4d N=1\mathcal{N} = 1/2d Yang-Mills Duality in Holography

We study the supergravity dual of four-dimensional ${\mathcal{N}=1}$ superconformal field theories arising from wrapping M5-branes on a K\"ahler two-cycle inside a Calabi-Yau threefold. We derive an effective three-dimensional theory living on the cobordism between the infrared and ultraviolet Riemann surfaces, describing the renormalization group flows between AdS$_7$ and AdS$_{5}$ as well as between different AdS$_{5}$ fixed points. The realization of this system as an effective theory is convenient to make connections to known theories, and we show that upon imposing (physical) infrared boundary conditions, the effective three-dimensional theory further reduces to two-dimensional $SU(2)$ Yang-Mills theory on the Riemann surface, thus deriving a correspondence between the gravity duals of a class of $\mathcal{N}=1$ superconformal field theories arising from wrapping M5-branes on a Riemann surface and two-dimensional Yang-Mills theory on the same Riemann surface.Comment: 18 pages, 2 figure

Perspectives of Protocol Based Breaking Bad News among Medical Patients and Physicians in a Teaching Hospital, Ethiopia

BACKGROUND፡ Discussing potentially bad outcomes is a standard communication task in clinical care. Physicians’ awareness on ways to communicate bad news is considered low. SPIKES protocol is the most popular strategy used by physicians, but its practice and patients' perception are not known. This study attempted to fill the knowledge gap on protocol implementation, patient preference and physician effects.METHODS: Hospital-based descriptive cross-sectional study was conducted at SPHMMC from May 1 to June 30 using structured interviews administered to patients and physicians. Three hundred and sixty patients and 111 physicians were included. Assessment of SPIKES performance, patient satisfaction, patient preference, and physician awareness, attitude and effects were studied.RESULTS: Performance of SPIKES protocol was setting (74.5%), perception (51.1%), invitation (56.3%), knowledge (15.9%), emotion (22.3%) and summary (10.1%). Only 30.6% of the patients were entirely satisfied with the interaction, and 19.2% with knowledge attained. Patient satisfaction was associated with physician asking how much information they like (P=0.025). Patient desire and report showed variation. Eighty-two percent of the physicians were not aware of the protocol, and 83.8% had no training. Half of the physicians feel depressed after disclosure.CONCLUSIONS: Patient satisfaction with communication process and knowledge is poor, as is performance of SPIKES components. Satisfaction is related to being asked how much patients want to know. Patients’ desires on how to be told news is different from how it is done. Breaking bad news increases feeling of depression. Awareness and training on the protocol are deficient; medical schools should incorporate it into their studies and implement proper follow-up.&nbsp

Depression Among Epileptic Patients and its Association with Drug Therapy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

BACKGROUND: Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. The objective of this systematic review and meta-analysis is to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa. METHODS: A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization\u27s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) conducted from December 2, 2017 to February 30, 2018, identified peer-reviewed, original research articles and doctoral dissertations using pre-defined quality and inclusion criteria. Relevant data were extracted and descriptive summaries of the studies presented in tabular form. The I2 statistic was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger\u27s tests were used to check for publication bias and the methodological quality of the included studies were assessed using the scale developed by Hoy and colleagues. The pooled prevalence of comorbidity at a 95% confidence interval (CI) was determined by applying a trim and fill analysis in a random-effects model. RESULTS: Our search identified 167 studies, of which 14 original research articles and two doctoral dissertations reporting on case-control and cross-sectional studies were eligible for inclusion in the final analysis. The pooled estimate of prevalence of depression among patients with epilepsy was 32.71% (95% CI: 25.50-39.91%). Regional sub-group analysis found that the pooled prevalence in East Africa was 34.52% (95% CI: 23.53-45.51%) and 29.69% (95% CI: 22.7-36.68%) in Southern and West Africa. The odds of depression among epileptic patients receiving polytherapy were 2.65 higher than in those receiving monotherapy (95% CI: 1.49-4.71, I2 = 79.1%, p \u3c 0.05). CONCLUSION: Our findings indicate high comorbidity in sub-Saharan Africa and suggest that it may be more prevalent there than elsewhere. Comorbidity is statistically associated with polytherapy in the studies reviewed. Given the high levels of comorbidity in the region, more attention should be paid to incorporating depression screening and treatment into existing epilepsy programs and to revising treatment guidelines on comorbid depression to reduce polytherapy

Empiric treatment of acute meningitis syndrome in a resource-limited setting: Clinical outcomes and predictors of survival or death

