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Abstract Background Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa. Methods The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords “liver function”, “renal function”, “sickle cell disease”, and “Africa” on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2. Results Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI − 2.99–20.23, I 2 = 97.0%, p 50%, there was substantial variation in the reported articles’ results. Systematic review registration PROSPERO CRD42022346771

Abstract Background Sex hormones and sex chromosomes play a vital role in cardiovascular disease. Testosterone plays a crucial role in men’s health. Lower testosterone level is associated with cardiovascular and cardiometabolic diseases, including inflammation, atherosclerosis, and type 2 diabetes. Testosterone replacement is beneficial or neutral to men’s cardiovascular health. Testosterone deficiency is associated with cardiovascular events. Testosterone supplementation to hypogonadal men improves libido, increases muscle strength, and enhances mood. We hypothesized that sex chromosomes (XX and XY) interaction with testosterone plays a role in arterial stiffening. Methods We used four core genotype male mice to understand the inherent contribution of sex hormones and sex chromosome complement in arterial stiffening. Age-matched mice were either gonadal intact or castrated at eight weeks plus an additional eight weeks to clear endogenous sex hormones. This was followed by assessing blood pressure, pulse wave velocity, echocardiography, and ex vivo passive vascular mechanics. Results Arterial stiffening but not blood pressure was more significant in castrated than testes-intact mice independent of sex chromosome complement. Castrated mice showed a leftward shift in stress–strain curves and carotid wall thinning. Sex chromosome complement (XX) in the absence of testosterone increased collagen deposition in the aorta and Kdm6a gene expression. Conclusion Testosterone deprivation increases arterial stiffening and vascular wall remodeling. Castration increases Col1α1 in male mice with XX sex chromosome complement. Our study shows decreased aortic contractile genes in castrated mice with XX than XY sex chromosomes. Graphical Abstract

Background: Hospitals within Nairobi County, Kenya, offer cervical cancer screening services. However, most female sex workers do not seek this service. Objective: To determine uptake of cervical cancer screening among female sex workers living with HIV in Nairobi, Kenya. Design: A descriptive cross-sectional study. Methods: Computerized simple random sampling was used to select 75 study participants who met the inclusion criteria; data were collected using a structured questionnaire. The study was carried out among female sex workers living with HIV in Nairobi, Kenya, attending the Sex Workers Outreach Program. Results: 40% ( n = 30) of respondents were aged 18–25 years. Only 45.3% (34) had been screened for cervical cancer within the last 1 year. 65.3% ( n = 49) of respondents knew that cervical cancer affects the cervix but were not aware of what caused the disease. 77.6% ( n = 58) found the 8 am–5 pm health facility opening hours a hinderance to seeking services and 66.7% ( n = 50) found the screening method uncomfortable. Cultural practices and beliefs fostered stigma in 39.2% ( n = 29) of the sex workers; hence, they did not seek out services. Conclusion: Lack of information, cultural barriers, and facility operating hours prevent female sex workers living with HIV from getting tested for cervical cancer. These barriers once addressed could improve cervical cancer screening uptake among this high-risk population.

Background Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers’ health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya. Methods We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on Nvivo® software. Iterative analysis process was utilized and themes were identified and collated. Results Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child’s illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative. Conclusion Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.

The goal of this study was to produce sustainable concrete by reducing reliance on cement, which contributes to high carbon footprints, and natural sand, which is being depleted. Sugarcane bagasse ash (SCBA) was used to partially replace cement at 5 %, 10 %, and 15 %, while recycled polyethylene terephthalate (RPET) was used to partially replace sand at 5 %, 10 %, 15 %, and 20 %. The effects of these substitutions on concrete's mechanical and physical properties were examined after 28 days of water curing. The study observed a decrease in fresh density by 0.36 %–2.67 % with SCBA and RPET inclusion. The slump values ranged between 93 mm and 140 mm, indicating good workability. The reference concrete's compressive strength was 39.65 MPa, while the mix with 5 % SCBA and 10 % RPET achieved 38.23 MPa. This mix also showed a 1.2 % higher split tensile strength than the reference concrete. Although the reference concrete's flexural strength was the highest at 4.56 MPa, all SCBA-RPET mixes remained within 86 % of this value. All modified mixes weighed less than the reference concrete, with the compressive strength-to-weight ratio of the mix with 5 % SCBA and 10 % RPET being closest to the reference mix with only a 2.44 % reduction. These findings suggest that SCBA and RPET can be effectively used to produce sustainable concrete with comparable mechanical properties to conventional concrete.

The damage caused by two-spotted spider mites, and the risks associated with chemical pesticides, including health and environmental risks necessitate the exploration of sustainable pest management methods. Predatory mites, such as Phytoseiulus persimilis, are effective biocontrol agents against pests like the two-spotted spider mite (Tetranychus urticae). Thus, this study aimed to evaluate the suitability of different crops for rearing predatory mites (Phytoseiulus persimilis) and assess their effectiveness in controlling two-spotted spider mites (Tetranychus urticae). Linear regression analysis showed significant effects of selected crops on mite populations across all collection times (Collection 1: F (3, 8) = 22.46, p = 0.0003; Collection 2: F (3, 8) = 11.45, p = 0.0029; and Collection 3: F (3, 8) = 9.17, p = 0.0057). ANOVA showed significant differences in mite counts among the crops (F (3, 32) = 18.06, p

Introduction Women engaging in sex work (WESW) have 21 times the risk of HIV acquisition compared with the general population. However, accessing HIV pre-exposure prophylaxis (PrEP) remains challenging, and PrEP initiation and persistence are low due to stigma and related psychosocial factors. The WiSSPr (Women in Sex work, Stigma and PrEP) study aims to (1) estimate the effect of multiple stigmas on PrEP initiation and persistence and (2) qualitatively explore the enablers and barriers to PrEP use for WESW in Lusaka, Zambia.Methods and analysis WiSSPr is a prospective observational cohort study grounded in community-based participatory research principles with a community advisory board (CAB) of key population (KP) civil society organi sations (KP-CSOs) and the Ministry of Health (MoH). We will administer a one-time psychosocial survey vetted by the CAB and follow 300 WESW in the electronic medical record for three months to measure PrEP initiation (#/% ever taking PrEP) and persistence (immediate discontinuation and a medication possession ratio). We will conduct in-depth interviews with a purposive sample of 18 women, including 12 WESW and 6 peer navigators who support routine HIV screening and PrEP delivery, in two community hubs serving KPs since October 2021. We seek to value KP communities as equal contributors to the knowledge production process by actively engaging KP-CSOs throughout the research process. Expected outcomes include quantitative measures of PrEP initiation and persistence among WESW, and qualitative insights into the enablers and barriers to PrEP use informed by participants’ lived experiences.Ethics and dissemination WiSSPr was approved by the Institutional Review Boards of the University of Zambia (#3650-2023) and University of North Carolina (#22-3147). Participants must give written informed consent. Findings will be disseminated to the CAB, who will determine how to relay them to the community and stakeholders.

