Global prevalence and genetic diversity of Cryptosporidium spp. in pigeons: A systematic review and meta-analysis.

Publication bias: Graphical and statistical methods

Supplementary Figures 68 - 80 from Imaging Features of HER2 Overexpression in Breast Cancer: A Systematic Review and Meta-analysis

Supplementary Figures 68 - 80 from Imaging Features of HER2 Overexpression in Breast Cancer: A Systematic Review and Meta-analysis

Global prevalence of Human Demodex Mite: A systematic review and meta-analysis.

Cadmium (Cd) is a heavy metal associated with several human disorders. Preeclampsia is a major cause of maternal mortality worldwide. The association between maternal Cd exposure and preeclampsia remains elusive. To better understand this relationship, we conducted a systematic review and meta-analysis of eligible studies from five databases (PubMed, Embase, Web of Science, Scopus, and CNKI) from their inception to September 10, 2022. The quality of these studies was evaluated using the Newcastle-Ottawa quality assessment scale (NOS). We use random-effects models to calculate overall standardized mean differences (SMDs) and 95% confidence intervals (CIs). Sensitivity analyses were performed to assess the robustness of our results. We also evaluated publication bias using Egger's and Begg's tests. Additionally, we conducted meta-regression and sub-group analyses to identify potential sources of heterogeneity between studies. Our analysis included a total of 17 studies with 10,373 participants. We found a significant association between maternal cadmium exposure and the risk of preeclampsia (SMD 0.27, 95% CI 0.09-0.44, p < 0.01). No significant publication bias was detected in Begg's or Egger's tests. Meta-regression suggested that geographical location, year of publication, cadmium samples, sample size, and measurement methods did not contribute to heterogeneity between studies. Our findings suggest that maternal blood cadmium levels are associated with an increased risk of preeclampsia. In contrast, the pregnant women's urine or placental levels of cadmium may not suggest preeclamptic risk during pregnancy. Further high-quality clinical studies and animal experiments are needed to understand this association better. PROSPERO, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=361291, identifier: CRD42022361291.

Diabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus. Articles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author's name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins' I2 statistics. Egger's test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect. Initially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and -0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, -1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: -0.99, basophils: 0.34, lymphocytes: -0.19 and monocyte: -0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were -0.10, -0.69, 0.19, and -0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: -0.57 (106/μL), Hb: -0.73 g/dL and HCT: -1.22%, Where as in T1DM RBC, Hb and HCT were -1.23 (106/μL), -0.80 g/dL and -0.29%, respectively. Patients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters. https://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].

BackgroundThe association of asthma with oral conditions such as dental caries, dental erosion, periodontal diseases and oral mucosal changes has been the subject of debate among dental practitioners. Existing evidence indicates that an inhaler is the most common and effective way of delivering the asthma medications directly into the lungs. Few studies in the past attributed this association to the changes in salivary flow caused due to these medications. Considering this unclear association, the aim of the present meta-analyses is to identify the association between erosive toothwear and asthma from individual studies conducted until date.MethodologyElectronic databases were systematically searched until 30th September 2022. Articles identified using the search strategy were imported to RAYYAN systematic review software. Data was extracted relating to study design, geographic location, year of publication, sample size, the assessment method for erosive toothwear and asthma. The Newcastle Ottawa scale was utilized to assess the quality of evidence reported from the included studies. RevMan Version 5.3 was used to perform a random-effects meta-analysis to produce pooled estimates from OR and 95% CI of included studies. The I² statistic was used to determine the extent of heterogeneity. A funnel plot was generated to visually assess the potential for publication bias. Sensitivity analyses were performed by excluding individual studies one at a time. GRADE approach was used for grading the evidence for key comparisons.ResultsTwelve articles were included in the final meta-analysis. A total of 1027 asthmatics and 5617 non-asthmatics were included. All studies demonstrated moderate to low risk of bias. The overall pooled estimate (OR: 2.03; 95% CI: 0.96, 4.29) and subgroup analyses in children (OR: 1.67; 95% CI: 0.63, 4.42) did not show statistically significant difference in the occurrence of dental erosion between the asthmatic and non-asthmatic group. However, asthmatic adults had significantly greater dental erosion in comparison to the control adults (OR: 2.76; 95% CI: 1.24, 6.16). Sensitivity analyses also provided inconclusive evidence. Funnel plot asymmetry indicated significant heterogeneity, changes in effect size and selective publication.ConclusionThe association between inhalational asthmatic medication and tooth wear is inconclusive. There are a number of confounding factors that play a greater role in causing dental erosion in these patients. Dentist must pay particular attention to these factors while treating asthmatic patients. The authors produce a comprehensive checklist in order to ensure complete assessment before providing advice on their medications alone.

