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What is known and objective: Tranexamic acid (TXA) is a novel treatment option for melasma; however, no consensus exists on its use. This study evaluates the efficacy and safety of TXA for melasma. Methods: A comprehensive literature review was conducted to search for randomized controlled trials comparing TXA alone, TXA as adjuvant to routine treatment and placebo. Changes in the Melasma Area Severity Index (MASI)/modified MASI (mMASI) between pre‐ and post‐treatment and between a certain melasma treatment and TXA were the primary outcomes. Twenty‐four trials comparing oral, topical or intradermal TXA with routine treatment were included in the meta‐analysis. Results and discussion: The change in MASI/mMASI scores at 4 (MD, 3.58; 95% confidence interval (CI), 2.15–5.01), 8 (MD, 5.08; 95% CI, 3.34–6.81), 12 (MD, 4.89; 95% CI, 3.80–5.97) and 16 (MD, 6.55; 95% CI, 2.62–10.48) weeks after treatment was all less than the baseline scores, regardless of the delivery route. The reduction in the MASI/mMASI scores between TXA adjuvant and routine treatment at 4 (MD, −0.43; 95% CI, −0.79 to −0.08), 8 (MD, −0.81; 95% CI, −1.09 to −0.54), 12 (MD, −1.10; 95% CI, −1.78 to −0.43) and 16 (MD, −1.12; 95% CI, −1.51 to −0.74) weeks was significant. However, the superiority of TXA was not detected when the topical or intradermal route was adopted. No serious adverse events occurred with the use of TXA. What is new and conclusion: These results suggest that oral TXA is an available, effective and safe alternative treatment for melasma. [ABSTRACT FROM AUTHOR]

There is evidence pointing to a possible role of diet on cancer etiology. Prior studies evaluating the relationship between fish consumption and lung cancer risk reported inconclusive results. The aim of this study was to achieve a comprehensive assessment of the relationship between fish consumption and lung cancer risk through systematic review and meta-analysis. Case control and cohort studies up to September 1, 2012 about fish consumption and lung cancer risk were confirmed by an online search. Separate relative risk (RR) or odds ratio (OR) estimates with 95% confidence interval (CI) of the relationship between lung cancer risk and fish consumption level from the included articles were combined by Stata11.0 software. Publication bias was evaluated by Egger's linear regression test and funnel plot. Twenty articles (17 case-control and 3 cohort studies) comprising 8799 cases of lung cancer and 17,072 noncases were included in the final analysis. The pooled results from all studies indicated that high fish consumption was significantly associated with a decreased risk of lung cancer (pooled RR: 0.79; 95% CI: 0.69–0.92). There was heterogeneity among the studies (I2= 73%,P< 0.05). Pooled RR in case control and cohort studies were 0.76 (95% CI: 0.63–0.91) and 0.95 (95% CI: 0.73–1.24), respectively. Omission of any single study had little effect on the combined risk estimates. This article had no publication bias. This study identifies a significant association between fish consumption and lung cancer, confirming a protective role of fish in lung cancer. More well-designed prospective studies are required to further verify the effect of fish consumption on lung cancer. [ABSTRACT FROM PUBLISHER]

Highlights: [•] The association between the T-182C polymorphism and MDD was assessed by a meta-analysis. [•] A total of 1779 cases and 1584 controls were included. [•] No association was found between the NET T-182C polymorphism and MDD. [ABSTRACT FROM AUTHOR]

Background: Cyclooxygenase-2 (COX-2) is believed to be involved in gastric carcinogenesis. However, it is still controversial whether COX-2 expression can be regarded as a prognostic factor for gastric cancer patients. Aim: To obtain a more accurate relationship between COX-2 overexpression and prognosis in gastric cancer by meta-analysis. Method: Relevant articles published up to May 2013 were searched by use of several keywords in electronic databases. Separate hazard ratio (HR) estimates and 95 % confidence intervals (95 % CI) for COX-2 overexpression and overall survival (OS) and disease-free survival (DFS) with gastric cancer were extracted. Combined HR with 95 % CI was calculated by use of Stata11.0 software to estimate the size of the effect. Publication bias testing and sensitivity analysis were also performed. Results: A total of 27 studies which included 3,891 gastric cancer patients were combined in the final analysis. Combined results suggested that COX-2 overexpression was associated with an unfavorable OS (HR 1.58, 95 % CI 1.36-1.84) but not DFS (HR 1.15, 95 % CI 0.93-1.43) among patients with gastric cancer. Publication bias was absent. Sensitivity analysis suggested that the results of this meta-analysis were robust. Conclusions: The results of this meta-analysis suggest that high COX-2 expression may be an independent risk factor for poor OS of patients with gastric cancer. More large prospective studies are now needed to further clarify the prognostic value of COX-2 expression for DFS in gastric cancer. [ABSTRACT FROM AUTHOR]

