Asthma control and its predictors in Ethiopia: Systematic review and meta-analysis

Background Determining the status of asthma control and identifying risk factors for poor asthma control is a key strategy for curbing the negative health impacts and the financial burden of the disease. Therefore, this review was aimed to determine the rate of asthma control and assess the predictors of uncontrolled asthma in Ethiopia. Methods PubMed, Web of Science, and Google Scholar searches were performed using key terms; “asthma, bronchial asthma, control, controlled, uncontrolled and Ethiopia” up to October 16, 2020. University repositories were also searched to retrieve gray literature. The results were presented as a prevalence rate with a 95% confidence interval (CI). Subgroup analysis and meta-regression were performed to identify the sources of heterogeneity in the outcomes. Results From 1,388 patients, based on the Global Initiative for Asthma (GINA) symptom control, the rate of the uncontrolled asthma was 45.0% (95% CI 34.0% - 56.0%) with a considerable heterogeneity between the studies; (I2: 94.55, p< 0.001). About 19.0% (95% CI 10.0% - 29.0%); (I2: 96.04, p< 0.001) of the asthma patients had a well-controlled asthma. Moreover, 36.0% (95% CI 22.0% - 50.0%), (I2: 97.11, p< 0.001) of patients had a partly controlled asthma. Similarly, based on the asthma control test (ACT), the rate of well-controlled asthma was 22.0% (95% CI 3% - 42.0%), with considerable heterogeneity between the studies; (I2: 97.75, p< 0.001). The most frequent predictors of uncontrolled asthma were incorrect inhalation techniques, frequent SABA use, moderate/severe persistent asthma, history of exacerbations, presence of comorbidities, use of oral corticosteroids, and irregular follow-up. Conclusion The rate of uncontrolled asthma in Ethiopia was high. Several factors are associated with uncontrolled asthma. Comprehensive asthma educations at each follow-up visit should be strengthened to minimize the morbidity and the cost of uncontrolled asthma.

The impact of the first COVID-19 lockdown in the UK for doctoral and early career researchers

Doctoral researchers and early career researchers (ECRs) are crucial to producing scientific advancements and represent the future of academic leadership. Their research endeavours were changed radically by lockdowns in response to the COVID-19 pandemic. The aim of this study was to explore the perceived benefits and challenges of the national lockdown in the UK from the perspective of doctoral researchers and ECRs. We present analysis of qualitative survey data from 1,142 doctoral researchers and ECRs on their experiences of the first UK lockdown collected from April 16, 2020–May 14, 2020. Our findings suggest considerable heterogeneity in how the pandemic impacted this key group of academic workers. Challenges arising from the lockdown largely cohered around a poor work environment, limited access to resources, perceptions of pressure, and negative psychological outcomes. Conversely, respondents also highlighted several benefits in the early stages of the pandemic, with the change to working from home creating more time, resulting in greater productivity and a better work-life balance. Collectively, findings indicate the importance of considering the personal circumstances and needs of individual researchers. We discuss the implications for support these researchers require to rebuild their careers in the wake of the initial disruption.

Helicobacter pylori infection is associated with reduced risk of Barrett’s esophagus: a meta-analysis and systematic review

Background Helicobacter pylori (Hp) is a class I carcinogen in gastric carcinogenesis, but its role in Barrett’s esophagus (BE) is unknown. Therefore, we aimed to explore the possible relationship. Methods We reviewed observational studies published in English until October 2019. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for included studies. Results 46 studies from 1505 potential citations were eligible for inclusion. A significant inverse relationship with considerable heterogeneity was found between Hp (OR = 0.70; 95% CI, 0.51–0.96; P = 0.03) and BE, especially the CagA-positive Hp strain (OR = 0.28; 95% CI, 0.15–0.54; P = 0.0002). However, Hp infection prevalence was not significantly different between patients with BE and the gastroesophageal reflux disease (GERD) control (OR = 0.99; 95% CI, 0.82–1.19; P = 0.92). Hp was negatively correlated with long-segment BE (OR = 0.47; 95% CI, 0.25–0.90; P = 0.02) and associated with a reduced risk of dysplasia. However, Hp had no correlated with short-segment BE (OR = 1.11; 95% CI, 0.78–1.56; P = 0.57). In the present infected subgroup, Hp infection prevalence in BE was significantly lower than that in controls (OR = 0.69; 95% CI, 0.54–0.89; P = 0.005); however, this disappeared in the infection history subgroup (OR = 0.88; 95% CI, 0.43–1.78; P = 0.73). Conclusions Hp, especially the CagA-positive Hp strain, and BE are inversely related with considerable heterogeneity, which is likely mediated by a decrease in GERD prevalence, although this is not observed in the absence of current Hp infection.