Background and aimThe quality of life (QoL) of the elderly can be easily threatened due to their special characteristics and needs. Various questionnaires have been developed to measure QoL. One of the most well-known and widely used questionnaires is LEIPAD. The abbreviation LEIPAD originates from the collaboration of institutions in Leiden (the Netherlands) and Padua (Italy). The purpose of this study was to determine the QoL of Iranian elderly people using the LEIPAD questionnaire.MethodThis study was a systematic review and meta-analysis. All published articles on the QoL of the elderly were identified using five databases (PubMed, Scopus, Web of Science, SID, and Magiran) and the Google Scholar search engine and were assessed for quality. The search was limited to articles published until 20 March 2025. The screening process, article selection, data extraction, and quality assessment were all conducted independently by two authors, with any disagreements resolved through consultation. Heterogeneity among studies was assessed using the I2 statistic and Cochran's Q test. Subgroup analysis based on the study location, QoL Dimensions, and setting was performed. The relationship between QoL of the Iranian elderly and publication year and sample size was evaluated using meta-regression. Publication bias was assessed using funnel plots and the Egger test. Finally, 20 articles were analyzed using CMA software.FindingsBased on the random-effects model, the average QoL of the Iranian elderly as measured by LEIPAD is 58.70 (52.31–65.09; 95% CI). The highest average is reported in Kerman city in 2013 at 90.30 (86.94–93.65; 95% CI), and the lowest average is reported in Tehran city in 2017 at 27.88 (26.57–29.18; 95% CI). The self-care dimension had the highest average score (13.32 (10.44–16.19)), and the sexual functioning scale had the lowest average score (2.31 (1.41–3.21)). Moreover, sample size and year were significantly correlated with QoL (P < 0.05). Publication bias for the QoL of Iranian elderly was not significant. Sensitivity analysis confirmed the stability of the findings.ConclusionThe findings of this study reveal that the QoL among the elderly population in Iran is assessed as average. This outcome highlights a significant concern, as the elderly demographic is particularly vulnerable and often faces unique challenges that can affect their overall well-being. Therefore, addressing the average QoL reported among Iranian elderly individuals requires a multifaceted approach involving policy reforms, resource allocation, community support, ongoing evaluation, and professional training. By taking these steps, health authorities can significantly improve the quality of life for this vulnerable demographic.

Cryptosporidium spp. are important zoonotic parasites that can cause moderate to severe diarrhea in humans and animals. However, the epidemiological data of Cryptosporidium in sika deer in China need to be updated. In this study, a total of 466 fecal samples were collected from sika deer in Shandong, Jilin, Liaoning, and Heilongjiang provinces. Nested PCR was used to amplify the SSU rRNA gene to detect Cryptosporidium spp. The results showed that the overall infection rate of Cryptosporidium spp. was 14.81%, with no significant differences among regions (p=0.05). The highest infection rate was found in Heilongjiang Province (23.60%) and the lowest in Jilin Province (10.71%). The infection rate in summer (23.61%) seemed higher than that in autumn (13.20%), but the difference was not statistically significant (p=0.30). Notably, young sika deer showed a significantly higher infection rate (28.21%) compared to adults (10.32%) (p<0.0001). Sequence analysis identified two Cryptosporidium species/genotypes: Cryptosporidium deer genotype (98.55%) and Cryptosporidium ubiquitum (1.45%). Subtyping revealed that the C. ubiquitum isolate belonged to the zoonotic XIIa subtype. These findings provide new insights into the prevalence and genetic diversity of Cryptosporidium in sika deer and suggest that sika deer may act as a potential reservoir for zoonotic Cryptosporidium transmission.

