Main Source Of Heterogeneity Research Articles

Abstract A024: ABO blood type and overall survival in patients with pancreatic adenocarcinoma: A systematic review and meta-analysis

Abstract Background/Aim: Recent studies have reported that blood group antigens influence the risk of pancreatic cancer. However, studies on the influence of ABO blood groups on the outcomes of pancreatic cancer have been controversial. Therefore, we aimed to perform a systematic review and meta-analysis to evaluate the association between ABO blood groups and the overall survival in patients with pancreatic adenocarcinoma. Methods: A systematic review of the literature was conducted using the PubMed/Medline, Cochrane Library, and Embase databases in June 2024. This review included observational studies published as complete articles that assessed overall survival or mortality in patients with pancreatic cancer with O blood group compared to non-O. Review Manager 5.1 was used for statistical analysis. Hazard ratios (HRs) with 95% CI were pooled across studies. A random-effects model was used for outcomes with high heterogeneity. In cases where significant heterogeneity was observed (I2 > 40%), sensitivity analyses were conducted. Statistical significance was defined as a p-value < 0.05. Results: Of the 1,624 entries initially identified, nine retrospective studies were included in this meta-analysis, comprising 4,965 individuals. Individuals with O blood type had no statistically significant difference in overall survival compared to the non-O group (HR 1.22; 95% CI 0.97 to 1.53; p = 0.09; I2 = 70%). However, sensitivity analysis revealed one study as the main source of heterogeneity, and its exclusion significantly modified the results favoring the O blood group (HR 1.32; 95% CI 1.13 to 1.54; p = < 0.001; I2 = 10%). Patients with O blood type also had no statistically significant difference in overall survival compared to type A (HR 1.04; 95% CI 0.95 to 1.14; p = 0.43; I2 = 38%) and type B (HR 1.10; 95% CI 0.84 to 1.45; p = 0.49; I2 = 65%). Conclusions: ABO blood groups do not seem to be significantly associated with overall survival and mortality in individuals with pancreatic cancer. However, some analyses revealed significant heterogeneity between the studies. Additionally, a few studies were excluded from the plot because their results were reported in a manner that could not be integrated into a meta-analysis. Further multicenter prospective studies are still needed to validate our results. Citation Format: Tulio L Correa, Marcelo Cristalli, Pedro Luiz Lage Bodour Danielian, Vanio L J Antunes, Matheus Vanzin Fernandes, Natalia Junkes Milioli, Otavio C Martins, Cynthia Florencio de Mesquita, Stefano Baraldo, Bruno Bockorny. ABO blood type and overall survival in patients with pancreatic adenocarcinoma: A systematic review and meta-analysis [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A024.

The Prevalence of Depression among the Global Public in the Context of the COVID-19 Epidemic: A Systematic Review and Meta-Analysis.

We aimed to analyze the prevalence of depression among the global public during COVID-19, identify its influencing factors in order to provide reference, and help safeguard public mental health. A comprehensive literature on global public depression in various countries during the COVID-19 pandemic was obtained through electronic searches of PubMed, Web of Science, and other databases, combined with literature tracing from Dec 2019 to Mar 2023. Then a meta-analysis was conducted using the random effects model by Stata 16.0. The heterogeneity was evaluated by I2 . Subgroup analysis, sensitivity analysis, and meta-regression analysis were used to explore the sources of heterogeneity and the factors influencing public depression. Egger's test was used to test publication bias. Overall, 68 articles with 234,678 samples were included in the study. Analysis revealed that the overall prevalence of depression among the population during COVID-19 was 32.0% (95% CI: 29.0%-35.0%). Of these, marital status (OR=0.65, 95% CI: 0.47-0.87), presence of infected cases (OR=2.45, 95% CI: 1.82-3.30), and fear of being infected by the virus (OR=9.31, 95% CI: 6.03-14.37) were the main factors influencing people's depression and the main source of heterogeneity. The prevalence of depression among the global public is at a high level during COVID-19. The prevalence of depression among people unmarried, divorced, or widowed, surrounded by infected cases, contact infection cases, and worried about being were higher than others.

