While research on political violence often focuses on its outcome, there is little attention to the process of political violence. Filling the knowledge gap, the present research applies the theory of instrumentalism to understand political violence as a means to achieve certain political ends. The research is a qualitative case study on Lyari, which was a comparatively peaceful neighborhood in Karachi but transformed into a violent no-go area during 2000s. The paper describes the process of instrumentalization of political violence in (...) Lyari with the objective of outlining the relationship of three key actors – political parties, state authorities, and criminal gangs – using violence for their respective interests. The paper explains how the convergence of their interests influenced the intensity of political violence and converted it into an ethnic conflict. Hence, it expands the literature on political violence by outlining the complexities of the real world where multiple political actors simultaneously use violence to achieve varied objectives that sometimes compliment and sometimes clashes with each other, resulting in further extension of violence. (shrink)

Background: Pembrolizumab, an inhibitory anti-PD-1 antibody, has led to significantly meaningful improvements in advanced melanoma. This meta-analysis discusses and presents the efficacy and safety of pembrolizumab versus control treatments in randomized controlled trials. Methods: Electronic databases were searched systematically for RCTs using pembrolizumab in advanced melanomas. Pooled estimates were calculated under random-effect models for overall response rates, PFS, OS, and TRAEs. Results: Nine RCTs including 5132 patients were analyzed. Pembrolizumab significantly realized better results in ORR, PFS and OS HR 0.62, (...) 95% CI 0.54, 0.71, P < 0.001 and HR 0.70, 95% CI 0.63, 0.78, P < 0.001 for control. PFS and OS were consistently better in first, second, and further lines and in groups stratified for PD-L1 status. Grade 3–5 TRAEs were lower with pembrolizumab than with chemotherapy 13.3% vs. 25.9% and ipilimumab 16.9% vs. 27.3%. Conclusions: Pembrolizumab monotherapy meaningfully improves ORRs, delays progression, and prolongs survival in advanced melanoma compared to current standard regimens, with the latter given its favorable toxicity profile. As such, pembrolizumab should be considered the new standard of care for treatment-naïve and previously treated subjects. (shrink)