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Metanalyses, Gateway Circular Quay, Sydney/Office Level 36, Gateway 1 Macquarie Place, North Sydney (2025)

17/12/2025

🅜🅔🅣🅐 Published Today December 16, 2025 - This meta-analysis evaluates the diagnostic accuracy of the prompt gamma-to-neutron ratio for real-time monitoring of proton beam range during cancer treatments, analyzing various detector systems.

TITLE: DIAGNOSTIC ACCURACY OF PROMPT GAMMA-TO-NEUTRON RATIO FOR PROTON BEAM RANGE VERIFICATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.1038/s41598-025-28563-9

🅼 Key Findings:

• The study confirms that the prompt gamma-to-neutron ratio (PGNR) is a highly reliable metric for real-time range verification in proton therapy, showing high sensitivity across different studies.

• Meta-analysis results indicate a pooled sensitivity of 0.92 and specificity of 0.89, suggesting robust performance in detecting deviations in the proton beam’s Bragg peak position during delivery.

• The research highlights that secondary radiation—specifically prompt gammas and neutrons—provides a non-invasive signature that can be captured to ensure the beam stops precisely at the tumor.

• Various detector geometries were compared, with liquid scintillators and high-purity germanium detectors showing the most promising results for clinical integration and timing resolution.

• Heterogeneity among studies was noted due to varying phantom materials and beam energies, but the overall diagnostic odds ratio remains high, supporting the clinical potential of PGNR.

🅼 Clinical Relevance

This research is vital for improving the precision of proton therapy. By accurately verifying the beam range in real-time, clinicians can reduce margins around tumors, sparing healthy surrounding tissue and critical organs from unnecessary radiation. This minimizes side effects and improves the therapeutic index for cancer patients undergoing advanced radiotherapy treatments.

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16/12/2025

🅜🅔🅣🅐 Published Today (December 15, 2025) - A systematic review and meta-analysis assessing the impact of pharmacogenomic-guided dosing for fluoropyrimidine chemotherapy on toxicity rates and overall patient survival. TITLE: THE IMPACT OF PHARMACOGENOMIC-GUIDED DOSE ADJUSTMENTS ON FLUOROPYRIMIDINE-RELATED TOXICITY: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: 10.1177/10781552251405216

🅼 Key Findings:

• PGx testing significantly reduced the incidence of Grade 3/4 hematological toxicity by 45% (Pooled OR: 0.55; 95% CI, 0.41–0.74) compared to standard body surface area dosing. • Patients receiving PGx-guided lower initial doses demonstrated comparable overall survival rates to the standard dose group, confirming efficacy maintenance. • Preemptive pharmacogenomic screening for DPYD deficiency prevented severe adverse drug reactions (ADRs) in 8 out of 10 at-risk patients identified across the included trials. • The median time to treatment interruption due to toxicity was extended by an average of 14 days in the personalized dosing cohort, improving treatment continuity. • Implementation of PGx protocols showed a favorable pharmacoeconomic profile due to reduced hospitalization days and lower costs associated with toxicity management.

🅼 Clinical Relevance

Oncology pharmacists must champion DPYD pharmacogenomic testing before initiating fluoropyrimidine therapy (5-FU, capecitabine). Integrating PGx data allows for personalized dose reduction in high-risk patients, preventing life-threatening toxicities and supporting uninterrupted treatment schedules. This shift elevates the standard of pharmaceutical care in colorectal and breast cancer treatments.

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15/12/2025

🅜🅔🅣🅐 Published Today (December 14, 2025) - Comparing sleep disorder prevalence and outcomes in patients undergoing dialysis versus those who have received a renal transplant. TITLE: SLEEP DISORDERS IN RENAL PATIENTS: A COMPARATIVE ANALYSIS OF DIALYSIS AND POST-RENAL TRANSPLANT OUTCOMES

🅼 Link: https://doi.org/10.1038/s41598-025-28159-3

🅼 Key Findings:

Renal transplantation patients showed significantly lower odds of experiencing sleep disorders compared to matched patients with End-Stage Renal Disease (ESRD) on dialysis.

The study found significant improvements in Excessive Daytime Sleepiness (EDS) rates, decreasing from 44% in dialysis patients to 4% in the post-transplant group.

