Search Results (8,099)

Exerkines are released in response to physical exercise and play a key role in promoting health, such as taking part in modulating brain morphology and function. Expression levels of some of them are associated with an increase in neuroplasticity and a decrease in the risk of brain-related diseases such as dementia and depression. Therefore, our objective is to investigate the response of exerkines in healthy individuals and its potential to promote brain health. The search was performed in five databases. Randomized controlled trials of humans and animals of all ages who performed acute and/or long-term exercise and assessed the effects of exerkines were included. Human data were used for quantitative analysis, and animal experiments were included as part of the qualitative analysis. No meta-analyzes were conducted on animal data; preclinical findings are presented solely to contextualize mechanisms and are not used for clinical inference. Eventually, the sample consisted of 3321 individuals, with an age range from 10 to 89 years. Meta-analysis reveals that both acute and chronic exercise induced increases in the brain-derived neurotrophic factor and insulin-like growth factor 1 in older adults. Other exerkines such as cathepsin B and vascular endothelial growth factor have also demonstrated potential power for brain health. In conclusion, physical exercise by altering the levels of exerkines may be a feasible strategy for healthy individuals aiming at healthy aging of the brain. Moreover, it is advisable to analyze additional exerkines or multiple simultaneous applications to assess the cerebral effects during physical exercise. PROSPERO registration number: CRD42023438803. Full article

Due to long-term burial underground, oil and gas pipelines are susceptible to external surface corrosion influenced by time and soil conditions, which can lead to leakage and burst failures. Pipeline failure not only results in significant economic losses but also has catastrophic impacts on human safety and the environment. Therefore, modeling and analyzing the corrosion failure of these pipelines is of critical practical importance to ensure their safe operation during service. Addressing the insufficient research on correlation effects in current reliability evaluations of corroded pipelines, this paper proposes a calculation method for the failure probability of corroded oil and gas pipelines that considers the influence of two-layer correlations. Taking a specific segment of the Shaanxi–Beijing pipeline as a case study, the Monte Carlo sampling algorithm is employed to calculate the impact of two-layer correlations and the quantity of defect on the pipeline’s failure probability. Furthermore, a sensitivity analysis of the correlation coefficients is conducted. The results indicate that the influence of defect correlation on pipeline failure probability is significantly more pronounced than that of random variable correlation. The probabilities of pinhole leakage and burst failure decrease as the correlation coefficient between defects increases, while they increase with the number of defects. Random variable correlation exhibits no impact on pinhole leakage probability; however, the burst failure probability decreases with an increasing correlation coefficient between wall thickness and pipe diameter, but increases as the correlation between initial defect length and depth grows. Furthermore, the correlation coefficient between axial and radial defect growth rates exerts a bidirectional effect on burst failure probability: during the first 25 years of the prediction period, the failure probability increases with the correlation coefficient, whereas it subsequently decreases after approximately 25 years. These findings are applicable to the reliability evaluation of oil and gas pipelines containing multiple corrosion defects, providing valuable technical references for ensuring safe operation and the steady supply of energy resources. Full article

Background: Cardiovascular diseases are the main cause of mortality and morbidity in Portugal, with coronary artery bypass grafting (CABG) being one of the most performed surgeries in cardiothoracic centers. After cardiac surgery, patients often experience a decrease in physical capacity, which results in an increased risk of mortality or hospitalization expenditures. The objective of this systematic review was to characterize changes in respiratory function in patients undergoing CABG. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using a predefined research strategy to identify relevant original studies published until August 2025. To be included, studies must have assessed adult patients submitted to CABG who evaluated the respiratory function before and after cardiac surgery. Studies that reported other types of cardiac surgery were excluded. The Risk of Bias in Non-randomized Studies-of-Exposure and the Cochrane risk-of-bias tool for randomized trials were used to analyze the risk of bias of the selected studies. Results: After screening 1184 potential articles, six studies met the inclusion criteria. The studies included participants who underwent CABG (n = 324), with a mean age ranging from 54.05 ± 13.6 to 67 ± 10 years. Conclusions: All included studies reported significant postoperative reductions in respiratory function following CABG, including forced vital capacity, forced expiratory volume in one second, maximal inspiratory pressure, and maximal expiratory pressure. Although these findings consistently indicate a decline in pulmonary function, the limited number of available studies limits the strength of the conclusions. This systematic review suggests that monitoring respiratory impairments after CABG may be clinically relevant to improve health-related quality of life. Full article

