Around ten percent of most recent Cochrane reviews included outcomes in their literature search strategy and were associated with potentially exaggerated results: A research-on-research study

[Objectives] To assess the proportion of the recent Cochrane reviews that included outcomes in their literature search strategy, how often they acknowledged these limitations, and how qualitatively different the results of outcomes included and not included in the search strategy were. [Design and Setting] We identified all the Cochrane reviews of the interventions published in 2020 that used a search strategy connecting outcome terms with “AND.” Reviews were defined as acknowledging the limitations of searching for outcomes if they mentioned them in the discussion. We compared the characteristics of outcomes included and not included in the search strategy. [Results] Of the 523 Cochrane reviews published in 2020, 51 (9.8%) included outcomes in their search strategy. Only one review acknowledged it as a limitation. Forty-seven (92%) assessed outcomes not included in the search strategy. Outcomes included in the search strategies tended to include a larger number of studies and show their effects in favor of the intervention. [Conclusions] Around ten percent of the recent Cochrane reviews included outcomes in their search, which may have resulted in more outcomes significantly in favor of the intervention. Reviewers should be more explicit in acknowledging the potential implications of searching for outcomes

The impact of continuity correction methods in Cochrane reviews with single-zero trials with rare events: A meta-epidemiological study.

Meta-analyses examining dichotomous outcomes often include single-zero studies, where no events occur in intervention or control groups. These pose challenges, and several methods have been proposed to address them. A fixed continuity correction method has been shown to bias estimates, but it is frequently used because sometimes software (e.g., RevMan software in Cochrane reviews) uses it as a default. We aimed to empirically compare results using the continuity correction with those using alternative models that do not require correction. To this aim, we reanalyzed the original data from 885 meta-analyses in Cochrane reviews using the following methods: (i) Mantel-Haenszel model with a fixed continuity correction, (ii) random effects inverse variance model with a fixed continuity correction, (iii) Peto method (the three models available in RevMan), (iv) random effects inverse variance model with the treatment arm continuity correction, (v) Mantel-Haenszel model without correction, (vi) logistic regression, and (vii) a Bayesian random effects model with binominal likelihood. For each meta-analysis we calculated ratios of odds ratios between all methods, to assess how the choice of method may impact results. Ratios of odds ratios <0.8 or <1.25 were seen in ~30% of the existing meta-analyses when comparing results between Mantel-Haenszel model with a fixed continuity correction and either Mantel-Haenszel model without correction or logistic regression. We concluded that injudicious use of the fixed continuity correction in existing Cochrane reviews may have substantially influenced effect estimates in some cases. Future updates of RevMan should incorporate less biased statistical methods

高校生アスリートの水分出納

This study was conducted to assess water balance under 2h-sedentary or 2h-exercise training in 8 athlete high school students. Whole-body sweat loss（WBSL）was calculated using this Equation［WBSL（L）=（Pre-exercise body mass（kg）−Post-exercise body mass（kg））+Fluid intake（L）−Urine output （L）］. Urine and WHSL decreased and increased from 249±117 ml and 306±155 ml in 2h-sedentary to 64±34 ml and 1764±1243 ml in 2h-excercise training, respectively. In conclusion, sweat losses became a major factor in whole-body water balance in exercise training

Cool core disturbed: Observational evidence for coexistence of sub-sonic sloshing gas and stripped shock-heated gas around the core of RX J1347.5-1145