Risk of Obstructive Sleep Apnea (OSA) significantly decreased following renal transplantation, as assessed by EDS and specific questionnaires.

The prevalence of Restless Legs Syndrome (RLS) saw a significant reduction post-transplant, which is a common complication often associated with electrolyte imbalance in dialysis.

The overall quality of sleep was significantly improved in the group who had undergone renal transplantation.

Sleep disorders are confirmed to be an ongoing effect of ESRD, and renal transplantation highlights the benefits in improving sleep outcomes.

While improved, the association of OSA in kidney transplant recipients remains considerably high, ranging from 25% to 45%.

🅼 Clinical Relevance

This study offers strong evidence to counsel ESRD patients on the non-renal benefits of transplantation, specifically the significant improvement in sleep quality and a reduction in conditions like OSA, RLS, and EDS, which collectively enhance patient quality of life and potentially improve long-term graft survival.

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14/12/2025

🅜🅔🅣🅐 Published Today (December 13, 2025) - This systematic review assesses how AI-driven smartphone apps and wearables impact patient adherence, clinical outcomes, and data security in chronic disease management. TITLE: ARTIFICIAL INTELLIGENCE INTEGRATION IN MOBILE HEALTH: A SYSTEMATIC REVIEW AND META-ANALYSIS ON PATIENT ENGAGEMENT AND CLINICAL EFFICACY.

🅼 Link: https://doi.org/10.1038/s41523-025-00879-9

🅼 Key Findings:

AI-driven mHealth solutions significantly improve medication adherence (Odds Ratio: 1.75; 95% CI 1.45–2.08) compared to standard care, particularly for Type 2 Diabetes Mellitus.

Personalized feedback algorithms based on real-time physiological data enhance patient self-efficacy and lead to measurable reductions in HbA1c levels (-0.5% average) over a 6-month period.

Interoperability remains a key challenge, with only 35% of reviewed apps demonstrating seamless integration with Electronic Health Records (EHRs), limiting comprehensive data synthesis.

Wearable device data streams showed a high correlation with self-reported health metrics, validating their use as reliable proxy measures for monitoring disease progression outside of clinical settings.

Data privacy and security concerns were noted across 70% of studies, emphasizing the need for robust regulatory frameworks tailored to protect sensitive health data gathered via digital platforms.

The meta-analysis highlights the need for standardized reporting of mHealth intervention studies to allow for better comparison and aggregation of clinical trial results globally.

Engagement rates for mHealth apps drop sharply after 3 months, suggesting gamification and continuous content updates are critical for sustained user adherence and long-term benefit.

🅼 Clinical Relevance

Provides evidence-based guidance for clinicians to integrate vetted AI-mHealth tools into chronic disease management protocols. It underscores the potential to improve outcomes through highly personalized, continuous monitoring and timely intervention, shifting care from reactive to proactive, while also advising on crucial data security considerations for patient trust.

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13/12/2025

🅜🅔🅣🅐 Published Today (December 12, 2025) - This study consolidates data from multiple RCTs to assess the efficacy of tailored exercise programs versus standard care for reducing pain & improving function in chronic low back pain patients. TITLE: THE EFFICACY OF TAILORED EXERCISE PROGRAMS VERSUS STANDARD CARE FOR CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.1007/s41465-025-00336-2

🅼 Key Findings:

’ Tailored exercise programs significantly reduced pain intensity (mean difference: -1.5 points on a 10-point scale) compared to standard care at 6 months follow-up across all included studies. ’ Functional disability scores improved markedly in the exercise group, showing a clinically relevant improvement in daily activities and quality of life for chronic low back pain sufferers. ’ Subgroup analysis indicated that supervised, personalized physiotherapy sessions yielded greater long-term adherence and superior pain relief results compared to unsupervised home exercise protocols. ’ No serious adverse events were reported across any of the included randomized controlled trials (RCTs), highlighting the safety profile of exercise interventions for this patient population. ’ Combining specific core strengthening with aerobic conditioning showed the highest magnitude of effect, suggesting an optimal combination for rehabilitation protocols.

🅼 Clinical Relevance

This meta-analysis strongly supports integrating individualized, supervised exercise into first-line treatment guidelines for chronic low back pain. It provides high-level evidence confirming that active, patient-centered rehabilitation is superior to passive treatments and standard non-specific care, potentially reducing the need for long-term opioid use and costly invasive procedures.

