Abstract: Background: Epidural analgesia is generally accepted as the most effective method for pain relief dur- ing labor. However, results of published studies regarding the efficacy of epidural analgesia with ropivacaine on the modes of delivery, labor progression, need for oxytocin, maternal and neonatal outcomes are inconsistent. Objective: We conducted a comprehensive meta-analysis to appraise the efficacy and security of ropivacaine epidur- al analgesia on labor, maternal and neonatal. Methods: Databases of the PubMed, Embase, and Cochrane Library were searched independently by 2 reviewers to retrieve eligible studies that compare the influence of ropivacaine epidural analgesia (REA) on labor, maternal and neonatal with non-epidural analgesia (NEA) in parturients. Primary outcomes were the modes of labor, duration of labor and the need for oxytocin, and secondary outcomes were maternal outcomes (pain scores, nausea, vomiting and pruritus), and neonatal outcomes (Apgar scores, umbilical artery pH). Standardised mean difference (SMD) or odds ratio (OR) with their 95% confidence intervals (CIs) were calculated by fixed- or random-effects models, depending upon the heterogeneity of the included trials. Sensitivity analyses and subgroup analyses were also performed. Newcastle-Ottawa Scale (NOS) was applied to assess the qualities of all included studies. Results: A total of eight studies (four prospective and four retrospectivestudies) with ten trials involving 18832 parturients were included in this analysis. Comparing with the NEA, the rate of spon- taneous vaginal delivery was decreased, the risk of instrumental delivery was increased, and the second stage of labor was prolonged in the REA group (OR 0.61, 95% CI 0.43-0.87, P=0.006, I 2 =84%; OR 2.2, 95% CI 1.93-2.54,
Four retrospectivestudies on the IPAF population have been considered. The study subjects differed in age, sex, smoking habit, ILD pattern and outcomes. Another important difference lies in the diverse items considered in the classification criteria. The retrospective design of the studies and the absence from some of them of a rheumatologist clearly involved in the diagnosis may have influenced the data, but current IPAF criteria seem to include a rather heterogeneous population. To overcome these discrepancies, this review suggests a limitation in the use of single items and the exclusion of extremely specific CTD criteria. This should avoid the definition of IPAF for those diseases at different stages or at early onset. The investigation of a functional or morphological cut-off of pulmonary involvement would be useful.
PPSS is the proposed scale system for the assessment of post- operative pain in retrospectivestudies. The score is obtained as a summation of points for each analgesic administered (via the intravenous route in the current study). The proposed scale is to be used in a clearly comparative manner, compar- ing pain intensity scores in retrospectivestudies to extract conclusions regarding factors affecting pain. It does not offer specific correlation of a score with a given level of pain.
All the literature included retrospectivestudies. The present scales for assessing the quality of the report of randomized, controlled trials or nonrandomized, con- trolled trials were not suitable, because they were nei- ther randomized nor controlled. A quality-assessment form designed specially for these retrospectivestudies on burns was used by our team to describe the relative qualities (Table 2) on the basis of the data-extraction forms regarding 11 items that were most important for describing the studies’ contents. A grade scale was estab- lished as follows: level A was a quality score of 24.76 to 33.00; level B, 16.60 to 24.75; level C, 8.26 to 16.50; and level D, 0.00 to 8.25. The qualities of the study were also evaluated by considering whether literal or statistical mistakes in the studies could be corrected. The qualities of 28 studies are described in Table 3.
(Figure 5). Molecular classification of CRC based on MSI status reflects global epigenomic and genomic aberrations in cancer cells, which has great importance during colorec- tal carcinogenesis. Our results indicated that MSI-high is inversely associated with LINE-1 hypomethylation. Previ- ous studies have proved that global hypomethylation pro- motes genomic instability which supporting the hypothesis that genome-wide hypomethylation might be involved in the pathway connected with MSI phenomena. 38 Evidence
Most of the hospitals conduct pharmacovigilance program through the spontaneous reporting system. But spontaneous reporting systems have limitations such as difficulties of recognizing ADR‟s, the uncontrolled nature of the reporting method, and underreporting. So, retrospective and prospective surveillance methods are considered to be effective than spontaneous reporting systems 8 . Retrospective systems tend to underestimate the burden of the ADR‟s in hospitals due to the poor documentation of ADR‟s in medical case sheets and incomplete information available in ADR reports. The main advantage of a prospective system which is unavailable in the retrospective system is: it provides high-quality information regarding an adverse event and early identification of a potential ADR before it exacerbates the clinical condition of an individual patient. Methods used by various pharmacovigilance programs differ greatly because they must be adapted to the specific characteristics of each hospital.
Given the rarity of penile cancer, prior studies that attempted to identify predictors of LNM had several meth- odological limitations, such as small series, single-center, and lack of randomized controlled trials. Moreover, the results of these studies were discrepant. Several predictive models had been developed to stratify the risk of develop- ing LNM, such as Solsona risk groups and Hungerhuber risk strati ﬁ cation. 16,17 Unfortunately, further validation denied the accuracy of these tools. 18 Furthermore, the prognostic value of several potential biomarkers, such as PD-L1, P53 protein, NLR, CRP, SCC-Ag, Ki-67, and HPV DNA, had not been conclusively established. Hence, we performed this comprehensive meta-analysis to determine the signi ﬁ cant predictors of LNM in penile cancer.