Objectives: The reported results of the relationship between genetic polymorphisms of tumor necrosis factor (TNF)-α −238, −308 locus and ankylosing spondylitis (AS) susceptibility are not always consistent. This article aims to perform a meta-analysis to collect all the relevant studies to date to further clarify the relationship between those genetic polymorphisms and AS. Methods: A computer search was carried out up to September 2011 for literature pertaining to AS and TNF-α polymorphisms. Results: Twenty-two articles were included, with 2,506 cases of AS and 3,023 normal controls. We searched for genotypes A allele vs. G allele, AA vs. GG + GA, and GA + AA vs. GG in a fixed/random-effects model. The effect summary odds ratios (ORs) and 95 % confidence intervals (CIs) were obtained, which shows there was no association between genetic polymorphisms and AS. As the heterogeneity was observed, in a subgroup analysis by ethnicity, the degree of risk of two genes with AS susceptibility was similar in populations of European and Asian origin. For the human leukocyte antigen (HLA)-B27+ population, results were not statistically significant. Conclusion: ORs of various comparisons indicate that there is no association between TNF-α −238, −308 polymorphisms and AS susceptibility in the overall population and in the subgroup of Asian and non-Asian descent. [ABSTRACT FROM AUTHOR]

Purpose: There has been a persistent claim that dairy products contain calcium-leaching proteins, although the soundness of such a claim has been challenged. A meta-analysis of randomized controlled trials (RCTs) on the effects of milk-derived protein supplementation on bone health indices in adults was performed to reconcile the controversy surrounding the potential skeletal safety concerns of proteins of dairy origin. Methods: The PubMed and Web of Science databases were searched for relevant RCTs. A random-effects model was used to generate pooled effect sizes and 95% confidence intervals. Results: Milk-derived protein supplementation did not significantly affect whole-body BMD (n = 7 RCTs) and BMD at the lumbar spine (n = 10), hip (n = 8), femoral neck (n = 9), trochanter (n = 5), intertrochanter (n = 2), and ultradistal radius (n = 2). The concentrations of bone formation markers (bone-specific alkaline phosphatase [n = 11], osteocalcin [n = 6], procollagen type 1 amino-terminal propeptide [n = 5]), bone resorption markers (N-terminal telopeptide of type 1 collagen [n = 7], C-terminal telopeptide of type 1 collagen [n = 7], deoxypyridinoline [n = 4]), and parathyroid hormone (n = 7) were not significantly affected. However, increased insulin-like growth factor-1 (IGF-1) concentrations (n = 13) were observed. Reduced IGF-1 concentrations were observed when soy protein was used as a comparator, and increased IGF-1 concentrations were observed when carbohydrate was used. Conclusion: Our findings do not support the claim that proteins of dairy origin are detrimental to bone health. [ABSTRACT FROM AUTHOR]

