METHODS: This study uses data from the Global Burden of Disease (GBD) study spanning 1990-2021 to analyze PCa trends in CEE. We assessed age-standardized rates (ASRs) of PCa to identify trend changes through joinpoint regression analysis, explored regional disparities using QGIS software, and made projections for 2031 using the ARIMA model.
RESULTS: Eastern Europe experienced greater changes across health metrics compared to Central Europe, with higher average annual percentage change values for incidence, prevalence, mortality, and DALYs rates. In 2021, Lithuania and Estonia recorded the highest PCa prevalence rates, while Estonia had the highest total percentage change (240.3). Estonia and Latvia also had the highest mortality rates (34.1 and 33.6 per 100,000, respectively). CEE's prevalence rates are projected to remain stable.
CONCLUSION: The findings highlight significant regional disparities in the burden of prostate cancer in CEE. Efforts to address these disparities should focus on enhancing diagnostic programs and treatment access, particularly in Eastern Europe, to reduce the ongoing burden of PCa in the region.
METHODS: A comprehensive search across PubMed, Embase, and Web of Science was conducted through December 10 2024, identifying observational studies exploring hydrocarbon exposure and stroke risk. Studies meeting predefined inclusion criteria, excluding those with major methodological flaws, were synthesized narratively. Variations in hydrocarbon types, population demographics, and stroke outcomes were considered.
RESULTS: Six studies, including five cross-sectional and one retrospective cohort, with sample sizes ranging from 5,537 to 283,666 participants, demonstrated significant associations between hydrocarbon exposure and stroke risk. Key findings revealed strong associations for metabolites like 1-hydroxynaphthalene (OR: 1.89; 95% CI: 1.62-2.20) and 2-hydroxyfluorene (OR: 1.94; 95% CI: 1.66-2.26). However, variability in findings was noted, attributed to differences in study design, exposure levels, and populations studied.
CONCLUSION: This review highlights a complex relationship between hydrocarbon exposure and stroke risk, with some studies indicating significant associations and others reporting inconsistencies. Standardized, large-scale research is essential to clarify this relationship, identify high-risk populations, and guide public health strategies to mitigate exposure and prevent stroke.
CLINICAL TRIAL NUMBER: Not applicable.
METHOD: A systematic search of PubMed, Embase, and Web of Science was conducted in accordance with the PRISMA framework and registered with PROSPERO (ID: CRD42025644604) to enhance transparency. The search, conducted up to January 2024, included studies focusing on the association between migraine and PPI use. Data screening and extraction were performed using Nested Knowledge software. Meta-analyses were conducted in R software, with heterogeneity assessed through the I² statistic. Pooled adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Sensitivity analyses were also performed to assess the robustness of the results. Gender and migraine subtype were considered in subgroup analyses. Additionally, the GRADE approach was applied to assess the certainty of the evidence across the pooled outcomes.
RESULTS: Five studies involving over 1.5 million participants met the inclusion criteria. The overall pooled adjusted odds ratio (aOR) was 2.508 (95% CI, 0.790-7.969; I² = 91.2%). However, there was a significant association in males (aOR, 3.875; 95% CI, 2.413-6.222; I² = 0%) but not in females (aOR, 2.475; 95% CI, 0.563-10.890; I² = 91.1%). No significant differences were found between migraine types: with aura (aOR, 2.079; 95% CI, 0.945-4.576; I² = 25.4%) and without aura (aOR, 2.524; 95% CI, 0.807-7.896; I² = 96.5%). The GRADE assessment indicated a very low certainty of the evidence.
CONCLUSION: This review found no significant overall association between PPI use and migraine. However, a significant association was observed in males but not in females. Further research is needed to clarify this association and explore the underlying causality mechanisms, and migraine subtypes, particularly why the association appears more pronounced in males.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to December 1, 2024. Observational studies assessing SHBG levels and prostate cancer risk were included. Effect sizes were pooled using random-effects meta-analysis. Heterogeneity was evaluated using the I2 statistic, and quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analysis was performed using R software version 4.4.
