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Korean Journal of Radiology Jul 2024This study systematically reviewed the role of diffusion-weighted imaging (DWI) in the assessment of molecular prognostic biomarkers in breast cancer, focusing on the... (Meta-Analysis)
Meta-Analysis Review
This study systematically reviewed the role of diffusion-weighted imaging (DWI) in the assessment of molecular prognostic biomarkers in breast cancer, focusing on the correlation of apparent diffusion coefficient (ADC) with hormone receptor status and prognostic biomarkers. Our meta-analysis includes data from 52 studies examining ADC values in relation to estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), and Ki-67 status. The results indicated significant differences in ADC values among different receptor statuses, with ER-positive, PgR-positive, HER2-negative, and Ki-67-positive tumors having lower ADC values compared to their negative counterparts. This study also highlights the potential of advanced DWI techniques such as intravoxel incoherent motion and non-Gaussian DWI to provide additional insights beyond ADC. Despite these promising findings, the high heterogeneity among the studies underscores the need for standardized DWI protocols to improve their clinical utility in breast cancer management.
Topics: Humans; Breast Neoplasms; Diffusion Magnetic Resonance Imaging; Female; Biomarkers, Tumor; Prognosis; Receptor, ErbB-2; Receptors, Estrogen; Receptors, Progesterone; Ki-67 Antigen
PubMed: 38942456
DOI: 10.3348/kjr.2023.1188 -
Journal of Affective Disorders Jun 2024Cariprazine has emerged as a promising augmenting treatment agent for unipolar depression and as a monotherapy option for bipolar depression. We evaluated cariprazine's...
BACKGROUND
Cariprazine has emerged as a promising augmenting treatment agent for unipolar depression and as a monotherapy option for bipolar depression. We evaluated cariprazine's efficacy in treating acute major depressive episodes in individuals with major depressive disorder (MDD) or bipolar disorder.
METHODS
A systematic review was conducted on MEDLINE, Embase, PyscInfo, Scopus and Web of Science, ClinicalTrials.gov and ScanMedicine. Study quality was assessed using the RoB 2 tool. Pairwise and dose-response meta-analyses were conducted with RStudio. Evidence quality was assessed with GRADE.
RESULTS
Nine RCTs meeting inclusion criteria encompassed 4877 participants. Cariprazine, compared to placebo, significantly reduced the MADRS score (MD = -1.49, 95 % CI: -2.22 to -0.76) and demonstrated significantly higher response (RR = 1.21, 95 % CI: 1.12 to 1.30) and remission (RR = 1.19, 95 % CI: 1.06 to 1.34) rates. Subgroup analysis unveiled statistically significant reductions in MADRS score in MDD (MD = -1.15, 95 % CI: -2.04 to -0.26) and bipolar I disorder (BDI) (MD = -2.53, 95 % CI: -3.61 to -1.45), higher response rates for both MDD (RR = 1.19, 95 % CI: 1.08 to 1.31) and BDI (RR = 1.27, 95 % CI: 1.10 to 1.46), and higher remission rates only for BDI (RR = 1.41, 95 % CI: 1.24 to 1.60). A higher rate of treatment discontinuation due to adverse events was observed.
LIMITATIONS
Reliance solely on RCTs limits generalisability; strict criteria might not reflect real-world diversity.
CONCLUSIONS
Cariprazine demonstrates efficacy in treating major depressive episodes, although variations exist between MDD and BDI and tolerability may be an issue.
PubMed: 38942207
DOI: 10.1016/j.jad.2024.06.099 -
Ageing Research Reviews Jun 2024The purpose of this study was to evaluate the effectiveness of Governor vessel acupuncture (GV Ac) in treating post-stroke cognitive impairment (PSCI). (Review)
Review
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of Governor vessel acupuncture (GV Ac) in treating post-stroke cognitive impairment (PSCI).