Background: Bacterial meningitis is a significant cause of morbidity and mortality in the developing world. However, limited research has focused on the diagnosis and management of meningitis in resource-limited settings.Methods: We designed a prospective case series of children admitted to a large, academic referral hospital with acute meningitis syndrome. Data were collected on age, time of presentation, prior antibiotics, cerebrospinal fluid (CSF) parameters, antibiotic and steroid prescription, and clinical outcome.Results: Data on 99 patients were collected and analyzed. Most of the patients were males, n=69 (70%), and were from a rural area, n=83 (84%). Incomplete  vaccination was common, n=36 (36%) and many have evidence of malnutrition, n=25 (38%). Most patients, n=64 (72%), had received antibiotics prior to admission with a mean duration of symptoms of 4.9 days prior to admission. The CSF white blood cell (WBC) count was higher in those who had not received prior antibiotics though it was elevated in both groups. The CSF WBC count was not associated with survival; malnutrition and length of symptoms prior to admission were both associated with decreased survival.Conclusions: While use of antibiotics prior to obtaining CSF in patients with acute meningitis syndrome may decrease their CSF WBC count, it is not clinically significant. Many patients had a significant delay in presentation that had an effect on survival, This is a potentially modifiable risk factor despite the resource-limited setting.Keywords: bacterial meningitis, children, antibiotics, glucocorticoid

Adherence to COVID-19 preventive measures and associated factors in Ethiopia: A systematic review and meta-analysis

Background: Reluctance to the COVID-19 preventive measures have been repeatedly reported in Ethiopia although compliance with these actions is the key step to minimize the pandemic’s burden. Hence, this systematic review and meta-analysis aims to address the gap in the literature by determining the pooled magnitude of adherence to COVID-19 preventive measures and identifying its associated factors in Ethiopia. Materials and methods: The electronic databases used to search articles were PubMed/MEDLINE, CINAHL, Web of Science, ScienceDirect, Research4Life and other sources of grey literature including Google Scholar and World Health Organization (WHO) database portals for low- and middle-income countries. Full English-language articles published between 2019 and 2022 were eligible for the review and meta-analysis. Relevant data extracted and descriptive summaries of the studies presented in tabular form. The methodological quality of articles assessed using the Joanna Briggs Institute (JBI) quality assessment tool. The pooled magnitude of adherence determined by applying a random-effects model at a 95% CI. Results: Of 1029 records identified, 15 articles were included in the systematic review and 11 were selected for meta-analysis. The pooled estimate of adherence to COVID-19 preventive measures in Ethiopia was 41.15% (95% CI:32.16–50.14%). Furthermore, perceived COVID-19 disease severity (AOR:1.77, 95% CI: (1.40–2.25)), attitude (AOR:1.85, 95% CI: (1.36–2.53)) and knowledge (AOR:2.51, 95% CI: (1.67–3.78)) to COVID-19 preventive measures showed significant association with adherence to COVID-19 preventive measures. Conclusion: The magnitude of adherence to COVID-19 preventive measures in Ethiopia appeared to be low. Therefore, the government of Ethiopia and other stakeholders should mobilize resources to improve the adherence level of the community to the COVID-19 preventive measures and decrease public fatigue

Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia:A review and meta-analysis

Aim: To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia. Methods: We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2 and I2 statistics. This meta-analytic review was reported in compliance with the PRISMA statement. Results: Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P <.001), paternal educational status (P =.001) and household income (P =.002), being married (P =.001) and multiparity (P =.01) were significantly associated with TIBF. There was no significant publication bias. Conclusions: Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries

Association Between the Level of Reported Good Medication Adherence and the Geographic Location of a Patient's Residence and Presence of a Glucometer Among Adult Patients with Diabetes in Ethiopia:A Systematic and Meta-Analysis

Background: Diabetes mellitus (DM) is a major public health problem worldwide that was estimated to have affected the lives of 425 million people globally in 2017. The prevalence and mortality rates of DM have increased rapidly in low- and middle-income countries with an estimated 2.6 million cases of DM occurring in Ethiopia alone in 2015. Objective: Considering that Ethiopia is undergoing an epidemiological transition, it is increasingly important to understand the significant influence DM has on Ethiopians annually. A systematic review and meta-analysis of the existing studies were conducted to better understand the factors that are associated with DM medication adherence across Ethiopia and to elucidate areas for further studies. Methods: Studies were retrieved through search engines in Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, PubMed, Google Scholar, Web of Science, Science Direct, and Scopus. The Newcastle–Ottawa Scale for cross-sectional studies was used to assess the critical appraisal of the included studies. Random effects model was used to estimate the association between the level of medication adherence and the geographic location of a patient's residence and presence of a glucometer at 95% CI with its respective odds ratio. Meta-regression was also used to identify the potential source of heterogeneity. Beggs and Egger tests were performed to determine publication bias. Subgroup analyses, based on the study area, were also performed. Results: A total of 1046 articles were identified through searching, of which 19 articles representing 7756 participants were included for the final analysis stage. Reported good medication adherence among patients with diabetes in Ethiopia was 68.59% (95% CI, 62.00%–75.18%). Subgroup analysis was performed, and the pooled estimate of reported good medication adherence among these patients in regions outside Addis Ababa was 67.81% (95% CI, 59.96%–75.65%), whereas in Addis Ababa it was 70.37% (95% CI, 57.51%–83.23%). Patients who used a glucometer at home had an odds ratio of 2.12 (95% CI, 1.42–3.16) and thus reported good adherence. We found no statistically significant association between the geographic location of a patient's residence and a good level of reported medication adherence (odds ratio, 1.81; 95% CI, 0.78–4.21). Conclusions: Most adult patients with diabetes in these studies had a good level of reported DM medication adherence. Having a glucometer was significantly associated with reported increased medication adherence. Our findings suggest the need for interventions to improve diabetes medication adherence