Comparative efficacy and safety of different anti-VEGF agents combined with different delivery methods for neovascular glaucoma: a systematic review and Bayesian network meta-analysis

ObjectiveTo compare the efficacy and safety of different anti-vascular endothelial growth factor (VEGF) agents combined with different delivery methods for neovascular glaucoma (NVG).DesignSystematic review and Bayesian network meta-analysis (NMA).Data sourcesPubMed,...

Clinical efficacy of acupuncture in treating postoperative gastrointestinal dysfunction of colorectal cancer, a systematic review and Meta analysis.

To evaluate the efficacy of acupuncture in the treatment of postoperative gastrointestinal dysfunction(POGD) of colorectal cancer. Randomized controlled trials of acupuncture in the treatment of POGD were retrieved from 7 databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP Chinese Journal Service Platform, WanFang Data Knowledge Service Platform, and China Biology Medicine disc. The search period ranged from the inception of the databases to November 10th, 2022. The quality of the included literature was assessed using the Cochrane bias risk assessment tool and the modified Jadad scale. Meta analysis was conducted using RevMan 5.4. Regression analysis and bias risk analysis were performed using Stata 16.0. Trial sequential analysis was conducted using TSA 0.9 software. A total of 27 randomized controlled trials involving 2 629 patients were included. Intervention measures included manual acupuncture, electroacupuncture, transcutaneous acupoint electrical stimulation, warm acupuncture, and thumb-tack needle. The results showed that acupuncture treatment significantly reduced time to tolerance of liquid diet after surgery (MD=-13.70, 95% CI=［-17.94, -9.46］, P<0.000 01), time to first defecation (MD=-18.20, 95% CI=［-22.62, -13.78］, P<0.000 01), time to first flatus (MD=-16.31, 95% CI=［-20.32, -12.31］, P<0.000 01), time to bowel sounds recovery (MD=-11.91, 95% CI=［-14.01, -9.81］, P<0.000 01), and length of hospital stay (MD=-1.49, 95% CI=［-2.27, -0.70］, P=0.000 2). Regression analysis indicated that cancer type, study quality and number of acupuncture were the main sources of heterogeneity. Bias analysis suggested potential publication bias risks. Trial sequential analysis indicated that the required number of cases had been met and the conclusion was reliable. Acupuncture is an effective intervention for promoting gastrointestinal recovery in patients undergoing colorectal cancer surgery. Further large-sample and well-designed clinical trials are still needed to compare different acupuncture techniques.

Effectiveness of fish oil in controlling inflammation in adult patients undergoing hemodialysis: A systematic review and meta-analysis.

Hemodialysis patients with chronic kidney disease often exhibit inflammation characterized by elevated levels of C-reactive protein, Interleukin 6 and tumor necrosis factor-alpha, and they are shown to be associated with cardiovascular impairment and enhanced renal failure. This study aims to assess the impact of fish oil intake on inflammation indicators in adult hemodialysis patients. From the inception to December 2023, the datasets Cochrane Central, Google Scholar, Science Direct, Embase, and Pubmed were examined. Two authors independently searched, selected, and screened the literature. The pooled results are represented by weighted mean difference (WMD) with 95% confidence intervals. To investigate the causes of heterogeneity, subgroup analysis was done. Sensitivity analysis was then used to evaluate the validity of the combined findings. Thirteen randomized control trials studies were included. The pooled results showed that fish oil supplementation caused a significant reduction of the C-reactive protein level (WMD, -2.92 mg/L; 95% Confidence interval, -5.23, to -0.61; p = 0.01; I 2 = 99%), especially in patients with baseline C-reactive protein ⩾5 mg/L (WMD, -4.39 mg/L; 95% Confidence interval, -5.93 to 2.85; p < 0.00001; I 2 = 33%). Subgroup analyses showed that C-reactive protein baseline level (C-reactive protein <5 mg/L) was the main source of heterogeneity. Fish oil intake may not reduce the level of Interleukin 6 (WMD, -2.26; 95% Confidence interval: -19.61 to 15.09; p = 0.80; I 2 = 93%), nor will it reduce the level of tumor necrosis factor-alpha (random model: WMD, -2.51; 95% Confidence interval: 6.08 to 1.06; p = 0.17; I 2 = 98%). Hemodialysis patients, especially those with C-reactive protein > 5 mg/L, responded to fish oil supplementation to reduce their C-reactive protein level; however, Interleukin 6 and tumor necrosis factor-alpha levels did not appear to be affected.

