ResearchPad - ethics https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Meta-analysis of the correlation between dietary copper supply and broiler performance]]> https://www.researchpad.co/article/elastic_article_15740 To conduct a meta-analysis assessing the correlation between dietary copper supply and broiler performanceMethodsStudies that were published prior to January 2019 and reported the dietary copper supply and broiler growth performance were identified using search functions in the Web of Science, Springer, Elsevier, Science Direct, and Taylor & Francis Online databases; the Journal of Dairy Research; and China National Knowledge Infrastructure (CNKI). We performed stratified analyses on the possible sources of bias, including differences in the study locations and years of publication. The publication bias was assessed with Egger’s test method.ResultsA total of 12 randomized controlled trial (RCT) studies were eligible for inclusion. The pooled WMDs of the ADG, ADFI and FCR were -0.166 (95% CI: -1.587 to 1.254), -0.844 (95% CI: -1.536 to -0.152) and -0.029 (95% CI: -0.057 to 0.000), respectively. In the Israeli and Indian studies, the ADG and ADFI data in the experimental group were higher than those in the control group; however, in America, a relatively high FCR value was found in the experimental group compared to that in the control group. The analysis of the study period showed that for the 1980s and 2010s, the ADG and ADFI of the experimental group were lower than those of the control group, while, in the 1990s and 2010s, the FCR of the experimental group were lower than those of the control group. The observed values were adjusted for study effects, and a model was used to obtain the copper supplementation under the optimal production performance. The results showed that the adjusted average daily gain (ADG), average daily feed intake (ADFI), and feed to gain ratio (FCR) presented a quadratic relationship with Cu supplementation (P<0.05). The maximum value of ADG (31.84 g/d) is reached when Cu is added at amount of 158 mg/kg, and the minimum value of FCR (1.53) is reached when Cu is added at amount of 217 mg/kg. No significant publication bias existed in the studies (Egger's test: P value were 0.81, 0.71 and 0.14).ConclusionFrom this study, it can be concluded that the traditional copper addition is no longer suitable for modern broiler breeding; the higher copper content may be beneficial for the production performance of broilers. ]]> <![CDATA[The prevalence of hepatitis C virus in hemodialysis patients in Pakistan: A systematic review and meta-analysis]]> https://www.researchpad.co/article/elastic_article_14616 Hepatitis C virus (HCV) infection is one of the most common bloodborne viral infections reported in Pakistan. Frequent dialysis treatment of hemodialysis patients exposes them to a high risk of HCV infection. The main purpose of this paper is to quantify the prevalence of HCV in hemodialysis patients through a systematic review and meta-analysis.MethodsWe systematically searched PubMed, Medline, EMBASE, Pakistani Journals Online and Web of Science to identify studies published between 1 January 1995 and 30 October 2019, reporting on the prevalence of HCV infection in hemodialysis patients. Meta-analysis was performed using a random-effects model to obtain pooled estimates. A funnel plot was used in conjunction with Egger’s regression test for asymmetry and to assess publication bias. Meta-regression and subgroup analyses were used to identify potential sources of heterogeneity among the included studies. This review was registered on PROSPERO (registration number CRD42019159345).ResultsOut of 248 potential studies, 19 studies involving 3446 hemodialysis patients were included in the meta-analysis. The pooled prevalence of HCV in hemodialysis patients in Pakistan was 32.33% (95% CI: 25.73–39.30; I2 = 94.3%, p < 0.01). The subgroup analysis showed that the prevalence of HCV among hemodialysis patients in Punjab was significantly higher (37.52%; 95% CI: 26.66–49.03; I2 = 94.5, p < 0.01) than 34.42% (95% CI: 14.95–57.05; I2 = 91.3%, p < 0.01) in Baluchistan, 27.11% (95% CI: 15.81–40.12; I2 = 94.5, p < 0.01) in Sindh and 22.61% (95% CI: 17.45–28.2; I2 = 78.6, p < 0.0117) in Khyber Pukhtoonkhuwa.ConclusionsIn this study, we found a high prevalence (32.33%) of HCV infection in hemodialysis patients in Pakistan. Clinically, hemodialysis patients require more attention and resources than the general population. Preventive interventions are urgently needed to decrease the high risk of HCV infection in hemodialysis patients in Pakistan. ]]> <![CDATA[Developing a typology of the roles public contributors undertake to establish legitimacy: a longitudinal case study of patient and public involvement in a health network]]> https://www.researchpad.co/article/elastic_article_12557 To identify how public contributors established their legitimacy in the functioning of a patient and public involvement programme at a health network.DesignA longitudinal case study with three embedded units (projects) involving public contributors. Interviews (n=24), observations (n=27) and documentary data collection occurred over 16 months.SettingThe West of England Academic Health Science Network (WEAHSN), 1 of 15 regional AHSNs in England.ParticipantsInterviews were conducted with public contributors (n=5) and professionals (n=19) who were staff from the WEAHSN, its member organisations and its partners.ResultsPublic contributors established their legitimacy by using nine distinct roles: (1) lived experience, as a patient or carer; (2) occupational knowledge, offering job-related expertise; (3) occupational skills, offering aptitude developed through employment; (4) patient advocate, promoting the interests of patients; (5) keeper of the public purse, encouraging wise spending; (6) intuitive public, piloting materials suitable for the general public; (7) fresh-eyed reviewer, critiquing materials; (8) critical friend, critiquing progress and proposing new initiatives and (9) boundary spanner, urging professionals to work across organisations. Individual public contributors occupied many, but not all, of the roles.ConclusionsLived experience is only one of nine distinct public contributor roles. The WEAHSN provided a benign context for the study because in a health network public contributors are one of many parties seeking to establish legitimacy through finding valuable roles. The nine roles can be organised into a typology according to whether the basis for legitimacy lies in: the public contributor’s knowledge, skills and experience; citizenship through the aspiration to achieve a broad public good; or being an outsider. The typology shows how public contributors can be involved in work where lived experience appears to lack relevance: strategic decision making; research unconnected to particular conditions; or acute service delivery. ]]> <![CDATA[The ‘tyranny of reproduction’: Could ectogenesis further women’s liberation?]]> https://www.researchpad.co/article/elastic_article_7001 This paper imagines what the liberatory possibilities of (full) ectogenesis are, insofar as it separates woman from female reproductive function. Even before use with human infants, ectogenesis productively disrupts the biological paradigm underlying current gender categories and divisions of labour. I begin by presenting a theory of women’s oppression drawn from the radical feminisms of the 1960s, which sees oppression as deeply rooted in biology. On this view, oppressive social meanings are overlaid upon biology and body, as artefacts of culture and history. I then argue that ectogenesis should be pursued to replace two modes of assisted gestation that can be seen as outgrowths of oppressive assumptions about women's function, ectogenesis should be pursued to replace two modes of assisted gestation. These are gestational surrogacy and uterine transplant, which arise partly from gendered, pronatalist, and geneticist norms. These practices are supported by assumptions about women’s identity and value. Pursuing technologies such as ectogenesis, which weaken the presumed link between biology and gender, is beneficial to (trans‐inclusionary radical) feminist aims, as part of a broad project of challenging dominant power relations resting on and maintaining gender categories. By allowing the conceptual separation of female reproductive function from ‘woman’, ectogenesis raises questions about how we determine who counts in this gender identity, and also how we value those who claim the identity ‘woman’. I conclude that ectogenesis has the potential to challenge traditional patriarchal family structures, and thence all other male‐dominated structures (of work, education, cultural production), allowing a reimagining of the family and society in more radical ways than we have yet achieved.

