Ultrasonographic Evaluation of The Effects of Orthodontic or Functional Orthopaedic Treatment on Masseter Muscles: A Systematic Review and Meta-Analysis

Objectives: This review investigated the effects of orthodontic or functional orthopedic therapy on masseter muscle thickness through the use of ultrasonography (US) in growing subjects when compared with untreated subjects. Materials and Methods: This review systematically assessed studies that investigated growing subjects undergoing orthopedic therapy for the correction of malocclusion of vertical, sagittal and transversal plane. Electronic databases (CENTRAL, MEDLINE-PubMed, Scopus and Web of Science) were searched up to February 2019, including available RCTs and CCTs, without language restrictions. The primary outcome was the effect of orthopedic or functional treatment on masseter muscle thickness. The risk of bias of included studies was assessed through the Newcastle-Ottawa quality assessment scale with the aim of defining their methodological quality. A random-effects meta-analysis analyzing mean differences with 95% confidence intervals was used for quantitative analysis. Results: The search retrieved 749 titles, but the studies selection resulted in a final sample of 5 CCTs. The studies retrieved data from 233 children (age range: 5–22 years) and were conducted at university dental clinics. Children were treated for Class II malocclusion, increased vertical dimension or lateral cross-bite variably with rapid or slow maxillary expansion, twin block, bite block, mandibular activators, quad helix, alone or in combination. Risk of bias was assessed as medium for three studies, low for one and high for another. The meta-analysis determined that at the end of orthopedic or functional treatment masseter muscle thickness, measured through the use of US, is significantly reduced (MD −0.79 mm; 95% CI −1.28 to −0.31). The reduction in muscle thickness, therefore, could be considered an indicator for the evaluation of the success of therapy with orthodontic appliances. Conclusions: Although the meta-analysis revealed that US could be considered a less invasive and effective method to evaluate the masseter muscle thickness, single-blinded RCTs, are required to confirm US reliability in this field of application. This review was registered on PROSPERO with the following registration number: CRD42018068402.

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Hallux valgus orthosis characteristics and effectiveness: a systematic review with meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-047273 ◽

2021 ◽

Vol 11 (8) ◽

pp. e047273

Author(s):

Mei-Ying Kwan ◽

Kit-Lun Yick ◽

Joanne Yip ◽

Chi-Yung Tse

Keyword(s):

Systematic Review ◽

Hallux Valgus ◽

Outcome Measurement ◽

Meta Analysis ◽

Outcome Data ◽

Risk Of Bias ◽

Eligibility Criteria ◽

Systematic Analysis ◽

Registration Number ◽

Mean Differences

ObjectiveThe treatment effect of orthoses for hallux valgus (HV) is unclear with little interventional studies, the design involves multiple complex factors, and therefore a systematic analysis with meta-analysis is necessary. The objective of this systematic review and meta-analysis is to determine whether current foot orthoses are effective in treating HV.DesignSystematic review with meta-analysis.Data sourcesElectronic databases (PubMed, Scopus, Cinahl and Medline) are searched up to February 2020.Eligibility criteria for selecting studiesInterventional studies with content focus on HV orthosis design and any of the outcomes related to effectiveness for treating HV are included. The standardised mean differences are calculated. The risk of bias in included studies is assessed using the Cochrane Collaboration’s risk of bias tools.ResultsIn total, 2066 articles are identified. Among them, nine are selected and quality rated, and data are extracted and closely examined. A meta-analysis is conducted, where appropriate. The main causes of potential bias are missing outcome data and outcome measurement error. The results show that orthosis with a toe separator has the best effect of correcting the HV angle (standardised mean difference: 0.50, 95% CI: 0.189 to 0.803).ConclusionThe orthoses design with a toe separator or an element that allows for the foot anatomic alignment is critical for reducing the HV angle and relieving foot pain. The results contribute to a better selection of treatment for patients.PROSPERO registration numberCRD42021260403.