Lateral Variations in Teleseismic Attenuation of the Conterminous U.S. and New Insights Derived From Its Relationship to Mantle Seismic Velocity

AbstractMuch of our knowledge of the North American lithosphere comes from imaging seismic velocities. Additional constraints on the subsurface can be gained by studying seismic attenuation, which has different sensitivity to physical properties. We produce a model of lateral variations in attenuation across the conterminous U.S. by analyzing data recorded by the EarthScope Transportable Array. We divide the study area into 12 overlapping tiles and differential attenuation is measured in each tile independently; and twice for four of the tiles. Measurements are combined into a smooth map using a set of linear inversions. Comparing results for adjacent tiles and for repeated tiles shows that the imaged features are robust. The final map shows generally higher attenuation west of the Rocky Mountain Front than east of it, with significant small length scale variations superimposed on that broad pattern. In general, there is a strong anticorrelation between differential attenuation and shear wave velocities at depths of 80–250 km. However, a given change in velocity may correspond to a large or small change in attenuation, depending on the area; suggesting that different physical mechanisms are operating. In the western and south‐central U.S., as well as the Appalachians, velocity variations are large compared to attenuation changes, while the opposite is true in the north‐central and southeastern U.S. Calculations with the Very Broadband Rheology calculator show that these results are consistent with the main source of heterogeneity being temperature and melt fraction in the former regions and grain size variability in the latter ones.

Comparison of the diagnostic value of 18F-NaF PET/CT and 99mTc-MDP SPECT for bone metastases: a systematic review and meta-analysis.

Bone scintigraphy, the standard tool for detecting bone metastases has some insufficiencies; thus, supplementary imaging techniques are needed. This study is a comprehensive meta-analysis of studies reporting and comparing the diagnostic efficacy of 18F-sodium fluoride (18F-NaF) positron emission tomography/computed tomography (PET/CT) and 99mTc-MDP single-photon emission computed tomography (SPECT) for bone metastases. Literature related to the diagnosis of bone metastases using 18F-NaF PET/CT and 99mTc-MDP SPECT was searched on PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang databases, and VIP. Evaluation of study quality was performed according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Pooled sensitivity (SEN) and specificity (SPE) were assessed along with heterogeneity. The subject operating characteristic curve was plotted, the area under the curve (AUC) was calculated, and the pre- and post-test probabilities were compared. Finally, 11 articles, consisting of 1,085 patients and 1,782 lesions, were included. At the patient level (11 articles), the results were pooled SEN =0.92 and SPE =0.96 for PET/CT, SEN =0.80 and SPE =0.90 for SPECT. The AUC of PET/CT [0.98 (0.96-0.99)] was higher than that of SPECT [0.92 (0.89-0.94), P<0.05]. At the lesion level (6 articles), the results were pooled SEN =0.96 and SPE =0.98 for PET/CT, SEN =0.76 and SPE =0.94 for SPECT. The AUC of PET/CT [0.99 (0.98-1.00)] was higher than that of SPECT [0.94 (0.92-0.96); P<0.05]. Statistical heterogeneity existed, and meta-regression showed that, at patient-based level, the study design type, tumor character, and the selection blinding method were the main sources of heterogeneity. Furthermore, both PET/CT and SPECT had superior SEN for osteogenic metastases than non-osteogenic metastases (P=0.01). At the lesion level, tumor character was a source of heterogeneity accompanied by an increased SEN for osteogenic metastases, and the SEN for SPECT combined with CT was improved [SEN =0.87 (0.68-1.00), P=0.03]. 18F-NaF PET/CT has a higher SEN and SPE than 99mTc-MDP SPECT in diagnosing bone metastases, nevertheless, it is necessary to fully understand the primary tumor and the characteristics of the imaging protocol to choose suitable modality for individuals. Combining SPECT with CT improves the diagnostic efficacy than having SPECT alone and can be a powerful supplement to PET/CT for suspected osteogenic bone metastases.