In addition, other interesting information from study was that out of 100 studies around 50 studies are on cancer. This indicates that for cancer research, retrospectivestudies might play a great role. The data show that the commonly used material for the retrospectivestudies (Table 2) are pathology reports, medical record, laboratory reports, cancer registry data, treatment records, prescription data, and PubMed/Electronic search. In around 33 studies, the pathology and laboratory reports have been used, 42 studies involve the medical record of patients, 9 studies include cancer registry data, 6 involved the treatment records and prescription data and in only 5 studies the internet search/PubMed/electronic search was carried out. Results are suggestive of voracious use of medical records for retrospectivestudies. Authors have also analyzed the number of publications published without the IEC approval against the Committee on Publication Ethics (COPE) regulations out of these 100 studies (Table 3). It clearly indicates 66% of papers in which informed consent and institutional ethical approval have not been taken for the retrospective study. If we go back in year 2000 then it is bit possible that papers could be published against COPE regulations but data of this study show that significant number of papers have been published without the informed consent and ethical approval even in 2011-2015. The COPE was found in 1997 to address breaches of research and publication ethics . According to the COPE guidelines the good research should be well justified, well planned, appropriately designed, and ethically approved. Fully informed consent should always be sought. If according to the circumstances it is not possible to take informed consent the approval or decision from the ethics committee is acceptable. When participants are unable to give fully informed consent, research should follow international guidelines, such as those of the CIOMS. Authors for the publication of their work Table 2: Data of material used and subject number for
The strength of this approach is that it presents a simple, straightforward, validated method for estimating sample size for retrospectivestudies focusing on multiple descriptive outcomes. In chart reviews, these calculations can be useful during the study design phase, to understand the trade- offs between the expenses in time and money from collecting data from additional charts, versus the additional precision around the estimates that can be obtained. This can be particularly important when considering chart review data as inputs for economic models, where the variability around the estimate can have a major impact. As is the case with estimating sample size a priori for any type of outcome, the applicability of these formulas is limited by the availability of useful preliminary data to use as the basis for the calculations.
Several retrospectivestudies reported PB lympho- mas separately and suggested that these topographic variants may have a seemingly favorable prognostic particularly when combining chemotherapy and radi- ation therapy (Table 2).[7,11,13,27] However, these studies report heterogeneous data and while DLBCL is the most frequently described histological subtype, other lymphomas are reported including follicular or anaplastic types. In contrast to most studies (Table 2), we excluded from our analysis non-DLBCL lymphomas. Moreover, therapeutic option used may also markedly differ among individual cohorts. In our current study, we focused on DLBCL with pure bone involvement treated homogeneously with either CHOP or ACVBP regimens in combination with rituximab in all cases.
Search limitations may also have created bias. This includes our decision, because of the large size of the literature, to limit our search to a single database. Whilst our choice of PsycINFO increased the likelihood of detecting the type of observational, non-clinical studies in which we were interested, reliability would have been improved by including other databases. Similarly, the lack of double extraction procedures may have reduced the quality of our findings. The exclusion of non- English language journals further risked language bias. The latter may be particularly relevant, as cross-cultural disparities are apparent in AE identification 80 and
The information about health-care resource use for hand and forearm injuries in children was collected during two previous studies [2,15]. Between 1996 and 2000  we retrospectively included all young children (0–6 years old) with an unintentional hand or forearm injury (N = 455) that were treated as outpatients or hospitalized at the Department of Hand Surgery, Malmö, Sweden. The chil- dren were identified from the diagnostic registers by the Swedish Version of the International Classification of Dis- eases, Ninth Revision (ICD-9) during 1996–1997 (800A- 999X) and Tenth Revision during 1998–2003 (S00.0- T98.3). Children with fractures of the radius and ulna or more proximal bones were not included, as they were treated at the Department of Orthopaedic Surgery. Chil- dren with bites and infections, due to trauma, were included.
For species that live long-term in stable social groups, the average size of social groups is typically used as a rough-and-ready index of the social complexity confronting any individual (Dunbar, 1992; Shultz & Dunbar, 2007). Numerous studies on a range of mammalian taxa have found positive correlations between absolute brain size (or absolute size of the neocortex; or the ratio of neocortex size to the rest of the brain) and average group size, which are taken to support the MI hypothesis (Barton & Dunbar, 1997). Much of the early work was carried out on primates, whose groupings are typically long-lasting, and in which researchers have shown that relationships are differentiated: an individual knows others as individuals, and behaves quite differently towards them according to their kin relationships, friendships, and history of part interactions with them. These characteristics are critical for the MI hypothesis, because it is only when relationships are differentiated among individuals that there is any real possibility of social complexity (Bergman & Beehner, 2015). Many groupings of mammals and birds are temporary aggregations, such as a winter flock of sparrows and finches foraging near a grain store, or a herd of deer or antelope feeding on a flush of young grass. Their typical group size is not predicted by MI to relate to any measures of brain size, and indeed they do not (Dunbar & Shultz, 2007; Emery & Clayton, 2005). Only for primates, and for some other mammalian families which live in semi-permanent groups, such as cetaceans and chiropteran bats, correlations with absolute brain size measures have regularly been found (Barton & Dunbar, 1997; Connor, 2007; Dunbar, 1993; Dunbar & Shultz, 2007; Holekamp, Sakai, & Lundrigan, 2007; Marino, 1996) but see Powell, Isler & Barton, 2017). Moreover, many brain functions do not contribute to the package of abilities we recognize as intelligence, but rather regulate the somatic and sensory functioning of the body; neither the brain, nor any specific brain part, is a dedicated ‘thinking machine’, and we have no principled way of taking account of all the other demands on neural capacity in addition to any cognitive computing. The idea that social complexity is a powerful driver of selection for cognitive power in animals is consistent with the social sophistication and