Combined Sample Size Research Articles

Association Between Patient Safety Culture and Missed Nursing Care in Healthcare Settings: A Systematic Review and Meta-Analysis.

To appraise and synthesise existing research on the relationship between patient safety culture and missed nursing care. Systematic review and meta-analysis. Peer-reviewed articles published from 2010 onwards were searched from five databases (CINAHL, ProQuest, PubMed, ScienceDirect and Web of Science). A total of nine studies were identified. Among these, seven studies with a combined sample size of 1661 participants were included in the meta-analysis. The meta-analysis revealed a significant negative correlation between overall patient safety culture and missed nursing care, with a pooled correlation coefficient of -0.205 (95% CI: -0.251 to -0.158) (p < 0.001). Heterogeneity was low to moderate (I2 = 13.18%, 95% CI: 0.00 to 78.60), and publication bias tests indicated no significant bias (Egger's test p = 0.0603; Begg's test p = 0.3476). The findings underscore a significant inverse relationship between patient safety culture and missed nursing care, highlighting the specific predictive roles of management support, organisational learning and unit-level safety culture. Enhancing patient safety culture within healthcare organisations can be a strategic approach to mitigate missed nursing care. Nursing leaders and administrators should prioritise fostering a safety-oriented culture through targeted interventions, continuous education and supportive policies to improve patient care outcomes. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. No patient or public contribution.

Prevalence of and factors associated with formula feeding among mothers with infants 0-6 months of age in Ethiopia: a systematic review and meta-analysis.

Inconsistent results have been reported regarding the prevalence of and factors associated with formula feeding in Ethiopia. This study aimed to determine the pooled prevalence of and factors associated with formula feeding among mothers with infants 0-6 months of age in Ethiopia. A comprehensive systematic search was conducted across 3 databases (PubMed, EMBASE, and ScienceDirect) and the Google Scholar search engine to identify relevant studies published up to April 2, 2024. After assessing the quality of each study using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies, data were independently extracted by 2 authors using pre-designed forms in an Excel spreadsheet. Any disagreements were resolved through discussion and consultation with additional authors. Statistical heterogeneity across studies was assessed using the I2 statistic. A random-effects meta-analysis was used to pool the proportions, due to high heterogeneity, while a fixed-effect meta-analysis was used to pool associated factors with low heterogeneity. A sensitivity analysis was performed to assess the potential impact of outlier studies on the overall estimates. Five studies, with a combined sample size of 2344 participants, were included. The pooled prevalence of formula feeding was 34.0% (95% CI: 23.0%, 44.0%). Factors significantly associated with formula feeding included cesarean delivery (POR [pooled odds ratio] = 4.72, 95% CI: 3.32, 6.71) compared with vaginal delivery, a positive attitude toward formula feeding (POR = 2.26, 95% CI: 1.45, 3.53) compared with a negative attitude, initiation of breastfeeding more than 1 hour after delivery (POR = 2.27, 95% CI: 1.25, 4.13) compared with initiation within 1 hour, and receiving information about formula feeding from friends or family (POR = 2.47, 95% CI: 1.46, 4.20) compared with receiving information from health-care professionals. The prevalence of formula feeding in Ethiopia is significant. Cesarean delivery, a positive attitude toward formula feeding, late initiation of breastfeeding, and receiving formula feeding-related information from friends and family were positively associated with formula feeding. Given these findings, the authors recommend that public health interventions in Ethiopia target these key determinants to decrease the high prevalence of formula feeding practices observed in the country. Strategies addressing factors such as promoting vaginal delivery, improving attitudes toward breastfeeding, encouraging early breastfeeding initiation, and limiting the influence of social networks on formula-feeding decisions may be beneficial.

Comparison of Incision Closure in Hand Plastic Surgery Using Non-absorbable Versus Absorbable Sutures: A Systematic Review of Randomized Controlled Trials.

