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Cells Aug 2023Immunotherapy has recently been incorporated into the spectrum of biliary tract cancer (BTC) treatment. The identification of predictive response biomarkers is essential... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Immunotherapy has recently been incorporated into the spectrum of biliary tract cancer (BTC) treatment. The identification of predictive response biomarkers is essential in order to identify those patients who may benefit most from this novel treatment option. Here, we propose a systematic literature review and a meta-analysis of PD-1, PD-L1, and other immune-related biomarker expression levels in patients with BTC.
METHODS
Prisma guidelines were followed for this systematic review and meta-analysis. Eligible studies were searched on PubMed. Studies published between 2017 and 2022, reporting data on PD-1/PD-L1 expression and other immune-related biomarkers in patients with BTC, were considered eligible.
RESULTS
A total of 61 eligible studies were identified. Despite the great heterogeneity between 39 studies reporting data on PD-L1 expression, we found a mean PD-L1 expression percentage (by choosing the lowest cut-off per study) of 25.6% (95% CI 21.0 to 30.3) in BTCs. The mean expression percentages of PD-L1 were 27.3%, 21.3%, and 27.4% in intrahepatic cholangiocarcinomas (iCCAs-15 studies), perihilar-distal CCAs (p/dCCAs-7 studies), and gallbladder cancer (GBC-5 studies), respectively. Furthermore, 4.6% (95% CI 2.38 to 6.97) and 2.5% (95% CI 1.75 to 3.34) of BTCs could be classified as TMB-H and MSI/MMRd tumors, respectively.
CONCLUSION
From our analysis, PD-L1 expression was found to occur approximately in 26% of BTC patients, with minimal differences based on anatomical location. TMB-H and MSI molecular phenotypes occurred less frequently. We still lack a reliable biomarker, especially in patients with mismatch-proficient tumors, and we must need to make an effort to conceive new prospective biomarker discovery studies.
Topics: Humans; B7-H1 Antigen; Programmed Cell Death 1 Receptor; Biliary Tract Neoplasms; Immunotherapy; Biomarkers; Bile Duct Neoplasms; Bile Ducts, Intrahepatic
PubMed: 37626908
DOI: 10.3390/cells12162098 -
Women's Health (London, England) 2023Despite all efforts in Jordan to increase the demand and use of family planning services, many challenges have likely influenced fertility and contraceptive use... (Review)
Review
BACKGROUND
Despite all efforts in Jordan to increase the demand and use of family planning services, many challenges have likely influenced fertility and contraceptive use outcomes. Improving accessibility and availability of family planning services and interventions to married women and their spouse is essential to improve pregnancy outcomes.
OBJECTIVES
This study reviewed the gray and peer-reviewed literature published between January 2010 and June 2022 that described family planning interventions implemented in Jordan and highlighted the gaps identified in the literature.
ELIGIBILITY CRITERIA
For inclusion, primary studies that included information regarding family planning interventions implemented in Jordan were retained.
SOURCES OF EVIDENCE
PubMed database was searched between 2010 till June 2022, as well as bibliographies of the retrieved literature were screened for the relevant literature.
CHARTING METHODS
Information extracted from the interventions included author, publication year, study design and purpose, intervention name, aim of the intervention, population descriptor and sample size of the intervention, and impact of the intervention.
RESULTS
A total of 10 studies that met the inclusion criteria were reviewed. The studies described/assessed 10 different interventions including communication interventions, child preparation programs, evidence-based educational program, counseling interventions, pharmacist booklet on effective use of oral contraceptive pills and Village Health Center project. Five family planning interventions targeted women and five targeted health care providers. Three interventions targeted men, two targeted religious leaders, and two targeted community health committees. Many of the interventions suffered from a lack of a robust methodological framework.
CONCLUSION
This scoping review showed that there is scarce information on the implementation of High Impact Practices in Family Planning in Jordan. The review identified a lack of robust evidence on the impact and effectiveness of family planning interventions on the access to and use of family planning services and methods. There is a need for developing, implementing, and evaluating family planning interventions that elicit a positive environment and encourage the use of family planning services.
Topics: Child; Female; Humans; Male; Pregnancy; Contraception; Contraceptives, Oral; Counseling; Family Planning Services; Jordan
PubMed: 37119031
DOI: 10.1177/17455057231170977 -
European Journal of Public Health Feb 2016Colorectal cancer (CRC) is one of the most common cancers in men and women. CRC screening programmes have been implemented in various countries. However, the... (Review)
Review
BACKGROUND
Colorectal cancer (CRC) is one of the most common cancers in men and women. CRC screening programmes have been implemented in various countries. However, the participation rate remains disappointingly low. For a screening method to be beneficial, high participation rates are essential. Therefore, understanding the factors that are associated with CRC screening and follow-up adherence is necessary. In this systematic review, factors studied in literature were identified that are associated with CRC screening adherence.