Abstract Introduction Scab is a fungal disease of common beans caused by the pathogen Elsinoë phaseoli. The disease results in major economic losses on common beans, and there are efforts to develop integrated pest management strategies to control the disease. Modern computational biology and bioinformatics tools were utilized to identify scab disease resistance genes in the common bean by identification of genomic regions and genes associated with resistance to scab disease during natural infection in the field. Methods A diverse set of common bean accessions were analyzed for genetic association with scab disease resistance using a Genome-Wide Association Study design of infected plants and non-infected plants (controls). A fixed and random model circulating probability unification model of these two covariates that considers a minor allele frequency threshold value of 0.03 were deployed during the analysis. Annotation of genes proteins with significant association values was conducted using a machine learning algorithm of support vector machine on prPred using python3 on Linux Ubuntu 18.04 computing platform with an accuracy of 0.935. Results Common bean accessions tested showed varying phenotypes of susceptibility to scab disease. Out of 179 accessions, 16 and 163 accessions were observed to be resistant and susceptible to scab disease, respectively. Genomic analysis revealed a significant association on chromosome one SNP S1_6571566 where the protein-coding sequence had a resistant possibility of 55% and annotated to the Enhancer of Poly-comb like protein. Conclusion The significant differences in the phenotypic variability for scab disease indicate wide genetic variability among the common bean accessions. The resistant gene associated with scab disease was successfully identified by GWAS analysis. The identified common bean accessions resistant to scab disease can be adopted into breeding programs as sources of resistance.

This study accessed the efficiency and health risks of drinking water from different sources treated by filtration, boiling, chlorination, flocculation, and solar disinfection. The microbial quality of 45 treated water samples from boreholes, wells, and pipe-borne water was analyzed to determine treatment effectiveness and to quantify risk using quantitative microbial risk assessment. The effectiveness of each treatment method was a function of sampling sources (p < 0.05) and location (p < 0.10), chlorination and boiling being the most efficient methods (100%). Shiegella in well water samples treated by filtration and flocculation had the highest daily infection risk of 69.5 × 10−1 and 67.5 × 10−1 pppd. The annual risk of infection from Salmonella, Shigella, and Staphylococcus ranged from 7.8 × 10−1 to 1.00 pppy, exceeding the U.S. EPA annual infection benchmark (≤10−4 pppy). Salmonella, Shigella, and Staphylococcus had the highest risk of illness of 4.50 × 10−1, 3.30 × 10−1, and 9.80 × 10−1, respectively. All disease burden values exceeded the WHO disease burden benchmark (≤10−6 DALYs/pppy), with Staphylococcus and Salmonella contributing the highest disease burden of 4.71 × 10−2 and 2.13 × 10−2, DALYs/pppy. Therefore, boiling and chlorination are the best disinfection methods for the pathogens tested. HIGHLIGHTS Filtration of drinking water with ceramic filters (the most common LHWT method in Bamenda, Cameroon) is the least effective method in removing bacterial contaminants such as Salmonella, Shigella and Staphylococcus.; Boiling and chlorinaIon are the most effective disinfection methods for the pathogens tested.; Filtration, flocculation, and SODIS did not reduce pathogenic concentraIons below risk levels.; Bacteria contaminants in poorly-treated drinking water exceeded the WHO disease burden benchmark.;

Abstract Africa accounts for a significant portion of the world’s sweetpotato production where it is widely grown as a staple crop. In sub-Saharan Africa (SSA), sweetpotato serves as an important year-round source of calories and nutrition, a form of income for smallholder and pre-commercial farmers, and is increasingly used as silage for animal feed. However, yield per hectare is considerably lower in SSA than from other regions primarily due to sweetpotato weevils (SPW, Cylas spp., Coleoptera: Brentidae). Weevil feeding causes physical damage to the root and can induce chemical responses that give the storage root a bitter taste, both of which make them unmarketable. Commercial growers in many developed countries rely on frequent chemical treatments and strict quarantine regulations to control SPW, however, this approach is currently not practical for many areas of SSA. In this paper we, (1) outline factors that contribute to SPW infestation; (2) review available strategies and ongoing research for control of SPW, including chemical pesticides, biological control (macro-organismal as well as microbial control), cultural practices, selective breeding, and biotechnology; and (3) discuss the potential for implementing an integrated pest management (IPM) approach that leverages a combination of techniques. We rationalize that a multifaceted strategy for SPW control will improve both the quantity and quality of sweetpotato production in Africa.

It has repeatedly been claimed that institutions play an important, and decisive role in economic development. Many studies have analyzed the effect of formal institution on financial development while informal institutions have received less attention. With this paper, we contribute to the effect of personal freedom as a measure for informal institutions on financial development using annual data from 40 African countries spanning 2000 to 2020. We employ the novel fixed effect panel quantile regression technique. The study documents that, in the upper quantile, personal freedom negatively and significantly affects financial development. This finding explicates that, a low level of personal freedom restricts human choices, limiting personal participation in the development of the financial system in Africa. Thus, personal freedom is important for Africa’s financial development. The study recommends that policymakers rally resolute support to defend and protect human rights and personal liberties that encourage human choices. Additionally, the findings intuitively reinforce the prerequisite for African governments regularly evaluate policies that promote financial sector development, particularly economic freedom and government expenditures.

AbstractThis research aims at [1] identifying the factors that influence visits to Bunso Eco-Park; [2] estimating the recreational demand function for the park; and [3] estimating visitors’ net benefit (consumer surplus) for embarking on an eco-park recreational trip to Bunso using a sample size of 440. Estimates indicate that the annual person value of the site is Gh¢ 191.06 ($ 22.29) translating into an annual economic value of Gh¢ 9,170,880 (US$ 1,070,114.35). There is an inverse relationship between the rate of visits and the travel cost. The positive intercept of the demand function indicates a normal demand curve for the Bunso Eco-Park. The variables of visitors’ family size, marital status, and years visitors have known the eco-park were not significant. Educational level, age, gender, and knowledge of alternative sites were found to be factors influencing the visitation to the Bunso Eco-Park. Further valuation of the non-recreational value of Bunso Eco-Park would be useful to policymakers to place suitable management plans in sustaining and improving the quality of eco-park service.

AbstractAs secularism is increasing and religious diversity is regaining momentum worldwide, it is important to understand how systemic religious differences have influenced financial development in Africa. To this end, this study seeks to investigate the impact of religiosity on financial development in Africa by using freedom of religion to proxy religiosity and domestic credit to the private sector to proxy financial development covered from 2000 to 2020. The results from the panel quantile regression show that religiosity is negatively associated with the use of financial services across the quantile, whereas freedom of association, assembly, and civil society, and security and safety are marginally stronger within the lower, middle, and upper quantiles. The findings underscore that, fundamental human rights exert significant influence on financial development in Africa. Our findings contribute to literature by expanding knowledge on the role of personal freedom on economic activities hence, African governments and policymakers constitutionalize freedom as a fundamental human right, as freedom matters for financial development in Africa.