The plain river network region is faced with ecological and environmental challenges such as insufficient hydrological connectivity and degradation of ecosystem services under the influence of urbanization and human activities, and therefore attention needs to be paid to river network changes in this region and the synergistic benefits of natural–social–economic multidimensional factors. This study took the Lixiahe region, a typical plain river network region, as the research object, using Mann–Kendall, spatial autocorrelation analysis, random forest, multiple validation and Granger causality test of key drivers to analyze the spatiotemporal evolution of its river network from 2013 to 2025 and quantify driving mechanisms from natural, social and economic factors. The results showed that: (1) From 2013 to 2025, the Lixiahe Plain river network region tended to be trunk and artificial, with the number and connectivity of river networks showing an upward trend while the curvature of river network decreased significantly. (2) The Global Moran’s I index of the Lixiahe Plain river network decreased from 0.612 to 0.534, indicating a continued weakening of spatial agglomeration in the water area and exhibiting characteristics of edge fragmentation. (3) Random forest analysis showed that socioeconomic factors dominated recent river network change in the Lixiahe Plain. Economic factors mainly influenced quantity-related indicators, while social factors were more important for meander degree and connectivity in several ecologically sensitive counties. Multilevel validation demonstrated the robustness and generalization ability of the model. Granger causality analysis further indicated that GDP, road network density, freshwater aquaculture area, and agricultural output statistically preceded changes in key hydrological indicators. These findings suggest that river network management in plain river network regions should move beyond quantity-based engineering expansion and adopt a multi-indicator, spatially differentiated approach. Integrating river quantity, morphology, and connectivity into management can better support the balance between socioeconomic development and ecological protection and promote the sustainable optimization of river network. Full article

This paper proposes a novel four-dimensional strongly dissipative nonlinearly coupled hyperchaotic system, investigates its dynamical characteristics, and demonstrates its applicability through Deoxyribonucleic Acid (DNA)-encoded RGB image encryption. First, a four-dimensional nonlinearly coupled hyperchaotic system with strong dissipativity is constructed. Nonlinear dynamics analysis methods, including phase trajectory diagrams, Lyapunov exponent spectra, and bifurcation diagrams, are employed to thoroughly reveal the system’s complex dynamical evolution mechanisms. The analysis indicates that the system not only possesses a wide range of chaotic parameters but also exhibits rich phenomena of multiple coexisting attractors, demonstrating a high degree of multistability. This characteristic offers potential advantages for image encryption, as it increases the diversity of dynamical behaviors and enhances sensitivity to initial conditions. The physical realizability of the chaotic behavior is further verified through an analog circuit implementation. Consequently, the system supports the design of encryption algorithms with larger key spaces, stronger resistance to phase space reconstruction, and improved pseudo-randomness, making it particularly suitable for applications with extremely high security requirements. Subsequently, leveraging the highly random chaotic sequences generated by this system, combined with various DNA coding rules and operations, the RGB image components are scrambled and diffused for encryption. Security analysis demonstrates that the algorithm effectively passes examinations across multiple dimensions, including histogram analysis, information entropy, adjacent pixel correlation, Number of Pixel Change Rate (NPCR), Unified Average Changing Intensity (UACI), and The Peak Signal-to-noise Ratio (PSNR). It achieves favorable encryption results, significantly enhances image resistance against attacks, and provides a reliable technical solution for the secure transmission of remote sensing and military images. Full article

Background/Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but severe complication of antiresorptive therapy for osteoporosis. This study investigated bacterial adhesion and microbial composition on two suture materials and their potential impact on early wound healing following tooth extraction in patients receiving antiresorptive therapy. Methods: In this prospective exploratory clinical study with partially randomized allocation, female patients undergoing antiresorptive therapy were evaluated for clinical parameters, including the Mombelli Plaque Index (MPI), Mombelli Bleeding Index (MBI), oral smear analysis, and Early Wound Healing Score (EHS). Suture samples (Vicryl and Monocryl, Ethicon, Germany) were removed after 10 days, measured, and weighed. Bacterial DNA was isolated and quantified by qPCR targeting the albumin and 16S rRNA genes. In addition, 16S rRNA gene amplicon sequencing was performed to assess the microbial community composition. Statistical and bioinformatic analyses were conducted to compare materials and evaluate the clustering patterns. Results: Fifty-two suture samples were analyzed. Vicryl exhibited significantly higher 16S rRNA gene copy numbers than Monocryl, indicating increased bacterial colonization, whereas albumin gene copy numbers were significantly higher in Monocryl. The suture weight correlated primarily with albumin gene copy numbers. Amplicon sequencing revealed no material-dependent differences in the microbial composition; instead, samples clustered predominantly by patient, particularly in split-mouth cases. The wound healing outcomes based on the EHS were comparable between materials. Conclusions: Although Vicryl and Monocryl differ in bacterial load and host material deposition, the microbial community composition is primarily patient-specific and the clinical healing outcomes are similar. Surgical management and patient-related factors appear more critical than suture material selection. Full article