Equine infectious anemia (EIA) is a lentiviral disease affecting members of the Equidae family, with global distribution and significant implications for animal health and biosecurity. Despite numerous individual reports, a comprehensive synthesis of its global prevalence and risk factors remains lacking. This study aimed to conduct a systematic review and meta-analysis to estimate the global prevalence of EIA, identify diagnostic trends, and evaluate factors associated with heterogeneity across studies. A systematic search was conducted in six major databases (PubMed, Scopus, Web of Science, ScienceDirect, Cochrane Library, and ProQuest), yielding 312 records. After Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided screening, 29 eligible studies published between 1975 and 2024 were included in the study. Meta-analysis was performed using R Studio (version 4.4.2) employing a random-effects model. Subgroup analyses and meta-regression were conducted to explore heterogeneity across host species, continent, diagnostic method, and study period. Publication bias was assessed through funnel plots and Egger's test. The global pooled prevalence of EIA was estimated at 20.97% (95% confidence interval [CI]: 11.08-30.85), with substantial heterogeneity (I2 = 99.3%). South America reported the highest regional prevalence (27.21%), while horses showed the greatest susceptibility among Equidae (25.40%). Diagnostic methods varied, with agar gel immunodiffusion being the most commonly used (18.62% prevalence detection). A declining trend in prevalence (2.19%-28.70%) was noted from 2015 to 2022. No significant publication bias was detected. Meta-regression revealed that climate and study period partially explained the heterogeneity. This study highlights the substantial global burden and diagnostic variability of EIA, emphasizing the need for enhanced surveillance in endemic areas, standardized diagnostic protocols, and strengthened quarantine practices. Expanding serological monitoring in underrepresented regions and integrating climatic and ecological data into control strategies are vital for mitigating EIA transmission risks.

MA10.05 Distress Screening in Lung Cancer Patients using a Distress Thermometer: A Meta-Analysis

This study assesses the incidence of ICU-acquired weakness (ICUAW) among patients using kidney replacement therapy (KRT) and explores the uncertain relationship between KRT and ICUAW in critically ill adult patients. A comprehensive search was conducted across PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to June 10, 2024. Inclusion criteria encompassed randomized controlled trials (RCTs), as well as prospective and retrospective cohort studies that examined the correlation between KRT and ICUAW in adult ICU patients. Heterogeneity was evaluated using the χ² and I² statistics. Publication bias was assessed qualitatively via funnel plots and quantitatively using Begg's and Egger's tests. A total of twelve cohort studies involving 2275 adult patients were included, with no RCTs meeting the criteria. The overall incidence of ICUAW was 49.5% in patients using KRT, compared to 34.8% in non-KRT controls. These studies collectively demonstrated a statistically significant association between KRT and a higher incidence of ICUAW (OR, 2.12; 95% CI, 1.34-3.34). Subgroup and sensitivity analyses reinforced this association, particularly in studies involving patients with clinical weakness, large sample sizes, and low risk of bias. However, studies focused on patients with abnormal electrophysiology and small sample sizes did not show this correlation. Despite the substantial findings, statistical heterogeneity was present. No significant publication bias was detected. This study highlights a significant association between KRT and an increased incidence of developing ICUAW.

The human immune virus or acquired immune deficiency syndrome, is a major threat to the health of millions of people worldwide. In Ethiopia, there were more than a million people living with HIV/AIDS. The continuous and appropriate use of condoms, particularly among those who have HIV-positive clients, is essential to a comprehensive and long-term approach to avoiding HIV and other STIs as well as unintended pregnancy. But irregular condom use is regularly reported. There is inconsistent reports of the prevalence and correlates of frequent condom use in Ethiopia. This study's goal is to provide an overview of the most recent research on magnitude condom use among people living with HIV in Ethiopia. Four databases of PubMed, Science Direct, Scopus, and Google Scholar were used. Finally, 10 studies that satisfied the eligibility criteria were included in the systematic review and meta-analysis. The data were collected using a methodical checklist for data extraction, and STATA 14 was utilized for the analysis. The consistent condom use was reported as use of condom in every sexual encounter preceding the study. The prevalence of consistent condom usage among HIV/AIDS patients was calculated by dividing the total number of patients who regularly used condoms by the total number of HIV/AIDS patients and multiplying that result by 100. The factors associated with a consistent use of condom were described using the pooled odds ratio (OR) and calculated based on binary outcomes from the included primary studies. The statistical significance was determined based on the correlation factor as their confidence level should not include 1. Subgroup analyses by region and publication years were carried out by using a random-effects model. The STATA commands of metan magnitude semagnitude, random xlab(.1,5,10) lcols (authors) by (variables)texts(120) xsize(18) ysize (14) were used to carried out the subgroup analysis. To assess the presence of publication bias, funnel plot, Egger test and Begg's test at 5% significant level were computed. The asymmetry of funnel plot and the Egger test and Begg's test P value of 0 >0.5 showed the absence of publication bias. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. The pooled magnitude of consistent condom use was 50.56% (95%CI: 38.09-63.02). The predictors of consistent condom use includes urban residence (AOR = 3.46; 95% CI: 2.24-5.35), marital status (AOR = 0.33; 95% CI: 0.18-0.61), and HIV disclosure status (AOR = 5.61;95%CI: 2.29-13.73). Half of the HIV/AIDS patients in our study regularly used condoms. According to this study, urban residency, disclosure status, and marital status were all associated with consistent condom use among HIV/AIDS patients. Therefore, health education about condom use should be provided to married couples and people living in rural regions. In addition, disclosing HIV status and the necessity of constant condom usage would be crucial for consistent condom use.