Background: NAD(P)H:quinone oxidoreductase 1 (NQO1), an obligate two-electron reductase, plays an important role in reducing reactive quinones to less reactive and less toxic hydroquinones. Genetic variations in NQO1 gene that impede its enzyme function may be considered as putative risk factor for cancer. Numerous studies have been performed to investigate the association between NQO1 Pro187Ser polymorphism and bladder cancer risk; nevertheless, the results remain controversial. Methods: We indentified eligible publications from PubMed, Embase and CBM databases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to access the strength of the associations. False-positive report probability (FPRP) analysis was also performed for all statistically significant findings. Results: We collected a total of 15 studies including 4298 cases and 4275 controls in the final meta-analysis. Overall, the NQO1 187Ser carriers were associated with an increased bladder cancer risk (homozygous: OR = 1.43, 95% CI = 1.08-1.90; recessive: OR = 1.33, 95% CI = 1.03-1.72; dominant: OR = 1.19, 95% CI = 1.04-1.37, and allele comparing: OR = 1.18, 95% CI = 1.06-1.33). Stratification analyses showed a statistically significant association among Asians (homozygous: OR = 1.82, 95% CI = 1.39-2.38; recessive: OR = 1.52, 95% CI = 1.20-1.93, dominant: OR = 1.40, 95% CI = 1.05-1.88, and allele comparing: OR = 1.35, 95% CI = 1.15-1.58), never smokers (homozygous: OR = 2.30, 95% CI = 1.14-4.65; heterozygous: OR = 2.26, 95% CI = 1.43-3.56; dominant model: OR = 1.59, 95% CI = 1.14-2.21, and allele comparing: OR = 1.72, 95% CI = 1.27-2.33), hospital-based studies (homozygous: OR = 1.46, 95% CI = 1.09-1.94; recessive: OR = 1.32, 95% CI = 1.02-1.69; dominant: OR = 1.28, 95% CI = 1.05-1.56, and allele comparing: OR = 1.24, 95% CI = 1.07-1.43), studies with genotyping performed by PCR-RFLP under all genetic models, and studies with minor allele frequency >0.30 (homozygous: OR = 1.69, 95% CI = 1.25-2.27; recessive: OR = 1.46, 95% CI = 1.10-1.95, and allele comparing: OR = 1.25, 95% CI = 1.04-1.51), respectively. Conclusions: Despite some limitations, our meta-analysis provides sufficient evidence that NQO1 Pro187Ser polymorphism may contribute to bladder cancer risk. These findings need further validation in well-designed prospective studies with larger sample size and different ethnicities, especially for Asians. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effectiveness and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of benign thyroid nodules (BTNs). Methods: PubMed, Embase and Cochrane databases were searched up to September 11, 2020. Volume reduction rate (VRR), symptomatic and cosmetic scores analysed by standardized mean difference (SMD), and complications analysed by risk difference (RD) were performed to evaluate the efficacy and safety of RFA and MWA for treating BTNs. Results: Five eligible studies were included. 899 patients with 956 BTNs and 869 patients with 938 BTNs received RFA and MWA, respectively. RFA and MWA have the similar pooled 3‐month (56.0% vs. 53.9%, p =.668) and 6‐month (80.8% vs. 74.9%, p =.080) VRRs. But RFA showed a significantly higher VRR than MWA after 12 months (86.2% vs. 80.0%, p =.036). The pooled symptomatic and cosmetic scores decreased significantly after 6 and 12 months in both RFA and MWA. The improvements of symptoms were equivalent between two groups at 6 (SMD: 1.17 vs. 1.12, p =.930) and 12 (SMD: 1.46 vs. 1.45, p =.930) months. No significant differences in cosmetic scores were found between two groups at 6 (SMD: 0.87 vs. 0.94, p = 0. 334) and 12 (SMD: 1.21 vs. 1.15, p = 0. 872) months. Major (RD = −0.02, P =.107) and minor (RD = 0.00, p =.661) complications did not significantly differ between RFA and MWA. Conclusions: RFA and MWA are effective and safe treatment modalities for BTNs. But RFA showed a superior 12‐month VRR. RFA may have a better long‐term effect on volume reduction of nodules compared with MWA. [ABSTRACT FROM AUTHOR]

Ambient temperature is an important determinant of mortality and morbidity, making it necessary to assess temperature-related burden of disease (BD) for the planning of public health policies and adaptive responses. To systematically review existing epidemiological evidence on temperature-related BD, we searched three databases (PubMed, Web of Science, and Scopus) on 1 September 2018. We identified 97 studies from 56 counties for this review, of which 75 reported the fraction or number of health outcomes (include deaths and diseases) attributable to temperature, and 22 reported disability-adjusted life years (include years of life lost and years lost due to disability) related to temperature. Non-optimum temperatures (i.e., heat and cold) were responsible for > 2.5% of mortality in all included high-income countries/regions, and > 3.0% of mortality in all included middle-income countries. Cold was mostly reported to be the primary source of mortality burden from non-optimum temperatures, but the relative role of three different temperature exposures (i.e., heat, cold, and temperature variability) in affecting morbidity and mortality remains unclear so far. Under the warming climate scenario, almost all projections assuming no population adaptation suggested future increase in heat-related but decrease in cold-related BD. However, some studies emphasized the great uncertainty in future pattern of temperature-related BD, largely depending on the scenarios of climate, population adaptation, and demography. We also identified important discrepancies and limitations in current research methodologies employed to measure temperature exposures and model temperature-health relationship, and calculate the past and project future temperature-related BD. Overall, exposure to non-optimum ambient temperatures has become and will continue to be a considerable contributor to the global and national BD, but future research is still needed to develop a stronger methodological framework for assessing and comparing temperature-related BD across different settings. [ABSTRACT FROM AUTHOR]

