• Title/Summary/Keyword: meta regression analysis

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Prognostic Value of Matrix Metalloproteinase 9 Expression in Breast Cancer Patients: A Meta-analysis

  • Song, Jian;Su, Hong;Zhou, Yang-Yang;Guo, Liang-Liang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1615-1621
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    • 2013
  • Background: Matrix metalloproteinase 9 (MMP-9) is related to tumor invasion and metastasis. However, the role of MMP-9 expression in breast cancer survival remains controversial. The purpose of this study was to accomplish a more accurate estimation of the association between MMP-9 expression and survival results in breast cancer patients through meta-analysis. Methods: A meta-analysis of published studies investigating the effects of positive MMP-9 expression on both relapse free survival (RFS) and overall survival (OS) was performed. Relevant literature was confirmed by searching electronic databases including PubMed, Ovid, EMBASE and China National Knowledge Infrastructure (CNKI) before November 1, 2012. Individual hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled HRs with 95% CIs were used to evaluate the strength of the association between positive MMP-9 expression and survival results of breast cancer patients. Funnel plot and Egger's regression tests were used to evaluate publication bias. Heterogeneity and sensitivity analysis was also conducted. All the work was completed using STATA. Results: A total of 2,344 patients from 15 evaluative studies were finally included. Pooled HRs and 95% CIs suggested that MMP-9 overexpression had an unfavorable impact on both OS (HR: 1.70, 95% CI: 1.41-2.04) and RFS (HR: 1.54, 95% CI: 1.17-2.01) in breast cancer patients. There was no significant heterogeneity observed in the studies reported for OS (P=0.360, $I^2$=8.8%), but not RFS (P=0.002, $I^2$=67%). Publication bias was absent among the studies both in OS and RFS cases (t=-0.54, P=0.605 and t=1.71, P=0.131, respectively). Omission of any single study had little effect on the combined risk estimates on sensitivity analysis. Conclusion: The results of this meta-analysis suggest that positive MMP-9 expression confers a higher risk of relapse and a worse survival in patients with breast cancer. Larger prospective studies are now needed to evaluate the clinical utility of MMP-9 expression.

A Study on ROK Military PBL Using Simulation and Meta Model (시뮬레이션과 메타 모델을 이용한 한국군 성과기반군수 연구)

  • Won, Bong Yeon;Lee, Sang Jin
    • Journal of the Korea Society for Simulation
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    • v.28 no.1
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    • pp.81-91
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    • 2019
  • The ROK military uses Performance Based Logistics(PBL) as one of the ways to utilize civilian resources and advanced techniques. However, the Korean PBL is mainly focused on purchasing and repairing parts, which is not contributing to the improvement of the availability of overall system. The objective of this study is to suggest the methodology to evaluate the PBL metrics using the simulation and meta model. A meta model is a regression model to analyze the effect of the PBL through simulating various scenarios with performance metrics. As a result, if the PBL is limited to the part level, the performance has little influence on the availability of overall system. In addition, analysis using the meta model shows that it cannot achieve the performance targets when the same metrics are applied to various items without considering the characteristics of the applied items. Therefore, in order to improve availability, PBL coverage should be extended to a system level that includes key components that have a large impact on availability. If multiple items are included in the PBL coverage, the metrics should be applied differently, taking into account the characteristics of each item.

The Effects of Metacognition and Resilience on Clinical Reasoning Competence of Nursing Students Who Completed Simulation Education Linked to Problem-based Learning (문제중심학습 연계 시뮬레이션교육을 이수한 간호대학생의 메타인지, 회복탄력성이 임상추론능력에 미치는 영향)

  • Kyoung-Hwa Baek;Jeong-Hwa Cho
    • Journal of Industrial Convergence
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    • v.21 no.10
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    • pp.111-120
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    • 2023
  • This study is a descriptive research to examine the effects of meta-cognition and resilience on clinical reasoning ability of nursing students who have completed the simulation education integrated with problem based learning. The study subjects were senior nursing students who had experienced SIM-PBL education, and data was collected by using a structured questionnaire from September to December 2021. The collected data was analyzed employing descriptive statistics, correlation, and hierarchical regression analysis using the SPSS program. The results demonstrated that meta-cognition and resilience had a significant positive correlation with clinical reasoning ability. The chief factors influencing on the clinical reasoning ability of nursing students were as follows: confidence in participating in the SIM-PBL education, meta-cognition, and resilience. In addition, the three factors explained the clinical reasoning ability at a high level of 75%. The clinical reasoning ability of nursing students may be cultivated by applying internal reinforcers of self-confidence, meta-cognition, and resilience into a SIM-PBL simulation.

Impact of KAAV's Essential Assemblies and Maintenance Float Inventory Levels on Operational Availability (시뮬레이션에 기반한 KAAV 주요 수리부속과 정비대체장비 재고수준이 운용가용도에 미치는 영향 연구)

  • Jeon, Hongjoo;Ma, Jungmok
    • Journal of the Korea Institute of Military Science and Technology
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    • v.21 no.4
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    • pp.520-528
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    • 2018
  • This paper studies the optimal inventory levels of Korea Assault Amphibious Vehicle(KAAV)'s assemblies in order to assure the required operational availability. The simulation model is built and implemented for the impact of the inventory levels on operational availability. Using regression analysis and integer programming, the optimal inventory levels of essential assemblies are suggested and analyzed. Finally, sensitivity analysis is conducted with recycling maintenance delay time.

