• Korean Journal of Clinical Pharmacy
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• v.30 no.4
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• pp.270-278
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• 2020

Background: Although the identification of clinical and laboratory features in pediatric COVID-19 patients is essential in establishing an appropriate treatment plan, a systematic review and meta-analysis on the topic has yet to be reported. Methods: We searched MEDLINE, Embase, and Web of Science to access clinical and laboratory characteristics as well as clinical outcomes of children with COVID-19 infection. A meta-analysis using random-effect model was performed to estimate pooled prevalence and 95% confidence intervals. Results: Among the 532 studies initially collected, 12 articles were finally included in the meta-analysis. Among the investigated 320 pediatric patients with COVID-19, fever (48.2%) and cough (39.3%) were the most common symptoms. Almost one third of patients (30.4%) were asymptomatic. In laboratory findings, only 11.4% of pediatric patients experienced lymphocytopenia. Increased inflammatory markers including c-reactive protein (18.6%) and procalcitonin (32.4%) were observed. Only a few patients needed mechanical ventilation and intensive care support, and only one death was reported. Conclusion: Pediatric patients with COVID-19 infection exhibited milder symptoms and more favorable outcomes compared to adults. However, considering the high rate of asymptomatic pediatric patients, close monitoring is required to prevent community infection in asymptomatic conditions and hidden disease progression.

• Journal of Korean Academy of Nursing
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• v.52 no.5
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• pp.479-498
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• 2022

Purpose: This study aimed to examine effect sizes of leadership styles of nursing managers on turnover intention of hospital nurses. Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA and MOOSE guidelines. Participants were nurses working in hospitals. The intervention involved nursing managers' leadership styles; the outcome assessed was nurses' turnover intention. This was an observational study design. Eleven databases were searched to obtain articles published in Korean or English. Of the 14,428 articles reviewed, 21 were included in systematic review and meta-analysis. Comprehensive Meta-Analysis and R software programs were used. Results: The total effect size r (ESr) was - 0.25 (95% confidence interval: - 0.29 to - 0.20). Effect sizes of each leadership style on turnover intention were as follows: ethical leadership (ESr = - 0.34), transformational leadership (ESr = - 0.28), authentic leadership (ESr = - 0.23), transactional leadership (ESr = - 0.21), and passive avoidant leadership (ESr = 0.13). Ethical leadership was the most effective style in decreasing turnover intention of hospital nurses. Conclusion: Positive leadership styles of nurse managers effectively decrease turnover intention of hospital nurses, and negative leadership styles of nurse managers effectively increase turnover intention of hospital nurses. The ethical leadership style is the most effective in decreasing turnover intention of hospital nurses; however, it requires careful interpretation as its effects are reported by only two studies. This study contributes to addressing the high turnover rate of hospital nurses and developing positive leadership styles of nurse managers in hospital settings.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.2
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• pp.11-24
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• 2022

Objectives : This study was designed to investigate the effect of Banhahubak-tang on gastroesophageal reflux disease(GERD) through a systematic review and meta-analysis of randomized controlled trials(RCTs). Methods : RCTs using Banhahubak-tang on GERD was searched in databases such as EMBASE, PubMed, MEDLINE, CENTRAL, CNKI, KISS, RISS, ScienceON, and OASIS. RCTs published up to October 8th, 2021 were included. Meta-analysis was performed by synthesizing outcome data, including Total Effectiveness Rate (TER), Reflux Symptom Index(RSI), Reflux Finding Score(RFS), and Incidence of Adverse Reactions. RevMan 5.4 software was used for data analysis. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. Results : Ten RCTs met the inclusion criteria. The total effective rate was the most commonly used outcome measure. The meta-analysis revealed that the TER in the experimental group was higher than that of the control group(N=2, RR:1.22, 95% CI:1.09 to 1.36, P=0.0004, I²=0%)(N=6, RR:1.22, 95% CI:1.14 to 1.32, P<0.00001, I²=0%)(N=8, RR:1.22, 95% CI: 1.14 to 1.30, P<0.00001, I²=0%). On the other hand, RSI(N=2, MD : -4.29, 95% CI: -4.71 to -3.86, I²=94%), RFS(N=2, MD : -3.28, 95% CI: -3.71 to -2.85, I²=96%), and Incidence of Adverse Reactions(N=5, RR: 0.32, 95% CI: 0.17 to 0.61, I²=0%) in the experimental group were lower than that of the control group. Conclusion : Treatment with Banhahubak-tang was found to be effective on GERD. However the results might be biased because of the poor quality and small sample size of the included RCTs.

