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BACKGROUND: The efficacy of simvastatin in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear. METHODS: In an ongoing international, multifactorial, adaptive platform, randomized, controlled trial, we evaluated simvastatin (80 mg daily) as compared with no statin (control) in critically ill patients with Covid-19 who were not receiving statins at baseline. The primary outcome was respiratory and cardiovascular organ support-free days, assessed on an ordinal scale combining in-hospital death (assigned a value of -1) and days free of organ support through day 21 in survivors; the analyis used a Bayesian hierarchical ordinal model. The adaptive design included prespecified statistical stopping criteria for superiority (>99% posterior probability that the odds ratio was >1) and futility (>95% posterior probability that the odds ratio was

Abstract Background Cardiovascular risk factors accelerate vascular ageing beyond chronological age, hence early vascular ageing (EVA). Carotid to femoral pulse wave velocity (cfPWV) is a measure of vascular ageing and is used to identify EVA and supernormal vascular ageing (SUPERNOVA). Vascular ageing is not completely understood in African populations. Therefore, we aimed to phenotype young South African adults stratified by cfPWV extremes in terms of non-modifiable and modifiable risk factors. This study included 1133 young adults (mean age: 24.5 years). We measured cfPWV using applanation tonometry. Body composition measures, self-reported 24-h dietary intake, smoking and alcohol consumption were included. Fasting blood samples were analysed for biochemical risk factors. Three groups based on cfPWV percentiles were compared and included SUPERNOVA (≤ 10th percentile), average vascular ageing (AVA, between 10 to 90th percentile) and EVA (≥ 90th percentile). Results Chronological age, male sex, smoking, alcohol use, and blood pressure were incrementally higher across PWV groups (all p trend ≤ 0.007). Black ethnicity was higher (p = 0.038) in the SUPERNOVA group. In exploratory factor analysis, a factor pattern including mean arterial pressure and fasting glucose showed beneficial odds (OR 0.62, p = 0.002) for SUPERNOVA and higher likelihood (OR 2.10, p

Abstract The establishment of industrial hemp (Cannabis sativa L.) fields near row crops has raised concerns about the potential adverse effects of herbicide drift on hemp production. This study examined hemp susceptibility to drift of herbicides registered for use in corn and/or soybeans. Herbicide solutions (2,4-D, dicamba, glufosinate, glyphosate, imazethapyr, lactofen, mesotrione) were applied separately in the wind tunnel (3.6 m s−1 airspeed), simulating drift scenarios, with conventional TP95015EVS (TP) and air inclusion AI95015EVS (AI) flat fan nozzles calibrated to deliver 140 L ha−1 carrier volume at 230 kPa. Mylar cards and hemp plants (20–25 cm tall) were placed downwind up to 12 m. Spray deposition from mylar cards was quantified using fluorometry and hemp biomass was collected 21 post application. Results indicated the nozzle design influenced downwind deposition; 5% of spray deposits from the TP nozzle reached 5.9 m downwind versus 2.0 m for the AI nozzle. Glyphosate, glufosinate, and mesotrione caused the highest biomass reductions, with 50% reductions observed at 19.3 (inferred), 8.7, and 9.3 m downwind for TP nozzle, and 4.1, 4.0, and 2.9 m for AI nozzle. These findings suggest herbicide applications at airspeeds of 3.6 m s−1 or greater present a risk to nearby hemp fields.

ABSTRACT Biomarkers of kidney function, including glomerular, tubular, and fibrotic markers, have been associated with blood pressure in elderly populations and individuals with kidney and cardiovascular diseases. However, limited information is available in young adults. In this study, we compared levels of several kidney function biomarkers between normotensive and hypertensive young adults and explored the associations of these biomarkers with blood pressure within these groups. In this cross‐sectional assessment, twenty‐four‐hour (24‐h) blood pressure measurements of 1055 participants (mean age = 24.6 years) were used to classify hypertension as per the 2018 ESC/ESH guidelines. Biomarkers of kidney function included estimated glomerular filtration rate, urinary albumin, alpha‐1 microglobulin (uA1M), neutrophil gelatinase‐associated lipocalin (uNGAL), uromodulin (uUMOD), and the CKD273 classifier. All urinary biomarkers, except for the CKD273 classifier, were standardized for urinary creatinine (Cr). In the hypertensive group (61.0% White; 73.2% men), urinary albumin‐to‐creatinine ratio (uACR), uNGAL/Cr and uUMOD/Cr were lower than the normotensive group. In multiple regression analyses, 24‐h systolic blood pressure (SBP) (β = 0.14; p = 0.042), 24‐h diastolic blood pressure (DBP) (β = 0.14; p = 0.040), and 24‐h mean arterial pressure (MAP) (β = 0.16; p = 0.020) associated positively with uA1M/Cr in the hypertensive group, while 24‐h MAP positively associated with uACR (β = 0.17; p = 0.017). In exploratory factor analysis, positive associations of 24‐h DBP and 24‐h MAP with a factor pattern including tubular biomarkers were observed in the hypertensive group (24‐h DBP: β = 0.18; p = 0.026, 24‐h MAP: β = 0.17; p = 0.032). In the setting of hypertension, high perfusion pressure in the kidneys may play a role in the development of proximal tubule damage and promote early deterioration in kidney function in young adults. Trial Registration: ClinicalTrials.gov identifier: NCT03292094

