Colorectal cancer (CRC) patients exhibit distinct gut microbiota disruption, known as dysbiosis, which is believed to play a causative role in CRC. One of the key bacterial species implicated in CRC dysbiosis is Bacteroides fragilis, which presents a paradox as it is also present in most healthy individuals. This discrepancy underscores the need for analysis beyond species-level associations and to investigate intraspecies variation within B. fragilis. From a highly specific collection of B. fragilis isolates from CRC patients and controls, a pangenome-wide association study was conducted, identifying intraspecies genetic variations associated with CRC. The CRC association of these genetic variations were then validated in a metagenome sequencing cohort of faecal samples from 877 individuals, with and without CRC. To test group differences a mixed effects logistic regression with cohort as a random effect was performed for each genetic variation. Here we show that CRC-associated B. fragilis isolates are infected with specific Caudoviricetes prophages, significantly more often than negative controls. The initial discovery was made in our highly specific isolate collection and then validated in an independent metagenome sequencing cohort, finding that CRC patients were twice as likely to have detectable levels of these phages (OR = 2.05, p = 2.522E-7, SE = 0.139). To our knowledge, these findings mark the first link betweenone of the most implicated driver bacteria and phages in CRC and suggest a more complex role of phages in CRC dysbiosis than current models suggest and highlights the potential of phages as CRC biomarkers.

To evaluate the safety and efficacy of Edaravone-Dexborneol as a neuroprotective agent in patients with acute ischemic stroke (AIS). We conducted a comprehensive search in PubMed, Scopus, Web of Science, and Cochrane CENTRAL until January 22, 2026, including clinical trials and observational studies comparing Edaravone-Dexborneol with Edaravone monotherapy, standard treatment, and placebo. Data on functional recovery (Modified Rankin Scale [mRS], National Institutes of Health Stroke Scale [NIHSS], Barthel Index [BI]), safety outcomes, and mortality were extracted. A random effects model was used for statistical analysis. Overall, 13 studies (5 cohort studies and 8 randomized controlled trials) involving 7,846 patients were included, demonstrating that Edaravone-Dexborneol significantly improved 90-day mRS scores (0-1) compared with Edaravone alone (RD: 0.08, 95% CI: [0.03, 0.13], P = 0.001). When compared with standard treatment, NIHSS scores were significantly lower in the Edaravone-Dexborneol group (MD: -2.18, 95% CI: [-3.75, -0.62], P = 0.006), and no significant difference was observed in mRS (0-1) or the risk of symptomatic intracranial hemorrhage (sICH). Safety outcomes showed a possible dose-dependent adverse event (AE), including hyperhomocysteinemia and hypokalemia. Edaravone-Dexborneol might be an effective treatment for improving functional recovery in patients with AIS and appears to have a relatively favorable safety profile. However, careful dosing is necessary to minimize AEs. Future research should focus on large-scale trials, long-term outcomes, and mechanistic studies to optimize treatment protocols.

Introduction Beverage intake is an important yet understudied contributor to blood pressure (BP) and proteinuria. This is particularly relevant in sub-Saharan Africa, where rapid shifts toward sugar-sweetened beverages (SSBs) and ultra-processed beverages, driven by affordability and aggressive marketing, are occurring alongside a high burden of Chronic Kidney Disease (CKD) within resource-limited health systems. Additionally, there are cultural differences within African populations that make beverage patterns in sub-Saharan Africa differ across populations and from Western cultures. Methods We conducted a cross-sectional analysis of 494 participants in the Diet, CKD, and APOL1 (DCA) Study cohort in West Africa. We assessed beverage consumption from 24-h dietary recalls and patterns using principal component analysis. We analyzed associations of beverage patterns with systolic BP (SBP), diastolic BP (DBP), and proteinuria using univariate and multivariable linear mixed-effects regression models. We adjusted for covariates, such as clinical site (random effect), socio-demographic factors, and lifestyle factors. Results We identified 4 unique beverage patterns: (i) SSB and Alcohol, (ii) Milk and Alcohol, (iii) SSB and Water without Alcohol, and (iv) Milk and Milk Products. No beverage patterns showed consistent association with SBP or DBP, and sensitivity analyses of individual beverages yielded null findings. In adjusted analyses, the Milk and Milk Products beverage pattern showed a positive association with SBP (Tertile 2 vs. 1: β = 5.61 mm Hg; 95% CI: 1.54–9.57) and a directionally consistent but not significant association in tertile 3 vs. tertile 1. An exploratory interaction suggested a stronger positive association of this pattern with SBP among individuals with diabetes. Conclusion The Milk and Milk Products beverage pattern may be associated with higher SBP in adults with CKD in West Africa, with a potentially stronger association among those with diabetes. Given that no associations remained significant after false discovery rate correction, these findings should be interpreted cautiously. Future studies are needed to confirm these findings and clarify their long-term implications for kidney and cardiovascular health.

