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To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.

The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.

CDIM measures clinical diversity on a scale that includes four domains with 11 items overall setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.

CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.

CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.

To evaluate the power of responder analyses in a randomized controlled trial.

Simulations were based on the Chronic Kidney Disease Antidepressant Sertraline Trial (CAST), which compared sertraline to placebo for the treatment of depression in kidney disease. Baseline disease severity, placebo response, effect size, and the proportion of responders were varied across 72 scenarios. Power was assessed using a t-test for change scores, and the chi-square test for dichotomized outcomes of the minimal important difference (MID), improvement and remission in 10,000 datasets with a fixed sample size of 193.

The t-test had >80% power except for scenarios with the lowest sertraline effect size. The chi-square test using the MID had <7% power in all scenarios while improvement and remission of achieved >80% power only at higher effect sizes and/or when the proportion of responders was highest at 0.5. The chi-square test for improvement had marginal power increases compared to the t-test (4/72 scenarios=5.6%) and that for remission did not outperform the t-test in any scenario.

The t-test outperforms the chi-square test for dichotomized outcomes regardless of baseline disease severity, placebo response, effect size and the proportion of responders to the intervention.

The t-test outperforms the chi-square test for dichotomized outcomes regardless of baseline disease severity, placebo response, effect size and the proportion of responders to the intervention.

To identify clinical trials registered later than 2015, that study the effect of an intervention on a primary outcome whose "Certainty of Evidence" (CoE) has already been rated "high" in a Cochrane SR.

We searched the Cochrane Library for all SRs from 2015. We analyzed SRs of interventions and excluded withdrawn reviews or those with no Summary of Findings (SoF) table. We retrieved the GRADE CoE ratings of each SR's primary outcomes in the SoF tables and identified those rated "high." We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials to identify records of clinical studies that tackled those outcomes and were registered after the date of publication of the respective 2015 SR.

We selected 602 SRs. Eighty-one contained a "high" CoE rating on at least one primary outcome, totaling 152 primary outcomes rated "high." We found 39 clinical trials registered for primary outcomes with evidence already rated as "high" in a 2015 Cochrane SR.

This study shows the existence of clinical trials registered to study primary outcomes whose CoE has already been rated "high" in a Cochrane SR.

This study shows the existence of clinical trials registered to study primary outcomes whose CoE has already been rated "high" in a Cochrane SR.Pancreatic cancer (PC) is one of the deadliest cancers with a very short rate of survival and commonly without symptoms in its early stage. This absence of symptoms can lead to a late diagnosis associated with an advanced metastasis process, for which therapy is not effective. Although with extensive research in this field, the 5-year survival rate has not increased significantly. Notwithstanding, novel insights on risk factors, genetic mutations and molecular mechanisms pave the way for novel therapeutics that urge with a significant part of PC patients presenting resistance to chemotherapy treatments. Exosomes are presented as a promising strategy, working as delivery systems, since they can transport and release their cargoes after fusing with the membrane of pancreatic cells. Exosomes present advantages over liposomes, being less toxic and reaching higher levels in the bloodstream, working as molecule carriers that can inhibit oncogenes, activating tumor suppressor genes and inducing immune responses as well as controlling cell growth. This review intends to provide an overview about the scientific and clinical studies regarding the entire process, from isolation and purification of exosomes, to their design and transformation into anti-oncogenic drug delivering systems, particularly to target PC cells.

Although the plantaris muscle is vestigial in humans, it is far too important to remain omitted. The aim of this study is to provide a comprehensive review of the existing literature focused on plantaris muscle clinical value, grafting usefulness and its morphological variations. Hopefully this study will be of great use for every medical practitioner due to its clarity and conciseness despite such broaden scope of this article.

The article is written based on 100 studies published since 1868 until 2020. During careful selection process 12 papers were dismissed due to their insufficient sample size, wrong methods used or results that were previously discovered.

Many aspects concerning the plantaris muscle are already well examined, summarized and described. ON-01910 inhibitor However this study has shown how much we still do not know and which fields require further investigations.

The anatomical variations of plantaris muscle morphology may cause mid-portion Achilles tendinopathy, tennis leg syndrome or increase the risk of failure while harvesting the tendons.