BackgroundPatients with cancer are at a higher risk of tuberculosis (TB) infection because of the immunosuppressive effect of prolonged chemotherapy. This study determined the prevalence of TB and TB-related deaths among patients with cancer from a global perspective.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct the current study. Extracted data from relevant articles were analyzed using Stata, version 17.0, software (StataCorp LP). The effect size estimate was computed using a random-effects model, considering a 95% confidence interval (CI). The I2 statistic and Galbraith plot were used to confirm heterogeneity. A univariate meta-regression, sensitivity, and subgroup analyses were conducted to identify the source of heterogeneity. The Egger test and a funnel plot were used to check publication bias.ResultsIn the 13 articles, of the 2 135 402 patients with malignancy, 31 073 had TB. The pooled estimate of TB was 3.69% (95% CI = 1.79% to 5.58%), with high heterogeneity (I2 = 99.99%). The pooled TB prevalence in Europe was 7.04 (95% CI = 1.09% to 12.99%). The prevalence of TB in a single study in North America was 8.78% (95% CI = 8.45% to 9.10%). A higher TB prevalence was observed in patients with solid tumors (6.84%, 95% CI = 4.30% to 9.38%), followed by hematologic malignancies and solid tumors (3.63%, 95% CI = 1.46% to 5.80%). Pulmonary and extrapulmonary TB were 3.05% and 0.77%, respectively. The rate of TB-related death was 0.04%. In meta-regression, publication year and sample size did not affect heterogeneity.ConclusionThere is a considerable burden of TB (3.69%) in patients with cancer, which calls for routine TB screening and early treatment of cases to reduce complications.

SummaryA caesarean section (CS) is a lifesaving procedure. With rising rates, women's delivery choices have become a global concern. This review assesses global CS preference and determinants. A search of 6 databases was conducted (PubMed, Medline, EMBASE, CINAHL, Google Scholar and Maternity and Infant Care) in accordance with PRISMA guidelines, including papers published between 2013 and 2024. Egger's test and funnel plot assessed publication bias, while the I2 statistic and Cochrane Q-test evaluated heterogeneity. Subgroup analysis considered sample size, publication year and economic condition. Initially, 73 articles were identified, of which 13 were deemed suitable, with a total sample size of 22,238. The pooled global CS preference was 26%. Subgroup analysis considered economic status, publication year and sample size. Variables associated with CS preference included age >25 years (adjusted odds ratio [AOR] = 4.9, 95% confidence interval [CI]: 1.4–8.4), higher education (AOR = 1.7, 95% CI: 1.05–2.3), urban residency (AOR = 1.9, 95% CI: 1.4–2.4), lack of knowledge of CS (AOR = 2.1, 95% CI: 1.5–3.6) and prior pregnancy complications (AOR = 4.8, 95% CI: 1.4–10). The pooled global CS preference was nearly one-fourth. This review found that an age greater than 25 years, higher education, urban residency, lack of knowledge about CSs and history of previous pregnancy complications were determinant factors for preference for caesarean delivery. As a result, strengthening healthcare systems is essential to improve women's decision-making regarding mode of delivery.