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Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis

Progress in Orthodontics ◽

10.1186/s40510-020-00334-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Allen Abbing ◽

Vasiliki Koretsi ◽

Theodore Eliades ◽

Spyridon N. Papageorgiou

Keyword(s):

Treatment Duration ◽

Meta Analysis ◽

Risk Of Bias ◽

Adult Patients ◽

Comprehensive Treatment ◽

Orthodontic Appliances ◽

Duration Of Treatment ◽

Quality Of Evidence ◽

Fixed Appliances

Abstract Objectives Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. Materials and methods Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. Results A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = − 0.8 month; 95% CI = − 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. Conclusions While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. Trial registration PROSPERO: (CRD42019148169)

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Astrocyte Biomarkers in Alzheimer Disease: A Systematic Review and Meta-analysis

Neurology ◽

10.1212/wnl.0000000000012109 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012109

Author(s):

Bruna Bellaver ◽

João Pedro Ferrari-Souza ◽

Lucas Uglione da Ros ◽

Stephen F Carter ◽

Elena Rodriguez-Vieitez ◽

...

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Effect Sizes ◽

Significant Progress ◽

Exclusion Criteria ◽

Mao B ◽

Positron Emission ◽

Registration Number ◽

Mean Differences

Objective:To perform a systematic review and meta-analysis to determine whether fluid and imaging astrocyte biomarkers are altered in Alzheimer's disease (AD).Methods:PubMed and Web of Science databases were searched for articles reporting fluid or imaging astrocyte biomarkers in AD. Pooled effect sizes were determined with mean differences (SMD) using the Hedge’s G method with random-effects to determine biomarker performance. Adapted questions from QUADAS-2 were applied for quality assessment. A protocol for this study has been previously registered in PROSPERO (registration number: CRD42020192304).Results:The initial search identified 1,425 articles. After exclusion criteria were applied, 33 articles (a total of 3,204 individuals) measuring levels of GFAP, S100B, YKL-40 and AQP4 in the blood and cerebrospinal fluid (CSF), as well as MAO-B, indexed by positron emission tomography 11C-deuterium-L-deprenyl ([11C]-DED), were included. GFAP (SMD = 0.94; 95% CI = 0.71-1.18) and YKL-40 (SMD = 0.76; CI 95% = 0.63-0.89) levels in the CSF, S100B levels in the blood (SMD = 2.91; CI 95% = 1.01-4.8) were found significantly increased in AD patients.Conclusions:Despite significant progress, applications of astrocyte biomarkers in AD remain in their early days. The meta-analysis demonstrated that astrocyte biomarkers are consistently altered in AD and supports further investigation for their inclusion in the AD clinical research framework for observational and interventional studies.

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Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-020-01271-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Haonan Tian ◽

Congman Xie ◽

Min Lin ◽

Hongmei Yang ◽

Aishu Ren

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Cochrane Central Register ◽

Canine Retraction ◽

Temporary Anchorage Devices ◽

The Mean ◽

Mean Differences ◽

Implant Anchorage

Abstract Background Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03). Conclusions There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.

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Tobacco, alcohol and illicit drugs during pregnancy and risk of neuroblastoma: systematic review

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-313615 ◽

2017 ◽

Vol 103 (5) ◽

pp. F467-F473 ◽

Cited By ~ 9

Author(s):

Eloise Müller-Schulte ◽

Gerhard Kurlemann ◽

Anja Harder

Keyword(s):

Illicit Drugs ◽

Illicit Drug ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Drug Consumption ◽

Case Control Studies ◽

Bias Analysis ◽

Random Effects Models ◽

Registration Number

ObjectiveTo determine whether prenatal and perinatal maternal consumption of alcohol, tobacco and/or illicit drugs is associated with risk of neuroblastoma.Data sourcesMedline and Embase (both from inception to February 2017), and reference lists of included studies.Study selectionTo be eligible, a study had to be an original report including data on intake of alcohol, tobacco smoking and/or consumption of illicit drugs during pregnancy and risk of neuroblastoma in the child.Data extractionFrom eligible studies, data study characteristics as well as effect measures and confounders were extracted. We assessed unadjusted and confounder-adjusted estimates, performed risk of bias analysis, constructed random-effects models and assessed heterogeneity.ResultsWe identified 14 case–control studies (1987–2016) involving a total of 3114 children with neuroblastoma. Meta-analysis of unadjusted estimates showed an association between alcohol (OR 1.26; 95% CI 1.07 to 1.49), tobacco (OR 1.22; 95% CI 1.04 to 1.44) and illicit drug consumption during pregnancy and risk of neuroblastoma during childhood, with illicit drug consumption showing the strongest association (OR 3.26; 95% CI 1.36 to 7.86). However, adjusted estimates were highly heterogeneous.LimitationsAll studies were at high risk of bias.ConclusionsSmoking, alcohol or illicit drugs during pregnancy might play a role in the development of neuroblastoma. However, well-designed studies are needed to assess whether these exposures are causal and whether time period during pregnancy, dose or co-consumption of substances is critical.Trial registration numberRegistration number CRD42016036165.