الملخص: أهداف البحث: غالبا ما يواجه الأفراد المصابون باضطراب طيف التوحد تحديات في الحفاظ على صحة الفم الجيدة بسبب عوامل مثل الحساسيات الحسية، وصعوبات التواصل، والاختلالات الميكروبية في تجويف الفم. على الرغم من الوعي المتزايد باضطراب طيف التوحد في المملكة العربية السعودية والعالم، لم تقم أي مراجعة منهجية بتقييم تأثير اضطراب طيف التوحد على حالة صحة الفم في المملكة العربية السعودية بشكل شامل. تهدف هذه الدراسة إلى تقييم ما إذا كانت صحة الفم لدى الأفراد المصابين باضطراب طيف التوحد في المملكة العربية السعودية تختلف عن تلك الخاصة بالأفراد الطبيعيين عصبيا، وذلك باستخدام إطار المراجعة المنهجية. طريقة البحث: باستخدام إطار المشاركين والتعرض والمقارنة والنتيجة، تم إجراء بحث منهجي لقواعد البيانات الإلكترونية، وتم إجراء الفحص بشكل مستقل من قبل اثنين من المراجعين، مع حل النزاعات من خلال المناقشة. تم استخراج البيانات المتعلقة بخصائص الدراسة ونتائج صحة الفم بشكل مستقل من قبل اثنين من المراجعين. تم تقييم خطر التحيز باستخدام قائمة التقييم النقدي لمعهد جوانا بريجز للدراسات التحليلية المستعرضة. النتائج: من أصل 763 مقالة تم تحديدها في البداية، استوفى 14 منها معايير الاشتمال. أشارت هذه الدراسات إلى أن الأطفال الذين يعانون من اضطراب طيف التوحد لديهم معدل انتشار أعلى لتسوس الأسنان، وزيادة التهاب اللثة، وزيادة خطر الإصابة بصدمات الأسنان مقارنة بأقرانهم ذوي النمط العصبي. أبدى آباء الأطفال الذين يعانون من اضطراب طيف التوحد مخاوف متزايدة بشأن صحة فم أطفالهم. الاستنتاجات: تدريب أطباء الأسنان على إدارة المرضى الذين يعانون من اضطراب طيف التوحد أمر ضروري. هناك حاجة إلى مزيد من البحث باستخدام عينات أكبر ومنهجية صارمة لتعزيز فهم العلاقة بين اضطراب طيف التوحد ونتائج صحة الفم في المملكة العربية السعودية. Abstract: Background: Individuals with autism spectrum disorder (ASD) often face challenges in maintaining good oral health, because of factors including sensory sensitivities, communication difficulties, and microbial imbalances in the oral cavity. Despite growing awareness of ASD, both in Kingdom of Saudi Arabia (KSA) and globally, no systematic review has comprehensively assessed the effects of ASD on oral health status in KSA. Objective: This study was aimed at assessing whether the oral health of individuals with ASD in KSA might differ from that of neurotypical individuals, on the basis of a systematic review framework. Materials and methods: According to the Participants, Exposure, Comparison, and Outcome (PICO) framework, a systematic search of electronic databases was conducted, and screening was independently performed by two reviewers. Conflicts were resolved through discussion. Data on study characteristics and oral health findings were independently extracted by the two reviewers. The risk of bias was assessed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Results: Of 763 initially identified articles, 14 met the inclusion criteria. These studies indicated that children with ASD have a higher prevalence of dental caries, greater gingival inflammation, and a greater risk of dental trauma than their neurotypical peers. Parents of children with ASD showed elevated concern regarding their children's oral health. Conclusion: Training dental professionals to manage patients with ASD is essential. Further research with larger sample sizes and rigorous methods is necessary to enhance understanding of the relationship between ASD and oral health outcomes in KSA.

