Search

Aims/Introduction: An overrepresentation of epilepsy has been suggested in patients with type 1 diabetes (T1D). This meta-analysis was conducted to evaluate if type 1 diabetes is associated with a higher incidence of epilepsy. Materials and Methods: Longitudinal observational studies which are relevant to the purpose of the meta-analysis were screened and obtained by searching PubMed, Embase, and Web of Science databases. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Results: Six observational studies involving 10 datasets of 8,001,899 participants were included, with six datasets including children and only one dataset including older people. Among them, 100,414 (1.25%) had type 1 diabetes. During the follow-up duration of 5.4-15.2 years (mean: 9.5 years), 98,644 cases (1.23%) of epilepsy were observed. Compared with participants with normoglycemia, those with type 1 diabetes were shown to have a higher incidence of epilepsy (risk ratio [RR]: 2.41, 95% confidence interval 1.69-3.44, P < 0.001; I2 = 95%) after adjustment of potential confounding variables including age and sex. Subgroup analysis showed consistent results in nested case-control and retrospective cohort studies, and in studies of children, non-elderly adult, and older participants (P for subgroup difference = 0.42 and 0.07). In addition, a stronger association of type 1 diabetes and epilepsy was suggested in studies with follow-up duration <10 years compared with those =10 years (RR: 3.34 vs 1.61, P for subgroup difference < 0.001). Conclusion: Patients with type 1 diabetes may have a higher risk of epilepsy, which was mainly driven by datasets including children. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the long‐term efficacy, safety, and cumulative retention rate of antitumor necrosis factor‐alpha (anti‐TNF‐α) therapy for patients with Behcet's uveitis (BU) using meta‐analysis. Methods: We searched the Web of Science and PubMed databases for eligible studies up to December 1, 2022. The quality of each identified study was assessed using the Joanna Briggs Institute's case series literature quality assessment tool. Statistical analysis was conducted using Stata 16.0 software with a random‐effects model. Results: Twelve studies comprising 1156 patients with BU were included in our analysis. We found that 85.0% of patients achieved ocular inflammation remission after receiving anti‐TNF‐α treatment, with a 95% confidence interval (CI) ranging from 78.7% to 90.5%. Additionally, 77.4% (95% CI: 57.5%–92.5%) experienced an improvement in visual acuity (VA). Moreover, the pooled dose reduction of glucocorticoids (GCs) was 11.08 mg (95% CI: −13.34 mg to −8.83 mg). Throughout the follow‐up period, the cumulative retention rate of the medication was 67.3% (95% CI: 53.7%–79.6%). Serious adverse events occurred in 5.8% (95% CI: 3.1%–8.9%) of cases, with the three most common types being severe infusion or injection reactions (2.7%; 95% CI: 0.8%–5.4%), tuberculosis (1.3%; 95% CI: 0.0%–3.9%), and bacterial pneumonia (1.3%; 95% CI: 0.1%–3.4%). Subgroup analysis revealed that ocular inflammation remission rates were 89.3% (95% CI: 81.2%–95.5%) for adalimumab treatment and 83.7% (95% CI: 75.3%–90.8%) for infliximab treatment. The drug retention rate after adalimumab therapy was 70.3% (95% CI: 62.0%–78.0%) compared to 66.4% (95% CI: 48.6%–82.2%) for infliximab treatment. Furthermore, the incidence of severe infusion or injection reactions was 2.2% (95% CI: 0.1%–5.8%) following adalimumab treatment and 3.5% (95% CI: 0.7%–7.7%) following infliximab treatment. Conclusions: Anti‐TNF‐α therapy represents an effective treatment for BU patients with favorable safety profile and high drug retention rate and a potential advantage of adalimumab over infliximab in terms of ocular inflammation remission, drug retention, and the incidence of severe infusion or injection reactions. [ABSTRACT FROM AUTHOR]

Summary: Polysomnographic studies have been performed to investigate the first‐night effect in insomnia disorder. However, these studies have revealed discrepant findings. This meta‐analysis aimed to summarise and quantify the characteristics of the first‐night effect in insomnia disorder. We performed a systematic search of the PubMed, Medline, EMBASE, Web of Science and PsycINFO databases to identify studies published through October 2019. A total of 11,862 articles were identified, and seven studies with eight independent populations were included in the meta‐analysis. A total of 639 patients with insomnia disorder and 171 healthy controls underwent more than 2 consecutive nights of in‐laboratory polysomnography. Pooled results demonstrated that both variables of sleep continuity and sleep architecture, other than slow‐wave sleep were significantly altered in the first‐night effect in insomnia disorder. Furthermore, the results indicated that patients with insomnia disorder had a disruption of sleep continuity in the first‐night effect, including increased sleep onset latency and reduced total sleep time, compared to healthy controls. Overall, the findings show that patients with insomnia disorder experience the first‐night effect, rather than reverse first‐night effect, and the profiles of the first‐night effect in patients with insomnia are different from healthy controls. These indicate that an adaptation night is necessary when sleep continuity and sleep architecture is to be studied in patients with insomnia disorder. More well‐designed studies with large samples are needed to confirm the results. [ABSTRACT FROM AUTHOR]