Attention-deficit/hyperactivity disorder is associated with increased risk of cardiovascular diseases: A systematic review and meta-analysis.

Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with other psychiatric and physical diseases. However, available evidence on associations between ADHD and cardiovascular diseases (CVDs) is mixed. To systematically review, quantitatively synthesize, and appraise available evidence on the link between ADHD with CVDs, we searched relevant articles in PubMed, Embase, PsycINFO, and Web of Science from inception to May 1, 2022. Study quality was assessed by using the Newcastle-Ottawa Scale, and random-effects model meta-analyses were performed. A total of 18,391,169 (ADHD: n=421,224) individuals from 11 studies were included in our systematic review and 8,196,648 (ADHD=332,619) individuals from five studies were included in the main meta-analysis of adjusted estimates. Pooled estimates showed that ADHD was significantly associated with an increased risk of CVDs in analyses based on adjusted effect size (odds ratio (OR)=1.96; 95% confidence interval (CI)=1.19-2.23, Q=140.74, P Q<0.001, I 2=97.2%). When restricted among adults, the heterogeneity declined to null (OR=1.73; 95% CI=1.14-2.62, Q=6.28, P Q=0.10, I 2=6.28%), suggesting age might be the main source of heterogeneity. In subgroup analyses, we found increased risk of CVDs associated with ADHD across age groups, type of CVDs, and data sources. This systematic review and meta-analyses indicate that ADHD is associated with increased risk for CVDs, but further studies with various study designs are warranted to advance the understanding of the underlying mechanisms for the observed association between ADHD and CVDs. Additional research is also needed to resolve the role of ADHD medications which remains unclear due to the limited number of primary studies exploring this issue.

Does cone-beam computed tomography examination increase the micronuclei frequency in the oral mucosa exfoliated cells? A systematic review and meta-analysis

ObjectiveThis systematic review (SR) with meta-analysis aimed to evaluate the frequency of micronuclei in the oral mucosa exfoliated cells after cone-beam computed tomography (CBCT) examination.MethodsWe performed language-independent computer-assisted data searches using PubMed databases, Cochrane, Embase, Web of Science all databases, and Google Scholar. The literature on micronucleus (MN) frequency of clinical trials before and after CBCT examination was included. The frequency of MN in exfoliated cells of the human oral mucosa was the primary outcome of the study. All statistical analyses were performed with R (version 4.1.0), RStudio (version 2022.02.2 + 485) software, and Meta packages (version 5.2–0). Two reviewers independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications. The heterogeneity of the data was analyzed using I2 statistics, in which I2 > 50% was considered substantial heterogeneity.ResultsA total of 559 articles were selected through the search strategy. After screening titles and abstracts, nine full-text manuscripts were assessed for eligibility, and six observational studies were included in the meta-analysis. The present study showed a significant increase in MN frequency of human oral mucosal exfoliated cells 10 days after CBCT examination compared to baseline (SMD = − 0.56, 95%-CI = − 0.99 ~ − 0.13, p = 0.01). Because of the high heterogeneity among the studies (I2 = 72%), after removing one study that was the main source of heterogeneity, excluding the study (I2 = 47%), the common-effect model was chosen, and the meta-analysis also showed that the frequency of MN in human oral mucosa exfoliated cells increased significantly 10 days after CBCT examination (SMD = − 0.35, 95%-CI = − 0.59 ~ − 0.11, p = 0.004).ConclusionThis review suggested that CBCT examination increases the frequency of micronuclei in oral mucosal exfoliated cells.

Unfractionated heparin or low-molecular-weight heparin for venous thromboembolism prophylaxis after hepatic resection: A meta-analysis.