Abstract We investigated the incidence and duration of morbidity symptoms among infants aged 6 to 9 months from a low socioeconomic community receiving one egg daily for 6 months. This was a secondary outcome of a randomised controlled trial (RCT) of 500 infants conducted in Jouberton, South Africa. The primary outcome was linear growth. Morbidity data were collected weekly using a symptoms diary and qualitative data with focus group discussions at the endpoint. Ethical approval was obtained from the North-West University Health Research Ethics Committee. The intervention group had a ~ 5% higher incidence of gastrointestinal morbidity (17.0%) compared to the control group (11.9%). Gastrointestinal morbidity without fever tended to be 1.4 times higher in the intervention group (OR: 1.43, 95% CI: 1.03, 1.93; P = 0.058) and tended to be 4 times higher with fever (OR: 4.07, 95% CI: 0.86, 19.23; P = 0.077). The duration of total gastrointestinal and respiratory morbidity was 1.5 days longer in the intervention group (β: 1.491; 95% CI 0.064, 2.918; P = 0.041). Complementary feeding with eggs may have contributed towards an increased risk for gastrointestinal morbidity.

Abstract Objective This study investigates the geographical distribution of private hospitals in Australian capital cities in relation to the Index of Relative Socioeconomic Disadvantage. Methods Using Geographic Information System analysis, the study examined how private hospitals are distributed across different socioeconomic quartiles, providing a comprehensive visualisation of health care accessibility. Results The results indicate an unequal distribution with a substantial concentration of private hospitals within the vicinity of communities classified in the highest socioeconomic classification. This raises significant concerns about health care equity, particularly in light of the increased strain on health care systems before, during and after the COVID‐19 pandemic. Conclusions This study underscores the need for targeted policy interventions to enhance the resilience and accessibility of the private health care sector, specifically targeting disadvantaged communities. It suggests that comprehensive, geographically‐informed data is crucial for policymakers to make informed decisions that promote health equity in the postpandemic landscape.

Abstract Background Dihydrogen (H₂) natural gas is a clean and renewable energy source of significant interest in the transition to sustainable energy. Unlike conventional petroleum-based fuels, H₂ releases only water vapor upon combustion, making it a promising alternative for reducing carbon footprints in the future. However, the microbial impact on H₂ dynamics in H2-emitting zones remains unclear, as does the origin of H2 — whether it is produced at greater depths or within shallow soil layers. In the São Francisco Basin, soil hydrogen concentrations of approximately 200 ppm were identified in barren ground depressions. In this study, we investigated the microbiome associated with this area using the 16S rRNA gene sequencing, with a focus on metabolic processes related to H₂ consumption and production. Soil samples were collected from two monitored (

Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Abstract Background The burden of chronic non-communicable diseases (NCDs) is a growing public health concern. The availability of cost-of-illness data, particularly public healthcare costs for NCDs, is limited in Sub-Saharan Africa (SSA), yet such data evidence is needed for policy action. Objective The objective of this study was to estimate the economic burden of type 2 diabetes (T2D) on Kenya’s public healthcare system in 2021 and project costs for 2045. Methods This was a cost-of-illness study using the prevalence-based bottom-up costing approach to estimate the economic burden of T2D in the year 2021. We further conducted projections on the estimated costs for the year 2045. The costs were estimated corresponding to the care, treatment, and management of diabetes and some diabetes complications based on the primary data collected from six healthcare facilities in Nairobi and secondary costing data from previous costing studies in low and middle-income countries (LMICs). The data capture and costing analysis were done in Microsoft Excel 16, and sensitivity analysis was conducted on all the parameters to estimate the cost changes. Results The total cost of managing T2D for the healthcare system in Kenya was estimated to be US$ 635 million (KES 74,521 million) in 2021. This was an increase of US$ 2 million (KES 197 million) considering the screening costs of undiagnosed T2D in the country. The major cost driver representing 59% of the overall costs was attributed to T2D complications, with nephropathy having the highest estimated costs of care and management (US$ 332 million (KES 36, 457 million). The total cost for T2D was projected to rise to US$ 1.6 billion (KES 177 billion) in 2045. Conclusion This study shows that T2D imposes a huge burden on Kenya’s healthcare system. There is a need for government and societal action to develop and implement policies that prevent T2D, and appropriately plan care for those diagnosed with T2D.