Background and Objective: Recently, vonoprazan‐amoxicillin (VA) dual therapy has been reported as a promising approach for Helicobacter pylori (H. pylori) eradication. However, the effects of VA therapy versus bismuth‐containing quadruple therapy (BQT) on H. pylori eradication remains unclear. The objective of this meta‐analysis was to compare the effects of VA dual therapy with BQT for H. pylori eradication. Methods: A comprehensive search of the literature was conducted from the beginning to September 2023, utilizing PubMed, Embase, the Cochrane Library and Web of Science database. A random‐effects model was used to perform a meta‐analysis to determine the pooled relative risk (RR) with 95% confidence intervals (CIs). Moreover, trial sequential analysis (TSA) was conducted to evaluate the conclusiveness of the H. pylori eradication rate. Results: Six randomized controlled trials (RCTs) with 1233 patients were included. The VA therapy has similar eradication rate (ITT analysis: 87% vs. 85.7%, RR = 1.01, 95% CI: 0.93–1.09, p = 0.84; PP analysis: 92.5% vs. 93.2%, RR = 1.00, 95% CI: 0.94–1.06, p = 0.97) and compliance (RR = 1.01, 95% CI: 0.99–1.03, p = 0.32) compared to BQT. The VA therapy group had a significantly lower incidence of total adverse events than the BQT group (16.3% vs. 40.0%, RR = 0.45, 95% CI: 0.37–0.55, p < 0.00001). The TSA result showed that the effect was conclusive. Conclusions: Current evidence indicated that VA therapy is just as successful as BQT in eliminating H. pylori, yet it has fewer adverse events and similar compliance. [ABSTRACT FROM AUTHOR]

Background: Although the 308 nm excimer laser is commonly used to cure vitiligo, its clinical efficacy is limited. Experts have found that the efficacy of compound glycyrrhizin tablets combined with the 308 nm excimer laser in the treatment of vitiligo is significantly enhanced, but the specific research methods and clinical data must be clarified. Objective: To determine the clinical efficacy of compound glycyrrhizin tablets combined with the 308 nm excimer laser in the treatment of vitiligo. Methods: Until August 2022, studies were searched in PubMed, the Cochrane Library, the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, and the Wan Fang Database. We also searched for clinical RCTs involving compound glycyrrhizin tablets combined with the 308 nm excimer laser for the treatment of vitiligo. The meta‐analysis was conducted in accordance with the Cochrane Handbook's recommendations. Two reviewers regulated the study selection, data extraction, and assessment of bias risk, and consulted a third reviewer as necessary. For the meta‐analysis, Review Manager 5.4 was utilized. Results: Finally, 9 articles and 1052 patients were included. A systematic review compared the efficacy of compound glycyrrhizin tablets combined with the 308 nm excimer laser to that of the 308 nm excimer laser alone: OR = 3.33, p < 0.00001, 95% confidence interval [2.25, 4.92]. Conclusion: In the treatment of vitiligo, compound glycyrrhizin tablets combined with the 308 nm excimer laser are more effective than the 308 nm excimer laser alone, and there are no serious adverse reactions. It is a safe and efficient way of treatment. [ABSTRACT FROM AUTHOR]

Cerebrospinal fluid (CSF) phosphorylated tau231 (P‐tau231) is associated with neuropathological outcomes of Alzheimer's disease (AD). The invasive access of cerebrospinal fluid has greatly stimulated interest in the identification of blood‐based P‐tau231, and the recent advent of single‐molecule array assay for the quantification of plasma P‐tau231 may provide a turning point to evaluate the usefulness of P‐tau231 as an AD‐related biomarker. Yet, in the plasma P‐tau231 literature, findings with regard to its diagnostic utility have been inconsistent, and thus, we aimed to statistically investigate the potential of plasma P‐tau231 in the context of AD via meta‐analysis. Publications on plasma P‐tau231 were systematically retrieved from PubMed, EMBASE, the Cochrane library and Web of Science databases. A total of 10 studies covering 2007 participants were included, and we conducted random‐effect or fixed‐effect meta‐analysis, sensitivity analysis and publication bias analysis using the STATA SE 14.0 software. According to our quantitative integration, plasma P‐tau231 increased from cognitively unimpaired (CU) populations to mild cognitive impairment to AD and showed significant changes in pairwise comparisons of AD, mild cognitive impairment and CU. Plasma P‐tau231 level was significantly higher in CU controls with positive amyloid‐β (Aβ) status compared with Aβ‐negative CU group. Additionally, the excellent diagnostic accuracy of plasma P‐tau231 for asymptomatic Aβ pathology was verified by the pooled value of area under the receiver operating characteristic curves (standard mean difference [95% confidence interval]:.75 [.69,.81], P < 0.00001). Overall, the increased plasma P‐tau231 concentrations were found in relation to the early development and progression of AD. [ABSTRACT FROM AUTHOR]

