Network Meta-Analysis on the Effect of Desensitizing Toothpastes on Dentine Hypersensitivity. Hu ML, Zheng G, Lin H, Yang M, Zhang YD, Han JM. J Dent 2019;88:103170.
National Natural Science Foundation of China (81771119).
Systematic review with meta-analysis of data.

Not all Desensitizing Toothpastes Perform Equally Well.

The aim of our work was to systematically review and meta-analyze epicardial adipose tissue (EAT) density values reported in literature, assessing potential correlations of EAT density with segmentation thresholds and other technical and clinical variables.
A systematic search was performed, aiming for papers reporting global EAT density values in Hounsfield Units (HU) in patients undergoing chest CT for any clinical indication. After screening titles, abstract and full text of each retrieved work, studies reporting mean and standard deviation for EAT density were ultimately included. Technical, clinical and EAT data were extracted, and divided into subgroups according to clinical conditions of reported subjects. Pooled density analyses were performed both overall and for subgroups according to clinical conditions. Metaregression analyses were done to appraise the impact of clinical and technical variables on EAT volume.
Out of 152 initially retrieved works, 13 were ultimately included, totaling for 7683 subjects. EAT density showed an overall pooled value of -85.86 HU (95% confidence interval [95% CI] -91.84, -79.89 HU), being -86.40 HU (95% CI -112.69, -60.12 HU) in healthy subjects and -80.71 HU (95% CI -87.43, -73.99 HU) in patients with coronary artery disease. EAT volume and lower and higher segmentation thresholds were found to be significantly correlated with EAT density (p = 0.044, p < 0.001 and p< 0.001 respectively).
Patients with coronary artery disease appear to present with higher EAT density values, while the correlations observed at metaregression highlight the need for well-established, shared thresholds for EAT segmentation.

CT-derived epicardial adipose tissue density: Systematic review and meta-analysis.

Lean is largely applied to the health sector and on the healthcare-associated infections (HAI). However, a few results on the improvement of the outcome have been reported in literature. The purpose of this study is to analyze if the lean application can reduce the HAI rate.
A comprehensive search was performed on PubMed/Medline, Scopus, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the following keywords: "lean" and "infection". Inclusion criteria were: 1) research articles with quantitative data and relevant information on lean methodology and its impact on healthcare infections; 2) prospective studies. The risk of bias and the study quality was independently assessed by two researchers using the "The National Institutes of Health (NIH) quality assessment tool for before-after (Pre-Post) study with no control group". The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines has been used. 22 studies were included in the present meta-analysis.
Lean application demonstrated a significant protective role on healthcare-associated infections rate (RR 0.50; 95% C.I.: 0.38-0.66) with significant impact on central line-associated bloodstream infections (CLABSIs) (RR 0.47; 95% C.I.: 0.28-0.82).
Lean has a positive impact on the decreasing of HAIs and on the improvement of compliance and satisfaction of the staff.

The management of healthcare-related infections through lean methodology: systematic review and meta-analysis of observational studies.

Osteoporotic fractures are a major contributor to late life morbidity and mortality, and impose a substantial societal cost, yet osteoporosis remains substantially underdiagnosed and undertreated. The purpose of this meta-analysis was to assess the pooled diagnostic sensitivity and specificity of computed tomography (CT) images for diagnosing osteoporosis in patients who meet WHO dual X-ray absorptiometry (DXA) osteoporosis criteria using specific Hounsfield unit (HU) values as a threshold.
Systematic literature searches in PubMed, Embase, Web of Science and Google Scholar were performed from the earliest available date through 1 July 2018, restricted to publications in English. Participants in all studies underwent CT scans that included the lumbar and/or thoracic spine for different indications and HU measurements were used to identify osteoporosis. DXA scans served as the reference standard.
Ten eligible studies were identified. The mean area under the hierarchical summary receiver operating characteristic (ROC) curve for diagnosis osteoporosis was 0.84 (95% CI: 0.81, 0.87). The pooled diagnostic sensitivity and specificity of CT images to identify osteoporosis were 0.83 (95% CI: 0.73, 0.90) and 0.74 (95% CI: 0.69, 0.79). The positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio were 3.4 (95% CI: 2.7, 4.5), 0.21 (95% CI: 0.12, 0.36), and 16.4 (95% CI: 7.8, 34.3), respectively. The bias-adjusted sensitivity and specificity of CT were 0.73 and 0.71. Meta-regression demonstrated that country of study, DXA criteria and scanner manufacturer were significant factors associated with the sensitivity of CT in detecting osteoporosis while scanner manufacturer was the only factor associated with specificity of CT.
This meta-analysis showed reasonable pooled sensitivity and specificity for using threshold values measured on CT scans to identify osteoporosis opportunistically.

Opportunistic CT screening of osteoporosis on thoracic and lumbar spine: a meta-analysis.

It is assumed that autoimmune limbic encephalitis (ALE) demonstrates distinct neuropsychological manifestations with differential responses to immunotherapy according to which associated autoantibody (AAB), if any, is identified. Towards investigating whether this is the case, this study aims to summarize respective findings from the primary literature on ALE with AABs binding to cell surface neural antigens and ALE with AABs against intracellular neural antigens.
We chose ALE with AABs against leucine-rich, glioma inactivated protein 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) as the most frequent cell surface membrane antigens, and ALE with AABs to Embryonic Lethal, Abnormal Vision, Like 1 (ELAVL) proteins (anti-Hu) and glutamic acid decarboxylase 65 (GAD65) as the most frequent intracellular neural antigens. The PubMed and Scopus databases were searched on March 1st, 2021 for neuropsychological test and -screening data from patients with ALE of these AAB-types. Findings were reviewed according to AAB-type and immunotherapy status and are presented in a review section and are further statistically evaluated and presented in a meta-analysis section in this publication.
Of the 1304 initial hits, 32 studies on ALE with AABs against LGI1, CASPR2, and GAD65 reporting cognitive screening data could be included in a review. In ALE with AABs against LGI1, CASPR2 and GAD65, memory deficits are the most frequently reported deficits. However, deficits in attention and executive functions including working memory, fluency, and psychological function have also been reported. This review shows that ALE patients with AABs against both LGI1 and CASPR2 show higher percentages of neuropsychological deficits compared to ALE patients with AABs against GAD65 before and after initiation of immunotherapy. However, the methodologies used in these studies were heterogenous, and longitudinal studies were not comparable. Moreover, 21 studies including ALE patients with AABs against LGI1 and GAD65 were also suitable for meta-analysis. No suitable study on ALE with AABs against ELAVL proteins could be identified. Meta-Analyses could be executed for cognitive screening data and only partially, due to the small number of studies. However, in statistical analysis no consistent effect of AAB or immunotherapy on performance in cognitive screening tests could be found.
Currently, there is no definite evidence supporting the notion that different AAB-types of ALE exhibit distinct neuropsychological manifestations and respond differently to immunotherapy. Overall, we could not identify evidence for any effect of immunotherapy on cognition in ALE. More systematic, in-depth and longitudinal neuropsychological assessments of patients with different AAB-types of ALE are required in the future to investigate these aspects.

Review and meta-analysis of neuropsychological findings in autoimmune limbic encephalitis with autoantibodies against LGI1, CASPR2, and GAD65 and their response to immunotherapy.

Papers