RESULTS: Sixteen studies, including 720,298 participants and 90,799 prostate cancer cases, were analyzed. The pooled odds ratio (OR) for prostate cancer risk per unit increase in SHBG was 0.907 (95% CI 0.799-1.030), indicating no statistically significant association. Substantial heterogeneity was observed among the included studies (I2 = 79%; P
METHODS: This review was conducted following the PRISMA guidelines and included studies up to March 2024 from PubMed, Embase, and Web of Science. Eligible studies were longitudinal, including prospective cohorts, nested case-controls, and post-hoc analyses of RCTs that reported stroke outcomes in relation to PPI use. Data were synthesized using random-effects meta-analysis models in R software version 4.3.
RESULTS: Our search yielded 41 studies encompassing over 800,000 participants globally. Meta-analysis of 14 observational studies revealed a slight but non-significant increased stroke risk among patients with prior CVD (pooled HR = 1.222, 95% CI: 0.963 to 1.481, I² = 78%). In contrast, analysis of 15 studies without prior CVD showed a modestly increased risk (pooled HR = 1.15, 95% CI: 1.023 to 1.288, I² = 98%). Five RCTs involving patients with CVD reported a pooled RR of 1.158 (95% CI: 0.914 to 1.466), indicating no significant risk increase.
CONCLUSION: The association between PPI use and stroke risk appears modest and is influenced by the presence of cardiovascular conditions. Clinical decision-making should consider individual patient risk profiles, and further high-quality studies are needed to guide safer PPI prescribing practices.
OBJECTIVE: This study aimed to explore the spatial trends of child growth failure (CGF) indicators and their association with household sanitation practices in India.
METHODS: We used data from the Indian Demographic and Health Surveys spanning 1998-2021. District-level CGF indicators (stunting, wasting, and underweight) were cross-referenced with sanitation and sociodemographic characteristics. Global Moran I and Local Indicator of Spatial Association were used to detect spatial clustering of the indicators. Spatial regression models were used to evaluate the significant determinants of CGF indicators.
RESULTS: Our study showed a decreasing trend in stunting (44.9%-38.4%) and underweight (46.7%-35.7%) but an increasing prevalence of wasting (15.7%-21.0%) over 15 years. The positive values of Moran I between 1998 and 2021 indicate the presence of spatial autocorrelation. Geographic clustering was consistently observed in the states of Madhya Pradesh, Jharkhand, Odisha, Uttar Pradesh, Chhattisgarh, West Bengal, Rajasthan, Bihar, and Gujarat. Improved sanitation facilities, a higher wealth index, and advanced maternal education status showed a significant association in reducing stunting. Relative risk maps identified hotspots of CGF health outcomes, which could be targeted for future interventions.
CONCLUSIONS: Despite numerous policies and programs, malnutrition remains a concern. Its multifaceted causes demand coordinated and sustained interventions that go above and beyond the usual. Identifying hotspot locations will aid in developing control methods for achieving objectives in target areas.
METHODS: A literature search was conducted through PubMed, Embase, Web of Science, Scopus, and the Cochrane Library up until August 10, 2024. The eligibility criteria focused on observational studies that evaluated hospitalization rates among mpox cases, distinguishing between HIV-positive and HIV-negative individuals. Newcastle-Ottawa Scale was used for evaluating study quality. The meta-analysis used a random-effects model to accommodate expected study heterogeneity using R software (V. 4.4).
RESULTS: The search yielded 686 records, with 14 studies meeting the inclusion and exclusion criteria after screenings and full-text assessments. The pooled analysis revealed a 56.6% increased risk of hospitalization among HIV-positive mpox cases compared to HIV-negative individuals (95% CI: 18.0-107.7%). Notable heterogeneity (I² = 76%) was observed, likely reflecting variations in study settings and methodologies. Sensitivity analysis confirmed the robustness of these findings, and no significant publication bias was detected (Egger's test p-value = 0.733).