Surgeons prioritize scar appearance after surgery, making suture choice crucial. Traditionally, non-absorbable sutures were standard but require removal, causing patient discomfort and extra visits. Absorbable sutures, while offering convenience, might raise concerns about scar quality. This study aims to provide an overview of the plastic surgery literature and clinically based evidence of the efficacy and outcome of absorbable and non-absorbable sutures. A systematic review of search databases in MEDLINE, EMBASE and the Cochrane Library was made to identify studies related to absorbable and non-absorbable sutures. The inclusion criteria for this study included RCTs comparing AS and NAS in plastic hand surgery, without any limitations of age or sex on recruited patients. A total of 532 hands were treated with a combined sample size of 517 patients undergoing plastic hand surgery. Two hundred seventy-three (51%) of patients had their wound closed with non-absorbable sutures, and 259 (49%) had absorbable sutures. Overall patient satisfaction among the studies that reported number of patients satisfied with the wound closure appearance was 64 (64%) in non-absorbable sutures cohort and 58 (59%) in absorbable sutures. Wound inflammation happened in 8 (3%) of wounds closed with non-absorbable sutures and in 9 (3.4%) of wounds closed with absorbable sutures. In both patients cohorts, the overall patient satisfaction and complication rates were not significantly different. Non-absorbable sutures appearedto have slightly higher patient satisfaction rates. However, absorbable sutures may offer some benefits in terms of convenience with lower risk of wound dehiscence. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Magnitude of female child sexual abuse in Ethiopia: A systematic review and meta-analysis.

Child sexual abuse is a grave issue with significant consequences for the well-being and development of children worldwide. Understanding the scope of this problem is essential, particularly in Ethiopia, where protecting the nation's youth is crucial. Although child sexual abuse is a critical issue, there is a lack of comprehensive assessment of its prevalence and associated factors in Ethiopia. This study aims to fill this gap by conducting a meta-analysis and systematic review to explore the current prevalence and contributing factors of female child sexual abuse in Ethiopia. This study followed the PRISMA checklist, focusing on Ethiopian studies. Nine relevant studies were identified from databases such as PubMed, Google Scholar, Scopus, Medline, and the Cochrane Library for the final meta-analysis and systematic review. The analysis was performed with STATA version 11, utilizing a structured checklist for data extraction. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were employed. To check for publication bias, Egger's weighted regression, Begg's test, and a funnel plot were utilized. A total of 1230 research articles were initially identified for this systematic review and meta-analysis. After screening, nine studies met the eligibility criteria, with a combined sample size of 3930 children across all studies. The pooled prevalence of child sexual abuse among female students was 36.83% [95% CI: 24.35-49.32]. This meta-analysis identified several factors significantly associated with child sexual abuse: children living alone (OR=4.45, 95% CI: 2.65-7.46), living with friends (OR=3.49, 95% CI: 2.35-5.18), alcohol consumption (OR=2.72, 95% CI: 1.70-4.35), cigarette smoking (OR=3.83, 95% CI: 1.66-8.83), parental conflicts (OR=2.50, 95% CI: 1.43-4.36), lack of open discussion about reproductive health (OR=3.44, 95% CI: 1.84-6.42), and family control practices (OR=1.92, 95% CI: 1.16-3.17). The pooled prevalence of child sexual abuse among female students (36.83%) highlights a critical need for focused preventive efforts. Key risk factors identified include living alone or with friends, alcohol consumption, cigarette smoking, parental conflicts, limited reproductive health discussions, and controlling family practices. Addressing these through community education, family support, and open communication on reproductive health could help reduce abuse risk among vulnerable groups.

Theoretical model for combined sample size and strain rate effect on tensile strength of quasi-brittle materials

Theoretical model for combined sample size and strain rate effect on tensile strength of quasi-brittle materials

Prognosis and Clinical Significance of Piezo2 in Tumor: A Meta-analysis and Database Validation.