Abstract Gun violence has led many police agencies to adopt acoustic gunshot detection technology (GDT) to identify gunshots and provide precise locations for rapid police response. Theoretically, GDT could reduce crime through incapacitation and/or deterrence. However, high costs and concerns about effectiveness have led some communities to discontinue its use. Despite growing policy interest, few studies have directly examined GDTs impact on crime. Only 14 such studies were identified in this systematic review, examining the impact of GDT on a range of crime types. A multilevel random effects meta-analysis was conducted of 44 effect sizes from 8 studies with sufficient information. The pooled effect size indicates no significant relationship between GDT and crime (RIRR=1.02; 95% CI [0.90, 1.16]). Moderator analyses using multilevel meta-regression models indicated that neither crime type nor study strength influenced the effects. Substantial between-study heterogeneity was observed, possibly due to inconsistent implementation across jurisdictions. Our findings suggest that while GDT might increase intermediary outcomes like evidence and arrests, it will not reduce crime on its own. Policymakers should consider how technologies like GDT could support other crime reduction efforts. A strategic crime control approach to GDT, including problem analysis, evidence-based responses, partnerships, strategic planning, and built-in accountability mechanisms, is discussed. Achieving GDT-facilitated incapacitation or deterrence requires a comprehensive approach to integrating GDT into organizational practices.

The study investigated the impact of credit risk management on the profitability of commercial banks in Ethiopia. The research adopted explanatory research design and a quantitative approach were employed. It used descriptive and inferential statistical analyses techniques. The population of this study includes 31 commercial banks that are working in Ethiopia, from which a purposive sample of ten leading banks were selected on the basis of their branch network and operational age. The study is panel from the period between 2013 and 2023. The Random effects Generalized Least Squares model was utilized as panel data regression analysis to test the impact of credit risk management factors on bank performance. The regression result shows that Non-Performing Loans were found to have a significant negative impact on bank profitability, which implies that a high level of non-performing loans decreases bank profitability, emphasizing the importance of effective credit risk management. Conversely, and contrary to conventional assumptions, both a higher Loan to Total Asset Ratio and Loan to Deposit Ratio were unexpectedly associated with decreased profitability, suggesting an optimal threshold for lending activity exists beyond which excessive loan expansion introduces detrimental liquidity and credit risks. In alignment with established financial principles, Capital Adequacy significantly enhanced bank performance, underscoring its crucial role in providing essential buffers against losses, maintaining stability, and fostering stakeholder confidence for sustainable returns. Bank size as measured by total assets is positively related to better performance but insignificance effect on it.

The objectives of this study were to systematically identify studies that 1) quantified the prevalence of breast cancer screening among female survivors of a prior cancer other than breast cancer and 2) compared the likelihood of undergoing breast cancer screening between cancer survivors and cancer-free controls. Effect estimates were pooled using random effects meta-analyses. Stratified analyses were performed across primary cancer sites with three or more studies. Sixty-two studies were included in this review. The prevalence of breast cancer screening among female cancer survivors was 0.67 (95%CI: 0.62, 0.71), ranging from 0.49 (lung) to 0.75 (cervical) across primary cancer sites. The prevalence of breast cancer screening was higher among studies that ascertained screening through self-report and studies conducted in North America. The odds of undergoing breast cancer screening was significantly greater among cancer survivors compared to cancer-free controls (Odds ratio: 1.24, 95%CI: 1.13-1.36). Although cancer survivors had higher rates of breast cancer screening compared to cancer-free controls, overall rates were below population-based screening targets. Given that cancer survivors are at an elevated risk of subsequent breast cancer, future studies should evaluate predictors of screening non-adherence and explore targeted approaches to improve participation in breast cancer screening among cancer survivors.