Background Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers’ health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya. Methods We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on Nvivo® software. Iterative analysis process was utilized and themes were identified and collated. Results Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child’s illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative. Conclusion Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.

Background: The brain drain of Ghanaian radiographers is a growing concern for the Ghana Health Service and patient care in the country. Unfortunately, this is affecting the quality of radiology services in Ghana. This study investigated the determinants of radiographers' brain drain from Ghana and identified potential mitigating factors. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire which was administered online to Ghanaian radiographers. The questionnaire gathered data on push and pull factors that influenced brain drain. Statistical analysis was performed using SPSS version 29. Results: A total of 128 radiographers participated in the study. The findings indicated that 92.2 % of Ghanaian radiographers expressed intentions to work abroad. The estimated means and standard deviations on a five-point Likert Scale demonstrated that poor salary (4.47 ± 0.1) and poor working conditions (4.17 ± 1.1) were the main push factors, while improved living conditions (4.62 ± 0.9) and better health infrastructure (4.55 ± 0.9) were the influential pull/attractive factors. Although there are variations in participants' demographics, comparative analyses of push and pull factors indicated that respondents did not significantly differ in their migration decisions intentions (p

Abstract Introduction Optimizing uptake of pre‐exposure prophylaxis (PrEP) for individuals at risk of HIV acquisition has been challenging despite clear scientific evidence and normative guidelines, particularly for key populations (KPs) such as men who have sex with men (MSM), female sex workers (FSWs), transgender (TG) people and persons who inject drugs (PWID). Applying an iterative Programme Science cycle, building on the effective programme coverage framework, we describe the approach used by the Centre for Infectious Disease Research in Zambia (CIDRZ) to scale up PrEP delivery and address inequities in PrEP access for KP in Lusaka, Zambia. Methods In 2019, CIDRZ partnered with 10 local KP civil society organizations (CSOs) and the Ministry of Health (MOH) to offer HIV services within KP‐designated community safe spaces. KP CSO partners led KP mobilization, managed safe spaces and delivered peer support; MOH organized clinicians and clinical commodities; and CIDRZ provided technical oversight. In December 2021, we introduced a community‐based intervention focused on PrEP delivery in venues where KP socialize. We collected routine programme data from September 2019 to June 2023 using programme‐specific tools and the national electronic health record. We estimated the before‐after effects of our intervention on PrEP uptake, continuation and equity for KP using descriptive statistics and interrupted time series regression, and used mixed‐effects regression to estimate marginal probabilities of PrEP continuity. Results Most (25,658) of the 38,307 (67.0%) Key Population Investment Fund beneficiaries were reached with HIV prevention services at community‐based venues. In total, 23,527 (61.4%) received HIV testing services, with 15,508 (65.9%) testing HIV negative and found PrEP eligible, and 15,241 (98.3%) initiating PrEP. Across all programme quarters and KP types, PrEP uptake was >90%. After introducing venue‐based PrEP delivery, PrEP uptake (98.7% after vs. 96.5% before, p

This paper describes the categories of shifts in the translation of the English Holy Bible; New International Version (NIV) into Dholuo Bible Muma Maler mar Nyasaye (1976). The aim is to evaluate the relevance of the translator’s style in rendering a religious text into the target language and the overall implication on the translation theory and practice. The data is collected through document analysis and Focus Group Discussions. We analyzed forty rank shifted segments purposively from six books from the source and target text based on the Relevance Theory by Sperber & Wilson (1986). The analysis is limited to rank-shifting at the level of clauses utilized in the source language which is translated into the target language. The data is analyzed using content analysis and descriptive method. The following categories of shifts are identified; structure shifts, unit shifts, class shifts and intra-system shifts. This study offers insight to bible translators to understand that since shifts are unavoidable in translation, they should aim to produce a target text that is as accurate and precise as possible to guard against loss of meaning. To do this, translators must understand the original source text and transfer it faithfully and accurately. Moreover, bible translators must understand the context of both the source text and the target text since context plays a great role in rendering translation.

Miombo woodlands benefit humans in a variety of ways, including by providing food and ecosystem services. However, Tanzania's Miombo woodlands are declining due to ever-increasing unsustainable human activities. This study used landsat images for the years 1996, 2006, and 2021 to quantify the extent of land use and cover change in the Mgori and Minyughe forest reserves of the Singida region in Central Tanzania. We conducted interviews with 154 villagers living near the forest reserves to determine the drivers of land use and cover change. The findings showed that increased cultivation, illegal settlements, forest harvesting for timber, charcoal production, and livestock grazing are the primary drivers of land use and cover changes. Over the study period, cultivated land in the Mgori forest reserve increased by 33.56%, settlements by 32.67%, and bushland by 0.52%, while woodlands and grassland decreased by −0.60% and −0.22%, respectively. In the Minyughe forest reserve, cultivated land has grown by 23.81%, scattered cultivation by 16.79%, settlements by 6.58%, and water by 1.02%. During the same time period, significant loss occurred in woodland with a dynamic index of (−3.50%), bushland (−0.75%), grassland (−0.40%), and seasonally inundated grassland (−1.86%). User accuracy was highly reliable in cultivated land, bushland, woodland, and grassland cover. The overall Kappa coefficient values provided substantial accuracy for a specific land cover category. In order to combat deforestation and forest cover loss, the study recommends that the Tanzanian government strengthen conservation in both forest reserves.

Solanum mauriatianum is a woody plant that grows naturally in the tropical and temperate regions. In most rural communities in Ghana and other parts of West Africa, it is widely used for treatment of ailments such as hemorrhoid, yaws, ulcers, and wounds. Despite the long-term usage of the plant in traditional medicine, there is no scientific report on its efficacy. Objective: This study investigates the wound healing properties of ethanolic extract of the plant. Method: The ethanolic leaf extract was formulated into aqueous cream (SME) at the concentrations of 2.5 %, 5.0 % and 7.5 % and the healing effect was tested using wound excision model in rats. The extract was qualitatively screened for the presence of phytochemicals. Results: We observed that the extract contains alkaloids, glycosides, saponins and flavonoids. The extract cream demonstrated significant wound healing by topical application. By day 18, a total wound closure (100 ± 0.00 %) was observed for 7.5 % Solanum mauriatianum leaf extract while the total wound closure for 1 % sulphadiazine at the same period was 92.00 ± 5.83 %. Microscopic examination of the tissues indicated a significant fibroblast proliferation, fibrosis, neovascularization, re-epithelization and scanty inflammatory cells in the wound tissues treated with the extracts compared with the untreated wound tissues. Conclusion: We conclude that ethanolic leaf extract of Solanum mauriatianum has greater potential for the treatment of open wounds.