The objective of this study is to assess the correlation between Piezo2 and tumors through a comprehensive meta-analysis and database validation. Case-control studies investigating the association between Piezo2 and tumors were obtained from various databases, including China National Knowledge Infrastructure (CNKI), SinoMed, Embase, Web of Science, The Cochrane Library, and PubMed. The search was performed from the inception of each database up until May 2023. Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies. Metaanalysis of the included literature was conducted using Stata 12.0 software. Additionally, the Gene Expression Profiling Interactive Analysis (GEPIA) database predicted a correlation between Piezo2 expression and prognostic value in tumor patients. A total of three studies, involving a combined sample size of 392 participants, were included in the meta-analysis. The findings revealed that the expression level of Piezo2 in tumor patients was not significantly associated with age, gender, or tumor size. However, it was found to be positively correlated with lymphatic invasion (OR = 7.89, 95%CI: 3.96-15.73) and negatively correlated with invasion depth (OR = 0.17, 95%CI: 0.06-0.47), TNM stage (OR = 0.48, 95%CI: 0.27-0.87), and histological grade (OR = 0.40, 95%CI: 0.21-0.77). Confirming these findings, the GEPIA database indicated that high expression of Piezo2 was associated with poor prognosis of disease-free survival in patients with colon adenocarcinoma (HR = 1.6, P = 0.049) and gastric cancer (HR = 1.6, P = 0.017). Piezo2 may be associated with poor prognosis and clinicopathological parameters in tumor patients.

Exploring the Link: A Systematic Review and Meta-Analysis on the Prevalence and Association Between Refractive Errors and Intermittent Exotropia.

Refractive errors and intermittent exotropia are prevalent conditions in pediatric populations, impacting visual development and quality of life. Despite the co-occurrence of conditions such as myopia, hypermetropia, and astigmatism with strabismus, comprehensive analyses of their coexistence are limited. This study aims to investigate the prevalence and characteristics of refractive error among children with intermittent exotropia and find the correlation between the angle of deviation for far and near with factors like mean spherical equivalent and age. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed and Scopus databases were searched up to February 13, 2024. Inclusion criteria encompassed studies detailing clinical presentation, management strategies, and outcomes, while exclusion criteria eliminated review articles, conference abstracts, animal research, and studies with inadequate clinical information. Data extraction and quality assessment were independently performed by multiple reviewers, with discrepancies resolved through consensus. Forest plot was used to show the mean spherical equivalent and the angle of deviation, while publication bias was demonstrated using funnel plot with Egger test. The search yielded 932 articles, with 23 meeting the inclusion criteria. Studies represented four geographical regions, with a combined sample size of 5407 participants aged 3-10 years. The mean refractive errors varied widely, with an overall pooled mean of -1.787 (95% CI: -5.392 to 1.818). Overminus lens therapy and surgical interventions were common management strategies, with surgery prevalent in cases with higher distant angle deviation. The myopia was more prevalent than hypermetropia (26.82%/16.10%). Meta-regression showed that the mean spherical equivalent had a significant effect on the angle of deviation far and near. There was a significant correlation between myopia and intermittent exotropia in Middle Eastern and Asian pediatric populations. Myopia is notably more prevalent with significant effect of mean spherical equivalent on near-angle deviation.

Abstract 4136969: Empagliflozin's Role in Post-Myocardial Infarction Management: Insights from a Meta-Analysis

