The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration

Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement-a reporting guideline published in 1999-there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA ( Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and metaanalyses.

A review of studies of ionizing radiation-induced double-strand break clustering

Underpinning current models of the mechanisms of the action of radiation is a central role for DNA damage and in particular double-strand breaks (DSBs). For radiations of different LET, there is a need to know the exact yields and distributions of DSBs in human cells. Most measurements of DSB yields within cells now rely on pulsed-field gel electrophoresis as the technique of choice. Previous measurements of DSB yields have suggested that the yields are remarkably similar for different types of radiation with RBE values less than or equal to1.0. More recent studies in mammalian cells, however, have suggested that both the yield and the spatial distribution of DSBs are influenced by radiation quality. RBE values for DSBs induced by high-LET radiations are greater than 1.0, and the distributions are nonrandom. Underlying this is the interaction of particle tracks with the higher-order chromosomal structures within cell nuclei. Further studies are needed to relate nonrandom distributions of DSBs to their rejoining kinetics. At the molecular level, we need to determine the involvement of clustering of damaged bases with strand breakage, and the relationship between higher-order clustering over sizes of kilobase pairs and above to localized clustering at the DNA level. Overall, these studies will allow us to elucidate whether the nonrandom distributions of breaks produced by high-LET particle tracks have any consequences for their repair and biological effectiveness. (C) 2001 by Radiation Research Society.

Opening the Frontier: The Gubbio-Perugia Frontier in the Course of History.

The frontier between Gubbio (ancient Umbria) and Perugia (ancient Etruria), in the northeast part of the modern region of Umbria, was founded in the late sixth century BC. The frontier endured in different forms, most notably in the late antique and medieval periods, as well as fleetingly in 1944, and is fossilized today in the local government boundaries. Archaeological, documentary and
philological evidence are brought together to investigate different scales of time that vary from millennia to single days in the representation of a frontier that captured a watershed of geological origins. The foundation of the frontier appears to have been a product of the active agency of the Etruscans, who projected new settlements across the Tiber in the course of the sixth century BC,
protected at the outer limit of their territory by the naturally defended farmstead of Col di Marzo. The immediate environs of the ancient abbey of Montelabate have been studied intensively by targeted, systematic and geophysical survey in conjunction with excavation, work that is still in progress. An overview of the development of the frontier is presented here, employing the data currently available.

Single course of antenatal steroids did not alter cortisol in preterm infants up to 18 months

To determine whether a single course of antenatal dexamethasone alters resting cortisol at 3, 8 and 18 months corrected age in preterm infants.

Transmission Potential of Rift Valley Fever virus over the course of the 2010 epidemic in South Africa

A Rift Valley fever (RVF) epidemic affecting animals on domestic livestock farms was reported in South Africa during January-August 2010. The first cases occurred after heavy rainfall, and the virus subsequently spread countrywide. To determine the possible effect of environmental conditions and vaccination on RVF virus transmissibility, we estimated the effective reproduction number (R) for the virus over the course of the epidemic by extending the Wallinga and Teunis algorithm with spatial information. Re reached its highest value in mid-February and fell below unity around mid-March, when vaccination coverage was 7.5%-45.7% and vector-suitable environmental conditions were maintained. The epidemic fade-out likely resulted first from the immunization of animals following natural infection or vaccination. The decline in vector-suitable environmental conditions from April onwards and further vaccination helped maintain R below unity. Increased availability of vaccine use data would enable evaluation of the effect of RVF vaccination campaigns.

The time course of conflict on the Cognitive Reflection Test

Reasoning that is deliberative and reflective often requires the inhibition of intuitive responses. The Cognitive Reflection Test (CRT) is designed to assess people’s ability to suppress incorrect heuristic responses in favour of deliberation. Correct responding on the CRT predicts performance on a range of tasks in which intuitive processes lead to incorrect responses, suggesting indirectly that CRT performance is related to cognitive control. Yet little is known about the cognitive processes underlying performance on the CRT. In the current research, we employed a novel mouse tracking mjavascript:void(0);ethodology to capture the time-course of reasoning on the CRT. Analysis of mouse cursor trajectories revealed that participants were initially drawn towards the incorrect (i.e., intuitive) option even when the correct (deliberative) option was ultimately chosen. Conversely, participants were not attracted to the correct option when they ultimately chose the incorrect intuitive one. We conclude that intuitive processes are activated automatically on the CRT and must be inhibited in order to respond correctly. When participants responded intuitively, there was no evidence that deliberative reasoning had become engaged.