METHODS
There was a total of seven databases examined. Four English databases (Cochrane Library, PubMed, Embase, and Medline) and three Chinese databases (Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Databases (VIP), and Wan Fang Database) contain all randomized controlled trials (RCTs) comparing Governor vessel acupuncture to other treatments or none acupuncture for PSCI. The exact dates for the search period are from January 1, 2000, to January 1, 2023.Two researchers independently reviewed the literature, gathered RCT data, and performed statistical analysis. All data were analyzed using Review Manager software (Rev Man) 5.3.
RESULTS
This meta-analysis includes a total of 39 trials with 2044 patients. There were 1022 participants in each of the test and control groups. Following 12-120 days of acupuncture treatment, a meta-analysis revealed that the treatment groups (GV Ac combined with conventional treatment groups) significantly increased their scores on the Curative ratio (OR=3.00, 95%CI=2.37-3.79, P=0.98, I²=0%), Montreal Cognitive Assessment (MoCA)(MD=1.82, 95%CI=1.60-2.03, P=0.11, I²=25%), Mini-Mental State Examination (MMSE)(MD=2.18, 95%CI=1.64-2.72, P<0.005, I²=92%), and Activity of Daily Living (ADL)(MD=5.99, 95%CI=5.33-6.64, P=0.19, I²=26%).
CONCLUSION
The results suggested that acupuncture on points of the Governor vessel enhanced cognitive function in stroke survivors.
PubMed: 38942201
DOI: 10.1016/j.arr.2024.102355 -
Journal of Clinical Epidemiology Jun 2024To use individual participant data meta-analysis (IPDMA) to estimate the minimal detectable change (MDC) of the Geriatric Depression Scale-15 (GDS-15) and to examine...
OBJECTIVE
To use individual participant data meta-analysis (IPDMA) to estimate the minimal detectable change (MDC) of the Geriatric Depression Scale-15 (GDS-15) and to examine whether MDC may differ based on participant characteristics and study-level variables.
STUDY DESIGN AND SETTING
This was a secondary analysis of data from an IPDMA on the depression screening accuracy of the GDS. Datasets from studies published in any language were eligible for the present study if they included GDS-15 scores for participants aged 60 or older. MDC of the GDS-15 was estimated via random-effects meta-analysis using 2.77 (MDC95) and 1.41 (MDC67) standard errors of measurement (SEM). Subgroup analyses were used to evaluate differences in MDC by participant age and sex. Meta-regression was conducted to assess for differences based on study-level variables, including mean age, proportion male, proportion with major depression, and recruitment setting.
RESULTS
5,876 participants (mean age 76 years, 40% male, 11% with major depression) from 21 studies were included. The MDC95 was 3.81 points (95% confidence interval [CI] 3.59, 4.04), and MDC67 was 1.95 (95% CI 1.83, 2.03). The difference in MDC95 was 0.26 points (95% CI 0.04, 0.48) between ≥ 80-year-olds and < 80-year-olds; MDC95 was similar for females and males (0.05, 95% CI -0.12, 0.22). The MDC95 increased by 0.29 points (95% CI 0.17, 0.41) per 10% increase in proportion of participants with major depression; mean age had a small association (0.04 points, 95% CI 0.00 to 0.09) with MDC95, but sex and recruitment setting were not significantly associated.
CONCLUSIONS
The MDC95 was 3.81 points and MDC67 was 1.95 points. MDC95 increased with the proportion of participants with major depression. Results can be used to evaluate individual changes in depression symptoms and as a threshold for assessing minimal clinical important difference estimates.
PubMed: 38942179
DOI: 10.1016/j.jclinepi.2024.111443 -
Journal of Clinical Epidemiology Jun 2024To map whether and how systematic reviews (SRs) with network meta-analysis (NMA) use presentation formats to report (a) structured evidence summaries - here defined as...
OBJECTIVE
To map whether and how systematic reviews (SRs) with network meta-analysis (NMA) use presentation formats to report (a) structured evidence summaries - here defined as reporting of effects estimates in absolute effects with certainty ratings and with a method to rate interventions across one or more outcome(s) - and (b) NMA results in general.