The Effect of Virtual Reality Programs on Upper Extremity Function in Stroke Patients : A Meta-Analysis (뇌졸중 환자의 가상현실 프로그램이 상지기능에 미치는 영향 : 메타분석)

  • Cho, Sung-Hyoun;Choi, Ki-Bok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.429-439
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    • 2020
  • This study examined the effect size of virtual reality programs on the upper extremity function of stroke patients through a meta-analysis. Databases, such as the Research Information Sharing Service, the Korean Studies Information Service System, the National Library of Korea, the Korean Citation Index, and the National Digital Science Library, were used. Previous articles were surveyed for virtual reality programs between January 2010 and June 2019. A meta-analysis was performed by selecting the final 14 studies based on the PICO standard. The RoB and RoBANS tools were used as quality assessment tools for randomized and non-randomized control trials, respectively. The CMA 3.0 program was used to calculate the effect size of each study. Sub-group analysis, meta-regression analysis, and publication bias were performed. The total effect size of the virtual reality programs on the upper extremity function was Hedges's g=0.390 (95% CI: 0.192~0.587) (p<.05). The virtual reality program positively affects the upper extremity function of stroke patients. Therefore, the development of various virtual reality programs and industry-academia cooperation technology for stroke patients is required in accordance with the fourth industry. Randomized control trials and detailed upper extremity function studies for virtual reality programs will be needed in follow-up studies.

Effect of cassia cinnamon intake on improvement of the glycemic response: An updated meta-analysis - Focus on preparation of dehydrated powder and water extract (계피의 혈당 개선 기능성 평가 : 메타분석 - 건조분말과 물추출물을 중심으로)

  • Kwak, Jin Sook;Park, Min young;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.50 no.5
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    • pp.437-446
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    • 2017
  • Purpose: This meta-analysis aimed to evaluate the effect of cassia cinnamon (Cinnamomum. cassia and C. aromaticum) on the glycemic response with a focus on the preparation of dehydrated powder and water extract. Methods: We searched Pubmed, Cochrane, EMBASE, Science Direct, and the Korean Studies Information Service System (KISS) through May 2017. In the meta-analysis for the preparation of powder, eight trials reporting fasting blood glucose (FBG), four trials reporting HbA1c, and three trials reporting the postprandial glycemic response were included. For the water extract, six trials reporting FBG and four trials reporting HbA1c were eligible for this study. A random-effects model was used to calculate the pooled effect size. Results: Cassia cinnamon powder intake significantly lowered FBG by -1.55 mmol/L (95% CI, -2.45, -0.64; p = 0.001) and the AUC of postprandial blood glucose level by $-51.8mmol/L{\cdot}min$ (95% CI, -85.5, -18.1; p = 0.003). There was a significant difference in FBG between water extract of cinnamon and placebo of -0.76 mmol/L (95% CI, -1.09, -0.43; p = 0.000). However, blood HbA1c level was not significantly altered by any preparation of cinnamon. No statistical heterogeneity was observed for any analysis except in the case of FBG for cinnamon powder. Results of funnel plots and Egger's regression suggest a low likelihood of publication bias in all biomarkers (p > 0.05). Conclusion: According to this meta-analysis, there was possible evidence to support a relationship between cassia cinnamon intake and fasting glucose in both preparation of powder and water extract. Furthermore, new evidence of the health benefits on postprandial glucose regulation of cinnamon powder was obtained.

Prediction of the risk of skin cancer caused by UVB radiation exposure using a method of meta-analysis (Meta-analysis를 이용한 UVB 조사량에 따른 피부암 발생 위해도의 예측 연구)

  • Shin, D.C.;Lee, J.T.;Yang, J.Y.
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.1 s.60
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    • pp.91-103
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    • 1998
  • Under experimental conditions, UVB radiation, a type of ultra violet radiation, has shown to .elate with the occurrence of skin erythema (sun-burn) in human and skin cancer in experimental animal. Cumulative exposure to UVB is also believed to be at least partly responsible for the 'aging' process of the skin in human. It has also been observed to have an effect of altering DNA (deoxyribonucleic acid). UVB radiation is both an initiator and a promoter of non-melanoma skin cancer. Meta-analysis is a new discipline that critically reviews and statistically combines the results of previous researches. A recent review of meta-analysis in the field of public health emphasized its growing importance. Using a meta-analysis in this study, we explored more reliable dose-response relationships between UVB radiation and skin cancer incidence. We estimated skin cancer incidence using measured UVB radiation dose at a local area of Seoul (Shin chou-dong). The studies showing the dose-response relationships between UVB radiation and non-melanoma skin cancer incidence were searched and selected for a meta-analysis. The data for 7 reported epidemiological studies of three counties (USA, England, Australia) were pooled to estimated the risk. We estimated rate of incidence change of skin cancer using pooled data by meta-analysis method, and exponential and power models. Using either model, the regression coefficients for UVB did not differ significantly by gender and age. In each analysis of variance, non-melanoma skin cancer incidence after removing the gender and age and UVB effects was significant (p>0.01). The coefficients for UVB dose were estimated $2.07\times10^{-6}$ by the exponential model and 2.49 by the power model. At a local area of Seoul (Shinchon-Dong), BAF value were estimated 1.90 and 2.51 by the exponential and power model, respectively. The estimated BAP value were increased statistical power than that of primary studies that using a meta-analysis method.