Background: Conventional fractional lasers (FLs) are well‐established treatments for acne scars with some inevitable adverse events. Fractional picosecond laser (FPL) is increasingly used for acne scars. Aims: To compare the efficacy and safety of FPL with non‐picosecond FLs for acne scars. Methods: PubMed, Embase, Ovid, Cochrane Library, and Web of Science databases were searched. We also searched ClinicalTrials, WHO ICTRP, and ISRCTN websites. A meta‐analysis was conducted to assess the clinical improvement and adverse events after FPL compared with other FLs. Results: Overall, seven eligible studies were included. Three physician evaluation systems showed no difference between FPL and other FLs in clinical improvement of atrophic acne scars (MD = 0.64, 95% CI:−9.67 to 10.94; MD = −0.14, 95% CI:‐0.71 to 0.43; RR = 0.81, 95% CI:0.32 to 2.01). Patient‐assessed effectiveness was also not significantly different between FPL and other FLs (RR = 1.00, 95% CI:0.69 to 1.46). Although temporary pinpoint bleeding was more common after FPL (RR = 30.33, 95% CI:6.14 to 149.8), the incidence of post‐inflammatory hyperpigmentation (PIH) and pain level were lower for FPL (RR = 0.16, 95% CI:0.06 to 0.45; MD = −1.99, 95% CI:−3.36 to −0.62). Additionally, edema severity after treatment did not differ between the two groups (MD = −0.35, 95% CI:−0.72 to 0.02). As for the duration of erythema, no difference between FPL and nonablative FL groups (MD = −1.88, 95% CI:−6.28 to 2.51). Conclusions: FPL seems similar to other FLs regarding clinical improvement of atrophic acne scars. With lower PIH risk and pain scores, FPL is more suitable for acne scar patients prone to PIH or sensitive to pain. [ABSTRACT FROM AUTHOR]

Background: Lactoferrin is a versatile protein with important modulatory functions in inflammation and immune response. This glycoprotein can bind and sequester iron and LPS, thereby intervening in certain signaling pathways and biological processes. In the present meta‐analysis, we aimed to pool experimental data regarding the immunomodulatory effects of lactoferrin and its derived peptides on the NF‐κB signaling pathway. Materials: We searched PubMed, Google Scholar, and Web of Science databases and obtained all related articles published before April 2022. Finally, 25 eligible studies were selected, and their reports were analyzed. Methods: We used Review Manager Version 5.2 to compute the standardized mean difference (SMD) and its 95% confidence interval. In addition, the source of heterogeneity was explored using meta‐regression and sensitivity analysis. The symmetry of the funnel plot and Egger's test were also used to evaluate publication bias utilizing Comprehensive Meta‐Analysis Version 2. Results: Comparing the group of cells and animals exposed to lipopolysaccharide alone with the group that received pretreatment with lactoferrin and its derivatives, we observed significant reductions in TNF‐α, IL‐1 beta, and IL‐6 levels by 8.73 pg/mL, 2.21 pg/mL, and 3.24 pg/mL, respectively, in the second group. Additionally, IKK‐β, p‐IκB, and NF‐κB (p65) levels were significantly lower by 7.37‐fold, 15.02‐fold, and 3.88‐fold, respectively, in various cells and tissues. Conclusion: Based on the results of this meta‐analysis, lactoferrin and its derived peptides can be considered potent prophylactic and therapeutic candidates against inflammation‐associated diseases by targeting the NF‐kB pathway. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that ambient temperature is associated with the morbidity and mortality of stroke although results among these investigations remained unclear. Therefore, the purpose of present meta‐analysis was to summarize the evidence of the relationship between ambient temperature and stroke morbidity and mortality. Methods: A systematic search of the PubMed, Embase, and Web of Science databases was from inception to April 13, 2022. The pooled estimates for heat ambient temperature and cold ambient temperature, which were defined as comparison between extreme hot or cold conditions and the reference or threshold temperature, were calculated utilizing a random‐effects model. A total of 20 studies were included in the meta‐analysis. Results: The pooled estimated show that the heat ambient temperature was significant associated with 10% (relative risk [RR], 1.10; 95% confidence interval [95%CI]: 1.02–1.18) and 9% (RR, 1.09; 95%CI: 1.02–1.17) increase in the risk of stroke morbidity and mortality, respectively. In addition, the pooled estimated show that the cold ambient temperature was significant associated with 33% (RR, 1.33; 95%CI: 1.17–1.51) and 18% (RR, 1.18; 95%CI: 1.06–1.31) increase in the risk of stroke morbidity and mortality, respectively. Conclusion: Integrated epidemiological evidence supports the hypothesis that both heat and cold ambient temperature have positive association with the risk of stroke morbidity and mortality. Targeted measures should be promoted in public health to reduce this risk. [ABSTRACT FROM AUTHOR]

