Individual participant data (IPD) meta-analyses that obtain "raw" data from studies rather than summary data typically adopt a "two-stage" approach to analysis whereby IPD within trials generate ...summary measures, which are combined using standard meta-analytical methods. Recently, a range of "one-stage" approaches which combine all individual participant data in a single meta-analysis have been suggested as providing a more powerful and flexible approach. However, they are more complex to implement and require statistical support. This study uses a dataset to compare "two-stage" and "one-stage" models of varying complexity, to ascertain whether results obtained from the approaches differ in a clinically meaningful way.
We included data from 24 randomised controlled trials, evaluating antiplatelet agents, for the prevention of pre-eclampsia in pregnancy. We performed two-stage and one-stage IPD meta-analyses to estimate overall treatment effect and to explore potential treatment interactions whereby particular types of women and their babies might benefit differentially from receiving antiplatelets. Two-stage and one-stage approaches gave similar results, showing a benefit of using anti-platelets (Relative risk 0.90, 95% CI 0.84 to 0.97). Neither approach suggested that any particular type of women benefited more or less from antiplatelets. There were no material differences in results between different types of one-stage model.
For these data, two-stage and one-stage approaches to analysis produce similar results. Although one-stage models offer a flexible environment for exploring model structure and are useful where across study patterns relating to types of participant, intervention and outcome mask similar relationships within trials, the additional insights provided by their usage may not outweigh the costs of statistical support for routine application in syntheses of randomised controlled trials. Researchers considering undertaking an IPD meta-analysis should not necessarily be deterred by a perceived need for sophisticated statistical methods when combining information from large randomised trials.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The accumulation of human-derived debris in the oceans is a global concern and a serious threat to marine wildlife. There is a volume of evidence that points to deleterious effects of marine debris ...(MD) on cetaceans in terms of both entanglement and ingestion. This review suggests that about 68% of cetacean species are affected by interacting with MD with an increase in the number of species reported to have interacted with it over the past decades. Despite the growing body of evidence, there is an ongoing debate on the actual effects of plastics on cetaceans and, in particular, with reference to the ingestion of microplastics and their potential toxicological and pathogenic effects. Current knowledge suggests that the observed differences in the rate and nature of interactions with plastics are the result of substantial differences in species-specific diving and feeding strategies. Existing projections on the production, use and disposal of plastics suggest a further increase of marine plastic pollution. In this context, the contribution of the ongoing COVID-19 pandemic to marine plastic pollution appears to be substantial, with potentially serious consequences for marine life including cetaceans. Additionally, the COVID-19 pandemic offers an opportunity to investigate the direct links between industry, human behaviours and the effects of MD on cetaceans. This could help inform management, prevention efforts, describe knowledge gaps and guide advancements in research efforts. This review highlights the lack of assessments of population-level effects related to MD and suggests that these could be rather immediate for small populations already under pressure from other anthropogenic activities. Finally, we suggest that MD is not only a pollution, economic and social issue, but also a welfare concern for the species and populations involved.
Display omitted
•The build-up of human-derived debris in the oceans is a global environmental plague.•68% of cetacean species are affected by marine debris either by ingestion or entanglement.•Covid-19 related debris are likely to further affect cetacean species.•Long-term population consequences of marine debris have not been assessed in 50 years.•Welfare concerns relating to marine debris are overlooked in conservation plans.
Marine litter is a pollution problem affecting thousands of marine species in all the world's seas and oceans. Marine litter, in particular plastic, has negative impacts on marine wildlife primarily ...due to ingestion and entanglement. Since most marine mammal species negatively interact with marine litter, a first workshop under the framework of the European Cetacean Society Conference, was held in 2017 to bring together the main experts on the topic of marine mammals and marine litter from academic and research institutes, non-governmental organisations, foundations and International Agreements. The workshop was devoted to defining the impact of marine litter on marine mammals by reviewing current knowledge, methodological advances and new data available on this emerging issue. Some case studies were also presented from European waters, such as seals and cetaceans in the North, Baltic, and Mediterranean Seas. Here, we report the main findings of the workshop, including a discussion on the research needs, the main methodological gaps, an overview of new techniques for detecting the effects of marine litter (including microplastics) on marine mammals and, also, the use of citizen science to drive awareness. The final recommendations aim to establish priority research, to define harmonised methods to detect marine litter and microplastics, enforce networking among institutions and support data sharing. The information gathered will enhance awareness and communication between scientists, young people, citizens, other stakeholders and policy makers, and thereby facilitate better implementation of international directives (e.g., the Marine Strategy Framework Directive) in order to answer the question about the actual status of our oceans and finding solutions.
•Harmonised protocols are needed to define the amount of ingested debris that can cause negative effects.•Protocols to evaluate the presence and effects of micro and nanoplastics should be further developed.•Methods to evaluate the exposure to plastics and plastic additives in free-ranging organisms are required.•Communicating to scientists, citizens, stakeholders and policy makers to enhance awareness raising.•A consistent monitoring approach is required, as marine litter pollution is estimated to increase.
To understand the sources, the transfer and the effects of marine litter, and therefore their impacts on marine mammal researchers need to apply a multidisciplinary standardized protocols.