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Diagnostic Value of Endorectal Ultrasound in Preoperative Assessment of Lymph Node Involvement in Colorectal Cancer: a Meta-analysis

  • Li, Li;Chen, Shi;Wang, Ke;Huang, Jiao;Liu, Li;Wei, Sheng;Gao, Hong-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3485-3491
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    • 2015
  • Background: Nodal invasion by colorectal cancer is a critical determinant in estimating patient survival and in choosing appropriate preoperative treatment. The present meta-analysis was designed to evaluate the diagnostic value of endorectal ultrasound (EUS) in preoperative assessment of lymph node involvement in colorectal cancer. Materials and Methods: We systematically searched PubMed, Web of Science, Embase, and China National Knowledge Infrastructure (CNKI) databases for relevant studies published on or before December 10th, 2014. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristics curve (AUC) were assessed to estimate the diagnostic value of EUS. Subgroup analysis and meta-regression were performed to explore heterogeneity across studies. Results: Thirty-three studies covering 3,016 subjects were included. The pooled sensitivity and specificity were 0.69 (95%CI: 0.63-0.75) and 0.77 (95%CI: 0.73-0.82), respectively. The positive and negative likelihood ratios were 3.09 (95%CI: 2.52-3.78) and 0.39 (95%CI: 0.32-0.48), respectively. The DOR was 7.84 (95%CI: 5.56-11.08), and AUC was 0.80 (95%CI: 0.77-0.84). Conclusions: This meta-analysis indicated that EUS has moderate diagnostic value in preoperative assessment of lymph node involvement in colorectal cancer. Further refinements in technology and diagnostic criteria are necessary to improve the diagnostic accuracy of EUS.

Depression and the Risk of Breast Cancer: A Meta-Analysis of Cohort Studies

  • Sun, Hui-Lian;Dong, Xiao-Xin;Cong, Ying-Jie;Gan, Yong;Deng, Jian;Cao, Shi-Yi;Lu, Zu-Xun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3233-3239
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    • 2015
  • Background: Whether depression causes increased risk of the development of breast cancer has long been debated. We conducted an updated meta-analysis of cohort studies to assess the association between depression and risk of breast cancer. Materials and Methods: Relevant literature was searched from Medline, Embase, Web of Science (up to April 2014) as well as manual searches of reference lists of selected publications. Cohort studies on the association between depression and breast cancer were included. Data abstraction and quality assessment were conducted independently by two authors. Random-effect model was used to compute the pooled risk estimate. Visual inspection of a funnel plot, Begg rank correlation test and Egger linear regression test were used to evaluate the publication bias. Results: We identified eleven cohort studies (182,241 participants, 2,353 cases) with a follow-up duration ranging from 5 to 38 years. The pooled adjusted RR was 1.13(95% CI: 0.94 to 1.36; $I^2=67.2%$, p=0.001). The association between the risk of breast cancer and depression was consistent across subgroups. Visual inspection of funnel plot and Begg's and Egger's tests indicated no evidence of publication bias. Regarding limitations, a one-time assessment of depression with no measure of duration weakens the test of hypothesis. In addition, 8 different scales were used for the measurement of depression, potentially adding to the multiple conceptual problems concerned with the definition of depression. Conclusions: Available epidemiological evidence is insufficient to support a positive association between depression and breast cancer.

Analysis on cognitive variables affecting proportion problem solving ability with different level of structuredness (비례 문제 해결에 영향을 주는 인지적 변인 분석)

  • Sung, Chang-Geun;Lee, Kwang-Ho
    • Journal of Educational Research in Mathematics
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    • v.22 no.3
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    • pp.331-352
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    • 2012
  • The purpose of the study is to verify what cognitive variables have significant effect on proportional problem solving. For this aim, the study classified proportional problem into well-structured, moderately-structured, ill-structured problem by the level of structuredness, then classified the cognitive variables as well into factual algorithm knowledge, conceptual knowledge, knowledge of problem type, quantity change recognition and meta-cognition(meta-regulation and meta-knowledge). Then, it verified what cognitive variables have significant effects on 6th graders' proportional problem solving abilities through multiple regression analysis technique. As a result of the analysis, different cognitive variables effect on solving proportional problem classified by the level of structuredness. Through the results, the study suggest how to teach and assess proportional reasoning and problem solving in elementary mathematics class.

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