• 대한간호학회지
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• 제51권4호
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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.

• Human Ecology Research
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• 제61권2호
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• pp.263-280
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• 2023

This study examined four ecological systems, namely individual, family, school, and media environments. A series of moderator analyses were conducted to examine variations in effect size estimates across the study characteristics. The current study estimated that the effect size results were gleaned from 360 primary studies, including 90 journal articles and 270 thesis/dissertations, published between 2011 and 2022. The current meta-analysis results supported the ecological framework. That is, the impact of each ecological system on the development of positive and negative peer relationships varies depending on age groups and protective-risk factors. Specifically, for positive peer relationships, the largest effect size of the protective factor was found at the individual level for young and school- aged children, but at the school level for adolescents. Regarding the risk factors for positive peer relationships, the media was the ecological system with the strongest effect size for both young children and adolescents, while the individual-level demonstrating the strongest effect for school-aged children. Results from this meta-analysis allow us to identify some vital intervention areas in terms of healthy peer-relationship development, which should be of considerable interest to the educators and policymakers who are responsible for assessing and intervening with at-risk young children, school-aged children, and adolescents. From a practical standpoint, the current meta-analysis results are expected to contribute to developing effective prevention initiatives by targeting specific protective and risk factors for peer relationship development on the ecological system level.

• Restorative Dentistry and Endodontics
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• 제48권4호
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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.

• 대한치과교정학회지
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• 제53권6호
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• pp.374-392
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• 2023

Objective: Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs). Methods: An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model. Results: Thirty one articles were included in the qualitative synthesis and 17 in the meta-analysis. CAs had a significantly lower negative impact on QoL, with an "important" effect size, while the influence of time was not significant. Periodontal indicators plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing show significantly better values in patients treated with CAs, with moderate to large effect sizes. PI and GI have a significant tendency to improve over time. In microbiological indicators, CAs present a lower biofilm mass without differences in the percentage of patients with high counts of Streptococcus mutans and Lactobacilli bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs. Conclusions: Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7509-7515
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• 2013

To assess the risk of cancers associated with sleep duration using meta-analysis of published cohort studies, we performed a comprehensive search using PubMed, Embase and Web of Science through October 2013. We combined hazard ratios (HRs) from individual studies using meta-analysis approaches. A random effect dose-response analysis was used to evaluate the relationship between sleep duration and cancer risk. Subgroup analyses and sensitivity analyses were also performed. Publication bias was evaluated using Funnel plots and Begg's test. A total of 13 cohorts from 12 studies were included in this meta-analysis, which included 723, 337 participants with 15, 156 reported cancer outcomes during a follow-up period ranging from 7.5 to 22 years. The pooled adjusted HRs were 1.06 (95% CI: 0.92, 1.23; P for heterogeneity =0.003) for short sleep duration, 0.91 (95% CI: 0.78, 1.07; P for heterogeneity <0.0001) for long sleep duration. In subgroup analyses stratified by cancer type, long duration of sleep showed an inverse relation with hormone-related cancer (HR=0.79; 95% CI: 0.65, 0.97; P for heterogeneity =0.009) and a greater risk of colorectal cancer (HR=1.29; 95% CI: 1.09, 1.52; P for heterogeneity =0.346). Further meta-analysis on dose-response relationships showed that the relative risks of cancer were 1.00 (95% CI: 0.99, 1.01; P for linear trend=0.9151) for one hour of sleep increment per day, and 1.00 (95% CI: 0.98, 1.01; P for linear trend=0.7749) for one hour of sleep increment per night. No significant dose-response relationship between sleep duration and cancer was found on non-linearity testing (P=0.5053). Our meta-analysis suggests a positive association between long sleep duration and colorectal cancer, and an inverse association with incidence of hormone related cancers like those in the breast. Studies with larger sample size, longer follow-up times, more cancer types and detailed measure of sleep duration are warranted to confirm these results.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4335-4339
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• 2012

Background: Whether sirolimus is useful in the prevention of non-melanoma skin cancer (NMSC) remains unclear and we therefore performed this meta-analysis of randomized controlled trials to test the hypothesis that Sirolimus-based immunosuppression is associated with a decrease in NMSC. Methods: The main outcomes were NMSC, squamous-cell carcinoma and basal-cell carcinoma. The pooled risk ratio (RR) with its 95% confidence interval (95%CI) were used to assess the effects. Results: 5 randomized trials involving a total of 1499 patients receiving kidney transplantation were included. Patients undergoing Sirolimus-based immunosuppression had much lower risk of NMSC (RR = 0.49, 95%CI 0.32-0.76, P = 0.001). Subgroup analyses by tumor type showed that Sirolimus-based immunosuppression significantly decreased risk of both squamous-cell carcinoma (RR = 0.58, 95%CI 0.43-0.78, P < 0.001) and basal-cell carcinoma (RR = 0.56, 95%CI 0.37-0.85, P = 0.006). The quality of evidence was high for NMSC, and moderate for squamous-cell carcinoma and basal-cell carcinoma. No evidence of publication bias was observed. Conclusion: High quality evidence suggests that Sirolimus-based immunosuppression decreases risk of non-melanoma skin cancer, and Sirolimus has an antitumoral effect among kidney-transplant recipients.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.38-48
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• 2011

