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The amstar2 package intends to facilitate the production of publication-ready tables and figures for the AMSTAR 2 tool.

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Myopia comprises the leading cause of visual impairment in childhood, showing a global rapid rise in prevalence over the past years. Myopia progression has been related with a number of ocular complications potentially resulting in blindness, including glaucoma, macular degeneration, cataract, and retinal detachment. Etiopathogenesis of this disorder is regarded multifactorial, involving both environmental and genetic components. Near work activities are believed to play a key role in myopic development, owing to the induced hyperopic defocus on the peripheral retina that may result in axial elongation. Other parameters including outdoor exposure, physical activity and digital screen time are also hypothesized to be connected with myopic development. Ocular examination of myopic subjects should include visual acuity assessment, refraction, biometry and choroidal thickness measurements, as well as evaluation of the accommodative functions. We propose a clinical assessment tool, as a useful guide for all eye care professionals examining and treating juvenile myopes., Aristotle Biomedical Journal, Vol 4, No 1 (2022)

BACKGROUND Poor recruitment of patients is the predominant reason for early termination of randomized clinical trials (RCTs). Systematic empirical investigations and validation studies of existing recruitment models, however, are lacking. We aim to provide evidence-based guidance on how to predict and monitor recruitment of patients into RCTs. Our specific objectives are the following: (1) to establish a large sample of RCTs (target n = 300) with individual patient recruitment data from a large variety of RCTs, (2) to investigate participant recruitment patterns and study site recruitment patterns and their association with the overall recruitment process, (3) to investigate the validity of a freely available recruitment model, and (4) to develop a user-friendly tool to assist trial investigators in the planning and monitoring of the recruitment process. METHODS Eligible RCTs need to have completed the recruitment process, used a parallel group design, and investigated any healthcare intervention where participants had the free choice to participate. To establish the planned sample of RCTs, we will use our contacts to national and international RCT networks, clinical trial units, and individual trial investigators. From included RCTs, we will collect patient-level information (date of randomization), site-level information (date of trial site activation), and trial-level information (target sample size). We will examine recruitment patterns using recruitment trajectories and stratifications by RCT characteristics. We will investigate associations of early recruitment patterns with overall recruitment by correlation and multivariable regression. To examine the validity of a freely available Bayesian prediction model, we will compare model predictions to collected empirical data of included RCTs. Finally, we will user-test any promising tool using qualitative methods for further tool improvement. DISCUSSION This research will contribute to a better understanding of participant recruitment to RCTs, which could enhance efficiency and reduce the waste of resources in clinical research with a comprehensive, concerted, international effort.

Objective To evaluate the efficacy and safety of artificial pancreas treatment in non-pregnant outpatients with type 1 diabetes. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, Cochrane Library, and grey literature up to 2 February 2018. Eligibility criteria for selecting studies Randomised controlled trials in non-pregnant outpatients with type 1 diabetes that compared the use of any artificial pancreas system with any type of insulin based treatment. Primary outcome was proportion (%) of time that sensor glucose level was within the near normoglycaemic range (3.9-10 mmol/L). Secondary outcomes included proportion (%) of time that sensor glucose level was above 10 mmol/L or below 3.9 mmol/L, low blood glucose index overnight, mean sensor glucose level, total daily insulin needs, and glycated haemoglobin. The Cochrane Collaboration risk of bias tool was used to assess study quality. Results 40 studies (1027 participants with data for 44 comparisons) were included in the meta-analysis. 35 comparisons assessed a single hormone artificial pancreas system, whereas nine comparisons assessed a dual hormone system. Only nine studies were at low risk of bias. Proportion of time in the near normoglycaemic range (3.9-10.0 mmol/L) was significantly higher with artificial pancreas use, both overnight (weighted mean difference 15.15%, 95% confidence interval 12.21% to 18.09%) and over a 24 hour period (9.62%, 7.54% to 11.7%). Artificial pancreas systems had a favourable effect on the proportion of time with sensor glucose level above 10 mmol/L (−8.52%, −11.14% to −5.9%) or below 3.9 mmol/L (−1.49%, −1.86% to −1.11%) over 24 hours, compared with control treatment. Robustness of findings for the primary outcome was verified in sensitivity analyses, by including only trials at low risk of bias (11.64%, 9.1% to 14.18%) or trials under unsupervised, normal living conditions (10.42%, 8.63% to 12.2%). Results were consistent in a subgroup analysis both for single hormone and dual hormone artificial pancreas systems. Conclusions Artificial pancreas systems are an efficacious and safe approach for treating outpatients with type 1 diabetes. The main limitations of current research evidence on artificial pancreas systems are related to inconsistency in outcome reporting, small sample size, and short follow-up duration of individual trials.

