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BACKGROUND: Globally, over 40 million lives have been claimed by HIV/AIDS. In Ghana, more than 350,000 people are living with HIV. Non-disclosure of HIV status is a major barrier to HIV/AIDS eradication; yet, little is known of the determinants of HIV status disclosure in resource limited settings in Africa like Ghana. OBJECTIVE: Determine the predictors of HIV status disclosure among people living with HIV (PLHIV) and stimulate policy discourse on support systems for self-disclosure in Africa. METHODS: This is a descriptive cross-sectional study among PLHIV (n = 181) in sub-Saharan Africa, specifically the Volta region of Ghana. Bivariate probit regression was run to determine factors associated with HIV status disclosure among PLHIV. RESULTS: HIV status self-disclosure was reported by 50% of the respondents; nearly 65% disclosed their status to non-family members and non-partners. Significant correlates of HIV status disclosure either to partners or non-partners were marital status, monthly income, type of occupation, and being divorced due to HIV status (p

Abstract The phosphatase and tensin homolog (PTEN) gene acts as a tumor suppressor by regulating the PI3K/AKT pathway, crucial for cell growth and survival. Mutations or loss of PTEN are common in breast cancer, leading to uncontrolled cell growth. Understanding PTEN’s role is vital for targeted therapies. 276 formalin-fixed paraffin-embedded (FFPE) breast cancer tissue blocks from 2012 to 2016 were analyzed for PTEN expression. Immunohistochemistry was performed to identify and assess tumor related clinicopathological characteristics as well as patient demographics. These were statistically matched with PTEN expression. Only 27.5% of the breast cancer tumors were PTEN-positive. PTEN expression correlated significantly with smaller tumor size, lower tumor grade, positive estrogen and progesterone receptor status, and favorable/unfavorable Ki67 status (p 0.05). The study confirms PTEN's association with favorable clinicopathological features in breast cancer, supporting its role as a prognostic marker. These findings underscore the importance of PTEN in breast cancer biology and its potential as a therapeutic target. Furthermore these findings confirm the prevalence of advanced stage and aggressive breast cancer tumors in Ghana.

BackgroundCOVID-19 disruptions including lockdowns and prioritization of COVID-19 control programs in Africa in 2020–2022 contributed to reductions in malaria control activities including malaria diagnosis, treatment and resistance monitoring. This study investigated the malaria burden and distribution on the background of active transmission of SARS-CoV-2 in Southern Ghana; utilizing community health education and medical screening (CHEMS) approach to determine epidemiological overlaps in COVID-19 and malaria.MethodsBetween October–December 2022, prospective cross-sectional surveys, with CHEMS were conducted in Greater Accra and Central regions, where 994 participants enrolled either at a hospital or community setting provided demographic and clinical data including history of clinical malaria infection and antimalarial treatment in the past 2 weeks. Of this study population, 953 provided nasal/throat swabs for COVID-19 RT-PCR testing, with a subset of 136 participants also providing finger-prick blood for malaria RDT testing.ResultsThe study population comprised of 73.6% adults, with 54.6% COVID-19 vaccination rate. Overall, 18.1% of participants had a history of clinical malaria, which was associated (adjusted odds ratio > 1.50, p-value ≤0.022) with COVID-19 symptoms and positivity, study area and hospital setting, suggestive of overlaps in the epidemiological risk for malaria. On a background of widespread SARS-CoV-2 infections (12–37%), malaria parasitaemia was detected in 6%, with 2% being co-infections with SARS-CoV-2. Among the malaria positives, 9.5% had a history of antimalarial treatment, which suggested that their infections were recrudescent parasitaemia.ConclusionThe epidemiological and clinical overlap between malaria and COVID-19 within the hospital and community settings underscores the need for accurate case diagnosis to inform effective clinical treatments. Innovative surveillance programs, with community engagement are needed to maximize control interventions including treatment of asymptomatic malaria infections.

Abstract Background Little is known about the nexus between online gambling and psychological distress among youth, especially in Ghana. This study aimed to investigate the effects of online sports betting on psychological distress, focusing on depression, anxiety, and stress among young individuals in the Volta region of Ghana. Methods A cross-sectional study was carried out at various betting centers in the Volta region of Ghana. Four hundred and three (403) participants were selected using a multi-stage sampling method. The study used a standardized questionnaire to assess psychological distress with the Depression, Anxiety, and Stress Scale (DASS 21) and problematic gambling with the Problem Gambling Severity Index (PGSI). The analysis included both descriptive and inferential methods. These include the implementation of the bootstrap technique within multiple regression models using the current versions of Jeffreys’s Amazing Statistics Program (JASP) [0.18.2], Statistical Package for the Social Sciences (SPSS) [29.0.2], and Microsoft Excel (2019). Results The study found a prevalence of 40% for problematic gambling and 44% for moderate gambling problems among participants, resulting in an overall gambling prevalence of 84%. Regarding psychological distress, the estimated prevalence of depression among participants was 43.6%, with stress reported at 31.1% and anxiety at 68.8%. The overall prevalence of psychological distress was 48%. When analyzing the link between gambling and psychological distress, the study noted that males were more prone to gambling-related psychological distress than females (β = 2.036, p = 0.025). Furthermore, individuals with problem gambling showed the highest probability of experiencing more significant psychological distress compared to other groups (β = 9.228, p = 0.002), followed by those with moderate gambling levels (β = 3.283, p = 0.002). Conclusion We recommend that the mental health unit of the Ghana Health Service, in collaboration with the Gaming Commission of Ghana, should develop youth-friendly interventions to address the prevalence and onset of problematic gambling among the youth, especially males. This could, in turn, reduce the prevalence of psychological distress among youth engaged in online gambling in Ghana.

