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Background: The existing literature regarding the treatment strategy for high‐power short‐duration (HPSD) ablation in patients diagnosed with atrial fibrillation (AF) is currently insufficient. The objective of this study is to perform a comparative analysis evaluating the effectiveness, safety, and procedural efficiency of HPSD versus cryoballoon ablation (CBA) for AF. Methods: A comprehensive search was conducted in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov databases to identify trials comparing HPSD with CBA for AF from their inception until December 25, 2023. Treatment effect measures were expressed as odds ratio (OR), mean difference (MD), accompanied by a 95% confidence interval (CI). Results: The analysis comprised six eligible trials involving a total enrollment of 2481 patients. No statistically significant disparities were observed in recurrent atrial arrhythmia (OR 0.90; 95% CI, 0.71–1.16) or total complications (OR 0.65; 95% CI, 0.38–1.12) between the two ablation techniques examined in this study. However, HPSD technique exhibited a significantly prolonged procedure time (MD 27.42; 95% CI, 19.03 to 35.81). Conversely, no significant differences were observed between the two modalities in terms of total fluoroscopy duration (MD −4.37; 95% CI −10.70 to 1.96) and ablation time (MD 7.95; 95% CI −3.97 to 19.88). Furthermore, HPSD demonstrated significantly higher odds of extrapulmonary vein (PV) trigger ablation compared to CBA (OR 18.86; 95% CI, 5.12–69.49). The subgroup analyses revealed that CBA continued to exhibit superior procedure time (except for the paroxysmal AF subgroup: [MD 29.52; 95% CI −4.25 to 63.60]), while no significant differences in safety and efficacy (except for the HPSD ≥ 70 W subgroup: [OR 0.44, 95% CI 0.20–0.97]) outcomes were still observed. Conclusion: Among patients undergoing ablation therapy for AF, both HPSD and CBA demonstrate comparable efficacy and safety profiles; however, HPSD is associated with longer procedural time and higher rates of extra‐PV trigger ablation. [ABSTRACT FROM AUTHOR]

Hematological indicators of chronic systemic inflammation are significant biomarkers for gastroenteropancreatic neuroendocrine neoplasms (GEP‐NENs). We performed a systematic review and meta‐analysis to assess the impact of certain factors on the overall survival (OS), progression‐free survival (PFS), and disease‐free survival (DFS) of patients with GEP‐NENs. These factors include the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and C‐reactive protein (CRP) levels. After searching the Medline, Embase, and Cochrane Library databases from January 1, 2000 to October 20, 2022 and the American Society of Clinical Oncology conference proceedings from January 1, 2017, hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted. Subgroup analyses were conducted to identify the origins of heterogeneity and examine the impact of factor grouping. The effects of the cut‐off values and sample size were assessed by meta‐regression. The results revealed that higher NLRs, PLRs, and CRP levels were associated with shorter OS (HR = 2.09, 95% CI = 1.55–2.8; HR = 1.79, 95% CI = 1.40–2.28; and HR = 2.88, 95% CI = 2.09–3.95, respectively; all p < 0.001). Higher NLRs and lower LMRs were associated with shorter DFS (HR = 3.34, 95% CI = 2.11–5.29 and HR = 2.71, 95% CI = 2.27–3.24, respectively; both p < 0.001). Higher PLRs and CRP levels were correlated with shorter PFS (HR = 3.48, 95% CI = 1.34–9.03, p = 0.01 and HR = 3.14, 95% CI = 1.63–6.08, p = 0.001). As demonstrated in the research, hematological indicators of systemic inflammation are promising biomarkers for GEP‐NEN assessment. [ABSTRACT FROM AUTHOR]

In vaccine research towards the prevention of infectious diseases, immune response biomarkers serve as an important tool for comparing and ranking vaccine candidates based on their immunogenicity and predicted protective effect. However, analyses of immune response outcomes can be complicated by differences across assays when immune response data are acquired from multiple groups/laboratories. Motivated by a real‐world problem to accommodate the use of two different neutralization assays in COVID‐19 vaccine trials, we propose methods based on left‐censored multivariate normal model assuming common assay differences across settings, to adjust for differences between assays with respect to measurement error and the lower limit of detection. Our proposed methods integrate external paired‐sample data with bridging assumptions to achieve two objectives, both using pooled data acquired from different assays: (i) comparing immunogenicity between vaccine regimens, and (ii) evaluating correlates of risk. In simulation studies, for the first objective, our method leads to unbiased calibrated assay mean with good coverage of bootstrap confidence interval, as well as valid test for immunogenicity comparison, while the alternative method assuming constant calibration model between assays leads to biased estimate of assay mean with undercoverage problem and invalid test with inflated type‐I error; for the second objective, in the presence of noticeable left‐censoring rate, our proposed method can drastically outperform the existing method that ignores left‐censoring, in terms of reduced bias and improved precision. We apply the proposed methods to SARS‐CoV‐2 spike‐pseudotyped virus neutralization assay data generated in vaccine and convalescent samples by two different laboratories. [ABSTRACT FROM AUTHOR]