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<![CDATA[Artificial womb technology and clinical translation: Innovative treatment or medical research?]]> https://www.researchpad.co/article/elastic_article_6858 In 2017 and 2019, two research teams claimed ‘proof of principle’ for artificial womb technology (AWT). AWT has long been a subject of speculation in bioethical literature, with broad consensus that it is a welcome development. Despite this, little attention is afforded to more immediate ethical problems in the development of AWT, particularly as an alternative to neonatal intensive care. To start this conversation, I consider whether experimental AWT is innovative treatment or medical research. The research–treatment distinction, pervasive in regulation worldwide, is intended to isolate research activities and subject them to a greater degree of oversight. I argue that there is a tendency in the literature to conceptualize AWT for partial ectogenesis as innovative treatment. However, there are sufficiently serious ethical concerns with experimental AWT that mean that it must not be first used on humans on the basis that it is a ‘beneficial treatment’. First, I outline the prospects for translation of AWT animal studies into treatment for human preterms. Second, I challenge the conceptualizations of experimental AWT as innovative treatment. It must be considered medical research to reflect the investigatory nature of the process and guarantee sufficient protections for subjects. Identifying that AWT is research is crucial in formulating further ethico‐legal questions regarding the experimental use of AWT. Third, I demonstrate that clinical trials will be a necessary part of the clinical translation of AWT because of requirements laid out by regulators. I consider the justification for clinical trials and highlight some of the crucial ethical questions about the conditions under which they should proceed.

