effect analysis, nor in the random-effect analysis (OR, 0.8, 95% Cr.I 0.26–2.2; OR, 0.78, 95% Cr.I 0.2–3.0; OR, 1.2, 95% Cr.I 0.51–3.1; and OR, 0.96, 95% Cr.I 0.30–3.0), respectively. Furthermore, the ranking probabilities in the fixed-effect and random-effect analysis showed that ceftaroline was ranked the first in terms of clinical cure (SUCRA, 40.02%) followed by ceftobiprole (SUCRA, 22.80%), delafloxacin (SUCRA, 16.60%), SOC (SUCRA, 13.80%), and then tigecycline (SUCRA, 6.70%). Conclusion Ceftaroline, ceftbiprole, delafoxacin, SOC and tigecycline are similarly effective. However, delafloxacin provides better convenience. Further comparative studies regarding their safety are needed. Disclosures All authors: No reported disclosures.

scholarly journals Prevalence of Preterm Birth in Pakistan: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Asif Hanif ◽  
Tahira Ashraf ◽  
Khadija Waheed ◽  
Mirza Rizwan Sajid ◽  
Nesrin Guler ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Meta Analysis ◽  
Random Effect ◽  
Fixed Effect ◽  
P Value ◽  
Local Data ◽  
Effect Model ◽  
Pooled Prevalence ◽  
Level Of Significance ◽  
Effect Heterogeneity

Abstract Objective:  This study is designed to systematically review the prevalence of preterm birth from previously published studies of Pakistan and to find pooled prevalence from available local data. Methodology:  Targeted literature was searched with specific key words such as “preterm birth, prematurity, prevalence and mortality in preterm birth in Pakistan”. Studies with copyright and/or permission issues were excluded. A total of 300 studies were found initially that were somewhat related to the topic, after careful screening only 5 studies met inclusion criteria for cur-rent study. To test the null hypothesis for all studies evaluating effect Cochran's Q was used and P-values with a level of significance of 5%were considered significant. Results:  The pooled prevalence of Preterm Birth was found to be 18.89% using fixed effect, 16.81% using random effect and 18.89% using fixed effect heterogeneity. I-squared for each effect model was > 75%. On applying Chi2 test we obtained significant p-value i.e. p-value < 0.01. Conclusion:  Through this meta-analysis we found one of the highest pooled prevalence of preterm birth in Pakistan. Reducing preterm birth can result in improvement of overall neonatal health and significantly reduce neonatal mortality in future.

scholarly journals Association of maternal prenatal selenium concentration and preterm birth: a multicountry meta-analysis

2021 ◽  
Vol 6 (9) ◽  
pp. e005856
Author(s):  
Nagendra Monangi ◽  
Huan Xu ◽  
Rasheda Khanam ◽  
Waqasuddin Khan ◽  
Saikat Deb ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Random Effect ◽  
Fixed Effect ◽  
Mass Spectrometry Analysis ◽  
Serum Samples ◽  
Entire Cohort ◽  
Spectrometry Analysis ◽  
Gestational Duration

BackgroundSelenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations.MethodsGestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. Maternal Se concentrations were determined by inductively coupled plasma mass spectrometry analysis. The associations between maternal Se with PTB and gestational duration were analysed using logistic and linear regressions. The results were then combined using fixed-effect and random-effect meta-analysis.FindingsIn all study samples, the Se concentrations followed a normal distribution with a mean of 93.8 ng/mL (SD: 28.5 ng/mL) but varied substantially across different sites. The fixed-effect meta-analysis across the 17 cohorts showed that Se was significantly associated with PTB and gestational duration with effect size estimates of an OR=0.95 (95% CI: 0.9 to 1.00) for PTB and 0.66 days (95% CI: 0.38 to 0.94) longer gestation per 15 ng/mL increase in Se concentration. However, there was a substantial heterogeneity among study cohorts and the random-effect meta-analysis did not achieve statistical significance. The largest effect sizes were observed in UK (Liverpool) cohort, and most significant associations were observed in samples from Malawi.InterpretationWhile our study observed statistically significant associations between maternal Se concentration and PTB at some sites, this did not generalise across the entire cohort. Whether population-specific factors explain the heterogeneity of our findings warrants further investigation. Further evidence is needed to understand the biologic pathways, clinical efficacy and safety, before changes to antenatal nutritional recommendations for Se supplementation are considered.

scholarly journals Impact of rate control in hospitalized patients with atrial fibrillation and sepsis: a systematic review and meta-analysis