The aim of the study was to identify which fall-prevention program offered in community settings in Korea is the most effective in strengthening muscles. Muscle weakness is one of the major risk factors causing falls among the elderly. Randomized controlled trials and clinical controlled trials published between 1996 and February 2011 were included in this study. Seventeen of the 69 identified studies met the study's criteria and were included in this meta-analysis. The overall effect size of the program was .822 (95% confidence interval= .717~.927). The general strengthening exercise (1.608), dance sports training (1.538), Thera-band exercise for lower extremities (1.517), Seniorobic exercise (1.146), gait training (.959), balance training (.909), gradual resistive exercise (.888), and multifactorial fall prevention (.842) programs all show positive effects on muscle strengthening. Subgroup analyses found that more relative effects are seen in programs offered to the more elderly. In this study, the effect of increasing muscle strength on the prevention of falls can only be indirectly suggested; there are few available studies that report the frequency or history of falls in Korea. Further studies are needed to examine the direct effect of fall prevention exercise programs among the elderly.

• 정보관리학회지
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• 제16권1호
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• pp.157-174
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• 1999

본 연구는 국내에서 제작된 주요 과학기술 데이터베이스 3개를 선정하고 각 데이터베이스의 검색결과를 조사하여 데이터베이스의 품질을 종합적으로 평가한 메타 연구이다. 종합적 평가로부터 지적된 문제점들을 나열하고 해결방안과 정책적인 제언을 모색하고자 하는 목적으로 진행되었다. 연구의 주요 결과는 첫째, 기준측정에서 상기한 연구대상들은 적지 않은 오류와 미비점을 보이고 있으며 둘째, 일반적으로 데이터베이스자체에 대한 공식적인 설명이나 안내가 누락되어 있고, 셋째, 검색되는 색인어나 주제어의 용어통제가 완벽하게 이루미지지 않고 있다. 넷째 최종 이용자 검색을 지원하고 있는 색인어 브라우징이나 주제별 상호참조와 같은 서비스 지원이 제대로 이루어지고 있지 않으며, 마지막으로 검색시 발생할 수 있는 오류와 그에 대한 이용자의 오류처리안내나 설명이 검색과정에서 제공되지 않거나 실질적인 도움을 주지 못하고 있는 것으로 나타났다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.397-405
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• 2014

Obesity has been considered as an important risk factor for the development of colorectal cancer (CRC), but the association has not been fully elucidated. Obesity is linked significantly to adipose tissue dysfunction and to alteration of adipokines in blood; in particular, obesity-induced inflammation is thought to be an important link between obesity and colorectal cancer. Based on epidemiological studies, we undertook a systematic review to understand the association of circulating levels of selected adipokines, including adiponectin, leptin, resistin, IL-6 and TNF-${\alpha}$, with the level of CRC risk. Most prospective studies suggested protective effects of adiponectin, but these were attenuated by body mass index (BMI) and waist circumference (WC) data in our meta-analysis. On the other hand, meta-analyses for leptin and CRC did not demonstrate any association, similar to the results of systematic review. Although it proved difficult to determine whether other selected adipokines (resistin, IL-6 and TNF-${\alpha}$) were related to CRC risk due to small number of reports, the present systematic review suggested a positive association with elevated resistin levels but null associations with IL-6 and TNF-${\alpha}$.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4665-4669
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• 2015

The aim of this study was to assess the diagnostic value of RASSF1A methylation in renal cell carcinoma. Systematically search were performed using the Pubmed, ProQest and Web of Science for all articles on the association between RASSF1A methylation and renal cell carcinoma before 15 April 2015. After the filtration, 13 studies involving 677 cases and 497 controls met our criteria. Our meta-analysis suggested that hypermethylation of RASSF1A gene was associated with the increased risk of RCC(OR:4.14, 95%CI:1.06-16.1). Stratified analyses showed a similar risk in qualitative detection method(OR:28.4, 95%CI:10.2-79.6), body fluid sample(OR:12.8, 95%CI:5.35-30.8), and American(OR:10.5, 95%CI:1.97-55.9). Our result identified that RASSF1A methylation had a strong potential in prediction the risk of Renal cell carcinoma.