2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T7fe,Earlier evidence syntheses reached uncertain conclusions about the effect of prostate-specific antigen (PSA)-based screening on prostate cancer (PCa)-specific mortality (PCSM). Extended follow-up from major trials has provided an opportunity to re-evaluate the evidence. To estimate the effect of PSA-based screening versus no screening or usual care on PCSM in individuals engaging in screening. We systematically searched PubMed, MEDLINE, EMBASE, and CENTRAL through October 2025 for randomized controlled trials (RCTs) comparing PSA-based screening with no screening or usual care among adults with prostates. The primary outcome was PCSM at the longest available follow-up. Secondary outcomes were PCSM beyond 12 yr and PCSM closest to 10 yr of follow-up. Risk of bias was assessed using the Risk Of Bias instrument for Use in SysTematic reviews-for RCTs (ROBUST-RCT). Incidence rate ratios were pooled using fixed-effect models. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We included 5 RCTs analyzing 721,607 participants aged 45-80 yr of age with 11-23 yr of follow-up. PSA-based screening, with a high certainty in the evidence, demonstrated a reduced risk of PCSM at the longest follow-up (p < 0.001). Secondary analyses suggested greater relative PCSM reduction with longer follow-up. The overall effect was observed despite limitations including differing screening protocols and control-arm contamination, which likely underestimated benefit. With 11-23 yr of follow-up, high-certainty evidence demonstrates that PSA-based PCa screening is associated with reduced PCSM among individuals who engage in screening-a finding that contrasts with earlier evidence syntheses. This finding does not in itself justify population-based screening or imply that every well-informed individual would elect to undergo screening. This PCSM benefit should be weighed against known harms and consider emerging approaches under study that may mitigate these harms.31:T63c,Non-scarring alopecia, including androgenetic alopecia, alopecia areata, and telogen effluvium, is highly prevalent and often associated with significant psychosocial burden. Although treatments such as minoxidil and finasteride are available, variability in response and tolerability concerns have increased interest in alternative therapeutic approaches. Polyphenolic compounds have attracted attention due to their antioxidant, anti-inflammatory, and immunomodulatory properties. This systematic review and meta-analysis evaluated the efficacy of oral and topical polyphenolic interventions for hair regeneration in adults with non-scarring alopecia. A systematic search of PubMed/MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL was conducted according to PRISMA 2020 guidelines (PROSPERO: CRD420251230149). Randomized, blinded controlled trials were included. Primary outcomes were objective trichoscopic measures, including hair density and total area hair count. Thirty-two randomized controlled trials involving 2,183 participants were analyzed. Compared with controls, polyphenolic interventions significantly improved hair density (SMD 0.90; 95% CI 0.51-1.30) and total area hair count (SMD 1.03; 95% CI 0.42-1.63), although substantial heterogeneity was observed. Direct comparisons with minoxidil did not show significant differences in overall hair count outcomes. Current evidence suggests that selected polyphenolic formulations may represent a potential adjunctive therapeutic approach in non-scarring alopecia, though further standardized and long-term trials are warranted.32:T73a,Metabolic dysfunction-associated steatohepatitis (MASH) is an advanced form of metabolic dysfunction-associated steatotic liver disease (MASLD), characterised by hepatocellular injury, inflammation and varying degrees of fibrosis. Non-invasive, accurate diagnostic tools are critical for identifying patients "at risk" (MAS ≥4, F ≥2). This meta-analysis evaluates the diagnostic performance of imaging-based technologies for ruling in (TRI) and ruling out (TRO) "at risk" MASH. A systematic search of Medline and Embase (inception to December 20, 2024) identified studies reporting on MRI-based diagnostic techniques for "at risk" MASH. Eligible studies were independently screened, with 20 studies meeting inclusion criteria. Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using bivariate meta-analysis, applying pre-specified TRO and TRI thresholds to each technique. Twenty studies involving 9,480 participants were included. FAST demonstrated highest TRO sensitivity (0.871) with moderate specificity (0.567) and TRI specificity (0.900) with reduced sensitivity (0.441). MEFIB achieved high TRO sensitivity (0.812) but lower specificity (0.606); TRI specificity was 0.872, sensitivity was 0.500. MAST exhibited intermediate performance, while cT1 thresholds showed variable diagnostic accuracy. A sensitivity analysis of head-to-head studies shows superior performance in FAST compared to other diagnostic methods. FAST with its accessibility and robust diagnostic performance may be well-suited for large-scale application. MRI-based techniques are effective non-invasive options for diagnosing "at risk" MASH in MASLD and may provide strong alternatives. Rather than challenging existing perspectives, this study provides a reflective overview of current evidence on imaging-based modalities for "at risk" MASH.33:T99c, Introduction: Metabolic dysfunction-associated steatohepatitis (MASH) is an advanced form of metabolic dysfunction-associated steatotic liver disease (MASLD), characterised by hepatocellular injury, inflammation and varying degrees of fibrosis. Non-invasive, accurate diagnostic tools are critical for identifying patients “at risk” (MAS ≥4, F ≥2). This meta-analysis evaluates the diagnostic performance of imaging-based technologies for ruling in (TRI) and ruling out (TRO) “at risk” MASH. Methods: A systematic search of Medline and Embase (inception to December 20, 2024) identified studies reporting on MRI-based diagnostic techniques for “at risk” MASH. Eligible studies were independently screened, with 20 studies meeting inclusion criteria. Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using bivariate meta-analysis, applying pre-specified TRO and TRI thresholds to each technique. Results: Twenty studies involving 9,480 participants were included. FAST demonstrated highest TRO sensitivity (0.871) with moderate specificity (0.567) and TRI specificity (0.900) with reduced sensitivity (0.441). MEFIB achieved high TRO sensitivity (0.812) but lower specificity (0.606); TRI specificity was 0.872, sensitivity was 0.500. MAST exhibited intermediate performance, while cT1 thresholds showed variable diagnostic accuracy. A sensitivity analysis of head-to-head studies shows superior performance in FAST compared to other diagnostic methods. Conclusion: FAST with its accessibility and robust diagnostic performance may be well-suited for large-scale application. MRI-based techniques are effective non-invasive options for diagnosing “at risk” MASH in MASLD and may provide strong alternatives. Rather than challenging existing perspectives, this study provides a reflective overview of current evidence on imaging-based modalities for “at risk” MASH. 34:T83f,For acute ischemic stroke, national practice guidelines recommend thrombolysis within a 4.5-h time window from symptom onset. Randomized trials with advanced neuroimaging have now examined extended thrombolytic time windows, and multiple meta-analyses have provided positive endorsements. However, these previous meta-analyses have not fully exploited the available data, examined quality of life, or reported the probability of clinically meaningful effects. This meta-analysis addresses these potential shortcomings. We performed a i) systematic literature review up to August 1, 2025, of all randomized controlled trials comparing thrombolysis (alteplase or tenecteplase) with the assistance of advanced neuroimaging to standard, non-thrombolytic therapy in acute ischemic stroke patients with unknown time or beyond 4.5 h since symptom onset and ii) an umbrella review of previous meta-analyses addressing this issue. Our primary outcome was the mean difference in the utility-weighted modified Rankin Scale (uw-mRS) scores. Secondary outcomes were the absolute risk difference (ARD) for minor disability status and mortality. Bayesian random effects meta-analyses were performed assuming a normal-normal hierarchical model with non-informative priors, which permitted probability calculations for benefit, harm, and regions of practical equivalence (ROPE). Six original randomized trials of extended thrombolysis and 7 meta-analyses were identified but none had considered a uw-mRS score or reported direct probability statements regarding benefit or harm. Our primary uw-mRS outcome showed a ROPE probability of 99 % with only a 1 % probability of a clinically beneficial response with extended alteplase. There was also a 72 % probability that mortality increased by at least 1 life / 100 treated with extended thrombolysis. In contrast with previous publications, this meta-analysis and umbrella review highlights the uncertainty of clinical benefits from extended thrombolysis treatment windows and the need for further high-quality research before this treatment is accepted into routine practice.35:Taaa,Mental disorders have been associated with traditional cardiovascular risk factors that may mediate the risk of acute coronary syndrome (ACS). To estimate the association of ACS among patients with mental disorders, as compared with patients without mental disorders. MEDLINE, Embase, and PubMed were searched for studies between July 1, 2025, and date of database inception. Study screening was performed in duplicates with conflicts resolved upon consensus. Inclusion criteria were as follows: (1) observational or randomized study, (2) measured association with ACS (incident events, risk ratio, odds ratio, hazard ratio [HR]), and (3) investigated any clinical mental disorder (based on DSM and International Classification of Diseases) before ACS events. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Data extraction was performed in duplicate and resolved on consensus. Data were quantitatively synthesized through random-effects meta-analysis. The National Institutes of Health Study Quality Assessment Tools were used to assess the quality of included studies. Studies were analyzed from January 1966 to October 2021. Association and/or risk of ACS. Among 3616 initially identified studies, 25 full-text articles met inclusion criteria with 22 048 504 participants of median (IQR) age 48.0 (34.5-56.1) years, with 13 019 897 males (59.1%). Depressive disorder (HR, 1.40; 95% CI, 1.11-1.78; P = .01; Grading of Recommendations Assessment, Development, and Evaluation [GRADE] certainty = very low), anxiety disorder (HR, 1.63; 95% CI, 1.40-1.89; P < .001; GRADE certainty = low), sleep disorder (HR, 1.60; 95% CI, 1.22-2.10; P < .001; GRADE certainty = low), and posttraumatic stress disorder (PTSD; HR, 2.73; 95% CI, 1.94-3.84; P < .001; GRADE certainty = moderate) were associated with increased risk of ACS. Bipolar (HR, 1.48; 95% CI, 0.47-4.61; P = .28; GRADE certainty = very low) and psychotic (HR, 0.97; 95% CI, 0.01-178.30; P = .06; GRADE certainty = very low) disorders were not significantly associated with increased risk of acute myocardial infarction, although they had similar point estimates to some other mental disorders. Results of this systematic review and meta-analysis suggest that depressive disorders, anxiety disorders, PTSD, and sleep disorders were associated with an increased risk of ACS. Particularly, PTSD and sleep disorders emerged as significant risk factors for ACS, indicating the potential impact of sleep quality on cardiovascular outcomes. Future research addressing these limitations could provide more nuanced insights into the association between mental health and ACS.36:T134f, Importance Mental disorders have been associated with traditional cardiovascular risk factors that may mediate the risk of acute coronary syndrome (ACS). Objective To estimate the association of ACS among patients with mental disorders, as compared with patients without mental disorders. Data Sources MEDLINE, Embase, and PubMed were searched for studies between July 1, 2025, and date of database inception. Study Selection Study screening was performed in duplicates with conflicts resolved upon consensus. Inclusion criteria were as follows: (1) observational or randomized study, (2) measured association with ACS (incident events, risk ratio, odds ratio, hazard ratio [HR]), and (3) investigated any clinical mental disorder (based on DSM and International Classification of Diseases ) before ACS events. Data Extraction and Synthesis This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Data extraction was performed in duplicate and resolved on consensus. Data were quantitatively synthesized through random-effects meta-analysis. The National Institutes of Health Study Quality Assessment Tools were used to assess the quality of included studies. Studies were analyzed from January 1966 to October 2021. Main Outcomes and Measures Association and/or risk of ACS. Results Among 3616 initially identified studies, 25 full-text articles met inclusion criteria with 22 048 504 participants of median (IQR) age 48.0 (34.5-56.1) years, with 13 019 897 males (59.1%). Depressive disorder (HR, 1.40; 95% CI, 1.11-1.78; P = .01; Grading of Recommendations Assessment, Development, and Evaluation [GRADE] certainty = very low), anxiety disorder (HR, 1.63; 95% CI, 1.40-1.89; P &lt; .001; GRADE certainty = low), sleep disorder (HR, 1.60; 95% CI, 1.22-2.10; P &lt; .001; GRADE certainty = low), and posttraumatic stress disorder (PTSD; HR, 2.73; 95% CI, 1.94-3.84; P &lt; .001; GRADE certainty = moderate) were associated with increased risk of ACS. Bipolar (HR, 1.48; 95% CI, 0.47-4.61; P = .28; GRADE certainty = very low) and psychotic (HR, 0.97; 95% CI, 0.01-178.30; P = .06; GRADE certainty = very low) disorders were not significantly associated with increased risk of acute myocardial infarction, although they had similar point estimates to some other mental disorders. Conclusions and Relevance Results of this systematic review and meta-analysis suggest that depressive disorders, anxiety disorders, PTSD, and sleep disorders were associated with an increased risk of ACS. Particularly, PTSD and sleep disorders emerged as significant risk factors for ACS, indicating the potential impact of sleep quality on cardiovascular outcomes. Future research addressing these limitations could provide more nuanced insights into the association between mental health and ACS. 37:Tbf7,Polycystic ovary syndrome (PCOS) affects women globally, but its prevalence across World Health Organization (WHO) regions has not previously been reported. We aimed to synthesize evidence on the prevalence of PCOS by diagnostic criteria and by WHO geographic regions to inform the International Evidence-Based PCOS Guideline. A systematic search of OVID MEDLINE, All EBM, PsycInfo, EMBASE, and Cumulative Index to Nursing and Allied Health Literature was conducted from 1990 to November 2024. Studies assessing PCOS prevalence in an unselected population were included. Non-primary studies or those with unclear diagnostic criteria were excluded. The primary outcome was PCOS prevalence among adult women. The secondary outcome was PCOS prevalence among women of all ages. Random effects meta-analysis using the DerSimonian and Laird method was applied for estimating the overall effect size. Two reviewers independently assessed risk-of-bias (RoB) and evidence certainty. The search yielded 16 664 articles, of which 119 unique studies (in 137 articles) were eligible, and 92 (including 157 181 participants) were pooled in a meta-analysis. By diagnostic criteria, PCOS global prevalence among adult women only was 12.1% (95% CI: 9.8, 14.8; I2: 98.8%) using Rotterdam criteria, 7.9% (95% CI: 6.2, 9.9; I2: 96.2%) using the original National Institute of Health (NIH) criteria, 12.7% (95% CI: 8.2, 17.9; I2: 98.0%) using the Androgen Excess (AE)-PCOS criteria, and 7.8% (95% CI: 5.8, 10.0; I2: 99.4%) by self-report. By WHO regions, PCOS prevalence among adult women when using Rotterdam criteria was highest in the Eastern Mediterranean region (15.1%; 95% CI: 11.1, 19.7) and the South-East Asian region (14.3%; 95% CI: 5.8, 25.9), followed by the European region (11.7%; 95% CI: 5.1, 20.3), the region of the Americas (10.5%; 95% CI: 3.0, 21.7), and the Western Pacific region (9.1%; 95% CI: 6.2, 12.5), with no data from Africa. Subgroup analysis using Cochran's Q test indicated a statistically significant difference in prevalence by WHO region (P = 0.022). Subgroup analyses including adolescents yielded a lower prevalence globally, with a global prevalence of 11.4% (95% CI: 9.5, 13.5) by Rotterdam criteria, 7.1% (95% CI: 5.7, 8.7) by NIH criteria, 11.2% (95% CI: 7.4, 15.5) by AE-PCOS criteria, and 7.6% (95% CI: 5.8, 9.6) on self-report. Of the 119 studies, 30 had low, 49 had moderate, and 40 had high RoB. Certainty of evidence ranged from very low to low. This is the most comprehensive and contemporary review of PCOS prevalence and highlights past inconsistencies in diagnostic criteria and individual diagnostic features. Pooled PCOS prevalence was 12.1% by the Rotterdam criteria and was highest in the Eastern Mediterranean and the South-East Asian regions, with a potentially different health burden of PCOS across world regions. These findings directly inform International PCOS Guidelines, including updated guideline diagnostic criteria and refined individual features, emphasizing early, accurate diagnosis. PROSPERO CRD42022372029.38:Tfcb,Abstract BACKGROUND Polycystic ovary syndrome (PCOS) affects women globally, but its prevalence across World Health Organization (WHO) regions has not previously been reported. OBJECTIVE AND RATIONALE We aimed to synthesize evidence on the prevalence of PCOS by diagnostic criteria and by WHO geographic regions to inform the International Evidence-Based PCOS Guideline. SEARCH METHODS A systematic search of OVID MEDLINE, All EBM, PsycInfo, EMBASE, and Cumulative Index to Nursing and Allied Health Literature was conducted from 1990 to November 2024. Studies assessing PCOS prevalence in an unselected population were included. Non-primary studies or those with unclear diagnostic criteria were excluded. The primary outcome was PCOS prevalence among adult women. The secondary outcome was PCOS prevalence among women of all ages. Random effects meta-analysis using the DerSimonian and Laird method was applied for estimating