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Background: Pancreatic head cancer patients who undergo pancreatoduodenectomy (PD) often experience disease recurrence, frequently associated with a positive margin status (R1). Total mesopancreas excision (TMpE) has emerged as a potential approach to increase surgical radicality and minimize locoregional recurrence. However, its effectiveness and safety remain under evaluation. Methods: We conducted a systematic review and meta-analysis to synthesize current evidence on TMpE outcomes. A systematic search of MEDLINE, EMBASE, Cochrane, and Web of Science databases was conducted up to March 2024 to identify studies comparing TMpE with standard pancreatoduodenectomy (sPD). The risk ratio (RR) or mean difference (MD) was pooled using a random effects model. Results: From 452 studies identified, 9 studies with a total of 738 patients were included, with 361 (49%) undergoing TMpE. TMpE significantly improved the R0 resection rate (RR 1.24; 95% CI 1.11–1.38; P < 0.05), reduced blood loss (MD -143.70 ml; 95% CI -247.92, -39.49; P < 0.05), and increased lymph node harvest (MD 7.27 nodes; 95% CI 4.81, 9.73; P < 0.05). No significant differences were observed in hospital stay, postoperative complications, or mortality between TMpE and sPD. TMpE also significantly reduced overall recurrence (RR 0.53; 95% CI 0.35–0.81; P < 0.05) and local recurrence (RR 0.39; 95% CI 0.24–0.63; P < 0.05). Additionally, the risk of pancreatic fistula was lower in the TMpE group (RR 0.66; 95% CI 0.52–0.85; P < 0.05). Conclusion: Total mesopancreas excision significantly increases the R0 resection rate and reduces locoregional recurrence while maintaining an acceptable safety profile when compared with standard pancreatoduodenectomy. Further prospective randomized studies are warranted to determine the optimal surgical approach for total mesopancreatic resection. [ABSTRACT FROM AUTHOR]

Purpose: In the past few years, there has been a notable rise in the incidence and prevalence of idiopathic pulmonary fibrosis (IPF) on a global scale. A considerable body of research has highlighted the 'obesity paradox,' suggesting that a higher body mass index (BMI) can confer a protective effect against numerous chronic diseases. However, the relationship between BMI and the risk of mortality in IPF patients remains underexplored in the existing literature. We aim to shed light on this relationship and potentially offer novel insights into prevention strategies for IPF. Methods: We conducted a systematic search of the PubMed, Embase, and Web of Science databases to collect all published studies examining the correlation between Body Mass Index (BMI) and the mortality risk in patients with IPF, up until February 14, 2023. For the synthesis of the findings, we employed random-effects models. The statistical significance of the association between BMI and the mortality risk in IPF patients was evaluated using the hazard ratio (HR), with the 95% Confidence Interval (CI) serving as the metric for effect size. Results: A total of 14 data sets involving 2080 patients with IPF were included in the meta-analysis. The combined results of the random-effects models were suggestive of a significant association between lower BMI and a higher risk of death (HR = 0.94, 95% CI = 0.91–0.97, P < 0.001). For baseline BMI, the risk of death from IPF decreased by 6% for each unit increase. The results of the subgroup analysis suggest that geographic location (Asian subgroup: HR = 0.95, 95%CI = 0.93–0.98, P = 0.001; Western subgroup: HR = 0.91, 95%CI = 0.84–0.98, P = 0.014), study type (RCS subgroup: HR = 0.95, 95%CI = 0.92–0.98, P = 0.004; PCS subgroup: HR = 0.89, 95%CI = 0.84–0.94, P < 0.001), and sample size (< 100 groups: HR = 0.93, 95%CI = 0.87–1.01, P = 0.079; >100 groups: HR = 0.94, 95%CI = 0.91–0.97, P < 0.001) were not significant influences on heterogeneity. Of the included literature, those with confounding factors corrected and high NOS scores reduced heterogeneity (HR = 0.93, 95%CI = 0.90–0.96, P < 0.001). Sensitivity analyses showed that the combined results were stable and not significantly altered by individual studies (HR = 0.93 to 0.95, 95% CI = 0.90–0.96 to 0.92–0.98). Egger's test suggested no significant publication bias in the included studies (P = 0.159). Conclusions: Higher BMI (BMI ≥ 25 kg/m2) is negatively correlated to some extent with the risk of death in IPF patients, and BMI may become a clinical indicator for determining the prognosis of IPF patients. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a neurological condition that typically shows up with aging. It is characterized by generalized slowness of movement, resting tremor or stiffness, and bradykinesia. PD patients' brains mostly exhibit an increase in inflammatory mediators and microglial response. Nevertheless, a variety of non-steroidal anti-inflammatory medications (NSAIDS) offered neuroprotection in animal models and preclinical trials. Aim: The current systematic review and meta-analysis were designed to try to resolve the debate over the association of NSAID use with the development of PD because the results of several studies were somehow contradictory. Methods: An intense search was performed on Scopus, PubMed, and Web of Science databases for articles relating the incidence of PD to the use of NSAIDs. Statistical analysis of the included studies was carried out using Review Manager version 5.4.1 by random effect model. The outcome was identified as the development of PD in patients who were on NSAIDs, ibuprofen only, aspirin only, and non-aspirin NSAIDs. This was analyzed using pooled analysis of odds ratio (OR) at a significance level of =0.05 and a confidence level of 95%. A statistically significant decreased risk of PD was observed in patients taking NSAIDs, Ibuprofen, and non-aspirin NSAIDs. Results: The ORs of PD occurrence in patients who took NSAIDs, Ibuprofen, and non-aspirin NSAIDs were 0.88 [95% CI (0.8-0.97), p = 0.01], 0.73 [95% CI (0.53-1), p = 0.05] and 0.85 [95% CI (0.75-0.97), p = 0.01]. Meanwhile, the risk of PD in patients who took aspirin was not statistically significant. Conclusion: In conclusion, Ibuprofen, non-aspirin NSAIDs, and other types of NSAIDs could be associated with a reduction in PD risk. However, there was no association between aspirin intake and the development of PD. [ABSTRACT FROM AUTHOR]

Background: Therapeutic endoscopy and gastroenterology fellows often participate in endoscopic retrograde cholangiopancreatography (ERCP) during their training period. However, it is generally feared that trainee involvement may increase ERCP-related complications, mainly because of the side-viewing nature of the endoscope and the higher risk of pancreatic duct cannulation. There is no concrete evidence to support this notion. This systematic review and meta-analysis aims to investigate the resultsof trainee participation on adverse events related to ERCP. Methods: PubMed, EMBASE, Google Scholar, SCOPUS, and Web of Science databases were searched from inception to 31 May 2023 for studies evaluating the ERCP outcomes defined as success rates, procedure time, failed attempts, and adverse events with and without trainee participation. A random effect model was used to perform the meta-analysis, and heterogeneity was assessed using the I2 statistics. Results: Seven studies were included in the final analysis, including 17,088 ERCPs. The pooled odds ratio (pOR) of success rate, incomplete/failed attempts in the trainee and no trainee groups were 0.466 (95% CI 0.13 to 1.66, I2 = 97.8%, p = 0.239) and 3.2 (95% CI 0.70 to 14.55), I2 = 98.5%, p = 0.134), respectively. The pOR of post-ERCP pancreatitis and bleeding in the trainee vs. no trainee groups was 0.97 (95% CI 0.76 to 1.23, I2 = 0%, p = 0.78) and 1.3 (95% CI 0.59 to 2.83, I2 = 49%, p = 0.54). The pOR of all adverse events in both groups was 1.028 (95% CI 0.917 to 1.152, I2 = 0%, p = 0.636). Surprisingly, the pooled std mean difference for the procedure time was 0.217 (95% − 0.093 to 0.05, I2 = 98.5%, p = 0.17). Conclusion: This meta-analysis comprising of 17,088 ERCPs in seven studies demonstrated comparable ERCP outcomes related to trainee participation regarding success rates, procedure time, and adverse events. Trainees' involvement in ERCP within a proper teaching setting appears safe and does not compromise the overall procedure's success. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is a major global public health problem. It currently affects more than 1.4 billion people worldwide, projected to increase to 1.6 billion by 2025. Despite numerous primary studies have been conducted to determine the prevalence of uncontrolled hypertension and identify its associated factors among hypertensive patients in Sub-Saharan Africa, these studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of uncontrolled hypertension and identify its associated factors. Methods: We have searched PubMed, Google Scholar, and Web of Science databases extensively for all relevant studies. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to compute the overall pooled prevalence of uncontrolled hypertension and the effect size of its associated factors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test. Results: A total of twenty-six primary studies with a sample size of 11,600 participants were included in the final meta-analysis. The pooled prevalence of uncontrolled hypertension was 50.29% (95% CI: 41.88, 58.69; I2 = 98.98%; P<0.001). Age of the patient [AOR = 1.57: 95% CI: 1.004, 2.44], duration of diagnosis [AOR = 2.57: 95% CI: 1.18, 5.57], non-adherence to physical activity [AOR = 2.13: 95% CI: 1.15, 3.95], khat chewing [AOR = 3.83: 95% CI: 1.59, 9.24] and habitual coffee consumption [AOR = 10.79: 95% CI: 1.84, 63.24] were significantly associated with uncontrolled hypertension among hypertensive patients. Conclusions: The pooled prevalence of uncontrolled hypertension was considerably high. Older age, duration of diagnosis, non-adherence to physical activity, khat chewing and habitual coffee consumption were independent predictors of uncontrolled hypertension. Therefore, health professionals and other responsible stakeholders should encourage hypertensive patients to adhere to regular physical activity, and abstain from khat chewing and habitual coffee consumption. Early identification of hypertension and management of comorbidities is crucial, and it should be emphasized to control hypertension easily. [ABSTRACT FROM AUTHOR]