Short telomere length (TL) has been associated with chronic diseases and reduced lifespan. Vitamin D may help preserve telomeres through its anti-inflammatory effects; however, the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and TL remains inconclusive. This meta-analysis was conducted to evaluate the association between circulating 25(OH)D and leukocyte TL (LTL). A comprehensive literature search was performed across PubMed, Scopus, Google Scholar, ClinicalTrials.gov, and Cochrane Library to identify relevant studies published up to February 2025. Standardized β coefficients with 95% confidence intervals were applied as the effect size metric to evaluate the associations using a random effect model. A total of 21 studies comprising 185,191 participants were analyzed. The overall results demonstrated a positive association between serum 25(OH)D levels and LTL (β = 0.04, 95% CI = 0.02-0.06), with remarkable heterogeneity across studies (I²= 89.1%, P ≤.001). This association was supported in adults (β = 0.04, 95% CI = 0.03-0.06), women (β = 0.05, 95% CI = 0.01-0.08), individuals with vitamin D deficiency (β = 0.22, 95% CI = 0.01-0.43), and studies that adjusted for covariates (β = 0.05, 95% CI = 0.01-0.08). No significant associations were found in men, participants with serum 25(OH)D levels ≥ 30 ng/mL, children, or studies without covariate adjustments. The relationships were not influenced by the method of TL assessment, body mass index, smoking status, and sample size. Serum 25(OH)D levels showed a positive correlation with LTL in women, adults, and individuals with vitamin D deficiency.

Chronic hyponatremia is a common electrolyte disturbance associated with adverse outcomes. The optimal rate of correction remains uncertain, with current guidelines emphasizing avoidance of overcorrection. This systematic review and meta-analysis aimed to synthesize the existing evidence on patient and healthcare utilization outcomes associated with overcorrection in adults with chronic hyponatremia. This study followed a pre-registered protocol (PROSPERO CRD42024606516). Medline and EMBASE were searched from inception to May 2024. Eligible studies included original experimental or observational research. Included studies reported outcomes for adult patients with chronic hyponatremia who experienced overcorrection, and those who did not. The outcomes of interest were neurologic complications, acute care utilization (hospital and intensive care unit length of stay, re-admission) and mortality. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Meta-analyses were performed using the Hartung-Knapp-Sidik-Jonkman random effects models when data allowed; otherwise, outcomes were synthesized narratively. Forty-three studies were included. Overcorrection of hyponatremia was associated with an increased odds of neurologic complications (OR 4.23, 95% CI 2.93 - 6.11, I2 = 0%) but lower odds of mortality (OR of 0.67, 95% CI 0.47 - 0.97, I2 = 82.3%). In sensitivity analyses restricted to studies at low risk of bias, the association between overcorrection and neurologic complications was no longer statistically significant (OR 3.22, 95% CI 0.40-25.83, I2 = 25.4%). Given the observational nature of included studies, indirect evidence, and high risk of bias across studies, the certainty of evidence is very low. While sodium overcorrection appears to be associated with increased risk of neurologic complications but lower risk of mortality, the limitations of the current literature warrant cautious application of these findings. Given the potential risks of under- and overcorrection, a reframing of practice to achieve adequate correction, rather than focusing on overcorrection avoidance alone may be warranted.