Abstract Background Systemic lupus erythematosus (SLE) is a complex, chronic autoimmune disease, and oestrogen is considered to be a predisposing factor for SLE. Although some studies are conducted to explore the association between oestrogen receptor alpha (ERα) gene polymorphisms and SLE susceptibility, their results are inconsistent. Methods Meta-analysis was conducted to confirm whether ERα gene polymorphisms were associated with SLE susceptibility, and the strength of association was anticipated by pooled ORs with 95% CIs. Stata software package version 12.0 was used to calculate all the statistical analyses. Results Twelve studies included 2494 cases and 4176 controls were incorporated in our meta-analysis. A significant association was found for ERα PvuII polymorphism in the overall population (CC+CT vs TT: OR = 1.334, 95% CI = 1.195–1.490, P < 0.001; CC vs TT: OR = 1.401, 95% CI = 1.096–1.791, P = 0.007; CT vs TT: OR = 1.284, 95% CI = 1.141–1.444, P < 0.001; C vs T: OR = 1.221, 95% CI = 1.084–1.375, P = 0.001), while there was no significant association for ERα XbaI polymorphism. Besides, in stratification analyses by ethnicity, the PvuII polymorphism was associated with an increased risk of SLE in Asians (CC+CT vs TT: OR = 1.379, 95% CI = 1.203–1.581, P < 0.001; CT vs TT: OR = 1.308, 95% CI = 1.130–1.515, P < 0.001; C vs T: OR = 1.240, 95% CI = 1.052–1.462, P = 0.010), while for ESR1 XbaI polymorphism, a significantly increased risk of SLE susceptibility was found in Asians (GA vs AA: OR = 1.271, 95% CI = 1.101–1.467, P = 0.001). Conclusion Our meta-analysis indicated that the ERα PvuII polymorphism was significantly associated with SLE susceptibility in the overall and Asian populations, while the ERα XbaI G A genotype only played a key role in SLE susceptibility in Asian populations. Highlights • PvuII polymorphism is a significant risk factor for SLE (under dominant model, homozygous model, heterozygous and allele model). • XbaI polymorphism in the heterozygous model is a significant risk factor for SLE in Asians. • For ERα polymorphism, SLE risk was significantly affected by ethnicity. • Screening for genotype of ERα gene may help identify high-risk populations of SLE. [ABSTRACT FROM AUTHOR]

Purpose: We conducted the meta-analysis to respectively evaluate the risk of prenatal antibiotics use during specific trimesters (first, second, and third trimester) on childhood asthma or wheeze and to explore whether the association was biased by potential confounding.Methods: The quality of included articles was assessed according to Newcastle-Ottawa Quality Assessment Scale and the Strengthening the Reporting of Observational Studies in Epidemiology. A random effects model was used to calculate pooled risk ratios and corresponding 95% confidence interval (CI), and publication bias was tested by Egger statistical test.Results: Eight studies were included finally. We found a crude positive association of prenatal antibiotics use during each pregnancy trimester and risk of childhood asthma or wheeze with RRs of 1.28 (95% CI, 1.09-1.51) for the first trimester of pregnancy, 1.25 (95% CI, 1.02-1.52) for the second trimester, and 1.25 (95% CI, 1.05-1.49) for the third trimester. However, when considering potential factors of maternal infections and presence of siblings, the relationship for each trimester was insignificant.Conclusions: This systemic review and meta-analysis proposed a crude positive association between prenatal antibiotic use in every specific trimester and risk of childhood asthma or wheeze. However, adjustment for confounders decreased the relative risk estimates, supporting the concept that these associations are, at least in part, because of confounding by indication. [ABSTRACT FROM AUTHOR]