Two systematic reviews summarized the efficacy and safety of pharmacological prophylaxis for venous thromboembolism (VTE) after hepatic resection, but both lacked a discussion of the differences in the pharmacological prophylaxis of VTE in different ethnicities. Therefore, we aimed to evaluate the efficacy and safety of low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) for VTE prophylaxis in Asian and Caucasian patients who have undergone hepatic resection. We searched PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP databases for studies reporting the primary outcomes of VTE incidence, bleeding events, and all-cause mortality from January 2000 to July 2022. Ten studies involving 4318 participants who had undergone hepatic resection were included: 6 in Asians and 4 in Caucasians. A significant difference in VTE incidence was observed between the experimental and control groups (odds ratio [OR] = 0.39, 95% confidence interval [CI]: 0.20, 0.74, P = .004). No significant difference in bleeding events and all-cause mortality was observed (OR = 1.29, 95% CI: 0.80, 2.09, P = .30; OR = 0.71, 95% CI: 0.36, 1.42, P = .33, respectively). Subgroup analyses stratified by ethnicity showed a significant difference in the incidence of VTE in Asians (OR = 0.16, 95% CI: 0.06, 0.39, P < .0001), but not in Caucasians (OR = 0.69, 95% CI: 0.39, 1.23, P = .21). No significant differences in bleeding events were found between Asians (OR = 1.60, 95% CI: 0.48, 5.37, P = .45) and Caucasians (OR = 1.11, 95% CI: 0.58, 2.12, P = .75). The sensitivity analysis showed that Ejaz's study was the main source of heterogeneity, and when Ejaz's study was excluded, a significant difference in VTE incidence was found in Caucasians (OR = 0.58, 95% CI: 0.36, 0.93, P = .02). This study's findings indicate that the application of UFH or LMWH for VTE prophylaxis after hepatic resection is efficacious and safe in Asians and Caucasians. It is necessary for Asians to receive drug prophylaxis for VTE after hepatic resection. This study can provide a reference for the development of guidelines in the future, especially regarding the pharmacological prevention of VTE in different ethnicities.

Effect of melatonin on quality of life and symptoms in patients with cancer: a systematic review and meta-analysis of randomised controlled trials

ObjectiveThis study systematically reviewed the effect of melatonin (MLT) on quality of life (QoL) and symptoms among patients with cancer.DesignSystematic review and meta-analysis.Data sourcesCochrane Library, PubMed, Embase, Web of Science,...

Effect of celecoxib on improving depression: A systematic review and meta-analysis.

BACKGROUNDAnti-inflammation drugs were uncovered to be a potential therapy for depression. Celecoxib as a selective COX2 inhibitor is also one anti-inflammation drugs. Celecoxib is widely used in the clinic, which is well known by medical workers. It is uncertain whether celecoxib has efficacy in improving depression.AIMTo estimate the effect of celecoxib on improving depression.METHODSAll literature was searched until 2022. The databases included PubMed, OVID database, Cochrane library, Web of Science, CNKI, Clinicaltrials.gov database and Wanfang database. The random effects model was used to estimate the standardized mean differences with 95%CIs. With determined diagnostic criteria, studies containing patients with depression in the celecoxib group and the control group were included in the meta-analysis. The primary outcome measures were set for depression scale scores.RESULTSTwenty-nine randomized controlled studies were included in the meta-analysis (including 847 subjects with depression and 810 control subjects). The meta-analysis showed that celecoxib had an effect of anti-depression. At the same time, heterogeneity was observed (I2 = 82.1%, P = 0.00), and meta-regression was implemented to estimate the source of heterogeneity, which showed that the type of depression scale and depression type may lead to the heterogeneity. Subgroup analysis with respect to depression scale and depression type suggested that depression type was the possible main source of heterogeneity. Moreover, Egger’s test, Begg’s test, funnel plot and Doi plot was implemented, and publication bias was found to be significant. Next, the trim and fill method was used to estimate the influence of publication bias on the outcome of the meta-analysis, which showed that the outcome of the meta-analysis was reliable. Sensitivity analysis was estimated by deleting a study one by one, and the outcome of the meta-analysis was significantly stable. The quality of all randomized controlled trial studies was assessed by risk of bias, which indicated the rank of evidence in the meta-analysis was high.CONCLUSIONCelecoxib could be effective for improving depression.

Effect of whey protein supplementation on weight and body composition indicators: A meta-analysis of randomized clinical trials.