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Should home-based ovulation predictor kits be offered as an additional approach for fertility management for women and couples desiring pregnancy? A systematic review and meta-analysis

BMJ Global Health ◽

10.1136/bmjgh-2019-001403 ◽

2019 ◽

Vol 4 (2) ◽

pp. e001403 ◽

Cited By ~ 2

Author(s):

Ping Teresa Yeh ◽

Caitlin E Kennedy ◽

Sheryl Van der Poel ◽

Thabo Matsaseng ◽

Laura Bernard ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Observational Study ◽

Pregnancy Rate ◽

Meta Analysis ◽

Risk Of Bias ◽

Time To Pregnancy ◽

Fertility Management ◽

Home Based ◽

Registration Number

IntroductionTo inform the WHO Guideline on self-care interventions, we conducted a systematic review of the impact of ovulation predictor kits (OPKs) on time-to-pregnancy, pregnancy, live birth, stress/anxiety, social harms/adverse events and values/preferences.MethodsIncluded studies had to compare women desiring pregnancy who managed their fertility with and without OPKs, measure an outcome of interest and be published in a peer-reviewed journal. We searched for studies on PubMed, CINAHL, LILACS and EMBASE through November 2018. We assessed risk of bias assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for observational studies, and conducted meta-analysis using random effects models to generate pooled estimates of relative risk (RR).ResultsFour studies (three RCTs and one observational study) including 1487 participants, all in high-income countries, were included. Quality of evidence was low. Two RCTs found no difference in time-to-pregnancy. All studies reported pregnancy rate, with mixed results: one RCT from the 1990s among couples with unexplained or male-factor infertility found no difference in clinical pregnancy rate (RR: 1.09, 95% CI 0.51 to 2.32); two more recent RCTs found higher self-reported pregnancy rates among OPK users (pooled RR: 1.40, 95% CI 1.08 to 1.80). A small observational study found higher rates of pregnancy with lab testing versus OPKs among women using donor insemination services. One RCT found no increase in stress/anxiety after two menstrual cycles using OPKs, besides a decline in positive affect. No studies measured live birth or social harms/adverse events. Six studies presented end-users’ values/preferences, with almost all women reporting feeling satisfied, comfortable and confident using OPKs.ConclusionA small evidence base, from high-income countries and with high risk of bias, suggests that home-based use of OPKs may improve fertility management when attempting to become pregnant with no meaningful increase in stress/anxiety and with high user acceptability.Systematic review registration numberPROSPERO registration number CRD42019119402.

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eHealth Interventions for Fruit and Vegetable Intake: A Meta-Analysis of Effectiveness

Health Education & Behavior ◽

10.1177/1090198119859396 ◽

2019 ◽

Vol 46 (6) ◽

pp. 947-959 ◽

Cited By ~ 1

Author(s):

Norma Patricia Rodriguez Rocha ◽

Hyekyeong Kim

Keyword(s):

Fruits And Vegetables ◽

Vegetable Intake ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Risk Of Bias ◽