Previous estimates to meta‐analyze administration error rates were limited by the high statistical heterogeneity, restricting their use. This study aimed to investigate sources of heterogeneity in pooled administration error rates in hospitalized adults. We systematically searched scientific databases up to November 2017 for studies presenting error rates/relevant numerical data in hospitalized adults. We conducted separate meta‐analyses for the numerators: One Medication Error (OME) (each dose can be correct or incorrect) and Total Number of Errors (TNE) (more than one error per dose could be counted), using the generic inverse variance with a 95% confidence interval. Heterogeneity was assessed using the I2 and Cochran's Q test. We meta‐analyzed 33 studies. The global pooled analyses based on the OME and TNE numerators showed very high heterogeneity (I2 = 100%; p < 0.00001). For each meta‐analysis, subgroup analyses based on study characteristics (countries, wards, population, routes of administration, error detection methods, and medications) yielded results with consistently elevated heterogeneity. Beyond these characteristics, we stratified the studies according to the mean error prevalence level as the threshold. Based on the OME numerator, we identified two subgroups of low (0.15[0.13–0.17]; I2 = 0%; p = 0.43) and high (0.26[0.24–0.27]; I2 = 38%; p = 0.17) pooled prevalence rates, with controlled heterogeneity. Similarly, for the TNE numerator, we identified two subgroups of low (0.10[0.09–0.10]; I2 = 0%; p = 0.76) and high (0.28[0.27–0.29]; I2 = 0%; p = 0.89) pooled prevalence rates, with controlled heterogeneity. These subgroups differed regarding the denominators used: Total opportunities for errors versus others (doses, observations, administrations). Calculation methods, specifically the denominator, seem a primary factor in explaining heterogeneity in error rates. Standardizing numerators, denominators, and definitions is necessary. [ABSTRACT FROM AUTHOR]

Objective: To explore whether narrow‐band imaging (NBI) endoscopy is accurate in the diagnosis of malignant transformation of vocal cord leukoplakia. Methods: The PubMed, Embase, Cochrane Library and Web of Science databases were searched to collect data on studies reporting the use of NBI endoscopy as a diagnostic test for diagnosing vocal cord leukoplakia from January 2015 to December 2021. Study design, analysis method, and extraction results were performed according to the PRISMA guidelines. The sensitivity, specificity, pooled positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) were used to summarize the performance metrics of the meta‐analysis. Risk of bias data and the quality of the included studies was evaluated according to the Quality Assessment of Diagnostic Accuracy Studies‐2 tool (QUADAS‐2). Results: Nine studies were finally included in the analysis. The results of the meta‐analysis showed that the pooled sensitivity and specificity of NBI endoscopy for diagnosing leukoplakia lesions were 0.76 (95% CI: 0.72–0.8) and 0.93 (95% CI: 0.91–0.95), respectively. The PLR and NLR were 10.09 (95% CI: 6.53–15.59) and 0.22 (95% CI: 0.13–0.38), respectively. The comprehensive diagnostic odds ratio (DOR) was 54.96 (95% CI: 24.32–124.17), and the area under the curve was 0.9584. The eight articles had a low risk of bias risk and one article was unclear. Conclusion: NBI likely has good accuracy for diagnosing malignant transformation of vocal cord leukoplakia. However, multicenter studies and large samples are still needed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the comprehensive prevalence of anxiety among postgraduates and estimate its changes with a meta‐analysis. Method: Systematic retrieval to SAGE, ERIC, EBSCO, Wiley, ScienceDirect, ProQuest, PubMed, EMBASE, and Web of Science database was performed for quantitative studies on the prevalence of anxiety among graduate students published before November 22, 2022. The prevalence of anxiety synthesized with random‐effects model, and subgroup analysis was conducted by study characteristics (publication year, sampling method, and measurements) and subjects' characteristics (gender, region, and educational level). Result: Fifty studies were included in the meta‐analysis, totaling 39,668 graduate students. The result revealed that 34.8% of graduates suffered from the anxiety (95% CI: 29.5%–40.5%). Specifically, 19.1% (95% CI: 15.4%–23.5%) had mild anxiety, 15.1% (95% C: 11.6%–19.6%) had moderate anxiety, and 10.3% (95% CI: 7.2%–14.6%) had severe anxiety. And this prevalence showed a upward trend since 2005. Besides, master students suffered slightly less than doctoral students (29.2% vs. 34.3%), and female had similar anxiety to male (26.4% vs. 24.9%). Due to the COVID‐19, the prevalence of anxiety is higher after the pandemic than that before (any anxiety: 34.3% vs. 24.8%). Compared with other countries, students from Saudi Arabia, India, and Nepal were more vulnerable. The results of quality assessment showed that, 5 (10%) were in high quality, 21 (42%) were in moderate to high quality, 21 (42%) were in low to moderate quality, and 3 (6%) were in low quality. But, the studies with low quality tend to report a higher prevalence than that with high quality (40.3% vs. 13.0%), studies with nonrandom sampling tend to report a higher prevalence than that with random sampling (33.6% vs. 20.7%). Although we included the data collected based on the standard scales, there were higher heterogeneity among the measure (Q = 253.1, df = 12, p <.00). Conclusion: More than one‐third postgraduates suffered from anxiety disorder, and this prevalence had a slight upward trend since 2005, school administrators, teachers and students should take joint actions to prevent mental disorder of graduates for deteriorating. [ABSTRACT FROM AUTHOR]