Whey protein (WP) is one of the well-known dairy driven products to help people to change their weight and body composition (BC). This study aimed to investigate the effect of WP on weight and BC on every published RCT on all populations. A systematic review of the literature was undertaken to identify RCTs that examined the effect of WP on weight, body fat, lean body mass, fat-free mass, and waist circumference. To create weighted-group-mean differences for within- and between-group comparisons, random effects models were used. Subgroup analyses were also done to determine the effect of potential sources of heterogeneity. Thirty-five RCTs, with a total of 1902 adult participants were included in pooled analysis. The effect of WP supplementation on BMI (-0.156, 95% CI:-0.31, 0.00, P<0.05), body fat mass (-0.144, 95% CI:-0.28, 0.00, P<0.05), and waist circumference (-0.448, 95% CI:-0.86,-0.03, P<0.05) in within group analysis, and BMI (-0.769, 95% CI:-1.54, 0.00, P<0.05) and lean body mass (0.741, 95% CI: 0.07, 1.41, P<0.05) in the between group analysis was indicated. Resistance training, WP dosage, sex, age group, the type of control group (placebo, different proteins, etc.), the control group dosage, and energy intake before and during the trial, as well as between the WP and control groups, were recognized as the main sources of heterogeneity. The data from trials currently available supports the use of WP to improve BC indicators. The benefits of WP on BC are expected to be greatest when combined with resistance training and a reduction in overall calorie consumption.

Shocks versus Menu Costs: Patterns of Price Rigidity in an Estimated Multisector Menu-Cost Model

Abstract Sectoral heterogeneity matters for monetary policy. Using CPI microdata, we estimate for 227 products a time-varying menu-cost model to investigate the quantitative relevance of this heterogeneity. We find a substantial degree of cross-sectoral heterogeneity in all structural parameters. Heterogeneity in the Calvo component of the pricing friction is, however, the main source of heterogeneity in price rigidity. Cross-sectoral heterogeneity amplifies the output effect of a monetary shock by a factor of about 2.5, compared to a single-sector model estimated with mean moments. Heterogeneity in the Calvo parameter plays a key role in this amplification.

A Meta Analysis of Physical Exercise on Improving Lung Function and Quality of Life Among Asthma Patients.

ObjectiveThis paper aims to perform a systematic assessment of the influence of physical exercise on asthma patients and discuss the intervention effects of different exercises on the lung function FEV1 (%pred) and quality of life among asthma patients so as to lay a scientific foundation for improving asthma symptoms.MethodsBoth Chinese and English databases were retrieved, including PubMed, Web of Science, Embase, The Cochrane Library, CBM, CNKI, Wan Fang Data, and VIP, whose retrieval period started from the founding date of each database to 1st, November 2021. Randomized controlled trials (RCT) studying the symptom indicators of asthma patients were collected. Those collected papers were screened according to the Inclusion Criteria and Exclusion Criteria. Then, methodological quality assessments were conducted on the included papers, and combined effect sizes were analyzed by using software ReMan 5.3.5.ResultsThe meta analysis showed that physical exercise could significantly improve lung function FEV1 (%pred) and quality of life score. Trails containing breathing exercise are the main source of heterogeneity, and the subgroup of breathing exercise may have better performance than the subgroup of aerobic exercise in improving FEV1 (%pred).ConclusionPhysical exercise can significantly improve the symptoms and quality of life of asthma patients. Except the breathing exercise that showed heterogeneity, the subgroup of aerobic exercise could improve the capacity of FEV1 (%pred) more effectively, which led to a significant difference in the influence of quality of life. However, with regard to the gymnastic exercise including breathing exercise, there are limited same intervention methods and insufficient same outcome indicators. Therefore, more precise and high-quality researches are needed to make deeper verification in the future.

Safety and efficacy of sofosbuvir-based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta-analysis.

