• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3253-3258
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• 2012

Objective: To evaluate the efficacy and safety of whole brain radiotherapy (WBRT) plus chemotherapy versus WBRT alone for treating brain metastases (BM) from lung cancer by performing a meta-analysis based on randomized controlled trials (RCTs). Methods: The PubMed, Embase, CENTRAL, ASCO, ESMO, CBM, CNKI, and VIP databases were searched for relevant RCTs performed between January 2000 and March 2012. After quality assessment and data extraction, the meta-analysis was performed using the RevMan 5.1 software, with funnel plot evaluation of publication bias. Results: 19 RCTs involving 1,343 patients were included. The meta-analyses demonstrated that compared to WBRT alone, WBRT plus chemotherapy was more effective with regard to the objective response rate (OR = 2.30, 95% CI = 1.79 - 2.98; P < 0.001); however, the incidences of gastrointestinal reactions (RR = 3.82, 95% CI = 2.33 - 6.28, P <0.001), bone marrow suppression (RR = 5.49, 95% CI = 3.65 - 8.25, P < 0.001), thrombocytopenia (RR = 5.83, 95% CI = 0.39 - 86.59; P = 0.20), leukopenia (RR = 3.13, 95% CI = 1.77 - 5.51; P < 0.001), and neutropenia (RR = 2.75, 95% CI = 1.61 - 4.68; P < 0.001) in patients treated with WBRT plus chemotherapy were higher than with WBRT alone. There was no obvious publication bias detected. Conclusion: WBRT plus chemotherapy can obviously improve total efficacy rate, butalso increases the incidence of adverse reactions compared to WBRT alone. From the limitations of this study, more large-scale, high-quality RCTs are suggested for further verification.

• Journal of Pharmacopuncture
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• v.24 no.3
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• pp.107-121
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• 2021

Objectives: The purpose of this study is to analyze the efficacy of traditional Chinese medicine (TCM) injections specified in the clinical guideline for COVID-19 by conducting a meta-analysis of viral pneumonia data. Methods: TCM injections data on viral pneumonia were collected until July 31, 2021. CNKI, PubMed, EMBASE, and the Cochrane electronic database were used to collect the clinical data. "COVID-19," "Viral pneumonia," "Tanreqing," "Xiyanping," "Reduning," "Xingnaojing," "Xuebijing," "Shenmai," "Shengmai," and "Shenfu" were used as keywords. All data collected were mainly about TCM injections and viral pneumonia. Furthermore, studies that included results such as the total effective rate, cough disappearance time, antipyretic time, lung rhomboid disappearance time, and adverse drug reaction were collected for the meta-analysis to identify the efficacy of TCM injections. However, data unrelated to TCM injections specified in the clinical guidelines for COVID-19 or viral pneumonia were excluded. The quality of included RCTs was assessed by the Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to conduct the meta-analysis. Results: A total of 18 studies with 1540 patients were included in this study. The results of the meta-analysis showed that the total effective rate OR = 4.61 (95% CI 2.92, 7.25, p = 1.00/ I² = 0%); the cough disappearance time: SMD -1.23 (-1.37, -1.09, p < 0.00001/ I² = 94%); the antipyretic time: SMD -1.26 (-1.40, -1.11, p < 0.00001/ I²=94%); lung rhomboid disappearance time: SMD -1.17 (-1.33, -1.02, p < 0.00001/ I² = 89%); and adverse drug reaction was OR 0.36 (95% CI 0.20, 0.64, p = 0.21/ I² = 30%). From the results, the treatment group (TCM injection) showed better efficacy than the control group (Western medication). Conclusion: Xiyanping, Reduning, and Tanreqing injections may yield benefits as COVID-19 treatments. However, clinical trials on TCM injections for the treatment of COVID-19 are still lacking. More high-quality clinical trials are still required.

• Environmental and Resource Economics Review
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• v.30 no.3
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• pp.471-501
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• 2021

We measure Environmental Efficiency (EE) based on CO₂ in four income groups from 1998 to 2018, using the Meta Stochastic Frontier Analysis method by Input Distance Function. Our results showed that economic growth and energy consumption would increase carbon dioxide emissions, and increasing labor and capital input will reduce it. Moreover, we compared Group Environmental Efficiency (GEE), Meta Environmental Efficiency (MEE), and Environmental Gap Ratio (EGR). The results showed that GEEs were be overestimated. Furthermore, the MEE showed a downward trend during this period. The lower-middle-income group had the highest EGR performance. High-income and upper-middle-income groups showed less efficiency in MEE and EGR. To improve environmental efficiency, we must reduce fossil fuels and find more scientific and technological ways to solve existing environmental problems as soon as possible.