Background: Empagliflozin, a Sodium Glucose Cotransporter 2 (SGLT2) Inhibitor, is used to treat type 2 diabetes mellitus and heart failure. Its safety and efficacy in patients with Myocardial Infarction (MI) have been studied recently. Research Questions/Hypothesis: What is the role of Empagliflozin in post-myocardial infarction management by preventing cardiovascular deaths, reducing hospitalization due to heart failure, and minimizing adverse events? Goals/Aims: Role of Empagliflozin in post-myocardial infarction management by preventing cardiovascular deaths, reducing hospitalization due to heart failure, and minimizing adverse events Methods: A literature search was done on PubMed, Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials from inception until May 2024. All Randomized Control Trials (RCT) reporting the safety and efficacy of Empagliflozin in MI management were selected. Outcomes were pooled as Mean Difference (MD) or Risk Ratio (RR) with 95% Confidence Intervals (CI) in this meta-analysis using Revman 5.4. Results: Data from ten RCTs, with a combined sample size of 10,560 patients was pooled, and showed that Empagliflozin is superior to placebo in terms of Cardiovascular death (RR=0.75, 95% CI [0.64, 0.88],p &lt; 0.0004) and hospitalization due to heart failure (RR=0.70, 95% CI [0.59, 0.82], p &lt; 0.0001). However, the results were non-significant for both groups in terms of adverse events (RR=1.00, 95% CI [0.96, 1.03], p &lt; 0.78). Conclusion: Empagliflozin significantly lowers the risk of cardiovascular events in patients with MI who are at a high risk of death due to cardiovascular causes.

Abstract 4134308: Re-evaluating the safety profile of Semaglutide: An updated meta-analysis

Background: Semaglutide is increasingly used in the management of type 2 diabetes mellitus and obesity. Ensuring safety of this medication is crucial for its clinical use. This meta-analysis evaluates the safety profile of semaglutide across patient populations and treatment durations. Methods: Randomized controlled trials assessing the safety of semaglutide versus placebo, with specified treatment durations were identified. The primary outcome was occurrence of any cardiovascular adverse events. Secondary outcomes included sudden cardiac death, adverse events leading to death, adverse events, gastrointestinal side effects, occurrence of hypoglycemia and new-onset neoplasm. Results: A total of 23 studies met the inclusion criteria with a combined sample size of 57,911 participants. The meta-analysis revealed that the adverse event associated with semaglutide is gastrointestinal in nature (nausea and vomiting). No significant differences were observed between semaglutide and comparator groups. (See Figure 1) Conclusion: Semaglutide appears to have a favorable safety profile across diverse patient populations and treatment durations, supporting its continued use in the management of type 2 diabetes mellitus and obesity. It is generally well-tolerated, with a low incidence of adverse events. Clinicians should be aware of these findings and monitor patients accordingly. Further long-term studies are warranted to assess the safety of semaglutide in clinical practice.

The Role of Formal Schooling, Literacy, and Health Knowledge in Addressing Domestic Violence Against Women in West Africa.

When "education" is cited as a solution for domestic violence, different aspects of knowledge acquisition are often omitted. This study uses 2019 Demographic and Health Surveys from four West African countries (The Gambia, Liberia, Senegal, Sierra Leone) with a combined sample size of 12,480 women and generalized ordered logit regression to examine the effects of types of knowledge (years of schooling, literacy, and health knowledge) on domestic violence (physical abuse, emotional abuse, and control issues). The results suggest that literacy has the most reliable beneficial impact on domestic violence and was consistently associated with decreased odds of abuse. However, greater findings suggest that schooling, literacy, and health knowledge function as separate types of education and that their relationships are complex and context-specific. By neglecting to see these types of knowledge as separate entities that can operate together, it is possible that mitigation strategies for domestic violence are going undiscovered.

Brucellosis Seroprevalence in Cattle in China During 2014–2024: A Systematic Review and Meta-analysis