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<![CDATA[Ectogestation ethics: The implications of artificially extending gestation for viability, newborn resuscitation and abortion]]> https://www.researchpad.co/article/elastic_article_6842 Recent animal research suggests that it may soon be possible to support the human fetus in an artificial uterine environment for part of a pregnancy. A technique of extending gestation in this way (“ectogestation”) could be offered to parents of extremely premature infants (EPIs) to improve outcomes for their child. The use of artificial uteruses for ectogestation could generate ethical questions because of the technology’s potential impact on the point of “viability”—loosely defined as the stage of pregnancy beyond which the fetus may survive external to the womb. Several medical decisions during the perinatal period are based on the gestation at which infants are considered viable, for example decisions about newborn resuscitation and abortion, and ectogestation has the potential to impact on these. Despite these possible implications, there is little existing evidence or analysis of how this technology would affect medical practice. In this paper, we combine empirical data with ethical analysis. We report a survey of 91 practicing Australian obstetricians and neonatologists; we aimed to assess their conceptual understanding of “viability,” and what ethical consequences they envisage arising from improved survival of EPIs. We also assess what the ethical implications of extending gestation should be for newborn and obstetric care. We analyze the concept of viability and argue that while ectogestation might have implications for the permissibility of neonatal life‐prolonging treatment at extremely early gestation, it should not necessarily have implications for abortion policy. We compare our ethical findings with the results of the survey.

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<![CDATA[Association between cigarette smoking and the risk of dysmenorrhea: A meta-analysis of observational studies]]> https://www.researchpad.co/article/N299c77b6-7bcf-4190-8f14-766ff39e61a2

Background

Emerging studies have found inconsistent results on the potential relationship between cigarette smoking and dysmenorrhea. Therefore, the aim of this study was to quantitatively synthesize the previous findings on the preceding relationship using meta-analysis.

Methods

Previous studies on the association between cigarette smoking and dysmenorrhea, published not later than November 2019, were systematically searched, using MeSH heading and/or relevant terms, in the electronic databases of PubMed, Medline, Web of Science and EMBASE. The I2 statistic was used to assess heterogeneity, whose source was explored using subgroup analysis. A pooled effect size was obtained using random effects model, and sensitivity analysis was performed to assess the consistency of the pooled effect size.

Results

After a rigorous screening process, 24 studies involving 27,091 participants were included in this meta-analysis. The results indicated that smokers were 1.45 times more likely to develop dysmenorrhea than non-smokers (odds ratio (OR) = 1.45, 95% confidence interval (CI): 1.30–1.61). In addition, individuals classified as currently smoking were 1.50 times more likely to develop dysmenorrhea than those who were classified as never smoking (OR = 1.50, 95% CI: 1.33–1.70), whereas being a former smoker was 1.31 times more likely to develop dysmenorrhea than being a never smoker (OR = 1.31, 95% CI: 1.18–1.46). Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect.

Conclusion

The evidence from this meta-analysis indicated a significant association between cigarette smoking (both current and former smoking) and dysmenorrhea. The adverse effects of smoking provide further support for prevention of dysmenorrhea and emphasize the need to target women.

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<![CDATA[Investigation of Stem cells Technology in The Light of Jurisprudential Documents ]]> https://www.researchpad.co/article/Nd67b81cd-b365-4035-93dd-66d6f0ce3c5f

Objective

The aim of this study is investigation of Stem cells Technology in The Light of Jurisprudential Documents.

Materials and Methods

In this analytical-descriptive research, we collected the relevant data through a literature search. We have used PubMed, ScienceDirect, Google Scholar, Iranian databases like SID, Iran doc, Iranian law and also Islamic resources for this study.

Results

There are so many controversies about safety of these cells and possible dangers for human body. As in Iran, laws of stem cells are not clear. Elimination of barriers requires drafting laws compatible with regional and cultural beliefs of Iranian people. Unfortunately, available laws could not keep up with the advances.

