highly significantP < 0.001
The natural logarithm of response ratios (LRR) exhibited highly significant heterogeneity among studies (I 2 = between 96.46 and 99.98%; Cochrane’s Q test = between 309.87 and 57,818.46; P < 0.001; SI Appendix , Table S1 ), with no evidence of publication bias (Rosenthal fail-safe, n = between 324 and 83,692, P < 0.001; SI Appendix , Table S2 ).