Purpose: From a patient’s perspective, participation is a major determinant of quality of life. We aimed to review contextual factors, both personal and environmental, potentially associated with post-stroke participation. Methods: PubMed, PsycINFO, and Web of Science were searched for original quantitative and qualitative studies that investigated contextual factors of post-stroke participation, measured participation as the primary outcome, and met inclusion criteria. Results: Socio-demographic determinants were mostly unrelated with participation or showed discordant and inconclusive results. Although less investigated, psychosocial/psychological factors, particularly self-esteem and acceptance, were associated with participation in most studies. Motivation was found in qualitative studies, but discordant in quantitative ones. Environmental factors were even less investigated and mainly in qualitative studies among patients with communication disabilities. Among these, social support and attitude of others appeared to be major determinants of participation as well as physical environment and societal environment (services and polices). Conclusions: Personal factors, particularly psychological and psychosocial factors, were identified as positively associated with post-stroke participation. Environmental factors such as support, relationships, and positive attitudes towards patients were major facilitators of participation as well as physical environment and accessibility to appropriate services. Most of these factors are modifiable and should be addressed to improve patient participation.

In this systematic review and meta-analysis, we evaluated the association between Attention-Deficit/Deficit Hyperactivity (ADHD) and atypical Sensory Processing Patterns (SPPs). We searched PubMed, Embase, and Web of Science from their inception until June 30^th, 2024. We included studies examining SPP using questionnaires in participants with a diagnosis of ADHD compared with healthy controls. The study risk of bias was assessed using a modified Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted using R software (Version 4.3.1), considering sensory modulation atypicities severity as the primary outcome. We explored the risk of publication bias and conducted sensitivity analyses to test the robustness of the findings. After screening 10,750 references, we included 30 studies (reported in 32 publications) encompassing a total of 5,374 participants, with 23 studies focusing on children, and seven on adults. Patients with ADHD presented significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity (k=13; SMD=1.17; 5% CI [0.75;1.59]; I²=87%), sensory avoiding (k=11; SMD=1.15; 95% CI [0.66;1.64]; I²=92%), low sensory registration (k=23; SMD=1.22; 95%CI [0.89;1.56]; I²=92%), and sensory seeking (k=15; SMD=1.23; 95%CI [0.48;1.97]; I²=97%). Heterogeneity was high in all analyses. Only nine studies were deemed at overall low risk of bias. Even though available ADHD clinical guidelines do not specifically mention the need to assess sensory processing in ADHD, our meta-analysis suggests that this should be systematically explored in the evaluation of children and adults referred for ADHD.

Background: The intersection of Autism and Gender Diversity (GD) is an emerging field of research. While prior studies have primarily focused on autistic traits within gender-diverse populations, limited evidence exists on the prevalence and characteristics of GD among individuals with a confirmed Autism Spectrum Disorder (ASD) diagnosis. This study aims to fill this gap through a systematic review and meta-analysis, offering comprehensive insights into the prevalence of GD in autistic individuals and the factors influencing this intersection. Methods: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. We searched for studies published between 2013 and 2023 in four databases. Inclusion criteria focused on studies assessing GD in children and adult participants with a formal ASD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition, criteria. We used random-effects models to estimate prevalence rates, and subgroup analyses explored potential influencing factors, including age, gender assigned at birth, type of GD assessment, ASD diagnosis methodology, and primary objective of the study. Results: From 7133 identified reports, we deemed 24 studies suitable for the systematic review, with 14 meeting all eligibility criteria for meta-analysis, representing 3894 autistic participants. We estimated the pooled prevalence of GD at 7.37% (95% confidence interval [CI]: 4.45–11.98). Subgroup analyses revealed no significant impact of age, type of GD assessment, or diagnostic methodology of ASD on GD prevalence. Although we found a higher prevalence of GD among individuals assigned female at birth (14.54%) compared with those assigned male at birth (8.15%), the difference was not statistically significant. However, studies explicitly addressing GD reported statistically higher GD rates (13.71%) compared with those with other primary objectives (4.71%). Non-binary identities appeared particularly prevalent, but we did not underexplore it due to variability in GD definitions across studies. Conclusion: This study highlights a notable prevalence of GD among autistic individuals, emphasizing the need for inclusive definitions and diagnostic process. Understanding this intersection is crucial for enhancing support services and ensuring equitable access to gender-affirming care for neurodiverse populations.

High-risk pulmonary embolism (PE) requires hemodynamic and respiratory support along with reperfusion strategies. Recently updated European guidelines assign a low class of recommendation to extracorporeal membrane oxygenation (ECMO) for high-risk PE. This systematic review assessed clinical outcomes after ECMO in high-risk PE. We searched electronic databases including PubMed, Embase and Web of Science from January 2000 to April 2020. Efficacy outcomes included in-hospital survival with good neurological outcome and survival at follow-up. Safety outcomes included lower limb ischemia and hemorrhagic and ischemic stroke. Where possible (absence of high heterogeneity), meta-analyses of outcomes were undertaken using a random-effects model. We included 16 uncontrolled case-series (533 participants). In-hospital survival with good neurological outcome ranged between 50% and 95% while overall survival at follow-up ranged from 35% to 95%, both with a major degree of heterogeneity (I² > 70%). The prevalence of lower limb ischemia was 8% (95% CI 3% to 15%). The prevalence of stroke (either hemorrhagic or ischemic) was 11% (95% CI 3% to 23%), with notable heterogeneity (I² = 63.35%). Based on currently available literature, it is not possible to draw definite conclusions on the usefulness of ECMO for high-risk PE. Prospective, multicenter, large-scale studies or nationwide registries are needed to best define the role of ECMO for high-risk PE. PROSPERO registration ID: CRD42019136282.