Conclusion

Iran juridical system should conduct and restrict actions in the area of stem cells technology by gathering experts of different political, science, medicine, social and mindful who are familiar with law, according to notions of intellectual jurists and legislators, Islam and Shia religious.

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<![CDATA[Do protocols for new randomised trials take previous similar trials into account? Cohort study of contemporary trial protocols]]> https://www.researchpad.co/article/N50727740-00d0-48ff-9445-34cef16f775f

Objective

To investigate to what extent evidence from previous similar trials or systematic reviews was considered before conducting new trials.

Design

Cohort study of contemporary protocols for trials with ethical approval.

Methods

All protocols for randomised trials approved by the five ethical committees in Denmark between January 2012 and March 2013 were screened for eligibility. Included protocols were read in full to determine whether a systematic search had been conducted and references were checked to evaluate whether trial rationale and design could be challenged for not adequately considering previous evidence. To investigate whether protocols cited relevant trials, we used simple search strategies that could easily be conducted by researchers without experience with literature searches.

Results

Sixty-seven protocols were included. Only two (3%) of the protocols explicitly stated to have conducted a literature search and only one (1%) provided information that allowed the search to be replicated. Eleven (16%) of the protocols described trials where we found the information insufficient to judge if the trial was ethically justified, either due to a comparator that was not supported by the presented evidence (six protocols), because they did not present a rationale for conducting the trial (two protocols), or for both reasons (three protocols). For eight (12%) of the protocols, our search identified trials that could have been relevant to cite as justification.

Conclusions

While most protocols seem to adequately consider existing evidence, a substantial minority of trials might lack a sufficient evidence base. Very few trials seemed to have been based on a literature search which makes it impossible to know whether all relevant previous trials had been considered. Rules for ethical approval should include requirements for systematic literature searches to ensure that research participants are not exposed to sub-optimal treatments or unnecessary harms as well as to reduce research waste.

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<![CDATA[Scrutinizing assortative mating in birds]]> https://www.researchpad.co/article/5c784fead5eed0c4840078f1

It is often claimed that pair bonds preferentially form between individuals that resemble one another. Such assortative mating appears to be widespread throughout the animal kingdom. Yet it is unclear whether the apparent ubiquity of assortative mating arises primarily from mate choice (“like attracts like”), which can be constrained by same-sex competition for mates; from spatial or temporal separation; or from observer, reporting, publication, or search bias. Here, based on a conventional literature search, we find compelling meta-analytical evidence for size-assortative mating in birds (r = 0.178, 95% CI 0.142–0.215, 83 species, 35,591 pairs). However, our analyses reveal that this effect vanishes gradually with increased control of confounding factors. Specifically, the effect size decreased by 42% when we used previously unpublished data from nine long-term field studies, i.e., data free of reporting and publication bias (r = 0.103, 95% CI 0.074–0.132, eight species, 16,611 pairs). Moreover, in those data, assortative mating effectively disappeared when both partners were measured by independent observers or separately in space and time (mean r = 0.018, 95% CI −0.016–0.057). Likewise, we also found no evidence for assortative mating in a direct experimental test for mutual mate choice in captive populations of Zebra finches (r = −0.020, 95% CI −0.148–0.107, 1,414 pairs). These results highlight the importance of unpublished data in generating unbiased meta-analytical conclusions and suggest that the apparent ubiquity of assortative mating reported in the literature is overestimated and may not be driven by mate choice or mating competition for preferred mates.

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<![CDATA[Strengthening Global Efforts to Combat Organ Trafficking and Transplant Tourism: Implications of the 2018 Edition of the Declaration of Istanbul]]> https://www.researchpad.co/article/5c973e64d5eed0c48496b677

Abstract

The 2018 Edition of the Declaration of Istanbul on Organ Trafficking and Transplant Tourism (DoI) provides an updated set of principles and definitions to guide policymakers and health professionals working in organ donation and transplantation. A draft of the new edition was circulated to the public and transplant professionals through an online consultation process, which also sought feedback on a draft explanatory article that explained the principles and discussed some of their practical implications. Both drafts were revised in response to feedback from participants in the consultation. We present here the discussion article, which is intended to assist stakeholders in applying the principles of the DoI by providing more detailed information about the meaning and potential implications of implementing the DoI in various contexts.