METHODS
A systematic search in PUBMED, EMBASE and COCHRANE was performed to identify barriers and facilitators for CRC screening adherence. Study characteristics were summarized and analysed.
RESULTS
Seventy-seven papers met the inclusion criteria to be applicable for review. Female gender, younger participants, low level of education, lower income, ethnic minorities and not having a spouse were the most frequently reported barriers. Health provider characteristics, such as health insurance and a usual source of care were also frequently reported barriers in CRC screening adherence. Disparities were found in weight, employment status and self-perceived health status.
CONCLUSION
Barriers and facilitators of CRC screening participation are frequently reported. Understanding these factors is the first step to possibly modify specific factors to increase CRC screening participation rate.
Topics: Age Factors; Body Mass Index; Colorectal Neoplasms; Early Detection of Cancer; Health Behavior; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Health Status; Humans; Patient Acceptance of Health Care; Sex Factors; Socioeconomic Factors
PubMed: 26370437
DOI: 10.1093/eurpub/ckv148 -
Birth (Berkeley, Calif.) Jun 2021To estimate the prevalence and associated risk factors of perinatal depression in Pakistan. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the prevalence and associated risk factors of perinatal depression in Pakistan.
METHODS
We conducted a systematic search of Medline, PsycINFO, CINAHL, EMBASE, and Global health, up through May 31, 2019. Studies reporting on the prevalence of perinatal depression in Pakistan with or without associated risks factors were included.
RESULTS
Forty-three studies reporting data from 17 544 women met the eligibility criteria and were included. Overall, the pooled prevalence of antenatal depression was 37% (95% CI: 30-44), while that of postnatal depression was 30% (95% CI: 25-36). The prevalence of perinatal depression in women residing in urban areas and those living in rural settings was not significantly different. The most frequently reported risk factors for antenatal depression were intimate partner violence and poor relationship with spouse, and that reported for postnatal depression was low-income level. An unintended pregnancy was significantly associated with perinatal depression in Pakistan.
CONCLUSIONS
We identified variability in prevalence rate of perinatal depression in Pakistan. It is difficult to gauge the true magnitude of this problem potentially due to differing risk factors between the antenatal and postnatal periods and the lack of uniformity of data collection protocols and procedures. The high prevalence rates of 30%-37% compared to global estimates suggest policy makers and stakeholders should direct additional resources toward improving perinatal mental health in Pakistan.
Topics: Depression; Depression, Postpartum; Female; Humans; Mental Health; Pakistan; Pregnancy; Prevalence
PubMed: 33580505
DOI: 10.1111/birt.12535 -
Oral Oncology Nov 2016To enhance the value of care, interventions should aim at improving endpoints that matter to patients. The preferences of head and neck cancer patients regarding... (Review)
Review
INTRODUCTION
To enhance the value of care, interventions should aim at improving endpoints that matter to patients. The preferences of head and neck cancer patients regarding treatment outcomes are therefore a major topic for patient-centered research.
METHODS
A systematic review (PROSPERO number CRD42016035692) was conducted by searching electronic databases (Medline, Embase, Cochrane, CINAHL) for articles evaluating patient or surrogate preferences in head and neck cancer. A qualitative review was performed but no quantitative synthesis.
RESULTS
Of 817 references retrieved, 20full-text articles were eventually included in the qualitative analysis Disease sites included mixed head and neck tumor sites, n=9; larynx, n=6; oropharynx/oral cavity, n=5. Overall, patients prioritized survival over functional endpoints. However, preferences and utility scores varied greatly between patients and healthy subjects, and differences were less pronounced with spouses or healthcare providers. Findings from studies of laryngeal preservation are consistent and conclude that a subset of patients would be willing to compromise a certain amount of survival to avoid laryngectomy. On the other hand, studies of patients with oropharyngeal cancer are too heterogeneous to draw conclusions about acceptable functional trade-offs or priorities, and should be the focus of future research.
CONCLUSION
Future research surrounding head and neck cancer patients will most likely be clinically applicable if the questions are focused on well-defined patient groups and treatment options. Gathering reliable and valid quality-of-life data, designing patient preference studies that use reliable and generalizable methods, and using the results to develop decision aids for shared decision-making strategies are recommended going forward.