Objective: To comprehensively evaluate the diagnostic efficacy of adenosine deaminase in cerebrospinal fluid (CSF) for tuberculous meningitis (TBM), and the potential influence of patients' age groups and cutoffs of measured adenosine deaminase. Methods: Systematic review and meta‐analysis of relevant studies retrieved from PubMed, Embase, and Web of Science databases. Pooled sensitivity and specificity were calculated with a random‐effect model. Results: Overall, 43 studies with 1653 patients with TBM and 3417 controls without were included. Pooled results showed that adenosine deaminase in CSF is associated with satisfactory diagnostic efficacy for TBM, with a pooled sensitivity of 0.86 (95% confidence interval [CI]: 0.82–0.90), specificity of 0.89 (95% CI: 0.86–0.91), positive likelihood ratio of 7.70 (95% CI: 6.16–9.63), and negative likelihood ratio of 0.15 (95% CI: 0.12–0.20). The pooled receiver operating characteristic (AUC) was 0.94 (95% CI: 0.91–0.96), suggesting good performance. Subgroup analyses showed good diagnostic efficacies of adenosine deaminase in CSF for both adults (AUC 0.95) and children (AUC 0.96) with TBM. AUCs indicating the diagnostic accuracies of adenosine deaminase in CSF for TBM were 0.93 for studies with cutoffs <10 U/L and and 0.94 for a cutoff =10 U/L, but only 0.90 for studies with cutoffs >10 U/L. Conclusions: Measuring adenosine deaminase of CSF shows satisfactory diagnostic efficacy for TBM in children and adults, particularly if using a cutoff ≤10 U/L. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have manifested long noncoding RNAs (lncRNAs) as biomarkers to determine the prognosis of multiple myeloma (MM) patients. Nevertheless, the prognostic role of lncRNAs in MM is still ambiguous. Herein, we performed a meta‐analysis to evaluate the predictive value of aberrantly expressed lncRNAs in MM. Methods: A systemic literature search was performed in PubMed, EMBASE, Cochrane, and Web of Science databases until October 9, 2021, and the protocol was registered in the PROSPERO database (CRD42021284364). Our study extracted the hazard ratios (HRs) and 95% confidence intervals (CIs) of overall survival (OS), progression‐free survival (PFS), or event‐free survival (EFS). Begg's and Egger's tests were employed to correct publication bias. Result: Twenty‐six individual studies containing 3501 MM patients were enrolled in this study. The results showed that aberrant expression of lncRNAs was associated with poor OS and PFS of MM patients. The pooled HRs for univariate OS and PFS were 1.48 (95% CI = 1.17–1.88, p < 0.001) and 1.30 (95% CI = 1.18‐1.43, p < 0.001), respectively, whereas the pooled HRs for multivariate OS and PFS were 1.50 (95% CI = 1.16‐1.95, p < 0.001) and 1.59 (95% CI = 1.22‐2.07, p < 0.001), respectively. Subgroup analysis suggested that MALAT1, TCF7, NEAT1, and PVT1 upregulation were associated with poor OS (p < 0.05), PVT1, and TCF7 upregulation were implicated with worse PFS (p < 0.05), while only TCF7 overexpression was correlated with reduced EFS (p < 0.05). Moreover, the contour‐enhanced funnel plot demonstrated the reliability of our current conclusion, which was not affected by publication bias. Conclusion: Aberrantly expressed particular lncRNAs are critical prognostic indicators in long‐term survival as well as promising biomarkers in progression‐free status. However, different cutoff values and dissimilar methods to assess lncRNA expression among studies may lead to heterogeneity. [ABSTRACT FROM AUTHOR]