Chikungunya virus (CHIKV) poses a significant burden on affected populations, presenting substantial challenges to public health. This study aimed to assess the seroprevalence of the CHIKV in the Horn of Africa. We conducted a systematic review and meta-analysis by searching PubMed/MEDLINE, Scopus, Scientific Direct, Google Scholar, and reference lists for primary articles published from the inception of the database until November 30, 2023. The inclusion criteria covered seroprevalence studies of CHIKV in Ethiopia, Kenya, Somalia, South Sudan, Sudan, Eritrea, Uganda, and Djibouti. Pooled seroprevalence was estimated using a random effects model, and the meta-analysis was conducted with R Studio version 4.3.1 and the Metapro package. The study protocol adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is registered in PROSPERO, CRD42023477057. From a pool of 87,567 potential studies, 34 eligible studies were included in our analysis. Most of the studies were conducted in Kenya (44%). Hospital-based studies were included in 59% of cases. A total of 23,400 participants were involved in the review. Of the 13,397 participants, 6778 (67.6% of those with information) were male. The pooled seroprevalence of CHIKV was 14% (95% CI: 9-23; I2 = 99%). Subgroup analysis was performed. The seroprevalence was higher in studies conducted in population settings: 15% (95% CI: 5-37; I2 = 99%) than in hospital settings. The seroprevalence of chikungunya was high from the 2004 to 2013 period, at 36% (95% CI: 13-68; I2 = 98%). Plaque reduction neutralization tests detected 15% (95% CI: 3-49%; I2 = 94%) of the chikungunya seroprevalence. The seroprevalence of CHIKV among inapparent infections was 17% (95% CI: 8-35; I2 = 98%). The meta-regression analysis revealed that the chikungunya seroprevalence was predicted by the countries of study, age group, and trends of infection over time. Our review highlights compelling evidence of CHIKV and other arbovirus circulation in the Horn of Africa, revealing diverse seroprevalence rates across different countries, age groups, laboratory tests, clinical manifestations, and time trends. The confirmatory gold standard, the plaque reduction neutralization test, increases diagnostic accuracy.

Introduction Chitinase 3-like protein 1 (CHI3L1 or YKL40) is a potential neuroinflammatory biomarker linked to the pathogenesis of Alzheimer’s disease (AD). Previous studies have produced inconsistent results regarding YKL40 levels in various clinical stages of AD. This study aims to establish the correlation between YKL40 levels and AD progression through a meta-analysis of YKL40 levels in cerebrospinal fluid (CSF) and peripheral blood. Methods Comprehensive searches were conducted in PubMed, Medline, Web of Science, and the Cochrane Library to identify observational studies reporting CSF and peripheral blood YKL40 levels in AD patients, mild cognitive impairment (MCI) patients, preclinical AD (pre-AD) and healthy controls (HCs). A random effects meta-analysis was used to calculate the standardized mean difference (SMD) and 95% confidence intervals (CIs). Results Thirty observational studies involving 2,102 AD patients, 1,504 MCI patients, 118 pre-AD individuals, and 2,091 HCs were included. Significant differences in CSF YKL-40 levels were observed in AD vs. HC (SMD = 1.37, 95%CI: [1.09, 1.65]; p = 0.000), MCI vs. HC (SMD = 0.96, 95%CI: [0.51, 1.41]; p = 0.000), and pre-AD vs. HC (SMD = 0.81, 95%CI: [0.39, 1.22]; p = 0.001) comparisons. Peripheral blood YKL-40 levels also demonstrated statistically significant elevations in both AD vs. HC (SMD = 0.40, 95%CI: [0.18, 0.63]; p = 0.000) and MCI vs. HC (SMD = 0.79, 95%CI: [0.03, 1.55]; p = 0.043) comparisons. However, CSF YKL-40 levels showed no statistically significant difference between AD and MCI groups (SMD = 0.25, 95%CI: [−0.08, 0.57]; p = 0.134). Discussion Elevated YKL-40 levels in both CSF and peripheral blood are associated with the presence of Alzheimer’s disease and its early stages, indicating that YKL-40 reflects neuroinflammatory processes involved in AD onset. While YKL-40 shows potential value for early identification along the AD continuum, its limited ability to differentiate between MCI and AD highlights the need for its combined use with other biomarkers in disease staging and progression assessment. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251031837 .

Abstract Asia is a principal source of global migration, and its intra-regional movements profoundly reshape the political, economic, and ecological landscapes of Asian nations. To address the spatiotemporal zero-inflated and dispersion present in migration data, as well as the need for interpretable inference on the overall mean, we develop a spatiotemporal marginalized zero-inflated Conway–Maxwell–Poisson (MZICMP) regression model. This model transcends the limitations of conventional zero-inflated approaches by employing a dispersion parameter that accommodates equidispersion, overdispersion, and under dispersion, and by jointly modelling excess zeros and the marginal mean through the inclusion of country-level covariates, smooth temporal effects, and spatial random effects. For parameter estimation, we implement a Bayesian Markov Chain Monte Carlo algorithm that combines Gibbs sampling with Metropolis–Hastings steps. Simulation demonstrates the model's efficacy in capturing both temporal autocorrelation and spatial zero-inflation patterns, and an empirical application to 1990–2020 intra-Asian out-migration reveals: (1) the share of secondary industry and the share of tertiary industry both show significant negative correlations with out-migration flows, whereas battle-related deaths and the total volume of bilateral trade exhibit positive correlations; (2) the average outmigration trend among Asian countries was relatively high during the period 2005–2010, then declined in 2015–2020; the model results indicate a satisfactory capture of this temporal pattern.