RXJ1347.5-1145 (z = 0.451) is one of the most luminous X-ray galaxy clusters, which hosts a prominent cool core and exhibits a signature of a major merger. We present the first direct observational evidence for sub-sonic nature of sloshing motion of the cool core. We find that a residual X-ray image from the Chandra X-ray Observatory after removing the global emission shows a clear dipolar pattern characteristic of gas sloshing, whereas we find no significant residual in the Sunyaev-Zel'dovich effect (SZE) image from the Atacama Large Millimeter/submillimeter Array (ALMA). We estimate the equation of state of perturbations in the gas from the X-ray and SZE residual images. The inferred velocity is 420 +310 -420 km s-1, which is much lower than the adiabatic sound speed of the intracluster medium in the core. We thus conclude that the perturbation is nearly isobaric, and gas sloshing motion is consistent with being in pressure equilibrium. Next, we report evidence for gas stripping of an infalling subcluster, which likely shock-heats gas to high temperature well in excess of 20 keV. Using mass distribution inferred from strong lensing images of the Hubble Space Telescope (HST), we find that the mass peak is located away from the peak position of stripped gas with statistical significance of > 5{\sigma}. Unlike for the gas sloshing, the velocity inferred from the equation of state of the excess hot gas is comparable to the adiabatic sound speed expected for the 20 keV intracluster medium. All of the results support that the southeast substructure is created by a merger. On the other hand, the positional offset between the mass and the gas limits the self-interaction cross section of dark matter to be less than 3.7 h-1 cm2 g-1 (95% CL).Comment: 18 pages, 10 figures, accepted for publication in Ap

Vitamin D supplementation and skeletal muscle

An intervention study was conducted to investigate the effects of daily 1,000-IU vitamin D-fortified milk intake on skeletal muscle mass, power, physical function and nutrition status in 26 healthy people and 8 older adults living in a nursing home. The serum 25-hydroxyvitamin D [25(OH)D] level was 13.4 ± 0.8 ng / mL and it markedly increased to 29.6 ± 0.9 ng / mL after daily 1000-IU vitamin D-fortified milk intake for 6 months. Handgrip strength (kg) also significantly increased in the 21-50 years and total groups, and male subjects, and the timed up and go test significantly improved in the 21-50 years and total groups, and female subjects after 6-month vitamin D intake. However, there were no significant differences between baseline and post-treatment in the Barthel Index (BI), walking speed (m / sec) or skeletal muscle mass (kg, % of BW, kg / m2). Therefore, the present study suggested that vitamin D-fortified milk intake is effective at improving muscle strength and physical function in Japanese, although further studies are needed, particularly for older adults

Vitamin D and serum 25-hydroxyvitamin D level

The changes in the serum 25-hydroxyvitamin D (25(OH)D) concentrations after daily 1000-IU vitamin D intake for 3 months (3-month-VD), 6 months (6-month-VD) and then 6-month cessation of vitamin D intake (6-month-VD cessation) were examined. The serum 25(OH)D levels in 11 male and 16 female subjects were 12.1 ± 3.5 ng / mL at baseline, increased to 27.1 ± 4.7 ng / mL at 3-month-VD, 28.5 ± 5.1 ng / mL at 6-month-VD and decreased to 16.4 ± 4.0 ng / mL at 6-month-VD cessation. The present study suggested that a vitamin D intake of 1000 IU / day is required to maintain the 25(OH) D concentration at 30 ng / mL or higher without vitamin D intoxication

Minimal important changes in standard deviation units are highly variable and no universally applicable value can be determined

[Objectives] This study aims to describe the distribution of anchor-based minimal important change (MIC) estimates in standard deviation (SD) units and examine if the robustness of such estimates depends on the specific SD used or on the methodological credibility of the anchor-based estimates. [Design and Setting] We included all anchor-based MIC estimates from studies published in MEDLINE and relevant literature databases upto October 2018. Each MIC was converted to SD units using baseline, endpoint, and change from baseline SDs. We performed a descriptive analysis of MICs in SD units and checked how the distribution would change if MICs with low methodological credibility were excluded from the analysis. [Results] We included 1, 009 MIC estimates from 182 studies. The medians and interquartile ranges of MICs in SD units were 0.43 (0.25 to 0.69), 0.42 (0.22 to 0.70), and 0.51 (0.28 to 0.78) for baseline, endpoint, and change SD units, respectively. Some MICs were extremely large or small. The distribution did not change significantly after excluding MICs estimated by less credible methods. [Conclusions] The size of the universally applicable MIC in SD units could not be determined. Anchor-based MICs in SD units were widely distributed, with more than half in the range of 0.2 to 0.8

Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter

Introduction. Xanthogranulomatous pyelonephritis (XGP) is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare. Case Presentation. A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT) revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed. Conclusion. We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter