Several clinical trials have investigated the relationship between rheumatoid arthritis (RA) and periapical periodontitis (AP), yielding inconsistent results. Our study aimed to synthesize clinical evidence through a meta-analysis and evaluate potential association using two-sample Mendelian randomization (TSM), which leverages genetic information for a more comprehensive perspective.

A systematic literature search was executed across PubMed, Web of Science, Scopus, and gray literature sources until February 20, 2025. Studies comparing radiolucent periapical lesions in RA patients with controls were qualified for this meta-analysis. Genetic data from genome-wide association studies of European populations with RA were used to scrutinize the relationships with diseases of pulp and periapical tissues, particularly chronic periapical periodontitis and pulpitis, employing a TSMR approach. Our primary estimates used the radial inverse-variance weighted method complemented by a series of sensitivity analyses to ensure robustness. MR-Egger intercept, Cochran's Q statistical analysis, and I2 were used to assess the potential heterogeneity and pleiotropy.

The meta-analysis included 1,206 participants across 5 selected studies. No significant correlation was found between radiographically diagnosed AP and RA at the patient level (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 0.91-2.67, P = .10). However, AP prevalence was 1.67 times higher in RA patients compared to healthy individuals at the tooth level (OR = 1.67, 95% CI = 1.18-2.35, P < .01). Genetically, RA was correlated with an elevated risk of diseases of pulp and periapical tissues (OR = 1.05; 95% CI = 1.03-1.07; P < .0000), chronic periapical periodontitis (OR = 1.05; 95% CI = 1.02-1.08; P = .0006) and pulpitis (OR = 1.01; 95% CI = 1.00-1.02; P = .0175), respectively.

Evidence from both the meta-analysis and the TSMR study moderately corroborates the associations between RA and pulpal-periapical diseases. Further research employing both human and animal models are recommended to confirm this link and elucidate potential underlying mechanisms.

The role of endogenous sex hormones in the risk of endometrial cancer (EC) remains contradictory across the studies. This meta-analysis was carried out to investigate the relation of circulating concentrations of sex hormones and sex hormone-binding globulin (SHBG) to EC risk.

A search of the PubMed, Web of Science, and Scopus databases was conducted to include relevant studies. We used odds ratios (OR) with 95% confidence intervals (CI) to pool effect sizes using a random effects model.

The analysis included 16 studies with 292,695 participants. SHBG levels showed an inverse relationship with EC (OR: 0.67). In contrast, higher circulating levels of total testosterone (OR: 1.70), free testosterone (OR: 1.75), dehydroepiandrosterone sulfate (OR: 1.39), and androstenedione (OR: 1.58) were positively associated with EC risk. Estrogens also demonstrated significant associations, so that estrone (OR: 1.55), unconjugated estrone (OR: 1.86), estradiol (OR: 1.38), unconjugated estradiol (OR: 2.14), estriol (OR: 1.75), and unconjugated estriol (OR: 1.99) were linked to increased EC risk, while conjugated estrogens showed no significant associations. A non-linear dose-response relationship was found for SHBG, estrone, estradiol, and total testosterone. The results were significantly affected by age, cancer type, geographic region, menopausal status, study type, and the level of adjustments for covariates. For all hormones, the significant associations were found only for postmenopausal women.

This study found an inverse association between SHBG and EC, while identified a direct relationship between sex hormones, except for conjugated estrogens, and EC risk only in postmenopausal women.

Randomized trials and meta-analyses have indicated longer survival with neoadjuvant than with adjuvant therapy in patients with resectable or borderline resectable (R/BR) pancreatic adenocarcinoma. Despite the efficacy of chemotherapy, the role of radiation therapy as an adjuvant or neoadjuvant treatment for patients with R/BR pancreatic adenocarcinoma remains unclear. In this systematic review and meta-analysis, we compared the benefits of additional chemoradiation therapy (CRT) to neoadjuvant chemotherapy (NAC) with NAC alone for R/BR pancreatic adenocarcinoma.

A systematic literature search was conducted on Embase, Web of Science, PubMed, Cochrane, and Google Scholar. Median overall survival (OS) was the primary endpoint. Secondary endpoints included disease-free survival (DFS), resection rate, and R0 resection rate.

This review and meta-analysis included 31 prospective studies, of which 9 were randomized trials. In these studies, 658 patients from 14 study arms received NAC alone and 912 patients from 19 study arms received both NAC and CRT (NAC-CRT). The pooled median OS was 25.55 months (95% CI, 21.59-30.24 months) for NAC alone and 17.55 months (95% CI, 16.47-18.70 months; P < .0001) for NAC-CRT. The pooled R0 resection rate was higher with NAC-CRT (83.43%) than with NAC (69.97%; P < .0001). No significant difference was observed in DFS or resection rate between the 2 groups. In patients who received 5 or more cycles of initial chemotherapy, NAC-CRT was associated with longer OS than NAC (23.30 vs 21.85 months; P = .856).

NAC provides significantly longer OS than NAC-CRT to R/BR pancreatic adenocarcinoma. NAC-CRT is associated with a significantly improved R0 resection rate. This positive local effect of CRT can be translated to extended survival when 5 cycles or more of NAC are prescribed.

Bronchoscopy-guided percutaneous dilatational tracheostomy (BPDT) and ultrasound-guided percutaneous dilatational tracheostomy (USPDT) are widely employed techniques. However, USPDT provides better vascular mapping and reduces bleeding risk, while BPDT offers better tracheal entry and fewer airway complications. Their comparative efficacy and safety were systematically evaluated, with special consideration for high-risk patients, including obese and critically ill individuals with complex airway anatomy. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an in-depth literature search was conducted in Embase, PubMed, Scopus, and Cochrane Library, focusing on adult patients undergoing percutaneous tracheostomy with USPDT, BPDT, or both. Quality assessment indicated that most studies exhibited a low risk of bias, though concerns regarding randomization and selective reporting were noted in some cases. A meta-analysis was conducted using pooled effect sizes, procedural success rates, complication rates, and heterogeneity (I²), applying a random-effects model. Ten studies involving 1,069 patients were analyzed. The pooled analysis demonstrated a moderate positive association between USPDT and BPDT in improving procedural success and reducing complications (CI: 0.41 to 0.55, standardized mean difference = 0.48, 95%, p < 0.05). However, significant heterogeneity (I² = 72.95%) was observed, likely due to variations in study design and patient populations. USPDT and BPDT are both practical and safe for percutaneous tracheostomy, with unique advantages for different clinical scenarios. The findings support a hybrid approach integrating both modalities to enhance procedural safety and efficiency, particularly in high-risk populations. Future large-scale trials should focus on reducing heterogeneity, assessing long-term outcomes, and improving cost-effectiveness to establish best-practice guidelines for broader clinical implementation.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by social impairments, sensory processing issues, repetitive behavior patterns, motor abnormalities, and executive function impairments.

To systematically review and meta-analyze the effects of various exercise modalities on flexibility and cognitive control, social skills, behavioral problems, motor skills, and coordination in children with ASD, providing scientific evidence for clinical practice to guide effective exercise interventions for children with ASD.

Literature searches were conducted in PubMed, EMbase, Cochrane Library, EBSCOhost, and Web of Science databases, covering the period from database inception to February 15, 2024. Inclusion criteria included studies involving children with ASD, any form of exercise intervention, reporting at least one ASD-related outcome, and designed as randomized controlled trials (RCTs) or quasi-experimental studies. Exclusion criteria included reviews, conference abstracts, commentary articles, and studies lacking sufficient statistical data for meta-analysis. Study quality was assessed using the PEDro scale. Effect sizes were calculated using standardized mean differences (SMD). Heterogeneity was assessed with the I 2 statistic. Multiple subgroup analyses were conducted, and publication bias was evaluated using Begg's Test and Egger's Test.

23 RCTs were included in this study, showing positive effects of exercise interventions in various domains.Upper grade students showed significant improvement in flexibility and cognitive control (SMD = -0.282, p = 0.161). Lower grade children showed the most significant improvement in motor skills and coordination (SMD = 0.475, p = 0.043). Preschool children showed significant enhancement in social skills (SMD = 0.312, p = 0.041). Behavioral problems improved significantly across all age groups (SMD = -0.674, p < 0.001). Martial arts and ball games were particularly effective in enhancing these domains, and appropriate periodic exercise interventions effectively improved various abilities in children with ASD. Results varied across different ages and intervention types.

Exercise interventions significantly improve flexibility, cognitive control, motor skills, coordination, social skills, and behavioral problems in children with ASD. This study supports exercise interventions as an effective method to enhance multiple abilities in children with ASD and emphasizes the importance of designing personalized intervention programs tailored to different ages and needs. Future research should focus on larger sample sizes and long-term follow-ups to confirm the sustainability and generalizability of intervention effects.

Cholangiocarcinoma is a rare and often fatal malignancy. Numerous studies have demonstrated promising outcomes and survival rates associated with adjuvant photodynamic therapy (PDT) in the palliative treatment of cholangiocarcinoma.

To systematically evaluate the existing meta-analyses on PDT for cholangiocarcinoma, assessing evidence quality and strength while performing updated meta-analyses to refine survival outcomes.

PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched up to September 18, 2024, to identify meta-analyses and clinical studies on PDT in patients with cholangiocarcinoma. The random-effects model was employed to re-synthesize existing meta-analyses, with a comprehensive evaluation of methodological quality. Updated meta-analyses of survival data were conducted, including subgroup analyses stratified by cholangiocarcinoma type and intervention modality.

A total of 5 meta-analyses and 21 clinical studies were included. The findings indicated that combining PDT with stenting or chemotherapy can significantly improve overall survival in patients with cholangiocarcinoma and reduce mortality rate, without increasing the risk of adverse events (AEs) such as cholangitis or abscess formation. For extrahepatic cholangiocarcinoma, adding PDT to stenting demonstrated a notable improvement in the 2-year survival rate. Meanwhile, for hilar cholangiocarcinoma, the addition of chemotherapy to PDT showed a more pronounced enhancement in the 1-year survival rate.

Current evidence indicates that PDT combined with stenting or chemotherapy in the palliative treatment of cholangiocarcinoma decreases overall mortality and enhances OS without increasing the incidence of AEs. Adding PDT to stenting or chemotherapy may be more beneficial for long-term efficacy.

The WHO considers anemia in pregnancy a severe public health issue when prevalence surpasses 40%. In response, we conducted a systematic review and meta-analysis to examine anemia among pregnant women in Egypt, focusing on its prevalence, determinants, and associated complications.

We conducted a systematic literature search for studies published between January 1, 2010, and August 18, 2024, to identify studies from Egypt reporting on anemia in pregnant women, including its prevalence, associated determinants, and complications. A meta-analysis was conducted using a random-effects model to estimate pooled prevalence, odds ratios (OR), and standardized mean differences (SMD). Sensitivity analyses and publication bias were performed. All statistical analyses were conducted using R software.

Eighteen studies met the eligibility criteria with a total sample size of 14,548. The overall prevalence of anemia among pregnant women was 49% (95% CI: 42-57), with no significant difference between Upper and Lower Egypt (P = 0.66). The sensitivity analysis demonstrated the absence of influential outliers and Egger's test indicated no evidence of publication bias (P = 0.17). Anemia prevalence was significantly higher in the third trimester (65%) compared to the second trimester (47%) (P = 0.03). Among anemic pregnant women, most cases were mild (47%) and moderate (47%). The determinants of anemia among pregnant women included being over 30 years old (OR: 1.95), residing in rural areas (OR: 1.76), illiteracy (OR: 1.93), birth spacing < 2 years (OR: 2.04), lack of iron supplementation (OR: 2.59), presence of intestinal parasites (OR: 1.38), antenatal visits < 5 (OR: 5.27), multiparity, and low income, all with statistical significance (p < 0.05). Regarding dietary determinants, a low intake of meat, vegetables, fruits, and high tea consumption was consistently associated with a higher risk of anemia. For neonatal complications, infants born to anemic mothers had significantly lower Apgar scores, gestational ages, and birth weights (P < 0.05), with birth weight being the most adversely impacted (SMD = -1.3).

This meta-analysis shows 49% anemia prevalence in pregnant Egyptian women, indicating severe health concern. The findings highlight the urgent need for targeted interventions aimed at addressing the key determinants identified in this study.

Mismatch repair deficient (dMMR) and microsatellite instability-high (MSI-H) cancers are associated with an increased number of somatic mutations, which can render tumors more susceptible to immune checkpoint blockade. However, a comprehensive evaluation of the efficacy profile of immune checkpoint inhibitors in this patient population across multiple cancer types is lacking. This study aims to address this knowledge gap by synthesizing data from phase I-III clinical trials.

A systematic search was conducted in PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Google Scholar from inception until June 2024. Eligible studies included randomized controlled trials (RCTs), nonrandomized comparative studies, and single-arm trials investigating immune checkpoint inhibitors in patients with dMMR/MSI-H advanced cancers. The primary outcome was objective response rate (ORR), and the secondary outcomes included disease control rate (DCR), 1-year, 2-year, and 3-year overall survival (OS) and progression-free survival (PFS) rates. Subgroup analyses were conducted for the primary outcome stratified by major study characteristics.

Of the 10 802 identified studies, 19 trials in 25 studies totaling 2052 participants met the inclusion criteria and were included in the meta-analysis. The pooled ORR was 41.7% (95% CI, 35.7-47.7%). The pooled DCR was 68.9% (95% CI, 62.2-75.7%). The pooled 12-month, 24-month, and 36-month OS rates were 29.1% (95% CI, 19.9-38.3%), 35.8% (95% CI, 23.6-48.0%), and 35.8% (95% CI, 23.6-48.0%), respectively. The pooled 12-month, 24-month, and 36-month PFS rates were 46.4% (95% CI, 39.1-53.8%), 67.0% (95% CI, 55.2-78.8%), and 63.1% (95% CI, 37.3-88.9%), respectively.

The study establishes the therapeutic potential of immune checkpoint inhibitors in dMMR/MSI-H advanced cancers, highlighting the importance of MSI status in this context. Further, head-to-head comparisons are needed to conclusively determine MSI's predictive power relative to proficient mismatch repair/microsatellite stable (pMMR/MSS) tumors.

Changes in functional genetic polymorphisms may increase or decrease the risk of cancer in patients. Nowadays, the association between polymorphisms in the interleukin-8 (IL-8) gene and the susceptibility of cancer risk have been investigated in many studies, however, above relationships remain unclear.

The current study aims to comprehensively evaluate the association between IL-8 gene six polymorphisms and the whole cancer risk, especially -251 polymorphism and gastric cancer.

Six polymorphisms (-251, -353, +678, +1633, +2767, +781) were collected. The expression of serum IL-8 was calculated by ELISA assay. First, 104 case-control studies were conducted. Second, this research has made significant discoveries regarding the -251, -353 and +781 polymorphisms and the potential associations with cancer risk. Finally, the serum IL-8 levels in gastric cancer patients with AA/TT genotypes were significantly higher than those with the same genotypes of healthy controls and TT genotypes in gastric cancer patients.

Overall, the investigation has revealed that IL-8 gene polymorphisms significantly influence vulnerability to cancer development, especially for gastric cancer.

Space flights can produce physiological changes in the spine, leading to the development of acute and chronic pain in passengers. However, there is a lack of comprehensive literature exploring physiological spine changes and acute and chronic pain in space passengers (astronauts and animals). The first aim of this study was to identify the physiological changes experienced by passengers (humans and animals) after space flight. The second aim was to identify the incidence of low back pain during and after space flight. This systematic review was conducted following PRISMA guidelines and was pre-registered in PROSPERO (ID 451144). We included Randomized Controlled Trials or longitudinal studies in humans and animals, and the variables must be assessed either in-flight or post-flight. We conducted a literature search in major databases combining the keywords: Pain; Space; Low Back Pain; Astronauts; Spine Changes; Microgravity; Physiological Changes; Humans; Animals. Risk of bias and quality of studies were analyzed, and the level of evidence was assessed using the GRADE system. After duplicates were removed, 115 abstracts were screened by two reviewers, and finally, 11 articles were included in this review. The evidence indicates that astronauts experience muscle atrophy in the lumbar multifidus with a moderate to large effect, especially in the L4-L5 and L5-S1 segments. Space flights also decrease the range of motion with a moderate effect, along with disc herniations and disc dehydration. 77% of astronauts experience pain during spaceflight, and 47% develop acute pain after spaceflight. Chronic pain was reported by 33% of the astronauts. After space flights, astronauts suffer from lumbar muscle atrophy, reduced range of motion, disc herniations, and disc dehydration, with a high incidence of both acute and chronic pain.

Postoperative infections remain a significant source of morbidity among patients undergoing colorectal cancer (CRC) surgery. While probiotics have been proposed as a potential strategy to mitigate the risk of these infections, contemporary meta-analyses have produced conflicting findings.

To synthesize the available evidence regarding the prophylactic efficacy of probiotics in preventing infections following CRC surgery.

A comprehensive search of PubMed and Scopus was conducted to identify relevant meta-analyses published up to February 2024. To assess the efficacy of probiotics on outcomes, relative risks (RR) and their corresponding 95%CI were pooled using a random effects model.

This comprehensive umbrella meta-analysis integrated eleven meta-analyses encompassing 11518 participants who fulfilled the inclusion criteria. Probiotics administration resulted in a statistically significant reduction in the incidence of total infections (RR: 0.40, 95%CI: 0.31-0.51; moderate certainty), surgical site infections (RR: 0.56, 95%CI: 0.49-0.63; high certainty), pneumonia (RR: 0.38, 95%CI: 0.30-0.48; high certainty), urinary tract infections (RR: 0.44, 95%CI: 0.31-0.61; moderate certainty), bacteremia (RR: 0.41, 95%CI: 0.30-0.56; high certainty), and sepsis (RR: 0.35, 95%CI: 0.25-0.44; high certainty). However, probiotics did not significantly affect intra-abdominal, central line, or peritoneal infections.

Probiotics have demonstrated potential in mitigating postoperative infectious complications among patients undergoing CRC surgery.

This study aimed to investigate the therapeutic efficacy and safety of Traditional medicine preparations (TMPs) given in combination with vascular endothelial growth factor receptor (VEGFR)-associated multi-targeted tyrosine kinase inhibitors (TKIs) for the treatment of middle to advanced-stage primary liver cancer (PLC).

This systematic literature survey employed 10 electronic databases and 2 clinical trial registration platforms to identify relevant studies on the use of TMPs + VEGFR-TKIs to treat patients with middle-advanced PLC. Furthermore, a meta-analysis was performed following the PRISMA guidelines using the risk ratio (RR) at 95% confidence intervals (CI) or standardized mean difference as effect measures.

A total of 26 studies comprising 1678 middle-advanced PLC patients were selected. The meta-analysis revealed that compared with VEGFR-TKI mono-treatment, the co-therapy of TMPs + VEGFR-TKIs considerably enhanced the objective response rate (RR = 1.49, 95% CI: 1.31-1.69), disease control rate (RR = 1.23, 95% CI: 1.16-1.30), and one-year overall survival (RR = 1.49, 95% CI: 1.28-1.74). Furthermore, the co-therapy was associated with reduced incidences of liver dysfunction (RR = 0.64, 95% CI: 0.45-0.91), proteinuria (RR = 0.43, 95% CI: 0.24-0.75), hypertension (RR = 0.66, 95% CI: 0.53-0.83), hand-foot skin reactions (RR = 0.63, 95% CI: 0.49-0.80), myelosuppression (RR = 0.63, 95% CI: 0.46-0.87), and gastrointestinal reactions (RR = 0.64, 95% CI: 0.45-0.92). Moreover, the co-therapy indicated no increase in the incidences of rash and fatigue.

This systematic analysis revealed that co-therapy with TMPs + VEGFR-TKIs has a higher effectiveness and safety profile for treating middle-advanced PLC patients. However, further validation using randomized control trials is required.

CRD42022350634.

Depression is prevalent among patients with cancer, affecting their quality of life and survival. Aerobic physical activity (APA) is an effective strategy for managing depression in the general population, but its effectiveness for reducing depressive symptoms among patients with cancer requires further study.

To evaluate whether APA decreases depression severity in patients with cancer by synthesizing data from published randomized clinical trials (RCTs).

Six databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and Scopus) were systematically searched for relevant citations published between January 1, 1980, and July 5, 2023.

This systematic review and meta-analysis included RCTs comparing APA interventions with usual care, waitlist control, or attention control for managing depression in patients with cancer, irrespective of age and cancer type.

Two reviewers independently conducted screening and data extraction. Risk of bias was evaluated using the Cochrane Risk of Bias Tool, version 2. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline was followed. Standardized mean differences (SMDs) were calculated using a random-effects model. Data collection and analyses were performed between June 2022 and March 2024.

The primary outcome was severity of self-reported depression reported within 1 month of the end of intervention (short term). Secondary outcomes were severity of self-reported depression between 1 and 6 months post intervention (medium term) and between 6 and 12 months post intervention (long term).

This meta-analysis included 25 RCTs with a total of 1931 adults with cancer (age range, 18-80 years). Ten RCTs (40%) had low risk of bias. Aerobic physical activity was associated with decreased self-reported depression among adults with cancer across the 25 included trials (n = 1931 participants; SMD, -0.38 [95% CI, -0.59 to -0.18]; P < .001; I2 = 76%). This decrease in depression scores was also significant for the secondary outcomes of long-term depression across 3 trials (n = 299 participants; SMD, -0.32 [95% CI, -0.60 to -0.04]; P = .03; I2 = 31%) but not for medium-term depression across 2 trials (n = 143 participants; SMD, -0.27 [95% CI, -0.60 to 0.06]; P = .10; I2 = 0%).

In this systematic review and meta-analysis, APA was associated with modest short-term and long-term reductions of depression among adults with cancer. Future studies should discern the effectiveness of APA in combination with other strategies for managing depression across various populations of patients with cancer.

Patients with long-term disease experience low resilience, emphasising the importance of psychological interventions to improve resilience. However, there is no comprehensive evidence on the efficacy of resilience-related psychological interventions (RRPIs) in this population. Therefore, we performed a meta-analysis to evaluate and extend knowledge from previous meta-analyses on the efficacy of RRPIs on resilience, stress, anxiety, depression and quality of life among patients with long-term disease. Cochrane Library, Embase, Ovid-MEDLINE, PubMed, Scopus, Web of Science and CINAHL electronic databases were searched until 3 February 2023. The pooled effect size of the efficacy of RRPIs was calculated using the Hedges' g (g) with random-effects model, while Cochrane Q-statistics and I2 tests assessed heterogeneity in Comprehensive Meta-Analysis 3.0 software. The Cochrane Risk of Bias 2.0 tool evaluated the quality of studies. Moderator analysis was used to explore sources of heterogeneity. Twenty randomised controlled trial studies were identified, representing a total of 1388 individuals with long-term disease. RRPIs significantly enhance resilience (g = 0.79), alleviate stress (g = -0.78), decrease anxiety (g = -1.14), mitigate depression (g = -0.96) and improve quality of life (g = 0.48). Positive psychology, mindfulness, cognitive behavioural therapy, acceptance and commitment-based intervention exhibited medium effects in strengthening resilience. Short-term effects of RRPIs on enhancing resilience were observed at 3-month follow-up period (g = 0.50). The incorporation of RRPIs into the management of patients with long-term disease shows a positive impact on their resilience, stress, anxiety, depression and quality of life. The results offer an evidence-based foundation for nurses in promoting resilience among patients with long-term disease.

PCOS is thought to be associated with metabolic disorders, endocrine disorders, and reproductive system problems. By collecting relevant literature and conducting meta-analyses, we integrated data from multiple studies to enhance the reliability of the analysis results. Studies with medical image data were selected to ensure the accuracy and credibility of the studies. A statistical framework was employed to examine the biodiversity indicators associated with the gut microbiota. These findings provide robust support for the notion that PCOS is intricately linked to notable alterations within the gut microbial community. The utilization of a statistical approach and the systematic synthesis of research findings in this meta-analysis contribute to a more comprehensive understanding of the substantial impact of PCOS on the gut microbiota landscape. PCOS patients showed significant changes in the relative abundance of certain bacteria in their gut microbiota. This imbalance will lead to the instability of intestinal microecological environment, and then affect the health of the body.

This article aims to investigate the changes of T helper 17 (Th17) cells, regulatory T (Treg) cells and their associated cytokines in patients with systemic lupus erythematosus (SLE).

Multiple databases were investigated to identify articles that explored Th17 cells, Treg cells and relevant cytokines in SLE patients. A random effects model was used for calculating pooled standardized mean differences. Stata version 15.0 was utilized to conduct the meta-analysis.

The levels of Th17 cells, IL-17, IL-6, IL-21 and IL-10 were higher in SLE patients than in healthy controls (HCs), but the TGF-β levels were lower. The percentage of Treg cells was lower than HCs in SLE individuals older than 33. Among studies that had 93% or lower females, the percentage of Th17 cells was greater in patients than in HCs. However, the percentage of Treg cells was lower when the proportion of females was less than 90%. Patients with lupus nephritis or active SLE had an increased proportion of Th17 cells and a decreased proportion of Treg cells.

The increased level of Th17 cells and related cytokines could be the main reason for the elevated Th17/Treg ratio in SLE. The percentages of Th17 and Treg cells were associated with gender, age, disease activity and kidney function. Furthermore, the reduced proportions of Treg cells may primarily result in a rise in the Th17/Treg ratio in older or active SLE patients.

https://www.crd.york.ac.uk/prospero, identifier CRD42023454937.

This article aims to evaluate the magnitude of adverse pregnancy outcomes (APOs) risks associated with different antiphospholipid antibody (aPL) profiles in women with systemic lupus erythematosus (SLE).

Multiple databases were investigated to identify articles that explored the relationship between aPLs and APOs in SLE patients. A random effects model was used for calculating pooled odds ratios (OR). Stata version 15.0 was utilized to conduct the meta-analysis.

There were 5234 patients involved in 30 studies. Overall aPL was linked to an increased incidence of any kind of APOs, fetal loss, and preterm birth. Any kind of APOs and preterm delivery were more common in patients with lupus anticoagulant (LA) positive. Anticardiolipin antibody (aCL) was associated with an increased risk of any kind of APOs and fetal loss. The association between aCL-IgM and fetal loss was also significant. Patients with anti-beta2-glycoprotein1 antibody (antiβ2GP1) positivity had an increased risk of fetal loss.

Both LA and aCL were risk factors of APOs in patients with SLE. Not only ACL, particularly aCL-IgM, but antiβ2GP1 were associated with an increased risk of fetal loss, while LA appeared to indicate the risk of preterm birth.PROSPERO (CRD42023388122).

Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains uncertain.

Receiving supplementary thiamine may not confer benefits to patients with CHF.

A comprehensive search was conducted across the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases up until May 2023 to identify articles investigating the effects of thiamine supplementation in CHF patients. Predefined criteria were utilized for selecting data on study characteristics and results.

Seven randomized, double-blind, controlled trials (five parallel trials and two crossover trials) involving a total of 274 patients were enrolled. The results of the meta-analysis pooling these studies did not reveal any significant effect of thiamine treatment compared with placebo on left ventricular ejection fraction (WMD = 1.653%, 95% CI:  -1.098 to 4.405, p = 0.239, I2 = 61.8%), left ventricular end-diastolic volume (WMD = -6.831 mL, 95% CI:  -26.367 to 12.704, p = 0.493, I2 = 0.0%), 6-min walking test (WMD = 16.526 m, 95% CI:  -36.582 to 69.634, p = 0.542, I2 = 66.3%), N-terminal pro-B type natriuretic peptide (WMD = 258.150 pg/mL, 95% CI:  -236.406 to 752.707, p = 0.306, I2 = 21.6%), or New York Heart Association class (WMD = -0.223, 95% CI:  -0.781 to 0.335, p = 0.434, I2 = 87.1%). However, it effectively improved the status of thiamine deficiency (TD).

Our meta-analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.

Primary Sjögren's syndrome (pSS) is an inflammatory autoimmune condition affecting the exocrine glands, which can adversely affect the sexual activities of women with pSS.

The study sought to evaluate the performance of the Female Sexual Function Index (FSFI) score in women with pSS regarding desire, arousal, orgasm, lubrication, satisfaction, and pain compared with those of healthy individuals.

A systematic review was conducted by examining studies published up to May 2023 using Embase, Web of Science, Scopus, and PubMed with the search terms "sexual" and "Sjögren's syndrome."

Out of the 228 articles retrieved, 9 met the criteria for inclusion in this systematic review. Six of these studies were cross-sectional, involving 229 women with pSS and 303 control subjects. Results from the meta-analysis showed that women with pSS had significantly lower scores in all 6 FSFI subdomains and the total FSFI score compared with healthy individuals. Lubrication showed the largest decrease, followed by pain. In addition, women with pSS exhibited significantly higher standardized mean differences in depression and in anxiety, as assessed by the Hospital Anxiety and Depression Scale, when compared with control subjects.

This updated meta-analysis underscores the importance of assessing genitourinary atrophy, disease-related psychological changes, and dyspareunia in women with pSS. It also emphasizes the need for customized therapeutic approaches to address these sexual dysfunctions effectively.

This study systemically reviewed the effects of robot-assisted percutaneous kyphoplasty (R-PKP) on the clinical outcomes and complications of patients with osteoporotic vertebral compression fracture (OVCF). The articles published from the establishment of the database to 19 April 2024 were searched in PubMed, The Cochrane Library, Web of Science, Embase, Scopus, China National Knowledge Infrastructure (CNKI), and Chinese biomedical literature service system (SinoMed). Meta-analysis was employed to evaluate the status of pain relief and complications between the control and R-PKP groups. Standardized mean difference (SMD) or mean difference (MD), risk ratios (RR), and 95% confidence interval (CI) were selected for analysis, and a common or random effect model was adopted to merge the data. Eight studies involving 773 patients with OCVFs were included. R-PKP could effectively Cobb's angles (MD = -1.00, 95% CI -1.68 to -0.33, P = 0.0034), and decrease the occurrence of cement leakage (RR = 0.36, 95% CI 0.21 to 0.60, P < 0.0001). However, there was no significant effect on the results of visual analog scale (MD = -0.09, 95% CI -0.20 to 0.02, P = 0.1145), fluoroscopic frequency (SMD = 5.31, 95% CI -7.24 to 17.86, P = 0.4072), and operation time (MD = -0.72, 95% CI -7.47 to 6.03, P = 0.8342). R-PKP could significantly correct vertebral angle and reduce cement leakage. Thus, R-PKP maybe an effective choice for correction vertebral Angle and reducing postoperative complications, while its impact on relieving pain, decreasing fluoroscopic frequency, and shortening operation time need further exploration.

C-X-C motif chemokine ligand (CXCL8), also known as interleukin-8, is a prototypical CXC family chemokine bearing a glutamic acid-leucine-arginine (ELR) motif that plays key roles in the onset and progression of a range of cancers in humans. Many prior studies have focused on exploring the relationship between CXCL8 gene polymorphisms and the risk of cancer. However, the statistical power of many of these reports was limited, yielding ambiguous or conflicting results in many cases.

Accordingly, the PubMed, Wanfang, Scopus and Web of Science databases were searched for articles published until July 20, 2023 using the keywords 'IL-8' or 'interleukin-8' or 'CXCL8', 'polymorphism' and 'cancer' or 'tumor'. Odds ratios (ORs) and 95% confidence intervals (CIs) were utilized to examine the association. The CXCL8 +781 polymorphism genotypes were assessed with a TaqMan assay.

About 29 related publications was conducted in an effort to better understand the association between these polymorphisms and disease risk. The CXCL8 -353A/T polymorphism was associated with an increased overall cancer risk [A vs. T, odds ratio (OR) = 1.255, 95% confidence interval (CI) (1.079-1.459), Pheterogeneity = 0.449, P = 0.003]. The CXCL8 +781 T/C allele was similarly associated with a higher risk of cancer among Caucasians [TT vs. TC + CC, OR = 1.320, 95%CI (1.046-1.666), Pheterogeneity = 0.375, P = 0.019]. Furthermore, oral cancer patients carrying the CXCL8 +781 TT + TC genotypes exhibited pronounced increases in serum levels of CXCL8 as compared to the CC genotype (P < 0.01), and also shown similar trend as compared to genotype-matched normal controls (P < 0.01). Finally, several limitations, such as the potential for publication bias or heterogeneity among the included studies should be paid attention.

Current study suggested that the CXCL8 -353 and +781 polymorphisms may be associated with a greater risk of cancer, which might impact cancer prevention, diagnosis, or treatment through the different expression of CXCL8. At the same time, the +781 polymorphism may further offer value as a biomarker that can aid in the early identification and prognostic evaluation of oral cancer.

Matrix metalloproteinases (MMPs) had a variety of subtypes, which may be related to tumor invasion and angiogenesis, and the polymorphisms from MMPs have been also associated with the susceptibility to a variety of tumors, including prostate cancer (PCa). However, previous studies have not systematically analyzed the association between MMP and prostate cancer, so we conducted systematic data collection and analyzed to evaluate the relationship among polymorphisms in MMPs and PCa susceptibility. We searched PubMed, Web of Science, Embase and Google Scholar for all papers published up to Apr 3rd, 2023, and systematically analyzed the relationship among MMP1-1607 2G/1G, MMP2-1306 T/C, MMP2-735 T/C, MMP7-181 G/A, MMP9-1562 T/C and PCa susceptibility using multiple comparative models and subgroup analyses. We found that MMP2-1306 T/C polymorphism showed associations with PCa susceptibility, with the Ethnicity subgroup (Asian) being more pronounced. Similarly, MMP9-1562 T/C has also had associations with PCa susceptibility. Our current study found that the polymorphisms of, MMP2-1306 T/C, and MMP9-1562 T/C had strong associations with PCa risk.

Current understanding of the cerebral vascular response to variations in blood pressure (BP) among individuals with hypertension is limited. The aim of this meta-analysis was to determine the correlation between hypertension, risk of stroke, and cerebral blood flow (CBF). We reviewed studies published between 2000 and 2023 from PubMed, Google Scholar, and Science Direct that compared mean CBF in normotensive (NTN) and hypertensive (HTN) patients. A random effects model was used to construct the risk ratio (RR), 95% confidence interval (CI), forest plot, and inverse variance weighting. Additionally, a mixed-effects meta-regression was employed to examine the impact of study-specific patient variables. This meta-analysis included eight prospective cross-sectional studies published from 2002 to 2023. It revealed a significant average difference in the standard mean CBF of -0.45 (95% CI -0.60 to -0.30, I2 = 69%, P < 0.00001), distinguishing NTN from HTN subjects. A RR of 0.90 (95% CI 0.63 to 1.30, I2 = 89%, P = 0.04) indicated a significant decrease in CBF among individuals with hypertension. We found a statistically significant relationship between changes in diastolic and systolic BPs and the mean CBF (R -0.81, P = 0.001 and R = -0.90, P = 0.005, respectively). Our research demonstrates a strong relationship between elevated BP and reduced CBF, with hypertension reducing CBF compared to NTN individuals, by increasing cerebrovascular resistance.

It is commonly accepted that immediate implantation is the best option for patients since it shortens the time patients must wait for ultimate restoration and provides a predictable functional and aesthetic result. However, this approach is still controversial in patients with apical pathosis. The goal of this systematic review and meta-analysis was to determine the efficacy of immediate implant insertion in patients with apical pathosis.

Between 2000 and 2023, PRISMA-compliant keywords were used to search PubMed, MEDLINE, CENTRAL, and the Cochrane Library. All English-language clinical studies that met PICOS criteria were included in a manual search. The included studies' demographic profile and event data for immediate dental implantation success in patients with or without apical pathosis were meta-analyzed using RevMan. The implant survival rate was assessed using risk ratio of plaque index and bleeding index. Begg's test using MedCalc and RevMan risk of bias assessment assessed publication bias.

A meta-analysis of 10 trials with 849 dental implantation patients found a substantial difference in initial implant placement success rates in infected sites. The pooled risk ratio for plaque index is 0.59 (95% CI: 0.36-0.96) with heterogeneity of Tau2 = 0.62, chi2 = 109.69, df = 11, I2 = 90%, z = 2.12, and p < 0.05. While, the pooled risk ratio for bleeding index is 0.77 (95% CI: 0.60 to 0.98) with Tau2 = 0.16, chi2 = 103.67, df = 11, I2 = 89%, z = 2.12, and p < 0.05. The pooled odds ratio of implant survival rate is 2.08 (95% CI: 1.56 to 1.79) with Tau2 0.16; chi2 52.43; df 9; I2 83%; z 4.93 and p < 0.05. As evidenced by the funnel plot and statistically insignificant Begg's test p values of 0.45.

The placement of immediate implants in locations affected by apical pathosis is a clinically beneficial surgery, resulting in favorable aesthetic and functional outcomes for patients.

Sarcopenia is a risk factor for adverse clinical outcomes in chronic kidney disease (CKD) patients, including mortality. Diagnosis depends on adopted consensus definition and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia and its traits across the wide spectrum of CKD. A systematic search was conducted using databases, including MEDLINE and EMBASE, for observational studies reporting the prevalence of sarcopenia. We considered sarcopenia according to the consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the Asian Working Group for Sarcopenia, the Foundation for the National Institutes of Health Sarcopenia Project, and the International Working Group on Sarcopenia (IWGS). Subgroup analyses by CKD stages, consensus, and gender were performed. Pooled prevalence was obtained from random-effect models. A total of 140 studies (42 041 patients) across 25 countries were included in this systematic review and meta-analyses. Global prevalence of sarcopenia was 24.5% [95% confidence interval (CI): 20.9-28.3) and did not differ among stages (P = 0.33). Prevalence varied according to the consensus definition from 11% to 30%, with no significant difference (P = 0.42). Prevalence of severe sarcopenia was 21.0% (95% CI: 11.7-32.0), with higher rates for patients on dialysis (26.2%, 95% CI: 16.6-37.1) compared to non-dialysis (3.0%, 95% CI: 0-11.1; P < 0.01). Sarcopenic obesity was observed in 10.8% (95% CI: 3.5-21.2). Regarding sarcopenia traits, low muscle strength was found in 43.4% (95%CI: 35.0-51.9), low muscle mass in 29.1% (95% CI: 23.9-34.5), and low physical performance in 38.6 (95% CI: 30.9-46.6) for overall CKD. Prevalence was only higher in patients on dialysis (50.0%, 95% CI: 41.7-57.4) compared to non-dialysis (19.6%, 95% CI: 12.8-27.3; P < 0.01) for low muscle strength. We found a high global prevalence of sarcopenia in the wide spectrum of CKD. Low muscle strength, the primary sarcopenia trait, was found in almost half of the overall population with CKD. Patients on dialysis were more prevalent to low muscle strength and severe sarcopenia. Nephrology professionals should be aware of regularly assessing sarcopenia and its traits in patients with CKD, especially those on dialysis.

To synthesise the evidence comparing the incidence rates of UAS post-RARC vs Open Radical cystectomy (ORC) in adults undergoing cystectomy and to compare differential stricture rates between Extracorporeal and Intracorporeal urinary diversion (ECUD vs ICUD). The primary outcome was incidence rate of UAS post RARC vs ORC and the secondary outcome was incidence rate of UAS in RARC post ECUD vs ICUD. Review authors conducted comprehensive search for studies comparing RARC with ORC in terms of incidence of UAS. Furthermore, we conducted a secondary search for studies which compared UAS incidence comparing ECUD and ICUD. We found that RARC may have higher incidence of UAS [OR: 1.39; 95% CI 1.11-1.75; p < 0.0001]. ECUD may result in lower rate of UAS as compared to ICUD [OR: 0.74; 95% CI 0.56 to 0.98; p= 0.04].

Aspirin is widely used for secondary prevention in patients with hypertension. However, previous studies mainly focused on the preventive effects of aspirin, and there has been a lack of reliable evidence on whether taking aspirin affects blood pressure This study aimed to investigate whether aspirin would affect the blood pressure in patients with hypertension.

PubMed, Cochrane database, Embase, Scopus and Medline databases were searched until September 2023. For continuous variables (e.g., blood pressure reduction), the mean difference (MD) was selected as the effect magnitude indices. We used the Cochrane Collaboration's Risk of Bias tool to assess the risk of bias.

A total of five studies were included, comprising 20,312 patients. We found that aspirin did not affect SBP (MD = -0.78, 95% CI: - 2.41, 0.84). A similar result was found for DBP (MD = -0.86, 95% CI: - 2.14, 0.42).

This study showed no significant difference in blood pressure between the aspirin and control groups, suggesting that aspirin does not affect blood pressure.

The clinical data regarding the relationships between body mass index (BMI) and abdominal aortic aneurysm (AAA) are inconsistent, especially for the obese and overweight patients. The aims of this study were to determine whether obesity is associated with the presence of AAA and to investigate the quantitative relationship between BMI and the risk of AAA presence and post-operative mortality.

PubMed, Web of Science and Embase databases were used to search for pertinent studies updated to December 2023. The pooled relative risk (RR) with 95% confidence interval (CI) was estimated by conventional meta-analysis based on random effects model. Dose-response meta-analyses using robust-error meta-regression (REMR) model were conducted to quantify the associations between BMI and AAA outcome variables. Subgroup analysis, sensitivity analysis and publication bias analysis were performed according to the characteristics of participants.

18 studies were included in our study. The meta-analysis showed a higher prevalence of AAA with a RR of 1.07 in patients with obesity. The dose-response meta-analysis revealed a non-linear relationship between BMI and the risk of AAA presence. A "U" shape curve reflecting the correlation between BMI and the risk of post-operative mortality in AAA patients was also uncovered, suggesting the "safest" BMI interval [28.55, 31.05] with the minimal RR.

Obesity is positively but nonlinearly correlated with the increased risk of AAA presence. BMI is related to AAA post-operative mortality in a "U" shaped curve, with the lowest RR observed among patients suffering from overweight and obesity. These findings offer a preventive strategy for AAA morbidity and provide guidance for improving the prognosis in patients undergone AAA surgical repair.

To investigate up-to-date evidence of the effectiveness of neural mobilisation techniques compared with any type of comparator in improving pain, function, and physical performance in people with musculoskeletal pain.

The following sources were consulted: PubMed, Web of Science, CENTRAL, CINAHL, Scopus, and PEDro databases; scientific repositories; and clinical trial registers. The last search was performed on 01/06/2023.

Two reviewers independently assessed the studies for inclusion. We included randomised, quasi-randomised, and crossover trials on musculoskeletal pain in which at least one group received neural mobilisation (alone or as part of multimodal interventions). Meta-analyses were performed where possible. The RoB 2 and the Grading of Recommendations Assessment, Development and Evaluation tools were used to assess risk of bias and to rate the certainty of evidence, respectively.

Thirty-nine trials were identified. There was a significant effect favouring neural mobilisation for pain and function in people with low back pain, but not for flexibility. For neck pain, there was a significant effect favouring neural mobilisation as part of multimodal interventions for pain, but not for function and range of motion. Regarding other musculoskeletal conditions, it was not possible to conclude whether neural mobilisation is effective in improving pain and function. There was very low confidence for all effect estimates.

Neural mobilisation as part of multimodal interventions appears to have a positive effect on pain for patients with low back pain and neck pain and on function in people with low back pain. For the other musculoskeletal conditions, results are inconclusive.

Microvascular obstruction (MVO) is an independent predictor of adverse cardiac events after ST-elevation myocardial infarction (STEMI). The Index of Microcirculatory Resistance (IMR) may be a useful marker of MVO, which could simplify the care pathway without the need for Cardiac Magnetic Resonance (CMR). We assessed whether the IMR can predict MVO in STEMI patients.

We conducted a systematic review and meta-analysis, including articles where invasive IMR was performed post primary percutaneous coronary intervention (PCI) in addition to MVO assessment with cardiac MRI. We searched PubMed, Scopus, Embase, and Cochrane databases from inception until January 2023. Baseline characteristics, coronary physiology and cardiac MRI data were extracted by two independent reviewers. The random-effects model was used to pool the data. Among 15 articles identified, nine articles (n = 728, mean age 61, 81% male) contained IMR data stratified by MVO. Patients with MVO had a mean IMR of 41.2 [95% CI 32.4-50.4], compared to 25.3 [18.3-32.2] for those without. The difference in IMR between those with and without MVO was 15.1 [9.7-20.6]. Meta-regression analyses demonstrated a linear relationship between IMR and TIMI grade (β = 0.69 [0.13-1.26]), as well as infarct size (β = 1.18 [0.24-2.11]) or ejection fraction at 6 months (β = -0.18 [-0.35 to -0.01]).

In STEMI, patients with MVO had 15-unit higher IMR than those without. IMR also predicts key prognostic endpoints such as infarct size, MVO, and long-term systolic function.

The molecular and physiological mechanisms activated in plants during drought stress tolerance are regulated by several key genes with both metabolic and regulatory roles. Studies focusing on crop gene expression following plant growth-promoting rhizobacteria (PGPR) inoculation may help understand which bioinoculant is closely related to the induction of abiotic stress responses.

Here, we performed a meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to summarise information regarding plant-PGPR interactions, focusing on the regulation of nine genes involved in plant drought stress response. The literature research yielded 3,338 reports, of which only 41 were included in the meta-analysis based on the chosen inclusion criteria. The meta-analysis was performed on four genes (ACO, APX, ACS and DREB2); the other five genes (ERD15, MYB, MYC, acdS, WRKY) had an insufficient number of eligible articles.

Forest plots obtained through each meta-analysis showed that the overexpression of ACO, APX, ACS and DREB2 genes was not statistically significant. Unlike the other genes, DREB2 showed statistically significant results in both the presence and absence of PGPR. Considering I2>75 %, the results showed a high heterogeneity among the studies included, and the cause for this was examined using subgroup analysis. Moreover, the funnel plot and Egger's test showed that the analyses were affected by strong publication bias.

This study argues that the presence of PGPR may not significantly influence the expression of drought stress response-related crop genes. This finding may be due to high heterogeneity, lack of data on the genes examined, and significant publication bias.

Despite widespread use, summary evidence from prior meta-analyses has contradictory conclusions regarding whether oseltamivir decreases the risk of hospitalization when given to outpatients. Several large investigator-initiated randomized clinical trials have not yet been meta-analyzed.

To assess the efficacy and safety of oseltamivir in preventing hospitalization among influenza-infected adult and adolescent outpatients.

PubMed, Ovid MEDLINE, Embase, Europe PubMed Central, Web of Science, Cochrane Central, ClinicalTrials.gov, and WHO International Clinical Trials Registry were searched from inception to January 4, 2022.

Included studies were randomized clinical trials comparing oseltamivir vs placebo or nonactive controls in outpatients with confirmed influenza infection.

In this systematic review and meta-analysis, Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed. Two independent reviewers (R.H. and É.B.C.) extracted data and assessed risk of bias using the Cochrane Risk of Bias Tool 2.0. Each effect size was pooled using a restricted maximum likelihood random effects model. The quality of evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.

Hospitalization was pooled as risk ratio (RR) and risk difference (RD) estimates with 95% CIs.

Of 2352 studies identified, 15 were included. The intention-to-treat infected (ITTi) population was comprised of 6166 individuals with 54.7% prescribed oseltamivir. Across study populations, 53.9% (5610 of 10 471) were female and the mean age was 45.3 (14.5) years. Overall, oseltamivir was not associated with reduced risk of hospitalization within the ITTi population (RR, 0.79; 95% CI, 0.48 to 1.29; RD, -0.17%; 95% CI, -0.23% to 0.48%). Oseltamivir was also not associated with reduced hospitalization in older populations (mean age ≥65 years: RR, 1.01; 95% CI, 0.21 to 4.90) or in patients considered at greater risk of hospitalization (RR, 0.65; 0.33 to 1.28). Within the safety population, oseltamivir was associated with increased nausea (RR, 1.43; 95% CI, 1.13 to 1.82) and vomiting (RR, 1.83; 95% CI, 1.28 to 2.63) but not serious adverse events (RR, 0.71; 95% CI, 0.46 to1.08).

In this systematic review and meta-analysis among influenza-infected outpatients, oseltamivir was not associated with a reduced risk of hospitalization but was associated with increased gastrointestinal adverse events. To justify continued use for this purpose, an adequately powered trial in a suitably high-risk population is justified.

Disorders of consciousness (DOC) result from neural system injury and manifest as changes in arousal or awareness. This systematic review and meta-analysis aimed to investigate the therapeutic effects of non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), on consciousness dysfunction in patients with brain disorders.

Literature was systematically searched in Medline, Embase, Cochrane database, Web of Science, EBSCO from inception to May 2023. Only randomized controlled trial with NIBS as an intervention and participants with DOC were included.

A total of 7 studies with 313 participants were included for meta-analysis. Compared with sham- or placebo-stimulation, NIBS can improve the Coma Recovery Scale-Revised scores significantly (mean difference [MD] = 1.96, 95 % confidence interval [CI] = [1.49; 2.43], P <.0001).

NIBS has a significant positive effect in enhancing the symptoms of DOC. Nevertheless, it is imperative for further investigations comprising high-quality research designs and larger sample sizes in order to comprehensively elucidate the effects of NIBS techniques on diverse targets of stimulation within the population of individuals suffering from DOC.

Ketamine is reported as a potent opioid alternative that provides significant reduction in pain with no severe adverse events. However, some studies didn't find its use satisfactory and reported less reduction in pain score with ketamine. The purpose of this study is to compare the efficacy and safety of ketamine versus morphine for the treatment of acute pain in emergency situations.

The PubMed, MEDLINE, PsycINFO EMBASE, Cochrane Library, PROSPERO registry platform, and ClinicalTrials.gov websites were queried in accordance with the PRISMA guidelines in order to locate relevant studies. According to the predefined PICOS criteria, articles were included and event data pertaining to changes in Visual Analog Scale or Numeric Rating Scale pain scales were extracted. Using RevMan and MedCalc, a meta-analysis was conducted to compare the effects of ketamine and morphine for the treatment of acute pain.

Twelve studies met the criteria for inclusion in this meta-analysis. Ketamine was found to be more effective than morphine at reducing pain scores, with an odds ratio of 0.60 (95% CI 0.48 to 0.76). Similarly, no severe adverse events related to ketamine were reported in any study, and it has a low-risk ratio of 0.78 (95% CI 0.70 to 0.87). Egger's Test P values (0.3052) and Begg's Test P values (0.3869) indicate a low risk of bias, and the Bland-Altman plot demonstrates a high degree of concordance.

Ketamine is a potent and effective alternative to morphine for the management of acute pain, and it reduces pain score significantly with minimal side effects.

The optimal cycle of neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) remains controversial. This study aimed to compare the efficacy of three and four cycles of NAC in the treatment of MIBC through a systematic review and meta-analysis of the literature.

Relevant studies were systematically collected and reviewed in PubMed, Medline, Embase, Web of Science Databases, and the Cochrane Library. Relative ratios (RRs), Hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to estimate outcome measures. Studies comparing the pathological response and prognosis of three versus four cycles of NAC for MIBC were included.

Five studies were included in this meta-analysis, including 2190 patients, of whom 1016 underwent three cycles of NAC and 1174 underwent four cycles of NAC. All studies were retrospective cohort studies. We found that 4 cycles of NAC had significantly better cancer-specific survival than 3 cycles (HR = 1.31, 95%CI,1.03-1.67, p = 0.029). There was no significant difference in overall survival between patients who received 3 and 4 cycles of chemotherapy (HR = 1.18, 95%CI = 0.83-1.69, p = 0.345). Similarly, no significant difference was observed in pathological objective response (RR = 0.95, 95%CI= 0.81-1.11, p = 0.515) and complete response rates (RR = 0.87, 95%CI = 0.69-1.11, p = 0.256) in MIBC after 3 or 4 cycles of NAC.

Three and four cycles of NAC had similar pathological responses and prognosis for MIBC, although the cancer-specific survival rate of four cycles was better than that of three cycles.

While neuroblastoma accounts for an estimated 8% of childhood cancers, it causes about 15% of childhood cancer deaths in the United States. The role of agricultural exposures in the development of neuroblastoma is unclear. We conducted a systematic review and meta-analysis of studies examining the relationship between agricultural exposures and neuroblastoma. MEDLINE, EMBASE, Scopus, and Google Scholar were searched in February 2022, identifying 742 publications. Seventeen articles met the inclusion criteria; all were published between 1985 and 2020 and included 14 case-control, one cross-sectional, and two cohort studies. Random and fixed effects models were used to calculate summary odds ratios (sORs) and 95% confidence intervals (CIs). An increased odds of developing neuroblastoma with parental exposure to any pesticides (sOR = 1.25, 95% CI: 1.03-1.48; 4 studies), insecticides (sOR = 1.55, 95% CI: 1.19-1.91; 3 studies), and residential exposure to crops/vegetables (sOR = 1.04, 95% CI: 1.01-1.06; 2 studies) was seen. Heterogeneity was low in all analyses, and no publication bias was evident. No significant associations were found with agricultural occupations, herbicides, and agricultural dusts. The studies were limited by exposure measurements and small sample sizes. Further studies are needed to explore mechanisms in the development of neuroblastoma in children with parental agricultural exposures, especially pesticides, and to improve methods of measuring agricultural-related exposures.

The emergence of multidrug-resistant tuberculosis (MDR-TB) in HIV-positive people poses a significant challenge to international efforts to eradicate tuberculosis (TB). Many studies found conflicting results when examining the correlation between HIV and MDR-TB. The purpose of the present investigation was to comprehensively review the literature on the association between HIV infection and MDR-TB in order to evaluate the impact of HIV on MDR-TB worldwide.

Utilizing the databases PubMed, Scopus, Google Scholar, and ScienceDirect, studies published between January 2000 and March 2023 that are eligible for meta-analysis were selected. Using the random-effects model, the aggregated odds ratio of the empirical relationship between HIV and MDR-TB was calculated, along with a confidence interval ranging from 0 to 95 %. Examining the asymmetry of the funnel plot and utilizing Egger's and Begg's test, the possibility of publication bias was investigated. The extent of heterogeneity was determined using the I2 statistics.

Through a database search, we identified 1214 studies, from which we ultimately selected 15 studies involving 9667 patients. The odds ratio of 2.78 (95 % confidence interval: 1.07-7.20) between HIV/AIDS and MDR-TB indicates a significant positive correlation. Tau 2 = 3.46, chi 2 = 1440.46, df = 14, I2 = 99.0 %, z = 2.10, and p 0.05 indicate that there is substantial heterogeneity among pooled studies. Since I2 is 99 % (>50 %), a random effect model was employed. The percentage of multidrug-resistant HIV-positive patients across all included studies follows a normal distribution, as shown by a Box and whisker plot with a symmetric skewness and a mesokurtic tail and a scatter plot with a significant R2 value below 1 [R2 = 0.2476] showed the positive correlation between multidrug resistance and HIV infection.

HIV infection increases MDR-TB risk, and the preceding pooled analysis showed an increased risk trend. Thus, MDR-TB, especially in HIV-positive patients, requires early case detection, quality-assured bacteriology diagnosis, and an effective infection control program.

Numerous studies have implicated that the gut microbiota is associated with polycystic ovary syndrome (PCOS). However, a comprehensive data-based summary shown that the effects of the PCOS on the gut microbiota is minimal. We aim to assess the alterations of gut microbiota in women with PCOS.

An electronic search of PubMed, Web of Science, Embase, Cochrane Library and Ovid was conducted for eligible studies published from inception to 28 March 2023, without any language or regional restrictions. We used Newcastle-Ottawa Quality Assessment Scale (NOS) to complete the assessment of the risk of bias and Stata 15.1 software to performed meta-analysis.

There were 19 human observational studies in total with 617 women with PCOS and 439 healthy individuals were identified. Compared to the control group, the Chao index (WMD -28.88, 95% CI -45.78 to -11.98, I2 = 100%), Shannon index (WMD -0.11, 95% CI -0.18 to 0.00, I2 = 92.2%); and observed operational taxonomic units (OTUs) counts (WMD - 23.48, 95% CI -34.44 to -12. 53, I2 = 99.6%) were significantly lower in women with PCOS. The relative abundance of Bacteroidaceae was significantly higher (WMD 0.12, 95% CI 0.02 to 0.22, I2 = 9.2%), however there were no statistical differences in Actinobacteria, Bacteroidetes, Firmicutes, Proteobacteria, Alcaligenaceae, Bifidobacteriaceae, Clostridiaceae, Enterobacteriaceae, Lachnospiraceae, Prevotellaceae, Ruminococcaceae, Veillonellaceae, Bacteroides, Bifidobacterium, Blautia, Dialister, Escherichia-Shigella, Faecalibacterium, Lachnoclostridium, Lachnospira, Megamonas, Phascolarctobacterium, Prevotella, Roseburia, and Subdoligranulum.

We demonstrated the alpha diversity of gut microbiota and the relative abundance of Bacteroidaceae in women with PCOS are altered. The results indicates that dysbiosis may be a potential pathogenetic factor in PCOS and provided reliable information to investigate the role of gut microbiota in the development and progression of PCOS.

Sacubitril-valsartan (SV) monotherapy has been shown to help patients with Heart failure with reduced ejection fraction (HFrEF), but whether adding a sodium-glucose cotransporter-2 inhibitor (SGLT2i) improves treatment results even more is unknown.

The goal of this study was to look at the efficacy of SV with additional SGLT2i in HFrEF patients.

For this study, several databases, such as PubMed, EMBASE, Web of Science, and the Cochrane Library, were searched. A coherent search approach was used for data extraction. Review Manager 5.2 and MedCalc were used for conducting the meta-analysis and bias analysis. A meta-regression study correlates patient mean age with primary and secondary outcomes.

Seven trials totaling 16 100 patients were included in this meta-analysis. All-cause mortality, cardiovascular mortality, and improvement in mean left ventricular ejection fraction (LVEF) were the study's major objectives, while hospitalization for heart failure (HF) was calculated to be its secondary outcome. Our analysis showed that HFrEF patients receiving the combination of SV and SGLT2i had better treatment outcomes than the standard SV monotherapy, with risk ratios of 0.76 (0.65-0.88) for all-cause mortality, 0.65 (0.49-0.86) for cardiovascular mortality, 1.41 (-0.59 to 3.42) for change in mean LVEF, and 0.80 (0.64-1.01) for hospitalization for HF. According to the regression analysis, older HFrEF patients have higher rates of hospitalization, cardiovascular disease, and overall death.

The combination of SV and SGLT2i may have a greater cardiovascular protective effect and minimize the risk of death or hospitalization due to heart failure in HFrEF.

Laminar airflow (LAF) technologies minimize infectious microorganisms to enhance air quality and surgical site infections (SSIs). LAF lowers SSIs in some clinical studies but not others. This study analyzes laminar airflow ventilation's capacity to reduce orthopaedic surgery-related SSIs.

The PRISMA-compliant keywords were utilized to conduct a search for pertinent articles in various databases including PubMed, MEDLINE, CENTRAL, Web of Sciences, and the Cochrane databases. Observational studies, including retrospective, prospective, and cohort designs, satisfy the PICOS criteria for research methodology. The assessment of quality was conducted utilizing the Robvis software, while the meta-analysis was performed using the RevMan application. The study's results were assessed based on effect sizes of odds ratio (OR) and risk ratio (RR).

From 2000 to 2022, 10 randomized controlled clinical trials with 10,06,587 orthopaedic surgery patients met the inclusion criteria. The primary outcomes were: (1) Risk of SSI, (2) Bacterial count in sampled air and (3) Reduction in SSIs. The overall pooled OR of all included studies was 1.70 (95% CI 1.10-2.64), and the overall pooled RR was 1.27 (95% CI 1.02-1.59) with p < 0.05. LAF is ineffective at preventing SSIs in orthopaedic procedures due to its high-risk ratio and odds ratio.

The present meta-analysis has determined that the implementation of LAF systems does not result in a significant reduction in the incidence of surgical site infections (SSIs), bacterial count in the air, or SSIs occurrence in orthopaedic operating rooms. Consequently, the installation of said equipment in operating rooms has been found to be both expensive and inefficient.

Background: Ginseng consumption has been associated with various health outcomes. However, there are no review articles summarizing these reports. Methods: PubMed, Embase, the Cochrane Library of Systematic Reviews, Scopus, CNKI and Wanfang databases were searched from inception to 31 July 2022. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) systems were used to assess the methodological quality and quality of evidence in each meta-analysis, and the results were summarized in a narrative form. Results: Nineteen meta-analyses that met the eligibility criteria were identified from among 1,233 papers. The overall methodological quality was relatively poor, with only five studies being low-quality, and 14 critically low-quality. When compared with control treatments (mainly placebo), ginseng was beneficial for improving fatigue and physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina and respiratory diseases. Adverse events included gastrointestinal symptoms and potential bleeding; however, no serious adverse events were reported. Conclusion: This umbrella review suggests that ginseng intake has beneficial therapeutic effects for diverse diseases. However, the methodological quality of studies needs to be improved considerably. In addition, it is imperative to establish the clinical efficacy of ginseng through high-quality randomized controlled trials.

Diet is emerging as a modifiable component of lifestyle for influencing the incidence of liver cancer.

To investigate and quantify the potential relationship between food groups and liver cancer.

PubMed and Web of Science were searched for eligible observational studies until 31st March, 2023.

The meta-analysis was conducted by pooling relative risk (RR), odds ratio (OR) or hazards ratio (HR) with 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by subgroup analysis. Sensitivity analysis and publication bias test were also carried out.

Through stepwise screening, a total of 27 studies were included. The pooled estimates of liver cancer for whole grains and legumes intake were 0.66 (95% CI: 0.54-0.82; I² = 25.3%) and 0.86 (95% CI: 0.75-0.99; I² = 14.3%), respectively. However, there were null associations of nuts, poultry, egg and sweetened beverages consumption with liver cancer and the association between refined grains and liver cancer was inconclusive. In dose-response meta-analysis, the pooled estimates of liver cancer were 0.77 (95% CI: 0.65-0.91) for every 50 g/day increment in whole grains intake. Non-linear dose-response relationship (P = 0.031) was observed in the association between the intake of legumes and liver cancer, and the protective effect occurred with the dose ranging from 8 g/day to 40 g/day.

This meta-analysis shows that whole grains and legumes were inversely associated with liver cancer, whereas intake of nuts, poultry, egg and sweetened beverages may not be associated with liver cancer. Further quantitative research needs to be undertaken within a range of populations to investigate the relationship between food groups and liver cancer.

PROSPERO registration no. CRD42021246142.