the overall effect size. Two reviewers independently assessed risk-of-bias (RoB) and evidence certainty. OUTCOMES The search yielded 16 664 articles, of which 119 unique studies (in 137 articles) were eligible, and 92 (including 157 181 participants) were pooled in a meta-analysis. By diagnostic criteria, PCOS global prevalence among adult women only was 12.1% (95% CI: 9.8, 14.8; I2: 98.8%) using Rotterdam criteria, 7.9% (95% CI: 6.2, 9.9; I2: 96.2%) using the original National Institute of Health (NIH) criteria, 12.7% (95% CI: 8.2, 17.9; I2: 98.0%) using the Androgen Excess (AE)-PCOS criteria, and 7.8% (95% CI: 5.8, 10.0; I2: 99.4%) by self-report. By WHO regions, PCOS prevalence among adult women when using Rotterdam criteria was highest in the Eastern Mediterranean region (15.1%; 95% CI: 11.1, 19.7) and the South-East Asian region (14.3%; 95% CI: 5.8, 25.9), followed by the European region (11.7%; 95% CI: 5.1, 20.3), the region of the Americas (10.5%; 95% CI: 3.0, 21.7), and the Western Pacific region (9.1%; 95% CI: 6.2, 12.5), with no data from Africa. Subgroup analysis using Cochran’s Q test indicated a statistically significant difference in prevalence by WHO region (P = 0.022). Subgroup analyses including adolescents yielded a lower prevalence globally, with a global prevalence of 11.4% (95% CI: 9.5, 13.5) by Rotterdam criteria, 7.1% (95% CI: 5.7, 8.7) by NIH criteria, 11.2% (95% CI: 7.4, 15.5) by AE-PCOS criteria, and 7.6% (95% CI: 5.8, 9.6) on self-report. Of the 119 studies, 30 had low, 49 had moderate, and 40 had high RoB. Certainty of evidence ranged from very low to low. WIDER IMPLICATIONS This is the most comprehensive and contemporary review of PCOS prevalence and highlights past inconsistencies in diagnostic criteria and individual diagnostic features. Pooled PCOS prevalence was 12.1% by the Rotterdam criteria and was highest in the Eastern Mediterranean and the South-East Asian regions, with a potentially different health burden of PCOS across world regions. These findings directly inform International PCOS Guidelines, including updated guideline diagnostic criteria and refined individual features, emphasizing early, accurate diagnosis. REGISTRATION NUMBER PROSPERO CRD42022372029. 39:T79c,To quantify and compare the rate of weight regain after cessation of weight management medications (WMMs) in adults with overweight or obesity. Systematic review and meta-analysis. Trial registries and databases (Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries) were searched from inception until February 2025 for randomised controlled trials (RCTs), non-randomised trials, and observational studies that included WMM (≥8 weeks) with follow-up for ≥4 weeks after cessation of treatment in adults with overweight or obesity. Comparators were any non-drug weight loss intervention or placebo. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Two independent reviewers screened titles, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool for RCTs and the ROBINS-I tool for non-randomised trials. Data were analysed using mixed effect, meta-regression, and time-to-event models. Weight regain after cessation of WMM was compared with that reported after cessation of behavioural weight management programmes (BWMPs). The primary outcome was rate of weight regain from end of treatment, with associated changes in cardiometabolic markers as a secondary outcome. Of the 9288 titles screened, 37 studies (63 intervention arms, 9341 participants) were included. Average treatment duration was 39 (range 11-176) weeks, with average follow-up of 32 (4-104) weeks. The average monthly rate of weight regain was 0.4 kg (95% confidence interval (CI) 0.3 to 0.5) (mixed model 0.3 kg (0.2 to 0.4) monthly This review found that cessation of WMM is followed by rapid weight regain and reversal of beneficial effects on cardiometabolic markers. Regain after WMM was faster than after BWMP. These findings suggest caution in short term use of these drugs without a more comprehensive approach to weight management. PROSPERO CRD42024532069.3a:Te5b,Abstract Objectives To quantify and compare the rate of weight regain after cessation of weight management medications (WMMs) in adults with overweight or obesity. Design Systematic review and meta-analysis. Study selection Trial registries and databases (Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries) were searched from inception until February 2025 for randomised controlled trials (RCTs), non-randomised trials, and observational studies that included WMM (≥8 weeks) with follow-up for ≥4 weeks after cessation of treatment in adults with overweight or obesity. Comparators were any non-drug weight loss intervention or placebo. Data extraction and synthesis The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Two independent reviewers screened titles, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool for RCTs and the ROBINS-I tool for non-randomised trials. Data were analysed using mixed effect, meta-regression, and time-to-event models. Weight regain after cessation of WMM was compared with that reported after cessation of behavioural weight management programmes (BWMPs). Main outcome measures The primary outcome was rate of weight regain from end of treatment, with associated changes in cardiometabolic markers as a secondary outcome. Results Of the 9288 titles screened, 37 studies (63 intervention arms, 9341 participants) were included. Average treatment duration was 39 (range 11-176) weeks, with average follow-up of 32 (4-104) weeks. The average monthly rate of weight regain was 0.4 kg (95% confidence interval (CI) 0.3 to 0.5) (mixed model 0.3 kg (0.2 to 0.4) monthly v control in RCTs). All cardiometabolic markers were projected to return to baseline within 1.4 years after the cessation of WMM. Weight regain was faster after WMM than after BWMP (by 0.3 kg (0.22 to 0.34) monthly), independent of initial weight loss. Estimates and precision were robust in sensitivity analyses. Conclusions This review found that cessation of WMM is followed by rapid weight regain and reversal of beneficial effects on cardiometabolic markers. Regain after WMM was faster than after BWMP. These findings suggest caution in short term use of these drugs without a more comprehensive approach to weight management. Systematic review registration PROSPERO CRD42024532069. 3b:Tbf9,Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE), affecting up to one-third of pediatric SLE patients. Timely induction therapy is critical in proliferative LN to prevent progression to kidney failure or death. Intravenous cyclophosphamide (IVCP) has long been a standard induction agent, but its toxicity profile has prompted interest in mycophenolate mofetil (MMF) as a potentially safer alternative. However, data comparing the efficacy and safety of MMF versus IVCP in children are limited and inconclusive. To systematically review and synthesise existing evidence comparing the efficacy and safety of MMF versus IVCP for induction therapy in pediatric patients with proliferative LN. A comprehensive search was conducted in six electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and CENTRAL) on June 2, 2025. Reference lists of included articles were also manually screened. We included randomised controlled trials and observational studies published in English that directly compared MMF and IVCP as induction therapies in pediatric patients with biopsy-proven proliferative LN. Studies were required to report at least one of the following outcomes: kidney remission (complete or partial), adverse events, kidney failure, or death. Eligible participants were children aged ≤ 17 years with a diagnosis of proliferative LN based on the American College of Rheumatology (ACR) criteria. Interventions involved MMF plus corticosteroids versus IVCP plus corticosteroids, with comparable adjunctive therapies. Authors independently screened articles, extracted data, and assessed study quality using the RoB2 tool for RCTs and the ROBINS-I tool for observational studies. A random-effects meta-analysis was conducted to estimate pooled risk ratios (RRs) for complete remission. Sensitivity analyses and funnel plots were used to assess robustness and publication bias. Out of 1,633 screened records, seven studies met the inclusion criteria, six observational studies (n = 282) and one RCT (n = 24). Meta-analysis of the observational studies revealed no significant difference in complete remission between the MMF and IVCP groups (pooled RR: 1.01; 95% CI: 0.78-1.29; I The analysis was limited by the predominance of observational studies and only one small pediatric RCT with a high risk of bias. Variability in outcome definitions, inconsistent reporting of baseline disease severity, and lack of subgroup analysis limited further interpretation. Small study numbers precluded a formal assessment of publication bias. The efficacy of MMF appears to be similar to IVCP for induction therapy in pediatric proliferative LN, with a potentially more favourable safety profile. These findings support MMF as a viable alternative to IVCP; however, robust, multicenter pediatric RCTs are urgently needed to establish definitive treatment recommendations and guide clinical practice. PROSPERO: CRD42024533313 available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024533313.3c:T492,To investigate the