Abstract Background Application of numerous malaria control interventions has led to reduction in clinical malaria cases and deaths but also the realisation that asymptomatic parasite carriers play a key role in sustaining transmission. This study assessed the effectiveness of using the Ultra-sensitive NxTek eliminate RDT (uRDT) and conventional SD Bioline HRP2 RDT (cRDT) in diagnosing asymptomatic parasitaemia while measuring the impact of mass testing, treatment and tracking (MTTT) on the prevalence of asymptomatic malaria over a 1-year period in Ghana. Methods A total of 4000 targeted participants from two towns, Obom and Kofi Kwei, with their surrounding villages, were tested for asymptomatic malaria four times over the study period using uRDT (intervention) and the cRDT (control) respectively. Participants carrying malaria parasites were followed by home visit and phone calls for compliance to treatment, and filter paper blood blots collected from participants were used to determine true parasite carriage by PET-PCR. A mathematical model of the study site was developed and used to test the impact of test sensitivity and mass migration on the effect of MTTT. Results The start and end point sensitivities of the cRDT were 48.8% and 41.7% and those for the uRDT were 52.9% and 59.9% respectively. After a year of MTTTs, asymptomatic parasite prevalence, as determined by PCR, did not differ statistically in the control site (40.6% to 40.1%, P = 0.730) but decreased at the intervention site (55.9% to 46.4%, P

Abstract Background Malaria in pregnancy can have adverse outcomes if untreated. Both malaria and pregnancy are associated with insulin resistance and diabetes. Although malaria is treated prophylactically with gestational diabetes mellitus (GDM) screened for in pregnancy as part a routine antenatal care, their impacts have not been examined in terms of other forms of dysglycaemia. This cross-sectional study examined insulin resistance and its relationship with dysglycaemia and malaria among pregnant women in the Cape Coast Teaching Hospital (CCTH). Methods Using a structured questionnaire, demographic and clinical information were obtained from 252 pregnant women aged 18–42 years. Weight and height were measured for computation of body mass index (BMI). Measurement of insulin, lipid profile and glucose were taken under fasting conditions followed by oral glucose tolerant test. Insulin resistance and beta-cell function were assessed by the homeostatic model as malaria was diagnosed by microscopy. Results The respective prevalence of GDM, gestational glucose intolerance (GGI) and insulin resistance were 0.8% (2/252), 19.44% (49/252) and 56.75% (143/252). No malaria parasite or dyslipidaemia was detected in any of the participants. Apart from BMI that increased across trimesters, no other measured parameter differed among the participants. Junior High School (JHS) education compared with no formal education increased the odds (AOR: 2.53; CI: 1.12–5.71; P = 0.03) but 2nd trimester of pregnancy compared to the 1st decreased the odds (AOR: 0.32; CI: 0.12–0.81; P = 0.02) of having insulin resistance in the entire sample. In a sub-group analysis across trimesters, pregnant women with JHS education in their 3rd trimester had increased odds (AOR: 4.41; CI: 1.25–15.62; P = 0.02) of having insulin resistance. Conclusion Prevalence of GDM and GGI were 0.8% and 19.44% respectively. The odds of insulin resistance increased in pregnant women with JHS education in the 3rd trimester. Appropriate measures are needed to assuage the diabetogenic risk posed by GGI in our setting.

Abstract Finite element analysis (FEA) is commonly used in orthopaedic research to estimate localised tissue stresses and strains. A variety of boundary conditions have been proposed for isolated femur analysis, but it remains unclear how these assumed constraints influence FEA predictions of bone biomechanics. This study compared the femoral head deflection (FHD), stresses, and strains elicited under four commonly used boundary conditions (fixed knee, mid-shaft constraint, springs, and isostatic methods) and benchmarked these mechanics against the gold standard inertia relief method for normal and pathological femurs (extreme anteversion and retroversion, coxa vara, and coxa valga). Simulations were performed for the stance phase of walking with the applied femoral loading determined from patient-specific neuromusculoskeletal models. Due to unrealistic biomechanics observed for the commonly used boundary conditions, we propose a novel biomechanical constraint method to generate physiological femur biomechanics. The biomechanical method yielded FHD (

The carbon neutrality policy aiming for net zero carbon emissions has led to a significant increase in the use of renewable energy sources (RES) globally. However, due to their uncertain nature, RES can cause imbalances in power demand. Recently, Power-to-X (P2X) station technology has gained attention as a solution to the uncertainties of RES and as a means to enhance the capacity and efficiency of RES operations. P2X stations can be utilized when power demand imbalances occur due to the uncertain output of RES or when the power system cannot accommodate the power supply from RES due to various stability issues. Specifically, when supply disruptions occur in the power system due to RES uncertainties, P2X stations contribute to preventing RES curtailment by supplying power to electric vehicle (EV) fuel sources, producing heat using electric heat pumps (EHP), or producing hydrogen using electrolyzers (ELZ), thus improving the uncertain financial benefits for independent power producers (IPP). This paper proposes a mixed-integer linear programming (MILP) based chance-constrained two-stage stochastic optimization (CCTS) approach to address imbalances in power demand from RES and to enhance the profitability of IPP by finding the optimal planning and operational solutions for P2X stations. The proposed method provides hierarchical level results, demonstrating that economic benefits can increase by up to 60.2% with the application of P2X stations and that curtailed energy from RES can be reduced by up to 76.5%. The proposed methodology is also validated for its superior performance by being compared with both the non-linear stochastic chance constraint method and the stochastic method.

Background: Diabetes is a condition marked by high blood sugar levels, that could lead to complications in organs such as the kidneys, liver, and heart. Previous research has identified diabetes as a primary risk factor for congestive heart failure (CHF), a condition where stiffened heart muscles hinder oxygenated blood circulation. Despite its severity, few studies have examined CHF prognosis in diabetic patients. This study aimed to provide survival estimates and provide their comparisons among predictors, assess mortality risks based on specific variables, and reveal patient outcome patterns. Methods: We analyzed data from a 2015 study at Faisalabad Institute of Cardiology and Allied Hospital (FICAH), Pakistan, focusing on diabetic patients with Class III or IV heart failure and left ventricular systolic dysfunction. Kaplan-Meier estimates provided survival rates, log-rank tests compared survival across variables, Cox regression models estimated hazard ratios, and cluster analysis grouped patients by characteristics and survival rates. Results: The study examined 125 diabetic heart failure patients. Of these, 40 (32%) were censored and the remaining 85 (68%) died. The total follow-up period was 278 days, on the 120th day, 0.752 [95% CI = 0.678 to 0.883] of the patients survived after initial diagnosis. Cox regression showed a decrement of 60% in the risk of death for females compared to males and identified age (HR = 1.065, p= 0.0006), smoking (HR = 2.228, p= 0.0669) and hypertension (HR = 1.663, p= 0.1639) as major mortality risk factors. Cluster analysis revealed the risk factors associated with middle aged and the older patients. Conclusion: The overall prognosis of heart failure patients with diabetes was poor, with high mortality rates, implying effective treatment and management.