Abstract Background The relationship between sunlight hours, temperature, and suicide has been investigated in many previous studies, but with inconsistent findings. We conducted this meta-analysis aiming at providing clear evidence about whether sunlight hours and temperature can affect the risk of suicide. Methods Relevant literature published before 7 Jul 2018 was searched in three electronic database of PubMed, Web of science and Cochrane. Between-study heterogeneity in the effect estimates were examined by study design (i.e., exposure time resolution, temperature measure and suicide classification) and population vulnerability (i.e., sex, national income level, climate zone and study location). Results Regarding temperature-suicide association, we identified 14 studies that provided 23 effect estimates for meta-analysis. Our random-effects model showed that each 1 °C increase in temperature was significantly associated with a 1% increase in the incidence of suicide (Incidence Rate Radio (IRR) = 1.01; 95%CI = 1.00–1.02; p < 0.05). As for sunlight duration and suicide, 11 effect estimates from 4 studies were pooled using a fixed-effects model. Significant association between sunlight duration (per 1 h increase) and the risk of suicide was not observed, and the pooled IRR was 1.00 (95%CI = 0.99–1.01; p > 0.05). There was significant heterogeneity between previous studies' effect estimates, and significantly lower heterogeneity was noted for the female group, for studies that did analyses at daily scale, and for studies using mean temperature as the exposure indicator. Conclusion Our findings suggest a significant and positive association between temperature rises and incidence of suicide, and a non-significant association between sunlight duration and incidence of suicide. Populations living in tropical and temperate zones or at middle-income level may be particularly vulnerable to temperature increase. Graphical abstract Unlabelled Image Highlights • Temperature rise increases suicidal risk and current studies don’t support the positive link between sunshine and suicide. • Rising temperature has a greater impact on completed suicide than suicide attempt. • It is more effective to measure the relationship between temperature rise and suicide risk on a daily or weekly time scale. • Populations in tropical and temperate zones or at middle-income countries are particularly vulnerable to temperature rise. [ABSTRACT FROM AUTHOR]

Background The relationship between ambient temperature, humidity and hand, foot, and mouth disease (HFMD) has been highlighted in East and Southeast Asia, which showed multiple different results. Therefore, our goal is to conduct a meta-analysis to further clarify this relationship and to quantify the size of these effects as well as the susceptible populations. Methods PubMed, Web of science, and Cochrane library were searched up to November 22, 2017 for articles analyzing the relationships between ambient temperature, humidity and incidence of HFMD. We assessed sources of heterogeneity by study design (temperature measure and exposed time resolution), population vulnerability (national income level and regional climate) and evaluated pooled effect estimates for the subgroups identified in the heterogeneity analysis. Results We identified 11 studies with 19 estimates of the relationship between ambient temperature, humidity and incidence of HFMD. It was found that per 1 °C increase in the temperature and per 1% increase in the relative humidity were both significantly associated with increased incidence of HFMD (temperature: IRR, 1.05; 95% CI, 1.02–1.08; relative humidity: IRR, 1.01; 95% CI, 1.00–1.02). Subgroup analysis showed that people living in subtropical and middle income areas had a higher risk of incidence of HFMD. Conclusions Ambient temperature and humidity may increase the incidence of HFMD in Asia-Pacific regions. Further studies are needed to clarify the relationship between ambient temperature, humidity and incidence of HFMD in various settings with distinct climate, socioeconomic, and demographic features. [ABSTRACT FROM AUTHOR]

Aim: Polymorphisms of xeroderma pigmentosum complementation group C ( XPC) are thought to have significant effects on prostate cancer (PCa) risk. The aim of our study was to evaluate the impact of XPC gene polymorphisms on PCa risk by using a meta-analysis. Methods: Data were collected from the following electronic databases: PubMed, EMBASE, Elsevier Science Direct, Cochrane Library, and CNKI, with the last report up to April 30, 2013. Odds ratios with 95% confidence intervals were used to assess the strength of the association. Results: A total of five separate case-control studies (1966 cases and 1970 controls) were included in this meta-analysis. Meta-analysis was performed for the rs2228001 and PAT+/−polymorphisms. We did not detect a significant association between rs2228001 polymorphism and PCa ( p>0.05). Similar results were found in stratification analyses by ethnicity and tumor stage. We detected a significant association of PAT+/−polymorphism with PCa ( p<0.05). In stratification analysis, we did not detect a significant association of PAT+/−polymorphism with risk of bone metastasis in PCa patients ( p>0.05). Conclusion: These analyses suggest that XPC gene PAT+/−polymorphism, but not rs2228001, likely contributes to susceptibility to PCa. [ABSTRACT FROM AUTHOR]