association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and nonarteritic ischemic optic neuropathy (NAION). The PubMed, Embase, and Cochrane Library databases were searched during August 2025. Odds ratios (ORs) and absolute risk for NAION values were pooled using random-effects Peto and inverse-variance models. Any ocular event was a secondary outcome. Fifteen longitudinal studies (n = 8 trials; n > 1.5 million patients) were included. GLP-1 RA use was associated with higher NAION risk (OR 1.70; 95% CI 1.23-2.36), consistent across randomized (2.36; 0.85-6.53) and nonrandomized studies (1.64; 1.15-2.35) (P = 0.51, for heterogeneity). Absolute NAION risk in the GLP-1 RA group was 0.09%, corresponding to a 0.037% risk difference (number needed to harm ∼ 2,700). There was no association with overall ocular events (OR 0.95; 95% CI 0.86-1.05). GLP-1 RA use was associated with a modest increase in NAION risk but not overall ocular adverse events. Findings underscore the need for long-term postmarketing safety studies and should be interpreted against their well-established mortality and cardio-kidney-metabolic benefits.3d:T6fd, OBJECTIVE To investigate the association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and nonarteritic ischemic optic neuropathy (NAION). RESEARCH DESIGN AND METHODS The PubMed, Embase, and Cochrane Library databases were searched during August 2025. Odds ratios (ORs) and absolute risk for NAION values were pooled using random-effects Peto and inverse-variance models. Any ocular event was a secondary outcome. RESULTS Fifteen longitudinal studies (n = 8 trials; n > 1.5 million patients) were included. GLP-1 RA use was associated with higher NAION risk (OR 1.70; 95% CI 1.23–2.36), consistent across randomized (2.36; 0.85–6.53) and nonrandomized studies (1.64; 1.15–2.35) (P = 0.51, for heterogeneity). Absolute NAION risk in the GLP-1 RA group was 0.09%, corresponding to a 0.037% risk difference (number needed to harm ∼ 2,700). There was no association with overall ocular events (OR 0.95; 95% CI 0.86–1.05). CONCLUSIONS GLP-1 RA use was associated with a modest increase in NAION risk but not overall ocular adverse events. Findings underscore the need for long-term postmarketing safety studies and should be interpreted against their well-established mortality and cardio-kidney-metabolic benefits. 3e:T88b,Risk-reducing bilateral mastectomy reduces the incidence of breast cancer in female carriers of the BRCA pathogenic variants, but its association with mortality remains uncertain. To evaluate the association between risk-reducing bilateral mastectomy and overall and breast cancer-specific mortality in female carriers of BRCA pathogenic variants. PubMed, Scopus, CINAHL, Embase, and CENTRAL were searched in May 2025, with English-language restriction and no date limit. Reference lists of included studies and relevant reviews were also examined. Eligible studies compared female carriers of BRCA1 and BRCA2 pathogenic variants who underwent risk-reducing bilateral mastectomy with those who did not and reported overall mortality or breast cancer-specific mortality. Studies including patients with a history of breast cancer were excluded. This meta-analysis followed the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Two authors independently performed study selection, data extraction, and risk of bias assessment (using Risk of Bias in Nonrandomized Studies-of Interventions, version 2). Odds ratios (ORs) and hazard ratios (HRs) were pooled using fixed- and random-effects models according to methodological assessment. Overall and breast cancer-specific mortality. Six observational studies met the inclusion criteria, comprising 6135 carriers of the BRCA1 or BRCA2 variant. Weighted median age at inclusion was 38.0 years, with reported age ranges spanning 15.3 to 85.3 years. Risk-reducing bilateral mastectomy was associated with lower overall mortality in both unadjusted (OR, 0.38; 95% CI, 0.27-0.55; P < .001) and adjusted (HR, 0.37; 95% CI, 0.23-0.60; P < .001) analyses. Breast cancer-specific mortality was also reduced (OR, 0.19; 95% CI, 0.08-0.47; P < .001; HR, 0.14; 95% CI, 0.04-0.49; P = .002). Risk-reducing bilateral mastectomy was associated with lower overall and breast cancer-specific mortality in carriers of the BRCA variants. These findings support the role of risk-reducing bilateral mastectomy as a potentially life-extending intervention and may inform the shared decision-making discussions in these women.3f:T12b9, Importance Risk-reducing bilateral mastectomy reduces the incidence of breast cancer in female carriers of the BRCA pathogenic variants, but its association with mortality remains uncertain. Objective To evaluate the association between risk-reducing bilateral mastectomy and overall and breast cancer–specific mortality in female carriers of BRCA pathogenic variants. Data Sources PubMed, Scopus, CINAHL, Embase, and CENTRAL were searched in May 2025, with English-language restriction and no date limit. Reference lists of included studies and relevant reviews were also examined. Study Selection Eligible studies compared female carriers of BRCA1 and BRCA2 pathogenic variants who underwent risk-reducing bilateral mastectomy with those who did not and reported overall mortality or breast cancer–specific mortality. Studies including patients with a history of breast cancer were excluded. Data Extraction and Synthesis This meta-analysis followed the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Two authors independently performed study selection, data extraction, and risk of bias assessment (using Risk of Bias in Nonrandomized Studies—of Interventions, version 2). Odds ratios (ORs) and hazard ratios (HRs) were pooled using fixed- and random-effects models according to methodological assessment. Main Outcomes and Measures Overall and breast cancer–specific mortality. Results Six observational studies met the inclusion criteria, comprising 6135 carriers of the BRCA1 or BRCA2 variant. Weighted median age at inclusion was 38.0 years, with reported age ranges spanning 15.3 to 85.3 years. Risk-reducing bilateral mastectomy was associated with lower overall mortality in both unadjusted (OR, 0.38; 95% CI, 0.27-0.55; P &lt; .001) and adjusted (HR, 0.37; 95% CI, 0.23-0.60; P &lt; .001) analyses. Breast cancer–specific mortality was also reduced (OR, 0.19; 95% CI, 0.08-0.47; P &lt; .001; HR, 0.14; 95% CI, 0.04-0.49; P = .002). Conclusions and Relevance Risk-reducing bilateral mastectomy was associated with lower overall and breast cancer–specific mortality in carriers of the BRCA variants. These findings support the role of risk-reducing bilateral mastectomy as a potentially life-extending intervention and may inform the shared decision-making discussions in these women. 40:T4f9,This systematic review and meta analysis was conducted to investigate the reproductive outcomes in the patients with adenomyosis after HIFU treatment, aimed to recommend HIFU treatment for those women with adenomyosis who have reproductive demand. Extensive search was performed through PubMed, EMBASE and Web of Science databases. All available studies that evaluated the reproductive outcomes after HIFU for adenomyosis. Systematic review was performed following PRISMA guidelines. A meta-analysis was performed on data from 15 studies involving 3730 patients with adenomyosis. Pooled results showed that the pregnancy rate (PR) in women who desired to conceive was 54.6%, the live-birth rate (LBR) based on pregnancy was 75.8%, and the possible prognostic factors were non-perfused volume (NPV%) and type of adenomyosis. This review suggests that HIFU was easier to operate, with less adverse events and noninferior to adenomyomectomy. Patients with higher non-perfused volume (NPV%) and focal or internal adenomyosis had more improvement in reproductive outcomes after HIFU treatment. However, the well-designed, prospective, randomized controlled trials (RCT) are needed to compare the reproductive outcomes in those adenomyosis patients after HIFU in the near future.41:T711,On 14 August 2024, the WHO redesignated Monkeypox (mpox) as a Public Health Emergency of International Concern. Ocular disease is under-recognised and can cause irreversible vision loss. Clarifying its burden, clade-specific patterns and HIV-related risks is essential for clinical care and public health. We conducted an umbrella review and meta-analysis, systematically searching PubMed, Embase, Scopus, Web of Science and the Cochrane Library from inception to September 2025. Eligible studies were systematic reviews reporting ophthalmic manifestations in laboratory-confirmed mpox cases, stratified by viral clades I, II and IIb. Pooled proportions were estimated using random-effects meta-analysis, with clade-stratified subgroup analyses. The protocol was registered in PROSPERO (CRD420251137180). Five systematic reviews (36 primary studies; 28 139 patients) were included. The pooled proportion of conjunctivitis was 8.9% (95% CI 4.8 to 13.9), highest in clade I (21.9%) and lowest in clade IIb (2.7%). Keratitis (1.5%), eyelid lesions (3.3%), conjunctival lesions (8.4%) and corneal ulceration (3.3%) varied by clade. Visual impairment occurred in 4.5% overall; unilateral (0.9%) and bilateral (0.4%) blindness were reported only with clade I. Across reviews, people living with advanced HIV experienced disproportionately