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Spatio-Temporal Trend and Geographic Disparity of Infertility Prevalence in Burkina Faso, 2011 to 2020
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作者 Oumarou Nabi René Tokira Poubouré Yabré +5 位作者 Pratibha Shrestha Aoua Sangaré Jérémie Sawadogo Miézan Brigitte Aka Smaila Ouédraogo Min Lian 《Open Journal of Obstetrics and Gynecology》 2024年第8期1288-1302,共15页
Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, part... Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, particularly for women who often face stigmatization. However, comprehensive and nationally representative data, including prevalence, temporal trends, and risk factors, are lacking, prompting a study in Burkina Faso to address the need for informed policies and programs in infertility care and management. Objectives: This study aims to better understand the spatiotemporal trend of infertility prevalence in Burkina Faso. Methodology: This is a retrospective population-based study of women infertility from healthcare facilities in Burkina Faso, during January 2011 to December 2020. We calculated the prevalence rates of infertility and two disparity measures, and examined the spatiotemporal trend of infertility. Results: Over the 10-year period (2011 to 2020), 143,421 infertility cases were recorded in Burkina Faso healthcare facilities, resulting of a mean prevalence rate of 3.61‰ among childbearing age women and 17.87‰ among women who consulted healthcare facilities for reproductive issues (except contraception). The findings revealed a significant increase of infertility, with the prevalence rate varied from 2.75‰ in 2011 to 4.62‰ in 2020 among childbearing age women and from 13.38‰ in 2011 to 26.28‰ in 2020 among women who consulted healthcare facilities for reproductive issues, corresponding to an estimate annual percentage change of 8.31% and 9.80% respectively. There were significant temporal and geographic variations in the prevalence of infertility. While relative geographic disparity decreased, absolute geographic disparity showed an increasing trend over time. Conclusion: The study highlights an increasing trend of infertility prevalence and significant geographic variation in Burkina Faso, underscoring the urgent necessity for etiologic research on risk factors, psychosocial implications, and economic consequences to inform effective interventions and mitigate the socioeconomic impact of infertility. 展开更多
关键词 INFERTILITY PREVALENCE Temporal Trend GEOGRAPHY DISPARITY
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Stroma-targeting strategies in pancreatic cancer:Past lessons,challenges and prospects 被引量:1
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作者 Faran Polani Patrick M Grierson Kian-Huat Lim 《World Journal of Gastroenterology》 SCIE CAS 2021年第18期2105-2121,共17页
Pancreatic ductal adenocarcinoma(PDAC)is projected to emerge as the second leading cause of cancer-related death after 2030.Extreme treatment resistance is perhaps the most significant factor that underlies the poor p... Pancreatic ductal adenocarcinoma(PDAC)is projected to emerge as the second leading cause of cancer-related death after 2030.Extreme treatment resistance is perhaps the most significant factor that underlies the poor prognosis of PDAC.To date,combination chemotherapy remains the mainstay of treatment for most PDAC patients.Compared to other cancer types,treatment response of PDAC tumors to similar chemotherapy regimens is clearly much lower and shorterlived.Aside from typically harboring genetic alterations that to date remain undruggable and are drivers of treatment resistance,PDAC tumors are uniquely characterized by a densely fibrotic stroma that has well-established roles in promoting cancer progression and treatment resistance.However,emerging evidence also suggests that indiscriminate targeting and near complete depletion of stroma may promote PDAC aggressiveness and lead to detrimental outcomes.These conflicting results undoubtedly warrant the need for a more in-depth understanding of the heterogeneity of tumor stroma in order to develop modulatory strategies in favor of tumor suppression.The advent of novel techniques including single cell RNA sequencing and multiplex immunohistochemistry have further illuminated the complex heterogeneity of tumor cells,stromal fibroblasts,and immune cells.This new knowledge is instrumental for development of more refined therapeutic strategies that can ultimately defeat this disease.Here,we provide a concise review on lessons learned from past stromatargeting strategies,new challenges revealed from recent preclinical and clinical studies,as well as new prospects in the treatment of PDAC. 展开更多
关键词 Stroma Pancreatic cancer Treatment resistance Cancer-associated fibroblasts Clinical trials
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表皮生长因子/HER2抑制剂在非小细胞肺癌患者治疗中的作用综述 被引量:5
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作者 Ramaswamy GOVINDAN 南娟 丁燕 《中国肺癌杂志》 CAS 2010年第4期363-369,共7页
晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)仍然是主要的全球健康问题。尽管可逆性表皮生长因子受体(epidermal growth factor receptor,EGFR)酪氨酸激酶抑制剂厄洛替尼可改善复发与再发NSCLC患者的生存期,但也存在明显的局限... 晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)仍然是主要的全球健康问题。尽管可逆性表皮生长因子受体(epidermal growth factor receptor,EGFR)酪氨酸激酶抑制剂厄洛替尼可改善复发与再发NSCLC患者的生存期,但也存在明显的局限性,包括仅对少数患者亚群具有临床疗效、生存率较低及产生耐药性。EGFR和HER2的非可逆性抑制剂是临床开发的新型药物,有可能预防并克服第一代EGFR抑制剂的获得性耐药。 展开更多
关键词 BIBW 2992 ERBB 厄洛替尼 吉非替尼 HKI-272 受体酪氨酸激酶
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A Study of Zoledronic Acid as Neo-Adjuvant, Perioperative Therapy in Patients with Resectable Pancreatic Ductal Adenocarcinoma 被引量:2
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作者 Dominic E. Sanford Matthew R. Porembka +12 位作者 Roheena Z. Panni Jonathan B. Mitchem Brian A. Belt Stacey M. Plambeck-Suess Goldie Lin David G. DeNardo Ryan C. Fields William G. Hawkins Steven M. Strasberg Craig Lockhart Andrea Wang-Gillam Simon Peter Goedegebuure David C. Linehan 《Journal of Cancer Therapy》 2013年第3期797-803,共7页
Background: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by abundant granulocytic myeloid-derived suppressor cells (G-MDSC = CD45+/Lin﹣/CD33+/CD11b+/CD15+), which infiltrate tumor... Background: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by abundant granulocytic myeloid-derived suppressor cells (G-MDSC = CD45+/Lin﹣/CD33+/CD11b+/CD15+), which infiltrate tumors and suppress anti-tumor immunity. We have previously demonstrated in a murine model of PDAC that zoledronic acid (ZA) depletes G-MDSC resulting in decreased tumor growth and improved survival. We report here the results of a phase 1 clinical trial (NCT00892242) using ZA as neo-adjuvant, perioperative therapy in patients with non-metastatic, resectable pancreatic adenocarcinoma. Methods: Eligible PDAC patients received ZA (4 mg) IV 2 weeks prior to surgery. Patients then received 2 additional doses of ZA 4 weeks apart. Blood and bone marrow were obtained from patients prior to treatment with ZA and 3 months after surgery for analysis of G-MDSC by flow cytometry. Results: Twenty-three patients received pre-operative ZA with at least 6 months of follow-up. Only 15 PDAC patients had nonmetastatic PDAC, which was amenable to resection. ZA was well tolerated, and all adverse events were grade 1 or 2. The most common adverse events were fatigue, abdominal pain/discomfort, anorexia, and arthralgia. Of resected PDAC patients treated with ZA, 1- and 2-year overall survival (OS) was 85.7% and 33.3%, respectively, with a median OS of 18 months. This group had a 1- and 2-year progression-free survival (PFS) of 26.9% and 8.9%, respectively, with a median PFS of 12 months. The prevalence of G-MDSC was unchanged in the blood and bone marrow of PDAC patients pre- and post-treatment with ZA. Conclusion: ZA is safe and well tolerated as neo-adjuvant, peri-operative therapy in PDAC patients. In this small study, we did not observe a difference in OS or PFS compared to historical controls. Also, there was no difference in the prevalence of G-MDSC in the blood and bone marrow of PDAC patients pre- and post-treatment with ZA. 展开更多
关键词 PANCREATIC Cancer Zoledronic ACID Myeloid-Derived SUPPRESSOR Cells
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Statistical Significance of Geographic Heterogeneity Measures in Spatial Epidemiologic Studies
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作者 Min Lian 《Open Journal of Statistics》 2015年第1期46-50,共5页
Assessing geographic variations in health events is one of the major tasks in spatial epidemiologic studies. Geographic variation in a health event can be estimated using the neighborhood-level variance that is derive... Assessing geographic variations in health events is one of the major tasks in spatial epidemiologic studies. Geographic variation in a health event can be estimated using the neighborhood-level variance that is derived from a generalized mixed linear model or a Bayesian spatial hierarchical model. Two novel heterogeneity measures, including median odds ratio and interquartile odds ratio, have been developed to quantify the magnitude of geographic variations and facilitate the data interpretation. However, the statistical significance of geographic heterogeneity measures was inaccurately estimated in previous epidemiologic studies that reported two-sided 95% confidence intervals based on standard error of the variance or 95% credible intervals with a range from 2.5th to 97.5th percentiles of the Bayesian posterior distribution. Given the mathematical algorithms of heterogeneity measures, the statistical significance of geographic variation should be evaluated using a one-tailed P value. Therefore, previous studies using two-tailed 95% confidence intervals based on a standard error of the variance may have underestimated the geographic variation in events of their interest and those using 95% Bayesian credible intervals may need to re-evaluate the geographic variation of their study outcomes. 展开更多
关键词 SPATIAL EPIDEMIOLOGY HETEROGENEITY Statistical Significance 95% CONFIDENCE INTERVAL 95% Credible INTERVAL
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Statistical Assessment of Neighborhood Socioeconomic Deprivation Environment in Spatial Epidemiologic Studies