Concrete is a widely used construction product. This product is presently concerned with the depleting nature of natural sand. Concrete is also being considered with supplementary materials to enhance its footprints. Hence, this study's goal is to examine the performance of reinforced concrete (RC) beams consisting of sustainable materials. The study seeks to qualify the use of concrete made using Sugarcane Bagasse Ash (SCBA) and Recycled Polyethylene Terephthalate (RPET) as structural elements. Proportionately, 10 % RPET is used to partially substitute sand, and 5 % SCBA is used to partially substitute cement. The innovation of this study is in the dual substitution approach and structural behaviour examination. The research probes how RPET and SCBA affect the RC beams’ flexural and shear capacities. The tests are completed ensuing 28 days of water curing. Three RC beams are made for each of the conventional concrete and SCBA-RPET concrete. A set of beams is made for the shear capacity test, while another set is made to examine flexural capacity. The beam dimensions are 160 × 200 × 1200mm3. The findings inform that the beams made with 5 % SCBA and 10 % RPET have a flexural capacity of 11 % less than the conventional beams'. However, the SCBA-RPET beams revealed a shear capacity that is 17.38 % more than the conventional beams'. The crack patterns during and after the shear and flexural strength tests are similar and comparable for the SCBA-RPET beams and the conventional beams. Thus, a sustainable concrete mix suitable for use as a structural beam is derived.

The novel concept called neutrosophic set was launched to take care of indeterminate factors in real-life data. The hybrid model of neutrosophic set and soft set has been widely studied in different areas of algebra, especially in associative structures such as fields, groups, rings, and modules. In this current paper, the novel concept is further introduce to a non-associative structure termed Q−neutrosophic soft quasigroup (Q−NSG) and investigate its different algebraic properties of the quasigroups.

Abstract Prediabetes is characterized by a cluster of glycemic parameters higher than normal but below the threshold of type 2 diabetes mellitus (T2DM). In recent years, phytochemical-rich plant extracts have gained popularity as therapeutic agents for metabolic disorders. This study investigated the effects of papaya leaf (PL) juice supplementation on blood glucose levels in diet-induced obese and prediabetic adult mice. B65JL F1 mice (n = 20) at 12–14 months old were fed a high fat/sugar diet (HFHS) for 120 days. Mice were switched to restricted rodent chow of 3 g feed/30 g body weight/day, supplemented with 3 g/100 mL PL juice for 30 days. HFHS diet remarkably increased fasting plasma glucose levels from 114 ± 6.54 mg/dL to 192.7 ± 10.1 mg/dL and body weight from 32.5 ± 1.6 to 50.3 ± 4.1 g. HFHS diet results in hyperglycemia, insulin resistance, hyperlipidemia, and liver steatosis. The combination of PL juice and restricted diet significantly reduced body weight and fasting blood glucose levels to 43.75 ± 1.4 g and 126.25 ± 3.2 mg/dl, respectively. Moreover, PL juice with a restricted diet significantly improved lipid profile: cholesterol from 204 to 150 mg/dL, LDL-c from 110.4 to 50 mg/dL, and triglyceride from 93.7 to 60 mg/dL. Additionally, PL juice combined with a restricted diet significantly reduced adiposity, reversed fatty liver, and restored skeletal muscle Glut4 and phosphorylated (p-AKT (ser473). This study demonstrated that supplementation of PL juice with a restricted diet was more effective than a restricted diet alone in reversing major symptoms related to prediabetic and obesity conditions.

ABSTRACTThe establishment of refugee settlements has caused profound segmented impacts on the coverage of land use/cover types. Few studies have computed the spatial drivers of land use/cover changes in Refugee prone areas. This study explored how refugee settlements induced geo-changes in land use/cover in Bidi-Bidi refugee settlement in Uganda. Sentinel-2B images (2015, 2017 and 2020) were used to assess and predict (2030 and 2040) the spatial areal extent of land use/cover changes. The images were classified using Supervised algorithm (Maximum-likelihood) and used CA-Markov model to generate transitions into the future. A Binary Logistic regression was used to compute the spatial drivers of geo-changes. Our results reveal that the settlements triggered more geo-changes in built-up (0.6%), refugee settlements (4.1%), and subsistence farmlands (7.0%) at the expense of woodlands (−0.3%), wetlands (−2.9%), and grasslands (−8.3%). The same trajectory will also be expected between 2030 and 2040. The most critical spatial drivers of these changes are as follows: population growth, increased temperatures, precipitation variation, distance to water sources, distance to roads, distance to police posts, and distance to trading centres. To reduce the acceleration of changes in land use/cover types, this study agitates for equal spatial establishment of woodlots, promotion of alternative sources of energy and livelihoods, and settlement construction materials.

Abstract Background Androgens are important sex hormones in both men and women and are supplemented when endogenous levels are low, for gender transitioning, or to increase libido. Androgens also circulate at higher levels in women with polycystic ovarian syndrome, a condition that increases the risk for cardiovascular diseases including hypertension and arterial stiffness. Since our previous work shows an important role for the G protein-coupled estrogen receptor (GPER) in arterial stiffness, we hypothesized that other hormones including androgens may impact arterial stiffness in female mice via downregulation of GPER. Methods The impact of the non-aromatizable androgen dihydrotestosterone (DHT), the glucocorticoid dexamethasone, and the progestin medroxyprogesterone acetate (all 100 nM for 24 h) on GPER and ERα expression was assessed in cultured vascular smooth muscle cells using droplet digital PCR (ddPCR). To assess the in vivo impact of the DHT-induced downregulation of GPER, female ovary-intact C57Bl/6 mice at 15–16 weeks of age were treated with silastic capsules containing DHT for 4 weeks, one with a dosage expected to mimic human male DHT levels and another to double the expected human concentration (n = 8–9/group). Results In cultured vascular smooth muscle cells, GPER mRNA was decreased by DHT (P = 0.001) but was not impacted by dexamethasone or medroxyprogesterone. In contrast, ERα expression in cultured cells was significantly suppressed by all three hormones (P