In this paper, an empirical model with the critical number of incidences and deaths for female cancers as adjustable parameters has been developed using life expectancy data from GLOBOCAN world estimates on cancer types. The model was developed based on the cumulative risk and exponential correlation techniques such that the significance of the adjustable parameters ascertains the strength of this research in two ways. First, it indicates indicates the rapid increase in female cancer morbidity with increase in the number of male cancer cases, regardless of incidence or mortality. Second, it suggests that female cancer cases may approach a virtual limiting value as male cancer cases reach extremely high levels. This projection aligns with the global population trends, indicating a proportional increase in cancer cases each year. Additionally, the cumulative risk of cancer incidences of each sex has been modelled separately against the global cumulative risk of cancer incidences of both sexes which revealed regions that have passed their inflection point and those that are yet to reach the inflection point. There was a curvature change, which indicates an inflection point coinciding with the South-Eastern Region and indicating that for the regions beyond the inflection point, the increase of the cumulative risk of cancer incidences of females against that of males is more accentuated compared with the regions before the inflection point. However, when the cumulative risk of cancer mortality of each sex is modelled separately against the global cumulative risk of cancer mortality of both sexes shows a non-linear dependence and the increase is more accentuated for males than for females. This finding indicates that cumulative risk is influenced by factors beyond the male-female population ratio. This study advances cancer studies as it provides a nuanced understanding of gender-specific cancer trends, crucial for developing targeted cancer prevention and treatment strategies. By elucidating the dynamics of cancer incidences and mortalities across different regions and sexes, the findings can inform public health policies and resource allocation to combat cancer more effectively on a global scale.

Particle Image Velocimetry (PIV) is considered the gold standard technique for flow visualization. However, its cost (at least tens of thousands of dollars) can prove inhibitive in its standard form. This article presents an alternative design, leveraging off-the-shelf and open-source options for each key component involved: camera, laser module, optical components, tracer particles, and analysis software. Flow visualization is a crucial technique to connect theory to practice in teaching and researching fluid mechanics. Despite the ubiquity of this field within engineering curricula, many undergraduate institutions globally forego utilizing such equipment, given the barriers to setting it up. The availability of this low-cost alternative (∼$500) that can be built in-house offers a path forward. Characterization was done by visualizing the rotational flow generated by a magnetic stirrer in a cylindrical beaker. The velocity magnitude around the stirrer bar measured by the low-cost PIV system was compared to expected values calculated analytically. The percent difference was between 1–2% when the flow stayed two-dimensional but increased as the flow began developing into more of a 3-D flow. Repeatability varied no more than 6% between experiments. This platform holds the potential for reliable replication across institutions broadly.

Abstract Climate‐smart agriculture (CSA) is key to addressing climate change threats faced by smallholder farmers in Ghana. Nonetheless, evidence of the barriers challenging smallholder farmers in the implementation of CSA practices remains limited in Ghana. This study, therefore, investigated the barriers opposing smallholder cassava farmers in implementing CSA practices in the Afigya Kwabre South District, Ghana. The study used descriptive statistics and content analysis to analyze primary data collected through 200 household surveys and 10 key informant interviews from four selected communities (Aboabogya, Aduamoa, Aduman Old Town, and Aduman New Town) in the district. Results revealed that the smallholder cassava farmers implemented key CSA practices including mulching (89%), mixed farming (86%), crop diversification (84%), and crop rotation (81%) to build their resilience in food systems. Furthermore, the results showed that the critical enablers to the farmers’ utilization of CSA practices were access to weather and climate services (82%), a secured land tenure system (75%), and knowledge of the effects of climate change (68%). Also, the results indicated that the key barriers challenging smallholder cassava farmers in the implementation of CSA practices were inadequate technological assistance (91%), the incidence of pests and diseases (90%), and a lack of knowledge and understanding of CSA (90%). We recommend that smallholder cassava farmers adopt improved varieties of cassava that are resistant to pests and diseases, drought tolerant, high yielding, and possessing desirable quality traits. Smallholder cassava farmers can also participate in contract farming schemes that link them to agribusinesses that can offer them access to quality inputs, credit, training, and guaranteed markets for their produce.

The study compared exhaustively the Successive Approximation Model (SAM) and Analyze, Design, Develop, Implement and Evaluate (ADDIE) model on the teaching and learning of Science, Technology, Engineering and Mathematics subjects in Ghana. We selected a sample of 30 student-teachers who offered Mathematics and Science in the distance mode of the University of Education, Winneba, Ghana in the 2018/2019 academic year. The first stage of the analysis compared the models separately within the Vygotskian framework using pre-post experimental design. The second stage made comparisons between and within the two models. The results of both stages showed that student-teachers preferred mostly SAM to ADDIE instructional models. There were not only consistently higher mean gains in the latter model, but the group averages of student-teachers in the post-treatment results also demonstrated clear improvements. Again, student-teachers showed tremendous improvements in the conceptual understanding of both models. However, the Successive Approximation Model recorded much more improvements in both pre-treatment and post-treatment results. It was therefore imperative to conclude that the Successive Approximation Model was more properly situated in the context of teaching and learning Mathematics and Science. We, therefore, recommended experimental explorations of SAM for STEM.

