Abstract

Fatty liver (hepatic steatosis) is one of the most common diseases globally, with increasing prevalence. The role of alcohol consumption in the development of hepatic steatosis has not been systematically examined. We searched Medline, Embase, and ProQuest Dissertations & Theses Global for original data on the relationship between alcohol consumption and hepatic steatosis measured by non-invasive imagery, excluding studies conducted in participants < 18 years, or subgroups related to viral and drug-induced liver disease. We identified 18 articles reporting adjusted data (Japan = 11, other high-income countries = 7). Random-effect categorical meta-analyses (< 20 g/day pure alcohol consumption vs non-drinkers) and dose-response meta-analyses for the whole range of alcohol consumption were conducted. In total, 99, 370 participants and 25, 662 cases of hepatic steatosis were included. In Japan, low alcohol consumption was consistently associated with substantially reduced incidence and prevalence of hepatic steatosis compared to non-drinkers (RR for < 20 g pure alcohol/day = 0.75, 95% CI: 0.71–0.79, I2 = 0%). No overall association was found in other countries (RR = 1.05, 95% CI: 0.86–1.30, I2 = 84%). Dose-response analyses in Japan (up to 80 g/day) showed an inverse relationship in men and a J-shape in women. Alcohol consumption showed a complex association with hepatic steatosis with substantial differences by ethnicity and sex. Low alcohol consumption was beneficial in Japan with good epidemiological evidence, whereas there was no association in other countries. However, heterogeneity was large in countries other than Japan. More and higher quality research in diverse ethnic populations is needed to further clarify this relationship.

Abstract

The usefulness of bronchoalveolar lavage fluid (BALF) CD4/CD8 ratio for diagnosing sarcoidosis has been reported in many studies with variable results. Therefore, we performed a meta-analysis to estimate the overall diagnostic accuracy of BALF CD4/CD8 ratio based on the bulk of published evidence. Studies published prior to June 2015 and indexed in PubMed, OVID, Web of Science, Scopus and other databases were evaluated for inclusion. Data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled from included studies. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Deekss funnel plot was used to detect publication bias. Sixteen publications with 1885 subjects met our inclusion criteria and were included in this meta-analysis. Summary estimates of the diagnostic performance of the BALF CD4/CD8 ratio were as follows: sensitivity, 0.70 (95%CI 0.64–0.75), specificity, 0.83 (95%CI 0.78–0.86), PLR, 4.04 (95%CI 3.13–5.20), NLR, 0.36 (95%CI 0.30–0.44), and DOR, 11.17 (95%CI 7.31–17.07). The area under the SROC curve was 0.84 (95%CI 0.81–0.87). There was no evidence of publication bias. Measuring the BALF CD4/CD8 ratio may assist in the diagnosis of sarcoidosis when interpreted in parallel with other diagnostic factors.

Abstract

This paper presents a comparative analysis of the effects of economic policy instruments in promoting environmentally sustainable transport. Promoting environmentally sustainable transport is defined as follows: (1) Reducing the volume of motorised travel; (2) Transferring travel to modes generating less external effects, and (3) Modifying road user behaviour in a way that will reduce external effects of transport. External effects include accidents, congestion, traffic noise and emissions to air. Four economic policy instruments are compared: (1) Prices of motor fuel; (2) Congestion charges; (3) Toll schemes; (4) Reward systems giving incentives to reduce driving or change driver behaviour. The effects of these policy instruments are stated in terms of elasticities. All four economic policy instruments have negative elasticities, which means that they do promote environmentally sustainable transport. Long-term elasticities tend to be larger than short term elasticities. The long-term elasticities of reward systems are unknown. (C) 2014 Elsevier Ltd. All rights reserved.

Abstract

The critical and follow-up headways are the two gap-acceptance parameters which explain the traffic interaction of a minor street vehicle when enters the roundabout, merging into or crossing one or more circulating (major) streams. Several studies and researches provide measurements of critical and follow-up headways from real data at roundabouts. The objective of our research is to synthesize the data from the series of selected studies to interpret variation across the studies. In order to match the research goal, a systematic literature review on estimations of critical and follow-up headways at roundabouts was undertaken. Since several studies and researches developed worldwide were examined, we were able to note that the effect size varied from study to study. Thus the meta-analysis of effect sizes was performed as part of the literature review through the random-effects model. After discussing the assumptions of this model, the dispersion in effects across studies was assessed and the summary effect for each of the parameters under examination was computed. Calculations were made both for single-lane roundabouts and double-lane roundabouts, as well as for turbo roundabouts. Compared to the results of individual studies, the single (quantitative) meta-analytic estimate provides an accurate and reliable synthesis on the specific issue here addressed, and gives, with greater power of the individual reviewed studies, a comprehensive measure for the parameters of interest. Document type: Article

Abstract

Widespread use of the Internet in 21st century society is not risk-free. This paper studies the comorbidity of some problematic uses of Internet with depression in order to assess their correlation. With that aim, a meta-analysis of 19 samples obtained from 13 different studies (n=33,458) was carried out. The subjects of these studies are adolescents between the ages of 12 and 18 years (µ=15.68) from different cultures and continents (Europe, Euro-Asia, America and Asia). The effect size obtained from the use of a random-effects model (r=0.3, p"0.000) is significant, moderate and positive, thus confirming the relation between pathologic uses of the Internet and depression. Moreover, meta-regression test results showed that 9% of the variance (R2=0.09) is associated with the male gender, while age and culture are not significant variables. The variability rate of the studies is high (I2=87.085%), as a consequence of heterogeneity rather than publication bias, as Egger’s regression test shows (1-tailed p-value=0.25; 2-tailed p-value=0.50, and ?=1.57). Therefore, the need for specific interventions in secondary education dealing with this issue is evident to ensure that it does not extend into adult life.