CONCLUSION: HIV infection is associated with a statistically significant increased risk of hospitalization in mpox cases. There is a critical need for integrated care and enhanced surveillance, especially in populations with high HIV prevalence. Our findings emphasize the importance of ongoing research to better understand HIV and mpox co-infection and to refine management strategies for this vulnerable group. Future studies should focus on long-term outcomes and the effectiveness of various management strategies across different healthcare settings.
RESEARCH DESIGN AND METHODS: We carried out analysis based on the data from the 2021 Global burden of disease study. Joinpoint regression was used to identify significant changes in trends over time, and ARIMA models were applied to forecast incidence rates.
RESULTS: Between 1990 and 2021, the average annual percentage change (AAPC) of age-standardized prevalence rates and incidence rates increased by 2.15 and 1.72 respectively. The age-standardized mortality rate rose more slowly, at 1.05 AAPC, with females experiencing a slightly higher AAPC than males. ARIMA forecasts suggest that by 2031, T2DM incidence rates will continue to rise significantly across all South Asian countries.
CONCLUSIONS: This study highlights the need for public health policies focused on preventing obesity, promoting physical activity, and improving healthcare access. It also calls for addressing regional disparities in T2DM prevalence and mortality to better allocate resources and prioritize policies to combat the diabetes epidemic inSouth Asia.
METHODS: Adhering the PRISMA 2020 guidelines and registered in the PROSPERO database, we conducted a systematic review and meta-analysis using the PubMed, Embase, and Web of Science databases up to October 2024. Nested Knowledge was used for screening and data extraction. Studies reporting quantitative data on the prevalence or mortality of dengue and leptospirosis co-infections were included. Data extraction and quality assessment were performed independently by two reviewers using the Modified Newcastle-Ottawa Scale. Statistical analyses, including prevalence and mortality estimation, sensitivity analysis were conducted using R, with heterogeneity evaluated by the I² statistic.
RESULTS: Out of 3,982 records, 14 studies met the eligibility criteria, yielding a pooled prevalence of dengue and leptospirosis co-infection at 2.33% (95% CI: 1.41-3.46%) across 16,638 participants, with significant heterogeneity (I² = 90%). The prediction interval for co-infection ranged from 0.05 to 7.27%. The pooled mortality rate among co-infected patients was 9.96% (95% CI: 0-53.49%), with moderate heterogeneity (I² = 71%). The prediction interval for mortality ranged from 0.00 to 100%. Publication bias was indicated by an LFK index of 2.52.
CONCLUSION: This meta-analysis revealed a moderate prevalence and a notable mortality rate for dengue and leptospirosis co-infections, with significant variability observed across different studies. Further research into the immunopathology and the implementation of integrated surveillance systems could enhance the effectiveness of diagnosis and treatment strategies in regions where these diseases are endemic.
METHODS: We conducted a comprehensive search across PubMed, Embase, and Web of Science until November 10 2024, selecting studies based on pre-defined criteria that involve adults with AF and measurements of VEGF levels. The selected studies included observational and experimental designs, excluding non-English and methodologically insufficient publications. Narrative synthesis was used for summarising the results.
RESULTS: Eight studies met the inclusion criteria. The studies show a general trend of elevated VEGF levels in AF patients compared to controls, with significant heterogeneity in findings across studies. VEGF subtypes such as VEGF-A and VEGF-D demonstrated stronger associations with AF risk compared to VEGF-C. These variations point to the complex role of VEGF in AF, influencing factors like angiogenesis, endothelial function, and inflammatory responses.
CONCLUSION: VEGF is potentially a significant contributor to AF pathophysiology, with its levels reflecting disease activity. The variability observed across studies suggests a need for standardized measurement approaches and further investigation into VEGF subtypes. Future research should focus on longitudinal studies to better understand the causal relationships and the potential of VEGF as a therapeutic target and biomarker in AF management.
CLINICAL TRIAL NUMBER: Not applicable.
DESIGN: Systematic review and meta-analysis.