The association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and diabetic nephropathy (DN) or diabetes mellitus (DM) risk has been widely reported, but the results are still debatable. To investigate the role of MTHFR C677T polymorphism on DM or DN, 13 separate studies in the Chinese population on the relation between MTHFR C677T polymorphism and DM or DN were analyzed by a meta-analysis. Five genetic models were used to estimate the association between MTHFR C677T polymorphism and the risk of DM or DN. Overall, our meta-analysis for DN versus healthy controls produced significant results for all genetic contrasts except for the co-dominant model (allele contrast: OR = 2.24, 95%CI: 1.88-2.65, p < 0.00001, Pheterogeneity = 0.49). However, the meta-analysis for DM versus healthy controls produced non-significant results for all contrasts (allele contrast: OR = 1.12, 95%CI: 0.92-1.35, p = 0.25, Pheterogeneity = 0.07). In addition, the meta-analysis for DM versus DN produced significant results for all contrasts (allele contrast: OR = 1.88, 95%CI: 1.65-2.15, p < 0.00001, Pheterogeneity = 0.83). The current meta-analysis suggested that MTHFR C677T polymorphism might influence DN risk, but not for DM in the Chinese population. [ABSTRACT FROM AUTHOR]

Abstract: The aim of our study was to assess the association between FKBP5 gene polymorphisms and treatment response in patients with mood disorders using a meta-analysis. Eight separate studies that included data from 2199 subjects were identified. Meta-analysis was performed for three FKBP5 gene polymorphisms (rs1360780, rs3800373, and rs4713916). A significant association of FKBP5 gene rs4713916 polymorphism and response rate was found in patients with mood disorders (Overall: A versus G: OR=1.28, 95%CI=1.06–1.53, P =0.01; GA+AA versus GG: OR=1.32, 95%CI=1.05–1.67, P =0.02. Caucasian: A versus G: OR=1.28, 95%CI=1.06–1.55, P =0.01; GA+AA versus GG: OR=1.33, 95%CI=1.04–1.70, P =0.02). However, we did not detect the association between FKBP5 gene rs1360780 and rs3800373 polymorphisms and treatment response in patients with mood disorders (P >0.05). This meta-analysis demonstrates that treatment response in patients with mood disorders is associated with FKBP5 gene rs4713916 polymorphism, but not rs1360780 and rs3800373. [Copyright &y& Elsevier]

Abstract: The aim of our meta-analysis was to assess the association between BDNF Val66Met polymorphism and treatment response in patients with MDD. 8 studies that included data from 1115 subjects were identified. We tested two phenotypes: response rate and remission rate. OR was used as a measure of the effect of the association in a fixed/random effect model. Meta-analysis was performed for genotypes Met/Met versus Val/Val, Val/Met versus Val/Val, Met/Met versus Val/Met, Val/Met+Met/Met versus Val/Val, Met/Met versus Val/Val+Val/Met, and Met allele versus Val allele. When all groups were pooled, a significant association of Val/Met genotype and increased response rate was found in comparison to Val/Val in overall population (OR=1.66, 95%CI=1.07–2.57, P =0.02). In the subgroup analysis, similar result was shown in Asian population (OR=1.83, 95%CI=1.03–3.26, P =0.04), but not in Caucasian population. We didn''t observe a significant association of BDNF Val66Met polymorphism with remission rate. This meta-analysis demonstrates the association between BDNF Val66Met polymorphism and treatment response in patients with MDD, and Val66Met heterozygous patients have a better response rate in comparison to Val/Val homozygote patients, especially in Asian population. [Copyright &y& Elsevier]

The tumor necrosis factor-α (TNF-α) promoter − 238A/G polymorphism has been repeatedly associated with systemic lupus erythematosus (SLE), but findings are not consistent across studies. Our aim was to do a meta-analysis to assess the association between TNF-α promoter − 238A/G polymorphism and SLE. Eleven published studies of this polymorphism with SLE in different ethnic groups were identified using a Medline search. Meta-analysis was performed for genotypes AA versus GG, GA versus GG, AA versus GG+GA, GA+AA versus GG, and A allele versus G allele in a fixed/random effect model. The overall odds ratio (OR) of the AA versus GG+GA genotypes was 3.46 (95% CI = 1.35–8.83, P = 0.01), and a similar result was found in Caucasian population (OR = 4.62, 95% CI = 1.20–17.80, P = 0.03); the overall OR of the AA versus GG genotypes was 3.36 (95% CI = 1.32–8.55, P = 0.01), and a similar result was found in Caucasian population (OR = 4.29, 95% CI = 1.11–16.53, P = 0.03); the OR of the GA versus GG genotypes was 0.48 (95% CI = 0.30–0.75, P = 0.001) in Caucasian population. In conclusion, this meta-analysis demonstrates the association between TNF-α promoter − 238A/G polymorphism and SLE, especially in Caucasian population. [ABSTRACT FROM AUTHOR]