Abstract Background Sarcopenia in liver cirrhosis is associated with low quality of life and high mortality risk. The pathogenesis has yet to be fully understood. We hypothesized that gut microbiome, bile acid (BA) composition and metabolites differ between cirrhotic patients with and without sarcopenia and contribute to pathogenesis. Methods Cirrhotic patients with (n = 78) and without (n = 38) sarcopenia and non‐cirrhotic controls with (n = 39) and without (n = 20) sarcopenia were included in this study. Faecal microbiome composition was studied by 16S rDNA sequencing, serum and faecal BA composition by ultra‐high‐performance liquid chromatography–tandem mass spectrometry, and metabolite composition in serum, faeces and urine by nuclear magnetic resonance. Results Bacteroides fragilis, Blautia marseille, Sutterella spp. and Veillonella parvula were associated with cirrhotic patients with sarcopenia, whereas Bacteroides ovatus was more abundant in cirrhotic patients without sarcopenia. We observed significantly elevated secondary BAs, deoxycholic acid (DCA; P = 0.01) and lithocholic acid (LCA; P = 0.02), and the ratios of deoxycholic acid to cholic acid (DCA:CA; P = 0.04), lithocholic acid to chenodeoxycholic acid (LCA:CDCA; P = 0.03) and 12 alpha‐hydroxylated to non‐12 alpha‐hydroxylated BAs (12‐α‐OH:non‐12‐α‐OH BAs; P = 0.04) in serum of cirrhotic patients with sarcopenia compared with cirrhotic patients without sarcopenia, indicating an enhanced transformation of primary to secondary BAs by the gut microbiome. CA (P = 0.02) and the ratios of CA:CDCA (P = 0.03) and total ursodeoxycholic acid to total secondary BAs (T‐UDCA:total‐sec‐BAs, P = 0.03) were significantly reduced in the stool of cirrhotic patients with sarcopenia compared with cirrhotic patients without sarcopenia. Also, valine and acetate were significantly reduced in the serum of cirrhotic patients with sarcopenia compared with cirrhotic patients without sarcopenia (P = 0.01 and P = 0.03, respectively). Multivariate logistic regression further confirmed the association of B. ovatus (P = 0.01, odds ratio [OR]: 12.8, 95% confidence interval [CI]: 168.1; 2.2), the ratios of 12‐α‐OH:non‐12‐α‐OH BAs (P = 0.03, OR: 2.54, 95% CI: 0.99; 6.55) and T‐UDCA:total‐sec‐BAs (P = 0.04, OR: 0.25, 95% CI: 0.06; 0.98) in serum and stool CA:CDCA (P = 0.04, OR: 0.79, 95% CI: 0.62; 0.99), and serum valine (P = 0.04, OR: 1.00, 95% CI: 1.02; 1.00) with sarcopenia in cirrhosis after correcting for the severity of liver disease and sex. Conclusions Our study suggests a potential functional gut microbiome–host interaction linking sarcopenia with the altered gut microbiomes, BA profiles and amino acids pointing towards a potential mechanistic interplay in understanding sarcopenia pathogenesis.

Sweetpotato (Ipomoea batatas L.) is an essential food crop globally, especially for farmers facing resource limitations. Like other crops, sweetpotato cultivation faces significant production challenges due to viral infections. This study aimed to identify and characterize viruses affecting sweetpotato crops in Uganda, mostly those associated with sweetpotato virus disease (SPVD). Infected leaf samples were collected from farmers’ fields in multiple districts spanning three regions in Uganda. MiSeq, a next-generation sequencing platform, was used to generate reads from the viral nucleic acid. The results revealed nine viruses infecting sweetpotato crops in Uganda, with most plants infected by multiple viral species. Sweet potato pakakuy and sweet potato symptomless virus_1 are reported in Uganda for the first time. Phylogenetic analyses demonstrated that some viruses have evolved to form new phylogroups, likely due to high mutations and recombination, particularly in the coat protein, P1 protein, cylindrical inclusion, and helper component proteinase regions of the potyvirus. The sweet potato virus C carried more codons under positive diversifying selection than the closely related sweet potato feathery mottle virus, particularly in the P1 gene. This study provides valuable insights into the viral species infecting sweetpotato crops, infection severity, and the evolution of sweet potato viruses in Uganda.

Models involving four species with prey refuge and type I responses have been studied with recommendations on their extension to include either type II or type III responses. However, models with Holling type II responses are de-stabilizing according to most studies. In this paper, therefore, a multi-species ecological system that includes a prey refuge and a Holling type III functional response is analyzed, to study the effect of reserved zones in enhancing the dynamical stability of the proposed system. The Routh-Hurwitz (RH) criterion and the eigenvalue technique are used to study the local stabilities. On the other hand, global stabilities have been studied using the Lyapunov technique. Numerical simulations have been carried out using the Matlab ode45 solver software to verify the analytical results. The findings show that refuge plays a significant part in improving the dynamic stability of the system.

The Q−neutrosophic soft quasigroup is a mathematical innovation for dealing with indeterminate occurrences. The characterization of quasigroups using the concept of Q−neutrosophic soft set is an evolving area of study that, in recent times, has attracted pools of researchers. Different researchers have defined the idea of a Q-neutrosophic soft set under associative structures like groups, fields, rings, and modules. The distributive and symmetric properties of the Q−neutrosophic soft quasigroup are examined in this study, which extends the idea of a Q−neutrosophic soft set to a non-associative behavior known as a quasigroup.

Geopolymer concrete has been the ideal replacement for Ordinary Portland cement concrete in producing green concrete. The binder in geopolymer concrete is a cementitious paste made from amorphous Aluminosilicate and activated by an Alkaline solution. The geopolymerization process is initiated at elevated temperatures. Thus, the curing requires elevated temperatures. This curing method limits the application of geopolymer concrete in the construction industry. In a geopolymer mix, the presence of Calcium ions allows the formation of Calcium Aluminate Silicate and Calcium Silicate Hydrate gels, allowing ambient temperature curing. Therefore, this study investigates the effect of micro lime on the Sugarcane Bagasse Ash-based geopolymer concrete. The micro lime was added to the geopolymer concrete in 1, 3, 5 and 7% by the Sugarcane Bagasse Ash weight. A mix design was based on a Densified Mix Design Algorithm. The tests carried out included compressive strength and water absorption. Ambient curing of the SCBA-based geopolymer concrete was achieved with 1% of the micro lime. The compressive strength increased with the increase of the micro lime, 10N/mm2 at 1%, to 18.25N/mm2 at 7% micro lime. The ambient temperature-cured geopolymer concrete at 3% micro lime had the lowest water absorption rate.

Understanding pollen and ovule fertility as factors influencing fruit and seed set is important in cassava breeding. Extended daylength with red light (RL) and plant growth regulators (PGRs) have been used to induce flowering and fruit set in cassava without any reference to effects on pollen viability or ovule fertilizability. This study investigated the effects of field-applied RL and PGR on pollen viability and ovule fertilizability. Panels of cassava genotypes with early or moderate flowering responses were used. RL was administered from dusk to dawn. Two PGRs, 6-benzyl adenine (BA), a cytokinin and silver thiosulphate (STS), an anti-ethylene, were applied. Pollen viability was assessed based on pollen grain diameter, in vitro stainability, in vivo germinability, ovule fertilizability, and ploidy level. Treating flowers with RL increased the pollen diameter from 145.6 in control to 148.5 µm in RL, 78.5 to 93.0% in stainability, and 52.0 to 56.9% in ovule fertilizability in treated female flowers. The fruit set also increased from 51.5 in control to 71.8% in RL-treated female flowers. The seed set followed a similar trend. The ploidy level of pollen from RL-treated flowers increased slightly and was positively correlated with pollen diameter (R2 = 0.09 *), ovule fertilization (R2 = 0.20 *), fruit set (R2 = 0.59 *), and seed set (R2 = 0.60 *). Treating flowers with PGR did not affect pollen diameter but increased stainability from 78.5% in control to 82.1%, ovule fertilizability from 42.9 to 64.9%, and fruit set from 23.2 to 51.9% in PGR-treated female flowers. Combined BA + STS application caused the highest ovule fertilizability, fruit, and seed set efficiency. These results show that RL and PGR treatments increase pollen viability and ovule fertilizability. This is important for planning pollination strategies in cassava breeding programmes.