What Is Known and ObjectiveSofosbuvir (SOF) is a new and highly effective medication that dramatically improved hepatitis C virus (HCV) management. However, ribavirin (RBV) is still added to SOF‐based medication regimens in several clinical scenarios, despite its well‐known toxicities. The aim of our study is to systematically review and analyse the impact of adding RBV to SOF‐based medication regimens on clinical outcomes among HCV patients.MethodsIncluded studies were randomized trials comparing the same SOF‐based medication regimens with and without RBV in HCV patients and measuring serious adverse events (SAEs) and/or sustained virologic response at 12 weeks post‐treatment (SVR‐12). Two investigators independently searched PubMed and Cochrane Library through September 2021. The Cochrane Risk of Bias tool was used to assess trials quality. Clinical outcomes were analysed as risk ratios (RR) using a random effects model using R version 4.1.2.Results and DiscussionOur study included a total of 26 trials with 5058 HCV patients. Quality assessment showed moderate risk of bias for most trials. Upon adding RBV, there was no significant difference in SAEs (RR 1.07, 95% CI: 0.77–1.48, I 2 = 10%), nor an impact on SVR‐12 (RR 1.00, 95% CI: 0.98–1.01, I 2 = 41%). There was no evidence of publication bias for either outcome. Subgroup analysis consistently showed lack of benefit among HCV subgroups. Additionally, NCT01826981 was identified as the main source of heterogeneity in the SVR‐12 outcome.What Is New and ConclusionOur findings suggest nonsignificant differences in safety and efficacy between SOF‐based medication regimens with and without RBV which should be considered in clinical practice.

Genetic association of ANRIL with susceptibility to Ischemic stroke: A comprehensive meta-analysis.

Ischemic stroke (IS) is a complex polygenic disease with a strong genetic background. The relationship between the ANRIL (antisense non-coding RNA in the INK4 locus) in chromosome 9p21 region and IS has been reported across populations worldwide; however, these studies have yielded inconsistent results. The aim of this study is to clarify the types of single-nucleotide polymorphisms on the ANRIL locus associated with susceptibility to IS using meta-analysis and comprehensively assess the strength of the association. Relevant studies were identified by comprehensive and systematic literature searches. The quality of each study was assessed using the Newcastle-Ottawa Scale. Allele and genotype frequencies were extracted from each of the included studies. Odds ratios with corresponding 95% confidence intervals of combined analyses were calculated under three genetic models (allele frequency comparison, dominant model, and recessive model) using a random-effects or fixed-effects model. Heterogeneity was tested using the chi-square test based on the Cochran Q statistic and I2 metric, and subgroup analyses and a meta-regression model were used to explore sources of heterogeneity. The correction for multiple testing used the false discovery rate method proposed by Benjamini and Hochberg. The assessment of publication bias employed funnel plots and Egger's test. We identified 25 studies (15 SNPs, involving a total of 11,527 cases and 12,216 controls maximum) and performed a meta-analysis. Eight SNPs (rs10757274, rs10757278, rs2383206, rs1333040, rs1333049, rs1537378, rs4977574, and rs1004638) in ANRIL were significantly associated with IS risk. Six of these SNPs (rs10757274, rs10757278, rs2383206, rs1333040, rs1537378, and rs4977574) had a significant relationship to the large artery atherosclerosis subtype of IS. Two SNPs (rs2383206 and rs4977574) were associated with IS mainly in Asians, and three SNPs (rs10757274, rs1333040, and rs1333049) were associated with susceptibility to IS mainly in Caucasians. Sensitivity analyses confirmed the reliability of the original results. Ethnicity and individual studies may be the main sources of heterogeneity in ANRIL. Our results suggest that some single-nucleotide polymorphisms on the ANRIL locus may be associated with IS risk. Future studies with larger sample numbers are necessary to confirm this result. Additional functional analyses of causal effects of these polymorphisms on IS subtypes are also essential.

Diagnostic value of circRNAs as effective biomarkers in human cardiovascular disease: an updated meta-analysis.