Trauma-related esophageal injuries (TEIs) are a rare but highly lethal condition. The presentation of TEIs is very diverse depending on the location and mechanism of injury (blunt vs. penetrating), as well as the presence or absence of concurrent injuries. The aim of the present systematic review and meta-analysis is to delineate the clinical features impacting TEI management. A systematic review of the Medline, Embase, and web of science databases was undertaken for studies reporting on patients with TEIs. A random effects model was employed in the meta-analysis of aggregated data. Eleven studies, incorporating 4605 patients, were included, with a pooled mortality rate of 19% (95% confidence interval (CI) 13–25%). Penetrating injuries were 34% more likely to occur (RR 0.66, 95% CI 0.49–0.89, P  = 0.01), predominantly in the neck compartment. Surgery was employed in 53% of cases (95% CI 32–73%), with 68% of patients having associated injuries (95% CI 43–94%). In terms of choice of surgical repair technique, primary suture repair was most frequently reported, irrespective of injury location. Postoperative drainage was employed in 27% of the cases and was more common following repair of thoracic esophageal injuries. The estimated dependence on mechanical ventilation was 5.91 days (95% CI 5.1–6.72 days), while the length of stay in the intensive care unit averaged 7.89 days (95% CI 7.14–8.65 days). TEIs are uncommon injuries in trauma patients, associated with considerable mortality and morbidity. Open suture repair of ensuing esophageal defects is by large the most employed approach, while stenting may be indicated in carefully selected cases. [ABSTRACT FROM AUTHOR]

Background: Fibroblast growth factor 21 (FGF21) is a key hormone factor that regulates glucose and lipid homeostasis. Exercise may regulate its effects and affect disease states. Therefore, we sought to determine how exercise affects FGF21 concentrations in adults. Methods: The review was registered in the International Prospective Systematic Review (PROSPERO, CRD42023471163). The Cochrane Library, PubMed, and Web of Science databases were searched for studies through July 2023. Studies that assessed the effects of exercise training on FGF21 concentration in adults were included. The random effect model, data with standardized mean difference (SMD), and 95% confidence intervals (CI) were used to evaluate the pooled effect size of exercise training on FGF21. The risk of heterogeneity and bias were evaluated. A total of 12 studies involving 401 participants were included. Results: The total effect size was 0.3 (95% CI [−0.3–0.89], p = 0.33) when comparing participants who exercised to those who were sedentary. However, subgroup analysis indicated that concurrent exercise and a duration ≥10 weeks significantly decreased FGF21 concentrations with an effect size of −0.38 (95% CI [−0.74–−0.01], p < 0.05) and −0.38 (95% CI [−0.63–−0.13], p < 0.01), respectively. Conclusion: Concurrent exercise and longer duration may be more efficient way to decrease FGF21 concentrations in adults with metabolic disorder. [ABSTRACT FROM AUTHOR]

Background: Frailty is a common condition among patients with liver cirrhosis. Nonetheless, its role in predicting liver transplant-free survival (TFS) remains unclear. Aim: This systematic review and meta-analysis were conducted to elucidate the relationship between frailty and TFS in patients with cirrhosis. Methods: Cohort studies addressing the objective of this meta-analysis were extracted from PubMed, Embase, and Web of Science databases. Between-study heterogeneity was assessed with the Cochrane Q test, and the I^2 statistic was estimated. Random-effect models, considering potential heterogeneity, were employed to combine the results. Results: The meta-analysis encompassed 17 cohort studies involving 6273 patients with cirrhosis, of whom 1983 (31.6%) were classified as frail at baseline. The follow-up periods in the included studies ranged from 3 to 29 months, with an average duration of 11.5 months. The analysis revealed that frailty was significantly associated with a poor TFS (risk ratio [RR]: 2.07, 95% confidence interval: 1.72 to 2.50, p<0.001; I2 = 51%). Sensitivity analyses that sequentially omitted one dataset consistently supported these findings (RR: 1.95 to 2.17, p<0.05 in all cases). Subgroup analyses based on variables such as study design, mean age of patients, baseline Model for End-Stage Liver Disease score, tool used for frailty evaluation, follow-up duration, and study quality score also yielded congruent results. Conclusions: The evidence suggests that frailty may be an independent risk factor for poor TFS in patients with liver cirrhosis, thus emphasizing the importance of early identification and management of frailty in this population. [ABSTRACT FROM AUTHOR]

Background and objectives: The potential association between rosacea and a heightened prevalence of Helicobacter pylori (HP) infection has been previously suggested. However, existing studies offer inconsistent results. This systematic review and meta-analysis aimed to elucidate the relationship between rosacea and HP infection. Methods: We conducted comprehensive searches of PubMed, Embase, and Web of Science databases to identify relevant observational studies for our investigation. We utilized the random-effects model to aggregate the data to address the potential influence of heterogeneity among the studies on the outcome. Results: Our analysis incorporated twenty-five datasets from 23 case-control and cross-sectional studies, encompassing 51,054 rosacea patients and 4,709,074 controls without skin disease. The pooled results revealed a significantly higher prevalence of HP infection in individuals with rosacea compared to controls (odds ratio [OR]: 1.51, 95% confidence interval [CI]: 1.17–1.95, p<0.001; I2 = 79%). Subgroup analysis indicated an increased prevalence of HP infection in rosacea studies that utilized one (OR: 1.72, 95% CI: 1.11–2.66, p = 0.02; I2 = 76%) or more tests for HP infection (OR: 2.26, 95% CI: 1.29–3.98, p = 0.005; I2 = 56%). However, this association was not observed in population-based studies that determined HP infection based on prescription records for HP eradication drugs (OR: 0.90, 95% CI: 0.76–1.07, p = 0.024; I2 = 54%). Conclusion: Rosacea may be significantly associated with a higher prevalence of HP infection. High-quality prospective studies with delicately controlled confounding factors are needed to determine if HP infection is a risk factor for rosacea. [ABSTRACT FROM AUTHOR]

Background: Retinal microvascular anomalies have been identified in patients with cardiovascular conditions such as arterial hypertension, diabetes mellitus, and carotid artery disease. We conducted a systematic review and meta-analysis (PROSPERO registration number CRD42024506589) to explore the potential of retinal vasculature as a biomarker for diagnosis and monitoring of patients with coronary artery disease (CAD) through optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: We systematically examined original articles in the Pubmed, Embase, and Web of Science databases from their inception up to November 2023, comparing retinal microvascular features between patients with CAD and control groups. Studies were included if they reported sample mean with standard deviation or median with range and/or interquartile range (which were computed into mean and standard deviation). Review Manager 5.4 (The Cochrane Collaboration, 2020) software was used to calculate the pooled effect size with weighted mean difference and 95% confidence intervals (CI) by random-effects inverse variance method. Results: Eleven studies meeting the inclusion criteria were incorporated into the meta-analysis. The findings indicated a significant decrease in the retinal nerve fiber layer (WMD −3.11 [−6.06, −0.16]), subfoveal choroid (WMD −58.79 [−64.65, −52.93]), and overall retinal thickness (WMD −4.61 [−7.05, −2.17]) among patients with CAD compared to controls (p < 0.05). Furthermore, vascular macular density was notably lower in CAD patients, particularly in the superficial capillary plexus (foveal vessel density WMD −2.19 [−3.02, −1.135], p < 0.0001). Additionally, the foveal avascular zone area was statistically larger in CAD patients compared to the control group (WMD 52.73 [8.79, 96.67], p = 0.02). Heterogeneity was significant (I2 > 50%) for most features except for subfoveal choroid thickness, retina thickness, and superficial foveal vessel density. Conclusion: The current meta-analysis suggests that retinal vascularization could function as a noninvasive biomarker, providing additional insights beyond standard routine examinations for assessing dysfunction in coronary arteries. [ABSTRACT FROM AUTHOR]

Event-related potential measures have been extensively studied in mental disorders. Among them, P300 amplitude and latency reflect impaired cognitive abilities in major depressive disorder (MDD). The present systematic review and meta-analysis was conducted to investigate whether patients with MDD differ from healthy controls (HCs) with respect to P300 amplitude and latency. PubMed and Web of Science databases were searched from inception to 15 January 2023 for case-control studies comparing P300 amplitude and latency in patients with MDD and HCs. The primary outcome was the standard mean difference. A total of 13 articles on P300 amplitude and latency were included in the meta-analysis. Random effect models indicated that MDD patients had decreased P300 amplitude, but similar latency compared to healthy controls. According to regression analysis, the effect size increased with the severity of depression and decreased with the proportion of women in the MDD samples. Funnel plot asymmetry was not significant for publication bias. Decreased P300 amplitude may be a candidate diagnostic biomarker for MDD. However, prospective studies testing P300 amplitude as a monitoring biomarker for MDD are needed. [ABSTRACT FROM AUTHOR]

