Impact of Hormone Replacement Therapy on the Overall Survival and Progression Free Survival of Ovarian Cancer Patients: A Systematic Review and Meta-Analysis

Background: Frequently, patients treated for Ovarian Cancer (OC) undergo menopause with subsequent symptoms. This review scrutinised the impact of Hormone Replacement Therapy (HRT) on the Overall Survival (OS) and Progression-Free Survival (PFS) of patients diagnosed with OC. Methods: A systematic literature search was conducted in the most popular English databases. Inclusion and exclusion criteria were applied to select publications that evaluate OS and PFS in these patients. End-point analysis targeted values of log(HR) and its Standard Error (SE). Results: Up to 1 September 2022, 11 studies were included in the qualitative synthesis. Eight publications, totalling 4191 patients, were included in the meta-analyses. Eight studies were considered for the OS analysis and pooled an HR of 0.66 with respective 95% CI between 0.57 and 0.76, with a p-value p = 0.02 at a Z value of 2.36. Further subgroup analyses highlighted the non-inferiority of this treatment. Conclusions: Patients treated for OC that receive HRT for menopausal symptoms after various treatments appeared to have better OS than never-users

Receiver Operator Characteristic Tools Graphic User Interface Extension for R Commander

Background: Receiver Operator Characteristic (ROC) curve, is a graphical plot which presents the performance of a binary classifier when the discrimination cutoff is varied. The aim of this work was to create an extension for R Commander that offers a graphical user interface for Receiver Operator Characteristic tools provided by several existing command line accessible packages like pROC and ROCR. Material and Methods: The extension was built and tested with R version 3.2.0 and R Commander 2.1-7. Results: We built an extension called RcmdrPlugin.ROC that we uploaded on the CRAN servers. The extension adds a new menu called ROC, along with two submenus pROC and ROCR that broadly corresponds to commands available to access the functions of these packages. The pROC menu offers several commands: to plot a ROC curve for a dataset or for a logistic regression model, to compare paired and unpaired ROC curves, each providing the following tabs: General (to select the variables for the analysis, and options for switching cases with controls); Smoothing (allowing the user to select different types of smoothing – binominal, density, distributions like normal, lognormal, ...); AUC (to specify the partial area under the curve (AUC) options), CI (to select the options of confidence intervals (CI) – the level, computing method: DeLong, bootstrap, ...); Plot (for the plotting options). The ROCR dialogue window offers more options in choosing the performance measures for the plot. Conclusion: The RcmdrPlugin.ROC extension helps less advanced users of R accessing ROC tools in a friendly graphical user interface

Evaluation of the Efficiency of Economic and Medical Activities in Romanian Hospitals

Medical work in public hospitals in Romania has a double subordination: strictly speaking the Health Care Directives is coordinated by the Ministry of Health and in terms of economics the activity is funded by the National Health Insurance through its county subsidiaries. This separation of the two fields, medical and economical, has generated problems in many cases of hospital activity in our country.Economic and financial parameters of 39 hospitals were extracted from their economic balance sheets for 2009-2010 and were entered into a multi-criteria analysis to generate an overall score. Then this was checked for possible relationships with the hospitals’ competence (established by the Ministry of Health with the help of a national program).The aim of this study was to assess the relationship between hospital medical competency and economical parameters in the Romanian Health Care System. The lack of correlation of the economic and financial parameters with the health parameters observed by our study reflects the current problems in the Romanian health system, where the impossibility of generating practical management solutions is the consequence of multiple subordination of hospital units, separate assessment of competence and administrative skills

Vaccine Hesitancy among European Parents—Psychological and Social Factors Influencing the Decision to Vaccinate against HPV: A Systematic Review and Meta-Analysis

Background: Due to low adherence to HPV vaccination programs, the European region struggles with vaccination rates lower than 30% among the targeted population. The present report investigated various socio-demographic and psychological factors influencing European parents’ hesitancy towards vaccinating their children. Methods: As of September 2023, four databases were searched. After applying inclusion criteria, all articles comparing psychological and socio-demographic factors in parents who vaccinate or do not vaccinate their children were included. Results: Twenty-five primary publications met the criteria, totaling 385,460 responders, of which 311,803 want to or have already vaccinated their child, and 73,555 do not wish to do so. Immigrant and employment status, religion, age of parents and the child’s gender seemed to influence their decision to vaccinate their child. Previous experience with vaccines, perceived safety and efficacy and the mother’s previous abnormal CCS results also impacted their decision. The caregivers’ education, gender, civil status, number of children, family history of neoplasia or mother’s CCS attendance did not influence their hesitancy to vaccine. Conclusion: Multiple demographic, social, economic and psychological barriers involved in the parents’ hesitancy to vaccinate their children against the HPV virus were highlighted. Specific at-risk categories that need to be targeted with information, education and vaccination campaigns were identified