scholarly journals The Impact on Survival and Morbidity of Portal–Mesenteric Resection During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma: A Systematic Review and Meta-Analysis of Comparative Studies

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1976
Author(s):  
Alessandro Fancellu ◽  
Niccolò Petrucciani ◽  
Alberto Porcu ◽  
Giulia Deiana ◽  
Valeria Sanna ◽  
...  
Keyword(s):  
Postoperative Morbidity ◽  
Meta Analysis ◽  
Pancreatic Head ◽  
Oncological Outcome ◽  
Multimodality Treatment ◽  
Venous Resection ◽  
R1 Resection ◽  
Impact On Survival ◽  
The Impact

Background: The literature is conflicting regarding oncological outcome and morbidity associated to portal–mesenteric resection during pancreaticoduodenectomy (PD) in patients with pancreatic head adenocarcinoma (PHAC). Methods: A meta-analysis of studies comparing PD plus venous resection (PD+VR) and standard PD exclusively in patients with adenocarcinoma of the pancreatic head was conducted. Results: Twenty-three cohort studies were identified, which included 6037 patients, of which 28.6% underwent PD+VR and 71.4% underwent standard PD. Patients who received PD+VR had lower 1-year overall survival (OS) (odds radio OR 0.79, 95% CI 0.67–0.92, p = 0.003), 3-year OS (OR 0.72, 95% CI 0.59–0.87, p = 0.0006), and 5-year OS (OR 0.57, 95% CI 0.39–0.83, p = 0.003). Patients in the PD+VR group were more likely to have a larger tumor size (MD 3.87, 95% CI 1.75 to 5.99, p = 0.0003), positive lymph nodes (OR 1.24, 95% CI 1.06–1.45, p = 0.007), and R1 resection (OR 1.74, 95% CI 1.37–2.20, p < 0.0001). Thirty-day mortality was higher in the PD+VR group (OR 1.93, 95% CI 1.28–2.91, p = 0.002), while no differences between groups were observed in rates of total complications (OR 1.07, 95% CI, 0.81–1.41, p = 0.65). Conclusions: Although PD+VR has significantly increased the resection rate in patients with PHAC, it has inferior survival outcomes and higher 30-day mortality when compared with standard PD, whereas postoperative morbidity rates are similar. Further research is needed to evaluate the role of PD+VR in the context of multimodality treatment of PHAC.

scholarly journals The Role of Elective Neck Treatment in the Management of Sinonasal Carcinomas: A Systematic Review of the Literature and a Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1842
Author(s):  
Costanza Galloni ◽  
Luca Giovanni Locatello ◽  
Chiara Bruno ◽  
Angelo Cannavicci ◽  
Giandomenico Maggiore ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Risk ◽  
Meta Analysis ◽  
Regional Recurrence ◽  
Observation Group ◽  
Review Of The Literature ◽  
Impact On Survival ◽  
The Impact ◽  
Nodal Relapse

The impact of elective neck treatment (ENT), whether by irradiation or dissection, on the prognosis of patients with cN0 sinonasal carcinomas (SNCs) remains an understudied issue. METHODS: A systematic review and meta-analysis of the literature were performed according to PRISMA guidelines in order to assess regional nodal relapse rate after ENT compared to observation in cN0 SNCs patients. Twenty-six articles for a total of 1178 clinically N0 patients were analyzed. Globally, the 5-year overall survival was 52%; 34.6% of patients underwent ENT and 140 regional recurrences were registered (5.9% in the ENT cohort and 15% in the observation group). ENT appears to confer a lower risk of regional recurrence compared to observation alone, with a cumulative OR of 0.38 (95% CI 0.25–0.58). Our meta-analysis supports the efficacy of ENT for reducing the risk of regional recurrence, but its overall impact on survival remains uncertain.