This systematic review examines the influence of resistance training (RT) on the performance outcomes of elite athletes. Adhering to PRISMA guidelines, a comprehensive search across PubMed, Scopus, SPORTDiscus, and Web of Science databases was conducted, considering studies up to November 19, 2023. The inclusion criteria were elite athletes involved in high-level competitions. Studies were categorized by the competitive level among elite athletes, athlete's sex, performance outcomes, and a training modality with subgroup analyses based on these factors. Thirty-five studies involving 777 elite athletes were included. The results of the meta-analysis revealed a large and significant overall effect of RT on sport-specific performance (standardized mean difference, SMD = 1.16, 95% CI: 0.65, 1.66), with substantial heterogeneity (I² = 84%). Subgroup analyses revealed differential effects based on the competitive level, the type of sport- specific outcomes, and sex. National elite athletes showed more pronounced (large SMD) benefits from RT compared to international elite athletes (small SMD). Global outcomes revealed a medium but non-significant (p > 0.05) SMD, while local outcomes showed a large SMD. Notably, female athletes exhibited a large SMD, though not reaching statistical significance (p > 0.05), probably due to limited study participants. No significant (p > 0.05) differences were found between heavy and light load RT. Resistance training is effective in improving sport-specific performance in elite athletes, with its effectiveness modulated by the competitive level, the type of the performance outcome, and athlete's sex. The findings underscore the need for personalized RT regimens and further research, particularly in female elite athletes, as well as advanced RT methods for international elite athletes. [ABSTRACT FROM AUTHOR]

Purpose: The ideal contrast agent for imaging patients with hepatocellular carcinoma (HCC) following locoregional therapies (LRT) remains uncertain. We conducted a meta-analysis to assess the diagnostic performance of magnetic resonance imaging with extracellular contrast agent (ECA-MRI) and hepatobiliary agent (EOB-MRI) in detecting residual or recurrence HCC following LRT. Methods: Original studies comparing the diagnostic performance of ECA-MRI and EOB-MRI were systematically identified through comprehensive searches in PubMed, EMBASE, Cochrane Library and Web of Science databases. The pooled sensitivity and specificity of ECA-MRI and EOB-MRI were calculated using a bivariate-random-effects model. Subgroup-analyses were conducted to compare the diagnostic performance of ECA-MRI and EOB-MRI according to different variables. Meta-regression analysis was employed to explore potential sources of study heterogeneity. Results: A total of 15 eligible studies encompassing 803 patients and 1018 lesions were included. Comparative analysis revealed no significant difference between ECA-MRI and EOB-MRI in the overall pooled sensitivity (87% vs. 79%) and specificity (92% vs. 96%) for the detection of residual or recurrent HCC after LRT (P = 0.41), with comparable areas under the HSROC of 0.95 and 0.92. Subgroup analyses indicated no significant diagnostic performance differences between ECA-MRI and EOB-MRI according to study design, type of LRT, most common etiology of liver disease, baseline lesion size, time of post-treated examination and MRI field strength (All P > 0.05). Conclusion: ECA-MRI exhibited overall comparable diagnostic performance to EOB-MRI in assessing residual or recurrent HCC after LRT. [ABSTRACT FROM AUTHOR]

Purpose: The association between the presence of sarcopenia in patients with cirrhosis and the onset of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) is yet to be established. We conducted a systematic review and meta-analysis to provide a thorough summary of the available evidence on this association. Methods: A thorough search of the literature was performed in the PubMed, EMBASE, and Web of Science databases. The protocol was duly registered on PROSPERO (CRD42023398856). The hazard ratio (HR) and corresponding 95% confidence intervals (CIs) for the occurrence of HE after TIPS were extracted from studies comparing cirrhotic patients with and without sarcopenia. These data were then combined using a random-effect model. Results: A total of 1135 patients from seven cohort studies that met our eligibility criteria were included in the meta-analysis. Our findings indicate a significantly higher risk of post-TIPS HE among cirrhotic patients with sarcopenia compared to those without sarcopenia (HR, 2.35; 95% CIs 1.32–4.19; p = 0.004; I2 = 75%). The findings remained consistent across subgroups stratified by liver disease etiology, study location, and severity of hepatic dysfunction. Conclusion: The study demonstrated that sarcopenia was strongly linked to an increased likelihood post-TIPS HE among cirrhotic patients. [ABSTRACT FROM AUTHOR]

Purpose: Previous research indicates that vitamin D and omega-3 co-supplementation may benefit overall health, but current evidence regarding its effects on lipid profile remains unclear. The present systematic review and meta-analysis aimed to examine the effects of vitamin D and omega-3 co-supplementation on lipid profile (total cholesterol [TC], low-density lipoprotein [LDL], triglyceride [TG] and high-density lipoprotein [HDL]) in adults. Design/methodology/approach: In this systematic review and meta-analysis, relevant studies were obtained by searching the PubMed, Scopus and Web of Science databases (from inception to January 2022). Weighted mean differences and 95% confidence intervals were estimated via a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods. Findings: Pooled analysis of six randomized controlled trials (RCTs) revealed that vitamin D and omega-3 co-supplementation yielded significant reductions in TG (p = 0.631). A pooled analysis of five trials indicated a significant association between omega-3 and vitamin D treatment and reductions in TC (p = 0.001) and LDL (p = 0.001). Although, pooled analyses of omega-3 and vitamin D did not significantly affect HDL. Originality/value: The findings suggest that vitamin D and omega-3 co-supplementation lowers TG, TC and LDL in adults. Future, large-scale, RCTs on various populations are needed to elucidate further beneficial effects of vitamin D and omega-3 co-supplementation on lipid profile and establish guidelines for clinical practice. [ABSTRACT FROM AUTHOR]

The aim of this study was to systematically review the current literature and analyze the effects of beetroot-based supplements (BRS) on muscular performance. Randomized controlled trials that assessed the acute or short-term effects of BRS administration on muscular endurance and/or strength in healthy male individuals were retrieved from PubMed, EMBASE, CENTRAL, and Web of Science databases from inception to February 20th, 2023. In addition, we also searched preprint papers in medRxiv.org, bibRxiv.org; thesis and dissertations included in oatd.org; and clinical trials published in ClinicalTrials.gov. Data extraction, risk of bias, and study quality were assessed by 2 authors. Meta-analyses and subgroup analyses of standardized mean differences (SMD) were performed using a random-effects model. A total of 1486 records were identified in the databases and 2 were obtained by manual search in the reference list. Of those, 27 studies attended eligibility criteria and composed this systematic review. BRS administration resulted in a positive effect on muscular endurance (SMD: 0.31; 95% confidence interval (CI): 0.10 to 0.51; p < 0.01; n = 16 studies). There was an overall significative effect for muscular strength (SMD: 0.26; 95% CI: 0.03 to 0.48; p < 0.05; n = 18 studies), but a subgroup analysis showed that significant effects were found when strength was measured in a fatigued (SMD: 0.64; 95% CI: 0.25 to 1.03; p < 0.01), but not resting state. BRS administration have a small ergogenic effect on muscular endurance and attenuate the decline in muscular strength in a fatigued state in healthy male individuals. Beetroot-based supplements can improve muscular endurance and attenuates the decline in muscular strength. These effects are attributed to the inorganic nitrate contained in these products, which ranged from 316–985 mg/day, ingested 2–3 hours before exercise. Beetroot-based supplements administration can generate a modest increase in the number of repetitions performed to failure or in exercise time to exhaustion, which may contribute to the performance and optimization of the results of people involved in isotonic exercises (e.g., resistance training). Beetroot-based supplements ingestion can improve muscular strength, particularly it aids in the recovery of muscular strength after a fatiguing task. [ABSTRACT FROM AUTHOR]

Recently, the serum levels of branched-chain amino acids (BCAAs) have been considered as an indicator to evaluate health status and predict chronic diseases risk. This systematic review and meta-analysis aimed to assess the relationship between Serum BCAAs and the risk of all-cause mortality. We carried out a comprehensive and systematic search in various important databases, including PubMed, Scopus, and Web of Science databases to find the relevant studies published up to October 2022 with no language, design, or time limitation. We extracted the reported hazard ratio (HR) with 95% confidence interval (CI) and odds ratio (OR) with 95%CI in cohorts and case–control studies, respectively, and computed the log HR or OR and its standard error. Then, we used the random-effects model with inverse variance weighting method for the present meta-analysis, to calculate the pooled effect size. Ten observational studies, including nine cohort studies and one case–control study, were included in the present meta-analysis. The number of participants ranges from 53 to 26,711, with an age range of 18–99 years. During 6 months to 24 years of follow-up, 3599 deaths were ascertained. The pooled results indicated that there was no significant association between serum BCAAs (RR: 1.17; 95% CI 0.85–1.60), isoleucine (RR: 1.41; 95%CI 0.92–2.17), leucine (RR: 1.13; 95% CI 0.94–1.36), and valine (RR: 1.02; 95%CI 0.86–1.22) and all-cause mortality. Also, there was significant heterogeneity between studies for serum BCAAs (I2 = 74.1% and P-heterogeneity = 0.021), isoleucine (I2 = 89.4% and P-heterogeneity < 0.001), leucine (I2 = 87.8% and P-heterogeneity < 0.001), and valine (I2 = 86.6% and P-heterogeneity < 0.001). Our results suggested that the serum BCAAs and its components, including isoleucine, leucine, and valine, were not associated with the risk of all-cause mortality. [ABSTRACT FROM AUTHOR]