Abstract As individuals near a desired goal, they become more motivated, and happier. When thwarted in their goal pursuit, frustration and negative affect ensue. Slot-machine research indicates that near-misses (being one symbol away from a jackpot) are highly arousing, frustrating, yet motivating outcomes. We used the popular game Wordle to illustrate goal gradient and near-miss effects. In Wordle, an individual tries to guess a five-letter word in six attempts. Wordle gives feedback — letters turn green, orange, or grey depending on how closely guesses match the target word. By analyzing feedback across guesses, players can gauge whether they are approaching or thwarted in their goal pursuit. Wordle also contains near-misses (guesses only one letter away from the target). When feedback indicated players were approaching their goal, positive affect and motivation significantly increased compared to thwarted outcomes which increased frustration. Near-misses were significantly more subjectively arousing than other outcomes. The first appearance of a near-miss (an “approaching” outcome) led to higher motivation and positive affect and less frustration than if the next guess revealed the same four green letters (a “thwarted” near-miss). These findings shed new light on erroneous cognitions among slot-machine players who misinterpret slots games as having goal gradient properties.

Abstract Despite advances in gut health research, the variability of important gut markers within individuals over time remains underexplored. We investigated the intra-individual variation of various faecal gut health markers using an optimised processing protocol aimed at reducing variability. Faecal samples from ten healthy adults over three consecutive days demonstrated marker-specific intra-individual coefficients of variation (CV%), namely: stool consistency (16.5%), water content (5.7%), pH (3.9%), total SCFAs (17.2%), total BCFAs (27.4%), total bacteria and fungi copies (40.6% and 66.7%), calprotectin and myeloperoxidase (63.8% and 106.5%), and untargeted metabolites (on average 40%). For thirteen microbiota genera, including Bifidobacterium and Akkermansia, variability exceeded 30%, whereas microbiota diversity was less variable (Phylogenetic Diversity 3.3%, Inverse Simpson 17.2%). Mill-homogenisation of frozen faeces significantly reduced the replicates CV% for total SCFAs (20.4–7.5%) and total BCFAs (15.9–7.8%), and untargeted metabolites compared to faecal hammering only, without altering mean concentrations. Our results show the potential need for repeated sampling to accurately represent specific gut health markers. We also demonstrated the effectiveness of optimised preprocessing of human stool samples in reducing overall analytical variability.

Abstract Background The use of non-invasive risk scores to detect undiagnosed type 2 diabetes (T2D) ensures the restriction of invasive and costly blood tests to those most likely to be diagnosed with the disease. This study assessed and compared the performance of the African Diabetes Risk Score (ADRS) with three other diabetes risk prediction models for identifying screen-detected diabetes based on fasting plasma glucose (FPG) or glycated haemoglobin (HBA1c). Methods Age, sex, waist circumference, body mass index, blood pressure, history of diabetes and physical activity levels from the SA-NW-PURE study were used to externally validate the ADRS and other established risk prediction models. Discrimination was assessed and compared using C-statistics and nonparametric methods. Calibration was assessed using calibration plots, before and after recalibration. Results Nine hundred and thirty-seven participants were included; 14% had prevalent undiagnosed T2D according to FPG and 26% according to HbA1c. Discrimination was acceptable and was mostly similar between models for both diagnostic measures. The C-statistics for diagnosis by FPG ranged from 0.69 for the Simplified FINDRISC model to 0.77 for the ADRS model and 0.77 for the Simplified FINDRISC model to 0.79 for the ADRS model for diagnosis by HbA1c. Calibration ranged from acceptable to good, though over- and underestimation were present. All models improved significantly following recalibration. Conclusions The models performed comparably, with the ADRS offering a non-invasive way to identify up to 79% of cases. Based on its ease of use and performance, the ADRS is recommended for screening for T2D in certain Black population groups in South Africa. HbA1c as a means of diagnosis also showed comparable performance with FPG. Therefore, further validation studies can potentially use HbA1c as the standard to compare to.

Enhancing the clinical trial capabilities within Africa is essential to augment the continent’s pandemic prevention, preparedness and response efforts. Here, we describe the critical challenges of clinical trials in Africa and draw upon the lessons learnt from the Consortium for COVID-19 Vaccine Clinical Trials (CONCVACT) experience, such as the importance of regional collaboration, capacity building and establishing standardized protocols.