Efficacy of Chinese herbal medicine in allergic rhinitis: a meta-analysis.

This paper presents a Bayesian spatio-temporal model with space-time interaction effects for longitudinal data. The main objective is to evaluate how spatial and temporal dependencies, together with their interactions, influence parameter estimation and interpretation. The model incorporates spatial random effects to capture unobserved heterogeneity between neighboring regions, temporal random effects to reflect trends over time, and interaction terms to account for localized space-time variations. A conditional autoregressive (CAR) prior is applied to address spatial dependence, while Markov chain Monte Carlo (MCMC) sampling is used for posterior estimation, supported by convergence diagnostics such as trace plots and the Geweke test. Bootstrap analysis is also applied to assess the stability of estimates and provide complementary validation. Results based on simulated datasets across multiple areal unit sizes show that the intercept and covariate effects are sensitive to spatial resolution, whereas spatial and temporal correlations remain relatively stable across scales. The variance components, particularly the interaction term, capture localized heterogeneity more effectively at smaller spatial units. The findings demonstrate that combining Bayesian estimation with bootstrap analysis provides a reliable framework for understanding spatial and temporal disease dynamics, with practical implications for public health planning and intervention strategies.

Preterm delivery (PTD) has been a significant cause of neonatal morbidity and mortality. Maternal serum ferritin, a biomarker of both iron stores and systemic inflammation, has shown inconsistent associations with PTD risk in individual studies. This systematic review and meta-analysis aimed to clarify the relationship between maternal serum ferritin levels and the risk of PTD. Following the PRISMA guidelines, we searched PubMed, Scopus, Web of Science, and Google Scholar up to August 2025. Twenty-four observational studies with more than 10000 participants were included. Pooled standardized mean differences (SMDs) and odds ratios (ORs) were calculated using random-effects models. The ROBINS-1 tool was used to assess the quality of the studies and the risk of bias. Ferritin levels were significantly higher in pregnancies ending in PTD (random-effects SMD 0.82, 95% CI 0.28-1.36; I2 = 97.3%), with the strongest association observed in the second trimester (SMD 1.18, 95% CI 0.74-1.63). No independent predictive role for ferritin was shown (random-effects OR 1.05, 95% CI 0.97-1.13). High heterogeneity and evidence of publication bias were noted. Hemoglobin levels did not differ between groups. Elevated levels of maternal serum ferritin, especially during the second trimester, are linked to PTD. However, the adjusted OR estimates have not shown statistical significance. There is considerable variability among the studies and a risk of bias that warrants cautious interpretation. Additionally, the diagnostic thresholds reported differ greatly and lack sufficient validation for clinical application. It is essential to conduct standardized prospective studies before ferritin-based clinical decision-making can be endorsed.

Effects of storage temperature on silage nutrient composition, fermentation profile, and aerobic stability through a meta-analysis.

Balloon-expandable valve (BEV) and self-expanding valve (SEV) are used in transcatheter aortic valve replacement (TAVR). Patients with a small aortic annulus (SAA) make up to one-third of the cases and face higher risks of prosthesis-patient mismatch and high valvular gradients. This meta-analysis aimed to compare balloon-expandable and self-expanding valves used in TAVR in patients with a SAA, focusing on hemodynamic and clinical outcomes. We systematically searched Cochrane Central, PubMed, and EMBASE for studies comparing balloon-expandable and self-expanding valves in patients with SAA undergoing TAVR. Random effects models were applied to generate odds ratios (ORs) and mean differences with 95% confidence interval (CI). Fifteen studies (two randomized controlled trials and 13 propensity-matched studies) with 5149 patients (48.4% balloon-expandable valves) were identified. BEVs were associated with a lower indexed effective orifice area (mean difference: -0.18, 95% CI: -0.25 to -0.10; P < 0.00001) and higher transvalvular mean pressure gradient (mean difference: 4.32, 95% CI: 3.39-5.24; P < 0.00001) and peak pressure gradients (mean difference: 4.87, 95% CI: 1.23-8.51; P = 0.009). Permanent pacemaker implantation (OR: 0.57, 95% CI: 0.44-0.73; P < 0.0001) and major bleeding (OR: 0.67, 95% CI: 0.47-0.96; P = 0.03) were lower in balloon-expandable valves. BEVs increased the odds of any prosthesis-patient mismatch (OR: 2.28, 95% CI: 1.61-3.22; P < 0.00001) and severe prosthesis-patient mismatch (OR: 3.16, 95% CI: 2.19-4.58; P < 0.00001). In patients with SAA undergoing TAVR, SEVs offer superior hemodynamic performance, whereas BEVs are associated with fewer conduction disturbances and bleeding events. Both valve platforms yielded similar clinical outcomes, underscoring the need for individualized device selection.