Notably, the growing use of radionuclear technology, especially in diagnostic and therapeutic procedures involving radiation exposure, raises concerns about the health effects of radiation. Although epidemiological studies have provided strong evidence for elevated thyroid cancer risk after radiation exposure in childhood, the risk of thyroid cancer associated with adult exposure remains to be investigated. We conducted a systematic review and meta-analysis of relevant studies on the risk of developing thyroid cancer after radiation exposure in adulthood. The PubMed and Web of Science databases were used to select eligible articles. After screening, a total of 15 studies were identified in which estimates of the standardized incidence ratio (SIR) and the relative risk (RR) of thyroid cancer were available in 8 and 11 studies, respectively. The overall SIR estimated by the random effects model was 2.19 [95% confidence interval (CI), 1.54, 3.10]. Cochran's Q test showed significant heterogeneity in the SIRs (Q  = 178, P  < 0.0001). The overall RR at 10 mGy was 1.0038 (95% CI, 0.9991, 1.0085), with no significant heterogeneity (Q  = 9.30, P  = 0.5041). The total SIR, as well as that from each study, indicated a statistically significant excess, which could be related to screening bias. Radiation-related thyroid cancer risk was elevated in a few studies; however, the overall estimate of the RR at 10 mGy was not significant. This study demonstrates no strong epidemiological evidence for the risk of thyroid cancer in radiation exposure during adulthood; however, further research is needed. [ABSTRACT FROM AUTHOR]

Fish and omega-3 polyunsaturated fatty acids (PUFA) have been suggested to play a role in improving cancer prognosis. However, results from epidemiological studies remain inconsistent. Here we assess the association between dietary fish and/or omega-3 PUFAs intake and cancer prognosis with meta-analysis of observational studies. A systematic search of related publications was performed using PubMed and Web of Science databases. Hazard ratios (HR) and 95% confidence intervals (CI) were extracted and then pooled using a random-effect model. Potential linear and non-linear dose-response relationships were explored using generalized least squares estimation and restricted cubic splines. As a result, 21 cohort studies were included in our analysis. Compared to the lowest category, the highest category of fish intake was associated with a significant lower mortality in patients with ovarian cancer (n = 1, HR = 0.74, 95% CI: 0.57–0.95) and overall cancer (n = 12, HR = 0.87, 95% CI: 0.81–0.94). Marine omega-3 PUFAs intake rather than total omega-3 PUFAs intake showed significant protective effects on survival of overall cancer (n = 8, HR = 0.81, 95% CI: 0.71–0.94), in particular prostate cancer (n = 2, HR = 0.62, 95% CI: 0.46–0.82). Dose-response meta-analysis indicated a nonlinear and a linear relationship between fish intake, as well as marine omega-3 PUFAs intake, and overall cancer survival, respectively. In conclusion, our analysis demonstrated a protective effect of dietary fish and marine omega-3 PUFAs consumption on cancer survival. [ABSTRACT FROM AUTHOR]

Background and Objectives: Sarcopenia is prevalent in patients with stroke. However, the relationship between sarcopenia and poor functional outcome of patients with acute stroke remains unknown. A systematic review and meta-analysis was performed to evaluate the above association. Methods and Study Design: Observational studies which evaluated the influence of sarcopenia on functional outcome in patients with acute stroke were retrieved by search the PubMed, Embase, Cochrane Library, and Web of Science databases. A poor functional outcome was defined as modified Rankin scale (mRS) of two or more points during follow-up. Two authors independently collected the data of study characteristics and outcomes. A random-effects model was used to pool the results via incorporating the influence of possible between-study heterogeneity. Results: Nine datasets from seven cohort studies contributed to the meta-analysis. A total of 1774 patients with stroke were included, and 481 (27.1%) of them had sarcopenia. Compared to patients without sarcopenia, those with sarcopenia were associated with a higher risk of poor functional outcome during follow-up duration up to 6 months after stroke onset (odds ratio: 2.42, 95% confidence interval: 1.76 to 3.33, p < 0.001) with mild heterogeneity (I² = 23%). Subgroup analyses according to study design (prospective versus retrospective), sex of the patient, type of stroke (ischemic or mixed), diagnostic methods for sarcopenia, follow-up duration and cutoff scores for mRS showed consistent results (p for subgroup analyses all > 0.05). Conclusions: Sarcopenia may be associated with poor functional outcome in patients with acute stroke. [ABSTRACT FROM AUTHOR]

The effect of iodinated contrast material (CM) temperature on injection pressures and viscosity has been well established. However, the effect of extrinsic warming of CM on allergic reactions and extravasations remains unclear. The purpose of this study is to compare the rates of allergic reactions and extravasations between warmed CM to room temperature CM. We conducted a comprehensive systematic search using PubMed, Embase, and Web of Science databases for all studies that assess the impact of warmed CM on adverse reactions. The primary outcomes of our study were allergic reaction and extravasation rates. We calculated weighted pooled odds ratios (OR) and 95% confidence intervals (CI) for all outcomes using the random-effects model. A P -value <0.05 was considered statistically significant. We conducted subgroup analyses based on the viscosity of the CM. A total of five studies, including 307,329 CM injections (86,676 at room temperature and 220,653 warmed to 37 °C), were included in the analysis. For high viscosity CM, pre-warming was associated with significantly lower allergic reaction rates (OR: 0.59, 95% CI: 0.49–0.72, P < 0.00001). There was no significant difference in rates of extravasation for high viscosity CM (OR: 0.53, 95% CI: 0.20–1.43, P = 0.21). Our meta-analysis suggests that warming CM to 37 °C is a safe and effective approach to reduce the risk of allergic reactions and physiologic reactions during injection of high-viscosity CM. However, there was no significant difference in extravasation rates between warmed and room temperature CM, regardless of viscosity. • Warming highly viscous contrast material to 37 °C reduces the rate of allergic and physiologic reactions. • Warming of low viscosity contrast material does not affect adverse reaction rates. • Warming highly viscous contrast material to 37 °C does not reduce the rate of extravasations. [ABSTRACT FROM AUTHOR]

Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I2 statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle–Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 [1.10–1.35], p < 0.001, I2 = 87%) compared to non-nappers. The meta-analysis results revealed variations in the summary ORs for studies conducted in China, Spain, the USA, and the UK. The ORs for China, Spain, the USA, and the UK were 1.05 (95% CI 0.90–1.23), 9.36 (95% CI 4.74–18.45), 1.27 (95% CI 1.10–1.47), and 1.39 (95% CI 1.32–1.47), respectively. A subgroup analysis based on age within the American population disclosed that napping in both adults and children heightened obesity incidence. A subgroup analysis based on nap duration found a significant rise in obesity occurrence when nap duration exceeded one hour, but no clear relationship emerged when nap duration was less than 1 h. In a subgroup analysis based on the definition of obesity, napping did not demonstrate a significant relationship with obesity when diagnostic criteria set obesity at a BMI of 25 or above. However, when the criteria were set at a BMI of 28 or 30 or more, napping significantly increased obesity risk. Our meta-analysis indicates a positive association between daytime napping and the risk of obesity. However, given the limited number of included studies, potential confounding factors might not have been fully addressed. Future well-designed prospective studies are required to further investigate this relationship. Large-scale studies are necessary to confirm our findings and elucidate the underlying mechanisms that drive these associations and causation. [ABSTRACT FROM AUTHOR]

Background: N-terminal probrain natriuretic peptide (NT-pro-BNP) and BNP are well-known markers for the diagnosis and prognostic of heart failure. Until now, it was not clear whether BNP levels are influenced by events occurring within Obstructive sleep apnea–hypopnea syndrome (OSAHS) with continuous positive airway pressure (CPAP). Methods: A thorough search in PubMed, EMBASE, Google Scholar, and Web of Science databases up to October 24, 2022, and a meta-analysis aimed to explore further accurate estimates of the effects of BNP on OSAHS after CPAP treatment to assess the strength of the evidence. Results: The forest plot outcome indicated that CPAP therapy did not change the BNP level in patients with OSAHS, with a weighted mean difference (WMD) of -0.47 (95% CI: -1.67 to 2.62; P = 0.53] based on the random effect model because of high significant heterogeneity (I2 = 80%) among the studies. Subgroup analysis also explored the changes in BNP levels in patients with OSAHS. Begg's test (P = 0.835) and Egger's test (P = 0.245) suggested significant negative publication bias. Conclusion: Our meta-analysis suggests that CPAP therapy does not change the BNP level in patients with OSAHS; therefore, it is not accurate to use BNP level as an index to evaluate heart function in patients with OSAHS, but more related research should be conducted. [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]

The metabolic score for insulin resistance (METS-IR) is a recently developed parameter for screening of metabolic disorder. However, the association between METS-IR and risk of hypertension in general adult population remains not fully determined. A meta-analysis was therefore performed. Observational studies evaluating the association between METS-IR and hypertension in adults were retrieved by searching PubMed, Embase, and Web of Science databases from inception to October 10, 2022. A random-effects model, which incorporates the potential influence of heterogeneity, was used to pool the results. Eight studies with 305 341 adults were included in the meta-analysis, and 47 887 (15.7%) of them had hypertension. Pooled results showed that a higher METS-IR was associated with hypertension after adjusting for multiple conventional risk factors [relative risk (RR) for highest versus lowest category of METS-IR: 1.67, 95% confidence interval (CI): 1.53 to 1.83, p<0.001, I2=8%]. The results were consistent in subgroup analyses according to study design, source of the cohort, age, sex, body mass index of the participants, and quality scores of the study (p for subgroup difference all>0.05). Results of meta-analysis with METS-IR analyzed in continuous variables also showed that METS-IR was associated with the risk of hypertension (RR for 1-unit increment of METS-IR: 1.15, 95% CI: 1.08 to 1.23, p<0.001, I2=79%). In conclusion, a high METS-IR is associated with hypertension in general adult population. Measuring METS-IR may be useful for screening participants at high risk of hypertension. [ABSTRACT FROM AUTHOR]