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
GF Romiti ◽  
M Proietti
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Sensitivity Analysis ◽  
Hospital Mortality ◽  
Rate Control ◽  
Meta Analysis ◽  
Random Effect ◽  
Fixed Effect ◽  
Channel Blockers ◽  
Reduced Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial Fibrillation (AF) is a common complication in patients with sepsis, and imposes a worse prognosis and challenging clinical management. Administration of antiarrhythmics is often needed, to achieve rate or rhythm control, especially in the occurrence of AF with rapid ventricular response; however, it is unclear whether different classes of antiarrhythmics are associated with better outcomes in patients with sepsis and AF. Methods We performed a systematic review and meta-analysis according to PRISMA Guidelines. Pubmed and EMBASE databases were systematically searched for studies reporting outcomes in patients with sepsis and AF, according to the use of Beta-blockers (BBs), calcium-channel blockers (CCBs), digoxin and amiodarone. Random-effect models were used to provide pooled estimates; fixed-effect models were also performed as a sensitivity analysis. Results Among 4,166 studies, 2 articles were included from the literature search, and an additional 1 from the author’s knowledge, yielding a total of 40,593 patients with sepsis and AF included. According to the data available from the included studies, the meta-analysis was performed only for in-hospital mortality. BBs were associated with a reduced risk of in-hospital mortality compared to amiodarone (OR 0.52, 95% CI: 0.46-0.58; I2 = 0%, Figure 1, Panel C), while no significant differences were observed for BBs. vs. CCBs (Figure 1, Panel A) and for BBs vs. digoxin (Figure 1, Panel B). In the pre-specified sensitivity analysis using a fixed-effect model, BBs resulted associated with a lower risk of in-hospital mortality compared with both CCBs and digoxin). Conclusion In patients with AF during sepsis, BBs were associated with reduced risk of in-hospital mortality, compared to amiodarone; inconclusive results emerged for the comparisons between BBs and CCBs or digoxin, although with a benefit of BBs observed in the fixed-effect models. Further studies are needed to provide definitive data and to guide physicians in the choice of the best rate control strategy in this clinical setting. Abstract Figure.

scholarly journals MUC1 Immunohistochemical Expression as a Prognostic Factor in Gastric Cancer: Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao-Tong Wang ◽  
Fan-Biao Kong ◽  
Wei Mai ◽  
Lei Li ◽  
Li-Ming Pang
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Random Effect ◽  
Prognostic Significance ◽  
Fixed Effect ◽  
Potential Biomarker ◽  
Histologic Differentiation ◽  
Cell To Cell Adhesion

MUC1, a member of the mucin family, is expressed in tumors of various human organs and may function as an antiadhesion molecule that inhibits cell-to-cell adhesion, inducing tumor metastasis, and served as a potential biomarker of tumor progression in early gastric cancer. However, its prognostic significance in gastric cancer is still in dispute. We performed a meta-analysis to evaluate the relationship between MUC1 expression and prognosis of gastric cancer. A total of ten eligible studies with 834 cases and 548 controls were included. MUC1 positive cases were highly positive in intestinal-type carcinomas (OR = 1.76, 95% CI: 1.27–2.44,P=0.0008fixed-effect), higher rate of vascular invasion (OR = 1.64, 95% CI: 1.13–2.39,P=0.009fixed-effect), and lymph node metastasis (OR = 2.10, 95% CI: 1.20–3.67,P=0.01random-effect), as well as lower 5-year survival rate (HR = 0.27, 95% CI: 0.11–0.66,P=0.004random-effect). However, the presence of MUC1 was not associated with gender, tumor size, histologic differentiation, and clinical stage. In summary, MUC1 is a prognostic factor in gastric cancer, which acts as a marker of poor outcome in patients with gastric cancer. Further clinical studies are needed to confirm the role of MUC1 in clinical practice.

scholarly journals 411 Relationships between dietary composition and reproductive outcomes in cattle

2019 ◽  
Vol 97 (Supplement_3) ◽  
pp. 166-166
Author(s):  
Ty C Davis ◽  
Robin R White
Keyword(s):  
Pregnancy Rate ◽  
Artificial Insemination ◽  
Diet Composition ◽  
Meta Analysis ◽  
Dietary Factors ◽  
Neutral Detergent Fiber ◽  
Dietary Composition ◽  
Reproductive Outcomes ◽  
Random Intercept ◽  
Structural Carbohydrate

Abstract Individual experiments and recent literature summaries suggest links between reproductive outcomes in cattle and dietary composition. The objective of this meta-analysis was to evaluate the effects of dietary composition on reproductive efficiency of cows and heifers. A literature search returned 42 previously published papers containing 164 treatment means that were eligible for use in the meta-analysis. Diet composition information of interest included neutral detergent fiber (NDF), acid detergent fiber (ADF), organic matter (OM), crude protein (CP), lignin, ether extract (EE), non-structural carbohydrate (NSC) and starch percentages. For papers to be included, they needed to report reproductive outcomes, dry matter intake (DMI), experimental design details (treatments, design, number of experimental units, measurement SE or SD values, and P-values), and diets with all ingredients and inclusion percentages. Details on diet composition, intake, and reproductive outcomes were extracted from these papers and analyzed using linear mixed effects models with a random intercept for each study. When diet composition information was not reported, it was estimated from commercial feed library data and reported dietary feed inclusion rates. Days to service, days to ovulation, pregnancy at first artificial insemination, and overall pregnancy rate were the primary reproductive outcomes of interest. Significant variables were identified through a backward elimination approach. Overall pregnancy rate tended to be affected by the percentage of lignin in the diet (P = 0.078). Days to service was affected by dietary NDF (P = 0.013), ADF (P = 0.022), and starch (P = 0.027) percentages, and tended to be affected by lignin (P = 0.0768) percentage. Days to ovulation and pregnancy at first artificial insemination were not affected by the nutritional factors tested here. Additional assessment is needed to assess how dietary factors interact with other experimental and environmental variables to influence reproductive outcomes.