Background: Melasma is considered as a type of acquired facial pigmentary disorder that is challenging to treat. Low‐fluence 1064 nm Q‐switched Nd: YAG laser (LQSNY) has clinical benefits against melasma; however, there are some disputes. Objective: To explore these contentious views, we conducted a meta‐analysis and systematic review to evaluate the efficacy and safety of LQSNY monotherapy and combined therapy for the treatment of melasma. Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant articles from inception to July 2021. The resulting data were analyzed using the Review Manager 5.3 software. Results: Twelve eligible studies comprising 358 patients were included. No significant differences in melasma area and severity index (MASI) were observed between the LQSNY and drug groups (mean difference (MD):−0.26, 95% confidence interval (CI):−1.16–0.64, p = 0.57). We found that combination therapy with LQSNY and drugs had a greater MASI improvement compared with LQSNY therapy alone (MD: 1.78, 95% CI 0.93–2.63, p < 0.0001); nevertheless, no statistically significant results were found in melanin index (MI) and self‐assessment. The melasma improvement was similar when using LQSNY alone and LQSNY combined with other lasers in terms of RMASI (MD 0.05, 95% CI:−0.61, 0.70, p = 0.56). Compared with intense pulsed light (IPL) alone, LQSNY with IPL provided an added benefit for melasma severity (MD:3.23, 95% CI:0.65–5.81, p = 0.01). Conclusion: Low‐fluence 1064 nm Q‐switched Nd: YAG laser can be applied as an alternative treatment for drug intolerance. Combination therapy with LQSNY and drugs or other lasers may have pleasantly surprising efficacy, but numerous studies are still needed to verify this. [ABSTRACT FROM AUTHOR]

Statistics plays a key role in many areas of modern society, including technology, social and behavior studies, economics, and the sciences. Statistics anxiety (SA) has a detrimental impact on academic experiences in university populations, although the mediating factors remain underexplored. We conducted the first systematic review and meta‐analysis focused on SA in university students in the context of statistical performance, individual differences in statistical learning, self‐perceptions regarding the statistics course and instructor, and sociodemographic factors. Searches were carried out in the PsycINFO, PubMed, Scielo, and Web of Science databases according to our preregistration. Forty studies were selected for systematic review. Seventeen were included in a series of six meta‐analyses concerning academic achievement, attitudes, self‐perception, procrastination, and gender. The findings reveal learning strategies, procrastination, self‐efficacy, and self‐awareness as predictors of SA. However, the impact of sociodemographic data in these moderators is still uncharted. We conclude with a critical appraisal of the selected studies and present future directions for research in SA. [ABSTRACT FROM AUTHOR]

Summary: It is unclear whether maternal working time has an impact on offspring's weight‐related outcomes especially obesity; the objective of this study is to conduct the first meta‐analysis to focus on this topic. We searched PubMed, Ovid, and Web of Science databases through August 2021. A random‐effect model was used to assess the pooled odds ratios (ORs) and regression coefficients (β) with their corresponding 95% confidence intervals (95% CIs). Subgroup analyses were conducted to explore sources of heterogeneity. Publication bias was evaluated by the Egger's tests. Twenty‐two observational studies were included with a total of 191,420 participants. Compared with children whose mothers worked less than 35 h/week, we found that children whose mothers worked more than 35 to 40 h/week had a 2.24‐fold increased risk of childhood overweight/obesity (OR = 2.24, 95% CI: 1.61–3.11). An increment of 10 h/week in maternal working was associated with an approximately 1.0 percentage points in the probability of childhood overweight/obesity (β = 0.008, 95% CI: 0.004–0.012). The pooled OR also indicated a similar result (OR = 1.09, 95% CI: 1.04–1.15). In addition, an increment of 10 h/week in maternal working was associated with 0.029 units increase in offspring's BMI z score (β = 0.029, 95% CI: 0.016–0.042). Maternal long working hours is a potential risk factor for offspring's weight‐related outcomes. Measures should be taken to protect the work welfare of females, thus facilitating the positive interaction of individual–family–society. [ABSTRACT FROM AUTHOR]