Background/Objectives: Placental vascular malperfusion, on both the maternal (MVM) and fetal (FVM) side, is a key mechanism linking hypertensive disorders of pregnancy, fetal growth restriction (FGR), stillbirth, preterm neonatal death and neonatal encephalopathy. Nevertheless, clinical use and medico-legal interpretation of placental findings remain inconsistent. To summarize recent evidence on the relationship between placental vascular malperfusion, perinatal mortality and neonatal brain injury, integrating standardized placental pathology with Doppler and angiogenic biomarkers, and to outline the main medico-legal implications. Methods: A PubMed search using the string “((placenta OR placental pathology) AND (stillbirth OR fetal death) AND (maternal vascular malperfusion OR fetal vascular malperfusion))” yielded 118 records. After excluding reviews, meta-analyses, case reports (except one illustrative SARS-CoV-2 placentitis case), non-human studies and papers without original histopathology, 33 studies were included: observational cohorts and case–control studies with standardized placental assessment, autopsy series, biomarker/Doppler cohorts, mechanistic work, one randomized trial protocol and a small number of focused clinical commentaries. Results: Across these studies, MVM emerges as the dominant placental lesion in pre-eclampsia, FGR and a large proportion of stillbirths, especially in early-onset disease and in association with maternal hypertension. FVM is strongly linked to stillbirth and term neonatal encephalopathy, and specific combinations of MVM, FVM and inflammatory lesions correspond to distinct patterns of brain injury. Large population-based cohorts confirm that maternal hypertensive disorders and placental malperfusion are major upstream causes of intrauterine hypoxia and preterm neonatal death. Doppler velocimetry and angiogenic biomarkers (PlGF, sFlt-1 and their ratio) are strongly associated with an increased likelihood of underlying MVM and adverse neonatal outcomes, although their predictive performance remains probabilistic and context-dependent rather than diagnostic. Mechanistic studies suggest roles for placental genomic instability and altered decidual immunity in defective placentation. Conclusions: Maternal and fetal vascular malperfusion represent converging pathways to FGR, stillbirth, preterm neonatal death and neonatal encephalopathy. Routine, standardized placental examination, interpreted together with Doppler and biomarker data, substantially improves causal attribution and timing of injury, with direct consequences for counselling, prevention and medico-legal assessment. Full article

Background: Almost all correlation measures currently available are unable to directly handle missing values. Typically, missing values are either ignored completely by removing them or are imputed and used in the calculation of the correlation coefficient. In either case, the correlation value will be impacted based on the perspective that the missing data represents no useful information. However, missing values occur in real datasets for a variety of reasons. In metabolomics datasets a major reason for missing values is that a specific measurable phenomenon falls below the detection limits of the analytical instrumentation (left-censored values). These missing data are not missing at random, but represent potentially useful information by virtue of their “missingness” at one end of the data distribution. Methods: To include this information due to left-censored missingness, we propose the information-content-informed Kendall-tau (ICI-Kt) methodology. We develop a statistical test and then show that most missing values in metabolomics datasets are the result of left-censorship. Next, we show how left-censored missing values can be included within the definition of the Kendall-tau correlation coefficient, and how that inclusion leads to an interpretation of information being added to the correlation. We also implement calculations for additional measures of theoretical maxima and pairwise completeness that add further layers of information interpretation in the methodology. Results: Using both simulated and over 700 experimental data sets from the Metabolomics Workbench, we demonstrate that the ICI-Kt methodology allows for the inclusion of left-censored missing data values as interpretable information, enabling both improved determination of outlier samples and improved feature–feature network construction. Conclusions: We provide explicitly parallel implementations in both R and Python that allow fast calculations of all the variables used when applying the ICI-Kt methodology on large numbers of samples. The ICI-Kt methods are available as an R package and Python module on GitHub. Full article