• Journal of Acupuncture Research
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• v.39 no.3
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• pp.159-169
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• 2022

Failed back surgery syndrome (FBSS) is a term that applies to symptoms such as persistent or recurring low back pain, paresthesia, sciatica, or numbness after spine surgery. Electroacupuncture (EA) has been reported to have excellent analgesic effects although there have been no systematic reviews on the effects of EA on FBSS. Therefore, a systematic review and meta-analysis of the effectiveness of EA on FBSS was conducted. Eight databases were searched for studies that used EA for FBSS and 7 randomized controlled trials (RCTs) were included. RCTs of EA as combination therapy for FBSS compared with conventional treatment demonstrated improvement in the level of pain, lumbar functional scale scores, and quality of life. However, meta-analysis showed that reduction in pain was not statistically significant, while evaluation of lumbar function significantly improved, although the quality of evidence in the RCTs was generally low. RCTs comparing EA alone with conventional treatment demonstrated an improved level of pain, lumbar function, and effective rate of treatment. Meta-analysis showed that pain was significantly decreased in the EA alone group compared with the control group, although the quality of evidence was low. To improve the quality of evidence, high-quality RCTs are required in the future.

• Journal of the Korean Applied Science and Technology
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• v.40 no.1
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• pp.123-134
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• 2023

This study presents a meta-analysis research to test the improve effects of obesity and blood lipids on Salicronia herbacea L. (S. herbacea) intake in rats. Individual research materials were selected from database such as PubMed, Embase, RISS, DBpia, and NDSL. The Review Manager 5.3 version was used to estimate effect size through meta-analysis. A total of 9 studies were finally included. Body weight gains were decreased in S. herbacea-treated groups as compared to the high fat diet groups. But, no significant effect was observed on FER, liver index, and total cholesterol. In addition, the effect size of triglyceride was reduced, whereas high density lipoprotein (HDL)-cholesterol was increased in S. herbacea-treated group. In this meta-analysis, the results indicated that S. herbacea have a strong effect on anti-obesity through the blood lipids improvement.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.296-311
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• 2023

Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through a systematic literature review and meta-analysis to provide basic data to explore the direction of development of nursing staffing standards. Methods: This study involved quantitative studies about nurses working in intensive care units related to nursing workload published in English or Korean since 2000. Search terms included 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia, MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment was conducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies with correlational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a total of 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness, length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illness measured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantly associated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, the characteristics of intensive care units and patients varied across studies, and a variety of scales for measuring workload and severity of illness were also used. Sustained research reflecting domestic intensive care unit work environments and assessing the workload of intensive care unit nurses should be imperative.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.11.1-11.17
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• 2023

Background: Studies on the relationship between organic solvent exposure and chronic kidney disease (CKD) have presented inconsistent results. Definition of CKD has changed in 2012, and other cohort studies have been newly published. Therefore, this study aimed to newly confirm the relationship between organic solvent exposure and CKD through an updated meta-analysis including additional studies. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was conducted on January 2, 2023 using Embase and MEDLINE databases. Case-control and cohort studies on the relationship between organic solvent exposure and CKD were included. Two authors independently reviewed full-text. Results: Of 5,109 studies identified, a total of 19 studies (control studies: 14 and cohort studies: 5) were finally included in our meta-analysis. The pooled risk of CKD in the organic solvent exposed group was 2.44 (1.72-3.47). The risk of a low-level exposure group was 1.07 (0.77-1.49). The total risk of a high-level exposure group was 2.44 (1.19-5.00). The risk of glomerulonephritis was 2.69 (1.18-6.11). The risk was 1.46 (1.29-1.64) for worsening of renal function. The pooled risk was 2.41 (1.57-3.70) in case-control studies and 2.51 (1.34-4.70) in cohort studies. The risk of subgroup classified as 'good' by the Newcastle Ottawa scale score was 1.93 (1.43-2.61). Conclusions: This study confirmed that the risk of CKD was significantly increased in workers exposed to mixed organic solvents. Further research is needed to determine the exact mechanisms and thresholds. Surveillance for kidney damage in the group exposed to high levels of organic solvents should be conducted.

