Risk Factors for Injuries During Military Static-Line Airborne Operations: A Systematic Review and Meta-Analysis

Objective: To identify and analyze articles in which the authors examined risk factors for soldiers during military static-line airborne operations. Data Sources: We searched for articles in PubMed, the Defense Technical Information Center, reference lists, and other sources using the key words airborne, parachuting, parachutes, paratrooper, injuries, wounds, trauma, and musculoskeletal. Study Selection: The search identified 17 684 potential studies. Studies were included if they were written in English, involved military static-line parachute operations, recorded injuries directly from events on the landing zone or from safety or medical records, and provided data for quantitative assessment of injury risk factors. A total of 23 studies met the review criteria, and 15 were included in the meta-analysis. Data Extraction: The summary statistic obtained for each risk factor was the risk ratio, which was the ratio of the injury risk in 1 group to that of another (baseline) group. Where data were sufficient, meta-analyses were performed and heterogeneity and publication bias were assessed. Data Synthesis: Risk factors for static-line parachuting injuries included night jumps, jumps with extra equipment, higher wind speeds, higher air temperatures, jumps from fixed-wing aircraft rather than balloons or helicopters, jumps onto certain types of terrain, being a female paratrooper, greater body weight, not using the parachute ankle brace, smaller parachute canopies, simultaneous exits from both sides of an aircraft, higher heat index, winds from the rear of the aircraft on exit entanglements, less experience with a particular parachute system, being an enlisted soldier rather than an officer, and jumps involving a greater number of paratroopers. Conclusions: We analyzed and summarized factors that increased the injury risk for soldiers during military static-line parachute operations. Understanding and considering these factors in risk evaluations may reduce the likelihood of injury during parachuting.

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Intensity and duration of lifestyle interventions for long-term weight loss and association with mortality: a meta-analysis of randomised trials

BMJ Open ◽

10.1136/bmjopen-2019-029966 ◽

2019 ◽

Vol 9 (8) ◽

pp. e029966 ◽

Cited By ~ 1

Author(s):

Navneet Singh ◽

Ralph Alan Huston Stewart ◽

Jocelyne Rachelle Benatar

Keyword(s):

Risk Factors ◽

Weight Loss ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Lifestyle Interventions ◽

Randomised Trials ◽

Eligibility Criteria ◽

Meta Analyses

ObjectivesTo evaluate the importance of the frequency and duration of lifestyle interventions for achieving weight loss over ≥1 year and associations with all-cause mortality.DesignMeta-analysis of randomised trials using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and RevMan software version 5·2 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen).Data sourcesMEDLINE, CENTRAL, Google and Science Direct databases alongside reference lists of appropriate articles and meta-analyses.Eligibility criteriaRandomised studies published in English-language journals from 1980 to June 2018 that assessed lifestyle compared with control interventions on weight loss and that included ≥100 subjects and reported weight change and mortality for ≥1 year.Data extraction and synthesisTwo independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CI and OR with 95% CI as appropriate. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2statistic). The Grading of Recommendations Assessment, Development, and Evaluation score was used to assess the certainty of the evidence.Results31 randomised trials with a total of 20 816 overweight or obese participants were included. 70% of participants had cardiometabolic risk factors. Body weight was lower for lifestyle intervention compared with the control at 1 year (3.63 kg, 95% CI 2.58 to 4.67) and at 3 years (2.45 kg, 95% CI 1.17 to 3.73). Weight loss at 1 year was greater in studies with >28 compared with ≤28 interventions per year (4.50 kg, 95% CI 3.03, 5.97 vs 2.38, 95% CI 0.78 to 3.98 kg, p=0.001). In all studies, there were 593 deaths (~0.3%/year). The ORs for mortality for weight loss interventions compared with the controls was 0.86 (95% CI 0.73 to 1.02), p=0.09.ConclusionIn predominantly healthy populations with risk factors, there is a dose response with number of lifestyle interventions and weight loss. Frequent and sustained interventions are needed to achieve a clinically significant 5% weight loss. There was insufficient evidence to reliably evaluate the benefits in persons with known cardiovascular disease or cancer.Trial registration numberCRD42018095067.

