Chinese patent medicine combined with calcium channel blockers in the treatment of essential hypertension:a Bayes network meta-analysis and systematic review.

Backgroud: The co-administration of Chinese patent medicine with calcium channel blockers (CCBs) is a prevalent practice in China for treating essential hypertension (EH). However, robust evidence supporting the efficacy and safety of tailored combinations of different Chinese patent medicines with CCBs, according to individual patient conditions, is still limited. This study sought to elucidate the efficacy and safety of these combinations using a systematic review and network meta-analysis. Materials and methods: Relevant studies were sourced from established databases, incorporating randomized controlled trials published up to 1 February 2023. The ROB2 tool from the Cochrane Collaborative Network was employed to independently assess and cross-verify the quality of the included literature. A network meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 and PRISMA-Network Meta-Analyses (PRISMA-NMA) guidelines. A Bayesian network meta-analysis was utilized to gauge the efficacy and safety of distinct integrations of Chinese patent medicine and CCBs. Primary outcomes were interpreted using a paired fixed-effect meta-analysis. Publication bias was appraised through Egger's test and represented with funnel plots. All statistical analyses were executed within the R statistical framework. Results: Following rigorous selection, data extraction, and bias evaluation, 36 articles were incorporated. Tianma Gouteng Granule, when combined with CCBs, displayed superior efficacy in reducing systolic blood pressure (SBP). In terms of diastolic blood pressure (DBP) reduction, Songling Xuemaikang Capsule combined with CCBs emerged as the most effective. Regarding enhancement of antihypertensive effective rates, Qinggan Jiangya Capsule paired with CCBs demonstrated optimal results. For diminishing Traditional Chinese Medicine syndrome scores, the Qiangli Dingxuan Tablet and CCBs combination proved most beneficial. When aiming to reduce total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels, Tianma Gouteng Granule and CCBs showcased superior results. In contrast, the combination of Songling Xuemaikang Capsule and CCBs was more effective in reducing LDL-C, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Conclusion: This study underscores variability in outcomes from combining Chinese patent medicine and CCBs for hypertension, emphasizing the importance of personalized medicinal combinations, especially Tianma Gouteng Granule and Songling Xuemaikang Capsule. The results offer robust evidence to inform clinical guidelines for essential hypertention and significantly aid clinician in seleting appropriate Chinese patent medicines for treatment.

Hardly traceable pitfalls in medical review articles.

The main purpose of review articles is to increase insight into the best possible practice for increasing the health condition of future subjects. This requires the collection of as many relevant data as possible from earlier case studies, but such data should be mutually independent. If the data from the reviewed single- or multi-case studies are not entirely mutually independent, the conclusions of the review study may easily - though not necessarily - become biased. This is shown on the basis of a 2020 systematic review about the effects of deep dry needling on spasticity and related physical disabilities. We analyzed this study by checking undisclosed possible overlaps regarding the subjects dealt with in the various case studies that were reviewed. This analysis raised also some questions about the accuracy of the number of subjects that had been treated, which is an aspects of which errors can commonly not be disclosed by the readers. The objective of our Letter is to show that insufficient attention by authors, editor and reviewers for an unambiguous presentation of the data regarding the subjects dealt with can make it impossible for readers to draw correct conclusions regarding the optimization of possible treatments.

Is the Psychopathic Brain an Artifact of Coding Bias? A Systematic Review.

Questionable research practices are a well-recognized problem in psychology. Coding bias, or the tendency of review studies to disproportionately cite positive findings from original research, has received comparatively little attention. Coding bias is more likely to occur when original research, such as neuroimaging, includes large numbers of effects, and is most concerning in applied contexts. We evaluated coding bias in reviews of structural magnetic resonance imaging (sMRI) studies of PCL-R psychopathy. We used PRISMA guidelines to locate all relevant original sMRI studies and reviews. The proportion of null-findings cited in reviews was significantly lower than those reported in original research, indicating coding bias. Coding bias was not affected by publication date or review design. Reviews recommending forensic applications-such as treatment amenability or reduced criminal responsibility-were no more accurate than purely theoretical reviews. Coding bias may have contributed to a perception that structural brain abnormalities in psychopaths are more consistent than they actually are, and by extension that sMRI findings are suitable for forensic application. We discuss possible sources for the pervasive coding bias we observed, and we provide recommendations to counteract this bias in review studies. Until coding bias is addressed, we argue that this literature should not inform conclusions about psychopaths' neurobiology, especially in forensic contexts.

Interventions for the prevention of musculoskeletal disorders in a seasonal work context: A scoping review.

Seasonal work is characterized by difficult working conditions further influenced by organizational, physical, and time constraints which expose seasonal workers to high risks of MSDs. Our aim was to provide an overview of the recommendations and interventions carried out in a seasonal work context to prevent MSDs. To do this, we conducted a scoping review through a systematic electronic search of seven scientific databases and the websites of ergonomics and occupational health and safety organizations. After screening by independent reviewers according to specific criteria sets, we performed qualitative analyses on the 16 studies retained. Findings revealed six categories of transformation targets sought by the interventions/recommendations with the technical devices/physical work environment category being the most reported. We also found it was quite rare for studies to consider the seasonal work context in and of itself when developing and implementing interventions. Our review thus highlights the need to pay attention to intervention processes in order to better understand the influence of seasonality on the measures taken to prevent MSDs in working environments.

The limitations to our understanding of peer review.