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作者 Min Lian James Struthers Ying Liu 《Open Journal of Statistics》 2016年第3期436-442,共7页
Neighborhood socioeconomic deprivation has been associated with health behaviors and outcomes. However, neighborhood socioeconomic status has been measured inconsistently across studies. It remains unclear whether app... Neighborhood socioeconomic deprivation has been associated with health behaviors and outcomes. However, neighborhood socioeconomic status has been measured inconsistently across studies. It remains unclear whether appropriate socioeconomic indicators vary over geographic areas and geographic levels. The aim of this study is to compare the composite socioeconomic index to six socioeconomic indicators reflecting different aspects of socioeconomic environment by both geographic areas and levels. Using 2000 U.S. Census data, we performed a multivariate common factor analysis to identify significant socioeconomic resources and constructed 12 composite indexes at the county, the census tract, and the block group levels across the nation and for three states, respectively. We assessed the agreement between composite indexes and single socioeconomic variables. The component of the composite index varied across geographic areas. At a specific geographic region, the component of the composite index was similar at the levels of census tracts and block groups but different from that at the county level. The percentage of population below federal poverty line was a significant contributor to the composite index, regardless of geographic areas and levels. Compared with non-component socioeconomic indicators, component variables were more agreeable to the composite index. Based on these findings, we conclude that a composite index is better as a measure of neighborhood socioeconomic deprivation than a single indicator, and it should be constructed on an area- and unit-specific basis to accurately identify and quantify small-area socioeconomic inequalities over a specific study region. 展开更多
关键词 ASSESSMENT NEIGHBORHOOD SOCIOECONOMIC DEPRIVATION Spatial Epidemiology
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Beyond just a tight fortress:contribution of stroma to epithelial-mesenchymal transition in pancreatic cancer 被引量:4
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作者 Ashenafi Bulle Kian-Huat Lim 《Signal Transduction and Targeted Therapy》 SCIE CSCD 2020年第1期328-339,共12页
Novel effective treatment is direly needed for patients with pancreatic ductal adenocarcinoma(PDAC).Therapeutics that target the driver mutations,especially the KRAS oncoprotein and its effector cascades,have been ine... Novel effective treatment is direly needed for patients with pancreatic ductal adenocarcinoma(PDAC).Therapeutics that target the driver mutations,especially the KRAS oncoprotein and its effector cascades,have been ineffective.It is increasing clear that the extensive fibro-inflammatory stroma(or desmoplasia)of PDAC plays an active role in the progression and therapeutic resistance of PDAC.The desmoplastic stroma is composed of dense extracellular matrix(ECM)deposited mainly by the cancer-associatedfibroblasts(CAFs)and infiltrated with various types of immune cells.The dense ECM functions as a physical barrier that limits tumor vasculatures and distribution of therapeutics to PDAC cells.In addition,mounting evidence have demonstrated that both CAFs and ECM promote PDAC cells aggressiveness through multiple mechanisms,particularly engagement of the epithelial-mesenchymal transition(EMT)program.Acquisition of a mesenchymal-like phenotype renders PDAC cells more invasive and resistant to therapyinduced apoptosis.Here,we critically review seminal and recent articles on the signaling mechanisms by which each stromal element promotes EMT in PDAC.We discussed the experimental models that are currently employed and best suited to study EMT in PDAC,which are instrumental in increasing the chance of successful clinical translation. 展开更多
关键词 stroma transition RENDER
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Cancer vaccines:shared tumor antigens return to the spotlight
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作者 Lijin Li S.Peter Goedegebuure William Gillanders 《Signal Transduction and Targeted Therapy》 SCIE CSCD 2020年第1期324-325,共2页
Sahin et al.recently reported interim data from a phase 1 clinical trial(NCT02410733)treating melanoma patients with a RNAlipoplex vaccine(RNA-LPX),targeting melanoma TAA.1 The trial is a multicenter,non-randomized,op... Sahin et al.recently reported interim data from a phase 1 clinical trial(NCT02410733)treating melanoma patients with a RNAlipoplex vaccine(RNA-LPX),targeting melanoma TAA.1 The trial is a multicenter,non-randomized,open-label,dose-escalation trial designed to evaluate the safety and tolerability of BNT111 targeting four melanoma TAA(NY-ESO-1,MAGE-A3,tyrosinase,and TPTE).Secondary endpoints include vaccine-induced immune responses and clinical response of patients with measurable disease. 展开更多
关键词 VACCINE MELANOMA CLINICAL
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