Abstract Background Despite the widespread prevalence of adolescent smoking in Gambia, a West African country, there is limited research exploring the relationships between exposure to pro-tobacco and anti-tobacco media messages and events and smoking behaviour among young people. This study investigates the interplay of these exposures and smoking behaviour among 11-17-year-old adolescents in Gambia. Methods Secondary data analysis was conducted using the 2017 Gambia Global Youth and Tobacco Survey (GYTS), which included a total of 9,127 respondents. Descriptive and inferential analyses, including proportions, Pearson’s chi-squared tests, and multivariable logistic regression models, were employed to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results The final model revealed significant associations between exposure to anti-tobacco media messages and events and smoking behaviour. Adolescents exposed to anti-tobacco media messages had a 29% increased odds of smoking (aOR 1.29,CI = 1.08,1.53) compared to those unexposed, while exposure to anti-tobacco media events showed a 31% increased odds (aOR 1.31,CI = 1.09,1.59) compared to those unexposed. Exposure to pro-tobacco messages, such as witnessing tobacco use on TV (aOR 1.41, CI = 1.17,1.69) and owning objects with tobacco brand logos (aOR 1.49,CI = 1.19,1.86), was associated with higher odds of smoking. Covariates, including sex, age, and exposure to smoking behaviour by significant others, also demonstrated associations with smoking behaviour. Notably, male respondents showed significantly higher odds of smoking (aOR = 4.01,CI = 3.28,4.89) compared to females. Respondents aged 15 years and older had increased odds of smoking (aOR = 1.47,CI = 1.22,1.76) compared to those below 15 years old. Those whose fathers smoke displayed higher odds of smoking (aOR = 1.35, CI = 1.04,1.76) compared to individuals with non-smoking parents. Additionally, those whose closest friends smoke showed remarkably higher odds of smoking (aOR = 2.87,CI = 2.37, 3.48) compared to those without such influence. Conclusion This study underscores the significant impact of exposure to both anti-tobacco and pro-tobacco media messages and events on smoking behaviour among adolescents in Gambia. However, pro-tobacco messages had a greater influence on smoking prevalence than anti-tobacco messages and events. Understanding these associations is crucial for devising effective public health interventions aimed at reducing tobacco use in this population.

Abstract Accurate physical activity monitoring is essential to understand the impact of physical activity on one’s physical health and overall well-being. However, advances in human activity recognition algorithms have been constrained by the limited availability of large labelled datasets. This study aims to leverage recent advances in self-supervised learning to exploit the large-scale UK Biobank accelerometer dataset—a 700,000 person-days unlabelled dataset—in order to build models with vastly improved generalisability and accuracy. Our resulting models consistently outperform strong baselines across eight benchmark datasets, with an F1 relative improvement of 2.5–130.9% (median 24.4%). More importantly, in contrast to previous reports, our results generalise across external datasets, cohorts, living environments, and sensor devices. Our open-sourced pre-trained models will be valuable in domains with limited labelled data or where good sampling coverage (across devices, populations, and activities) is hard to achieve.

Schistosomiasis is a neglected tropical disease that affects more than 200 million people and 45% of infections have been shown to occur in school-aged children. A large percentage of the disease burden lies in Africa. In 2012, the WHO outlined a roadmap for the elimination of schistosomiasis by 2020; however, this was not achieved. Treatment for schistosomiasis is by the use of Praziquantel, a drug in use for over 30 years and there is a concern for emerging drug resistance. There are several species of the genus Schistosoma causing infection in humans. For this study, Schistosoma mansoni which causes intestinal schistosomiasis will be investigated. There are reports of lowering cure rates and suboptimal response to praziquantel following several cycles of mass drug administration (MDA). Praziquantel resistance has also been reported in some countries and laboratory-bred schistosome experiments. To address the concerns of resistance, this study aims to employ a two-part approach to assess the prevalence of S. mansoni. praziquantel resistance amongst school-aged children in schistosomiasis endemic communities in Ghana and develop a diagnostic tool to aid in field assessment of infections. To achieve this, the study will attempt to answer the following research questions: 1. Is there developing S. mansoni praziquantel resistance in communities that have undergone several mass drug administrations? 2. Is there an interplay between intermediate host exposure to praziquantel and the development of praziquantel drug resistance in the definitive host?

Abstract Objective To assess the association between cardiovascular risk factor (CRF) profile and premature all-cause and cardiovascular disease (CVD) mortality among US adults (age

Abstract Background Haemoglobin (Hb) variants such as sickle cell trait (SCT/HbAS) play a role in protecting against clinical malaria, but little is known about the development of immune responses against malaria parasite (Plasmodium falciparum surface protein 230 (Pfs230) and Plasmodium falciparum erythrocyte binding antigen 175 region-3 (PfEBA175-3R)) and vector (on the An. gambiae Salivary Gland Protein-6 peptide 1 (gSG6-P1)) antigens in individuals with variants Hb genotypes. This study assessed antibody (IgG) responses against malaria parasite, Pfs230 and PfEBA175-3R and vector, gSG6-P1 in febrile individuals with variant Hb genotypes. Methods The study was conducted on symptomatic malaria patients attending various healthcare facilities throughout Ghana. Microscopy and ELISA were used to determine the natural IgG antibody levels of gSG6-P1, PfEBA175-3R & Pfs230, and Capillarys 2 Flex Piercing was used for Hb variants determination. Results Of the 600 symptomatic malaria patients, 50.0% of the participants had malaria parasites by microscopy. The majority 79.0% (398/504) of the participants had Hb AA, followed by HbAS variant at 11.3% (57/504) and HbAC 6.7% (34/504). There were significantly (p