Why Do Firms Participate in Voluntary Environmental Programs? A Meta-Analysis of the Role of Institutions, Resources, and Program Stringency

2021 ◽  
pp. 108602662199006
Author(s):  
Peter Tashman ◽  
Svetlana Flankova ◽  
Marc van Essen ◽  
Valentina Marano
Keyword(s):  
Quality Management ◽  
Prior Experience ◽  
Meta Analysis ◽  
Institutional Pressures ◽  
Environmental Programs ◽  
Voluntary Environmental Programs ◽  
Management Standards ◽  
Trade Offs ◽  
The Impact

We meta-analyze research on why firms join voluntary environmental programs (VEPs) to assess the impact of program stringency, or the extent to which they have rigorous, enforceable standards on these decisions. Stringency creates trade-offs for firms by affecting programs’ effectiveness, legitimacy, and adoption costs. Most research considers singular programs and lacks cross program variation needed to analyze program stringency’s impact. Our meta-analysis addresses this by sampling 127 studies and 23 VEPs. We begin by identifying common institutional and resource-based drivers of participation in the literature, and then analyze how program stringency moderates their impacts. Our results suggest that strictly governed VEPs encourage participation among highly visible and profitable firms, and discourage it when informal institutional pressures are higher, and firms have prior experience with other VEPs or quality management standards. We demonstrate that VEP stringency has nuanced effects on firm participation based on the institutional and resource-based factors facing them.

scholarly journals Impact of remdesivir on 28 day mortality in hospitalized patients with COVID-19: February 2021 Meta-analysis

2021 ◽  
Author(s):  
Robert Robinson ◽  
Vidhya Prakash ◽  
Raad Al Tamimi ◽  
Nour Albast ◽  
Basma Al-Bast ◽  
...  
Keyword(s):  
Usual Care ◽  
English Language ◽  
Meta Analysis ◽  
Severity Of Illness ◽  
Hospitalized Patients ◽  
Randomized Controlled ◽  
Analysis Process ◽  
All Cause Mortality ◽  
The Impact

AbstractBackgroundThe COVID-19 pandemic has stimulated worldwide investigation into a myriad of potential therapeutic agents, including antivirals such as remdesivir. The first RCT reporting results on the impact of remdesivir on COVID-19 in a peer reviewed journal was the ACTT-1 trial published in November, 2020. The ACTT-1 trial showed more rapid clinical improvement and a reduced risk of 28-day mortality in patients who received remdesivir.This study is a meta-analysis of peer reviewed RCTs aims to estimate the association of remdesivir therapy compared to the usual care or placebo on all-cause mortality in hospitalized patients with COVID-19. Software based tools to accelerate the analysis process.MethodsMeta-analysis of peer reviewed RCTs comparing remdesivir to usual care or placebo. The protocol for this meta-analysis was registered and published in the PROSPERO database (CRD42021229985) on February 5, 2021.ResultsFour English language RCTs were identified, including data from 7,333 hospitalized patients worldwide using remdesivir in COVID-19 positive patients.Meta-analysis of all identified RCTs showed no difference in survival in patients who received remdesivir therapy compared to usual care or placebo. The random effects meta-analysis has a summary odd ratio is 0.89 (95% CI 0.65-1.21, p = 0.30). Considerable variability in the severity of illness is noted with the rates of IMV at the time of randomization ranging from 0% to 27%.ConclusionsThis meta-analysis of randomized controlled trials published in peer-reviewed literature by February 1, 2021 did not show reduced mortality in hospitalized patients with COVID-19 who received remdesivir. Further research is needed to clarify the role of remdesivir therapy in the management of COVID-19.

scholarly journals The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4462
Author(s):  
Konstantinos G. Kyriakoulis ◽  
Anastasios Kollias ◽  
Garyphallia Poulakou ◽  
Ioannis G. Kyriakoulis ◽  
Ioannis P. Trontzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Severe Pneumonia ◽  
Hospitalized Patients ◽  
Current Evidence ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
The Impact

The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19.

scholarly journals The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Jingxuan Quek ◽  
Grace Lim ◽  
Wen Hui Lim ◽  
Cheng Han Ng ◽  
Wei Zheng So ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Mortality ◽  
Lower Risk ◽  
Meta Analysis ◽  
Clinical Endpoints ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Impact ◽  
Dietary Indices