Objective: The association between gastroenteritis exposure and schizophrenia (SCZ) onset has been investigated, but the findings were inconsistent. This study aimed to determine whether gastroenteritis would increase the risk of SCZ onset.Methods: We performed a systematic literature search in PubMed, Cochrane Library and the Web of Science database up to 23 November 2019. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of gastroenteritis on SCZ. Stratified analysis was conducted by study design, diagnostic criteria, region, adjustment for confounders, gastroenteritis sub-classification and data source.Results: This meta-analysis included nine published articles with 13,830,871 subjects. Overall, there was no significant relationship between gastroenteritis and SCZ onset (N [number of studies] = 11, RR = 1.06, 95% CI: 0.81-1.39). However, pooled results from cohort studies suggested that gastroenteritis significantly increased the risk of SCZ (N = 7, RR = 1.27, 95% CI = 1.05-1.53). Increased risk of SCZ was observed in America (N = 3) and Australia (N = 2), whereas no association was found in Europe (N = 1) and Asia (N = 5). The pooled RR, adjusting for ≥2 confounders (N = 5), was higher than those adjusting for <2 confounders (N = 6). The effects also varied in diagnostic criteria, gastroenteritis sub-classification and data source.Conclusion: Based on current research evidence, it is not yet certain that gastroenteritis is a risk factor for SCZ, and more research on the association between specific gastroenteritis and SCZ is needed. [ABSTRACT FROM AUTHOR]

Heatwaves affect human health and global heatwave-related disease burden will continue to rise as climate change proceeds, but the effects of heatwaves on cardiovascular and respiratory diseases have not yet been investigated globally and nationally. This systematic review and meta-analysis aim to quantify heatwave effects on four major health outcomes: cardiovascular and respiratory morbidity and mortality. We searched PubMed, Scopus, Embase, and Web of Science for relevant studies from database inception to November 2018. Categories of morbidity included hospital admissions, emergency department visits, and ambulance attendances/call-outs. A random-effects meta-analysis model was used to pool previous estimates of heatwave effects on mortality and morbidity due to cardiovascular and respiratory diseases. Subgroup analyses by gender, age, and disease cause were conducted. Sensitivity analyses were performed by the categories of morbidity, heatwave definitions, study design, and using a leave-one-out cross validation approach. This study is registered with PROSPERO (number: CRD42018101964). We identified 54 studies conducted in 20 countries. In total, there were significant associations between heatwaves and cardiovascular mortality (risk estimates (RE): 1.149, 95% confidence interval (CI): 1.090, 1.210) and respiratory mortality (RE: 1.183, 95%CI: 1.092, 1.282), but the magnitude of these associations varied across countries and studies. Heatwaves appeared to be marginally associated with cardiovascular and respiratory morbidities (RE: 0.999, 95%CI: 0.996, 1.002, p -value = 0.61 for cardiovascular morbidity; RE: 1.043, 95%CI: 0.995, 1.093; p -value = 0.08 for respiratory morbidity). For mortality, significant associations were observed for the elderly, ischemic heart disease, stroke, heart failure, and chronic obstructive pulmonary disease. Sensitivity analyses suggested that these findings were robust. Mortality of cardiovascular and respiratory diseases appeared to be more vulnerable to heatwaves in comparison to morbidity. Considering high heterogeneity detected between studies and limited investigations into subpopulations, more research are required to provide a clearer picture of how heatwaves affect cardiovascular and respiratory diseases in different settings. • First study to examine heatwave effects on cardiorespiratory diseases globally. • Heatwaves increase the risk of cardiorespiratory mortalities. • Adverse heatwave effects on cardiorespiratory morbidities need to be further confirmed. • Vulnerable people are the elderly, and those with ischemic heart disease, COPD, etc. [ABSTRACT FROM AUTHOR]