STUDY DESIGN AND SETTING
We conducted a systematic survey, searching MEDLINE (Ovid) for SRs with NMA published between January 1, 2020, and December 31, 2021. We planned to include a random sample of publications, with predefined mechanisms in place for saturation, and included SRs that met pre-specified quality criteria and extracted data on presentation formats that reported: (a) estimates of effects, (b) certainty of the evidence, or (c) rating of interventions.
RESULTS
The 200 eligible SRs, from 158 unique Journals, utilized 1133 presentation formats. We found structured evidence summaries in 10 publications (5.0%), with three (1.5%) reporting structured evidence summaries across all outcomes, including benefits and harms. Sixteen of the 133 SRs (11.7%) reporting dichotomous outcomes included estimates of absolute effects. Seventy-six SRs (38.0%) reported both benefits and harms and 26 SRs (13.0%) reported certainty ratings in presentation formats, 20 (76.9%) used Grading of Recommendations Assessment, Development and Evaluation (GRADE) and six (23.1%) used Confidence In Network Meta-analysis (CINeMA). Surface Under the Cumulative Ranking Curve (SUCRA) was the most common method to rate interventions (69 SRs, 34.5%). NMA results were most often reported using forest plots (108 SRs, 54.0%) and league tables (93 SRs, 46.5%).
CONCLUSION
Most SRs with NMA do not report structured evidence summaries and only rarely do such summaries include reporting of both benefits and harms. Those that do offer effective user-friendly communication and provide models for optimal NMA presentation practice.
PubMed: 38942177
DOI: 10.1016/j.jclinepi.2024.111445 -
NeuroImage Jun 2024Under resource distribution context, individuals have a strong aversion to unfair treatment not only toward themselves but also toward others. However, there is no clear... (Review)
Review
Under resource distribution context, individuals have a strong aversion to unfair treatment not only toward themselves but also toward others. However, there is no clear consensus regarding the commonality and distinction between these two types of unfairness. Moreover, many neuroimaging studies have investigated how people evaluate and respond to unfairness in the abovementioned two contexts, but the consistency of the results remains to be investigated. To resolve these two issues, we sought to summarize existing findings regarding unfairness to self and others and to further elucidate the neural underpinnings related to distinguishing evaluation and response processes through meta-analyses of previous neuroimaging studies. Our results indicated that both types of unfairness consistently activate the affective and conflict-related anterior insula (AI) and dorsal anterior cingulate cortex/supplementary motor area (dACC/SMA), but the activations related to unfairness to self appeared stronger than those related to others, suggesting that individuals had negative reactions to both unfairness and a greater aversive response toward unfairness to self. During the evaluation process, unfairness to self activated the bilateral AI, dACC, and right dorsolateral prefrontal cortex (DLPFC), regions associated with unfairness aversion, conflict, and cognitive control, indicating reactive, emotional and automatic responses. In contrast, unfairness to others activated areas associated with theory of mind, the inferior parietal lobule and temporoparietal junction (IPL-TPJ), suggesting that making rational judgments from the perspective of others was needed. During the response, unfairness to self activated the affective-related left AI and striatum, whereas unfairness to others activated cognitive control areas, the left DLPFC and the thalamus. This indicated that the former maintained the traits of automaticity and emotionality, whereas the latter necessitated cognitive control. These findings provide a fine-grained description of the common and distinct neurocognitive mechanisms underlying unfairness to self and unfairness to others. Overall, this study not only validates the inequity aversion model but also provides direct evidence of neural mechanisms for neurobiological models of fairness.
PubMed: 38942102
DOI: 10.1016/j.neuroimage.2024.120707 -
EBioMedicine Jun 2024In developing countries, the safety of blood transfusions remains an important public health concern as it is associated with a higher risk of transfusion-transmissible...
BACKGROUND
In developing countries, the safety of blood transfusions remains an important public health concern as it is associated with a higher risk of transfusion-transmissible infections (TTIs). In this study, we aimed to estimate the seroprevalence of HIV among blood donors in Africa and assess the temporal trends and regional differences within the continent through a systematic review and meta-analysis.
