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Cervical cancer, closely linked to human papillomavirus (HPV) infection, is a major global health concern. Our study aims to fill the gap in understanding HPV vaccine awareness and acceptance in the Middle East, where national immunization programs are often lacking and cultural perceptions hinder acceptance. This systematic review and meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search across several databases was conducted on 5 September 2023. We included quantitative studies on HPV vaccine awareness and acceptance in Middle Eastern countries. Data extraction and quality assessment were conducted independently by multiple reviewers to ensure accuracy. Statistical analyses, including subgroup analyses, were performed using R to calculate pooled estimates, assess heterogeneity, and publication bias. We reviewed 159 articles from 15 Middle Eastern countries, focusing on 93,730 participants, predominantly female and healthcare workers. HPV vaccine awareness was found to be 41.7% (95% CI 37.4%-46.1%), with higher awareness among healthcare workers. The pooled acceptance rate was 45.6% (95% CI 41.3%-50.1%), with similar rates between healthcare and non-healthcare workers. Our study highlights the critical need for increased HPV vaccine awareness and acceptance in the Middle East, emphasizing the importance of integrating the vaccine into national immunization programs and addressing cultural and religious factors to improve public health outcomes.

Background: Despite no scientific evidence linking vaccines to Autism Spectrum Disorder (ASD), vaccine hesitancy persists among parents of children with ASD. This study aims to compare vaccine hesitancy and behaviors among parents of children with ASD, other Neurodevelopmental Disorders (NDD), and without NDD, and to examine the relationship between stress coping mechanisms and vaccine hesitancy, including comparing coping mechanisms between diagnostic groups as well as their association with hesitancy., Methods: In this cross-sectional study, one parent of each child with ASD, non-ASD NDD, or without NDD was included. Data were collected using a researcher-created form, the Vaccine Hesitancy Scale in Turkish, and the Coping Style Scale Brief Form. Vaccine hesitancy, parents' COVID-19 vaccination status, and vaccination status of children's younger siblings were analyzed through univariate and multivariate analyses, with a focus on correlations between vaccine hesitancy and coping styles., Results: The study included one parent from each of 299 children. Parents of children with ASD showed an adjusted odds ratio of 2.66 (95% CI 1.35-5.06) for high vaccine hesitancy, 2.57 (95% CI 1.17-5.65) for not receiving the COVID-19 vaccine, and 1.40 (95% CI 0.45-4.40) for younger siblings not receiving routine vaccines. A weak but significant correlation was observed between vaccine hesitancy and the use of restraint coping style among these parents (r = 0.280; p = 0.010)., Conclusions: The study underscores the importance of targeted educational efforts and personalized communication to address vaccine hesitancy among parents of children with ASD. Enhancing vaccination coverage in this community requires further research to develop interventions tailored to their specific needs., (© 2024. The Author(s).)

This systematic review and meta-analysis aims to estimate the prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy in Turkey, which can aid future health policies and strategies. A comprehensive search was conducted on various databases using keywords related to COVID-19 vaccine hesitancy in Turkey. Quality assessment was performed using Joanna Briggs Institute (JBI) checklist for prevalence studies. Data extraction was conducted. The random effect model (DerSimonian and Laird method) was used in pooled prevalence data analysis (95% confidence interval [CI]). A total of 1,072 articles were identified. After removing duplicates and excluding articles, 61 articles remained for bias assessment. Among these, 19 articles with low risk of bias were included in the review and meta-analysis. Total population included in the analysis was 15,164, vaccine hesitancy was 30.5% (95% Cl: 24.3-36.8%). Prevalence of the vaccine hesitancy was found to be 39.8% (95% Cl: 31.4-48.2%) in studies conducted before the initiation of vaccination, while in studies conducted after the commencement of vaccination, hesitancy was 20.4% (95% Cl: 12.9-28%). We suggest conducting high-quality studies in different populations to understand the level of vaccine hesitancy, as many of the previous studies have mainly focused on healthcare workers and students, and rest were community-based studies, which have generally shown high bias. Also, we suggest that early vaccination can reduce vaccine hesitancy.

Aldehyde dehydrogenase 1 (ALDH1) has been identified as a marker of cancer stem cells in breast cancer (BC). Recent studies showed that ALDH1 expression is correlated with poor prognostic parameters and worse clinical outcome in BC. We evaluated ALDH1 expression by immunohistochemistry in a series of 217 invasive BCs and investigated the correlation between ALDH1 expression and clinicopathological parameters, molecular subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 [HER2] type, and triple-negative BC [TNBC]), and patient survival. There was a significant association between ALDH1 expression and tumor grade (p < 0.001), i.e., the expression of ALDH1 was higher in high-grade tumors. ALDH1 expression was significantly associated with estrogen and progesterone receptor (ER and PR) negativity (p < 0.001) and HER2 positivity (p = 0.001). ALDH1 expression ratios were higher in HER2 type and TNBC. There was a statistically significant correlation between ALDH1 negativity and luminal A subtype (p < 0.001). The overall and disease free survival were shorter in ALDH1+ tumors, although without statistical significance. We confirm that ALDH1 is a potentially important, poor prognostic factor in BC, associated with high histological grade, ER/PR negativity and HER2 positivity. For more accurate results, ALDH1 expression should be evaluated in larger case series including various types/subtypes of BC.