Background: Previous studies have been showed an association between previous abortion history and risk of Autism spectrum disorders (ASD). However, there is still controversy about true effect estimate of the association. Purpose: This meta-analysis aimed to evaluate the association between previous abortion history and the risk of ASD. Methods: A systematic search was performed using PubMed, Scopus, and Web of Sciences databases to identify potential studies published until December 2021. The presence of statistical heterogeneity was determined using the I2 value. In the case of substantial heterogeneity, the random-effects model metaanalysis was used to estimate the pooled relative risks. The publication bias was assessed using the Egger and Begg tests. Results: Thirteen studies with a total of 331,779 children remained in the present meta-analysis. The estimated odds ratio of the risk of ASD associated with previous abortion history was 1.64 (95% confidence interval [CI], 1.28-2.0; I2=61.7%) in adjusted studies and 1.10 (95% CI, 1.01-1.20; I2=0.0%) in crude studies, based on the random effect model. There was moderate heterogeneity in adjusted studies. The p values for Egger and Begg regression among children with ASD were 0.393 and 0.056, respectively. Conclusion: This meta-analysis suggests that children born from mothers with a history of previous abortion have an increased risk of development of ASD compared to children of mothers without a history of previous abortion. [ABSTRACT FROM AUTHOR]

Background: There is still no consensus on managing zone II level partial flexor tendon lacerations, and the management of zone II partial flexor tendon injuries is controversial. No reliable large cohort studies or metaanalysis papers on partial flexor tendon laceration management are available in PubMed or Embase. Methods: We searched PubMed, Embase, Cochrane Library, Insight, Scopus, and Web of Science databases for primary research articles investigating outcomes of patients with partial flexor tendon injuries. The initial search was limited to human studies that were published from 1970–2021 and indexed as randomized controlled or clinical trials or observational, cross-sectional, or cohort studies. We used statistical package R version 4.1.2 for this meta-analysis. Results: The Standardised mean difference (SMD) of the common effects model was 2.020 (95% CI; 1.583–2.457; P < 0.0001), indicating that the results of conservative treatment without surgical intervention are similar to surgical intervention or better in some articles. The SMD of the random effect model was 7.093 (95% CI; 1.090–13.096; P < 0.0206), indicating the same result. Higgins' I2 value was 97.6%, indicating serious heterogeneity. Conclusions: In this first meta-analysis on flexor zone II conservative treatment, five papers with publication bias were analyzed. It is meaningful to verify the result of conservative treatment statistically. Even though this is a heterogeneous paper, conservative treatment seems to have a lot of benefits for the patient, including offering a fairly solid longterm prognosis with very few complications. [ABSTRACT FROM AUTHOR]

Insomnia commonly occurs in schizophrenia, and insomnia is associated with suicide risk. Clozapine has anti-suicidal properties and beneficial effects on sleep. We performed a meta-analysis of insomnia in randomized controlled trials (RCTs) of patients with schizophrenia treated with clozapine. We hypothesized that compared to clozapine there is an increased odds of insomnia in patients treated with other antipsychotics. We systematically searched PubMed, PsycINFO, and Web of Science databases. We included RCTs, in English, with data on insomnia in patients with schizophrenia treated with clozapine versus other antipsychotics. Data were pooled using a random effects model. Eight RCTs (1952 patients: 922 on clozapine and 1030 on other antipsychotics) met inclusion criteria. Patients treated with other antipsychotics versus clozapine had a significant increased odds of insomnia (22.3 % versus 12.4 %, OR = 2.20, 95 % CI = 1.64–2.94, p < 0.01). Olanzapine, quetiapine, risperidone, and ziprasidone were each associated with significant increased odds of insomnia compared to clozapine. In meta-regression analyses, clozapine dose, publication year, sex, trial duration, and study quality score were unrelated to the association; however, there was a significant association with age. The observed ORs for insomnia from RCTs were almost perfectly correlated with reported ORs from pharmacovigilance data. Clozapine is associated with significantly less insomnia compared to other antipsychotics. Findings provide additional evidence for improvement in sleep as a potential pathway underlying clozapine's anti-suicidal properties. A greater mechanistic understanding of this association is needed. [ABSTRACT FROM AUTHOR]

Malnutrition evidenced by low geriatric nutritional risk index (GNRI) has been suggested as a potential predictor of poor prognosis of patients with various clinical conditions. We performed a meta-analysis to systematically assess the association between GNRI and the prognosis of patients after stroke. Cohort studies were identified by search of PubMed, Embase, Cochrane's Library and Web of Science databases from inception to March 25, 2022, according to the aim of the meta-analysis. A random-effect model incorporating the potential between-study heterogeneity was used to pool the results. Eight cohort studies with 13573 patients with stroke contributed to the meta-analysis. Pooled results showed that malnutrition as evidenced by low GNRI was independently associated with a higher risk of poor functional outcome [risk ratio (RR): 1.54, 95% confidence interval (CI): 1.19 to 1.98, p<0.001; I2=69%] and an increased incidence of all-cause mortality (RR: 1.82, 95% CI: 1.35 to 2.47, p<0.001; I2=74%). Sensitivity analyses showed consistent results in patients with ischemic stroke, and in prospective cohort studies. Subgroup analyses showed that the associations were not significant for patients with GNRI-defined mild malnutrition (p=0.18 and 0.20 for functional and mortality outcomes, respectively), but significant for patients with moderate-severe malnutrition (both p<0.001). Difference in follow-up durations did not significantly affect the associations (p for subgroup difference=0.75 and 0.70, respectively). In conclusion, a low GNRI is associated with poor functional and survival outcomes in patients after stroke. [ABSTRACT FROM AUTHOR]

Previous epidemiologic evidence suggests a protective effect of Toxoplasma gondii infection against multiple sclerosis (MS) development; however, inconsistent findings have been reported in this regard. Therefore, we performed an updated meta-analysis of observational studies to investigate the association of To. gondii infection with MS development. We searched all articles published in PubMed, Scopus, Embase and Web of Science databases as of 20 December 2021. A random effects meta-analysis model was used to generate the pooled OR at 95% CIs. The heterogeneity between studies was assessed using I 2 and Cochran's Q statistics. Moreover, the likelihood of publication bias was determined by Egger's regression test. A total of 11 studies were eligible for meta-analysis, including 1172 MS cases and 1802 controls. Our findings indicated that 29.8% (95% CI 22.8 to 37.2%) of MS patients were seropositive for To. gondii infection, compared with 34.2% (95% CI 21.9 to 47.6%) of control subjects. The estimated pooled OR was 0.79 (95% CI 0.49 to 1.26), suggesting a non-significant negative association between To. gondii infection and MS development (p>0.05). The current study does not support the significant protective role of To. gondii infection on MS development. Our findings imply that further well-designed epidemiological and mechanistic studies are warranted to ascertain the possible association between To. gondii infection and MS and to exclude the potential confounders. [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis was to analyze the influence of a maternal and/or offspring high-fat diet (HFD) on the morphology of the offspring adipocytes and amount of food and energy consumption. The search was conducted through Pubmed, EMBASE, and Web of Science databases up to October 31st, 2021. The outcomes were extracted and pooled as a standardized mean difference with random effect models. 5,004 articles were found in the databases. Of these, only 31 were selected for this systematic review and 21 were included in the meta-analysis. A large discrepancy in the percentage of fat composing the HFD (from 14% to 62% fat content) was observed. Considering the increase of adipose tissue by hyperplasia (cell number increase) and hypertrophy (cell size increase) in HFD models, the meta-analysis showed that excessive consumption of a maternal HFD influences the development of visceral white adipose tissue in offspring, related to adipocyte hypertrophy, regardless of their HFD or control diet consumption. Upon following a long-term HFD, hyperplasia was confirmed in the offspring. When analyzing the secondary outcome in terms of the amount of food and energy consumed, there was an increase of caloric intake in the offspring fed with HFD whose mothers consumed HFD. Furthermore, the adipocyte hypertrophy in different regions of the adipose tissue is related to the sex of the pups. Thus, the adipose tissue obesity phenotypes in offspring are programmed by maternal consumption of a high-fat diet, independent of postnatal diet. • Maternal high-fat diet intake affects the adipogenic capacity of offspring. • Maternal-HFD programs hypertrophy of adipocytes independent of postnatal diet. • Hyperplasia of adipose tissue is related to the high-fat diet consumption. • Alterations in area and number of adipocytes are sex-specific in offspring. [ABSTRACT FROM AUTHOR]