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<![CDATA[Thoracic spine manipulation for the management of mechanical neck pain: A systematic review and meta-analysis]]> https://www.researchpad.co/article/5c6dc9ced5eed0c48452a202

Objective

To investigate the role of thoracic spine manipulation (TSM) on pain and disability in the management of mechanical neck pain (MNP).

Data sources

Electronic databases PubMed, CINAHL, Pedro, Embase, AMED, the Cochrane Library, and clinicaltrials.gov were searched in January 2018.

Study selection

Eligible studies were completed RCTs, written in English, had at least 2 groups with one group receiving TSM, had at least one measure of pain or disability, and included patients with MNP of any duration. The search identified 1717 potential articles, with 14 studies meeting inclusion criteria.

Study appraisal and synthesis methods

Methodological quality was evaluated independently by two authors using the guidelines published by the Cochrane Collaboration. Pooled analyses were analyzed using a random-effects model with inverse variance methods to calculate mean differences (MD) and 95% confidence intervals for pain (VAS 0-100mm, NPRS 0-10pts; 0 = no pain) and disability (NDI and NPQ 0–100%; 0 = no disability).

Results

Across the included studies, there was increased risk of bias for inadequate provider and participant blinding. The GRADE approach demonstrated an overall level of evidence ranging from very low to moderate. Meta-analysis that compared TSM to thoracic or cervical mobilization revealed a significant effect favoring the TSM group for pain (MD -13.63; 95% CI: -21.79, -5.46) and disability (MD -9.93; 95% CI: -14.38, -5.48). Meta-analysis that compared TSM to standard care revealed a significant effect favoring the TSM group for pain (MD -13.21; 95% CI: -21.87, -4.55) and disability (MD -11.36; 95% CI: -18.93, -3.78) at short-term follow-up, and a significant effect for disability (MD -4.75; 95% CI: -6.54, -2.95) at long-term follow-up. Meta-analysis that compared TSM to cervical spine manipulation revealed a non-significant effect (MD 3.43; 95% CI: -7.26, 14.11) for pain without a distinction between immediate and short-term follow-up.

Limitations

The greatest limitation in this systematic review was the heterogeneity among the studies making it difficult to assess the true clinical benefit, as well as the overall level of quality of evidence.

Conclusions

TSM has been shown to be more beneficial than thoracic mobilization, cervical mobilization, and standard care in the short-term, but no better than cervical manipulation or placebo thoracic spine manipulation to improve pain and disability.

Trial registration

PROSPERO CRD42017068287

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<![CDATA[Effects of angiotensin converting enzyme gene polymorphism on hypertension in Africa: A meta-analysis and systematic review]]> https://www.researchpad.co/article/5c6f1488d5eed0c48467a24c

Background

Hypertension is dramatically increasing in Africa with evidence of increased severity and resistance to treatment. Although angiotensin converting enzyme gene polymorphism is associated with higher prevalence of hypertension, the evidence is inconclusive on its influence on the emerging pattern in Africa. This meta-analysis is conducted to pool the available evidence to inform future research and interventions.

Methods

Articles published through May 2018 were systematically searched in PubMed, Scopus and EMBASE databases. Studies were assessed for inclusion by two independent researchers. Six models were used to assess the effect of angiotensin converting enzyme deletion-insertion gene polymorphism. Heterogeneity and publication bias were tested and sensitivity analysis was carried out. Odds ratio and 95% confidence intervals were measured for pooled effect. Both random effect and fixed effect models were used, whilst the frequency of DD, II and DI genotypes were computed and compared.

Result

Patients with D allele were 1.49 times more likely to develop essential hypertension compared with patients who carry the I allele (OR:1.49; CI:1.07, 2.07). Similarly, patients who had homozygous co-dominance genotype DD (i.e., DD vs II) were at a 2.17 times higher risk of essential hypertension compared to the co-dominant genotype II (OR:2.17, CI:1.79, 3.18), dominant model (I.e., DD+ID vs II) (OR:1.48; CI:1.03, 2.12), and recessive model (OR:1.64; CI:1.03, 2.61). On subgroup analysis, participants from Sub-Saharan Africa were more genetically susceptible to hypertension compared to their North Africa counterparts. There was no publication bias found, but there was high to moderate heterogeneity.

Conclusion

ACE I/D polymorphism is associated with essential hypertension in Africa in the allele contrast model, as well as the dominant, recessive and homozygous codominance model. On subgroup analysis, ACE I/D was associated with essential hypertension in patients from Sub-Saharan Africa but not in North Africa. A future large scale study, which includes different ethnic groups, is recommended.