REPRINTED WITH PERMISSION OF IASP – PAIN 161 (2020) 880–888: Neck pain and headache after whiplash injury: a systematic review and meta-analysis

Neck pain and headache are 2 of the most common complications of whiplash injury. Therefore, we performed a systematic literature search on PubMed and Embase for publications reporting on the prevalence of neck pain and headache after whiplash injury. The literature search identified 2709 citations of which 44 contained relevant original data. Of these, 27 studies provided data for the quantitative analysis. For non-population-based studies, the present metaanalysis showed that a pooled relative frequency of neck pain was 84% confidence interval (68–95%) and a pooled relative frequency of headache was 60% (46–73%), within 7 days after whiplash injury. At 12 months after injury, 38% (32–45%) of patients with whiplash still experienced neck pain, while 38% (18–60%) of whiplash patients reported headache at the same time interval after injury. However, we also found considerable heterogeneity among studies with I2-values ranging from 89% to 98% for the aforementioned meta-analyses. We believe that the considerable heterogeneity among studies underscores the need for clear-cut definitions of whiplash injury and standardized reporting guidelines for postwhiplash sequelae such as neck pain and headache. Future studies should seek to optimize these aspects paving the way for a better understanding of the clinical characteristics and natural course of whiplash-associated sequelae.

Self vs. other, child vs. adult. An experimental comparison of valuation perspectives for valuation of EQ-5D-Y-3L health states

Objectives EQ-5D-Y-3L health states are valued by adults taking the perspective of a 10-year-old child. Compared to valuation of adult EQ-5D instruments, this entails two changes to the perspective: (i) child health states are valued instead of adult health states and: (ii) health states are valued for someone else instead of for oneself. Although earlier work has shown that these combined changes yield different values for child and adult health states that are otherwise equal, it currently remains unclear why. Hence, we aimed to disentangle the effects of both changes. Methods A sample of 205 students (mean age: 19.48) was surveyed. Each respondent completed visual analogue scale (VAS) and time trade-off (TTO) tasks for five EQ-5D-Y-3L states, using four randomly ordered perspectives: (i) self-adult (themselves), (ii) other-adult (someone their age), (iii) self-child (themselves as a 10-year-old), (iv) other-child (a child of 10 years old). We compared how each perspective impacted outcomes, precision and quality of EQ-5D-Y-3L valuation. Results Overall, differences between perspectives were consistent, with their direction being dependent on the health states and respondents. For VAS, the effect on outcomes of valuation depended on severity, but variance was higher in valuation with child perspectives. For TTO, we observed that EQ-5D-Y-3L states valued on behalf of others (i.e., children or adults) received higher valuations, but lower variances. Conclusion The use of a different perspective appears to yield systematic differences in EQ-5D-Y-3L valuation, with considerable heterogeneity between health states and respondents. This may explain mixed findings in earlier work.

Bilingual lexical representation

This paper has two aims: (1) to examine evidence for noncognate translation priming from cross-language masked priming studies of printed words. (2) to introduce an automatic procedure for creating masked speech priming experiments. For (1) we conducted two meta-analyses that aggregated evidence from masked translation priming studies in the L1 to L2 and L2 to L1 prime-target directions. These showed that there was evidence of significant priming for both directions, and that priming was larger for the L1-L2 direction. The analyses revealed considerable heterogeneity in outcomes, particularly for priming in the L1 to L2 direction. For (2) we outlined some of the practical difficulties that are involved in implementing a masked speech priming experiment and offered a largely automated solution (that we will make available).1 We then briefly considered whether the work with written primes and targets may translate to the spoken medium.

Rethinking Women's Interests: An Inductive and Intersectional Approach to Defining Women's Policy Priorities

Much of the vast literature on the substantive representation of women takes as its point of departure important a priori assumptions about the nature of women as a group. Calling for a rethink of many of those assumptions, a recent body of work recommends an inductive approach to defining women's interests. In line with this view, this article draws on a recently constructed dataset that codes nearly a million Americans' policy priorities over the past 75 years to explore what constitutes women's interests and whether gender differences in priorities cut across partisan and racial divisions. The results suggest there are consistent gender gaps across a large number of policy categories, with women showing particular concern for policy areas traditionally associated with issues of ‘women's interests’. While in many policy areas women were more likely to share policy priorities with other women than with their male counterparts of the same race or partisan background, the results also document considerable heterogeneity among women in various policy areas, which has major policy implications for the representation of women's interests.

Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis

There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11–0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36–0.52) and aphthous lesions 0.10 (95% CI 0.01–0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.

A Murine Model of Mycobacterium kansasii Infection Reproducing Necrotic Lung Pathology Reveals Considerable Heterogeneity in Virulence of Clinical Isolates

Among non-tuberculous mycobacteria, Mycobacterium kansasii is one of the most pathogenic, able to cause pulmonary disease indistinguishable from tuberculosis in immunocompetent susceptible adults. The lack of animal models that reproduce human-like lung disease, associated with the necrotic lung pathology, impairs studies of M. kansasii virulence and pathogenicity. In this study, we examined the ability of the C57BL/6 mice, intratracheally infected with highly virulent M. kansasii strains, to produce a chronic infection and necrotic lung pathology. As a first approach, we evaluated ten M. kansasii strains isolated from Brazilian patients with pulmonary disease and the reference strain M. kansasii ATCC 12478 for virulence-associated features in macrophages infected in vitro; five of these strains differing in virulence were selected for in vivo analysis. Highly virulent isolates induced progressive lung disease in mice, forming large encapsulated caseous granulomas in later stages (120–150 days post-infection), while the low-virulent strain was cleared from the lungs by day 40. Two strains demonstrated increased virulence, causing premature death in the infected animals. These data demonstrate that C57BL/6 mice are an excellent candidate to investigate the virulence of M. kansasii isolates. We observed considerable heterogeneity in the virulence profile of these strains, in which the presence of highly virulent strains allowed us to establish a clinically relevant animal model. Comparing public genomic data between Brazilian isolates and isolates from other geographic regions worldwide demonstrated that at least some of the highly pathogenic strains isolated in Brazil display remarkable genomic similarities with the ATCC strain 12478 isolated in the United States 70 years ago (less than 100 SNPs of difference), as well as with some recent European clinical isolates. These data suggest that few pathogenic clones have been widely spread within M. kansasii population around the world.

Control and Intimate Partner Aggression

<p>Control is fundamental to theoretical conceptualizations of intimate partner aggression (IPA). In particular, it has been instrumental in the development of typologies of IPA, where control has been associated with more frequent and serious IPA carried out by men against women. Consequently, the concept of control has heavily influenced the design of treatment and legislation targeting partner violence. However, there is considerable theoretical divergence as to how control should be conceptualized, operationalized, and measured. This thesis comprises a series of studies designed to test the validity of some of the key theoretical assumptions that inform the common conceptualizations of control by examining control as a behavior, as a motivation, and as an outcome. Chapter 1 provides an overview of the thesis rationale and objectives. Chapter 2 investigated the theoretical assumption that non-physical ‘controlling behaviors’ (e.g., restricting access to money; threatening harm) comprise a unique form of IPA. Exploratory (N = 561) and confirmatory (N = 424) factor analyses on 54 measures used across the IPA literature identified three forms of aggression: Eclectic Aggression, Direct Psychological Aggression, Monitoring Acts. There was no evidence for a distinct form of ‘controlling behaviors’. Chapter 3 systematically reviewed the literature on motivations for physical and psychological IPA. The review aimed to appraise the quality of the literature and ascertain which motivations had the largest effect sizes. A meta-analysis of the motivations for physical IPA suggested self-defense, retaliation for emotional hurt, and communication difficulties had larger effect sizes than control. Chapter 4 investigated the assumptions that control motivations are associated with more severe and frequent IPA and IPA perpetrated by men. Categorical principal and latent class analyses (N = 1166) found considerable heterogeneity in motivations for IPA for both genders, but no evidence of distinct patterns or profiles of controlling motivations for either men or women. Chapter 5 investigated the assumptions that coercive control is experienced exclusively by women and is related to experiencing specific types and more frequent IPA (N = 1174). Evidence did not support a “coercive control” pattern or profile in people who experienced IPA, or that coercive control outcomes were gendered, or associated with the type or the frequency of IPA behaviors used. Regressing the item-average of coercive control outcomes on experiences of IPA in a path analysis provided some evidence that gender and experiences of physical and psychological aggression predicted feelings of coercive control. Collectively, the results of the thesis identified considerable heterogeneity in the patterns of behaviors, motivations and outcomes for IPA. The evidence challenges existing conceptualizations of control as a distinct and gendered construct and indicates the need for the development of a theoretical explanation of control, that is both gender-inclusive and multi-factorial, to guide future research.</p>