Peer review is embedded in the core of our knowledge generation systems, perceived as a method for establishing quality or scholarly legitimacy for research, while also often distributing academic prestige and standing on individuals. Despite its critical importance, it curiously remains poorly understood in a number of dimensions. In order to address this, we have analysed peer review to assess where the major gaps in our theoretical and empirical understanding of it lie. We identify core themes including editorial responsibility, the subjectivity and bias of reviewers, the function and quality of peer review, and the social and epistemic implications of peer review. The high-priority gaps are focused around increased accountability and justification in decision-making processes for editors and developing a deeper, empirical understanding of the social impact of peer review. Addressing this at the bare minimum will require the design of a consensus for a minimal set of standards for what constitutes peer review, and the development of a shared data infrastructure to support this. Such a field requires sustained funding and commitment from publishers and research funders, who both have a commitment to uphold the integrity of the published scholarly record. We use this to present a guide for the future of peer review, and the development of a new research discipline based on the study of peer review.

Non-dietary factors associated with n-3 long-chain PUFA levels in humans - a systematic literature review.

Numerous health benefits are attributed to the n-3 long-chain PUFA (n-3 LCPUFA); EPA and DHA. A systematic literature review was conducted to investigate factors, other than diet, that are associated with the n-3 LCPUFA levels. The inclusion criteria were papers written in English, carried out in adult non-pregnant humans, n-3 LCPUFA measured in blood or tissue, data from cross-sectional studies, or baseline data from intervention studies. The search revealed 5076 unique articles of which seventy were included in the qualitative synthesis. Three main groups of factors potentially associated with n-3 LCPUFA levels were identified: (1) unmodifiable factors (sex, genetics, age), (2) modifiable factors (body size, physical activity, alcohol, smoking) and (3) bioavailability factors (chemically bound form of supplements, krill oil v. fish oil, and conversion of plant-derived α-linolenic acid (ALA) to n-3 LCPUFA). Results showed that factors positively associated with n-3 LCPUFA levels were age, female sex (women younger than 50 years), wine consumption and the TAG form. Factors negatively associated with n-3 LCPUFA levels were genetics, BMI (if erythrocyte EPA and DHA levels are <5·6 %) and smoking. The evidence for girth, physical activity and krill oil v. fish oil associated with n-3 LCPUFA levels is inconclusive. There is also evidence that higher ALA consumption leads to increased levels of EPA but not DHA. In conclusion, sex, age, BMI, alcohol consumption, smoking and the form of n-3 LCPUFA are all factors that need to be taken into account in n-3 LCPUFA research.

Heterogeneity in arterial hypertension and ocular perfusion pressure definitions: Towards a consensus on blood pressure-related parameters for glaucoma studies.

PURPOSE: Glaucoma studies have long taken into account the blood pressure (BP) status of patients. This study summarizes and evaluates the impact of the different criteria that have been used for BP-related variables in glaucoma research. METHODS: Studies included in two meta-analyses that reviewed the role of BP in glaucoma were analyzed. Additional studies published after the search periods of the meta-analyses were also included. Criteria for the definition of arterial hypertension and other BP-related variables, such as mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP), were retrieved. RESULTS: Sixty-four studies were evaluated. One-third used 140 mmHg as a systolic BP cut-off to define hypertension, 20% used 160 mmHg and the remaining half used various other criteria. Less than 20% of studies reported MAP and/or MOPP. While eight of the ten studies reporting MAP used a correct formula that only happened for five of the eleven studies reporting MOPP. Using as an example average blood pressure values, incorrectly used formulas could have led to an overestimation of more than 100% of the expected values. CONCLUSION: Considerable heterogeneity exists in BP-related variables in glaucoma research and different definitions can lead to large disparities. Glaucoma research would benefit from a consensus regarding blood pressure parameters.

Associação entre atividade física e percepção de saúde em adolescentes: revisão sistemática / Association between physical activity and self-rated health in adolescents: systematic review

O objetivo do presente estudo foi sintetizar por meio de revisão sistemática as evidências disponíveis quanto à associação entre a prática de atividades físicas e a percepção de saúde em adolescentes. As buscas foram realizadas em bases de dados eletrônicas (SCOPUS, PUBMED/MEDLINE, LILACS e SCIELO) e na lista de referências dos artigos identificados. Foram incluídos artigos originais publicados até 2009, em qualquer idioma. A busca dos artigos foi baseada nos descritores sugeridos pelo MeSH e em termos específicos que vêm sendo utilizados para designar as variáveis "percepção de saúde" e "atividade física". Foram analisados 16 estudos, nenhum estudo envolvendo adolescentes brasileiros. A maioria dos estudos foi transversal quanto ao delineamento, publicado nos últimos cinco anos (2005-2009), utilizou medidas subjetivas de atividade física (questionários e diários de atividade) e operacionalizou a medida da percepção de saúde por uma única pergunta. Em 14 dos 16 estudos analisados, verificou-se uma associação direta entre a prática de atividade física e uma percepção de saúde mais positiva. Concluiu-se que a prática de atividade física está associada à percepção de saúde neste grupo populacional; todavia, devido ao delineamento transversal dos estudos realizados não se pode estabelecer uma relação causal entre estes fatores.

The aim of this study was to review the available evidence on the association between physical activity and self-rated health among adolescents. Systematic reviews of the literature were undertaken considering relevant publications that were done until 2009 in databases (SCOPUS, PUBMED/MEDLINE, LILACS e SCIELO) as well as in the reference list of each one of the papers that were retrieved during the search. The review process was carried out by combining specific Medical Subject Headings (MeSH) and terms that have been usually used in the literature to label self-rated health and physical activity studies. Seventeen studies were analyzed, none of them enrolling Brazilian adolescents. Most of the studies were cross-sectionals, published during the last 5 years (2005-2009), have used indirect measures of physical activity, and health perception was assessed by using one single question. In sixteen studies it was reported a direct association between physical activity practice and higher levels of health perception. It was concluded that physical activity is a factor associated to health perception in adolescents; however, since the studies were cross-sectional it is not possible to establish a causal relationship between these factors.