Brucellosis, caused by several species of Brucella, continues to be a significant illness that poses a global threat to public health. China remains a persistent hotspot for brucellosis, despite the implementation of extensive control measures. This study aims to conduct a systematic review and meta-analysis of the seroprevalence of bovine brucellosis in different breeds and regions of China from 2014-2024, and to provide predictions on the future prevalence patterns of brucellosis in cattle and humans. The analysis comprised a total of 80 research studies, which consisted of 187 datasets and a combined sample size of 3,130,706. We estimated the overall pooled seroprevalence of bovine brucellosis in China to be 1.5% (95% CI: 0.6-2.6%). Subgroup analysis revealed that the seroprevalence in dairy cattle was 3.1%, surpassing the seroprevalence in beef cattle (1.3%) and yak (1.5%). Regions that had authorized vaccination programs exhibited higher seroprevalence (1.8%) compared to regions that did not have vaccination (0.5%). Notably, the study observed a simultaneous rise in both the prevalence of brucellosis in cattle and the number of human brucellosis cases. This suggests that high-quality routine surveillance of brucellosis in cattle will be essential for predicting and responding to cases in humans. Additionally, given the existing prevention and control measures, brucellosis will likely continue to be prevalent in both cattle and people. This systematic review will assist policymakers in adjusting animal surveillance and interregional livestock movement policies, ultimately contributing to the public safety goal of preventing brucellosis in humans by controlling it in animals.

The efficacy and safety of CDK4/6 inhibitors combined with endocrine therapy versus endocrine therapy alone in the adjuvant treatment of patients with high-risk invasive HR+/HER2-early breast cancer: A comprehensive updated meta-analysis of randomized clinical trials

BackgroundThis paper aimed to evaluate the effectiveness of incorporating CDK 4/6 inhibitors (CDK4/6i) into ET for the adjuvant treatment of HR + HER2-resected early-stage breast cancer (ESBC) patients, employing meta-analysis. MethodsIn this paper, we compiled randomized clinical trials focusing on CDK4/6i used in the adjuvant treatment of high-risk invasive HR-positive and HER2-ESBC patients. A meta-analysis was performed in line with the PRISMA guidelines. ResultsWe identified four clinical trials that met our inclusion criteria and were published between 2020 and 2024. These trials involved a combined sample size of 17,749 patients diagnosed with breast cancer. The data obtained from the pooled analysis revealed a remarkable beneficial trend in terms of invasive disease-free survival (iDFS) for the use of ET in combination with CDK4/6i compared to the group receiving ET alone (HR = 0.81, 95 % CI: 0.67–0.98, p = 0.03). Of note, CDK4/6 inhibitors demonstrated a notably beneficial effect in both grade 2 (HR = 0.69, 95 % CI: 0.59–0.81, p < 0.001) and grade 3 (HR = 0.76, 95 % CI: 0.65–0.89, p < 0.001). Significant improvements were noted in terms of distant relapse-free survival (dRFS) in the groups treated with abemaciclib and ribociclib (HR = 0.65, 95 % CI: 0.56–0.76, p < 0.001; HR = 0.72, 95 % CI: 0.58–0.89, p = 0.003, respectively). CDK4/6i didn't yield a statistically significant difference in overall survival (OS) (HR = 0.96, 95 % CI: 0.77–1.19, p = 0.69). The use of CDK4/6i with ET was associated with an increased risk of adverse events, particularly anemia and neutropenia, compared with ET alone (OR = 9.12, 95 % CI = 5.04–16.48, p < 0.001). ConclusionThe findings of this paper demonstrate a significant improvement in iDFS when ET is combined with CDK4/6i, compared to ET alone. Specifically, treatments with abemaciclib and ribociclib showed notable enhancements in dRFS.

Child and adolescent social withdrawal predict adult psychosocial adjustment: A meta-analysis