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<![CDATA[Evidence that nonsignificant results are sometimes preferred: Reverse P-hacking or selective reporting?]]> https://www.researchpad.co/article/5c57e687d5eed0c484ef35c2

There is increased concern about poor scientific practices arising from an excessive focus on P-values. Two particularly worrisome practices are selective reporting of significant results and ‘P-hacking’. The latter is the manipulation of data collection, usage, or analyses to obtain statistically significant outcomes. Here, we introduce the novel, to our knowledge, concepts of selective reporting of nonsignificant results and ‘reverse P-hacking’ whereby researchers ensure that tests produce a nonsignificant result. We test whether these practices occur in experiments in which researchers randomly assign subjects to treatment and control groups to minimise differences in confounding variables that might affect the focal outcome. By chance alone, 5% of tests for a group difference in confounding variables should yield a significant result (P < 0.05). If researchers less often report significant findings and/or reverse P-hack to avoid significant outcomes that undermine the ethos that experimental and control groups only differ with respect to actively manipulated variables, we expect significant results from tests for group differences to be under-represented in the literature. We surveyed the behavioural ecology literature and found significantly more nonsignificant P-values reported for tests of group differences in potentially confounding variables than the expected 95% (P = 0.005; N = 250 studies). This novel, to our knowledge, publication bias could result from selective reporting of nonsignificant results and/or from reverse P-hacking. We encourage others to test for a bias toward publishing nonsignificant results in the equivalent context in their own research discipline.

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<![CDATA[Prognostic role of early D-dimer level in patients with acute ischemic stroke]]> https://www.researchpad.co/article/5c5df327d5eed0c484580dc4

Object

The purpose of our study was to assess the prognostic role of early D-dimer level in patients with acute ischemic stroke (AIS).

Methods

The included patients’ D-dimer levels have to be tested within 24 hours from stroke onset. Poor functional outcome was defined as modified Rankin Scale (mRS) ≥3. The endpoints included recurrence on 5-day diffusion-weighted imaging, 30-day mRS ≥3, 30-day mortality and 90-day mRS ≥3. Regarding to each endpoint, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the prognostic role of D-dimer in patients with AIS.

Results

A total of 2,479 patients were included. The results showed that elevated D-dimer levels were associated with recurrence on 5-day diffusion-weighted imaging (OR = 2.28, 95% CI = 1.32–3.95), 30-day mRS≥3 (OR = 1.59, 95% CI = 1.37–1.85), 30-day mortality (OR = 1.92, 95% CI = 1.27–2.90) and 90-day mRS≥3 (OR = 1.61, 95% CI = 1.05–2.46).

Conclusions

In conclusion, for patients with AIS, higher D-dimer level within 24 hours from stroke onset was associated with recurrence on 5-day diffusion-weighted imaging, mortality at 30 days, and poor functional outcome at both 30 days and 90 days. However, more studies are warranted to clarify this issue.

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<![CDATA[Percutaneous nephrolithotomy versus open surgery for surgical treatment of patients with staghorn stones: A systematic review and meta-analysis]]> https://www.researchpad.co/article/5c5ca31ad5eed0c48441f16c

Objectives

To compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) and open surgery (OS) for surgical treatment of patients with staghorn stones based on published literatures.

Materials and methods

A comprehensive literature search of Pubmed, Embase, CNKI and Cochrane Library was conducted to identify studies comparing outcomes of PCNL and OS for treating patients with staghorn stones up to Jan 2018.

Results

There was no significant difference in final-SFR between PCNL and OS (odds ratio[OR]: 1.17; 95% confidence interval [CI]: 0.64, 2.15; p = 0.61), while PCNL provided a significantly lower immediate-SFR compared with OS (OR: 0.29; 95% CI: 0.16, 0.51; P < 0.0001). PCNL provided significantly lower overall complication rate, shorter operative times, hospitalization times, less blood loss and blood transfusion compared with OS (OR: 0.59; 95% CI: 0.41, 0.84; P = 0.004), (weighted mean difference [WMD]: -59.01mins; 95% CI: -81.09, -36.93; p < 0.00001), (WMD: -5.77days; 95% CI: -7.80, -3.74; p < 0.00001), (WMD: -138.29ml; 95% CI: -244.98, -31.6; p = 0.01) and (OR: 0.44; 95% CI: 0.29, 0.68; P = 0.00002), respectively. No significant differences were found in minor complications (Clavien I-II) (OR: 0.72; 95% CI: 0.47, 1.09; p = 0.12) and major complications (Clavien III-V) (OR: 0.5; 95% CI: 0.23, 1.08; P = 0.08). In subgroup analysis, there were no significant differences for overall complications and operative times between mini-PCNL and OS. In sensitivity analysis, there was no significant difference for overall complications between PCNL and OS.