In the ever-changing landscape of education, the integration of technology has become an inevitable force that reshapes the foundations of teaching and learning. Amidst this transformative wave, the concept of Artificial Intelligence (AI) has taken center stage, promising innovative approaches, and increased efficiency. Within this context, the exploration of preservice teachers' behavioural intention to employ AI in lesson planning has emerged as a critical issue for examination. This study used a descriptive cross-sectional survey design and employed a purposive sampling technique to recruit 783 preservice teachers. By employing a cutting-edge dual-staged partial least squares structural equation modelling-artificial neural network (PLS-SEM-ANN) approach, this study investigated the influence of the following essential variables on preservice teachers' intentions to incorporate AI into their lesson planning endeavours: performance expectancy, effort expectancy, habit, hedonic motivation, social influence, and facilitating conditions. Social influence emerged as the most significant positive predictor of preservice teachers' behavioural intention to use AI in lesson planning. Additionally, habit, performance expectancy, effort expectancy, and facilitating conditions substantially positively influenced preservice teachers' behavioural intention to use AI in lesson planning. Conversely, hedonic motivation did not significantly affect preservice teachers’ behavioural intention to use AI in lesson planning. This study not only enhances our understanding of technology integration in pedagogy from a theoretical standpoint but also provides practical recommendations for refining educational curricula and instructional strategies that promote effective AI integration.

AbstractThe study examines the effect of compliance with national governance frameworks on the relationship between corporate governance and the performance of publicly traded companies in Ghana. A sample of 31 companies listed on the Ghana Stock Exchange was drawn for the study based on their annual reports spanning from 2013 to 2022. A new national governance quality index composed of items drawn from world governance indicators and a corporate governance index was developed by principal component analysis. The study used the Huber M-estimation Robust Least Squares (HMRLS) regression method. The findings of our study reveal that corporate governance practices adversely affect the level of firm performance. However, our results demonstrate that compliance with national governance and institutional frameworks plays a significant moderating role in the relationship between corporate governance and firm performance. The study offers managerial implications, as listed firms can adopt effective national governance and institutional quality practices to improve firm performance.

AbstractThis study explored the perspectives of community members on the management and ownership of freshwater resources. A mixed-method study was conducted targeting household heads, traditional leaders, and assembly members in communities surrounding the lake. Household heads (309), and 14 focus group discussions were used in the study. There were 46.9% and 29.4% of the respondents who perceived that the lake was owned by the government and the community (chiefs and the indigene) respectively. While 48.2% and 28.8% perceived the traditional authority and the government separately as the managers of the lake. The study found out that, the community perceives the Lake as their resource and hence their traditional leaders should have control over it with support from the government and other NGOs. This implies that activities carried out concerning the Lake should have the approval of people to avoid conflict and power struggles.

AbstractTeacher self-efficacy is one of the most critical factors influencing students’ learning outcomes. Accordingly, school reforms globally have advocated professional learning communities (PLCs) as a school-level approach for improving teachers’ instructional practices. This inquiry tested the influence of PLCs on teaching efficacy beliefs of Economics teachers. Survey data were collected from 97 Economics teachers in senior high schools of Cape Coast Metropolis, Ghana, using adapted Professional Learning Community Assessment-Revised (PLCA-R) and Teacher Sense of Efficacy scale (TSES). The data were analysed using descriptive statistics and structural equation modelling. The findings showed that Economics teachers had high level of teaching efficacy. They were moderately engaged in the implementation of PLCs. The research also revealed that shared and supportive leadership (SSL) had statistically significant effect on teachers’ teaching efficacy beliefs. Further, it was discovered that shared value and vision (SVV), collective learning applications (CLA), shared personal practice (SPP), supportive conditions-relationships (SCR) and supportive conditions-structures (SCS) had positive effects on teachers’ teaching efficacy. The study recommended that the Ministry of Education (MoE) and school administrators should continue to provide positive school culture that builds teachers’ teaching efficacy and engagement in PLCs.

AbstractThe study investigated the home factors affecting the academic performances of girl children in the Dome cluster of schools. A descriptive survey methodology was employed in this research. Through a multistage sample technique, 197 respondents were randomly selected. The primary data for the study were collected using a closed-ended questionnaire prepared by the researchers. The findings from the data collection were presented in terms of frequencies, percentages, averages, and standard deviations. The study concluded that the girl child at the Dome cluster of school was involved in household chores, fetching water, household income-generating activities, looking after their siblings and food preparation. The study, also, concluded that parents of students at the Dome cluster of school are of high socioeconomic status and highly involved in their academic work. Also, a girl’s academic performance at the Dome cluster of schools is positively influenced by her home environment factors such as access to educational resource, parental involvement in school events, and her family’s socioeconomic level. However, girl child home activity negatively influenced academic performance. It was recommended that authorities may encourage a balanced distribution of household chores, enhance parental involvement in school events and provide additional support for girls from lower socioeconomic backgrounds.

Over the past few years (2020-present), the United States has experienced a period of racial unrest, which has led to heated debates about school curriculum and policy. Considering the current sociopolitical context, this critical policy analysis traces the trends in statelevel education legislation related to race/ethnicity that was both introduced and enacted between 2020 and 2022. Informed by critical race theory, we analyzed 61 legislative documents spanning 33 states to determine 1) whether the policy promoted or inhibited progress toward racial equity; 2) area(s) of racial equity the policy addressed; and 3) how the policy aimed to address those areas. We observed five key areas of equity the legislation addressed: racial/ethnic knowledge, anti-racism and social justice, disparities, representation, and discrimination. Although the majority of policies (n = 44) promoted progress toward racial/ethnic equity, some of these policies may result in more symbolic action rather than meaningful change. Furthermore, larger structural issues that affect equity--such as segregation--were not addressed. This paper demonstrates the need for education policies to be grounded in research on racial inequity and to intentionally target systemic racism in order to improve educational opportunities. As debates around race and education are ongoing, we hope the findings can be used by both policymakers and leaders in education to help improve equity in education.