Background: Previous epidemiological studies revealed inconsistent associations between sugar-sweetened beverage (SSB) consumption and cognitive disorders, but there have been no meta-analyses of the pooled results. Thus, a meta-analysis was performed to determine the association between SSB consumption and cognitive disorders.Methods: A systematic search of the literature prior to May 20, 2022 was performed using the PubMed and Web of Science databases. Random effects models were used to calculate and combine odds ratios (ORs) depending on the degree of heterogeneity.Results: 13 studies met the inclusion criteria. A total of 242,014 participants (2752 in three cross-sectional studies and 239,262 in ten cohort studies) were included. A random effects meta-analysis, according to the comprehensive analysis of SSB consumption, was associated with a greater prevalence of cognitive disorders (OR = 1.17, 95 % CI = 1.05-1.29; I2 = 90.1 %). Subgroup analyses of study design, type of SSB, or cognitive disorders outcome was performed. In subgroup analyses, we found that SSB intake was associated with a higher prevalence of cognitive disorders in cohort studies, middle-aged and elderly population, and participants with sugar-sweetened soft drinks. However, no significant association was found in other subgroups.Conclusion: Our results indicate that SSB intake is positively associated with the prevalence of cognitive disorders. Therefore, attention should be paid to reducing SSB intake as an early intervention for cognitive disorders. [ABSTRACT FROM AUTHOR]

Background and Aim: Total mesorectal excision (TME) remains the treatment of choice in T2N0 tumors. However, evidence suggest that one‐size‐fits‐all approach is not always beneficial for this group of patients. The aim of this study is to synthesize data on long‐term outcomes after neoadjuvant therapy (NAT) followed by local excision (LE) in T2N0 rectal cancer patients in the perspective of a rectal‐preserving strategy. Methods: A systematic search of PubMed/MEDLINE, SCOPUS, and Web of Science databases was conducted until October 2021 to identify studies comparing LE after NAT and TME or reporting oncologic outcomes after conservative approach. A pooled analysis was conducted using a fixed‐effect model in the case of non‐significant heterogeneity (P > 0.1), and a random effect model (DerSimonian–Laird method) when significant heterogeneity was present (P < 0.1) CRD42022300344. Results: Nine studies were included in the analysis. Three of them were comparative studies. The pooled 3‐year DFS, 5‐year DFS, 3‐year OS, 5‐year OS, local and distant recurrence rates were 92.8% (95% CI 81.6–99.5%), 91.3% (95% CI 88.3–94.3%), 96.1% (95% CI 90.5–100%), 72.6% (95% CI 57.5–87.7%), 4% (95% CI 18–63%), and 4.9% (95% CI 2–7.8%), respectively, in subjects treated with NAT followed by LE. No heterogeneity was found for all these analyses, except for the 5‐year OS sub‐analysis (I2 95.5%, P < 0.001). Complete pathological response (ypT0) rate after NAT and LE ranges from 26.7% to 59%. Conclusion: LE following neoadjuvant CRT may provide comparable survival benefit to radical surgery for patients with clinical stage T2N0 in selected patients although the evidence is still limited to provide solid recommendations. A personalized therapeutic approach taking into account tumor and patient‐related factors should be considered. [ABSTRACT FROM AUTHOR]

Background: Vaccination is the promising strategy to control the coronavirus disease 2019 (COVID-19) pandemic. However, the success of this strategy will rely mainly on the rate of vaccine acceptance among the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of COVID-19 vaccine acceptance and its determinants in Ethiopia. Methods: We searched PubMed, Scopus, Google Scholar, African Journals Online, and Web of Sciences database to retrieve related articles. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Funnel plot and Eggers test were done to assess publication bias. Cochrane Q-test and I2 statistic were done to chick evidence of heterogeneity. Subgroup analysis was computed based on the study region and the study population. Data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA version 14 statistical software. Weighted inverse variance random effect model was run to estimate the pooled prevalence of COVID-19 vaccine acceptance. Results: A total of 12 studies with 5,029 study participants were included. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 51.64% (95%CI; 43.95%-59.34%). Being male (AOR = 4.46, 1.19–16.77, I2 = 88%), having secondary and above educational status (AOR = 3.97, 1.94–8.12, I2 = 69%), good knowledge (AOR = 3.36, 1.71–6.61, I2 = 93%), and positive attitude (AOR = 5.40, 2.43–12.00, I2 = 87%) were determinants of COVID-19 vaccine acceptance in Ethiopia. Conclusion: The pooled prevalence of COVID-19 vaccine acceptance was low. Being male, having secondary and above educational status, good knowledge, and positive attitude were the determinants of COVID-19 vaccine acceptance. High level of COVID-19 vaccine acceptance among the general population is crucial to achieve herd immunity in the community. Therefore, policymakers, vaccine campaign program planners, and stakeholders should target to improve public awareness of vaccination that enhances vaccine acceptance and in turn helps to control the pandemic. [ABSTRACT FROM AUTHOR]

Background: Dengue is a major public health issue worldwide and severe dengue (SD) is life threatening. It is critical to triage patients with dengue infection in the early stage. However, there is limited knowledge on early indicators of SD. The objective of this study is to identify risk factors for the prognosis of SD and try to find out some potential predictive factors for SD from dengue fever (DF) in the early of infection. Methods: The PubMed, Cochrane Library and Web of Science databases were searched for relevant studies from June 1999 to December 2020. The pooled odds ratio (OR) or standardized mean difference (SMD) with 95% confidence intervals (CI) of identified factors was calculated using a fixed or random effect model in the meta-analysis. Tests for heterogeneity, publication bias, subgroup analyses, meta-regression, and a sensitivity analysis were further performed. Findings: A total of 6,848 candidate articles were retrieved, 87 studies with 35,184 DF and 8,173 SD cases met the eligibility criteria. A total of 64 factors were identified, including population and virus characteristics, clinical symptoms and signs, laboratory biomarkers, cytokines, and chemokines; of these factors, 34 were found to be significantly different between DF and SD, while the other 30 factors were not significantly different between the two groups after pooling the data from the relevant studies. Additionally, 9 factors were positive associated with SD within 7 days after illness when the timing subgroup analysis were performed. Conclusions: Practical factors and biomarkers for the identification of SD were established, which will be helpful for a prompt diagnosis and early effective treatment for those at greatest risk. These outcomes also enhance our knowledge of the clinical manifestations and pathogenesis of SD. [ABSTRACT FROM AUTHOR]

Some studies have suggested that diabetes may be a risk factor for osteoarthritis. However, whether prediabetes is also associated with osteoarthritis has not been comprehensively examined. We performed a meta-analysis to evaluate the relationship between prediabetes and osteoarthritis. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intra-study heterogeneity was selected to pool the results. Ten datasets from six observational studies were included, which involved 41 226 general adults and 10 785 (26.2%) of them were prediabetic. Pooled results showed that prediabetes was not independently associated with osteoarthritis [risk ratio (RR): 1.07, 95% confidence interval (CI): 1.00 to 1.14, p=0.06, I2 =0%]. Sensitivity limited to studies with adjustment of age and body mass index showed consistent result (RR: 1.06, 95% CI: 0.99 to 1.14, p=0.09, I2 =0%). Results of subgroup analyses showed that prediabetes was not associated with osteoarthritis in cross-sectional or cohort studies, in studies including Asian or non-Asian population, or in studies with different quality scores (p for subgroup difference>0.10). Besides, prediabetes was not associated with osteoarthritis in men or in women, in studies with prediabetes defined as impaired fasting glucose, impaired glucose tolerance, or HbA1c (approximately 39–46 mmol/mol). Moreover, prediabetes was not associated with overall osteoarthritis, and knee or hip osteoarthritis. Current evidence does not support that prediabetes is independently associated with osteoarthritis in adult population. [ABSTRACT FROM AUTHOR]

Introduction: Pyrazinamide (PZA) susceptibility testing plays a critical role in determining the appropriate treatment regimens for multidrug-resistant tuberculosis. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of sequencing PZA susceptibility tests against culture-based susceptibility testing methods as the reference standard. Methods: We searched the MEDLINE/PubMed, Embase, and Web of Science databases for the relevant records. The QUADAS-2 tool was used to assess the quality of the studies. Diagnostic accuracy measures (i.e., sensitivity and specificity) were pooled with a random-effects model. All statistical analyses were performed with Meta-DiSc (version 1.4, Cochrane Colloquium, Barcelona, Spain), STATA (version 14, Stata Corporation, College Station, TX), and RevMan (version 5.3, The Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, Denmark) software. Results: A total of 72 articles, published between 2000 and 2019, comprising data for 8,701 isolates of Mycobacterium tuberculosis were included in the final analysis. The pooled sensitivity and specificity of the PZA sequencing test against all reference tests (the combination of BACTEC mycobacteria growth indicator tube 960 (MGIT 960), BACTEC 460, and proportion method) were 87% (95% CI: 85–88) and 94.7% (95% CI: 94–95). The positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under the curve estimates were found to be 12.0 (95% CI: 9.0–16.0), 0.17 (95% CI: 0.13–0.21), 106 (95% CI: 71–158), and 96%, respectively. Deek's test result indicated a low likelihood for publication bias (p = 0.01). Conclusions: Our analysis indicated that PZA sequencing may be used in combination with conventional tests due to the advantage of the time to result and in scenarios where culture tests are not feasible. Further work to improve molecular tests would benefit from the availability of standardized reference standards and improvements to the methodology. [ABSTRACT FROM AUTHOR]