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12/12/2025

🅜🅔🅣🅐 Published Today December 11, 2025 - This meta-analysis synthesized data from 27 studies on 11,575 patients to determine how common oral frailty is among people who are hospitalized, revealing a significantly high prevalence and variation by disease type. TITLE: SYSTEMATIC REVIEW AND META-ANALYSIS OF ORAL FRAILTY PREVALENCE AMONG OLDER HOSPITALIZED PATIENTS

🅼 Link: https://doi.org/10.3389/fpubh.2025.1681594

🅼 Key Findings:

’ Oral frailty is highly prevalent, affecting 51% (95% CI: 47–55%) of the 11,575 older hospitalized patients studied across 27 systematic reviews. ’ The prevalence (38–67% range) is significantly higher in hospital settings compared to the 24–32% reported among older adults dwelling in the community. ’ Prevalence rates vary substantially based on the patient's specific disease type, indicating a need for stratified risk assessment and tailored care pathways. ’ The results identify high-risk populations, underscoring the urgency for developing preventive and therapeutic measures customized for the hospital environment. ’ This systematic review adhered to PRISMA guidelines and utilized nine databases (e.g., PubMed, Embase, CNKI) in its search strategy up to July 2025.

🅼 Clinical Relevance

The extremely high prevalence of oral frailty in hospitalized patients makes it a critical public health concern. Clinicians must recognize oral frailty as a major risk factor for poor outcomes, especially in older adults. Implementing routine oral health screening and targeted interventions, such as nutritional support and specific oral exercises, can prevent complications, improve quality of life, and potentially shorten hospital stays.

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11/12/2025

🅜🅔🅣🅐 Published Today December 10, 2025 - This meta-analysis assesses the effectiveness and safety of using probiotics alongside standard antihistamine treatment for patients suffering from urticaria (hives), confirming their role as a valuable complementary therapy. TITLE: EFFICACY AND SAFETY OF PROBIOTICS AS A COMPLEMENTARY TREATMENT FOR URTICARIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

🅼 Link: https://doi.org/10.3389/fmicb.2025.1634990

🅼 Key Findings:

' Probiotics combined with antihistamines significantly improve the Urticaria Relief Rate (URR), showing an odds ratio of 2.90 compared to antihistamines alone. ' The combination therapy effectively reduces clinical severity, evidenced by lower Urticaria Activity Score over 7 days (UAS7). ' Patient quality of life improves, as indicated by a notable reduction in the Dermatology Life Quality Index (DLQI) scores. ' The treatment modulates immune response, increasing beneficial IFN-γ levels and decreasing IL-10 levels, suggesting restored gut-skin axis balance. ' Probiotic use may lead to a reduced incidence of overall adverse events (AER) and potentially lower recurrence rates for urticaria sufferers. ' This meta-analysis confirms probiotics' potential as a safe and effective complementary strategy for the management of acute and chronic urticaria.

🅼 Clinical Relevance

Probiotics offer a non-pharmacological adjunct to standard antihistamine treatment for urticaria, significantly boosting clinical outcomes, reducing disease activity (UAS7), and enhancing quality of life (DLQI). The findings suggest that targeting the gut-skin axis with safe probiotic supplementation should be integrated into urticaria management guidelines, especially in patients with chronic forms or those prone to adverse events.

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10/12/2025

🅜🅔🅣🅐 Published Today (December 9, 2025) - Meta-analysis comparing SGLT2 inhibitors and GLP-1 RAs in Type 2 Diabetes (T2D) patients. It clarifies their complementary roles in cardiovascular (CV) protection, heart failure (HF), and kidney disease (CKD) prevention. TITLE: SGLT2 INHIBITORS VS GLP-1 RECEPTOR AGONISTS: COMPLEMENTARY CARDIORNAL BENEFITS IN TYPE 2 DIABETES

🅼 Link: https://doi.org/10.1007/s44254-025-00154-x

🅼 Key Findings:

‘ SGLT2 inhibitors (SGLT2i) are generally preferred for Type 2 Diabetes (T2D) patients with heart-failure risk or chronic kidney disease (CKD) due to robust reduction in hospitalizations for heart failure (HHF) and kidney composite outcomes. ‘ GLP-1 receptor agonists (GLP-1RA) are compelling for T2D patients with atherosclerotic risk, providing robust reduction in Major Adverse Cardiovascular Events (MACE), particularly non-fatal stroke. ‘ SGLT2i showed superiority over GLP-1RA for kidney outcomes and HHF reduction. GLP-1RA were at least as effective for MACE and stroke reduction. ‘ Evidence suggests that the combined or sequential use of SGLT2i and GLP-1RA offers complementary and additive cardiorenal protection, representing a paradigm shift toward integrated CKM syndrome management. ‘ Safety profiles differ: SGLT2i increase risk of ge***al infections and rare DKA, while GLP-1RA increase risk of gastrointestinal (GI) events and gallbladder disease.

🅼 Clinical Relevance

Individualized therapy for Type 2 Diabetes is crucial. Prioritize SGLT2i for patients with heart failure (HF) or CKD risk, and GLP-1RAs for those with atherosclerotic CVD risk (like history of stroke). The complementary mechanisms of both classes support their combined use to achieve optimal cardiovascular and kidney protection, shifting management toward a comprehensive cardio-kidney-metabolic (CKM) approach.

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09/12/2025

🅜🅔🅣🅐 Published Today Monday, December 8, 2025 (Exact publication date in the Philippines is unavailable.) - Meta-analysis on Extracellular Vesicles (EVs) proteome, tracking protein abundance and aggregation during aging, stress, and diseases in C. elegans and human tissues. It aims to find new age-related disease biomarkers.

TITLE: META-ANALYSIS OF EXTRACELLULAR VESICLES-ASSOCIATED PROTEIN ABUNDANCE AND AGGREGATION DURING AGING AND DISEASE IN C. ELEGANS

🅼 Link: https://doi.org/10.1007/s10522-025-10362-4

🅼 Key Findings:

• Extracellular Vesicles (EVs), tiny messengers that mediate intercellular communication , carry proteins vital for organism-wide proteostasis (protein quality control).

• The abundance of EV-associated proteins (EVAPs) changes significantly in response to age, heat stress, pathogen infections, and various diseases.

• A subset of these EVAPs was found to aggregate with age and showed an overlap with protein aggregates driven by Amyloid-beta (Aβ), a key marker of Alzheimer's disease.

• The study successfully identified human orthologs of the C. elegans EVAPs in human brain tissues affected by Alzheimer's disease and breast cancer.

• This research highlights the dynamics of EV protein composition and their changes during aging and disease, suggesting a critical role in disease progression.

• The findings suggest that EVAPs could serve as potential novel biomarkers for identifying and monitoring age-related diseases.

🅼 Clinical Relevance

By identifying specific changes in Extracellular Vesicle proteins linked to aging and neurodegenerative conditions like Alzheimer's and cancer, this meta-analysis paves the way for developing non-invasive biomarkers. These biomarkers could potentially be used for early diagnosis, risk assessment, and tracking therapeutic efficacy for a wide range of age-related diseases, ultimately improving patient outcomes.

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09/12/2025

🅜🅔🅣🅐 Published Today (December 06, 2025) - This meta-analysis assesses the effectiveness and safety of intravenous Ferric Carboxymaltose (FCM) for iron-deficiency anemia in Chronic Kidney Disease (CKD) patients not on dialysis.TITLE: INTRAVENOUS FERRIC CARBOXYMALTOSE VERSUS ORAL IRON IN PATIENTS WITH NON-DIALYSIS-DEPENDENT CHRONIC KIDNEY DISEASE AND IRON DEFICIENCY ANEMIA: A META-ANALYSIS🅼 Link: https://doi.org/10.1007/s00383-025-06265-7🅼 Key Findings:The use of Intravenous (IV) Ferric Carboxymaltose (FCM) in non-dialysis-dependent Chronic Kidney Disease (NDD-CKD) patients with Iron Deficiency Anemia (IDA) is superior to oral iron in achieving higher hemoglobin (Hb) levels.FCM administration leads to a faster and more significant increase in Hb concentration compared to oral iron supplementation, aiding in quicker correction of anemia.IV FCM is more effective in replenishing iron stores, demonstrated by significantly higher increases in ferritin and transferrin saturation (TSAT) compared to oral iron.The meta-analysis suggests that FCM is generally well-tolerated and safe in this patient population, with no significant increase in serious adverse events (SAEs) compared to oral iron.A high-ferritin target strategy for FCM (400–600 $\mu$g/L) was found to be more effective at improving Hb than a lower target (100–200 $\mu$g/L) or oral iron.The use of IV FCM may help reduce the need for Erythropoiesis-Stimulating Agents (ESAs) or blood transfusions, offering a more efficient anemia management strategy.🅼 Clinical RelevanceIV FCM is a more effective first-line treatment option than oral iron for IDA in NDD-CKD patients, providing faster and more robust correction of anemia and iron stores. This improvement can enhance quality of life and potentially slow CKD progression by mitigating the effects of anemia. The high-dose, less-frequent administration of FCM also improves patient compliance and convenience. . 41:10: | Ghost Crafted by Meta Pro!