Distracted driving is one of the primary causes of road traffic accidents. Behavior recognition technology based on machine vision has emerged as a research hotspot due to its non-contact and high-efficiency nature. To address the challenges of complex lighting conditions in the driver’s cabin, low detection accuracy for small-scale keypoints, and the difficulty in effectively characterizing behavioral features, this paper proposes a distracted driving behavior recognition method based on an improved YOLOv8n-Pose model and multi-feature fusion. First, the original YOLOv8n-Pose model is optimized. A P2 detection layer is added to enhance the feature extraction capabilities for small-scale human keypoints, and the SE attention module is incorporated to improve the model’s robustness under complex lighting conditions. In addition, the loss function is replaced with focal loss to tackle the class imbalance problem, thus forming the YOLOv8n-PSF-Pose keypoint detection network. Subsequently, based on the coordinates of 12 human keypoints extracted by this network, a multi-dimensional feature vector is constructed, which takes joint angles as the core and integrates the relative distances between keypoints and the number of valid keypoints. Finally, a BP neural network is adopted to classify the constructed feature vectors, enabling the accurate recognition of six typical distracted driving behaviors (normal driving, drinking or eating, making phone calls, using mobile phones, operating vehicle infotainment systems, and turning around to fetch items). The experimental results show that the improved YOLOv8n-PSF-Pose model achieves an mAP50 of 93.8% in keypoint detection, which is 6.7 percentage points higher than the original model; the BP classification model based on multi-feature fusion achieves an F1-score of 97.7% in the behavior recognition task, which is significantly better than traditional classifiers such as SVM and random forest, and the image processing speed on the NVIDIA RTX 3090TI reaches a high throughput of 45 FPS. This proves that the proposed method achieves an excellent balance between accuracy and speed. This study provides an effective solution for the real-time and accurate recognition of distracted driving behaviors. Full article

Background/Objectives: Telerehabilitation expands access to specialized neuropediatric physiotherapy for families facing barriers related to geography, work, or caregiving. This systematic review aimed to summarize the evidence regarding the effects of telerehabilitation on gross motor function (GMF) in children with cerebral palsy (CP). Methods: An electronic search was conducted in the following databases: PubMed, Web of Science, Embase, and the Cochrane Library; Google Scholar was consulted for additional literature. The search targeted randomized and non-randomized intervention studies evaluating the effects of telerehabilitation on GMF in children with CP at various levels of the Gross Motor Function Classification System (GMFCS), as well as related functional outcomes. The risk of bias in the included studies was assessed using the original Cochrane Collaboration risk of bias tool. The certainty of evidence was graded according to the GRADE framework. Results: Five studies involving 152 children were included, with CP aged 2.5 to 17 years. Telerehabilitation programs varied in duration, frequency, and type of intervention, as well as in caregiver involvement, comparator conditions, and outcome measures. The included studies suggested potential benefits in GMF and related functional outcomes; however, findings were heterogeneous, and superiority over comparison conditions was not consistently demonstrated. Conclusions: Although the reviewed studies suggest that telerehabilitation may be a feasible and potentially beneficial approach for children with CP, the limited number of studies and variability of interventions highlight the need for caution in interpreting these findings. Further high-quality studies with standardized outcome reporting are needed to clarify its contribution to GMF. Full article

Background: Carbohydrate quality and culinary processing can meaningfully alter postprandial glycemia in people with type 1 diabetes (T1D). Cooling gelatinized starch promotes retrogradation and increases resistant starch (RS), potentially attenuating postprandial glucose excursions. Objectives: We investigated whether pasta cooled after cooking (24 h at 4 °C) and reheated before consumption improves postprandial glycemia in adults with T1D without increasing hypoglycemia risk under routine insulin pump bolus-calculator dosing. Methods: In this randomized, single-blind, crossover study, 32 adults with T1D treated with continuous subcutaneous insulin infusion (CSII) consumed two standardized pasta-based meals (50 g of available carbohydrate): freshly cooked pasta and cooled/reheated pasta. Participants administered rapid-acting insulin boluses calculated by their pump bolus calculator 10 min before the meal. Interstitial glucose was recorded for 180 min using flash glucose monitoring. Results: Compared with freshly cooked pasta, cooled/reheated pasta produced lower maximum glycemia (10.7 vs. 12.6 mmol/L, p = 0.0001), lower maximum glycemic rise (2.8 vs. 4.7 mmol/L, p < 0.0001), lower incremental area under the curve (iAUC; 211.9 vs. 524.8 mmol/L × 180 min, p < 0.0001), and a shorter time-to-peak (65 vs. 125 min, p = 0.014). Resistant starch content increased after cooling (12.88 ± 0.06 vs. 8.03 ± 0.08 g/100 g). The number of hypoglycemic episodes did not differ between conditions. Conclusions: Cooling and reheating pasta therefore increased RS and attenuated postprandial glycemia in adults with T1D without increasing early postprandial hypoglycemia in the studied setting. Full article