This systematic review and set of five meta-analyses synthesized the results of prospective longitudinal publications on childhood and/or adolescent social withdrawal as a predictor of adult psychosocial adjustment. Meta-analyses were conducted with results for five adult outcomes from 31 publications derived from 14 longitudinal samples and a combined sample size of 19,806 adults (50% women, M = 38.88 years, 83% White) with childhood and/or adolescent ( ≤ 16 years) histories of social withdrawal and their offspring (N = 175). Dependency among publications derived from the same longitudinal samples was explicitly modeled in meta-analyses with clustering. Meta-analytic results support childhood and/or adolescent social withdrawal as a medium-sized risk factor for adult social anxiety and intergenerational difficulties in mothers and their offspring (both p &amp;lt; 0.0001); a small-size risk factor for delayed adult developmental milestones (p &amp;lt; 0.05), adult social withdrawal (p &amp;lt; 0.0001), other anxiety (p &amp;lt; 0.05), and depression (p &amp;lt; 0.01); and a small-size protective factor against adult substance use (p &amp;lt; 0.01). However, meta-analytic results did not support childhood and/or adolescent social withdrawal as a predictor of physical health, likely due to the heterogeneous nature of the investigated health outcomes. Consistent with a Developmental Science Model, results are interpreted as supporting interpersonal mechanisms (missing out, interpersonal stress, and poor relationship quality) and developmental cascades (cross domain-influences) in socially withdrawn children's life-course development. Because evidence for intergenerational difficulties was based on a single longitudinal sample, confidence in intergenerational effects would be increased by replication in other samples. Heterogeneity among effect sizes included in most meta-analyses suggests that the relation between childhood and/or adolescent social withdrawal and adult outcomes is likely to be moderated by other factors. Future directions in this area of research are discussed.

Episodic memory impairment and its influencing factors in individuals with autism spectrum disorder: systematic review and meta-analysis.

Individuals with autism spectrum disorders (ASD) are considered to experience difficulties with episodic memory (EM), while studies on EM in ASD have shown inconsistent results. A meta-analysis of 65 episodic memory studies with a combined sample size of 1652 individuals with ASD and 1626 typically developing individuals was conducted to analyze factors that may affect EM in ASD. The results showed that ASD had a significant medium to large effect size decrease in EM ability. Age period, task type, and reporting method significantly reduced the observed heterogeneity while EM type did not reduce the observed heterogeneity. The results of the meta-regression revealed that it was verbal IQ rather than full-scale IQ that was significantly correlated with EM in individuals with ASD. These findings suggest that individuals with ASD have reduced EM abilities and the potential factors is still needed to be explored.

A - 12 Neuropsychological Test Best Fit for Identifying on-the-Road Driving Behaviors in Normal and Abnormal Aging Populations: a Systematic Review

Abstract Objective This systematic review’s purpose is to identify neuropsychological assessments that are accurate at predicting driving behaviors in geriatric populations. The population included normal aging, mild cognitive impairment (MCI), and dementia. Data Selection PubMed and APA PsycNet databases were searched using two separate keyword searches: cognitive evaluation and driving behaviors and aging; neuropsychological test and driving behaviors and aging. The databases were searched March 10, 2024, and again on April 26, 2024. This yielded 278 articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to identify articles. Articles were excluded if they did not have on-road driving behaviors or simulated driving behaviors, neuropsychological test, if the average participant age was not geriatric, or if it was a non-peer reviewed article. Data Synthesis After following PRISMA selections, eight articles were included, creating a combined sample size of 927 (Mean age = 74.16, SD = 2.38; mean years of education = 14.17, SD = 1.09; female percentage = 40.78). The test deemed most correlated were Neuropsychological Assessment Battery: Driving Scene Test, Clock Drawing, Useful Field of View, Trail making task, Mini-Mental State Exam, verbal and visual memory components from the Wechsler Memory Scale, Rey-Osterrieth Complex Figure, and Maze Navigation Task. Conclusion General cognitive screening tests as well as visuomotor, visual–spatial, visual attention and verbal and non-verbal memory tests highly correlate with real driving behaviors and accurately predict on-the-road driving behaviors. This indicates the cognitive and behavioral complexity of driving. Though these tests accurately predict driving behaviors, their abilities to do so may differ depending on cultural groups.