It is uncertain which simple measures of childhood obesity are best for predicting future obesity-related health problems and the persistence of obesity into adolescence and adulthood.
To investigate ...the ability of simple measures, such as body mass index (BMI), to predict the persistence of obesity from childhood into adulthood and to predict obesity-related adult morbidities. To investigate how accurately simple measures diagnose obesity in children, and how acceptable these measures are to children, carers and health professionals.
Multiple sources including MEDLINE, EMBASE and The Cochrane Library were searched from 2008 to 2013.
Systematic reviews and a meta-analysis were carried out of large cohort studies on the association between childhood obesity and adult obesity; the association between childhood obesity and obesity-related morbidities in adulthood; and the diagnostic accuracy of simple childhood obesity measures. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and a modified version of the Quality in Prognosis Studies (QUIPS) tool. A systematic review and an elicitation exercise were conducted on the acceptability of the simple measures.
Thirty-seven studies (22 cohorts) were included in the review of prediction of adult morbidities. Twenty-three studies (16 cohorts) were included in the tracking review. All studies included BMI. There were very few studies of other measures. There was a strong positive association between high childhood BMI and adult obesity odds ratio 5.21, 95% confidence interval (CI) 4.50 to 6.02. A positive association was found between high childhood BMI and adult coronary heart disease, diabetes and a range of cancers, but not stroke or breast cancer. The predictive accuracy of childhood BMI to predict any adult morbidity was very low, with most morbidities occurring in adults who were of healthy weight in childhood. Predictive accuracy of childhood obesity was moderate for predicting adult obesity, with a sensitivity of 30% and a specificity of 98%. Persistence of obesity from adolescence to adulthood was high. Thirty-four studies were included in the diagnostic accuracy review. Most of the studies used the least reliable reference standard (dual-energy X-ray absorptiometry); only 24% of studies were of high quality. The sensitivity of BMI for diagnosing obesity and overweight varied considerably; specificity was less variable. Pooled sensitivity of BMI was 74% (95% CI 64.2% to 81.8%) and pooled specificity was 95% (95% CI 92.2% to 96.4%). The acceptability to children and their carers of BMI or other common simple measures was generally good.
Little evidence was available regarding childhood measures other than BMI. No individual-level analysis could be performed.
Childhood BMI is not a good predictor of adult obesity or adult disease; the majority of obese adults were not obese as children and most obesity-related adult morbidity occurs in adults who had a healthy childhood weight. However, obesity (as measured using BMI) was found to persist from childhood to adulthood, with most obese adolescents also being obese in adulthood. BMI was found to be reasonably good for diagnosing obesity during childhood. There is no convincing evidence suggesting that any simple measure is better than BMI for diagnosing obesity in childhood or predicting adult obesity and morbidity. Further research on obesity measures other than BMI is needed to determine which is the best tool for diagnosing childhood obesity, and new cohort studies are needed to investigate the impact of contemporary childhood obesity on adult obesity and obesity-related morbidities.
This study is registered as PROSPERO CRD42013005711.
The National Institute for Health Research Health Technology Assessment programme.
Animal cultures matter for conservation Brakes, Philippa; Dall, Sasha R X; Aplin, Lucy M ...
Science (American Association for the Advancement of Science),
03/2019, Letnik:
363, Številka:
6431
Journal Article
Recenzirano
Odprti dostop
Understanding the rich social lives of animals benefits international conservation efforts
Animal culture, defined as “information or behavior—shared within a community—which is acquired from ...conspecifics through some form of social learning” (
1
), can have important consequences for the survival and reproduction of individuals, social groups, and potentially, entire populations (
1
,
2
). Yet, until recently, conservation strategies and policies have focused primarily on broad demographic responses and the preservation of genetically defined, evolutionarily significant units. A burgeoning body of evidence on cultural transmission and other aspects of sociality (
3
) is now affording critical insights into what should be conserved (going beyond the protection of genetic diversity, to consider adaptive aspects of phenotypic variation), and why specific conservation programs succeed (e.g., through facilitating the resilience of cultural diversity) while others fail (e.g., by neglecting key repositories of socially transmitted knowledge). Here, we highlight how international legal instruments, such as the Convention on the Conservation of Migratory Species of Wild Animals (CMS), can facilitate smart, targeted conservation of a wide range of taxa, by explicitly considering aspects of their sociality and cultures.
Human activities are increasingly impacting our oceans and the focus tends to be on their environmental impacts, rather than consequences for animal welfare. Global shipping density has quadrupled ...since 1992. Unsurprisingly, increased levels of vessel collisions with cetaceans have followed this global expansion of shipping. This paper is the first to attempt to consider the severity of ship-strike on individual whale welfare. The methodology of the 'Welfare Assessment Tool for Wild Cetaceans' (WATWC) was used, which is itself based upon the Five Domains model. Expert opinion was sought on six hypothetical but realistic case studies involving humpback whales (
) struck by ships. Twenty-nine experts in the cetacean and welfare sector took part. They were split into two groups; Group 1 first assessed a case we judged to be the least severe and Group 2 first assessed the most severe. Both groups then additionally assessed the same four further cases. This was to investigate whether the severity of the first case influenced judgements regarding subsequent cases (i.e. expert judgements were relative) or not (i.e. judgements were absolute). No significant difference between the two groups of assessors was found; therefore, the hypothesis of relative scoring was rejected. Experts judged whales may suffer some level (>1) of overall (Domain 5) harm for the rest of their lives following a ship-strike incident. Health, closely followed by Behaviour were found to be the welfare aspects most affected by ship-strikes. Overall, the WATWC shows a robust potential to aid decision-making on wild cetacean welfare.