Background: Desmopressin acetate was recommended for nocturia in benign prostatic hyperplasia (BPH) patients recently, but its effect and safety is still controversial. We aimed to establish a systematic review and meta‐analysis to confirm its effect on symptom relief and adverse effects. Methods: A systematic search was performed in PubMed, Cochrane Library, EMBASE, Medline, Web of Science and Science Direct databases from January 2000 to October 2021 for controlled trials of BPH patients comparing oral desmopressin with control groups. The mean difference (MD) and odds ratio (OR) were meta‐analyzed. Results: Four articles with 500 patients were included. Significantly greater benefit was detected for the desmopressin group in the improvement of nocturia (P =.004), international prostate symptom score – storage (IPSS‐S) (P =.03), and quality of life (QoL) (P =.04) scores. Patients treated with desmopressin were at higher risk than the control group for short‐term adverse events (P <.001), including nausea (4.71%, P =.04), headache (20%, P <.00001), dizziness (5.88%, P =.02) and hyponatremia (4.71%, P =.04), but the long‐term incidence might decrease. Conclusion: Desmopressin acetate can reduce nocturia frequency and improve the IPSS‐S and QoL score in BPH patients. Some adverse reactions of desmopressin, such as hyponatremia, headache, dizziness and nausea, may be mild and short‐term. No significant difference of desmopressin was found in improving the overall IPSS score and maximum urine flow. [ABSTRACT FROM AUTHOR]

Background: Although the negative impacts of idiopathic hirsutism (IH) on psychological aspects are well‐documented, there is no enough study estimating the prevalence of this endocrine disorder. Objective: This meta‐analysis was conducted to estimate the pooled prevalence of IH in the women population. Methods: PubMed, Scopus, and Web of Science databases were explored to obtain papers published from inception to September 2020 investigating the prevalence of IH in women. A meta‐regression was conducted to assess the impact of polycystic ovary syndrome (PCOS) diagnostic criteria, and ethnicity on the pooled prevalence of IH. Results: Of 8346 records retrieved through searching databases and other sources, eight studies were selected for the final analyses. The pooled prevalence of idiopathic hirsutism among women, regardless of PCOS diagnostic criteria, and the race was 7.74% (95% CI: 4.10, 14.14). The meta‐regression analysis showed that the pooled prevalence of idiopathic hirsutism did not significantly differ based on the PCOS diagnostic criteria and ethnicity. A subgroup analysis based on the PCOS criteria showed the pooled prevalence of 7.24% (95% CI: 2.84, 17.24), 13.05% (95% CI: 10.02, 16.81), and 3.12% (95% CI: 2.16, 4.48) for NIH (National Institutes of Health), Rotterdam, and not reported PCOS diagnostic criteria groups, respectively. The subgroup analysis based on the ethnicity estimated a pooled prevalence of 6.01% (95% CI: 1.87, 17.69) and 9.36% (4.07, 16.63) for European and Asian groups, respectively. Conclusion: The meta‐analysis demonstrated that the pooled prevalence of IH was 7.74% and there was no difference between PCOS criteria and ethnicity subgroups. [ABSTRACT FROM AUTHOR]

Background: Percutaneous ethanol injection (PEI) is used for the treatment of benign cystic thyroid nodules. This systematic review and meta‐analysis aimed to obtain strong evidence of its long‐term efficacy and safety. Methods: PubMed, CENTRAL, Scopus and Web of Science databases were searched until November 2020 for studies reporting data on volume reduction rate (VRR), compressive symptoms and cosmetic concerns. Associated complications were assessed. A random‐effects model was designed to pool the data. Results: Out of 385 papers, nine studies evaluating 1667 nodules were finally included. Overall, VRR at 6, 12, 24, 36, 60 and 120 months was 77%, 81%, 72%, 68%, 74% and 69%, respectively. Significant reductions in the compressive symptoms and cosmetic concerns were observed. No permanent complications were observed. Conclusions: The present meta‐analysis showed that PEI could significantly reduce the volume of benign cystic thyroid nodules. This reduction was already effective at 6 months post‐treatment, and the effect was stable over time. [ABSTRACT FROM AUTHOR]