scholarly journals Meta-analysis of SNP-environment interaction with heterogeneity for overlapping data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qinqin Jin ◽  
Gang Shi
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect Model ◽  
Fixed Effect ◽  
Type I ◽  
Environment Interaction ◽  
Genome Wide Association Studies ◽  
Overlapping Data ◽  
Effect Model

AbstractMeta-analysis is a popular method used in genome-wide association studies, by which the results of multiple studies are combined to identify associations. This process generates heterogeneity. Recently, we proposed a random effect model meta-regression method (MR) to study the effect of single nucleotide polymorphism (SNP)-environment interactions. This method takes heterogeneity into account and produces high power. We also proposed a fixed effect model overlapping MR in which the overlapping data is taken into account. In the present study, a random effect model overlapping MR that simultaneously considers heterogeneity and overlapping data is proposed. This method is based on the random effect model MR and the fixed effect model overlapping MR. A new way of solving the logarithm of the determinant of covariance matrices in likelihood functions is also provided. Tests for the likelihood ratio statistic of the SNP-environment interaction effect and the SNP and SNP-environment joint effects are given. In our simulations, null distributions and type I error rates were proposed to verify the suitability of our method, and powers were applied to evaluate the superiority of our method. Our findings indicate that this method is effective in cases of overlapping data with a high heterogeneity.

scholarly journals Is Metformin Use Associated With a Decreased Mortality for COVID-19 Diabetic Patients? A Meta-Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A348-A348
Author(s):  
Chenyu Sun ◽  
Ce Cheng ◽  
Keun Young Kim ◽  
Mubashir Ayaz Ahmed ◽  
Reveena Manem
Keyword(s):  
Sensitivity Analysis ◽  
Publication Bias ◽  
Meta Analysis ◽  
Random Effect ◽  
Fixed Effect ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Risk Of Mortality ◽  
Reduced Risk ◽  
Hospital Use

Abstract Introduction: Coronavirus disease 2019 (COVID-19) has been spreading globally for more than half a year. Previous studies remain controversial regarding whether metformin is associated with reduced risk for COVID-19 diabetic patients. Thus, this meta-analysis is performed. Method: A comprehensive literature search on PubMed and Web of Science was conducted to identify all relevant studies published prior to October 2020 according to the established inclusion criteria. This meta-analysis was reported in conformity to the Preferred Reporting Project declared by the Systematic Review and Meta-Analysis (PRISMA). The quality assessment was performed by the Newcastle-Ottawa Scale (NOS). The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated to estimate the association between metformin use and mortality for COVID-19 patients. A random-effect or fixed-effect model was used based on heterogeneity significance. Subgroup analysis was performed based on in-hospital-use or home-use, and different sample sizes. Sensitivity analysis and publication bias detection were also performed. All statistical analyses were performed using RevMan software (version 5.3; Cochrane library) and STATA 12.0 statistical software (Stata Corp., College Station, TX), and all P values were two-tailed, the test level was 0.05. Result: 97 articles were obtained from the database search, and 5 articles obtained from other sources. 8 articles involving 11,169 participants were included. Most studies were considered moderate quality. A statistically significant association between metformin use and decreased mortality of COVID-19 patients was found (OR 0.53, 95%CI: 0.34, 0.83, P=0.005, I2=77%). In the subgroup analyses, home-use of metformin was also associated with a reduced risk of mortality (OR 0.54, 95%CI: 0.35, 0.84, P=0.006, I2=66%), and one study reporting in-hospital use did not find reduced mortality among COVID-19 patients taking metformin (OR 1.65, 95%CI: 0.71, 3.86, P=0.247). For sample size &gt;1,000, no statistically significant reduced risk of mortality (OR 0.84, 95%CI: 0.57, 1.26, P=0.41, I2=73%) was found, however, for sample ≤1,000, a statistically significant reduced risk of mortality (OR 0.29, 95%CI: 0.19, 0.44 P&lt;0.00001, I2=0%) was found. Sensitivity analysis by change fixed-effect models to random-effect models and by omitting each study at a time confirmed the relative stability of the result. Begg’s test (z=0.37, P=0.711) and Egger’s test (t=-1.98, P=0.096) did not detect a significant risk of publication bias. Conclusion: The current meta-analysis demonstrates that metformin use is associated with decreased mortality for COVID-19 diabetic patients. However, only one study investigating the in-hospital use of metformin. More high-quality original studies are needed to further explore the association between metformin use and mortality risk of COVID-19.

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