Background: Catheter-associated urinary tract infections (CAUTIs) are a common source of morbidity and antibiotic use. Camstent Ltd. surface coated catheters aim to reduce bacterial colonization and infection. This study compares outcomes with Camstent Coated Catheters (CCC) versus standard uncoated catheters, Standard Care (SC). Objectives: The aim of the study was to investigate the reduction in bacteriuria in CCC versus SC, uncoated catheters. Methods: This is a prospective, UK, multi-center, randomized study including an Intention to Treat (ITT) population and a Per Protocol (PP) population of 200 and 188 subjects respectively. The PP population was sub-divided into primary and secondary cohorts with 107 and 81 subjects considered for study randomization receiving either a CCC or SC respectively. The primary endpoints including time to infection, number of days of infection and incidence of infection, and secondary endpoints including time to symptoms, UTI antibiotic use, patient reported outcomes like patient discomfort and catheter blockage were evaluated at days 0, 3, 5, 7, 10, 14, 21 and 28. For statistical analysis, Hodges–Lehmann and Fisher’s exact test were used. Results: The primary end points: Colonization-free rates at day 7 were higher in the CCC group than in the SC group (79% versus 46%) and the difference persisted on day 14 (69% versus 39%) (p = 0.016); the mean number of days infected during the first 14 days was lower in the CCC group than the SC group (3 versus 4.6 days) (two-sided; p = 0.0117); the infection rates at day 14 were lower in the CCC group than SC group (33% versus 50%). This trend continued at days 21 and 28, with consistently lower infection rates in the CCC group than SC group but did not reach statistical significance (p > 0.05). The secondary endpoint is in the secondary cohort: Time to the development of symptoms defined as a UTI requiring antibiotics showed that zero cases occurred in the CCC compared with the SC group (0% versus 20%) at p = 0.0054; median time to symptoms in the SC group was 9.0 days; and expanding this endpoint to include the primary cohort revealed that symptomatic infections occurred at 4% in the CCC group and 20% in the SC group (p = 0.0007) with a longer median time to symptoms in the CCC group than SC (13.5 versus 7 days); UTI antibiotic use was significantly lower in the CCC group than the SC group (4% vs. 21%). Conclusions: Compared with SC, CCCs were associated with substantial reductions in bacterial colonization, symptomatic CAUTI, and antibiotic use, supporting their adoption within strategies to prevent CAUTIs and promote antimicrobial stewardship. Trial registration: This study was registered prospectively in the Clinical Trials Registry (NCT04461262; Study Details|NCT04461262|The Impact Of A Catheter Coating On Clinical Bacteriuria|r). Full article

As an efficient solid–liquid separation device, the hydrocyclone is widely applied in various industrial fields such as coal preparation and oil impurity removal, and its classification performance directly determines the efficiency of industrial separation operations., As the core separation zone of the hydrocyclone, the cone segment, its structure and the number of cone angles directly affect the flow field distribution characteristics and particle classification performance of the hydrocyclone. To reveal the regulation mechanism of the combined cone angles on the classification performance of hydrocyclones, numerical analysis and experimental verification methods were adopted to investigate the internal flow field and classification performance of hydrocyclones under different cone angle combinations. The evolution laws of velocity field, pressure field, turbulence characteristics, and particle classification effect under different configurations were systematically explored. The results show that the basic characteristics of the core flow field of the hydrocyclone do not change essentially with the increase in the number of cone segments, but the amplitude, distribution, and stability of flow field parameters are significantly regulated. The three-cone configuration achieves the optimal flow field synergy effect: the amplitude of the high turbulence intensity zone is lower and concentrated near the central axis; the zero-velocity envelope surface is stably maintained at approximately 8 mm in the core separation zone; and the full axial fluctuation of the air core is gentle, which effectively inhibits random particle diffusion and flow pattern mixing. In terms of separation performance, the three-cone configuration exhibits the highest classification efficiency in the core range of sub-coarse particles (10~30 μm), with the cut size (approximately 17.5 μm) in a reasonable range, the steepness index reaching a peak value (approximately 0.55), and the pressure drop (approximately 1.8 × 10⁵ Pa) and split ratio (2.8%) achieving synergistic optimization, balancing separation accuracy and energy consumption control. The single-cone configuration causes flow field disturbance due to the one-time contraction of the flow channel, while the four-cone configuration falls into the dilemma of “high pressure drop–marginal performance gain”, and neither achieves optimal performance. The regulation law of the number of cone segments revealed in this study provides a scientific basis for the structural optimization and engineering application of multi-cone hydrocyclones, and is of great significance for improving the particle classification efficiency in fields such as wastewater treatment and mineral processing. Full article