• Journal of East-West Nursing Research
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• v.27 no.1
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• pp.1-13
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• 2021

Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

• Clinical and Experimental Pediatrics
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• v.62 no.6
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• pp.206-212
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• 2019

Purpose: The present study aimed to determine the prevalence of childhood obesity and overweight in Iranian children under 5 years of age using a systematic review and meta-analysis. Methods: We searched MEDLINE (PubMed), Web of Science, Google Scholar, Scopus, CINHAL, and the Iranian databases, including Scientific Information Database (www.sid.ir), Iranian Research Institute for Information Science and Technology (Irandoc.ac.ir), Iranmedex (www.iranmedex.com), and Magiran (www.magiran.com), for all articles published between January 1989 and August 2017. Sources of heterogeneity were determined using subgroup analysis and meta-regression. Results: Six articles were ultimately included in the meta-analysis to estimate the pooled prevalence, based on which the prevalence of obesity and overweight were estimated to be 8% (95% confidence interval [CI], 6%-10%) and 9% (95% CI, 7%-11%), respectively. The results of the subgroup analysis showed that the prevalence of obesity in boys and girls was 9% (95% CI, 6%-13%) and 7% (95% CI, 4-10%), respectively, and the prevalence of overweight in boys and girls was 10% (95% CI, 5%-15%) and 9% (95% CI, 5%-13%), respectively. Conclusion: Despite high heterogeneity among the results of the articles included in the meta-analysis, the prevalence of obesity and overweight is higher in Iranian children under 5 years of age. Therefore, parents and the health system must pay more attention to the lifestyle, nutritional habits, and physical activity of these children.

• Journal of Family Relations
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• v.21 no.2
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• pp.3-23
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• 2016

Objectives: The purpose of this study is to conduct a meta-analysis of results of death education program implemented with a wide range of learners from preschoolers to the elderly and use the findings to suggest effect sizes of the intervention program, variables, and measurement tools and activity elements of the variables. Method: Among preceding studies conducted domestically until 2015, 21 studies that meet the meta-analysis criteria were selected and analyzed using CMA(Comprehensive Meta-Analysis 3.0 version). Results: The findings are as follows. The overall average effect size was rather large at 0.997. Reviewing by research subject group, victims of domestic violence indicated the largest effect size(2.381). As for variables, death awareness showed the largest effect size(2.908). In terms of activity elements, the largest effect size for total number of sessions was 16 sessions (4.972), while that for per week sessions was 2 sessions/week (2.327). With effect size for activity hours largest at 30 minutes(5.365) followed by 108 minutes(2.381) and 360 minutes(1.607), it was found that there is no positive relationship between activity time and effect size. In terms of publication type, effect size of academic journal paper was 1.107 while that of thesis or dissertation was 0.894, indicating that academic journal papers are relatively highly effective. Conclusions: The present study is meaningful in that it provides baseline data applicable to program development and implementation by verifying the effectiveness of domestically implemented death education programs and variables relevant to such programs.

• Journal of Convergence for Information Technology
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• v.11 no.1
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• pp.109-117
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• 2021

In this paper, the meta-model based approximate optimization was carried out for the structure design of an ocean automatic salt collector in order to minimize the structure weight. The structural analysis was performed by using the finite element method to evaluate the strength performance of the ocean automatic salt collector in its initial design. In the structural analysis, it was evaluated the strength performance of the design load conditions. The optimum design problem was formulated so that design variables of main structure thickness would be determined by minimizing the structure weight subject to strength performance constraints. The meta-models used in the approximate optimization were the response surface method, Kriging model, and Chebyshev orthogonal polynomials. Regarding to the numerical characteristics, the solution results from approximate optimization techniques were compared to the results of non-approximate optimization. The Chebyshev orthogonal polynomials among the meta-models used in the approximate optimization showed the most appropriate optimum design results for the structure design of the ocean automatic salt collector.

• Journal of Korean Academy of Nursing
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• v.51 no.4
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• pp.414-429
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• 2021

Purpose: This systematic review and meta-analysis analyzed the effects of 2% chlorhexidine bathing on the incidence of hospital-acquired infection (HAI) and multidrug-resistant organisms (MDRO) in adult intensive care units. Methods: PubMed, CINAHL, Cochrane library, and RISS database were systematically searched, and 12 randomized studies were included in the analysis. Comprehensive Meta-Analysis version 3.0 was used to calculate the effect size using the odds ratio (OR) and a 95% confidence interval (CI). Subgroup analysis was performed according to the specific infection and intervention types. Results: In general, 2% chlorhexidine bathing has a significant effect on the incidence of HAI (OR, 0.59; 95% CI, 0.40~0.86) and MDRO (OR, 0.52; 95% CI, 0.34~0.79). Subgroup analyses show 2% chlorhexidine bathing is effective in bloodstream infections (OR, 0.51; 95% CI, 0.39~0.66) but not for urinary tract infections, ventilator-associated pneumonia infections, and Clostridium difficile infections. Moreover, 2% chlorhexidine bathing alone or its combination with other interventions has a significant effect on the incidence of HAI and MDRO (OR, 0.59; 95% CI, 0.38~0.92). Conclusion: This meta-analysis reveals that 2% chlorhexidine bathing significantly reduces the incidence of HAI and MDRO in intensive care units. The effect of 2% chlorhexidine bathing on pediatric patients or patients at general wards should be further assessed as a cost-effective intervention for infection control.

• Journal of Korean Academy of Nursing
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• v.52 no.1
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• pp.4-23
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• 2022

Purpose: The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults. Methods: A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger's regression. Results: The results of the meta-analysis (n = 16) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges' g = - 0.35, 95% Confidence Interval [CI] = - 0.55~- 0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges' g = 0.45, 95% CI = - 0.75~- 0.15) was higher than the auricular acupuncture (Hedges' g = 0.27, 95% CI = - 0.53~0.00): the longer the intervention period, the greater the effect size. Conclusion: In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.37.1-37.17
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• 2023

This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I² = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I² = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I² = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.