Abstract Cassava mosaic disease is caused by a complex of whitefly-transmitted begomoviruses, which often occur in co-infections. These viruses have bipartite genomes consisting of DNA-A and DNA-B that are encapsidated into separate virions. Individual viruses exist in plants and whitefly vectors as populations comprising both genome segments, which can occur at different frequencies. Both segments are required for infection, and must be transmitted for virus spread to occur. Cassava plants infected with African cassava mosaic virus (ACMV) and/or East African cassava mosaic Cameroon virus (EACMCV), in which the ratios of DNA-A:DNA-B titers differed between plants, were used to examine how titers of the segments in a plant relate to their respective probabilities of acquisition by whiteflies and to the titers of each segment acquired and subsequently transmitted by whiteflies. The probabilities of acquiring each segment of ACMV did not reflect their relative titers in the source plant but they did for EACMCV. However, for both viruses, DNA-A:DNA-B ratios acquired by whiteflies differed from those in the source plant and the ratios transmitted by the whitefly did not differ from one – the ratio at which the highest probability of transmitting both segments is expected.

Haemonchus contortus is one of the most common and fatal pathogenic gastrointestinal nematodes of small ruminants causing significant economic losses, particularly in low-income countries. A cross-sectional study was carried out in randomly selected small ruminants kept under traditional husbandry systems in the Apac district (now split into Apac and Kwania districts) in northern Uganda to assess the prevalence, intensity, and associated risk factors of H. contortus infection from May 2018 to January 2019. Faecal samples were collected from a total of 768 randomly selected small ruminants (384 sheep and 384 goats) and examined for parasites using the floatation method and coproculture. The overall prevalence of H. contortus in small ruminants was 73.3% (563/768) by faecal egg count and 70.6% (542/768) by coproculture. The mean number of eggs per gram of faeces in small ruminants was 2046±107 and differed significantly across the host animals ranging from 1729±120 (mean±SE) in goats to 2364±176 in sheep. Significant predictors of infection were the origin of study animals, animal species, breed of animal, age of study animal, faecal consistency, lactation, multispecies grazing, grazing method, and anthelmintic use. The findings of our study provide information on the current status of H. contortus infections in goats and sheep under traditional husbandry systems in Uganda which are critical in designing effective control strategies for the disease.

Rising income inequality has recently garnered intensive attention owing to its significance in theory and practice. This has rendered the mechanism through which inequality can be understood, even from a microscopic perspective, to institute proper policies that curtail it important. We contribute to the literature by examining the effect of freedom on income inequality using data from 34 least-free and 18 most-free countries from 2000 to 2020 in Sub-Saharan Africa and Western Europe, respectively. A novel fixed-effects panel quantile regression econometric estimator was employed, and the findings showed a non-linear relationship between personal freedom and income inequality for both regions. Again, both regions reported an inverse relationship between personal freedom and income inequality within the medium-run quantiles. However, a positive relationship was reported in the short-run and long-run quantiles of Sub-Saharan Africa and Western Europe, respectively, whereas the inverse was the same. Finally, the significant adverse relationship was more dominant in Western Europe, implying that high levels of personal freedom in the region explain the low levels of income inequality compared to Sub-Saharan Africa, which has lower levels of personal freedom and higher income inequality. Concerning the findings, it is recommended that policymakers and governments of least- and most-free regions institutionalise personal liberties that support human capital development and establish mechanisms to implement enacted freedoms.

Employees at wild great ape sites are at high risk of transmitting infectious diseases to endangered great apes. Because of the significant amount of time employees spend near great apes, they are a priority population for the prevention and treatment of zoonotic and zooanthroponotic spillover and need adequate preventive and curative healthcare. Qualitative, semi-structured interviews with 46 staff (rangers and porters) at Bwindi Impenetrable National Park, Uganda (BINP) and key informants from five other wild great ape sites around the world were performed. The objectives of the study were to 1) evaluate health-seeking behavior and health resources used by staff in contact with great apes at Bwindi Impenetrable National Park; 2) evaluate existing occupational health programs for employees working with great apes in other parts of the world; and 3) make recommendations for improvement of occupational health at BINP. Results show that BINP employees do not frequently access preventive healthcare measures, nor do they have easy access to diagnostic testing for infectious diseases of spillover concern. Recommendations include assigning a dedicated healthcare provider for great ape site staff, providing free annual physical exams, and stocking rapid malaria tests and deworming medication in first aid kits at each site.

Background Malaria remains a public health problem in Malawi and has a serious socio-economic impact on the population. In the past two decades, available malaria control measures have been substantially scaled up, such as insecticide-treated bed nets, artemisinin-based combination therapies, and, more recently, the introduction of the malaria vaccine, the RTS,S/AS01. In this paper, we describe the epidemiology of malaria for the last two decades to understand the past transmission and set the scene for the elimination agenda. Methods A collation of parasite prevalence surveys conducted between the years 2000 and 2022 was done. A spatio-temporal geostatistical model was fitted to predict the yearly malaria risk for children aged 2–10 years (PfPR 2–10) at 1×1 km spatial resolutions. Parameter estimation was done using the Monte Carlo maximum likelihood method. District-level prevalence estimates adjusted for population are calculated for the years 2000 to 2022. Results A total of 2,595 sampled unique locations from 2000 to 2022 were identified through the data collation exercise. This represents 70,565 individuals that were sampled in the period. In general, the PfPR2_10 declined over the 22 years. The mean modelled national PfPR2_10 in 2000 was 43.93 % (95% CI:17.9 to 73.8%) and declined to 19.2% (95%CI 7.49 to 37.0%) in 2022. The smoothened estimates of PfPR2_10 indicate that malaria prevalence is very heterogeneous with hotspot areas concentrated on the southern shores of Lake Malawi and the country's central region. Conclusions The last two decades are associated with a decline in malaria prevalence, highly likely associated with the scale-up of control interventions. The country should move towards targeted malaria control approaches informed by surveillance data.