To conduct a systematic review and meta‐analysis to characterize inflammatory markers in comparisons of multisystem inflammatory syndrome in children (MIS‐C) versus severe/non‐severe COVID‐19, severe MIS‐C versus non‐severe MIS‐C, and among age groups of MIS‐C. Nine databases were searched for studies on inflammatory markers of MIS‐C. After quality checks, data were pooled using a fixed or random effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C‐reactive protein (CRP), procalcitonin (PCT), ferritin, D‐dimer, lactate dehydrogenase (LDH), fibrinogen, and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty‐one studies with 1735 participants yielded 787 MIS‐C patients. Compared to non‐severe COVID‐19 patients, MIS‐C patients had lower ALC and higher ANC, CRP, and D‐dimer levels. Compared to severe COVID‐19 patients, MIS‐C patients had lower LDH and PLT counts and higher ESR levels. Severe MIS‐C patients had higher levels of WBC, ANC, CRP, D‐dimer, and ferritin than non‐severe MIS‐C patients. For MIS‐C, younger children (0–5 years) had lower CRP and ferritin levels than middle‐aged/older children/adolescents. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS‐C and the associated disorders. Research Highlights: •To conduct a comprehensive characterization of the inflammatory markers of MIS‐C during the COVID‐19 pandemic.•This meta‐analysis summarized the available data and demonstrated significant implications by characterizing the laboratory inflammatory markers of MIS‐C that has widely emerged as a major complication among children with COVID‐19.•The results indicated that inflammatory markers, including WBC, ALC, ANC, PLT, CRP, PCT, ferritin, D‐dimer, LDH, fibrinogen, and ESR, were different while comparing MIS‐C versus severe/non‐severe COVID‐19, severe MIS‐C versus non‐severe MIS‐C, and age groups of MIS‐C. [ABSTRACT FROM AUTHOR]

Purpose: This study is a systematic review and meta‐analysis compare the short‐ and long‐term outcomes of splenectomy (SP) versus splenic preservation (NSP) in radical gastric cancer surgery. Methods: A comprehensive search of PubMed, Embase, Cochrane Library and Web of Knowledge was performed. Evaluation of short‐ and long‐term outcomes was collected and analyzed by a fixed or random effects model, according to the heterogeneity using RevMan 5.2 software. Results: A total of 5431 gastric cancer patients who underwent radical surgery (1706 with SP and 3725 with NSP) were reviewed in 11 studies included in this study. Compared with NSP, SP was significantly associated with higher rate of overall postoperative complication and increased incidence of pulmonary complications, abdominal abscess and pancreas complications. No statistical difference was observed regarding mortality, wound infection, anastomotic leakage and postoperative 5‐year overall survival. Conclusion: There was no difference in long‐term oncological outcome but remarkably poorer short‐term outcomes in SP group than NSP group. Therefore, SP seems unnecessary in radical gastric cancer surgery. However, well‐designed, multicenter, prospective, randomized controlled trials are warranted for further validation. [ABSTRACT FROM AUTHOR]

Background: Clinical prediction rules (CPRs) provide an objective method of assessment in the diagnosis of acute appendicitis. There are a number of available CPRs for the diagnosis of appendicitis, but it is unknown which performs best. Aim: The aim of this study was to identify what CPRs are available and how they perform when diagnosing appendicitis in adults. Method: A systematic review was performed in accordance with the PRISMA guidelines. Studies that derived or validated a CPR were included. Their performance was assessed on sensitivity, specificity and area under curve (AUC) values. Results: Thirty-four articles were included in this review. Of these 12 derived a CPR and 22 validated these CPRs. A narrative analysis was performed as meta-analysis was precluded due to study heterogeneity and quality of included studies. The results from validation studies showed that the overall best performer in terms of sensitivity (92%), specificity (63%) and AUC values (0.84-0.97) was the AIR score but only a limited number of studies investigated at this score. Although the Alvarado and Modified Alvarado scores were the most commonly validated, results from these studies were variable. The Alvarado score outperformed the modified Alvarado score in terms of sensitivity, specificity and AUC values. Conclusion: There are 12 CPRs available for diagnosis of appendicitis in adults. The AIR score appeared to be the best performer and most pragmatic CPR. [ABSTRACT FROM AUTHOR]