Early and accurate detection of acute kidney injury (AKI)in children is difficult because serum creatinine rises late and lacks sensitivity. Serum cystatin C has been proposed as an earlier biomarker, but pediatric evidence has been inconsistent. We performed a systematic review and meta-analysis of studies evaluating serum cystatin C for pediatric acute kidney injury. PubMed, Cochrane Library, Scopus, and Web of Science were searched from inception through June 2025. Eligible studies compared cystatin C against standardized AKI definitions (KDIGO, pRIFLE, or AKIN) and reported sufficient diagnostic accuracy data. Two reviewers independently screened, extracted, and assessed study quality using QUADAS-2. Pooled estimates of sensitivity and specificity were calculated using a bivariate random effects model with hierarchical summary receiver operating characteristic curves. Subgroup and meta-regression analyses explored sources of heterogeneity. Certainty of evidence was assessed with GRADE-DTA. The review was registered with PROSPERO (CRD420251104342). Twenty-six studies comprising 3742 pediatric patients were included. Pooled sensitivity was 78.2% (95% CI 72.6-82.9) and specificity was 79.5% (95% CI 73.5-84.5), with an area under the curve of 0.854, reflecting good overall discriminatory power. Predictive values varied with disease prevalence: at 10% prevalence, the negative predictive value reached 97.0%, while at 40% prevalence, the positive predictive value increased to 71.8%. Bayesian meta-regression identified clinical setting as a significant effect modifier, with higher accuracy in ward-based studies compared with pediatric intensive care unit cohorts. Sensitivity analyses confirmed robustness, and no evidence of publication bias was detected. Certainty of evidence was rated moderate for sensitivity and specificity and high for area under the curve. Serum cystatin C is a reliable biomarker for early pediatric AKI detection, offering superior performance to creatinine and particularly strong rule-out value in lower-prevalence settings. Its clinical utility would be enhanced by standardized cut-offs, cost-effectiveness evaluation, and integration into biomarker panels.

Cattell–Horn–Carroll models of intelligence frequently show that, at the group-factor level, G f is most strongly related to g , whereas at the subtest level, G c -associated measures exhibit the highest g loadings. One proposed solution to this “ g paradox” holds that Stratum-III g and Stratum-II G f are identical, and that the sizeable g loadings of crystallized subtests merely reflect the investment of G f into learning. Investment theory is weakly evidenced, however. We argue that the “ g paradox” results from subtests measuring facets of G f exhibiting pronounced specificity for cognitive entities. Capturing everything that goes into G f is difficult on a single-measure basis, hence lower Stratum-I g loadings. The G f group factor is nonetheless reflective of the composite of these entities and therefore is uniquely (at Stratum II) associated with g . Subtests measuring G c broadly index the quality of global systems involving many cognitive processes, not entities, and so relate to factors that have formative effects on g , which are Stratum-I specific. We posit the existence of two distinguishable sources of general covariance: a formative g (associated primarily with G c ) and a reflective g (associated primarily with G f ), with the latter hierarchically superordinate to the former. Network analysis of “pure” psychometric measures of the G c and G f domains indicates that the former exhibits significantly greater network integrity than the latter, consistent with this formative/reflective model. Random effects meta-analysis of SEM contrast parameters, derived from four large genetically informed studies, finds that subtests assigned to a “ G c ” category are associated with higher-magnitude direct (formative) genetic paths relative to those in a “ G f ” category, suggesting a weak but discriminable and broad Stratum-I g in the residual covariance structure. Given the theorized phylogenetic histories of these two g s, we term the formative (“bottom-up”) g “proto g ” ( g p ), and the reflective (“top-down”) g “neo g ” ( g n ).