Background Social determinants of health (SDoH) are associated with cardiovascular risk factors and outcomes; however, they are absent from risk prediction models. We aimed to assess if the addition of SDoH improves the predictive ability of the MESA (Multi‐Ethnic Study of Atherosclerosis) Risk Score. Methods and Results This was a community‐based prospective population cohort study that enrolled 6286 men and women, ages 45–84 years, who were free of clinical coronary heart disease (CHD) at baseline. Data from 10‐year follow‐up were examined for CHD events, defined as myocardial infarction, fatal CHD, resuscitated cardiac arrest, and revascularization in cases of anginal symptoms. Participants included 53% women with average age of 62 years. When adjusting for traditional cardiovascular risk factors, SDoH, and coronary artery calcium, economic strain, specifically low family income, was associated with a greater risk of CHD events (hazard ratio [HR], 1.42 [95% CI, 1.17–1.71], P value

The main thrust of this study was to assess the infrastructure inequality and academic performance nexus. Education statistics (2018) from the Ghana Statistical Service was used for the study. Firstly, ANOVA was used to estimate whether district-level academic performance differed at various infrastructure distribution levels (Infrastructure Quintile levels). The study further assessed the relationship between infrastructure and academic performance based on the System General Methods of Moments technique. It was found that the difference in district-level academic performance is conditioned on the infrastructure inequality. Also, previous academic performance had a significant positive relationship with performance. A U-shaped relationship found to exist between academic performance and class size, The study recommends the pursuit of policies aimed at bridging the education infrastructure gap such as prioritisation of education infrastructure development in deprived communities, so as, to impact academic performance.

ABSTRACT The COVID-19 pandemic has highlighted the critical need for accurate and efficient diagnostic tools for detecting severe acute respiratory coronavirus 2 (SARS-CoV-2) infections. This study presents a comparison of two diagnostic tests: RT-PCR and antigen detection rapid diagnostic tests (Ag-RDTs). This study focused on their performance, variant specificity, and their clinical implications. A simultaneous testing of 268 samples was carried out for SARS-CoV-2 using RT-PCR and Ag-RDTs [flourescence immunoassay (FIA) and lateral flow immunoassay (LFIA)]. Viral load was quantified, and variant identification was performed using a PCR-based assay. The prevalence was found to be 30.2% using reverse transcription PCR (RT-PCR), 26.5% using FIA, and 25% using LFIA. When comparing the FIA and LFIA, the overall diagnostic performance was found to be 80.25% vs 76.54%, 96.79% vs 97.33%, 91.55% vs 90.51%, and 91.88% vs 92.56% for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), respectively. Both Ag-RDTs showed a strong agreement with RT-PCR (κ = 0.78–0.80). The overall accuracies of the FIA and LFIA were 92.41% and 92.13%, respectively. The FIA showed higher sensitivity (73.68%) and PPV (92.08%) than the LFIA (65.79% and 90.56%, respectively) in asymptomatic patients. At low Ct values ( 30. The diagnostic sensitivity of FIA compared to LFIA for detecting the Alpha variant was 78.85% vs. 69.23% and 72.22% vs. 83.33% for the Delta variant. Both Ag-RDTs had 100% sensitivity for detecting Omicron. Both Ag-RDTs performed well in patients with high viral loads and Omicron variant infections compared to those infected with Alpha and Delta variants. This study confirms the comparable performance of RT-PCR and Ag-RDTs, specifically FIA and LFIA, for SARS-CoV-2 detection. The FIA showed higher sensitivity and PPV in asymptomatic cases, while both Ag-RDTs exhibited strong agreement with RT-PCR results. Notably, Ag-RDTs, particularly FIA, proved effective in detecting the Omicron variant and cases with high viral loads, highlighting their potential clinical utility in managing the COVID-19 pandemic.IMPORTANCEThis study is of utmost importance in providing effective responses to manage the COVID-19 pandemic. It rigorously compares the diagnostic accuracy, variant specificity, and practical considerations of reverse transcription PCR (RT-PCR) and antigen detection rapid diagnostic tests (Ag-RDTs) for severe acute respiratory coronavirus 2 (SARS-CoV-2), answering critical questions. The results of this study will help healthcare professionals choose the appropriate testing methods, allocate resources effectively, and enhance public health strategies. Given the evolution of the virus, understanding the performance of these diagnostic tools is crucial to adapting to emerging variants. Additionally, the study provides insights into logistical challenges and accessibility issues, which will contribute to refining testing workflows, particularly in resource-limited settings. Ultimately, the study’s impact extends to global healthcare, providing valuable information for policymakers, clinicians, and public health officials as they work together for mitigating the impact of the pandemic.

Though little research has been done, shea nut oil (Shea Butter), is a promising shea product with great potential for use in industrial shea product manufacture. To assess the oil obtained from the shea nuts for personal, commercial, and industrial use, this study focuses on the extraction process, the optimal solvent for extraction, thermodynamics and kinetic studies, and characterization of the oil. Using different solvents as well as extraction temperatures and times, the oil was extracted using the solvent extraction method. Moreover, models of thermodynamics and kinetics were used in examining the Shea nut oil extraction at different durations and temperatures. At the highest temperature of 333 K (at 130min), the highest oil yields of 70.2 % and 59.9 % for n-hexane and petroleum ether, respectively, were obtained, following first order kinetics. For both petroleum ether and n-hexane, the regression coefficient (R2) was 1. For the extraction with n-hexane and petroleum ether, the mass transfer coefficient (Km), activation energy (Ea), entropy change (ΔS), enthalpy change (ΔH), and Gibb's free energy (ΔG) were, respectively, (0.0098 ± 0.0061 and 0.0123 ± 0.0084) min−1, 74.59 kJ mol−1 and 88.65 kJ mol−1, (−236.15 ± 0.16 and −235.63 ± 0.17) J/mol K, (71.88 ± 0.06 and 85.94 ± 0.06) kJ/mol, and (148.75 ± 1.52 and 162.46 ± 1.52) kJ/mol. These values favor an irreversible, forward, endothermic, and spontaneous process. Gas chromatography analysis was used to identify the principal fatty acids in the oil, which include stearic acid (52 %), oleic acid (30 %), and linoleic acid (3 %), as well as various minor fatty acids. The oil's potential bonds and functional groups were identified using Fourier Transform Infrared analysis, and the physicochemical parameters such as the iodine value, peroxide value, acid and free fatty acid values were found to be within acceptable ranges for use in domestic, commercial, and industrial settings.