Topics: Head and Neck Neoplasms; Humans; Patient Preference
PubMed: 27865371
DOI: 10.1016/j.oraloncology.2016.09.008 -
Contraception Aug 2022Systematically review the existing evidence about couples-based interventions and postpartum contraceptive uptake and generate recommendations for future research. (Review)
Review
OBJECTIVE
Systematically review the existing evidence about couples-based interventions and postpartum contraceptive uptake and generate recommendations for future research.
DATA SOURCES
PubMed, Web of Science, PsycINFO, Embase, and CINAHL through June 7, 2021.
STUDY SELECTION AND DATA EXTRACTION
Studies with a couples-based intervention assessing postpartum contraceptive uptake. Two independent reviewers screened studies, extracted data, and assessed risk of bias with RoB-2 (Cochrane Risk of Bias 2) for randomized and ROBINS-I (Risk of Bias in Non-Randomized Studies - Interventions) for observational studies. Data were synthesized in tables, figures, and a narrative review.
RESULTS
A total of 925 papers were identified, 66 underwent full text review, and 17 articles, which included 18 studies - 16 randomized, 2 observational - were included. The lack of intervention and outcome homogeneity precluded meta-analysis and isolating the effect of partner involvement. Four studies were partner-required, where partner involvement was a required component of the intervention, and 14 were partner-optional. Unadjusted risk differences ranged from 0.01 to 0.51 in favor of couples-based interventions increasing postpartum contraceptive uptake versus standard of care. Bias assessment of the 16 randomized studies classified 8, 3, and 5 studies as at a high, some concern, and low risk of bias. Common sources of bias included intervention non-adherence and missing outcome data. One observational study was at a high and the other at a low risk of bias.
CONCLUSIONS
Future studies that assess couples-based interventions must clearly define and measure how partners are involved in the intervention and assess how intervention adherence impacts postpartum contraceptive uptake.
Topics: Contraceptive Agents; Contraceptive Devices; Female; Humans; Observational Studies as Topic; Postpartum Period; Text Messaging
PubMed: 35577147
DOI: 10.1016/j.contraception.2022.05.001 -
Nursing Open Sep 2021This review aimed to determine the social determinants of healthy lifestyle among Iranian women. (Meta-Analysis)
Meta-Analysis Review
AIM
This review aimed to determine the social determinants of healthy lifestyle among Iranian women.
DESIGN
A systematic review and meta-analysis.
METHOD
A comprehensive electronic search was carried out with no time limit until 6 September 2019. Newcastle-Ottawa Quality Assessment Scale (adapted for evaluating cross-sectional survey/studies) was used to evaluate the quality of the articles. The metap code was used in SATATA16 to combine the p-values using Edgington's additive method.
RESULTS
Twelve studies entered the systematic review. The meta-analysis results showed that social determinants of healthy lifestyle among Iranian women included income, job, education, spouse's education and occupation, housing and social support.
CONCLUSIONS
Given the relationship between modifiable factors and women's lifestyles, it seems that it is necessary to set policies to improve the status of factors related to women's lifestyle including reducing poverty, promoting education and providing social support to eliminate.
Topics: Cross-Sectional Studies; Female; Healthy Lifestyle; Humans; Iran; Life Style; Social Determinants of Health
PubMed: 34388863
DOI: 10.1002/nop2.657 -
Journal of the American Medical... Mar 2023Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in older adults.
DESIGN
Systematic review and meta-analysis.
SETTING AND PARTICIPANTS
Adults aged 60 years and older.
METHODS
We searched for observational studies without language restrictions in 11 databases from inception to August 2022. Pooled odds ratio (OR) and 95% CI were calculated using the R software (version 4.2.1). The modified Newcastle-Ottawa Scale was used to evaluate the risk of bias.
RESULTS
Eighteen factors were grouped into 5 themes. The following 13 factors were statistically significant: (1) demographics theme: aged 80 years and older (OR: 2.41; 95% CI: 1.20-4.85), less than or equal to a high school degree (OR: 1.68; 95% CI: 1.44-1.97), smoking (OR: 1.43; 95% CI: 1.18-1.73), and male (OR: 1.38; 95% CI: 1.01-1.89); (2) environment theme: low social support (OR: 7.77; 95% CI: 3.45-17.50) and no homeownership (OR: 1.38; 95% CI: 1.25-1.51); (3) role theme: no social participation (OR: 3.18; 95% CI: 1.30-7.80) and no spouse (OR: 2.61; 95% CI: 1.37-4.99); (4) physical health: hearing loss (OR: 2.78; 95% CI: 1.54-5.01), activities of daily living impairment (OR: 2.38; 95% CI: 1.57-3.61), and poor health status (OR: 1.52; 95% CI: 1.32-1.74); and (5) mental health: cognitive decline (OR: 1.85; 95% CI: 1.40-2.45) and depression (OR: 1.72; 95% CI: 1.21-2.44).