Background: We assessed the effects of a 6-week, low-volume Nordic hamstring exercise (NHE) intervention on hamstring flexibility, muscle mechanical properties and eccentric and isometric isokinetic knee flexion strength in recreationally active adults. Methods: Eighteen recreationally active adults were randomized into an NHE intervention group (IG; n = 9; females/males: 3/6; mean ± SD, age: 24.1 ± 1.3 years) and control group (CG; n = 9; females/males: 5/4; mean ± SD, age: 23.5 ± 1.8 years). The NHE intervention involved a progressive, supplementary training program performed initially one (weeks 1 and 2) and then two times per week over a 6-week period. The number of repetitions per session increased from 15 to 36 repetitions/week. The CG maintained their usual exercise routine over the same period. Standard goniometry, myotonometry, and isokinetic dynamometry (60°/s) were used to measure hamstring flexibility, muscle properties and isometric and eccentric isokinetic strength prior to and five days following the intervention. Results: The Linear Mixed Methods analysis identified a significant group × time interactions for isometric torque (IG: +5% vs. CG: −12%, p = 0.022) and flexibility (IG: +1% vs. CG: +7%, p = 0.023). Peak eccentric torque (IG: +7% vs. CG: −7%, p = 0.053) and muscle mechanical properties remained unchanged over the intervention period. Conclusions: Six weeks of low-volume NHE training marginally improved isometric and eccentric hamstring strength in recreationally active adults without changing hamstring flexibility or mechanical properties. The findings may have important implications for performance enhancement and hamstring injury risk reduction during high-intensity recreational sports. Full article

Background: Despite major advancements in the treatment of post-acute coronary syndrome (ACS), the prevalence of early and late major adverse cardiovascular events (MACEs) remains high. Inflammation, a key feature of atherosclerosis, plays an important role in the healing process following ACS. This suggests that anti-inflammatory agents might improve both atherosclerotic progression and cardiovascular outcomes. Colchicine has potent anti-inflammatory effects and may, therefore, be a suitable agent for mitigating this response. Methods: We conducted a systematic search up to September 2025 across Embase, MEDLINE, the Cochrane databases, and the Clinical Trials.gov registry to assess whether colchicine administration after ACS reduces the risk of a MACE (a composite of cardiovascular death, ACS, stroke, and urgent revascularization). We selected placebo-controlled randomized trials enrolling more than 500 participants, in which colchicine was administered as a long-term intervention, defined as treatment and/or follow-up of at least 12 months, and in which MACEs were assessed as the primary endpoint. Results: We included three large, long-term, placebo-controlled randomized trials (n = 12,602 participants). Primary events occurred in 485 participants in the colchicine group and 551 in the control group, with a calculated odds ratio (OR) of 0.87 (95% CI 0.77–0.99, p = 0.03), with high heterogeneity between studies (I² ≈ 71%): p for heterogeneity ≈ 0.03. Subgroup analysis of diabetic patients (OR 0.81, 95% CI 0.63–1.04), as well as of individual components of the primary outcome, showed non-significant effects: OR= 0.92 (95% CI 0.76–1.11, p = 0.38) for myocardial infarction, OR = 0.88 (95% CI 0.72–1.07, p = 0.15) for revascularization, OR = 1.09 (95% CI 0.86–1.38, p = 0.29) for cardiovascular death, and OR = 0.89 (95% CI 0.63–1.27, p = 0.47) for stroke. Conclusions: In this meta-analysis of large, long-term, placebo-controlled randomized trials, colchicine administration after ACS was associated with a modest reduction in MACEs. However, the proximity of the confidence interval to unity reflects a statistical equilibrium between opposing trial-level effects rather than a robust treatment signal. Further investigation is warranted, given the small number of existing large trials and their heterogeneity. Full article