Diabetes in axial spondyloarthritis: a systematic review and meta-analysis of observational studies

Axial spondyloarthritis (axSpA) is a chronic inflammatory condition with an increased risk of cardiovascular disease (CVD). Diabetes is a well-established risk factor for CVD and stroke. The objective of this study was to conduct a systematic review to: (i) identify the prevalence of diabetes in axSpA and (ii) compare the risk of diabetes in patients with axSpA and without. A comprehensive literature search was performed for articles published between 1 January 2000 and 15 November 2023 using Medline, Embase and Scopus (PROSPERO: CRD42023482573). Observational studies reporting prevalence, incidence or risk of diabetes in axSpA were included. Search results were independently screened by at least two reviewers. Quality of included studies were assessed using the JBI critical appraisal tool. Study-specific proportions and odds ratios (OR) were combined in a random-effects meta-analysis. 2257 articles were identified from database searching from which 23 studies were included for analysis amounting to a combined sample size of 65 025 patients. The pooled prevalence of diabetes in people with axSpA was 7.0% (95% CI 5.9–8.0%; predictive interval 2.4–12.9%; p < 0.001). The funnel plot was symmetric suggesting no small-study effects (I2 = 98.1% (95% CI 0.05–0.08), τ2 = 0.02; p < 0.001). Comparing patients with axSpA to those without, the pooled OR was 1.29 (95% CI 1.10–1.52; predictive interval 0.76–2.22; p = 0.001) for diabetes. The study suggests an increased prevalence and probably an increased risk of diabetes in people with axSpA. Routine screening for diabetes and lifestyle modifications should be encouraged in this cohort.

A Large-Scale Genome-Wide Gene-Sleep Interaction Study in 732,564 Participants Identifies Lipid Loci Explaining Sleep-Associated Lipid Disturbances.

We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify novel genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets. We collected data from 55 cohorts with a combined sample size of 732,564 participants (87% European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) total sleep time were defined by the extreme 20% of the age- and sex-standardized values within each cohort. Based on cohort-level summary statistics data, we performed meta-analyses for the one-degree of freedom tests of interaction and two-degree of freedom joint tests of the main and interaction effect. In the cross-population meta-analyses, the one-degree of freedom variant-sleep interaction test identified 10 loci (P int <5.0e-9) not previously observed for lipids. Of interest, the ASPH locus (TG, LTST) is a target for aspartic and succinic acid metabolism previously shown to improve sleep and cardiovascular risk. The two-degree of freedom analyses identified an additional 7 loci that showed evidence for variant-sleep interaction (P joint <5.0e-9 in combination with P int <6.6e-6). Of these, the SLC8A1 locus (TG, STST) has been considered a potential treatment target for reduction of ischemic damage after acute myocardial infarction. Collectively, the 17 (9 with STST; 8 with LTST) loci identified in this large-scale initiative provides evidence into the biomolecular mechanisms underpinning sleep-duration-associated changes in lipid levels. The identified druggable targets may contribute to the development of novel therapies for dyslipidemia in people with sleep disturbances.

Machine learning-based antibiotic resistance prediction models: An updated systematic review and meta-analysis.

The widespread use of antibiotics has led to a gradual adaptation of bacteria to these drugs, diminishing the effectiveness of treatments. To comprehensively assess the research progress of antibiotic resistance prediction models based on machine learning (ML) algorithms, providing the latest quantitative analysis and methodological evaluation. Relevant literature was systematically retrieved from databases, including PubMed, Embase and the Cochrane Library, from inception up to December 2023. Studies meeting predefined criteria were selected for inclusion. The prediction model risk of bias assessment tool was employed for methodological quality assessment, and a random-effects model was utilised for meta-analysis. The systematic review included a total of 22 studies with a combined sample size of 43,628; 10 studies were ultimately included in the meta-analysis. Commonly used ML algorithms included random forest, decision trees and neural networks. Frequently utilised predictive variables encompassed demographics, drug use history and underlying diseases. The overall sensitivity was 0.57 (95% CI: 0.42-0.70; p< 0.001; I2= 99.7%), the specificity was 0.95 (95% CI: 0.79-0.99; p< 0.001; I2 = 99.9%), the positive likelihood ratio was 10.7 (95% CI: 2.9-39.5), the negative likelihood ratio was 0.46 (95% CI: 0.34-0.61), the diagnostic odds ratio was 23 (95% CI: 7-81) and the area under the receiver operating characteristic curve was 0.78 (95% CI: 0.74-0.81; p< 0.001), indicating a good discriminative ability of ML models for antibiotic resistance. However, methodological assessment and funnel plots suggested a high risk of bias and publication bias in the included studies. This meta-analysis provides a current and comprehensive evaluation of ML models for predicting antibiotic resistance, emphasising their potential application in clinical practice. Nevertheless, stringent research design and reporting are warranted to enhance the quality and credibility of future studies. Future research should focus on methodological innovation and incorporate more high-quality studies to further advance this field.