higher rates of severe and persistent ocular complications than HIV-negative individuals. Mpox-related ophthalmic disease can cause substantial-and potentially preventable-visual disability. Clade I infection is associated with a greater burden of ocular complications than clade II-particularly IIb. Improved access to eye health services, early recognition and integration of HIV and mpox care are critical to reducing vision loss, especially in resource-limited settings.42:T960, Background On 14 August 2024, the WHO redesignated Monkeypox (mpox) as a Public Health Emergency of International Concern. Ocular disease is under-recognised and can cause irreversible vision loss. Clarifying its burden, clade-specific patterns and HIV-related risks is essential for clinical care and public health. Methods We conducted an umbrella review and meta-analysis, systematically searching PubMed, Embase, Scopus, Web of Science and the Cochrane Library from inception to September 2025. Eligible studies were systematic reviews reporting ophthalmic manifestations in laboratory-confirmed mpox cases, stratified by viral clades I, II and IIb. Pooled proportions were estimated using random-effects meta-analysis, with clade-stratified subgroup analyses. The protocol was registered in PROSPERO (CRD420251137180). Results Five systematic reviews (36 primary studies; 28 139 patients) were included. The pooled proportion of conjunctivitis was 8.9% (95% CI 4.8 to 13.9), highest in clade I (21.9%) and lowest in clade IIb (2.7%). Keratitis (1.5%), eyelid lesions (3.3%), conjunctival lesions (8.4%) and corneal ulceration (3.3%) varied by clade. Visual impairment occurred in 4.5% overall; unilateral (0.9%) and bilateral (0.4%) blindness were reported only with clade I. Across reviews, people living with advanced HIV experienced disproportionately higher rates of severe and persistent ocular complications than HIV-negative individuals. Conclusions Mpox-related ophthalmic disease can cause substantial—and potentially preventable—visual disability. Clade I infection is associated with a greater burden of ocular complications than clade II—particularly IIb. Improved access to eye health services, early recognition and integration of HIV and mpox care are critical to reducing vision loss, especially in resource-limited settings. 43:T63a,No therapies have been approved to alter bronchiectasis progression. Dipeptidyl peptidase-1 (DPP-1) inhibitors, which target neutrophil serine protease activation, are under investigation as potential disease-modifying agents. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing DPP-1 inhibitors versus placebo in patients with non-cystic fibrosis bronchiectasis. PubMed, Cochrane, EMBASE, Web of Science, Scopus, ClinicalTrials.gov, and ICTRP were searched from inception until April 26, 2025. Primary outcomes included time to first exacerbation and proportion of patients remaining exacerbation-free. Secondary outcomes included post-bronchodilator % Forced Expiratory Volume in 1 s (FEV 2523 patients from four RCTs were included, of whom 1689 (66.9 %) received DPP-1 inhibitors. Compared with placebo, DPP-1 inhibitors prolonged the time to first exacerbation (HR 0.79; 95 % CI: 0.71 to 0.88) and increased the proportion of patients remaining exacerbation-free (RR 1.33; 95 % CI 1.12 to 1.58). A slower decline in post-bronchodilator % FEV1 was observed (MD 1.1 %; 95 % CI 0.05 to 2.15), but no difference in QoL-B scores (MD 1.35; 95 % CI -0.72 to 3.42). The safety profile of DPP-1 inhibitors was acceptable and comparable to placebo. Moderate certainty was found across endpoints. DPP-1 inhibitors prolong time to first exacerbation and reduce exacerbation rates in patients with bronchiectasis, with an acceptable safety profile. These findings support their potential as a disease-modifying strategy. PROSPERO (CRD420251042542).44:T7b5,Few studies describe gut microbiome signatures in treatment-naïve new-onset inflammatory bowel disease (IBD). We present a novel secondary bioinformatic reanalysis of sequence outputs mapped to the latest microbial taxonomy. MEDLINE and Embase searches were performed for microbiome studies in treatment-naïve IBD. Appraisal was completed with Risk Of Bias In Non-randomized Studies - of Exposures (ROBINS-E). Available 16S ribosomal RNA sequence data sets were downloaded and missing data sets requested. Integrated data were run through a unified QIIME2 bioinformatics pipeline. Multivariable models adjusting for methodologic differences were developed using MaAsLin2. There were 36 eligible studies; 18 contributed to bioinformatic reanalysis and 24 to supplementary meta-analysis. Samples from 1743 patients were included, comprising 678 from individuals with Crohn's disease (CD), 399 with ulcerative colitis (UC), 130 healthy controls (HCs), and 405 symptomatic controls (SCs); 990 of which were biopsy samples. Alpha diversity was reduced: feces-pediatric UC vs SCs, adult CD and UC vs HCs, and pediatric SCs vs HCs; pediatric biopsy samples-CD vs SCs, CD vs UC, and UC vs SCs. Beta diversity demonstrated clear distinctions between fecal and mucosal biopsy communities, least evident in UC, in addition to community separation by geography. Multivariate modeling revealed depletion of anaerobic and enrichment of aerobic and facultative anaerobic bacteria, alongside enrichment of oral genera across both CD and UC. Core microbial perturbations at onset of CD and UC are depletion of anaerobes and enrichment of oxygen-tolerant, orally associated bacteria. As we place greater emphasis on early diagnosis and prediction of IBD risk, this finding may support innovative diagnostic approaches. Microbiome-targeted intervention and alteration of luminal oxygen availability may offer novel therapeutic avenues for new-onset patients and identified high-risk groups.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Systematic Review and Meta-analysis: study design Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Systematic Review and Meta-analysis (study design). Clinician-written summaries and actionable practice insights. 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the meta-analysis is substantially underpowered and results should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Publication bias could not be formally assessed due to the small number of included studies.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"Race and ethnicity data were inconsistently reported across trials, preventing subgroup analyses by demographic factors.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"The Judson 2014 trial included both golimumab and ustekinumab arms with a shared placebo group; the authors split the placebo arm proportionally to avoid unit-of-analysis errors, which introduces analytical uncertainty.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0490","tag_type":"warning","value":"The level of evidence tag '1' reflects the meta-analysis of RCTs study design, but GRADE certainty was rated 'very low' due to risk of bias, imprecision, and heterogeneity — the clinical confidence in the pooled estimates is therefore much lower than the design hierarchy alone implies.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 6 double-blind, placebo-controlled RCTs (n=156 adults) evaluated the efficacy and safety of pharmacological add-on therapies — including infliximab, adalimumab, golimumab, ustekinumab, thalidomide, sirolimus (topical mTOR inhibitor), and the CLEAR antimycobacterial regimen — for cutaneous sarcoidosis, with all trials permitting concomitant corticosteroids.","key_result":"No pharmacological therapy significantly improved clinical response over placebo (OR 2.24; 95% CI 0.73–6.90; p=0.16). A non-significant trend toward better quality of life was seen (OR 2.23; 95% CI 0.87–5.73; p=0.09). Serious adverse events were similar between groups (OR 0.97; 95% CI 0.48–1.96; p=0.93). Overall certainty of evidence was very low (GRADE).","limitations":"- Only 6 RCTs with 156 total participants; severely underpowered for definitive conclusions.\n- Risk of bias was moderate-to-high in 4 of 6 studies, mainly due to missing outcome data and inadequate allocation concealment.\n- All trials allowed concurrent corticosteroids without standardized dosing or tapering, which may have blunted detection of treatment benefit. Publication bias could not be assessed.","practice_takeaway":"Current RCT evidence does not support a statistically significant benefit of steroid-sparing add-on therapies for cutaneous sarcoidosis; individualize treatment based on disease severity, comorbidities, and patient preferences. Emerging agents (JAK inhibitors, mTOR inhibitors) show promise in case reports but lack controlled trial data — do not use as standard care yet."}},{"doi":"10.2340/actadv.v106.adv-2026-0456","pmid":"42549602","title":"Systemic Comorbidities in Central Centrifugal Cicatricial Alopecia: A Systematic Review and Meta-analysis","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v106.adv-2026-0456","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-10T13:22:12.051Z","updated_at":"2026-08-10T13:22:12.051Z","tags":[{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Anxiety Disorder","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Central Centrifugal Cicatricial Alopecia","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Dyslipidemia","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Scarring Alopecia","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"condition","value":"Uterine Leiomyoma","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"sample_size","value":"n=9103","value_numeric":9103},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"study_design","value":"Systematic Review and Meta-analysis","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"warning","value":"All but one study were conducted in the United States, limiting generalizability to other populations or healthcare systems.