Abstract Background Phlebotomus papatasi is considered the primary vector of Leishmania major parasites that cause zoonotic cutaneous leishmaniasis (ZCL) in the Middle East and North Africa. Phlebotomus papatasi populations have been studied extensively, revealing the existence of different genetic populations and subpopulations over its large distribution range. Genetic diversity and population structure analysis using transcriptome microsatellite markers is important to uncover the vector distribution dynamics, essential for controlling ZCL in endemic areas. Methods In this study, we investigated the level of genetic variation using expressed sequence tag-derived simple sequence repeats (EST-SSRs) among field and colony P. papatasi samples collected from 25 different locations in 11 countries. A total of 302 P. papatasi sand fly individuals were analyzed, including at least 10 flies from each region. Results The analysis revealed a high-level population structure expressed by five distinct populations A through E, with moderate genetic differentiation among all populations. These genetic differences in expressed genes may enable P. papatasi to adapt to different environmental conditions along its distribution range and likely affect dispersal. Conclusions Elucidating the population structuring of P. papatasi is essential to L. major containment efforts in endemic countries. Moreover, the level of genetic variation among these populations may improve our understanding of Leishmania–sand fly interactions and contribute to the efforts of vaccine development based on P. papatasi salivary proteins. Graphical Abstract

Abstract Introduction The Department of Health and Human Services recently recommended rescheduling cannabis from Schedule I to Schedule III, which might have broad effects on public health outcomes related to cannabis. In this changing environment, understanding national patterns in how people obtain information about cannabis is critical to informing public health outreach and education. Methods We surveyed American adults (≥ 18 years) between June 22nd-26th, 2023 using the AmeriSpeak panel. We assessed past year cannabis use, intentions for cannabis use, and where participants got their information about cannabis. We investigated differences by past year use and explored associations between demographic and cannabis use characteristics with information sources using logistic regression. Results Participants (n = 1,161) were 48.3±27.3 years of age (mean±standard deviation), 51% female, and 27% reported past year cannabis use. The most common information sources used were friends/family (35.6%) and websites (33.7%), while the least common information sources were health/medical care providers (9.3%), employees at place of purchase (8.6%), and government agencies (4.7%). Past year cannabis use was positively associated with all information sources except government agencies and popular media articles. A higher proportion of those using cannabis medically (with or without recreational use) obtained information from a healthcare provider (16.4% vs. 5.2%, p = 0.006). Conclusions As cannabis accessibility increases and legality continues changing, there is a strong need for better clinician education, improved public health outreach, and improved communication between patients and clinicians about cannabis.

A statistically designed property database of six commercial glass families is leveraged to develop models relating viscosity to temperature and composition. Specialized models for each glass family were designed based on the Adam–Gibbs equation. We show that the whole range of viscosity data of one glass family from 100 to 1012 Pa s can be accurately modeled using one composition-dependent and two composition-independent parameters when glass transition temperature and viscosity at that temperature are independently determined. Generalization to a broader composition space using the same approach leads to a loss of accuracy compared to specialized models. However, this can be mostly negated when Gaussian process regression is used to estimate the compositional dependence of configuration entropy and fragility exponent parameters of the Adam–Gibbs equation.

Abstract Background This study aimed to assess the usefulness of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire in the South-African context and to validate it as an appropriate tool for measuring health-related quality of life (HRQoL). Method The ExAMIN Youth SA study was designed to investigate lifestyle behaviours, including psychosocial factors that may adversely impact on cardiovascular health of children. Construct validity was examined by using exploratory and confirmatory factor analysis, while internal consistency was tested by Cronbach’s alpha. The final factor structure was confirmed by model fit indices. Results The study included children (n = 1088) aged between 5 and 10 years in North-West, South Africa. The reliability coefficients of the original factors could not be reproduced in this data set, with the Cronbach’s alphas ranging between 0.46 and 0.78. With exploratory factor analysis, including the additional items, our data supported a 7-factor structure with acceptable internal consistency (Cronbach’s alpha: 0.68–0.79; Omega: 0.75–0.85) and acceptable model fit indices (CFI: 0.91; TLI: 0.90; RMSEA: 0.05; SRMR: 0.07). Two factors (emotional wellbeing and everyday functioning) further split into separate factors for positive and negative experiences related to each of these dimensions. Conclusion We confirmed a new factor structure of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire, which can be used in the African context. Although the new factor structure has great overlap with the original structure, some items did not contribute to the factors as expected. Language and cultural differences between the original German group and the current South African study group resulted in a different factor structure.