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Predictability of rotational tooth movement with orthodontic aligners comparing software-based and achieved data: A systematic review and meta-analysis of observational studies

Journal of Orthodontics ◽

10.1177/14653125211027266 ◽

2021 ◽

pp. 146531252110272

Author(s):

Despina Koletsi ◽

Anna Iliadi ◽

Theodore Eliades

Keyword(s):

Effect Size ◽

Tooth Movement ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Patient Treatment ◽

Qualitative Synthesis ◽

Meta Analyses ◽

Enamel Reduction

Objective: To evaluate all available evidence on the prediction of rotational tooth movements with aligners. Data sources: Seven databases of published and unpublished literature were searched up to 4 August 2020 for eligible studies. Data selection: Studies were deemed eligible if they included evaluation of rotational tooth movement with any type of aligner, through the comparison of software-based and actually achieved data after patient treatment. Data extraction and data synthesis: Data extraction was done independently and in duplicate and risk of bias assessment was performed with the use of the QUADAS-2 tool. Random effects meta-analyses with effect sizes and their 95% confidence intervals (CIs) were performed and the quality of the evidence was assessed through GRADE. Results: Seven articles were included in the qualitative synthesis, of which three contributed to meta-analyses. Overall results revealed a non-accurate prediction of the outcome for the software-based data, irrespective of the use of attachments or interproximal enamel reduction (IPR). Maxillary canines demonstrated the lowest percentage accuracy for rotational tooth movement (three studies: effect size = 47.9%; 95% CI = 27.2–69.5; P < 0.001), although high levels of heterogeneity were identified (I2: 86.9%; P < 0.001). Contrary, mandibular incisors presented the highest percentage accuracy for predicted rotational movement (two studies: effect size = 70.7%; 95% CI = 58.9–82.5; P < 0.001; I2: 0.0%; P = 0.48). Risk of bias was unclear to low overall, while quality of the evidence ranged from low to moderate. Conclusion: Allowing for all identified caveats, prediction of rotational tooth movements with aligner treatment does not appear accurate, especially for canines. Careful selection of patients and malocclusions for aligner treatment decisions remain challenging.

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Relationship between hospital or surgeon volume and outcomes in joint arthroplasty: protocol for a suite of systematic reviews and dose–response meta-analyses

BMJ Open ◽

10.1136/bmjopen-2018-022797 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022797 ◽

Cited By ~ 2

Author(s):

Xiang-Dong Wu ◽

Meng-Meng Liu ◽

Ya-Ying Sun ◽

Zhi-Hu Zhao ◽

Quan Zhou ◽

...

Keyword(s):

Systematic Reviews ◽

Dose Response ◽

Data Extraction ◽

Meta Analysis ◽

High Volume ◽

Joint Arthroplasty ◽

Surgeon Volume ◽

Published Data ◽

Records Management ◽

Meta Analyses

IntroductionJoint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume–outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood. Furthermore, whether elective arthroplasty should be restricted to high-volume hospitals or surgeons remains in dispute, and little is known regarding where the thresholds should be set for different types of joint arthroplasties.Methods and analysesThis is a protocol for a suite of systematic reviews and dose–response meta-analyses, which will be amended and updated in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Electronic databases, including PubMed and Embase, will be searched for observational studies examining the relationship between the hospital or surgeon volume and clinical outcomes in adult patients undergoing primary or revision of joint arthroplasty. We will use records management software for study selection and a predefined standardised file for data extraction and management. Quality will be assessed using the Newcastle-Ottawa Scale, and the meta-analysis, subgroup analysis and sensitivity analysis will be performed using Stata statistical software. Once the volume–outcome relationships are established, we will examine the potential non-linear relationships between hospital/surgeon volume and outcomes and detect whether thresholds or turning points exist.Ethics and disseminationEthical approval is not required, because these studies are based on aggregated published data. The results of this suite of systematic reviews and meta-analyses will be submitted to peer-reviewed journals for publication.PROSPERO registration numberCRD42017056639.