Sociodemographic Factors Predicting Exclusive Breastfeeding in Ethiopia:Evidence from a Meta-analysis of Studies Conducted in the Past 10 Years

OBJECTIVES: To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia.METHODS: PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2, and I2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were conducted.RESULTS: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03-1.89; I2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05-1.55; I2 = 60.9%) and being married (OR 1.39; 95% CI 1.05-1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status.CONCLUSIONS: In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia.</p

The Effect of Disclosure on Adherence to Antiretroviral Therapy Among Adults Living with HIV in Ethiopia: A Systematic Review and Meta-Analysis.

BACKGROUND: Several factors have been identified as being associated with increased adherence to antiretroviral therapy, including sero-status disclosure; however, studies examining the effect of disclosure on ART adherence in Ethiopia have had inconsistent findings. This systematic review and meta-analysis therefore aims to estimate the pooled effect of disclosure on adherence to ART among adults living with HIV in Ethiopia. METHODS: We performed a systematic search for articles reporting on peer-reviewed, quantitative, English-language observational studies of reporting the association between self sero-status disclosure and good ART adherence in adults living with HIV/AIDS in Ethiopia during published from 2010 to 2015. We searched four electronic databases: PubMed/Medline, the World Health Organization\u27s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) for studies from December 1, 2017 to January 30, 2018. We also searched university repositories and conference abstracts for unpublished studies. We conducted a meta-analysis for the pooled effect of adherence using a random effects model in Stata version 14 and assessed publication bias using the Egger\u27s test for funnel plot asymmetry. RESULTS: Our search returned in 179 studies, of which seven (3.9%), were eligible and included in the final meta-analysis. The seven included studies were conducted from 2010 to 2015. Our analysis found that disclosure had a significant effect on the adherence to ART in adult patients living with HIV. Patients who disclosed were 1.64 times more likely to have good adherence to ART compared with those who did not (OR: 1.64, 95% CI: 1.11, 2.42). The small number of studies eligible for review and differences in study definitions of adherence and disclosure were the main limitations of this study. CONCLUSION: This review found a statistically significant positive effect of disclosure status on the adherence to ART in adult patients living with HIV in Ethiopia. This suggests that Ethiopia\u27s national treatment and prevention programs should redouble efforts to encourage self-disclosure among people living with HIV/AIDS. Encouraging supportive social environments for disclosure, and promoting partner notification and partner disclosure support initiatives might be particularly helpful in this regard

Magnitude, risk factors and outcomes of stroke at Debre Markos Referral Hospital, Northwest Ethiopia:a retrospective observational study

Background: Stroke is one of the leading causes of death and disability in developing countries. The burden of stroke has varied widely in different areas, and there is a paucity of information about stroke in the selected study area. Objectives: To assess the burden, risk factors, and outcomes of stroke at Debre Markos Referral Hospital, Northwest Ethiopia Patients and methods: A hospital-based retrospective observational study was conducted in the medical ward of Debre Markos Referral Hospital from March 2017 to April 2019. A pretested checklist was used to extract relevant data from the chart of stroke patients. All statistical analyses were performed in the SPSS version 20 software. Results: From a total of 2100 admissions in the medical ward, 162 of them were stroke patients, giving the in-hospital magnitude of 7.7%. The in-hospital case fatality rate was 8.6%. Additionally, 27.2% of patients were improved and 39.5% of them were referred. There was a significant association between types of stroke and risk factors such as sex, comorbid hypertension, hyperlipidemia, and atrial fibrillation (P ≤ 0.05). Conclusion: The in-hospital period prevalence of stroke was 7.7%. Ischemic stroke was the most common type of stroke. Hypertension and hyperlipidemia were the leading identified risk factors for stroke. The overall in-hospital mortality was lower than previous studies in sub-Saharan African countries. Therefore, effective strategies and guidelines for the prevention and control of stroke and its risk factors are needed