Introduction. Hypertension has been identified as one of the\ud commonest modifiable determinants for chronic kidney disease\ud progression. A variety of antihypertensive drugs are available and\ud their effect on kidney function has been investigated by a large\ud number of randomized controlled trials. Observational studies,\ud although scarcely been used, outpatient can reflect everyday\ud practice, where drug exposures vary over time, and may provide\ud an alternative for detecting longitudinal changes in kidney function.\ud Materials and Methods. We applied mixed model repeated measures\ud analysis to investigate the effect of antihypertensive drug categories\ud and their combinations on kidney function change over time in a\ud cohort of 779 patients with essential hypertension, using the data\ud from a Greek hypertension outpatient clinic. Antihypertensive\ud drugs were grouped in 5 categories. Their effect was evaluated\ud and their combinations with and without renin-angiotensin-system\ud inhibitors (RASI) to each other. In addition, the combination of\ud RASI with calcium channel blockers (CCBs) was studied.\ud Results. Diuretics, RASI, CCBs, and beta-blockers had a significant\ud renoprotective and blood pressure lowering effect. Combinations\ud with RASI had a smaller beneficial effect on kidney function\ud compared to CCBs (0.75 mL/min/1.73 m2\ud per year of drug use\ud versus 0.97 mL/min/1.73 m2). There was no additional effect\ud when combining RASI with CCBs. However, the lowering effect\ud on systolic blood pressure was greater (-0.83 mm Hg per year of\ud drug use, P < .001).\ud Conclusions. RASI were found to have a smaller, although\ud significant, renoprotective effect. There was no additional effect\ud on kidney function when combining RASI with CCBs.

OBJECTIVE: To evaluate the efficacy and safety of artificial pancreas treatment in non-pregnant outpatients with type 1 diabetes. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, Cochrane Library, and grey literature up to 2 February 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials in non-pregnant outpatients with type 1 diabetes that compared the use of any artificial pancreas system with any type of insulin based treatment. Primary outcome was proportion (%) of time that sensor glucose level was within the near normoglycaemic range (3.9-10 mmol/L). Secondary outcomes included proportion (%) of time that sensor glucose level was above 10 mmol/L or below 3.9 mmol/L, low blood glucose index overnight, mean sensor glucose level, total daily insulin needs, and glycated haemoglobin. The Cochrane Collaboration risk of bias tool was used to assess study quality. RESULTS: 40 studies (1027 participants with data for 44 comparisons) were included in the meta-analysis. 35 comparisons assessed a single hormone artificial pancreas system, whereas nine comparisons assessed a dual hormone system. Only nine studies were at low risk of bias. Proportion of time in the near normoglycaemic range (3.9-10.0 mmol/L) was significantly higher with artificial pancreas use, both overnight (weighted mean difference 15.15%, 95% confidence interval 12.21% to 18.09%) and over a 24 hour period (9.62%, 7.54% to 11.7%). Artificial pancreas systems had a favourable effect on the proportion of time with sensor glucose level above 10 mmol/L (-8.52%, -11.14% to -5.9%) or below 3.9 mmol/L (-1.49%, -1.86% to -1.11%) over 24 hours, compared with control treatment. Robustness of findings for the primary outcome was verified in sensitivity analyses, by including only trials at low risk of bias (11.64%, 9.1% to 14.18%) or trials under unsupervised, normal living conditions (10.42%, 8.63% to 12.2%). Results were consistent in a subgroup analysis both for single hormone and dual hormone artificial pancreas systems. CONCLUSIONS: Artificial pancreas systems are an efficacious and safe approach for treating outpatients with type 1 diabetes. The main limitations of current research evidence on artificial pancreas systems are related to inconsistency in outcome reporting, small sample size, and short follow-up duration of individual trials.