Comparing mainly clinical and functional outcomes as well as prosthesis survival with neutral and residual mild varus alignment, we searched PubMed, Embase, Cochrane Library and Web of Science databases from 1 January 1974 to 18 December 2020 to identify studies comparing clinical and functional outcomes as well as prosthesis survival in the presence of different alignments after total knee arthroplasty (TKA) for varus knees. The included studies were assessed by two researchers according to the Newcastle–Ottawa Scale (NOS). Postoperative neutral alignment (0° ± 3°) was compared to residual mild varus (3°–6°) and residual severe varus (>6°). Meta‐analysis was performed using Review Manager 5.3. The odds ratios (OR) and mean differences (MD) were used to compare dichotomous and continuous variables. The fixed‐effect model and random‐effect model were used to meta‐analyze the data. Nine studies were included in the meta‐analysis with 1410 cases of postoperative neutral alignment, 564 of residual mild varus alignment and 175 of residual severe varus alignment following TKA, all of which were published after 2013. Three studies scored 7 points on the NOS, while the remaining studies scored 8 points, suggesting high quality. The pooled mean differences (MDs) of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were 1.07 [95% confidence interval (CI) −1.06 to 3.20; P = 0.32; I2 = 79%]. The meta‐analysis showed that neutral alignment and mild varus alignment were associated with similar the Oxford Knee Score (OKS), Knee Society Knee Score (KS‐KS), and Knee Society Function Score (KS‐FS), while neutral alignment was associated with lower Forgotten Joint Score (FJS) [mean difference −6.0, 95% confidence interval (CI) −9.37 to −2.64, P = 0.0005]. Neutral alignment was associated with higher KS‐KS than severe alignment (M 2.98, 95% CI 1.42 to 4.55, P = 0.0002; I2 = 0%) as well as higher KS‐FS (M 8.20, 95% CI 4.58 to 11.82, P < 0.00001; I2 = 0%). Neutral alignment was associated with similar rate of survival as mild varus alignment (95% CI 0.36 to 9.10; P = 0.48; I2 = 65%) or severe varus alignment (95% CI 0.94 to 37.90; P = 0.06; I2 = 61%). There was no statistical difference in others. Residual mild varus alignment after TKA may lead to similar or superior outcomes than neutral alignment in patients with preoperative varus knees, yet the available evidence appears to be insufficient to replace the current gold standard of neutral alignment. Severe varus alignment should be avoided. [ABSTRACT FROM AUTHOR]

Food handlers regardless of whether preparing or serving food, play key roles in the transmission of food‐borne infections. This study aimed to evaluate the prevalence of intestinal parasitic infections in food handlers in Iran. In the present study, a comprehensive literature search was carried out in electronic databases, including PubMed, Scopus, Google Scholar, Science Direct, Magiran, Scientific Information Database (SID), Iran Medex and Iran Doc, to identify all the published studies from 2000 to 31st April 2019. A total of 25 articles from different regions of Iran were identified and fulfilled our eligibility criteria. Totally, 140,447 cases were examined and 1163 cases were infected with intestinal parasites. Of all cases, 19,516 were male and 5901 were female with 1163 and 652 infected cases, respectively. The overall prevalence of intestinal parasitic infections was evaluated 14.0% [95% CI: 11.0‐17.0%]. It is revealed that protozoan, such as Giardia lamblia, with prevalence of 41.0% [95% CI: 25.0‐59.0%], Blastosystis hominis with 28.0% [95% CI: 15.0‐44.0%] and Entamoeba coli with 22.0% [95% CI: 16.0‐29.0%] had the highest prevalence while, Dientamoeba fragilis 5.0% [95% CI: 4.0‐7.0%], Iodamoeba bütschlii 5.0% [95% CI: 2.0‐8.0%], Chilomastix mesnili 5.0% [95% CI: 2.0‐9.0%] and Endolimax nana with 3.0% [95% CI: 1.0‐7.0%], were less prevalent. Infection with Ascaris lumbricoides7.0% [95% CI: 0.0‐29.0%] was more prevalent helminth followed with Enterobius vermicularis 3.0% [95% CI: 1.0‐5.0%], Hymenolepis nana 2.0% [95% CI: 1.0‐3.0%], Taenia spp. 2.0% [95% CI: 0.0‐7.0%] and Trichuris trichiura 1.0% [95% CI: 0.0‐1.0%]. The high prevalence of commensal parasites, such as Entamoeba coli, which does not need cure is indicating the importance of personal hygiene in food handlers. Our results revealed the high prevalence of intestinal parasitic infection in food handlers in Iran. Monitoring programs to prevent and controlling of transmission to individuals are needed. [ABSTRACT FROM AUTHOR]

Daytime napping is common in many regions around the world and has been an important part of people's daily life. Daytime napping has attracted increasing attention in recent years. Thus, we conducted a meta‐analysis to evaluate the relationship between daytime napping and stroke, and help reduce the risk of stroke by improving living habits. The Embase, PubMed, Web of Science and PsycINFO databases were searched for cohort studies published before October 2020 and eight eligible studies with 524,408 participants and 5,875 stroke cases were included in the final analysis. The pooled relative risk (RR) of stroke was 1.47 (95% confidence interval [CI]: 1.24–1.74; p <.001) with significant heterogeneity (I2 = 58%, p for heterogeneity = 0.02). However, the heterogeneity decreased when the study in which adjusting for sleep duration and stratifying the results based on sleep duration was not performed was excluded (RR: 1.38; 95% CI: 1.19–1.60, I2 = 44%, p for heterogeneity = 0.10). In dose–response analysis, the linear trend indicated that for every 10‐min increase in daytime napping, the risk of stroke increased by 3%. Further well‐designed large studies are needed to explore the effects of daytime napping on stroke and the underlying biological mechanisms. [ABSTRACT FROM AUTHOR]