The Course of Conflict. A Study in the Thought of Paul Ricoeur

Esta tese leva a cabo uma clarificação conceptual e uma reconstrução histórica da noção de conflito, tal como ela aparece na filosofia. Num primeiro momento, analisa-se o fenómeno do conflito na fonte Grega (em Homero, Heraclito, Platão, nas tragédias gregas e nas formas de interação agonística no espaço público) e na filosofia moderna (principalmente em Kant, Hegel e Marx). Num segundo momento, estabelece-se, nos seus traços gerais, uma cartografia da recuperação desta noção na contemporaneidade através da discussão das contribuições provenientes da teoria crítica (Habermas, Honneth, Hunyadi), da sociologia pragmática (Boltanski, Thévenot) e da filosofia política anglo-saxónica (Rawls, Walzer, Taylor), entre outras. Estas partes iniciais da tese desembocam numa análise aprofundada da obra do filósofo francês Paul Ricoeur e das muitas instanciações do conflito nessa obra, naquilo a que chamo o “percurso do conflito” no pensamento de Ricoeur. Neste “percurso do conflito” o objetivo é duplo: por um lado, provar que o conflito é a pedra de toque não só da filosofia de Ricoeur, mas também de um grande conjunto de outros autores; por outro lado, que é necessário reavaliar o papel desta noção no debate contemporâneo e que nesse contexto a filosofia de Ricoeur e as suas análises finas e plurais podem ser de uma grande utilidade. Assim sendo, este “percurso do conflito” divide-se em três partes, as quais lidam com diferentes tipos de conflito: conflitos “existenciais”, “hermenêuticos” e “práticos”. Ao longo destas partes, várias disciplinas são chamadas à colação, como a hermenêutica, a psicanálise e a filosofia prática (ética, filosofia política e filosofia social), numa tentativa de esclarecer os diferentes fenómenos em causa. Em última instância, chega-se à conclusão que o conflito é inevitável em filosofia, tal como na vida, mas que este não é (pelo menos não em todas as suas formas e instanciações) um fenómeno estritamente negativo; por vezes, os conflitos podem ser criativos e positivos. Porém, aceitar este facto implica igualmente consentir que o reconhecimento dos conflitos está intrinsecamente ligado à busca de soluções para eles, formas de lidar com eles e torná-los criativos e positivos. Para que possa ser compreendido, em traços gerais, como é que estes procedimentos funcionam, esta tese elabora uma tipologia de diferentes tipos de conflito e respetivas formas de lidar com eles, mediando-os, conciliando-os ou, nalguns casos, apenas aceitando a sua existência e mesmo multiplicando-os. A busca da melhor solução tem sempre de ser operada caso a caso. Nas partes finais da tese, e partindo das análises de Ricoeur e dos outro autores apresentadas ao longo da mesma, delineia-se o projeto de uma filosofia social hermenêutica e argumenta-se que aquilo de que precisamos hoje em dia é de uma nova crítica da razão, uma “crítica da razão miserável” que possa repensar o mundo social em novos termos e que, ao fazê-lo, possa evitar os perigos do reducionismo nas suas múltiplas formas.

Extent of non-publication in cohorts of studies approved by research ethics committees or included in trial registries

BACKGROUND: The synthesis of published research in systematic reviews is essential when providing evidence to inform clinical and health policy decision-making. However, the validity of systematic reviews is threatened if journal publications represent a biased selection of all studies that have been conducted (dissemination bias). To investigate the extent of dissemination bias we conducted a systematic review that determined the proportion of studies published as peer-reviewed journal articles and investigated factors associated with full publication in cohorts of studies (i) approved by research ethics committees (RECs) or (ii) included in trial registries. METHODS AND FINDINGS: Four bibliographic databases were searched for methodological research projects (MRPs) without limitations for publication year, language or study location. The searches were supplemented by handsearching the references of included MRPs. We estimated the proportion of studies published using prediction intervals (PI) and a random effects meta-analysis. Pooled odds ratios (OR) were used to express associations between study characteristics and journal publication. Seventeen MRPs (23 publications) evaluated cohorts of studies approved by RECs; the proportion of published studies had a PI between 22% and 72% and the weighted pooled proportion when combining estimates would be 46.2% (95% CI 40.2%-52.4%, I2 = 94.4%). Twenty-two MRPs (22 publications) evaluated cohorts of studies included in trial registries; the PI of the proportion published ranged from 13% to 90% and the weighted pooled proportion would be 54.2% (95% CI 42.0%-65.9%, I2 = 98.9%). REC-approved studies with statistically significant results (compared with those without statistically significant results) were more likely to be published (pooled OR 2.8; 95% CI 2.2-3.5). Phase-III trials were also more likely to be published than phase II trials (pooled OR 2.0; 95% CI 1.6-2.5). The probability of publication within two years after study completion ranged from 7% to 30%. CONCLUSIONS: A substantial part of the studies approved by RECs or included in trial registries remains unpublished. Due to the large heterogeneity a prediction of the publication probability for a future study is very uncertain. Non-publication of research is not a random process, e.g., it is associated with the direction of study findings. Our findings suggest that the dissemination of research findings is biased.

TIME COURSE OF SIGNALING PROCESSES INVOLVED WITH EXTRACELLULAR OSMOTIC - INDUCED GLUCOSE UPTAKE IN MAMMALIAN SKELETAL MUSCLE

Extracellular hyper-osmotic (HYPER) stress increases glucose uptake to defend cell volume, when compared to iso-osmotic (ISO) conditions in skeletal muscle. The purpose of this study was to determine a time course for changes in common signaling proteins involved in glucose uptake during acute hyper-osmotic stress in isolated mammalian skeletal muscle. Rat extensor digitorum longus (EDL) muscles were excised and incubated in a media formulated to mimic ISO (290 ± 10 mmol/kg) or HYPER (400 ± 10 mmol/kg) extracellular condition (Sigma Media-199). Signaling mechanisms were investigated by determining the phosphorylation states of Akt, AMPK, AS160, cPKC and ERK after 30, 45 and 60 minutes of incubation. AS160 was found to be significantly more phosphorylated in HYPER conditions compared to ISO after 30 minutes (p<0.01). It is speculated that AS160 phosphorylation increases glucose transporter 4 (GLUT4) content at the cell surface thereby facilitating an increase in glucose uptake under hyper-osmotic stress.