Generally, an aneurysm is a disease of the elderly due to the degenerative aetiological factor. Isolated internal iliac artery aneurysm (IIIAA) is rare, representing 0.3–0.5 % of all intra-abdominal aneurysms. It is a focal dilatation of the internal iliac artery alone with a threshold for surgical intervention set at 8 mm. Herein, we present an unusual presentation of a rare condition of a huge left internal iliac artery aneurysm in a young man with no identifiable risk factor complicated by left ilio-femoral deep vein thrombosis. Even though this is an interesting case study, the lack of facilities to do anaerobic cultures remains a major limitation in our setting.

This paper seeks to establish the cognitive contextual frames of references (CFRs) in the translation of George Orwell’s Animal Farm from English to Kiswahili. The source text “Animal Farm” and the target text "Shamba la Wanyama" were used to gather the study's data. The paper offers insights on how CFRs can be employed in literary translation to domesticate the target text so that it is relevant to the target language audience. Specific word and phrase meanings were deduced from sentences of both the source text and the target text. The analyzed data revealed that the translator used organizational category shifts, textual category shifts, communicational category shifts, and socio-cultural category shifts. The most common CFRs in the Kiswahili translation of Animal Farm were found to be communicational category shifts. The target text is made relevant to the audience through such manipulations.

PurposeIn Uganda, sweetpotato [Ipomoea batatas (L.) Lam] is typically a “woman’s crop,” grown, processed, stored and also mainly consumed by smallholder farmers for food and income. Farmers value sweetpotato for its early maturity, resilience to stresses, and minimal input requirements. However, productivity remains low despite the effort of breeding programs to introduce new varieties. Low uptake of new varieties is partly attributed to previous focus by breeders on agronomic traits and much less on quality traits and the diverse preferences of men and women in sweetpotato value chains.MethodTo address this gap, breeders, food scientists, and social scientists (including gender specialists) systematically mainstreamed gender into the breeding program. This multidisciplinary approach, grounded in examining gender roles and their relationship with varietal and trait preferences, integrated important traits into product profiles.ResultsBuilding on earlier efforts of participatory plant breeding and participatory varietal selection, new interventions showed subtle but important gender differences in preferences. For instance, in a study for the RTBFoods project, women prioritized mealiness, sweetness, firmness and non-fibrous boiled roots. These were further subjected to a rigorous gender analysis using the G+ product profile query tool. The breeding pipelines then incorporated these gender-responsive priority quality traits, prompting the development of standard operating procedures to phenotype these traits.ConclusionFollowing an all-inclusive approach coupled with training of multidisciplinary teams involving food scientists, breeders, biochemists, gender specialists and social scientists, integration into participatory variety selection in Uganda enabled accentuation of women and men’s trait preferences, contributing to clearer breeding targets. The research has positioned sweetpotato breeding to better respond to the varying needs and preferences of the users.

AbstractThis paper appraises the role of contemporary Kiswahili music, a form of oral art, in promoting environmental awareness and advocacy. Using case studies from Kenya and Tanzania, we analyse whether East African music infused with suitable environmental practices can help mainstream environmental education, arouse public interest towards nature, advocate for change in mind-sets, and call for proactive action on environmental conservation, while still offering entertainment. Ethnomusicological Kiswahili songs encouraging connection to nature were purposively chosen and acquired from YouTube. The lyrics of these songs were transcribed, translated, and analysed using Critical Discourse Analysis and Conceptual Metaphor Theories. By examining the context and meanings of these songs, we demonstrate that contemporary environmental songs are art forms of expression that advocate for increased environmental management by eliciting discussions and encouraging active societal eco-friendly remedial actions towards ecological resilience and environmental integrity. This article contributes to the emerging discourse on educational and environmental connections through the use of contemporary music, entertainment, and metaphors, with an overarching view to addressing current and emerging environmental concerns. Consequently, we affirm that African music can be used for entertainment, communication of messages and promotion of positive behaviour change.

Infantile cholelithiasis is a rare occurrence. It is often diagnosed incidentally during ultrasonography for other conditions as most cases are asymptomatic and may be self-limiting. A few cases may however present with prolonged neonatal or infantile jaundice.We report our initial experience with an incidental case of infantile cholelithiasis in an 8-week-old male infant who was brought to our ultrasound unit in Accra, Ghana, for an abdominal ultrasound on account of conjugated hyperbilirubinemia and pigmented stools. The patient had presented initially at the children's emergency unit of the Korle-Bu Teaching Hospital, 2 days after an uneventful delivery, with a history of yellowing of the eyes, noticed on the first day of life, which necessitated the request for the ultrasound examination, leading to this rare finding of infantile cholelithiasis. The availability and use of modern sonographic equipment are likely to result in more effective detection of this incidental finding and its subsequent management.

Abstract Ebola virus is highly lethal for great apes. Estimated mortality rates up to 98% have reduced the global gorilla population by approximately one-third. As mountain gorillas (Gorilla beringei beringei) are endangered, with just over 1000 individuals remaining in the world, an outbreak could decimate the population. Simulation modeling was used to evaluate the potential impact of an Ebola virus outbreak on the mountain gorilla population of the Virunga Massif. Findings indicate that estimated contact rates among gorilla groups are high enough to allow rapid spread of Ebola, with less than 20% of the population projected to survive at 100 days post-infection of just one gorilla. Despite increasing survival with vaccination, no modeled vaccination strategy prevented widespread infection. However, the model projected that survival rates greater than 50% could be achieved by vaccinating at least half the habituated gorillas within 3 weeks of the first infectious individual.

BackgroundSpeech intelligibility and speech comprehension for dysarthric speech has attracted much attention recently. Dysarthria is characterized by irregularities in the speed, strength, pitch, breath control, range, steadiness, and accuracy of muscle movements required for articulatory aspects of speech production. ObjectiveThis study examined the contributions made by other studies involved in dysarthric speech comprehension. We focused on the modes of meaning extraction used in generalizing speaker-listener underpinnings in light of semantic ontology extraction as a desired technique, applied method types, speech representations used, and databases sourced from. MethodsThis study involved a systematic literature review using 7 electronic databases: Cochrane Database of Systematic Reviews, Web of Science Core Collection, Scopus, PubMed, ACM, IEEE Xplore, and Google Scholar. The main eligibility criterion was the extraction of meaning from dysarthric speech using natural language processing or understanding approaches to improve on dysarthric speech comprehension. In total, out of 834 search results, 30 studies that matched the eligibility requirements were acquired following screening by 2 independent reviewers, with a lack of consensus being resolved through joint discussion or consultation with a third party. In order to evaluate the studies’ methodological quality, the risk of bias assessment was based on the Cochrane risk-of-bias tool version 2 (RoB2) with 23 of the studies (77%) registering low risk of bias and 7 studies (33%) raising some concern over the risk of bias. The overall quality assessment of the study was done using TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis). ResultsFollowing a review of 30 primary studies, this study revealed that the reviewed studies focused on natural language understanding or clinical approaches, with an increase in proposed solutions from 2020 onwards. Most studies relied on speaker-dependent speech features, while others used speech patterns, semantic knowledge, or hybrid approaches. The prevalent use of vector representation aligned with natural language understanding models, while Mel-frequency cepstral coefficient representation and no representation approaches were applied in neural networks. Hybrid representation studies aimed to reconstruct dysarthric speech or improve comprehension. Comprehensive databases, like TORGO and UA-Speech, were commonly used in combination with other curated databases, while primary data was preferred for specific or unique research objectives. ConclusionsWe found significant gaps in dysarthric speech comprehension characterized by the lack of inclusion of important listener or speech-independent features in the speech representations, mode of extraction, and data sources used. Further research is therefore proposed regarding the formulation of models that accommodate listener and speech-independent features through semantic ontologies that will be useful in the inclusion of key features of listener and speech-independent features for meaning extraction of dysarthric speech.