Objectives Increasing number of studies suggested that biallelic CEBPA (bi CEBPA) mutations were associated with favorable prognosis in patients with acute myeloid leukemia ( AML), but the results remain inconclusive. We therefore present a meta-analysis to evaluate the prognostic value of bi CEBPA mutations in patients with AML. Methods A comprehensive literature search was undertaken through August 2014 looking for eligible studies. Pooled hazard ratios ( HRs) estimates and 95% confidence intervals (95% CIs) in overall survival ( OS) and event-free survival ( EFS) were used to calculate estimated effect. Results Ten studies covering a total of 6219 subjects were included in this analysis. Overall, bi CEBPA mutations were associated with favorable clinical outcome in patients with AML ( HR for EFS: 0.41, 95% CI: 0.32-0.52; for OS: 0.37, 95% CI: 0.27-0.50), in cytogenetically normal ( CN)- AML ( HR for EFS: 0.38, 95% CI: 0.29-0.49; for OS: 0.32, 95% CI: 0.23-0.43). When took the cohort of monoallelic CEBPA (mo CEBPA) mutated and wild-type CEBPA (wt CEBPA) AML as a reference group, bi CEBPA mutated AML also shown beneficial outcomes ( HR for OS: 0.52, 95% CI: 0.37-0.72). No significant difference was found between mo CEBPA mutation and wt CEBPA in patients with AML or CN- AML ( P > 0.05). Conclusion Bi CEBPA mutations in patients with AML are strongly associated with a favorable prognosis, which suggested that bi CEBPA mutations would potentially serve as a novel prognostic marker in AML. [ABSTRACT FROM AUTHOR]

Objective Published results on association between eNOS polymorphisms and cancer risk are conflicting. We aimed to investigate the association and give an overall understanding of possible risk role of eNOS. Method We searched PubMed and EMbase databases. The pooled ORs and 95% CIs for the association between eNOS polymorphisms and cancer risk was estimated using fixed- or random- effect model. Subgroup and sensitivity analyses were employed for further analysis. Results The Overall results showed no significant association of G894T polymorphism with cancer susceptibility (T vs. G: OR 1.02, 95% CI 0.97 to 1.07; TT+GT vs. GG: OR 1.02, 95% CI 0.96 to 1.09; TT vs. GT+GG: OR 1.05, 95% CI 0.93 to 1.17). For the T-786C polymorphism, pooled OR under recessive model suggested that CC genotype was significantly associated with increased cancer risk (CC vs. TC+TT: OR 1.31, 95% CI 1.09 to 1.57). For the 4b/a polymorphism, pooled OR for recessive model suggested positive result of 4a/4a genotype (aa vs. ba+bb: OR 1.64, 95% CI 1.11 to 2.43). In subgroup analysis by ethnicity, significant association was found in Caucasians in recessive model but not in Asians for T-786C and 4b/a, respectively. In subgroup analysis by cancer types, significant result was obtained for breast cancer in recessive model for the T-786C polymorphism. Conclusion The eNOS G894T polymorphism may not be a major risk factor for most types of cancers. The CC of T-786C polymorphism and 4a/4a of 4b/a polymorphism are associated with cancer risk, especially in Caucasians. There is significant association between T786C polymorphism and breast cancer risk. More data are needed to verify these results. [ABSTRACT FROM AUTHOR]

Aim The association between parity and rheumatoid arthritis (RA) risk has been investigated, but results are controversial. Thus, our aim was to systematically analyze the effect of number of parity on the risk of RA in women. Methods Relevant published studies were identified using PubMed and embase databases through 1 April 2016. We pooled the relative risks (RR) and 95% confidence intervals (CI) using random-effects models. Results In all, 12 studies with a total of 2 497 580 participants and 11 521 RA cases were included. A borderline significant inverse association was observed when we compared parity with nulliparity for RA, with summarized RR = 0.90 (95%CI: 0.79-1.02; I2 = 58.5%, Pheterogeneity = 0.010). In dose-response analysis, we observed a significant nonlinear ( Pnonlinearity = 0.000) relation between parity number and the risk of RA. Compared with null parity, the pooled RR of RA were 0.89 (95%CI: 0.86-0.93), 0.84 (95%CI: 0.79-0.89), 0.85 (95%CI: 0.79-0.90), 0.88 (95%CI: 0.81-0.95), 0.90 (95%CI: 0.83-0.97), 0.92 (95%CI: 0.84-1.02), and 0.94 (95%CI: 0.83-1.07) for 1, 2, 3, 4, 5, 6, and 7 live births, respectively. Subgroup and sensitivity analyses showed similar associations. No publication bias was found. Conclusion The findings from the current meta-analysis indicate that parity was related to decreased risk of RA. The greatest risk reduction appeared when the parity number reached two. Further studies are warranted to confirm our findings. [ABSTRACT FROM AUTHOR]