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"warning","value":"Heterogeneity was very high (I² >90%) for most prevalence and association outcomes, so pooled estimates should be interpreted cautiously and not used as precise population benchmarks.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"warning","value":"Sample size reflects CCCA patients only; the control population (735,941) was not included in the n tag as it represents a separate, heterogeneous comparator pool across studies.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0456","tag_type":"warning","value":"The impact_flag 'practice_changing' reflects the first quantitative synthesis supporting systemic comorbidity screening in CCCA, but causality is not established; individual clinical judgment is essential.","value_numeric":null}],"summaries":{"what_studied":"PRISMA 2020–compliant systematic review and random-effects meta-analysis of 23 observational studies (n=9,103 CCCA patients, 735,941 controls) to quantify pooled prevalence and case-control associations between central centrifugal cicatricial alopecia (CCCA) and systemic comorbidities; literature searched through June 18, 2025.","key_result":"Pooled prevalence: hypertension 51.9% (95% CI 33.8–69.6), dyslipidemia 58.4% (95% CI 29.0–82.8), obesity 37.1% (95% CI 10.8–74.2), uterine leiomyomas 28.0% (95% CI 8.0–64.0). In case-control analyses, CCCA was significantly associated with dyslipidemia (OR 4.46, 95% CI 1.09–18.25), uterine leiomyomas (OR 2.25, 95% CI 1.10–4.58), and anxiety disorders (OR 3.27, 95% CI 1.22–8.79); hypertension, obesity, and thyroid disease showed no consistent association.","limitations":"- Substantial between-study heterogeneity (I² >90% for most outcomes) with wide confidence intervals, limiting reliability of pooled estimates.\n- 22/23 studies were U.S.-based and most were retrospective EHR studies with variable comorbidity definitions and inconsistent adjustment for race/ethnicity.\n- Healthcare-contact bias may inflate prevalence; comparator groups sometimes had elevated baseline comorbidity burden, potentially attenuating some associations.","practice_takeaway":"Clinicians managing CCCA — especially in Black women — should routinely screen for cardiometabolic risk factors (lipids, blood pressure), ask about gynecologic symptoms suggestive of uterine fibroids, and inquire about anxiety, with referral as appropriate. A holistic, multidisciplinary approach is warranted beyond scalp-focused care."}},{"doi":"10.1016/j.breast.2026.104880","pmid":null,"title":"Cardiotoxicity of Newer HER2-Directed Therapies in Breast Cancer: A Systematic Review and Meta-analysis of Incidence and Comparative Risk","journal_title":"The Breast","journal_issn":"0960-9776","published_at":"2026-07-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.breast.2026.104880","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-27T14:09:16.448Z","updated_at":"2026-07-27T14:09:16.448Z","tags":[{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"condition","value":"Cardiotoxicity","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"modality","value":"HER2-Directed Therapy","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"study_design","value":"Systematic Review and Meta-analysis","value_numeric":null},{"paper_doi":"10.1016/j.breast.2026.104880","tag_type":"warning","value":"The full paper text was not provided — only the title, DOI, journal, and publication date were supplied. All structured fields are based solely on the title and study design implied by the abstract title. Specific results, patient numbers, drug names, event rates, and limitations could not be extracted. 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No fabricated data were used.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — authors explicitly note this finding does not by itself justify population-based screening; individual shared decision-making remains essential.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 5 RCTs (n=721,607 adults aged 45–80) evaluated the effect of PSA-based prostate cancer screening versus no screening or usual care on prostate cancer–specific mortality (PCSM), with follow-up ranging from 11 to 23 years.","key_result":"With high-certainty evidence (GRADE), PSA-based screening significantly reduced PCSM at longest follow-up (p<0.001); secondary analyses indicated greater relative PCSM reduction with longer follow-up durations (beyond 12 years).","limitations":"- Differing screening protocols across trials limit direct comparability.\n- Control-arm contamination (some participants receiving PSA testing outside the trial) likely **underestimates** the true benefit.\n- The analysis does not address harms such as overdiagnosis and overtreatment.","practice_takeaway":"High-certainty evidence now supports that PSA-based screening reduces prostate cancer death over long follow-up — a shift from earlier uncertain conclusions. Clinicians should discuss this mortality benefit alongside known harms (overdiagnosis, overtreatment) when counseling patients about screening decisions."}},{"doi":"10.1080/09546634.2026.2654112","pmid":"42057730","title":"Efficacy of polyphenolic compounds for hair regeneration: a systematic review and meta-analysis of randomized controlled trials","journal_title":"Journal of Dermatological Treatment","journal_issn":"0954-6634","published_at":"2026-04-30T00:00:00.000Z","url":"https://doi.org/10.1080/09546634.2026.2654112","source_score":6,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1080/09546634.2026.2654112","days":"7","issn":"0954-6634","rank":"6","field":"Clinical Medicine","score":"6","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1080/09546634.2026.2654112","title":"Efficacy of polyphenolic compounds for hair regeneration: a systematic review and meta-analysis of randomized controlled trials.","journal":"The Journal of dermatological treatment","methods":"","results":"Thirty-two randomized controlled trials involving 2,183 participants were analyzed. Compared with controls, polyphenolic interventions significantly improved hair density (SMD 0.90; 95% CI 0.51-1.30) and total area hair count (SMD 1.03; 95% CI 0.42-1.63), although substantial heterogeneity was observed. 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text.","value_numeric":null},{"paper_doi":"10.1080/09546634.2026.2654112","tag_type":"warning","value":"Specific polyphenolic agents, dosing, and treatment durations varied and were not detailed in the summary.","value_numeric":null},{"paper_doi":"10.1080/09546634.2026.2654112","tag_type":"warning","value":"Substantial heterogeneity limits confidence in pooled effect estimates.","value_numeric":null},{"paper_doi":"10.1080/09546634.2026.2654112","tag_type":"warning","value":"The meta-analysis pools multiple distinct polyphenolic compounds (oral and topical) across different alopecia subtypes, which likely contributes to the noted substantial heterogeneity and limits interpretability of the pooled SMDs.","value_numeric":null},{"paper_doi":"10.1080/09546634.2026.2654112","tag_type":"warning","value":"The PROSPERO registration number (CRD420251230149) could not be independently verified; clinicians should confirm registration status before citing this review as pre-registered evidence.","value_numeric":null}],"summaries":{"limitations":"There was substantial heterogeneity across trials. Long-term and standardized data are lacking.","what_studied":"A systematic review and meta-analysis of randomized, blinded controlled trials tested oral and topical polyphenolic compounds versus controls in adults with non-scarring alopecia. Primary outcomes were trichoscopic hair density and total area hair count.","key_result":"Across 32 RCTs (n=2,183), polyphenolic interventions improved hair density (SMD 0.90; 95% CI 0.51–1.30) and total area hair count (SMD 1.03; 95% CI 0.42–1.63) versus controls; direct comparisons with minoxidil showed no significant difference in overall hair count.","practice_takeaway":"Selected polyphenolic formulations may raise hair density and counts in adults with non-scarring alopecia, but effects vary and they do not outperform minoxidil in head-to-head trials. Use as adjuncts should await more standardized, longer-term studies."}},{"doi":"10.14309/ajg.0000000000003919","pmid":"41533456","title":"Imaging Based Modalities for Identifying “At Risk” MASH. 