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In der mitteleuropäischen Pflanzensoziologie hat die Veröffentlichung von Primärdaten in Form von Vegetationstabellen eine lange Tradition. Zeitschriften wie Tuexenia sind nicht zuletzt aus diesem Grunde wichtige Archive für die Biodiversitätsforschung und die angewandte Vegetationskunde. Allerdings steht der hohe Aufwand einer Kompilation dieser Daten einer breiteren Nutzung im Wege. Digitale Vegetationsdatenbanken mit Einzelaufnahmen erlauben ein rasches Suchen, Filtern, Kompilieren und synthetisches Auswerten von Datensätzen unterschiedlicher Herkunft. Konzepttaxonomische Datenbankstrukturen reduzieren insbesondere den Aufwand für den taxonomischen Abgleich. Das unter floraweb vom Bundesamt für Naturschutz bereitgestellte Onlineangebot VegetWeb enthält bereits > 7.000 Wald-Vegetationsaufnahmen und soll zu einem gemeinsamen Datenpool der deutschen Pflanzensoziologen ausgebaut werden. Die Dateneinspeisung soll einerseits aus regionalen Datenerfassungsprojekten erfolgen. Andererseits sollen ab sofort die in Tuexenia abgedruckten Vegetationsaufnahmen in VegetWeb bereitgestellt werden. Die von den Autoren gelieferten Tabellenvorlagen mit einem Mindestmaß an Zusatzinformationen werden vom Verfasser für die Einspeisung in VegetWeb vorbereitet. Es wird erwartet, dass die leichtere Verfügbarkeit der Primärdaten die Wahrnehmung der Publikationen erhöht und pflanzensoziologische Metaanalysen stimuliert.
Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention.
OBJECTIVE: To compare efficacy, safety, and tolerability of an oral enzyme combination (OEC) containing proteolytic enzymes and bioflavonoid vs diclofenac (DIC), a nonselective nonsteroidal anti-inflammatory drug in the treatment of osteoarthritis of the knee.
MATERIALS AND METHODS: This was an individual patient-level pooled reanalysis of patient-reported data from prospective, randomized, double-blind, parallel-group studies in adult patients with moderate-to-severe osteoarthritis of the knee treated for at least 3 weeks with OEC or DIC. Appropriate trials were identified with a systemic literature and database search. Data were extracted from the original case-report forms and reanalyzed by a blinded evaluation committee. The primary end point was the improvement of the Lequesne algofunctional index (LAFI) score at study end vs baseline. Secondary end points addressed LAFI response rates, treatment-related pain-intensity changes, adverse events, and laboratory parameters.
RESULTS: Six trials were identified that enrolled in total 774 patients, of whom 759 had post-baseline data for safety analysis, 697 (n=348/349 with OEC/DIC) for intent to treat, 524 for per protocol efficacy analysis, and 500 for laboratory evaluation. LAFI scores - the primary efficacy end point - decreased comparably with both treatments and improved with both treatments significantly vs baseline (OEC 12.6±2.4 to 9.1±3.9, DIC 12.7±2.4 to 9.1±4.2, effect size 0.9/0.88; P<0.001 for each). In parallel, movement-related 11-point numeric rating-scale pain intensity improved significantly (P<0.001) and comparably with both treatments from baseline (6.4±1.9/6.6±1.8) to study end (3.8±2.7/3.9±2.5). Overall, 55/81 OEC/DIC patients of the safety-analysis population (14.7%/21.1%, P=0.022) reported 90/133 treatment-emergent adverse events, followed by premature treatment discontinuations in 22/39 patients (5.9%/10.2%, P=0.030). Changes in laboratory parameters were significantly less with OEC vs DIC: on average 18.8% vs 86.3% of patients presented a decrease with respect to hemoglobin, hematocrit, or erythrocyte count (P<0.001), and 28.2% vs 72.6% showed an increase in AST, ALT, or GGT (P<0.001).
CONCLUSION: When compared with DIC, OEC showed comparable efficacy and a superior tolerability/safety profile associated with a significantly lower risk of treatment-emergent adverse events, related study discontinuations, and changes in laboratory parameters.
Cannabinoid drugs are registered for postoperative nausea and emesis, Tourette syndrome and tumor-related anorexia, but are also used for spasticity and pain relief, among other conditions. Clinical studies for spasmolysis have been equivocal and even conclusions from meta-analyses were not consistent. This may be due to uncertainty in diagnostic criteria as well as a lack of direct spasmolytic activity (direct causality). In this review we used the Hill criteria to investigate whether a temporal association is causal or spurious. Methods: A systematic literature search was performed to identify all clinical trials of cannabinoids for spasticity. Studies were evaluated for dose dependency and time association; all studies together were analyzed for reproducibility, coherence, analogy and mechanistic consistency. A Funnel plot was done for all studies to identify selection or publication bias. Results: Twenty-seven studies were included in this meta-analysis. The spasmolytic activity (effect strength) was weak, with a nonsignificant small effect in most studies and a large effect only in a few studies (“enriched” studies, low patient numbers). No dose dependency was seen and plotting effect size vs. daily dose resulted in a slope of 0.004. Most studies titrated the cannabinoid to the optimum dose, e.g., 20 mg/d THC. The effect decreased with longer treatment duration (3–4 months). The spasmolytic effect is consistent for different European countries but not always within a country, nor is the effect specific for an etiology (multiple sclerosis, spinal cord injury, others). For other criteria like plausibility, coherence or analogous effects, no data exist to support or refute them. In most studies, adverse effects were frequently reported indicating a therapeutic effect only at high doses with relevant side effects. Conclusions: Current data do not support a specific spasmolytic effect; a general decrease in CNS activity analogous to benzodiazepines appears more likely. Whether individual patients or specific subgroups benefit from cannabinoids is unclear. Further studies should compare cannabinoids with other, nonspecific spasmolytic drugs like benzodiazepines.
Elusive flaws are identified in techniques widely adopted to organize the Material Examined sections in taxonomic publications, mostly regarding the usage of the term ibidem and the nesting of information such as country and states. Logical errors are identified that prevent objective retrieval of the original information and can hinder or block its interpretation, even in case-by-case analyses. It is demonstrated that the free usage of ibidem in the sense of “same as previous except as follows” compromises the interpretation of data, characterizing bad practice. Solutions are proposed for the precise usage of both the term ibidem and the nesting technique. A new technique for organizing, compressing, and presenting information, called grid-setting, is described and evaluated. Its most notable practical effect is that the Material Examined section becomes literally a coded data sheet, which can be accurately converted back to spreadsheet format. In addition, the grid-setting technique was able to generate texts up to 30% shorter than those edited with the best-known traditional techniques. The new ideas and fixes are incorporated into a new software, flexible enough to process varied and unlimited data into largely user-defined texts, which remain nevertheless universal in their format and logical interpretation.