Appendicitis has traditionally been managed with urgent surgery. Because of operative room and logistic constraints, surgery may be delayed. Evidence on the impact of this delay remains equivocal. The aim of this systematic review and meta-analysis is to assess postoperative outcomes of delayed appendectomy amongst both pediatric and adult populations. A systematic review with meta-analysis was performed including studies comparing cohorts of urgent versus delayed appendectomy, excluding those with interval appendectomy. Studies were included as long as one relevant postoperative complication was mentioned; for adults, only prospective studies were included. A comprehensive search of six databases was performed including studies from January 1, 2000, to January 15, 2024. A meta-analysis with a random effects model and restricted maximum likelihood was used. Of 11,227 citations, 20 pediatric and 5 adult studies were included, with 827,019 and 4250 patients, respectively. Definitions of early surgery cohorts were usually surgery within 4 to 12 hours or overnight, and delayed surgery >4 to 12 hours or next day. The pediatric meta-analysis revealed no increased risk of intraoperative perforation in delayed versus emergent cohorts (odds ratio [OR], 1.16; 95% confidence interval [CI], 0.78-1.72), length of stay (mean difference, 1.2 days; 95% CI, -0.3 to -2.8), abscess (OR, 0.80; 95% CI, 0.29-2.25), surgical site infection (OR, 1.11; 95% CI, 0.93-1.30), or readmission (OR, 0.82; 95% CI, 0.55-1.21). The adult meta-analysis results revealed no difference between the delayed and emergent appendectomy groups for intraoperative perforation (OR, 1.29; 95% CI, 1.00-1.67), abscess (OR, 1.54; 95% CI, 0.58-4.10), surgical site infection (OR, 1.35; 95% CI, 0.71-2.56), or conversion to open (OR, 0.81; 95% CI, 0.64-1.03). Subgroup analyses showed increased length of stay in pediatric population (mean difference, 0.42 days; 95% CI, 0.10-0.74). These findings suggest that a modest delay in appendectomy may be permissible in pediatric and adult settings and adult patients presenting with acute appendicitis. While this does not replace surgeon clinical acumen, it may help guide decision making in resource-constrained settings. Systematic Review and Meta-analysis; Level II.

The balance between gross primary productivity (GPP) and ecosystem respiration (ER) defines an ecosystem’s carbon sink-source status. Under global warming, hydrothermal conditions critically shape carbon fluxes, yet their differential impacts on GPP and ER remain insufficiently understood, especially across biomes. Elucidating these differences is essential for reducing uncertainties in terrestrial carbon cycle projections under ongoing climate change. Here, based on flux observations from global terrestrial sites with a focus on forest ecosystems, we selected mean annual temperature (MAT), latent heat flux (LH), vapor pressure deficit (VPD), soil water content (SWC), and annual precipitation as representative indicators of hydrothermal conditions, and employed mixed-effects models to examine how these key environmental drivers influence GPP and ER. After analyzing the fixed effects, LH and MAT promoted GPP more strongly than ER (slope = 0.5 &gt; 0.253, slope = 0.595 &gt; 0.392, respectively), whereas VPD suppressed GPP more than ER (slope = −0.658 &lt; −0.499), yet accounted for a greater proportion of variance in ER than in GPP (R2 = 0.14 &gt; 0.07). Although SWC had a significant (p &lt; 0.001) positive effect on GPP, the effect size was minimal, and its impact on ER was insignificant. R2 decomposition showed that marginal R2 values were similar for the GPP and ER models (0.43 and 0.44), whereas the GPP model exhibited a substantially higher conditional R2 (0.82 vs. 0.63), indicating that MAT exerted a stronger influence on GPP than on ER across ecosystem types. The combined analysis of fixed and random effects indicated that MAT affected GPP more variably than ER across ecosystem types, with the strongest responses in mixed forests and savannas, intermediate responses in evergreen needleleaf forests, and the weakest responses in evergreen broadleaf forests. Overall, this study advances our understanding of how environmental factors differently influence GPP and ER, and incorporating these differences can improve predictions of forest carbon fluxes and climate-carbon feedbacks.