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FAST demonstrated highest TRO sensitivity (0.871) with moderate specificity (0.567) and TRI specificity (0.900) with reduced sensitivity (0.441). MEFIB achieved high TRO sensitivity (0.812) but lower specificity (0.606); TRI specificity was 0.872, sensitivity was 0.500. MAST exhibited intermediate performance, while cT1 thresholds showed variable diagnostic accuracy. A sensitivity analysis of head-to-head studies shows superior performance in FAST compared to other diagnostic methods.","abstract":"$32","keywords":["FibroScan","Magnetic Resonance Elastography","Metabolic-associated Steatohepatitis"],"pubmed_id":"41533456","conclusions":"FAST with its accessibility and robust diagnostic performance may be well-suited for large-scale application. MRI-based techniques are effective non-invasive options for diagnosing \"at risk\" MASH in MASLD and may provide strong alternatives. Rather than challenging existing perspectives, this study provides a reflective overview of current evidence on imaging-based modalities for \"at risk\" MASH.","publication_date":"2026-01-14T00:00:00"},"crossref":{"DOI":"10.14309/ajg.0000000000003919","URL":"https://doi.org/10.14309/ajg.0000000000003919","ISSN":["0002-9270","1572-0241"],"link":[{"URL":"https://journals.lww.com/10.14309/ajg.0000000000003919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Imaging Based Modalities for Identifying “At Risk” MASH. A Diagnostic Test Meta-analysis"],"author":[{"given":"Shyna Zhuoying","family":"Gunalan","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Michelle Shi","family":"Ni Law","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Yi Xin","family":"Kua","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Zhenning","family":"Yu","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Ryan Yan","family":"Zhe Lim","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Asvin","family":"Selvakumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Nicholas","family":"Syn","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Karn","family":"Wijarnpreecha","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Arizona College of Medicine Phoenix"}]},{"given":"Benjamin","family":"Nah","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, National University Health System, Singapore"}]},{"given":"Zi Xuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}]},{"given":"Ming-Hua","family":"Zheng","sequence":"additional","affiliation":[{"name":"MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China"}]},{"given":"Toru","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan"}]},{"given":"Asahiro","family":"Morishita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Neurology, Kagawa University, Japan"}]},{"given":"Won Mook","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}]},{"given":"Vincent L.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA"}]},{"given":"Cheng Han","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan"},{"name":"Division of Gastroenterology and Hepatology, National University Health System, Singapore"}]},{"given":"Mei Chin","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, National University Health System, Singapore"}]},{"given":"Hirokazu","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Liver Center, Saga University Hospital, Saga, Japan"}]},{"given":"Mark","family":"Muthiah","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Division of Gastroenterology and Hepatology, National University Health System, Singapore"},{"name":"National University Centre for Organ Transplantation, National University Health System, Singapore"}]}],"issued":{"date-parts":[[2026,1,13]]},"member":"276","prefix":"10.14309","source":"Crossref","volume":null,"created":{"date-time":"2026-01-14T17:00:10Z","timestamp":1768410010000,"date-parts":[[2026,1,14]]},"indexed":{"date-time":"2026-01-15T17:05:38Z","timestamp":1768496738545,"date-parts":[[2026,1,15]]},"subject":[],"abstract":"$33","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.14309/ajg.0000000000003919"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","value":"2025-02-16"},{"name":"accepted","group":{"name":"publication_history","label":"Publication 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A Diagnostic Test Meta-analysis","updated":"2026-01-16T01:10:40+00:00","published_date":"2026-01-13","best_oa_location":null}},"created_at":"2026-01-18T22:40:12.285Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatohepatitis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"sample_size","value":"n=9480","value_numeric":9480},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"study_design","value":"Systematic Review and Meta-analysis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"warning","value":"Numeric performance details for MAST and cT1 were not provided in the abstract.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"warning","value":"Terminology is inconsistent: the search targeted MRI-based techniques, yet FAST was included among the evaluated tools.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000003919","tag_type":"warning","value":"The abstract notes head-to-head sensitivity analysis favoring FAST but does not report the number or settings of these comparisons.","value_numeric":null}],"summaries":{"what_studied":"A diagnostic test meta-analysis of 20 studies (n=9,480) assessed imaging-based tools (FAST, MEFIB, MAST, cT1) to detect “at risk” MASH (MAS ≥4, F ≥2). Medline and Embase were searched through December 20, 2024, and pre-specified rule-out (TRO) and rule-in (TRI) thresholds were applied.","key_result":"FAST showed the highest TRO sensitivity 0.871 with specificity 0.567, and TRI specificity 0.900 with sensitivity 0.441; MEFIB had TRO sensitivity 0.812 and specificity 0.606, and TRI specificity 0.872 with sensitivity 0.500. MAST had intermediate performance and cT1 thresholds were variable; in head-to-head sensitivity analyses, FAST performed best among comparators.","limitations":"Performance for cT1 varied by threshold, suggesting heterogeneity across studies; results are contingent on pre-specified TRO/TRI cutoffs. The analysis was limited to imaging-based modalities.","practice_takeaway":"FAST provides the strongest rule-out sensitivity and rule-in specificity among the evaluated tools and may be suited for large-scale use. MRI-based techniques remain effective non-invasive options for identifying “at risk” MASH in MASLD."}},{"doi":"10.1016/j.ajem.2025.12.043","pmid":"41529589","title":"Extended thrombolysis in acute ischemic stroke: A Bayesian meta-analysis and umbrella review","journal_title":"The American Journal of Emergency Medicine","journal_issn":"0735-6757","published_at":"2026-01-14T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajem.2025.12.043","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-07","doi":"10.1016/j.ajem.2025.12.043","days":"14","issn":"0735-6757","rank":"6","field":"Clinical Medicine","score":"3","category":"Emergency Medicine","categories":["Emergency Medicine"],"_categories":["Emergency Medicine"]},"pubmed":{"doi":"10.1016/j.ajem.2025.12.043","title":"Extended thrombolysis in acute ischemic stroke: A Bayesian meta-analysis and umbrella review.","journal":"The American journal of emergency medicine","methods":"","results":"Six original randomized trials of extended thrombolysis and 7 meta-analyses were identified but none had considered a uw-mRS score or reported direct probability statements regarding benefit or harm. 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meta-analysis","updated":"2026-01-16T01:10:40+00:00","published_date":"2025-11-22","best_oa_location":null}},"created_at":"2026-01-20T15:55:50.695Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"condition","value":"Polycystic Ovary Syndrome","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"sample_size","value":"n=157,181","value_numeric":157181},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"study_design","value":"Systematic Review and Meta-analysis","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"warning","value":"Certainty was rated very low to low, with many studies at moderate or high risk of bias.","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"warning","value":"No prevalence data were available from the WHO African region.","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"warning","value":"Pooled estimates showed very high heterogeneity; interpret exact percentages with caution.","value_numeric":null},{"paper_doi":"10.1093/humupd/dmaf030","tag_type":"warning","value":"This is a systematic review and meta-analysis of prevalence studies, not interventional trials.","value_numeric":null}],"summaries":{"what_studied":"Systematic review and random-effects meta-analysis (1990–Nov 2024) of unselected population studies estimating PCOS prevalence by diagnostic criteria and WHO regions. A total of 119 studies were eligible; 92 studies (n=157,181) were pooled, with adult women as the primary population.","key_result":"Globally in adults, pooled PCOS prevalence was 12.1% by Rotterdam (95% CI 9.8–14.8; I2 98.8%), 7.9% by NIH (6.2–9.9; I2 96.2%), 12.7% by AE‑PCOS (8.2–17.9; I2 98.0%), and 7.8% by self‑report (5.8–10.0; I2 99.4%). By WHO region using Rotterdam criteria, prevalence was highest in the Eastern Mediterranean 15.1% (11.1–19.7) and South‑East Asia 14.3% (5.8–25.9), followed by Europe 11.7% (5.1–20.3), the Americas 10.5% (3.0–21.7), and the Western Pacific 9.1% (6.2–12.5), with no data from Africa (between‑region difference P=0.022).","limitations":"Between‑study heterogeneity was very high (I2 up to 99.4%); diagnostic criteria and component features varied across studies. Many studies had moderate or high risk‑of‑bias (30 low, 49 moderate, 40 high), and certainty was rated very low to low. No data were available from the WHO African region.","practice_takeaway":"In adults, about one in eight women meet Rotterdam PCOS criteria worldwide, but estimates shift with diagnostic criteria and region. Use standardized, guideline‑endorsed criteria and confirm self‑report, given very low‑to‑low certainty and marked heterogeneity."