Heart Rate Variability Biofeedback as a Treatment for Military PTSD: A Meta-Analysis.

Emerging research has provided tentative support for the use of heart rate variability biofeedback (HRVB) as a treatment for several psychological disorders, with meta-analyses providing compelling evidence for HRVB as a promising treatment for anxiety, depression, and PTSD. Given the prevalence of PTSD in military veterans and the comparatively lower benefit and higher attrition rate of traditional psychological treatment for PTSD relative to civilian counterparts, it is important to examine complementary and alternative treatment approaches such as HRVB in this population. Although studies of HRVB for PTSD have been conducted with military veterans, they have involved relatively small sample sizes, limiting interpretation. To address this, the current article presents a comprehensive meta-analysis, consolidating existing literature to more accurately evaluate the efficacy of HRVB in reducing PTSD symptoms within military populations. This meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and our protocol was registered with PROSPERO to increase review transparency. A literature search of HRVB interventions was conducted using PubMed, PsycINFO, Military Database, PTSDPubs, and EBSCO's Psychological and Behavioral Sciences Collection. Five studies met eligibility criteria, providing a combined sample size of 95 military services members. For all studies, effect sizes were negative, indicating a reduction in PTSD symptoms. Effect sizes ranged from -1.614 to -0.414, resulting in an overall moderate to large mean effect for HRVB (Hedges's g = -0.557; 95% confidence interval = -0.818 to -0.296; P < .001). Additionally, cumulative attrition was 5.8%, significantly lower than commonly reported rates for evidence-based treatments (16%-36%). The present study is the first meta-analysis to examine HRVB as a treatment for military service members with PTSD. Results indicate that HRVB may be a viable treatment approach to reduce PTSD symptomatology. Low attrition rates, ease of accessibility, and favorable participant outlook serve as additional benefits for the use of HRVB.

Biological Insights from Schizophrenia-associated Loci in Ancestral Populations.

Large-scale genome-wide association studies of schizophrenia have uncovered hundreds of associated loci but with extremely limited representation of African diaspora populations. We surveyed electronic health records of 200,000 individuals of African ancestry in the Million Veteran and All of Us Research Programs, and, coupled with genotype-level data from four case-control studies, realized a combined sample size of 13,012 affected and 54,266 unaffected persons. Three genome-wide significant signals - near PLXNA4, PMAIP1, and TRPA1 - are the first to be independently identified in populations of predominantly African ancestry. Joint analyses of African, European, and East Asian ancestries across 86,981 cases and 303,771 controls, yielded 376 distinct autosomal loci, which were refined to 708 putatively causal variants via multi-ancestry fine-mapping. Utilizing single-cell functional genomic data from human brain tissue and two complementary approaches, transcriptome-wide association studies and enhancer-promoter contact mapping, we identified a consensus set of 94 genes across ancestries and pinpointed the specific cell types in which they act. We identified reproducible associations of schizophrenia polygenic risk scores with schizophrenia diagnoses and a range of other mental and physical health problems. Our study addresses a longstanding gap in the generalizability of research findings for schizophrenia across ancestral populations, underlining shared biological underpinnings of schizophrenia across global populations in the presence of broadly divergent risk allele frequencies.