Background: Air pollution and particularly the fine particulate matter (PM2.5) is a major environmental risk factor of cardiovascular diseases (CVD). Millions of untimely deaths every year have been reported because of it. The epidemiological literature has linked long-term exposure to PM2.5 and mortality rates of CVDs. This meta-analysis aims to synthesize the estimates of long-term PM2.5 exposure and CVDs. Methods: Based on the PRISMA guidelines, PubMed, Embase, Web of Science, and Scopus were searched up to October 2025. Random-effects model was used to pool HRs, and the heterogeneity was measured with the help of I². Results: Four studies were included in this meta-analysis. There was an increased incidence of CVD with higher exposure to PM2.5 on a long-term basis (pooled HR=1.22, 95% CI: 1.06–1.41; p=0.006; I²=96%). CVD mortality did not show any significant association with PM2.5 exposure (pooled HR=1.00, 95% CI: 0.71–1.41; p=0.98; I²=29%). No significant difference was found between the PM2.5 exposure and ischemic heart disease (IHD) (pooled HR=1.65, 95% CI: 0.90–3.00; p=0.10; I²=95%). The Same pattern was noted between the PM2.5 exposure and stroke (pooled HR=1.61, 95% CI: 0.96–2.68; p=0.07; I²=74%). Conclusion: The PM2.5 exposure is associated with high CVD in the long term. Results reveal the significance of establishing strict air-drome quality standards and targeted interventions to mitigate the risks in the areas of issues. More integrated studies are required to support our findings and fill the knowledge gap.

Background: Gastric and gastroesophageal junction (GEJ) cancer is not responsive to surgery and perioperative chemotherapy. Immune checkpoint inhibitors (ICIs) have been effective in advanced disease. This meta-analysis assesses the benefits of the addition of ICIs to perioperative chemotherapy in case of resectable gastric/GEJ cancer. Methods: PubMed, Embase, Cochrane CENTRAL and Web of Science were identified until 2026. Randomized controlled trials with comparison of perioperative ICI with chemotherapy against chemotherapy were included. A random-effects model was used to. Risk ratios was calculated for all the dichotomous outcomes. I² was used to assess the heterogeneity. Results: Four trials (2,125 patients) were included. ICI plus chemotherapy, however, had significant positive effects on pathological complete response (RR = 2.87; 95% CI: 1.66 -4.99; p = 0.018) and complete tumour regression (RR = 2.74; 95% CI: 1.24 -6.04; p = 0.006). No significant different was found for R0 resection rates and surgery completion between the two groups. Similarly, no significant different was found for adverse events, surgical morbidity, or deaths. However, immune-related adverse events (RR = 3.18; 95% CI: 2.48–4.08) and treatment discontinuation (RR = 1.31; 95% CI: 1.11–1.54) were significantly higher in ICI plus chemotherapy group. Conclusion: The inclusion of ICIs in perioperative chemotherapy enhances pathological response and does not pose more surgical risk. Although adverse events were high in the ICI plus chemotherapy group so large scale studies are needed to validate these findings.