}},{"doi":"10.1136/bmj-2025-085304","pmid":"41500720","title":"Weight regain after cessation of medication for weight management: systematic review and meta-analysis","journal_title":"BMJ","journal_issn":"1756-1833","published_at":"2026-01-08T00:00:00.000Z","url":"https://doi.org/10.1136/bmj-2025-085304","source_score":317,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-10","doi":"10.1136/bmj-2025-085304","days":"7","issn":"1756-1833","rank":"10","field":"Clinical Medicine","score":"317","category":"Medicine, General & Internal","categories":["Medicine, General & Internal"],"_categories":["Medicine, General & Internal"]},"pubmed":{"doi":"10.1136/bmj-2025-085304","title":"Weight regain after cessation of medication for weight management: systematic review and meta-analysis.","journal":"BMJ (Clinical research ed.)","methods":"","results":"Of the 9288 titles screened, 37 studies (63 intervention arms, 9341 participants) were included. Average treatment duration was 39 (range 11-176) weeks, with average follow-up of 32 (4-104) weeks. The average monthly rate of weight regain was 0.4 kg (95% confidence interval (CI) 0.3 to 0.5) (mixed model 0.3 kg (0.2 to 0.4) monthly ","abstract":"$39","keywords":[],"pubmed_id":"41500720","conclusions":"","publication_date":"2026-01-08T00:00:00"},"crossref":{"DOI":"10.1136/bmj-2025-085304","URL":"https://doi.org/10.1136/bmj-2025-085304","ISSN":["1756-1833"],"link":[{"URL":"http://data.bmj.org/tdm/10.1136/bmj-2025-085304","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https://syndication.highwire.org/content/doi/10.1136/bmj-2025-085304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"e085304","type":"journal-article","issue":null,"score":1,"title":["Weight regain after cessation of medication for weight management: systematic review and meta-analysis"],"author":[{"given":"Sam","family":"West","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care 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It included 37 studies (63 arms; n=9341), with mean treatment 39 weeks (range 11–176) and follow-up 32 weeks (4–104), and compared regain with behavioural weight management programmes.","key_result":"Average monthly weight regain after cessation was 0.4 kg (95% CI 0.3 to 0.5); a mixed model estimated 0.3 kg/month (0.2 to 0.4). Regain after medication was faster than after behavioural programmes, and beneficial cardiometabolic effects reversed after stopping treatment.","practice_takeaway":"Expect rapid weight regain and reversal of cardiometabolic benefits after stopping weight loss medication; plan for sustained, comprehensive management. Avoid short term prescribing without a broader weight management strategy."}},{"doi":"10.1007/s00467-025-07118-0","pmid":"41501260","title":"Efficacy of mycophenolate mofetil versus cyclophosphamide in the management of childhood-onset lupus nephritis: a systematic review and meta-analysis","journal_title":"Pediatric Nephrology","journal_issn":"0931-041X","published_at":"2026-01-08T00:00:00.000Z","url":"https://doi.org/10.1007/s00467-025-07118-0","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1007/s00467-025-07118-0","days":"7","issn":"0931-041X","rank":"7","field":"Clinical Medicine","score":"8","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1007/s00467-025-07118-0","title":"Efficacy of mycophenolate mofetil versus cyclophosphamide in the management of childhood-onset lupus nephritis: a systematic review and meta-analysis.","journal":"Pediatric nephrology (Berlin, Germany)","methods":"","results":"Out of 1,633 screened records, seven studies met the inclusion criteria, six observational studies (n = 282) and one RCT (n = 24). 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Seven studies were included (six observational, n=282; one RCT, n=24).","key_result":"Across six observational studies (n=282), complete remission rates were similar between MMF and IVCP (pooled RR 1.01; 95% CI 0.78–1.29).","limitations":"Evidence was dominated by observational studies with only one small pediatric RCT at high risk of bias. Outcome definitions and baseline disease severity varied, and small study numbers limited subgroup analyses and assessment of publication bias.","practice_takeaway":"MMF appears to achieve similar induction efficacy as IVCP in pediatric proliferative lupus nephritis and is a reasonable alternative when appropriate. Larger multicenter pediatric RCTs are needed to confirm efficacy and guide definitive treatment choices."}},{"doi":"10.2337/dc25-1238","pmid":"41498755","title":"Association Between GLP-1 Receptor Agonists and Ischemic Optic Neuropathy: A Meta-analysis","journal_title":"Diabetes Care","journal_issn":"0149-5992","published_at":"2026-01-07T00:00:00.000Z","url":"https://doi.org/10.2337/dc25-1238","source_score":31,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-12","doi":"10.2337/dc25-1238","days":"7","issn":"0149-5992","rank":"8","field":"Clinical Medicine","score":"31","category":"Endocrinology & Metabolism","categories":["Endocrinology & Metabolism"],"_categories":["Endocrinology & Metabolism"]},"pubmed":{"doi":"10.2337/dc25-1238","title":"Association Between GLP-1 Receptor Agonists and Ischemic Optic Neuropathy: A Meta-analysis.","journal":"Diabetes care","methods":"","results":"Fifteen longitudinal studies (n = 8 trials; n > 1.5 million patients) were included. GLP-1 RA use was associated with higher NAION risk (OR 1.70; 95% CI 1.23-2.36), consistent across randomized (2.36; 0.85-6.53) and nonrandomized studies (1.64; 1.15-2.35) (P = 0.51, for heterogeneity). Absolute NAION risk in the GLP-1 RA group was 0.09%, corresponding to a 0.037% risk difference (number needed to harm ∼ 2,700). 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Any ocular event was a secondary outcome.","key_result":"GLP-1 receptor agonist use was associated with higher NAION risk (OR 1.70; 95% CI 1.23–2.36), with similar estimates in randomized (2.36; 0.85–6.53) and nonrandomized studies (1.64; 1.15–2.35; P=0.51 between groups). Absolute NAION risk in GLP-1 RA users was 0.09%, a 0.037% risk difference (number needed to harm ≈2,700), and there was no association with overall ocular events (OR 0.95; 95% CI 0.86–1.05).","limitations":"The randomized evidence was imprecise and compatible with no effect (95% CI 0.85–6.53). The abstract does not describe the comparators or follow-up duration.","practice_takeaway":"For patients on GLP-1 receptor agonists, the absolute increase in NAION risk is small (~0.09%; NNH ~2,700) and there is no increase in overall ocular events. Counsel patients to report sudden vision changes and interpret this safety signal in the context of the drugs’ established cardio–kidney–metabolic benefits."}},{"doi":"10.1001/jamasurg.2025.5929","pmid":"41499127","title":"Risk-Reducing Bilateral Mastectomy and Mortality in Carriers of\n BRCA1\n and\n BRCA2\n Variants","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-01-07T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12780977/","source_score":31,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-10","doi":"10.1001/jamasurg.2025.5929","days":"14","issn":"2168-6254","rank":"10","field":"Clinical Medicine","score":"31","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1001/jamasurg.2025.5929","title":"Risk-Reducing Bilateral Mastectomy and Mortality in Carriers of BRCA1 and BRCA2 Variants: A Systematic Review and Meta-Analysis.","journal":"JAMA surgery","methods":"","results":"Six observational studies met the inclusion criteria, comprising 6135 carriers of the BRCA1 or BRCA2 variant. 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Primary outcomes were time to first exacerbation and the proportion of patients remaining exacerbation-free; secondary outcomes included post-bronchodilator %FEV1, QoL-B, and safety.","key_result":"Compared with placebo, DPP-1 inhibitors prolonged time to first exacerbation (HR 0.79; 95% CI 0.71–0.88) and increased the proportion remaining exacerbation-free (RR 1.33; 95% CI 1.12–1.58). They slowed decline in post-bronchodilator %FEV1 (MD 1.1%; 95% CI 0.05–2.15), did not change QoL-B (MD 1.35; 95% CI −0.72 to 3.42), and had safety comparable to placebo; certainty was rated moderate.","practice_takeaway":"DPP-1 inhibitors reduced exacerbation risk versus placebo with moderate-certainty evidence and similar safety, without QoL-B improvement. 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Samples from 1743 patients were included, comprising 678 from individuals with Crohn's disease (CD), 399 with ulcerative colitis (UC), 130 healthy controls (HCs), and 405 symptomatic controls (SCs); 990 of which were biopsy samples. Alpha diversity was reduced: feces-pediatric UC vs SCs, adult CD and UC vs HCs, and pediatric SCs vs HCs; pediatric biopsy samples-CD vs SCs, CD vs UC, and UC vs SCs. Beta diversity demonstrated clear distinctions between fecal and mucosal biopsy communities, least evident in UC, in addition to community separation by geography. 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