BackgroundPostoperative cervical haematoma represents an infrequent but potentially life-threatening complication of thyroidectomy. Since this complication is uncommon, the assessment of risk factors associated with its development is challenging. The main aim of this study was to identify the risk factors for its occurrence.MethodsPatients undergoing thyroidectomy in seven high-volume thyroid surgery centers in Europe, between January 2020 and December 2022, were retrospectively analysed. Based on the onset of cervical haematoma, two groups were identified: Cervical Haematoma (CH) Group and No Cervical Haematoma (NoCH) Group. Univariate analysis was performed to compare these two groups. Moreover, employing multivariate analysis, all potential independent risk factors for the development of this complication were assessed.ResultsEight thousand eight hundred and thirty-nine patients were enrolled: 8,561 were included in NoCH Group and 278 in CH Group. Surgical revision of haemostasis was performed in 70 (25.18%) patients. The overall incidence of postoperative cervical haematoma was 3.15% (0.79% for cervical haematomas requiring surgical revision of haemostasis, and 2.35% for those managed conservatively). The timing of onset of cervical haematomas requiring surgical revision of haemostasis was within six hours after the end of the operation in 52 (74.28%) patients. Readmission was necessary in 3 (1.08%) cases. At multivariate analysis, male sex (P

Abstract Most artificial intelligence (AI) research and innovations have concentrated in high-income countries, where imaging data, IT infrastructures and clinical expertise are plentiful. However, slower progress has been made in limited-resource environments where medical imaging is needed. For example, in Sub-Saharan Africa, the rate of perinatal mortality is very high due to limited access to antenatal screening. In these countries, AI models could be implemented to help clinicians acquire fetal ultrasound planes for the diagnosis of fetal abnormalities. So far, deep learning models have been proposed to identify standard fetal planes, but there is no evidence of their ability to generalise in centres with low resources, i.e. with limited access to high-end ultrasound equipment and ultrasound data. This work investigates for the first time different strategies to reduce the domain-shift effect arising from a fetal plane classification model trained on one clinical centre with high-resource settings and transferred to a new centre with low-resource settings. To that end, a classifier trained with 1792 patients from Spain is first evaluated on a new centre in Denmark in optimal conditions with 1008 patients and is later optimised to reach the same performance in five African centres (Egypt, Algeria, Uganda, Ghana and Malawi) with 25 patients each. The results show that a transfer learning approach for domain adaptation can be a solution to integrate small-size African samples with existing large-scale databases in developed countries. In particular, the model can be re-aligned and optimised to boost the performance on African populations by increasing the recall to $$0.92 \pm 0.04$$ 0.92 ± 0.04 and at the same time maintaining a high precision across centres. This framework shows promise for building new AI models generalisable across clinical centres with limited data acquired in challenging and heterogeneous conditions and calls for further research to develop new solutions for the usability of AI in countries with fewer resources and, consequently, in higher need of clinical support.

Abstract Background Large numbers of elderly patients are admitted to hospitals in acute confusional states. In many, the underlying causes are easily found; in some, correct diagnosis is difficult. Pulmonary embolism (PE), the most serious clinical presentation of venous thromboembolism, is often misdiagnosed because of its non-specific features including delirium. Case presentation A 73-year-old woman was admitted to our hospital in a confused state with no obvious risk factors of PE. D-dimer levels were elevated and contrast-enhanced high-resolution computed tomography (HRCT) of the chest confirmed the diagnosis of PE. She was treated with enoxaparin and discharged on dabigatran. Her symptoms had resolved at the time of discharge, and she has been stable for over three month’s follow-up visit. Conclusion PE should be regarded as a differential in elderly patients with an acute confusional state despite the absence of obvious risk factors. Investigating for and treating when confirmed may save a life.

Abstract Background Pre-eclampsia is the second leading cause of maternal death in Uganda. However, mothers report to the hospitals late due to health care challenges. Therefore, we developed and validated the prediction models for prenatal screening for pre-eclampsia. Methods This was a prospective cohort study at St. Mary's hospital lacor in Gulu city. We included 1,004 pregnant mothers screened at 16–24 weeks (using maternal history, physical examination, uterine artery Doppler indices, and blood tests), followed up, and delivered. We built models in RStudio. Because the incidence of pre-eclampsia was low (4.3%), we generated synthetic balanced data using the ROSE (Random Over and under Sampling Examples) package in RStudio by over-sampling pre-eclampsia and under-sampling non-preeclampsia. As a result, we got 383 (48.8%) and 399 (51.2%) for pre-eclampsia and non-preeclampsia, respectively. Finally, we evaluated the actual model performance against the ROSE-derived synthetic dataset using K-fold cross-validation in RStudio. Results Maternal history of pre-eclampsia (adjusted odds ratio (aOR) = 32.75, 95% confidence intervals (CI) 6.59—182.05, p = 0.000), serum alkaline phosphatase(ALP)

This study examined the relationship between on-job and off-job training on employee job satisfaction at Mbarara University of Science and Technology (MUST) in Western Uganda. To be able to realise the study objectives, a cross-sectional survey design, quantitative in nature was adopted. The targeted population comprised the employees of MUST where a sample of 230 respondents was chosen guided by Krejcie and Morgan sample determination table. Primary data was collected using structured questionnaires through telephone interview in order to adhere to Corona Virus pandemic guidelines related to social distancing. Simple random sampling technique was adopted during sample selection. Data collected was analysed using the analysis function of the Statistical package for the social sciences (SPSS version 20). The study findings indicate a moderate positive and significant relationship between on-job training/off-job training and job satisfaction. On-job training predicted job satisfaction to the tune of 14% compared to 9% variation in job satisfaction caused by off-job training. On the basis of observation that the case institution does not organize trainings for supervisors on how to conduct appraisals, the study recommends that human resource (HR) practitioners and policy makers inculcate trainings for supervisors on how to conduct performance appraisals in order to equip supervisors with sufficient performance appraisal skills to be able to appropriately identify employee training needs. Future research may carry out a long tudinal study to test how on-job and off-job training predict job satisfaction in a private higher learning institution setting in another country.