Purpose: To perform a systematic review and meta-analysis to quantify the technical success rate of adrenal venous sampling (AVS) with and without intraprocedural computed tomography (CT). Methods: A systematic search of the Medline, Scopus, EMBASE, and Web of Science databases for comparative studies using intraprocedural CT was undertaken. More than 1,000 records were screened using titles and abstracts. Full texts of 121 studies were reviewed and 14 eligible studies were identified. Nine studies had adequate comparative data and were included in the meta-analysis. Results: A research synthesis was performed and data from 809 patients were pooled in multiple random effect models. Overall success rate of AVS without and with intraprocedural CT was 72.7% (59.3–83.0%) and 92.5% (86.6–95.9), respectively. The addition of intraprocedural CT increased the technical success rate by 19.8% (P < 0.001), with an odds ratio (OR) of 5.5 (3.3–9.2; P < 0.01). In meta-regression, odds of success with intraprocedural CT was associated with younger age (beta: 0.16 ± 0.05; P:0.001), higher body mass index (BMI; beta:0.08 ± 0.03; P:0.002), and higher selectivity index (defined as the ratio of cortisol in the adrenal vein to that in the inferior vena cava; beta:0.35 ± 0.08, P < 0.001). We found a linear inverse association between operator's success without CT and improved success with intraprocedural CT (R2: 0.86). Conclusions: Intraprocedural CT is not required for every case, but can be performed in difficult cases or when operators' success is limited. The benefit was more pronounced in younger patients with higher BMI, female gender, and with higher selectivity. Level of evidence: III Systematic review and meta-analysis of non-randomized clinical trials. [ABSTRACT FROM AUTHOR]

Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of chronological aging. The risk factors of skin aging have been studied previously, using methods of quantifying skin aging. However, these studies have yet to be reviewed. To better understand skin aging risk factors and collate the available data, we aimed to conduct a systematic review and meta-analysis. We conducted our systematic review in compliance with Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase, PubMed and Web of Science databases were searched in October 2020 using specific search strategies. Where odds ratios were reported, meta-analyses were conducted using the random effects model. Otherwise, significant factors were reported in this review. We identified seven notable risk factors for various skin aging phenotypes: age, gender, ethnicity, air pollution, nutrition, smoking, sun exposure. This review's results will guide future works, such as those aiming to examine the interaction between genetic and environmental influences. [ABSTRACT FROM AUTHOR]

Background: Previous literature on the association between infections and the risk of developing ankylosing spondylitis (AS) presented controversial results. This meta-analysis aimed to quantitatively investigate the effect of infections on the risk of AS. Methods: We searched the PubMed, Embase, and Web of Science databases until March 26, 2021 for analytical epidemiological studies on the association between infections and the risk of AS. Fixed or random effect models were used to calculate total risk estimates based on study heterogeneity. Subgroup analysis, and sensitivity analysis were also performed. Publication bias was estimated using funnel plots and Begg's test. Results: Six case-control articles (n=1,296,239) and seven cohort articles (n=7,618,524) were incorporated into our meta-analysis. The pooled odds ratio (OR) from these case-control studies showed that infections were associated with an increased risk of AS (OR=1.46, 95% confidence interval [CI], 1.23–1.73), and the pooled relative risk (RR) from the cohort studies showed the same findings (RR=1.35, 95% CI, 1.12–1.63). Subgroup analysis showed that infections in participants with unadjusted comorbidities (OR=1.66, 95% CI, 1.35–2.03), other types of infection (OR=1.40, 95% CI, 1.15–1.70), and infection of the immune system (OR=1.46, 95% CI, 1.42–1.49) were associated with the risk of AS in case-control studies. In cohort studies, infections with adjusted comorbidities (RR=1.39, 95% CI, 1.15–1.68), viral infection (RR=1.43, 95% CI, 1.22–1.66), other types of infection (RR=1.44, 95% CI, 1.12–1.86), and other sites of infection (RR=1.36, 95% CI, 1.11–1.67) were associated with an increased risk of AS. Conclusions: The findings of this meta-analysis confirm that infections significantly increase the risks of AS. This is helpful in providing an essential basis for the prevention of AS via the avoidance of infections. [ABSTRACT FROM AUTHOR]

Objective: The associations between sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption and the risk of metabolic syndrome (MetS) remain controversial. A quantitative assessment of dose-response associations has not been reported. This study aims to assess the associations between the risk of MetS and SSB, ASB, and total sweetened beverage (TSB, the combination of SSB and ASB) consumption by reviewing population-based epidemiological studies.Design: Meta-analysis.Setting: We searched PubMed, Embase and Web of Science databases prior to 4 November 2019, for relevant studies investigating the SSB-MetS and ASB-MetS associations. A random effects model was used to estimate pooled relative risks (RR) and 95 % CI. Dose-response association was assessed using a restricted cubic splines model.Participants: We identified seventeen articles (twenty-four studies, including 93 095 participants and 20 749 MetS patients).Results: The pooled RR for the risk of MetS were 1·51 (95 % CI 1·34, 1·69), 1·56 (1·32, 1·83) and 1·44 (1·19, 1·75) in high consumption group of TSB, SSB and ASB, respectively; and 1·20 (1·13, 1·28), 1·19 (1·11, 1·28) and 1·31 (1·05, 1·65) per 250 ml/d increase in TSB, SSB and ASB consumption, respectively. Additionally, we found evidence of non-linear, TSB-MetS and SSB-MetS dose-response associations and a linear ASB-MetS dose-response association.Conclusions: TSB, SSB and ASB consumption was associated with the risk of MetS. The present findings provide evidence that supports reducing intake of these beverages to lower the TSB-, SSB- and ASB-related risk of MetS. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present systematic review and meta-analysis is to compare laparoscopic right colectomy (LRC) versus robotic right colectomy (RRC) using homogeneous subgroup analyses for extra-corporeal anastomosis (EA) and intra-corporeal anastomosis (IA). Methods: MEDLINE, Scopus, and Web of Science databases were searched up to April 2020 for prospective or retrospective studies comparing LRC versus RRC on at least one short- or long-term outcome. The primary outcome was the length of hospital stay (LOS). The secondary outcomes included operative and pathological results, survival, and total costs. LRC and RRC were compared using three homogeneous subgroups: without distinction by the type of anastomosis, EA only, and IA only. Pooled data analyses were performed using mean difference (MD) and random effects model. Results: Thirty-seven of 448 studies were selected. The included patients were 21,397 for the LRC group and 2796 for the RRC group. Regardless for the type of anastomosis, RRC showed shorter LOS, lower blood loss, lower conversion rate, shorter time to flatus, and lower overall complication rate compared with LRC, but longer operative time and higher total costs. In the EA subgroup, RRC showed similar LOS, longer operative time, and higher costs compared with LRC, the other outcomes being similar. In the IA subgroup, RRC showed shorter LOS and longer operative time compared with LRC, with no difference for the remaining outcomes. Conclusions: Most included articles are retrospective, providing low-quality evidence and limiting conclusions. The more frequent use of the IA seems to explain the advantages of RRC over LRC. [ABSTRACT FROM AUTHOR]

It remains unclear whether a specific chest CT characteristic is associated with the clinical severity of COVID-19. This meta-analysis was performed to assess the relationship between different chest CT features and severity of clinical presentation in COVID-19. PubMed, Embase, Scopus, web of science databases (WOS), Cochrane library, and Google scholar were searched up to May 19, 2020 for observational studies that assessed the relationship of different chest CT manifestations and the severity of clinical presentation in COVID-19 infection. Risk of bias assessment was evaluated applying the Newcastle-Ottawa Scale. A random-effects model or fixed-effects model, as appropriately, were used to pool results. Heterogeneity was assessed using Forest plot, Cochran's Q test, and I2. Publication bias was assessed applying Egger's test. A total of 18 studies involving 3323 patients were included. Bronchial wall thickening (OR 11.64, 95% CI 1.81–74.66) was more likely to be associated with severe cases of COVID-19 infection, followed by crazy paving (OR 7.60, 95% CI 3.82–15.14), linear opacity (OR 3.27, 95% CI 1.10–9.70), and GGO (OR 1.37, 95% CI 1.08–1.73). However, there was no significant association between the presence of consolidation and severity of clinical presentation (OR 2.33, 95% CI 0.85–6.36). Considering the lesion distribution bilateral lung involvement was more frequently associated with severe clinical presentation (OR 3.44, 95% CI 1.74–6.79). Our meta-analysis of observational studies indicates some specific chest CT features are associated with clinical severity of COVID-19. • Chest CT can be considered a key tool to evaluate the progression of COVID-19. • There is an association between chest CT findings and clinical severity. • Bronchial wall thickening is the highest chest CT predictor of poor outcome. [ABSTRACT FROM AUTHOR]

Background: Although female sex workers (FSWs) have long been identified as a key human papillomavirus (HPV)-affected population, the burden and scope of their disproportionate risk for HPV infection have not been systematically estimated. We therefore aimed to estimate the prevalence of HPV and the distribution of HPV types in FSWs at the country, regional and global levels.Methods: We searched the PubMed, Embase, SCOPUS, EBSCO, ProQuest, Cochrane Library and Web of Science databases for articles published between 1 January 1990 and 31 June 2019. Studies of genital HPV prevalence in FSWs, or with sufficient data (e.g. adequate number of HPV-positive cases and sample size) to compute prevalence rates in FSWs, were included in this systematic review. The meta-analysis was completed using the random effects model.Results: We ultimately identified 107 studies in 45 countries or regions with sufficient data to calculate HPV prevalence in FSWs. The pooled global HPV prevalence among FSWs was 39.5% (95% CI 35.3, 43.9%), with notable variations by WHO region and country. Globally, the five most common HPV types in FSWs were HPV16 (9.0%), HPV 52 (8.3%), HPV89 (7.0%), HPV58 (6.2%), and HPV53 (5.3%).Conclusions: Our findings suggest that FSWs are disproportionately affected by HPV, which is more pronounced in the Western Pacific and African regions, and are therefore in need of prevention, treatment and care services. [ABSTRACT FROM AUTHOR]