Conclusion

Our analysis suggested that standard PCNL turns out to be a safe and feasible alternative for patients with staghorn stones compared to OS or mini-PCNL. Because of the inherent limitations of the included studies, further large sample, prospective, multi-centric and randomized control trials should be undertaken to confirm our findings.

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<![CDATA[Cigarette smoking as a risk factor for diabetic nephropathy: A systematic review and meta-analysis of prospective cohort studies]]> https://www.researchpad.co/article/5c61e925d5eed0c48496f872

Background

Observational studies suggested that tobacco smoking was associated with diabetic nephropathy (DN). However, the results were conflicting and inconsistent. In the study, we performed a meta-analysis to assess the relationship between tobacco smoking and the development of DN.

Materials and methods

We searched in PubMed, Embase, Web of Science and the Cochrane Library (CENTRAL) from database inception until Mar 8, 2018, and updated our search on May 1, 2018. We screened the reference lists of the retrieved articles. Only original prospective cohort studies which have investigated the association between smoking and DN incidence or its progression were included. Pooled HRs and 95% confidence intervals (CIs) were calculated using a random effects model.

Results

A total of 9 prospective cohort studies were identified, including more than 203337 participants. Compared with those of no smoking, smoking participants increased the risk of developing DN (HR = 1.07, 95% CI: 1.01–1.13, P = 0.01). The subgroup analysis showed that the current and total smoking may increase the risk of DN, but these results did not reach statistical significance (current: HR = 1.69, 95% CI = 0.79–3.64, p = 0.17; total: HR = 1.17, 95% CI = 0.97–1.41, p = 0.10), whereas former smoking significantly increased the risk of DN (HR = 1.04, 95% CI = 1.03–1.05, p<0.001). Compared with no-smokers, smokers showed an elevated risk of developing DN (HR = 1.05; 95% CI, 1.00–1.11, P = 0.05). In patients with T2DM, those who smoked were at an increased risk of developing DN, as compared to those who had never smoked (HR = 1.05; 95% CI, 1.00–1.11, P = 0.05). However, compared to no smoking, smoking did not increase the risk of DN development in patients with T2DM (HR = 1.15; 95% CI, 0.9–1.47, P = 0.25). Univariate and multivariate meta-regression did not find any confounding factors. No publication bias was found in the meta-analysis.

Conclusions

The present study highlighted that smoking was an independent risk factor for DN, especially in patients with T1DM. This is the first meta-analysis of prospective cohort studies to discuss the relationship between smoking and DN.

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<![CDATA[The effect of gender on food insecurity among HIV-infected people receiving anti-retroviral therapy: A systematic review and meta-analysis]]> https://www.researchpad.co/article/5c3d0159d5eed0c48403a7c8

Background

HIV-infected adults receiving anti-retroviral therapy have a high prevalence of food insecurity in both high- and low-income settings., Women bear an inequitable burden of food insecurity due to lack of control over resources and over household food allocation decision-making. The few studies conducted on the association between food insecurity and gender among HIV-infected adults have inconclusive findings. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled effect of gender on food insecurity among HIV-infected adults receiving antiretroviral therapy.

Method

We conducted an electronic, web-based search using PubMed, CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library, the Web of Science and Google Scholar. We included studies which reported the association between food insecurity and gender among HIV-infected adults receiving antiretroviral therapy whose age was greater than 18 years. The analysis was conducted using STATA 14 software. A random effects model was used to estimate the pooled effect a 95% confidence interval(CI). Forest plots were used to visualize the presence of heterogeneity. Funnel plots and Egger’s and Begg’s tests were used to check for publication bias.