METHODS
Seven electronic databases (PubMed, Web of Science, Cochrane, Scopus, HINARI, Global Index Medicus and Clinical.
TRIAL
gov) were searched for relevant studies for our research. We included all primary studies that estimated the seroprevalence of HIV among blood donors in Africa with an age population from 16 to 65 years old, without language restrictions, from inception up to March 1st 2024. The pooled seroprevalence was estimated through the DerSimonian-Laird random effects model. The temporal trends and regional differences were assessed through subgroup and meta-regression analysis.
FINDINGS
We obtained 122 studies that met our inclusion criteria, comprising 7,814,996 blood donors tested for HIV. Sixty-six percent of the studies were from Western and Eastern Africa. The pooled seroprevalence of HIV among blood donors in Africa was 2.66% (95% CI: 2.17-3.20%; I = 99.80%, p < 0.01). The highest prevalence was observed in the Central African region, 3.28% (95% CI: 2.57%-4.06%), followed by the Eastern 3.21% (95% CI: 2.12%-4.52%), and the Western 2.66% (95% CI: 1.93%-3.49%) regions. Lower prevalences were observed in the Northern region, 0.57% (95% CI: 0.0%-2.10%), followed by the Southern African region with 0.45% (95% CI: 0.16%-0.86%). We observed a temporal decreased trend of HIV prevalence.
INTERPRETATION
The prevalence of HIV infection among African blood donors remains high and is not homogeneous across the continent. Efficient measures to strengthen HIV testing and prevent HIV transmission through blood transfusion are needed in Africa. Systematic review protocol registration: PROSPERO CRD42023395616.
FUNDING
This article was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020).
PubMed: 38941957
DOI: 10.1016/j.ebiom.2024.105210 -
Archives of Gerontology and Geriatrics Jun 2024A meta-analysis was conducted to evaluate the impact of resistance training on pro-inflammatory cytokines c-reactive protein (CRP), interleukin 6 (IL 6), and tumor...
BACKGROUND AND OBJECTIVE
A meta-analysis was conducted to evaluate the impact of resistance training on pro-inflammatory cytokines c-reactive protein (CRP), interleukin 6 (IL 6), and tumor necrosis factor- α (TNF- α) in middle-aged and elderly individuals.
METHODS
The retrieval period for the Web of Science and other large electronic databases is set by default to March 2022. Both included and excluded researchers are independent examination literature on the impact of resistance exercise on markers of inflammation in the elderly. The physical medical care Evidence Database scale (Physical Therapy Evidence Database, PEDro) was used to evaluate the research quality, and Revmen 5.3 was used to end the index analysis.
RESULTS
After a total of four rounds of elimination, 12 items were eventually included. The total sample size for the research was 388 persons. Resistance training substantially reduced CRP levels in middle-aged and older individuals, with SMD = -0.56 and 95 % confidence interval ([-0.78, -0.34], P < 0.00001, correspondingly. Resistance training can successfully lower IL6 concentrations in middle-aged and older adults, although the combined impact is not substantial. SMD = -0.25, 95 % CI [-0.54, 0.04]; P = 0.09. TNF- concentrations did not alter significantly following resistance exercise in middle-aged and older adults. The overall effect was SMD = -0.07, with a 95 % confidence interval [-0.37, 0.23], while P = 0.64.
CONCLUSION
Resistance training reduces CRP, IL6, and TNF-α levels among middle-aged and elderly people. However, it has no significant anti-inflammatory effects on TNF-α. Resistance exercise at a moderate level for 3 times / week with a duration of 6-12 weeks or 16-32 weeks, significantly reduced CRP levels. This work contributing to exploring the resistance training program for the elderly to reduce inflammatory markers, and further, providing suggestions for the elderly to participate in resistance training and reduce the concentration of inflammatory markers.