• The Journal of Internal Korean Medicine
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• v.45 no.4
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• pp.549-567
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• 2024

Objectives: This study was aimed at evaluating the effectiveness and safety of Danggui buxue decoction (DBD) for iron deficiency anemia (IDA) by systematic review and meta-analysis of the randomized controlled trials (RCTs). Methods: Randomized controlled trials on the treatment of DBD for IDA patients were selected from among the literature published from the beginning of each database to May 30, 2023 in nine domestic and foreign databases (PubMed, EMBASE, Cochrane, Chinese Academic Journals (CAJ), CiNii Research, J-STAGE, Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), and ScienceON). The quality of the literature was evaluated using the Cochrane ROB tool 2.0 (ROB2) and GRADE method. The meta-analysis was conducted using RevMan5.4. Results: A total of 636 patients with IDA were finally selected from the 7 RCTs. The meta-analysis showed that the treatment groups that underwent both DBD and conventional treatment were statistically higher than the control groups that performed only conventional treatment in all indicators that showed effectiveness of DBD such as red blood cell (mean difference (MD) 0.38×10¹²/L, 95% CI: 0.16-0.60), hemoglobin (MD 12.45 g/L, 95% CI: 10.27-14.63), serum ferritin (MD 3.50 ㎍/L, 95% CI: 1.71-5.29), and total effective rate (relative risk (RR) 1.13, 95% CI: 1.05-1.21). The incidence of adverse events was 0.39 times lower in the DBD group than in the conventional group (RR 0.39, 95% CI: 0.22-0.70). Conclusion: This study demonstrated the effectiveness and safety of DBD with conventional treatment and further provided a basis for administering DBD to patients with IDA in clinical treatment.

• Journal of Preventive Medicine and Public Health
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• v.49 no.2
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• pp.97-107
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• 2016

Objectives: Research on how the risk of gastric cancer increases with Epstein-Barr virus (EBV) infection is lacking. In a systematic review that investigated studies published until September 2014, the authors did not calculate the summary odds ratio (SOR) due to heterogeneity across studies. Therefore, we include here additional studies published until October 2015 and conduct a meta-analysis with meta-regression that controls for the heterogeneity among studies. Methods: Using the studies selected in the previously published systematic review, we formulated lists of references, cited articles, and related articles provided by PubMed. From the lists, only case-control studies that detected EBV in tissue samples were selected. In order to control for the heterogeneity among studies, subgroup analysis and meta-regression were performed. Results: In the 33 case-control results with adjacent non-cancer tissue, the total number of test samples in the case and control groups was 5280 and 4962, respectively. In the 14 case-control results with normal tissue, the total number of test samples in case and control groups was 1393 and 945, respectively. Upon meta-regression, the type of control tissue was found to be a statistically significant variable with regard to heterogeneity. When the control tissue was normal tissue of healthy individuals, the SOR was 3.41 (95% CI, 1.78 to 6.51; I-squared, 65.5%). Conclusions: The results of the present study support the argument that EBV infection increases the risk of gastric cancer. In the future, age-matched and sex-matched case-control studies should be conducted.

• Journal of Nutrition and Health
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• v.36 no.5
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• pp.515-527
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• 2003

Objectives： A meta-analysis of the literatures was conducted to evaluate the cost-effectiveness of medical nutrition therapy by dietitians. Methods : The 30 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and the PQD database until May, 2002 and a review of reference lists. The main search terms were“dietitian”,“dietary intervention”,“nutrition intervention”, “cost”,“cost-effectiveness”and“cost-benefit analysis”. The subgroup analysis was performed by publication year, study design, intervention provider, type of patient (in/out-patient) and type of cost (total cost/direct cost). Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. Results : The 30 studies were identified using the electric database search and bibliographies. The 17 trials were eligible for inclusion criteria, then the systematic review and a meta-analysis were conducted on effectiveness and cost-effectiveness of medical nutrition therapy. The quality of the studies was evaluated using the quality assessment tool for observational studies. The quality score was 0.515 $\pm$ 0.121 (range : 0.279-0.711, median : 0.466). The meta-analysis of 17 studies based on the random effect model showed that medical nutrition therapy was highly effective in treating the diseases (effect size 0.3092 : 95% confidence interval 0.2282-0.3303). The vote-counting method, one of meta-analysis methods, was applied to evaluate the cost-effectiveness of medical nutrition therapy conducted by dietitians. Two criteria (method 1, method 2) for voting were used. The calculated p-values for method 1 (more conservative method) and method 2 (less conservative method) were 0.1250 and 0.0106, respectively. Medical nutrition therapy by dietitians was significantly cost-effective in the method 2. Conclusion. This meta-analysis showed that the effectiveness of medical nutrition therapy was statistically significant in treating disease (effect size 0.3092), and that the cost-effectiveness of medical nutrition therapy was statistically significant in the method 2 (less conservative method) of vote counting. (Korean J Nutrition 36(5): 515~527, 2003)