Background: The association between plant-based diets and cardiovascular disease (CVD) remains poorly characterized. Given that diet represents an important and a modifiable risk factor, this study aimed to assess (1) the relationships between the impact of adherence to plant-based diets on cardiovascular mortality, incident CVD, and stroke; (2) if associations differed by adherence to healthful and less healthful plant-based diets.Methods and Findings: MEDLINE and EMBASE databases were searched up to May 2021. Studies assessing CVD outcomes with relation to plant-based dietary patterns or according to plant-based dietary indices (PDI) were included. A meta-analysis of hazard ratios (HR) was conducted using DerSimonian and Laird random effects model. Thirteen studies involving 410,085 participants were included. Greater adherence to an overall plant-based dietary pattern was significantly associated with a lower risk of cardiovascular mortality (pooled HR: 0.92, 95% CI: 0.86–0.99 p = 0.0193, I2 = 88.5%, N = 124,501) and a lower risk of CVD incidence (pooled HR: 0.90, 95% CI: 0.82–0.98, p = 0.0173, I2 = 87.2%, N = 323,854). Among the studies that used PDI, unhealthful plant-based diets were associated with increased risk of cardiovascular mortality (pooled HR: 1.05, 95% CI: 1.01–1.09, p = 0.0123, I2 = 0.00%, N = 18,966), but not CVD incidence. Conversely, healthful plant-based diets were associated with decreased CVD incidence (pooled HR: 0.87, 95% CI: 0.80–0.95, p = 0.0011, I2 = 57.5%, N = 71,301), but not mortality. Vegetarians also had significantly lower CVD incidence (HR: 0.81, 95% CI: 0.72–0.91, p = 0.0004, I2 = 22.2%, N = 16,254), but similar CVD mortality or stroke risk when compared to the meat-eaters.Conclusion: To date, this comprehensive study examines the effects of a plant-based diet on major clinical endpoints using more holistic PDIs. These findings highlight the favorable role of healthful plant-based foods in reducing cardiovascular mortality and CVD.

scholarly journals The Role of Machine Learning Techniques to Tackle COVID-19 Crisis: A Systematic Review.

2020 ◽  
Author(s):  
Hafsa Bareen Syeda ◽  
Mahanazuddin Syed ◽  
Kevin Wayne Sexton ◽  
Shorabuddin Syed ◽  
Salma Begum ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Disease Progression ◽  
Meta Analysis ◽  
Machine Learning Techniques ◽  
Data Types ◽  
Detection And Diagnosis ◽  
Novel Coronavirus ◽  
The Impact

Background: The novel coronavirus responsible for COVID-19 has caused havoc with patients presenting a spectrum of complications forcing the healthcare experts around the globe to explore new technological solutions, and treatment plans. Machine learning (ML) based technologies have played a substantial role in solving complex problems, and several organizations have been swift to adopt and customize them in response to the challenges posed by the COVID-19 pandemic. Objective: The objective of this study is to conduct a systematic literature review on the role of ML as a comprehensive and decisive technology to fight the COVID-19 crisis in the arena of epidemiology, diagnosis, and disease progression. Methods: A systematic search in PubMed, Web of Science, and CINAHL databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify all potentially relevant studies published and made available between December 1, 2019, and June 27, 2020. The search syntax was built using keywords specific to COVID-19 and ML. A total of 128 qualified articles were reviewed and analyzed based on the study objectives. Results: The 128 publications selected were classified into three themes based on ML applications employed to combat the COVID-19 crisis: Computational Epidemiology (CE), Early Detection and Diagnosis (EDD), and Disease Progression (DP). Of the 128 studies, 70 focused on predicting the outbreak, the impact of containment policies, and potential drug discoveries, which were grouped into the CE theme. For the EDD, we grouped forty studies that applied ML techniques to detect the presence of COVID-19 using the patient's radiological images or lab results. Eighteen publications that focused on predicting the disease progression, outcomes (recovery and mortality), Length of Stay (LOS), and number of Intensive Care Unit (ICU) days for COVID-19 positive patients were classified under the DP theme. Conclusions: In this systematic review, we assembled the current COVID-19 literature that utilized ML methods to provide insights into the COVID-19 themes, highlighting the important variables, data types, and available COVID-19 resources that can assist in facilitating clinical and translational research.

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