PubMed: 38941946
DOI: 10.1016/j.archger.2024.105536 -
International Immunopharmacology Jun 2024Immunotherapy in combination with chemotherapy has been approved as an initial treatment strategy for unresectable advanced gastric cancer (GC). However, the efficacy of... (Review)
Review
Perioperative immune checkpoint inhibitors combined with chemotherapy versus chemotherapy for locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma: A systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Immunotherapy in combination with chemotherapy has been approved as an initial treatment strategy for unresectable advanced gastric cancer (GC). However, the efficacy of adding immunotherapy to perioperative chemotherapy in locally advanced resectable gastric or gastroesophageal junction adenocarcinoma (GC/GEJC) remains uncertain. Therefore, a meta-analysis of randomized controlled trials (RCTs) was performed to compare the effectiveness of perioperative immune checkpoint inhibitors (ICIs) plus chemotherapy versus chemotherapy alone in patients with locally advanced resectable GC/GEJC.
METHODS
A comprehensive search of online databases was conducted to identify RCTs published until November 30, 2023. Odds ratios (ORs) with 95% confidence interval (CI) were calculated for primary outcomes, including R0 resection rate, D2 lymphadenectomy, pathologic complete response (pCR), and treatment-related adverse events (TRAEs).
RESULTS
A total of 2718 patients from five RCTs (six reports) were included in the analysis. The pooled ORs of R0 resection rate and D2 lymphadenectomy demonstrated that combination therapy with ICIs showed no significant difference compared to chemotherapy alone. However, the addition of ICIs significantly improved pCR rates (OR = 3.43, 95 % CI 2.61-4.50, p < 0.0001). There were no significant differences observed in the incidence of any grade TRAEs and grade 3-4 TRAEs. However, ICIs combination therapy was associated with significantly higher incidences of any grade irAEs (OR = 4.03, 95 % CI: 2.70-6.00, p < 0.0001), as well as grade 3-4 irAEs (OR = 4.51, 95 % CI: 2.27-8.97, p < 0.0001).
CONCLUSIONS
This study represents the first meta-analysis to demonstrate that perioperative combination therapy with ICIs yields superior pCR rates for patients with locally advanced GC/GEJC compared to chemotherapy.
PubMed: 38941672
DOI: 10.1016/j.intimp.2024.112576 -
Ecotoxicology and Environmental Safety Jun 2024This study aims to investigate the effect of arsenic exposure on urinary levels of arsenic metabolites, semen parameters, and testosterone concentrations. A systematic... (Review)
Review
This study aims to investigate the effect of arsenic exposure on urinary levels of arsenic metabolites, semen parameters, and testosterone concentrations. A systematic comprehensive literature search was conducted up till 31st January 2024 using Embase, MEDLINE/Pubmed, and Scopus. This study adopted the Population Exposure Comparator Outcome and Study Design (PECOS) framework. Four studies with a total of 380 control subjects and 347 exposed men were included. Arsenic exposure significantly increased urinary levels of total arsenic (Mean Difference (MD) - 53.35 [95 % Confidence Interval (CI): - 100.14, - 6.55] P= 0.03), and reduced primary arsenic methylation index (PMI) (MD 0.22 [95 % CI: 0.14, 0.31] P< 0.00001), semen volume (MD 0.30 [95 % CI: 0.05, 0.54] P= 0.02) and total testosterone (MD 0.48 [95 % CI: 0.23, 0.73] P= 0.0002). In addition, arsenic exposure marginally reduced sperm concentration (MD 25.04 [95 % CI: - 45.42, 95.50] P= 0.49) and total sperm motility (MD 22.89 [95 % CI: - 14.15, 59.94] P= 0.23). The present meta-analysis demonstrates that arsenic exposure lowers semen quality and testosterone levels. Since the general human population is exposed to arsenic occupationally or domestically, adequate strategic measures should be put in place to limit arsenic exposure in an attempt to preserve semen quality. In addition, studies investigating interventions that may inhibit the bioaccumulation of arsenic in men who are exposed are recommended.
PubMed: 38941661
DOI: 10.1016/j.ecoenv.2024.116645