Results

A total of 776 studies were identified of which seventeen studies were included in the meta-analysis, with a total of 5827 HIV infected adults receiving antiretroviral therapy. We found that the gender of HIV-infected adults receiving anti-retroviral therapy had statistically significant effects on food insecurity. The pooled odds of developing food insecurity among female HIV infected adults receiving anti-retroviral therapy was 53% higher than male HIV infected adults (OR: 1.53, 95% CI: 1.29, 1.83). Our analysis indicate the findings of studies conducted in the high-income countries showed weakest associations between gender and food insecurity than those conducted in low- and middle-income countries.

Conclusion

Our systematic review and meta-analysis showed statistically significant effect of gender on food insecurity among HIV-infected adults receiving anti-retroviral therapy in which odds of food insecurity was higher among female HIV infected adults compared to male HIV-infected adults. These findings suggest that the need to include within food and nutrition interventions for HIV-infected adults receiving antiretroviral treatment, culture- and context-specific gender-based policies to address the sex/gender related vulnerability to food insecurity.

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<![CDATA[Association of PPARGC1A Gly428Ser (rs8192678) polymorphism with potential for athletic ability and sports performance: A meta-analysis]]> https://www.researchpad.co/article/5c3fa576d5eed0c484ca4a0f

Background

Genetics plays a role in determining potential for athletic ability (AA) and sports performance (SP). In this study, AA involves comparing sedentary controls with competitive athletes in power and endurance activities as well as a mix between the two (SP). However, variable results from genetic association studies warrant a meta-analysis to obtain more precise estimates of the association between PPARGC1A Gly482Ser polymorphism and AA/SP.

Methods

Multi-database literature search yielded 14 articles (16 studies) for inclusion. Pooled odds ratios (ORs) and 95% confidence intervals (CI) were used to estimate associations. Summary effects were modified based on statistical power. Subgroup analysis was based on SP (power, endurance and mixed) and race (Caucasians and Asians). Heterogeneity was assessed with the I2 metric and its sources examined with outlier analysis which dichotomized our findings into pre- (PRO) and post-outlier (PSO).

Results

Gly allele effects significantly favoring AA/SP (OR > 1.0, P < 0.05) form the core of our findings in: (i) homogeneous overall effect at the post-modified, PSO level (OR 1.13, 95% CI 1.03–1.25, P = 0.01, I2 = 0%); (ii) initially homogeneous power SP (ORs 1.22–1.25, 95% CI 1.05–1.44, P = 0.003–0.008, I2 = 0%) which precluded outlier treatment; (iii) PRO Caucasian outcomes (ORs 1.29–1.32, 95% CI 1.12–1.54, P = 0.0005) over that of Asians with a pooled null effect (OR 0.99, 95% CI 0.72–1.99, P = 0.53–0.92) and (iv) homogeneous all > 80% (ORs 1.19–1.38, 95% CI 1.05–1.66, P = 0.0007–0.007, I2 = 0%) on account of high statistical power (both study-specific and combined). In contrast, none of the Ser allele effects significantly favored AA/SP and no Ser-Gly genotype outcome favored AA/SP. The core significant outcomes were robust and showed no evidence of publication bias.

Conclusion

Meta-analytical applications in this study generated evidence that show association between the Gly allele and AA/SP. These were observed in the overall, Caucasians and statistically powered comparisons which exhibited consistent significance, stability, robustness, precision and lack of bias. Our central findings rest on association of the Gly allele with endurance and power, differentially favoring the latter over the former.

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<![CDATA[Involving Patients in Research? Responsible Research and Innovation in Small- and Medium-Sized European Health Care Enterprises]]> https://www.researchpad.co/article/5c42741cd5eed0c484664e07

Abstract:

Health research is generally undertaken to resolve existing health problems or enhance existing solutions. Research ethics committees have been the main governance tool for research for more than half a century. Their role is to ensure that research is undertaken ethically. To close the increasing gap between science and society, other governance tools are required. The European Commission recommends and actively promotes the policy of responsible research and innovation (RRI). In addition to sound research ethics, a key feature of RRI is the involvement of different societal stakeholders throughout the research process.

But how accepted is the involvement of societal stakeholders in the research of small- and medium-sized enterprises (SMEs) in the health care sector? This question is examined based on 18 in-depth interviews with private health care industry representatives from across Europe in companies focusing on developing medical device technology. Findings suggest that SMEs are reluctant to undertake research involving patients, especially in the early stages of the research and innovation process. For some SMEs this is due to concerns about the dangers of raising expectations they cannot meet, while for others the main concerns are increasing costs and producing less competitive products. Implications of the research findings are discussed.

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