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Leishmanicidal effects of resveratrol and its derivatives: a systematic review and meta-Analysis

10.21203/rs.3.rs-25274/v1 ◽

2020 ◽

Author(s):

Nasrin Amiri Dashatan ◽

Marzieh Ashrafmansouri ◽

Mehdi Koushki ◽

Nayebali Ahmadi

Keyword(s):

Systematic Review ◽

Publication Bias ◽

Data Extraction ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Protective Effects ◽

Random Effects Models ◽

Important Health ◽

Mean Differences ◽

Meta Analyses

Abstract Background Leishmaniasis is one of the most important health problems worldwide. The evidence has suggested that resveratrol and its derivatives have anti-leishmanial effects; however, the results are inconsistent and inconclusive. The aim of this study was to assess the effect of resveratrol and its derivatives on the Leishmania viability through a systematic review and meta-analysis of available relevant studies. Methods The electronic databases PubMed, ScienceDirect, Embase, Web of Science and Scopus were queried between October 2000 and April 2020 using a comprehensive search strategy. The eligible articles selected and data extraction conducted by two reviewers. Mean differences of IC50 (concentration leading to reduction of 50% of Leishmania) for each outcome was calculated using random-effects models. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity and the stability of the pooled results. Publication bias was evaluated using the Egger’s and Begg’s tests. We also followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for this review. Results Ten studies were included in the meta-analysis. We observed that RSV and its derivatives had significant reducing effects on Leishmania viability in promastigote [24.02 µg/ml; (95% CI 17.1, 30.8); P < 0.05; I2 = 99.8%; P heterogeneity = 0.00] and amastigote [18.3 µg/ml; (95% CI 13.5, 23.2); P < 0.05; I2 = 99.6%; P heterogeneity = 0.00] stages of Leishmania. A significant publication bias was observed in the meta-analysis. Sensitivity analyses showed a similar effect size while reducing the heterogeneity. Subgroup analysis indicated that the pooled effects of leishmanicidal of resveratrol and its derivatives were affected by type of stilbenes and Leishmania species. Conclusions Our findings clearly suggest that the strategies for the treatment of leishmaniasis should be focused on natural products such as RSV and its derivatives. Further study is needed to identify the mechanisms mediating this protective effects of RSV and its derivatives in leishmaniasis.

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Aromatherapy for Symptom Relief in Patients with Burn: A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina58010001 ◽

2021 ◽

Vol 58 (1) ◽

pp. 1

Author(s):

Hye Won Lee ◽

Lin Ang ◽

Jung Tae Kim ◽

Myeong Soo Lee

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Symptom Relief ◽

Routine Care ◽

Risk Of Bias ◽

Review Author ◽

Beneficial Effects ◽

Study Selection ◽

Meta Analyses

Background and Objectives: This review aimed to provide an updated review of evidence regarding the effects of aromatherapy in relieving symptoms of burn injuries, focusing on pain and physiological distress. Materials and Methods: Fifteen databases (including five English databases, four Korean medical databases, and four Iranian databases) and trial registries were searched for studies published between their dates of inception and July 2021. Two review authors individually performed study selection, data extraction, and risk of bias assessment, and any discrepancies were solved by a third review author. Results: Eight RCTs met our inclusion criteria and were analyzed in this updated systematic review. Our meta-analyses revealed that inhaled aromatherapy plus routine care showed beneficial effects in relieving pain after dressing, as compared to placebo plus routine care (p < 0.00001) and routine care alone (p = 0.02). Additionally, inhaled aromatherapy plus routine care (p < 0.00001) and aromatherapy massage plus routine care (p < 0.0001) also showed superior effects in calming anxiety, as compared to routine care alone. None of the included studies reported on AEs. Overall, the risk of bias across the studies was concerning. Conclusions: This updated review and synthesis of the studies had brought a more detailed understanding of the potential application of aromatherapy for easing the pain and anxiety of burn patients.