A key goal of conservation is to protect biodiversity by supporting the long-term persistence of viable, natural populations of wild species. Conservation practice has long been guided by genetic, ...ecological and demographic indicators of risk. Emerging evidence of animal culture across diverse taxa and its role as a driver of evolutionary diversification, population structure and demographic processes may be essential for augmenting these conventional conservation approaches and decision-making. Animal culture was the focus of a ground-breaking resolution under the Convention on the Conservation of Migratory Species of Wild Animals (CMS), an international treaty operating under the UN Environment Programme. Here, we synthesize existing evidence to demonstrate how social learning and animal culture interact with processes important to conservation management. Specifically, we explore how social learning might influence population viability and be an important resource in response to anthropogenic change, and provide examples of how it can result in phenotypically distinct units with different, socially learnt behavioural strategies. While identifying culture and social learning can be challenging, indirect identification and parsimonious inferences may be informative. Finally, we identify relevant methodologies and provide a framework for viewing behavioural data through a cultural lens which might provide new insights for conservation management.
Climate change is predicted to impact the distribution of many marine species. In the North-East Atlantic and elsewhere in the world, studies indicate that climate change is leading to poleward ...shifts in cetacean distribution.
Here, strandings data collected in the British Isles from 1990 to 2020 were used to assess whether there is evidence of a shift in baleen whale distribution. Linear regression models were used to compare the number of strandings over time between six regions of the British Isles and, whilst the results indicate no significant change in the number of strandings in the most southerly region of the British Isles, there have been significant increases in more northern regions. Data related to stranded minke whales is the primary driver of these increases, with a number of potential variables affecting this trend, including observer effort. These variables are discussed and further research to explore this potential association is suggested.
•Climate change is predicted to impact the distribution of marine species.•Strandings data are used to assess baleen whale distribution in the British Isles.•The number of strandings from 1990 to 2020 was compared between six regions.•In the most southerly region, the number of strandings remained constant.•In more northern regions, the number of strandings increased significantly.•Population growth and/or a northern distribution shift may explain this.
Where individual participant data are available for every randomised trial in a meta-analysis of dichotomous event outcomes, “one-stage” random-effects logistic regression models have been proposed ...as a way to analyse these data. Such models can also be used even when individual participant data are not available and we have only summary contingency table data. One benefit of this one-stage regression model over conventional meta-analysis methods is that it maximises the correct binomial likelihood for the data and so does not require the common assumption that effect estimates are normally distributed. A second benefit of using this model is that it may be applied, with only minor modification, in a range of meta-analytic scenarios, including meta-regression, network meta-analyses and meta-analyses of diagnostic test accuracy. This single model can potentially replace the variety of often complex methods used in these areas. This paper considers, with a range of meta-analysis examples, how random-effects logistic regression models may be used in a number of different types of meta-analyses. This one-stage approach is compared with widely used meta-analysis methods including Bayesian network meta-analysis and the bivariate and hierarchical summary receiver operating characteristic (ROC) models for meta-analyses of diagnostic test accuracy.
Background International guidelines recommend the routine use of oxygen in the initial treatment of myocardial infarction, yet it is uncertain what effect this might have on physiologic and clinical ...outcomes. Methods We undertook a systematic search of Medline, Cochrane Database of Systematic Reviews, EMBASE, and CINHAL using the key words “oxygen,” “coronary blood flow,” “hyperoxia,” and “coronary circulation” to identify human studies involving a measure of coronary blood flow while breathing oxygen and room air. The primary outcome measure was coronary blood flow; secondary outcomes included coronary vascular resistance and myocardial oxygen consumption. Results From 2,072 potential publications, there were 6 studies from 4 publications that met the inclusion criteria, with 6 healthy subjects and 61 subjects with cardiac disease. It was not possible to undertake a meta-analysis due to methodological limitations. In the 6 studies, high-concentration oxygen therapy resulted in hyperoxia, with a range in mean Pa o2 of 273 to 425 mm Hg. Hyperoxia caused a significant reduction in coronary blood flow (mean change −7.9% to −28.9%, n = 6 studies). Hyperoxia caused a significant increase in coronary vascular resistance (mean change 21.5% to 40.9%, n = 4 studies) and a significant reduction in myocardial oxygen consumption (mean change −15.3% to −26.9%, n = 3 studies). Conclusions Hyperoxia from high-concentration oxygen therapy causes a marked reduction in coronary blood flow and myocardial oxygen consumption. These physiologic effects may have the potential to cause harm and are relevant to the use of high-concentration oxygen therapy in the treatment of cardiac and other disorders.
PDF