Healthy Population ◽

Effective Interventions ◽

Minimum Number ◽

Mean Differences

Background. An adequate intake of fruits and vegetables (FVI) has shown benefits for reduced risk of manifesting chronic diseases. Thus, development of effective interventions to promote FVI is paramount. Aim. To assess the effectiveness of eHealth interventions for FVI targeted to healthy population, in comparison with control groups, and identify the moderators contributing to their effectiveness. Method. A database search was conducted in April 2016 and July 2018 using MEDLINE, PsycINFO, ERIC, Google Scholar, SciELO, and RISS, yielding 19 eligible studies. Risk of bias was assessed using Cochrane’s Risk of Bias Tool. Random-effects model was used to calculate effect sizes (ES) by weighted standardized mean differences. Results. This meta-analysis includes 19 studies and 6,894 participants. The most common eHealth tool used was Internet-based interventions ( n = 10). Most of studies were conducted in adults ( n = 11), followed by children ( n = 4), and adolescents ( n = 4). The minimum number of behavior change techniques (BCTs) used was one, and the maximum seven. The overall ES was small (0.26, p < .001), favoring eHealth interventions. The between-studies heterogeneity was large ( I2 = 62.77%, p < .001). Subgroup analyses showed that the components with larger ES were tailored interventions (0.27, p < .001), computer-based interventions (0.44, p < .001), and use of ≥7 BCTs (0.42, p < .001). Discussion. All studies showed a positive ES favoring interventions. Large heterogeneity could be explained in part by the number of BCTs and type of eHealth tool used. Nonetheless, more concrete evidence regarding other intervention components effectiveness was limited by small sample size. Conclusion. The use of eHealth tools for the improvement of FVI showed to be more effective compared with nonintervention and interventions not using these technologies. Nonetheless, more research is needed to determine the specific combination of intervention components that could translate into larger effectiveness.

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Effects of Acupressure on Anxiety: A Systematic Review and Meta-Analysis

Acupuncture in Medicine ◽

10.1136/acupmed-2014-010720 ◽

2015 ◽

Vol 33 (5) ◽

pp. 353-359 ◽

Cited By ~ 30

Author(s):

Doreen W H Au ◽

Hector W H Tsang ◽

Paul P M Ling ◽

Christie H T Leung ◽

P K Ip ◽

...

Keyword(s):

Effect Size ◽

Citation Index ◽

Meta Analysis ◽

Allocation Concealment ◽

Risk Of Bias ◽

Medium Effect ◽

Physiological Indicators ◽

Medium Effect Size ◽

Mean Differences ◽

Randomised Controlled

Objective To evaluate the evidence from randomised controlled trials (RCTs) and quantify the effects of acupressure on anxiety among adults. Methodology RCTs published between January 1997 and February 2014, comparing acupressure with sham control, were identified from the databases Science Citation Index/Social Sciences Citation Index, Scopus, PubMed and PsycINFO. Meta-analysis of eligible studies was performed and the magnitude of the overall effect size was calculated for the anxiety outcome. Revised STRICTA (the Standards for Reporting Interventions in Clinical Trials of Acupuncture) criteria were used to appraise the acupressure procedures, and the Cochrane risk of bias tool was used to assess the methodological quality of the studies. Results Of 39 potentially relevant studies, seven RCTs met the inclusion criteria for review while five studies met the criteria for meta-analysis. All studies reported the positive effect of acupressure on relieving anxiety from the anticipation of surgery or treatment. EX-HN3 ( Yintang), HT7 ( Shenmen) were the commonest points selected and two studies used bilateral points. The acupressure procedure was generally well reported and studies had a low risk of bias. The combined results of the five trials showed a greater overall reduction in anxiety in the acupressure group than in the sham controls (standardised mean differences (SMD)=−1.11; 95% CI −1.61 to −0.61; p<0.0001 heterogeneity: I2=75%; χ2=16.17; p=0.003; r=0.485). Conclusions Acupressure seems to be effective in providing immediate relief of pretreatment anxiety among adults, and has a medium effect size. However, conflicting results were found for the improvements on physiological indicators. More rigorous reporting, including allocation concealment procedure, is needed to strengthen the results.

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Reliability of Mouse Behavioural Tests of Anxiety: a Systematic Review and Meta-Analysis on the Effects of Anxiolytics.

