What Is the Evidence on Natural Recovery Over the Year Following Sports-Related and Non-sports-Related Mild Traumatic Brain Injury: A Scoping Review

Background: Treatment approaches often differ dependent upon whether a person experiences a sports-related or a non-sports-related mild traumatic brain injury. It remains unclear if recovery from these injuries is comparable or unique to context of the injury.Objective: To identify knowledge gaps on self-reported outcomes and trajectories between sports- and non-sports-related mild traumatic brain injuries and how they are assessed in adults.Methods: This scoping review used a systematic search of key electronic databases, including PubMed, SPORTDiscus, Embase, MEDLINE, and CINAHL for articles published in 1937 until March 10, 2021. Articles were included if they were available in English; full text published in a peer-reviewed journal; had a prospective or retrospective study design; reported data on mild TBI cases >16 years of age, and included data from at least two time points on self-reported outcomes within 12 months post-injury. A standardized data extraction spreadsheet was used to determine the participant characteristics, definitions, assessment methods, outcomes, and recovery time frames.Results: Following removal of duplicates, the search strategy elicited 6,974 abstracts. Following abstract review, 174 were retained for full text review. Of the 42 articles that met inclusion criteria, 18 were sports related (15 in the USA and three in Canada) and 24 were general population studies (six in USA, three in Canada, three in Australasia, nine in Europe, two in Taiwan, and one in Morocco). Direct comparison in recovery trajectories between the sport and general population studies was difficult, given notable differences in methodology, definitions, types of outcome measures, and timing of follow-up assessments. Only one article reported on both sports-related and non-sports-related traumatic brain injuries separately at comparable timepoints. This study revealed no differences in recovery time frames or overall symptom burden.Discussion: Whilst there is a clear benefit in researching specific subpopulations in detail, standardized outcome measures and follow-up time frames are needed across contexts to facilitate understanding of similarities and differences between sports- and non-sports-related mild traumatic brain injuries to inform clinical treatment.

Declining HIV incidence in sub-Saharan Africa: a systematic review and meta-analysis of empiric data

ABSTRACTBackgroundUNAIDS models suggest HIV incidence is declining in sub-Saharan Africa; however, it is unclear whether modeled trends are supported by empirical evidence.MethodsWe conducted a systematic review and meta-analysis of adult HIV incidence data from sub-Saharan Africa by searching Embase, Scopus, PubMed, and OVID databases and technical reports published between January 1, 2010 and July 23, 2019. We included studies that directly measured incidence from blood samples. Incidence data were abstracted according to population risk group, geographic location, sex, intervention arm, and calendar period. Weighted regression models were used to assess incidence trends across general population studies by sex. We also identified studies reporting ≥3 incidence measurements since 2010 and assessed trends within them.Findings292 studies met inclusion criteria. Most studies were conducted in South Africa (n=102), Uganda (n=46), and Kenya (n=41); there were 27 countries with no published incidence data, most in western and central Africa. Across general population studies, average annual incidence declines since 2010 were 0.16/1000 person-years (95%CI:0.06-0.26;p=0.004) among men and 0.16/1000 person-years (95%CI: −0.01-0.33;p=0.060) among women in eastern Africa, and 0.25/1000 person-years (95%CI:0.17-034;p<0.0001) among men and 0.42/1000 person-years (95%CI:0.23-0.62;p=0.0002) among women in southern Africa. In 9/10 studies with multiple measurements, incidence declined over time. Incidence was typically higher in women than men (median ratio=1.45, IQR: 1.12-1.83) with increasing sex disparity over time.InterpretationEmpirical incidence data show the rate of new HIV infections is declining in eastern and southern Africa. However, recent incidence data are non-existent or very limited for many countries, particularly in western and central Africa.FundingNational Institute of Allergy and Infectious Diseases

Resting heart rate as a cardiovascular risk factor in hypertensive patients: An update

A large body of evidence has shown that resting heart rate (RHR) holds important prognostic information in several clinical conditions. In the majority of the general population studies, a graded association between RHR and mortality from all causes, cardiovascular disease, ischaemic heart disease, and stroke has been observed. These associations appeared even stronger and more consistent in hypertensive patients. Studies performed with 24h ambulatory recording have shown that an elevated night-time heart rate may confere an additional risk on top of office RHR.

The Predictive Value of the AQ and the SRS-A in the Diagnosis of ASD in Adults in Clinical Practice

Questionnaires are widely used in autism assessment. However, their psychometric properties are generally not evaluated in clinical practice, and the comparability and applicability of such research is limited because questionnaires are often not simultaneously evaluated. This certainly pertains to predictive values which are highly population and setting specific. This study evaluated the power of AQ and SRS-A in predicting an ASD diagnosis within the same clinical population. The patient records of 92 adults, referred for autism assessment, were analyzed. The AQ proved somewhat better than the SRS-A at discriminating and predicting autism. The predictive values of both questionnaires were lower than reported in general population studies. Psychometric results in core publications appear less representative for clinical practice.

Prevalence of Anti-HCV Antibody Among the General Population in Mainland China Between 1991 and 2015: A Systematic Review and Meta-analysis

Our study aims to estimate the burden of hepatitis C virus (HCV) infection among the general population in Mainland China. We searched 4 databases for studies of the prevalence of anti-HCV antibody among the general population. Studies that met the selection criteria were included in the meta-analysis. Ninety-four studies with 10729 929 individuals were finally included. Overall, the prevalence of anti-HCV antibody among the general population in Mainland China is 0.91% (95% confidence interval, 0.81%–1.03%). The prevalence rates of anti-HCV antibody were geographically different, with a range of 0.32%–6.51%, and the East and South of China had a relatively lower prevalence. The prevalence of anti-HCV antibody increased successively from 0.16% to 3.95% with advancing age. It was noteworthy that the prevalence of anti-HCV antibody decreased continuously from 2.09% to 0.45% during 1991–2010, whereas it increased to 0.58% during 2011–2015.