Accuracy of baseline low-dose computed tomography lung cancer screening: a systematic review and meta-analysis

Background:Screening using low-dose computed tomography(LDCT)is a more effective approach and has the potential to detect lung cancer more accurately.We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer.Methods:MEDLINE,Excerpta Medica Database,and Web of Science were searched for articles published up to April 10,2022.According to the inclusion and exclusion criteria,the data of true positives,false-positives,false negatives,and true negatives in the screening test were extracted.Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature.A bivariate random effects model was used to estimate pooled sensitivity and specificity.The area under the curve(AUC)was calculated by using hierarchical summary receiver-operating characteristics analysis.Heterogeneity between studies was measured using the Higgins I 2 statistic,and publication bias was evaluated using a Deeks’funnel plot and linear regression test.Results:A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis;most of them were from Europe and America(38 studies),ten were from Asia,and one was from Oceania.The recruitment period was 1992 to 2018,and most of the subjects were 40 to 75 years old.The analysis showed that the AUC of lung cancer screening by LDCT was 0.98(95%CI:0.96-0.99),and the overall sensitivity and specificity were 0.97(95%CI:0.94-0.98)and 0.87(95%CI:0.82-0.91),respectively.The funnel plot and test results showed that there was no significant publication bias among the included studies.Conclusions:Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer.However,long-term follow-up of the whole study population(including those with a negative baseline screening result)should be performed to enhance the accuracy of LDCT screening.

Strontium-substituted sub-micron bioactive glasses inhibit ostoclastogenesis through suppression of RANKL-induced signaling pathway

Strontium-substituted bioactive glass(Sr-BG)has shown superior performance in bone regeneration.Sr-BG-induced osteogenesis has been extensively studied;however,Sr-BG-mediated osteoclastogenesis and the underlying molecular mechanism remain unclear.It is recognized that the balance of osteogenesis and osteoclastogenesis is closely related to bone repair,and the receptor activators of nuclear factor kappaB ligand(RANKL)signaling pathway plays a key role of in the regulation of osteoclastogenesis.Herein,we studied the potential impact and underling mechanism of strontium-substituted sub-micron bioactive glass(Sr-SBG)on RANKL-induced osteoclast activation and differentiation in vitro.As expected,Sr-SBG inhibited RANKL-mediated osteoclastogenesis significantly with the experimental performance of decreased mature osteoclasts formation and downregulation of osteoclastogenesis-related gene expression.Furthermore,it was found that Sr-SBG might suppress osteoclastogenesis by the combined effect of strontium and silicon released through inhibition of RANKL-induced activation of p38 and NF-κB pathway.These results elaborated the effect of Sr-SBG-based materials on osteoclastogenesis through RANKLinduced downstream pathway and might represent a significant guidance for designing better bone repair materials.