10.1101/2021.07.28.454267 ◽

2021 ◽

Author(s):

Marianna Rosso ◽

Robin Wirz ◽

Ariane Vera Loretan ◽

Nicole Alessandra Sutter ◽

Charlène Tatiana Pereira da Cunha ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Control Treatment ◽

Test Results ◽

Animal Models Of Anxiety ◽

Mean Differences ◽

Behavioural Tests ◽

Meta Analyses ◽

Quality Checklist

Animal research on anxiety and anxiety disorders relies on valid animal models of anxiety. However, the validity of widely used rodent behavioural tests of anxiety has repeatedly been questioned, as they often fail to produce consistent results across independent replicate studies using different study populations or different anxiolytic compounds. In this study, we assessed the sensitivity of behavioural tests of anxiety in mice to detect anxiolytic effects of drugs prescribed to treat anxiety in humans. To this end, we conducted a pre-registered systematic review of studies reporting tests of anxiolytic compounds against a control treatment using common behavioural tests of anxiety in mice. PubMed and EMBASE were searched on August 21 st 2019 for studies published in English and 814 papers were identified for inclusion. Risk of bias was assessed based on Syrcle’s risk of bias tool and the Camarades study quality checklist on a randomly selected subsample of 180 papers. Meta-analyses on effect sizes of treatments using standardized mean differences (Hedges’ g) showed that only two of 17 test measures reliably detected effects of anxiolytic compounds other than diazepam. Further, we report considerable variation in both direction and size of effects of most anxiolytics on most outcome variables, indicating poor replicability of test results. This was corroborated by high heterogeneity in most test measures. Finally, we found an overall high risk of bias. Our findings indicate a general lack of sensitivity of common behavioural tests of anxiety in mice to anxiolytic compounds and cast serious doubt on both construct and predictive validity of most of those tests. The use of animals to model human conditions can be justified only if the expected results are informative, reproducible, and translatable. In view of scientifically valid and ethically responsible research, we call for a revision of behavioural tests of anxiety in mice and the development of more predictive tests .

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Lisfranc injuries: fix or fuse?

Bone & Joint Open ◽

10.1302/2633-1462.210.bjo-2021-0127.r1 ◽

2021 ◽

Vol 2 (10) ◽

pp. 842-849

Author(s):

Noortje Anna Clasina van den Boom ◽

Guido A. N. L. Stollenwerck ◽

Laureanne Lodewijks ◽

Jeroen Bransen ◽

Silvia M. A. A. Evers ◽

...

Keyword(s):

Meta Analysis ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Risk Of Bias ◽

Level Of Evidence ◽

Assessment Development ◽

Significant Difference ◽

Patient Reported ◽

Mean Differences ◽

Lisfranc Injuries

Aims This systematic review and meta-analysis was conducted to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA) in the treatment of Lisfranc injuries, regarding patient-reported outcome measures (PROMs), and risk of secondary surgery. The aim was to conclusively determine the best available treatment based on the most complete and recent evidence available. Methods A systematic search was conducted in PubMed, Cochrane Controlled Register of Trials (CENTRAL), EMBASE, CINAHL, PEDro, and SPORTDiscus. Additionally, ongoing trial registers and reference lists of included articles were screened. Risk of bias (RoB) and level of evidence were assessed using the Cochrane risk of bias tools and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The random and fixed-effect models were used for the statistical analysis. Results A total of 20 studies were selected for this review, of which 12 were comparative studies fit for meta-analysis, including three randomized controlled trials (RCTs). This resulted in a total analyzed population of 392 patients treated with ORIF and 249 patients treated with PA. The mean differences between the two groups in American Orthopedic Foot and Ankle Society (AOFAS), VAS, and SF-36 scores were -7.41 (95% confidence interval (CI) -13.31 to -1.51), 0.77 (95% CI -0.85 to 2.39), and -1.20 (95% CI -3.86 to 1.46), respectively. Conclusion This is the first study to find a statistically significant difference in PROMs, as measured by the AOFAS score, in favour of PA for the treatment of Lisfranc injuries. However, this difference may not be clinically relevant, and therefore drawing a definitive conclusion requires confirmation by a large prospective high-quality RCT. Such a study should also assess cost-effectiveness, as cost considerations might be decisive in decision-making. Level of Evidence: I Cite this article: Bone Jt Open 2021;2(10):842–849.

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