Background: A growing body of literature has demonstrated that circular RNAs (circRNAs) are the potential biomarkers in human cardiovascular disease (CVD). Therefore, a meta-analysis based on current studies was accomplished to appraise the role of circRNAs in the diagnostic of CVD patients.Methods: Studies before October 30, 2021, were searched using PubMed, EMBASE, the Web of Science, and Cochrane Library. The diagnostic odds ratio (DOR) with a confidence interval (CI) of 95% was used to investigate the associations between circRNAs and CVDs.Results: A total of 27 eligible articles were selected, including 47 studies, with 6833 participants meeting the criteria standard constrain. The pooled overall sensitivity and specificity for circRNAs expression profile in differentiating CVD patients from controls (non-CVDs or healthy subjects) were 0.81 (95%CI 0.78-0.83) and 0.74 (95%CI 0.68-0.78), respectively; the overall positive likelihood ratio was 3.1 (95%CI 2.5-3.7); the negative likelihood ratio was 0.26 (95%CI 0.22-0.31); the overall diagnostic odds ratio corresponding to an area under the curve of 0.85 (95%CI 0.81-0.88) was 12 (95%CI 9-16). Subgroup analysis indicated that the serum rather than blood has higher diagnostic accuracy. Likewise, meta-regression analysis demonstrated that the specimen, detection method, sample size, and publication year were the main sources of heterogeneity. Sensitivity analysis and Deeks' funnel plot revealed that our results are relatively robust.Conclusions: Our evidence-based analysis results suggested that circRNAs provide higher diagnostic accuracy in the prediction of CVDs. Thus, circRNAs might be potential biomarkers in CVDs.

Clinical Significance of Pim-1 in Human Cancers: A Meta-analysis of Association with Prognosis and Clinicopathological Characteristics.

BackgroundPim-1 is overexpressed in cancer tissues and plays a vital role in carcinogenesis. However, its clinical significance in cancers is not fully verified by meta-analysis, especially in relation to prognosis and clinicopathological features.MethodsFour databases, PubMed, Embase, Cochrane Library, and Web of Science, were searched. Literature screening and data extraction according to the inclusion and exclusion criteria. The quality of the included literatures was evaluated using the Newcastle-Ottawa scale and the data analysis was performed using STATA and Review Manager software.Results15 articles were finally included for meta-analysis, involving 1651 patients. Effect-size pooling analysis showed that high Pim-1 was related to poor overall survival (OS) (HR 1.68 [95% CI 1.17-2.40], P = .004) and disease-free survival (DFS) (HR 2.15 [95 %CI 1.15-4.01], P = .000). Subgroup analysis indicated that the detection techniques of Pim-1 were the main sources of heterogeneity, and 2 literatures using quantitative polymerase chain reaction (qPCR) for Pim-1mRNA had high homogeneity (I2 = .0%, P = .321) in OS. Another 13 studies that applied immunohistochemistry (IHC) for Pim-1 protein had significant heterogeneity (I2=82.2%, P = .000; I2=92%, P = .000) in OS and DFS, respectively, and further analysis demonstrated that ethnicity, sample size, and histopathological origin were considered to be the main factors affecting their heterogeneity. In addition, high Pim-1 was associated with lymph node metastasis (OR 1.40 [95% CI 1.02-1.92], P = .04), distant metastasis (OR 2.69 [95%CI 1.67-4.35], P < .0001), and clinical stage III-IV (OR .7 [95% CI .50-.96, P = .03). Sensitivity analysis suggested that the pooled results of each effect-size were stable and reliable, and there was no significant publication bias (P = .138) in all included articles.ConclusionHigh Pim-1 can not only predict poor OS and DFS of cancer, but also help to infer the malignant clinical characteristics of tumor metastasis. Pim-1 may be a potential and promising biomarker for early diagnosis, prognostic analysis and targeted therapy of tumors.

Does urbanization matter in the expenditure‐happiness nexus?

AbstractThis study aims to improve the regional well‐being literature on the so‐called “reversal issue” of the expenditure‐happiness nexus, accounting for two main sources of heterogeneity: degree of urbanization and individual spending habits. Moreover, we investigate the role of happiness across the entire expenditure distribution using a quantile modelling approach. The results show that satisfaction has a positive, significant and non‐linear effect on total expenditure across different urbanization categories. To better investigate the multidimensional nature of happiness, analysis of the nexus is expounded to different satisfaction domains and related spending aggregates offering a comprehensive and complex behavioural profile of individuals.