The occurrence of pharmaceuticals and xenoestrogen compounds (PXCs) in drinking water presents a dire human health risk challenge. The problem stems from the high anthropogenic pollution load on source water and the inefficiencies of the conventional water treatment plants in treating PXCs. This study assessed the PXCs levels and the consequential health risks of exposure to tap water from selected Ghanaian communities as well as that of raw water samples from the respective treatment plants. Thus the PXCs treatment efficiency of two drinking water treatment plants in the metropolises studied was also assessed. The study also conducted source apportionment of the PXCs in the tap water. Twenty six (26) tap and raw water samples from communities in the Cape Coast and Sekondi-Takoradi metropolises were extracted using SPE cartridges and analysed for PXCs using Ultra-fast-HPLC-UV instrument. Elevated levels of PXCs up to 24.79 and 22.02 μg/L were respectively recorded in raw and tap water samples from the metropolises. Consequently, elevated non-cancer health risk (HI > 1) to residential adults were found for tap water samples from Cape Coast metropolis and also for some samples from Sekondi-Takoradi metropolis. Again, elevated cumulative oral cancer risks >10−5 and dermal cancer risk up to 4 × 10−5 were recorded. The source apportionment revealed three significant sources of PXCs in tap water samples studied. The results revealed the inefficiency of the treatment plants in removing PXCs from the raw water during treatments. The situation thus requires urgent attention to ameliorate it, safeguarding public health. It is recommended that the conventional water treatment process employed be augmented with advanced treatment technologies to improve their efficacy in PXCs treatment.

Introduction: In spite of the negative effects of the coronavirus disease 2019 (COVID-19) on the global health system, its long-term impact on the evolution of diabetes is not fully ascertained. The current study was therefore designed to examine the diabetogenic risk of adults who had recovered from COVID-19 compared with their counterparts without any history of the condition in the Cape Coast metropolis of Ghana. Research design and methods: This cross-sectional study involved 110 recovered COVID-19 and 110 COVID-19 unexposed respondents. Weight, height, hip circumference (HC) and waist circumference (WC) were measured for computation of body mass index (BMI), waist-to-hip ratio (WHR), and weight-to-height ratio (WtHtR). Also, systolic blood pressure, insulin, C-reactive protein (CRP), fasting blood glucose (FBS), lipid profile, 2-hour oral glucose tolerance test (2hr OGTT), total and visceral fat levels were measured. Homeostatic model assessment of beta-cell function (HOMAB) was applied to assess the secretory function of beta cells with insulin resistance determined by the homeostatic model assessment of insulin resistance (HOMA-IR), fasting insulin resistance index (FIRI), quantitative insulin sensitivity check index (QUICKI), and triglyceride-glucose index (TyG). Results: Recovered COVID-19 respondents exhibited higher (P < 0.05) levels of BMI, WC, HC, WtHtR, CRP, FIRI, HOMA-IR, HOMAB and insulin but lower level of QUICKI than their unexposed counterparts. Compared with the recovered COVID-19 respondents, the overweight/obese COVID-19 unexposed group demonstrated higher insulin resistance but lower beta-cell function. Irrespective of COVID-19 background, FBS and insulin remained independent predictors for FIRI, QUICKI and HOMA-IR as TyG was predicted by FBS and selected components of lipid profile. Conclusion: The recovered COVID-19 respondents demonstrated a higher risk of developing type 2 diabetes mellitus through increased insulin resistance and beta-cell dysfunction than their uninfected counterparts. Urgent measures are needed to mitigate the identified risk.

IntroductionDiversity in malarial antigens is an immune evasion mechanism that gives malaria parasites an edge over the host. Immune responses against one variant of a polymorphic antigen are usually not fully effective against other variants due to altered epitopes. This study aimed to evaluate diversity in the Plasmodium falciparum antigens apical membrane antigen 1 (PfAMA1) and circumsporozoite protein (PfCSP) from circulating parasites in a malaria-endemic community in southern Ghana and to determine the effects of polymorphisms on antibody response specificity.MethodsThe study involved 300 subjects, whose P. falciparum infection status was determined by microscopy and PCR. Diversity within the two antigens was evaluated by msp2 gene typing and molecular gene sequencing, while the host plasma levels of antibodies against PfAMA1, PfCSP, and two synthetic 24mer peptides from the conserved central repeat region of PfCSP, were measured by ELISA. ResultsOf the 300 subjects, 171 (57%) had P. falciparum infection, with 165 of the 171 (96.5%) being positive for either or both of the msp2 allelic families. Gene sequencing of DNA from 55 clonally infected samples identified a total of 56 non-synonymous single nucleotide polymorphisms (SNPs) for the Pfama1 gene and these resulted in 44 polymorphic positions, including two novel positions (363 and 365). Sequencing of the Pfcsp gene from 69 clonal DNA samples identified 50 non-synonymous SNPs that resulted in 42 polymorphic positions, with half (21) of these polymorphic positions being novel. Of the measured antibodies, only anti-PfCSP antibodies varied considerably between PCR parasite-positive and parasite-negative persons. DiscussionThese data confirm the presence of a considerable amount of unique, previously unreported amino acid changes, especially within PfCSP. Drivers for this diversity in the Pfcsp gene do not immediately seem apparent, as immune pressure will be expected to drive a similar level of diversity in the Pfama1 gene.

Over the years, there has been a tremendous increase in enrollment in higher education as well as the cost of attendance. This article comparatively analyzes the higher education finance between the United States of America (U.S.A.) and Ghana, taking into consideration the goals of higher education, enrollment and expenditure, and the various sources of finance available to students in both countries. The source of education finance between both countries is examined through the lens of neoliberalism, which prioritizes capitalism, free trade, and market in public institutions, specifically higher education. While there are disparities in the financing of higher education in both countries, there is a similarity in the limited access to higher education and funding by students from low socioeconomic backgrounds.