CONCLUSIONS AND IMPLICATIONS
Social isolation in older adults is associated with various factors. Hence, focused intervention should be adopted for older adults. In addition, further longitudinal studies are required to confirm a direct link between multiple factors and social isolation.
Topics: Humans; Male; Middle Aged; Aged; Activities of Daily Living; Social Isolation; Health Status; Social Participation; Longitudinal Studies
PubMed: 36549651
DOI: 10.1016/j.jamda.2022.11.008 -
Journal of Epidemiology and Community... Jun 2015The developing world accounts for 99% of global maternal deaths. Men in developing countries are the chief decision-makers, determining women's access to maternal health... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The developing world accounts for 99% of global maternal deaths. Men in developing countries are the chief decision-makers, determining women's access to maternal health services and influencing their health outcomes. At present, it is unclear whether involving men in maternal health can improve maternal outcomes. This systematic review and meta-analysis aimed to investigate the impact of male involvement on maternal health outcomes of women in developing countries.
METHODS
Four electronic databases and grey literature sources were searched (up to May 2013), together with reference lists of included studies. Two reviewers independently screened and assessed the quality of studies based on prespecified criteria. Measures of effects were pooled and random effect meta-analysis was conducted, where possible.
RESULTS
Fourteen studies met the inclusion criteria. Male involvement was significantly associated with reduced odds of postpartum depression (OR=0.36, 95% CI 0.19 to 0.68 for male involvement during pregnancy; OR=0.34, 95% CI 0.19 to 0.62 for male involvement post partum), and also with improved utilisation of maternal health services (skilled birth attendance and postnatal care). Male involvement during pregnancy and at post partum appeared to have greater benefits than male involvement during delivery.
CONCLUSIONS
Male involvement is associated with improved maternal health outcomes in developing countries. Contrary to reports from developed countries, there was little evidence of positive impacts of husbands' presence in delivery rooms. However, more rigorous studies are needed to improve this area's evidence base.
Topics: Decision Making; Developing Countries; Female; Humans; Male; Maternal Health; Maternal Health Services; Postpartum Period; Pregnancy; Pregnancy Outcome; Social Support; Spouses
PubMed: 25700533
DOI: 10.1136/jech-2014-204784 -
Clinical Genitourinary Cancer Feb 2023Adrenocortical carcinoma (ACC) is a very rare endocrine cancer and is associated with a poor prognosis. There is a paucity of randomized clinical trials for this rare... (Review)
Review
A Systematic Review of Published Clinical Trials in the Systemic Treatment of Adrenocortical Carcinoma: An Initiative Led on Behalf of the Global Society of Rare Genitourinary Tumors.
Adrenocortical carcinoma (ACC) is a very rare endocrine cancer and is associated with a poor prognosis. There is a paucity of randomized clinical trials for this rare disease. We aimed to perform a systematic review of the literature on systemic therapy options in different stages of ACC. A systematic review was performed using Pubmed and Embase databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 24 trials of systemic therapy in the treatment of ACC were identified and included in this review. Only one clinical trial in the adjuvant setting was identified, the negative phase III trial ADIUVO, which tested mitotane in low to intermediate-risk ACC patients. In the treatment of advanced ACC, cisplatin-based chemotherapy was evaluated in small and non-randomized phase II trials, and response rates ranged from 21% to 53.5%. The phase III trial FIRM-ACT compared etoposide, doxorubicin, cisplatin, and mitotane versus treatment with streptozotocin and mitotane and showed no difference in OS, but higher RR and PFS were reported with the multi-drug regimen. Six clinical trials of immunotherapy and seven studies of targeted therapy in advanced ACC were included, with modest activity and no phase 3 trials were identified. Treatment recommendations of ACC are based on retrospective and small studies with limited systemic therapy options. International and multi-center collaboration is essential to expand clinical research and improve outcomes.
Topics: Humans; Adrenocortical Carcinoma; Mitotane; Adrenal Cortex Neoplasms; Cisplatin; Retrospective Studies; Antineoplastic Combined Chemotherapy Protocols
PubMed: 36376169
DOI: 10.1016/j.clgc.2022.10.011