METHODS: A comprehensive literature search was conducted across PubMed, Embase, Scopus and Web of Science, identifying studies published through October 5, 2024. Studies involving adult patients with Type 1 or Type 2 diabetes and reporting diagnostic metrics such as sensitivity and specificity were included. The primary outcomes were pooled sensitivity and specificity of IDX-DR. A bivariate random-effects model was used for meta-analysis, and summary receiver operating characteristic (SROC) curves were generated to assess diagnostic performance. Statistical analyses were performed using MetaDisc software version 2.0.
RESULTS: Thirteen studies involving 13,233 participants met the inclusion criteria. IDX-DR's pooled sensitivity was 0.95 (95% CI: 0.82-0.99), and its pooled specificity was 0.91 (95% CI: 0.84-0.95). The SROC curve confirmed IDX-DR's high diagnostic accuracy in detecting diabetic retinopathy across various clinical environments. The AUC value of 0.95 demonstrated high sensitivity and specificity, indicating a robust diagnostic performance for IDX-DR in detecting diabetic retinopathy.
CONCLUSION: IDX-DR is a highly effective diagnostic tool for diabetic retinopathy screening, with robust sensitivity and good specificity. Its integration into clinical practice, especially in resource-limited settings, can potentially improve early detection and reduce vision loss. However, careful implementation is needed to address challenges such as over-diagnosis and ensure the tool complements clinical judgment. Future studies should explore the long-term impacts of AI-based screening and address ethical considerations surrounding its use.
METHODS: We used Global Burden of Disease (GBD) 2021 data to assess the burden of AHE across eight South Asian countries from 1990 to 2021. Joinpoint regression was used to analyze temporal trends and Estimated Annual Percentage Change (EAPC) was calculated to quantify trends. The relationship between age-standardized disability-adjusted life years rate (ASDR) and socio-demographic index (SDI) was assessed using smoothing spline model and Spearman rank correlation. Rates are expressed per 100,000 population.
RESULTS: Bangladesh had highest age-standardized prevalence rate (ASPR) [33.27 (95 % Uncertainty Interval: 27.64 to 39.95)] and age-standardized incidence rate (ASIR) [433.01 (359.61 to 519.76)], while India had highest ASDR [9.52 (4.33 to 18.42)]. Males had higher ASIR and ASPR than females in most South Asian countries, except Bhutan and India, and higher ASDR except in Nepal and Pakistan. Bhutan had the highest EAPC for both sexes in ASPR and ASIR, while India had the highest EAPC in ASDR, closely followed by Bhutan for both sexes. Age group 5-9 had the highest ASPR and ASIR whereas <1-year age group had the highest ASDR. There was an inverse relationship between ASDR and SDI (R = -0.49, p < 0.01).
CONCLUSION: South Asia bears a high burden of AHE, with variations across countries. Improvements in Water Sanitation and Hygiene (WASH) services are needed to achieve Sustainable Development Goals 3 and 6.
METHODS: Data from the GBD study were analysed to evaluate incidence, prevalence, and years lived with disability (YLDs) for headache disorders and their subtypes. Trends were assessed using absolute numbers and age-standardized rates, with demographic patterns by age and gender examined to identify vulnerable populations. Joinpoint regression analysis was employed to detect significant temporal shifts.
RESULTS: From 1990 to 2021, headache disorders in South Asia rose from 114.2 million to 206.8 million in incidence, and from 367.4 million to 698.5 million in prevalence, with YLDs nearly doubling from 6.0 million to 11.6 million. Migraines accounted for 294.4 million cases, while TTH contributed 495.4 million cases, with YLDs increasing by 92.88 and 99.35%, respectively. Afghanistan saw the highest relative growth, while India contributed the largest absolute burden. Women and middle-aged adults were disproportionately affected, with the highest prevalence observed in females aged 30-34 years. The Maldives showed dramatic increases in TTH-related YLDs, highlighting disparities in smaller nations.
CONCLUSION: The rising burden of headache disorders in South Asia highlights the need for region-specific strategies targeting high-burden subtypes, countries, and vulnerable populations to mitigate their disabling impacts.