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Endemic Cryptosporidium infection and drinking water source: a systematic review and meta-analyses

Water Science & Technology ◽

10.2166/wst.2006.474 ◽

2006 ◽

Vol 54 (3) ◽

pp. 231-238 ◽

Cited By ~ 9

Author(s):

F.A.S. Gualberto ◽

L. Heller

Keyword(s):

Risk Factors ◽

Drinking Water ◽

Meta Analysis ◽

Water Source ◽

Drinking Water Source ◽

Cryptosporidium Infection ◽

Water Users ◽

Increased Risk ◽

Unsafe Water ◽

Meta Analyses

Cryptosporidium is a well-known cause of diarrhoea in humans. Little is known about risk factors associated with endemic cryptosporidiosis, which constitutes the majority of cases. We carried out meta-analyses to verify if drinking water is also associated with endemic infection and to assess the magnitude of the associations. The global meta-analysis suggests that there is an increased risk of Cryptosporidium infection among unsafe water users (OR 1.40 [1.15, 1.72]). Studies were stratified, according to the exposure to different sources of safe drinking water, due to the heterogeneity presented. The consumption of non-well and unboiled water was associated with an increased chance of endemic cryptosporidiosis, though only the latter was significant (OR 1.45 [0.95, 2.20]; OR 1.61 [1.09, 2.38]). Drinking non-bottled water did not present a risk factor associated with endemic cryptosporidiosis (OR 0.87 [0.72, 1.05]). These meta-analyses present results that could be useful to clarify the epidemiology of Cryptosporidium. We recommend that other risk factors could also be studied by this approach.

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Parachute Ankle Brace and Extrinsic Injury Risk Factors During Parachuting

Aviation Space and Environmental Medicine ◽

10.3357/asem.2218.2008 ◽

2008 ◽

Vol 79 (4) ◽

pp. 408-415 ◽

Cited By ~ 12

Author(s):

Joseph J. Knapik ◽

Salima Darakjy ◽

David Swedler ◽

Paul Amoroso ◽

Bruce H. Jones

Keyword(s):

Risk Factors ◽

Injury Risk ◽

Ankle Brace ◽

Injury Risk Factors

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SEARCH PROCEDURE AND DATA EXTRACTION FOR META-ANALYSIS IN BIOMEDICAL RESEARCH

10.46793/iccbi21.190o ◽

2021 ◽

Author(s):

Jasmina Obradovic ◽

◽

Vladimir Jurisic

Keyword(s):

Biomedical Research ◽

Data Extraction ◽

Meta Analysis ◽

Extraction Procedure ◽

Microsoft Excel ◽

Pooled Data ◽

Reference Manager ◽

Reference Number ◽

Meta Analyses ◽

Precise Time

The meta-analysis provides a unique scientific conclusion with precise statistical analysis of pooled data extracted from previously reported relevant studies. That gives a better insight into the current issue with more statistical certainty than any single study observation in biomedical research. Occasionally, meta-analyses don’t provide a precise time for each step of the search strategy. The complete meta-analysis procedure is usually time-consuming, with 6-18 months reported, but it depends on the numbers of collected articles manually reviewed by two or more researchers to prevent potential bias. The purpose of this paper was to present a part of meta-analysis research with a focus on a timeline manner for extraction procedure and suggestions for preparing the database of collected articles. PRISMA guidelines were followed, and Pub Med, Scopus, and ISI Web of Science for the search were used. EndNote reference manager v.7 and Microsoft Excel 2007 were used for base preparation. Results showed that the final reference number was 4918, and 99.88% of them were excluded. A month was necessary for the search of the electronic databases. For reading titles and abstracts and extracting the papers was needed the fourth month. A month was needed for an additional search of bibliographies of the eligible papers. Even with the dedication of the team of reviewers, it is hard to predict the exact time for conducting the meta-analysis, indeed. Our results could be applicable in planning the potential systematic reviews, with or without meta-analysis, and overcoming the obstacles in the single database preparation.

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Timely Revisit of Proprioceptive Deficits in Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

Global Spine Journal ◽

10.1177/21925682211066824 ◽

2021 ◽

pp. 219256822110668

Author(s):

Kenney K. L. Lau ◽

Karlen K. P. Law ◽

Kenny Y. H. Kwan ◽

Jason P. Y. Cheung ◽

Kenneth M. C. Cheung ◽

...