The school curriculum is often the formal document designed for teachers to treat topics that allow for the impartation of knowledge and the development of competencies that prepare students for further studies. Achieving this depends mainly on its content structure and sequencing. The aim of this study is two-fold: to find the extent of vertical articulation of topics in the economics syllabus that makes it possible for the syllabus to achieve its purpose of preparing students for further studies; and to explore the extent to which the syllabus is up-to-date and relevant in dealing with current economic issues. Document analysis was used to analyse the syllabus, while eight (8) service teachers purposively selected were interviewed. The study found that the SHS economics curriculum lacked vertical content articulation regarding the learning competencies for Forms 1 to 3. Also, the interviews revealed that the curriculum is not up-to-date though relevant since many evolving economic concepts have not been captured. The study supports the call for curriculum change and alignment of content to improve its vertical articulation and coherence and its currency and relevance in helping to equip students with the requisite knowledge and fundamental economic tools for their daily survival.

Head and neck cancer (HNC) recurrence is ever increasing among Ghanaian men and women. Because not all machine learning classifiers are equally created, even if multiple of them suite very well for a given task, it may be very difficult to find one which performs optimally given different distributions. The stacking learns how to best combine weak classifier models to form a strong model. As a prognostic model for classifying HNSCC recurrence patterns, this study tried to identify the best stacked ensemble classifier model when the same ML classifiers for feature selection and stacked ensemble learning are used. Four stacked ensemble models; in which first one used two base classifiers: gradient boosting machine (GBM) and distributed random forest (DRF); second one used three base classifiers: GBM, DRF, and deep neural network (DNN); third one used four base classifiers: GBM, DRF, DNN, and generalized linear model (GLM); and fourth one used five base classifiers: GBM, DRF, DNN, GLM, and Naïve bayes (NB) were developed, using GBM meta-classifier in each case. The results showed that implementing stacked ensemble technique consisting of five base classifiers on gradient boosted features achieved better performance than achieved on other feature subsets, and implementing this stacked ensemble technique on gradient boosted features achieved better performance compared to other stacked ensemble techniques implemented on gradient boosted features and other feature subsets used. Learning stacked ensemble technique having five base classifiers on GBM features is clinically appropriate as a prognostic model for classifying and predicting HNSCC patients’ recurrence data.

Abstract Background One of the key targets of Ghana’s Adolescent Health Service Policy and Strategy is to ensure that 90% of adolescents and young people have knowledge of sexual and reproductive health services and rights. This phenomenon has led to the establishment of adolescent-friendly health facilities to increase access to health information and services among adolescents. Despite these efforts, access to health information and service utilisation remains low among adolescents. Our study seeks to examine adolescents’ perception of sexual and reproductive health rights (SRHR) and access to reproductive health information and services in the Adaklu district of the Volta region of Ghana. Methods A baseline cross-sectional household survey of 221 adolescents aged 10–19 years in 30 randomly selected communities was used. A structured questionnaire was developed and administered to the respondents. A binary logistic regression analysis was used to examine the association between adolescents’ perception of adolescent sexual and reproductive health rights (ASRHR) and access to reproductive health information and services. Results Adolescents’ perception of SRHR was poor, and this poor perception may have been reflected in a few proportions (10%) of adolescents accessing SRH information and services. Majority (91.9%) of adolescents do not use sexual and reproductive health (SRH) services in the Adaklu district. Adolescents who attained primary education (aOR = 5.99, CI: 1.16–30.95), those who never had sexual communication with their father (aOR = 8.89, CI: 1.99–39.60) and adolescents who never experienced any form of sexual coercion (aOR = 11.73, CI: 1.61–85.68) had a higher likelihood of not utilising SRH services in Adaklu district. Regarding access to SRH information, adolescents who ever discussed sexual matters with their fathers, those who ever used contraceptives and adolescents who ever experienced sexual coercion had lower odds of accessing information on contraception, sexually transmitted infections, and teenage pregnancy. Conclusions Access to and use of sexual and reproductive information and health services among adolescents in Adaklu district remain very low, which has implications for adolescents’ knowledge and perception of their SRHR. Considering the factors predicting this phenomenon, it is recommended that interventions can be tailored to address the unique challenges faced by adolescent in accessing comprehensive SRH support.

Abstract Background Globally, over 40 million lives have been claimed by HIV/AIDS. In Ghana, more than 350,000 people are living with HIV. Non-disclosure of HIV status is a major barrier to HIV/AIDS eradication; yet, little is known of the determinants of HIV status disclosure in resource limited settings in Africa like Ghana. Objective Determine the predictors of HIV status disclosure among people living with HIV (PLHIV) and stimulate policy discourse on support systems for self-disclosure in Africa. Methods This is a descriptive cross-sectional study among PLHIV (n = 181) in sub-Saharan Africa, specifically the Volta region of Ghana. Bivariate probit regression was run to determine factors associated with HIV status disclosure among PLHIV. Results HIV status self-disclosure was reported by 50% of the respondents; nearly 65% disclosed their status to non-family members and non-partners. Significant correlates of HIV status disclosure either to partners or non-partners were marital status, monthly income, type of occupation, and being divorced due to HIV status (p

Cross-border litigation is complex. Generally, judgments made by the courts of one sovereign state are, by themselves, not enforceable in the courts of another sovereign state. Collecting monetary damages or other remedies awarded by a court in an international dispute can be even more difficult because, normally, decisions of a state’s courts have no force outside the territorial boundaries of that state. Efforts to create an internationally accepted convention for the recognition and enforcement of foreign judgments have not had much success, and regional and bilateral agreements have limited reach. This study compares the legal rules in Ghana and the European Union (Brussels I Recast) on the recognition and enforcement of foreign judgments. The study discusses the rules within the two jurisdictions, pointing out any deficiencies that may be identified in the two legal regimes. The aim is to provide recommendations that may be useful in developing the rules under consideration. The recommendations are aimed at adopting appropriate legal rules on the recognition and enforcement of foreign judgments that would likely aid in the promotion of international sales contracts among private persons and other commercial entities located in different countries.