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: A search was conducted across multiple databases until February 15, 2024. Observational studies that assessed the prevalence of gaming disorder were included. Nested Knowledge software was used for screening and data extraction. The quality assessment was performed using the Joanna Briggs Institute tool. Meta-analysis using a random effect model was used to synthesize prevalence rates. Statistical analyses were performed in R software version 4.3.
RESULTS: The meta-analysis included 84 studies covering a diverse geographical scope totaling 641,763 individuals. The pooled prevalence of gaming disorder was 8.6 % (95 % CI: 6.9 %-10.8 %), (I2 = 100 %). Subgroup analysis revealed varying prevalence rates by country, with China reporting the highest rate at 11.7 % (95 % CI: 8.6 %-15.7 %). Meta-regression analysis highlighted an increasing trend in the prevalence of gaming disorder over the years, underscoring the growing impact of digital technologies.
CONCLUSION: A significant prevalence of gaming disorder among adolescents is observed. With an increasing trend, fostering healthy gaming habits, enhancing awareness, and implementing effective intervention programs are crucial. This emphasizes the importance of global efforts in combating the growing challenge of gaming disorder among adolescents.
METHODS: We conducted a thorough search up until October 10, 2024, across databases such as PubMed, Web of Science, and Embase. Studies that reported lipid profiles in both H. pylori-infected and non-infected patients were considered eligible. The primary outcomes were triglyceride, LDL-C, HDL-C, and total cholesterol levels, which were examined using a random-effects model in R software version 4.4.
RESULTS: There were 17 studies with more than 150,000 participants from 681 screened publications. Higher levels of LDL (MD: 5.32 mg/dL; 95% CI: 1.315 to 9.319) and total cholesterol (MD: 6.28 mg/dL; 95% CI: 0.718 to 11.842), as well as lower levels of HDL (MD: -2.06 mg/dL; 95% CI: -3.212 to -0.915), were the results of the meta-analysis. Among those infected, triglyceride levels were likewise higher (MD: 7.93 mg/dL; 95% CI: 0.413 to 15.436), but the odds ratio (OR) did not show a significant increase in risk (OR: 1.002; 95% CI: 0.995 to 1.010).
CONCLUSION: H. pylori infection is associated with significant dyslipidemia, suggesting a potential link between chronic bacterial infection and lipid metabolism. The findings emphasize the need for further research to explore the mechanisms and potential therapeutic interventions.
METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to September 20, 2024. Observational studies assessing the association between ENDS use and COPD risk were included. A random-effects meta-analysis was performed using R statistical software (version 4.4). Tobacco smoking, a key confounder in COPD research, was accounted for in many included studies, with adjustments varying across studies.
RESULTS: Fifteen studies met the inclusion criteria. The pooled odds ratio (OR) for current ENDS use and COPD risk was 1.488 (95 % CI: 1.363-1.623). Former ENDS users had an OR of 1.839 (95 % CI: 1.513-2.234), and ever-users had an OR of 1.787 (95 % CI: 1.421-2.247). Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected.
CONCLUSION: This meta-analysis provides evidence of a significant association between ENDS use and increased COPD risk, even after adjusting for tobacco smoking. Future research should standardize smoking adjustments and investigate the independent impact of ENDS use on COPD.
OBJECTIVE: This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions.
METHODS: We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative.
RESULTS: Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses.
CONCLUSIONS: This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies.
TRIAL REGISTRATION: PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr.
METHODS: A systematic search of PubMed, Web of Science, and Embase was conducted for studies published up to August 2024. Eligibility criteria included cohort, case-control, and cross-sectional studies assessing air pollution exposure and mortality in PLWH. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was applied for quality assessment. A narrative approach and tabular summarization were used for data synthesis and presentation.
RESULTS: Nine studies, mostly from China, demonstrated a significant association between long-term exposure to PM1, PM2.5, and PM10 and increased risks of AIDS-related and all-cause mortality in PLWH. Hazard ratios for mortality increased by 2.38-5.13% per unit increase in PM concentrations, with older adults (> 60), females, and those with lower CD4 counts (