Keyword(s):

Systematic Review ◽

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Case Reports ◽

Data Extraction ◽

Meta Analysis ◽

Detection Threshold ◽

Mean Difference ◽

Case Control Studies ◽

Meta Analyses

Study Design Systematic review and meta-analysis Objectives The present review aimed to summarize the evidence regarding differences in proprioception between children with and without adolescent idiopathic scoliosis (AIS). Methods Seven electronic databases were searched from their inception to April 10, 2021. Articles were included if they involved: (1) AIS patients aged between 10 and 18 years, (2) measurements of proprioceptive abilities, and (3) comparisons with non-AIS controls. Animal studies, case reports, commentaries, conference proceedings, research protocols, and reviews were excluded. Two reviewers independently conducted literature screening, data extraction, risks of bias assessments, and quality of evidence evaluations. Relevant information was pooled for meta-analyses. Results From 432 identified citations, 11 case-control studies comprising 1121 participants were included. The meta-analyses showed that AIS participants displayed proprioceptive deficits as compared to non-AIS controls. Moderate evidence supported that AIS participants showed significantly larger repositioning errors than healthy controls (pooled mean difference = 1.27 degrees, P < .01). Low evidence substantiated that AIS participants had significantly greater motion detection threshold (pooled mean difference = 1.60 degrees, P < .01) and abnormal somatosensory evoked potentials (pooled mean difference = .36 milliseconds, P = .01) than non-AIS counterparts. Conclusions Consistent findings revealed that proprioceptive deficits occurred in AIS patients. Further investigations on the causal relationship between AIS and proprioception, and the identification of the subgroup of AIS patients with proprioceptive deficit are needed.

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Abstract 17059: Re-Use of Clinical Trial Data From the NHLBI Data Repository (BioLINCC) for Patient-Level Meta-Analyses of Cardiovascular Outcomes: Challenges and Opportunities

Circulation ◽

10.1161/circ.138.suppl_1.17059 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Helena Sviglin ◽

Gauri Dandi ◽

Eileen Navarro Almario ◽

Tejas Patel ◽

Colin O Wu ◽

...

Keyword(s):

Risk Factors ◽

Meta Analysis ◽

Cardiovascular Outcomes ◽

Data Repository ◽

Common Data Elements ◽

Patient Level Data ◽

Patient Level ◽

Level Data ◽

Data Elements ◽

Meta Analyses

Introduction: An objective of the Meta-AnalyTical Interagency Group (MATIG) is to conduct patient-level meta-analyses of cardiovascular outcomes using data from publicly available repositories. We describe challenges with data re-use from a seminal trial, provide a systematic approach to identify and curate data elements for hypothesis generation, and establish stackable trials to support these analyses. Methods: We used data from the ACCORD trial to assess risk factors and their gender specific differences for the event of hospitalization or death due to heart failure (hdHF), in patients with type 2 diabetes*. We identified the data elements needed to answer the research questions, reviewed the trial protocol to verify definitions, extracted patient-level data, performed quality assessment and statistical analysis. The results showed a gender difference in the effect of intensive vs. standard glucose-lowering therapy on hdHF. To validate the findings, we sought additional trials in BioLINCC to develop a compendium for meta-analysis, and repeated these steps for each trial. Results: Challenges for reusing the ACCORD trial included access to complete patient-level data and metadata. The compendium, developed to evaluate the stackability** of data across trials, identified differences in trial designs, patient populations, study interventions, and data elements that may impact the feasibility and interpretation of meta-analysis. An example of compendium components is shown in Table 1. Conclusion: High-quality metadata facilitate re-use of trial repository data. This compendium standardizes common data elements for gender, racial and age-group specific outcome assessment in major clinical trials. It provides the framework to assess the fitness of trials for patient-level meta-analyses. Efforts are underway by MATIG to expand the compendium to include risk factors and major cardiovascular outcomes across multiple large trials for meta-analysis.

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