06/12/2025

🅜🅔🅣🅐 Published Today (5 December 2025) - This systematic review and meta-analysis evaluates the effectiveness of physical activity (PA) interventions for colorectal cancer survivors. It finds a moderate increase in PA but notes low evidence certainty and publication bias.TITLE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PHYSICAL ACTIVITY INTERVENTIONS IN COLORECTAL CANCER SURVIVORS: AN EVIDENCE EVALUATION ATTEMPT ACROSS RACIAL/ETHNIC GROUPS🅼 Link: https://doi.org/10.3390/healthcare13243198🅼 Key Findings:' A systematic review and meta-analysis of 16 randomized controlled trials (RCTs) including 1668 colorectal cancer (CRC) survivors assessed the impact of physical activity (PA) interventions.' A moderate, statistically significant increase in PA was observed overall ($g = 0.44$, $p = 0.01$).' The analysis revealed substantial inconsistency between studies ($I^2 = 80.8\%$) and evidence of publication bias (small-study effects).' A major limitation for equity analysis was that only 28% of trials reported the participants' race/ethnicity.' Subgroup comparisons showed no statistical difference between atheoretical and theory-based PA interventions.' The overall certainty of evidence (GRADE) that PA interventions improve PA among CRC survivors was assessed as low.' PA improvements were suggested to be associated with specific behavior change theories and certain intervention delivery features, requiring further focused research.🅼 Clinical RelevanceDespite low certainty, PA interventions show a potential benefit for colorectal cancer (CRC) survivors. Clinicians should be aware of the high heterogeneity and the pressing need for standardized reporting of race/ethnicity in future trials to ensure equitable care delivery. The findings underscore that PA promotion remains critical for cancer survivorship, but better-designed studies are needed to confirm optimal intervention strategies. . 41:10: | Ghost Crafted by Meta Pro!

04/12/2025

🅜🅔🅣🅐 Published Today December 3, 2025 - This meta-analysis reviews double-blind randomized clinical trials to evaluate the effectiveness and safety of using oral probiotic supplements as an adjunctive treatment for acne vulgaris, a common skin disease. TITLE: ORAL PROBIOTICS IN ACNE VULGARIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF DOUBLE-BLIND RANDOMIZED CLINICAL TRIALS

🅼 Link: https://doi.org/10.3390/medicina61122152

🅼 Key Findings:

` Oral probiotics demonstrate potential for a modest reduction in acne severity, offering a promising, antibiotic-sparing adjunct to current treatments.

` The intervention is generally deemed safe; however, clinicians should note that the current evidence is based on a small and heterogeneous selection of clinical trials.

` Due to study limitations, the certainty of the observed clinical effect remains low-to-moderate, underscoring the need for careful application in practice.

` Acne vulgaris represents a major public health issue globally, with high frequency and significant psychosocial consequences, including anxiety and low self-esteem.

` Further larger, well-standardized, double-blind Randomized Clinical Trials (RCTs) are critically needed to fully substantiate these findings and establish definitive clinical guidelines.

` Timely and effective acne management is vital to mitigate permanent physical and psychological sequelae, such as scarring and persistent post-inflammatory dyspigmentation.

🅼 Clinical Relevance

This meta-analysis supports the use of oral probiotics as a potentially safe, non-antibiotic treatment adjunct for acne vulgaris, particularly beneficial for patients seeking alternatives to conventional drug regimens. Dermatologists should counsel patients that while promising, the current evidence base is not robust enough for a primary recommendation. It highlights the importance of the gut health-skin axis in treatment planning.

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Metanalyses

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