Using bibliometric methods, this paper analyzes the total amount and keyword composition among 910 studies in the field of farmland abandonment published in the Web of Science database from 1992 to 2019. According to the usage of keywords, existing studies are reviewed from the three aspects of monitoring and mapping, driving forces and influencing factors, and effects assessment and trade-off. The results show that: (1) At present, the extraction and mapping of abandoned farmland data mainly rely on household surveys and remote sensing technology, and combing NDVI time series with spatial information can provide abandoned farmland data with high precision. (2) The driving forces and influencing factors of cultivated land abandonment have been summarized in terms of extent, sources and attributes, respectively. Cultivated land marginalization is the fundamental driving force of cultivated land abandonment, labor migration is the direct driving force, and changes in socio-economic factors are the main driving forces. (3) The environmental effects of cultivated land abandonment are spatially heterogeneous, and temporal-spatial differences, the landscape environment, climate, cultivation and topographic features will all play decisive roles in shaping the ultimate environmental effects. Studies of trade-offs between the impacts of cultivated land abandonment mainly focus on ecosystem service function and value, while the role of spatial background is often ignored. Based on a systematic review of existing literature, this paper suggests that future efforts should carry out large-scale investigations on abandoned cultivated land at the national level, conduct multi-scale research on the driving forces of land abandonment, and conduct trade-off research on the effects of land abandonment based on national conditions. [ABSTRACT FROM AUTHOR]

Backgrounds and Purpose: Currently, circulating microRNAs (miRNAs) are considered to be non-invasive diagnostic biomarkers in a broad range of tumors. Nevertheless, so far, miRNAs have not been fully applied to the clinic for routine screening in glioma patients. Thus, our goal is to evaluate the diagnostic performance of circulating miRNAs for gliomas via a meta-analysis. The present study is registered on the PROSPERO website, with the number CRD42020195883. Methods: Literature retrieval was implemented in the PubMed, Embase, and Web of Science databases using the established search strategy. We pooled the sensitivity, specificity, and its 95% confidence intervals (CIs) for the included studies using the Stata 14.0 software. In addition, the heterogeneity between studies was assessed via the Q statistics and I 2 values calculated by a Chi-square test. A bivariate random effects model was selected due to significant heterogeneity. Specifically, for exploring the factors influencing the heterogeneity, we implemented subgroup and meta-regression analyses. Ultimately, a Deek's funnel plot asymmetry test was used to estimate the potential publication bias. Results: A total of 18 articles covering 24 studies were included, containing 2,170 glioma patients and 1,456 healthy participants. The overall pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.84 (95%CI: 0.79–0.87), 0.84 (95%CI: 0.80–0.88), 5.3 (95%CI: 4.1–6.8), 0.19 (95%CI: 0.15–0.25), 27 (95%CI: 18–41), and 0.91 (95%CI: 0.88–0.93), respectively. Additionally, the findings revealed that serum miRNAs and miRNA panels presented superior diagnostic performance. Conclusion: Thus, circulating miRNAs have the potential to serve as diagnostic biomarkers for gliomas, but need to be verified via a large pool of prospective studies. Additionally, specific miRNAs still need to be elucidated in the diagnosis of a glioma, especially in the early screening stage. The findings may provide diagnostic and therapeutic strategies for the glioma population. [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which is caused by the interplay of genetic and environmental risk factors such as second-hand smoke (SHS). The association between postnatal exposure to SHS and ADHD risk in children was still inconclusive. We performed a systematic review and meta-analysis to explore the definite association. We searched for relevant studies from PubMed, Embase, Ovid, and Web of Science databases up to January 2020. We used random effect models to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses and sensitive analyses were also performed to solve the heterogeneity. According to our inclusion criteria, 9 studies including 6 cross-sectional studies, 2 cohort studies, and 1 case-control study were included in the final analysis. Postnatal exposure to SHS increased the risk of ADHD in children (OR: 1.60; 95% CI: 1.37–1.87). Children who exposed to SHS were found a slight risk for conduct problems (OR: 1.33, 95% CI: 1.00–1.77). Among the studies which used cotinine as a biomarker for SHS exposure, a lower pooled OR (OR = 1.16, 95%CI = 1.01, 1.33) was observed between cotinine and ADHD in children. Our meta-analysis results suggested that SHS exposure may be a risk factor for ADHD. We also found that SHS exposure may be associated with some adverse behavioral outcomes. More prospective studies should be conducted to confirm the relationship between SHS exposure and ADHD in children. [ABSTRACT FROM AUTHOR]

• Changed peripheral BDNF, NGF, IGF-1, VEGF, and S100B levels are strongly associated with pathogenesis MDD. • Peripheral S100B is associated with antidepressant treatment response in MDD. • Peripheral BDNF levels can be used to assess the response of antidepressant treatment. • Peripheral VEGF levels are significantly increased in responders after antidepressant treatment. The neurotrophin hypothesis indicates that neurotrophic factors are important for the pathophysiology of major depressive disorder (MDD), with alterations in peripheral neurotrophin levels having potential clinical application for MDD. The present meta-analysis aimed to investigate the diagnostic value for MDD of peripheral neurotrophin levels in cross-sectional studies and the association between peripheral neurotrophin levels and the response to antidepressant treatment in longitudinal studies. Published studies in the PubMed and Web of Science databases were systematically searched up to February 2020. The search terms included depressive disorder, neurotrophic factor, serum/plasma and their synonyms. Human studies reporting on BDNF, GDNF, IGF-2, VEGF, NGF, FGF-2, and S100B levels in MDD patients were included. Data comparing MDD patients and healthy controls, and/or between responders and non-responders before and after antidepressant treatment were extracted. A random effects model was used to calculate standardized mean differences. A total of 177 original studies were identified, including 139 cross-sectional and 38 longitudinal studies. Significantly reduced BDNF and NGF levels and significantly elevated IGF-1, VEGF, and S100B levels were reported in MDD patients compared with healthy controls, while GDNF and FGF-2 levels were not significantly different. Furthermore, compared with non-responders, S100B levels at baseline and BDNF levels following treatment were significantly elevated in responders. In addition, there was a significantly elevated level of VEGF after treatment in responders only. In conclusions, alterations in peripheral neurotrophins levels were strongly associated with the biology and the treatment response of MDD. Further investigations are required to examine potential sources of heterogeneity. [ABSTRACT FROM AUTHOR]

Objectives: To summarize the current evidence on the association between maternal breastfeeding and the occurrence of attention deficit/hyperactivity disorder (ADHD) in offspring. Methods: We searched for studies published in English before May 2018 using the PubMed, EMBASE, Cochrane, and Web of Science databases. We included cohort studies, case–control studies, and cross-sectional studies, that focused on the association between maternal breastfeeding and the occurrence of ADHD in offspring. Random effects models were used for combined analyses. Results: Two cohort studies, 7 case–control studies and 3 cross-sectional studies, with 3,686 cases and 106,907 participants, were included. Children with any maternal breastfeeding had a lower incidence of ADHD than children who were never breastfed (odds ratio [OR]: 0.70; 95% confidence interval [CI]:0.52–0.93). Further analyses also showed associations between reduced ADHD incidence and duration of breastfeeding. Children breastfed for over 1 month, over 3 months, over 6 months, and over 12 months had a lower incidence of ADHD than children breastfed for less than 1 month (OR: 0.20; 95% CI: 0.11–0.38), less than 3 months (OR: 0.33; 95% CI: 0.23–0.47), less than 6 months (OR: 0.50; 95% CI: 0.41–0.61), and less than 12 months (OR: 0.55; 95% CI: 0.37–0.81), respectively. These results were stable in the 1-month, 3-month, and 6-month breastfeeding groups. Conclusion: With our meta-analysis, we provide evidence that maternal breastfeeding may reduce the risk of ADHD in children. The causality of this relationship and underlying mechanisms need to be explored in future prospective studies. [ABSTRACT FROM AUTHOR]

Objective: To estimate the current evidence regarding the association between gestational acrylamide (AA) exposure and offspring's growth.Design: Systematic review and meta-analysis.Setting: A systematic literature search for relevant publications was conducted using PubMed, Medline, Embase, Web of Science databases from inception to 26 April 2019. The standardised mean difference (SMD) or OR with 95 % CI was selected as the effect sizes and was calculated using a random effects model.Results: Five cohort studies including 54 728 participants were identified. Offspring's birth weight was significantly lower in high AA exposure group than in low AA exposure group (SMD -0·05, 95 % CI -0·09, -0·02, P = 0·005). There was also an association between maternal AA exposure and small for gestational age (OR 1·14, 95 % CI 1·06, 1·23, P < 0·001). In addition, pooled ORs suggested that children had a high risk of developing overweight/obesity in the future in maternal high AA exposure group (OR 1·14, 95 % CI 1·08, 1·21, P < 0·001 at age 3; OR 1·13, 95 % CI 1·07, 1·19, P < 0·001 at age 5; OR 1·09, 95 % CI 1·02, 1·16, P = 0·020 at age 8).Conclusions: These findings have important implications for conducting health education, providing guidance on maternal diet and developing an appropriate dietary strategy for pregnant women to reduce dietary AA exposure. [ABSTRACT FROM AUTHOR]