For Bernard Stiegler 'the question of philosophy is first of all that of action' (p.7). By extending this statement to philosophy of education, I consider the possibilities of action in education in responding to the conditions of the contemporary. These conditions, which have come to be discussed and dissected with reference to such terms as Anthropocene (Stoermer, Crutzen), Capitalocene (Moore), Plantationocene (Haraway), hold unprecedented and mostly devastating consequences for all life. To consider possibilities for action within the field of education to the conditions of the contemporary, I read Walter Mignolo's concept of the colonial wound together with Gilles Deleuze's conceptualisation of the wound. Based on this reading, I argue for the conditions of the contemporary to be understood as a wound in both Mignolo's and Deleuze's sense. Conceptualising it as such in turn allows me to ask how we might counter-actualise the wounds of the contemporary. In other words, how might we be worthy of the wound-event and respond in an affirmative yet critical manner to it within the field of education, and in so doing generate new possibilities of (educational) life. To consider what one such possibility of counter-actualisation might entail, I propose that education be informed by the notion of incompleteness, as expressed in the concept of conviviality. I conclude by reflecting on implications of counter-actualising the wound of the contemporary in relation to education if we were to activate the concepts of incompleteness and conviviality and pursue a different aesthetics of (educational) life.

Following a preliminary study that examined the potential effectiveness of a computer-assisted consecutive interpreting (CACI) mode, this paper presents a further trial of the CACI workflow. The workflow involves respeaking using speech recognition (SR) in phase I and production assisted by the SR text and its machine translation (MT) output in phase II. This study introduces a training framework for CACI that encompasses respeaking, sight translation, and post-editing. Additionally, it seeks to evaluate the CACI workflow with a group of trained students. Comparative analyses were conducted between conventional consecutive interpreting (CI) and CACI. Most of the findings from the preliminary study were successfully replicated in this study. The investigation revealed that CACI outperformed conventional CI in overall interpreting quality and accuracy in both directions of interpreting. Moreover, CACI exhibited higher fluency and lower cognitive load compared to conventional CI, albeit only in the L1-L2 direction. The quality of respeaking was found to be positively correlated with interpreting quality in both directions, underscoring the critical role of respeaking within the CACI workflow.

Advocacy for social justice is a core duty of the social work profession. Social injustice, oppression, and marginalization in the United States demand that social workers critically evaluate and address systemic oppression, in the profession, society, and social work education. This study sought to explore the attitudes of social work students in institutions of higher education in one Midwestern state concerning social justice, systemic racism, race relations, and policing to measure the impact of social work educational programming on promoting anti-oppressive and anti-racist practice. Survey responses from undergraduate and graduate students (n = 74) from two universities in an upper, Midwestern state were analyzed to assess attitude and beliefs on social justice, policing, and racial relations. Results indicate the majority of students endorsed an understanding of injustice in the world and high perceptions of themselves as advocates and agents of social change. Alternatively, students' responses to items regarding a general belief in the world as providing just rewards and punishments were neutral. These results suggest the need for increased examination of the implicit and explicit curriculum. The use of Critical Race Theory, decolonization practices for higher education which includes diversifying perspectives in course materials and learning activities among other practices, and modeling of the positionality of self by social work instructors is examined.

Abstract Background Mortality data and comparative risk assessments from sub-Saharan Africa are limited. There is an urgent need for high quality population health surveys to be conducted, to improve the national health surveillance system. Our aim was to perform a comparative risk assesment and report on the mortality status and cause of death data of participants from a South African site of the international Prospective Urban Rural Epidemiology study. Methods 1 921 Black participants were included, with a median observational time of 13 years resulting in 21 525 person-years. We performed a comparative risk assessment considering four health status domains: locality (rural vs. urban), socio-economic status (SES) (education and employment), lifestyle factors (physical activity, smoking and alcohol consumption) and prevalent diseases (human immunodeficiency virus (HIV), type 2 diabetes mellitus and hypertension). Next, population-attributable fractions (PAFs) were calculated to determine the mortality risk attributable to modifiable determinants. Results 577 all-cause deaths occurred. Infectious diseases (28.1% of all deaths) were the most frequent cause of death, followed by cardiovascular disease (CVD) (22.4%), respiratory diseases (11.6%) and cancer (11.1%). The three main contributors to all-cause mortality were HIV infection, high SES and being underweight. HIV infection and underweight were the main contributors to infectious disease mortality and hypertension, the urban environment, and physical inactivity to CVD mortality. HIV had the highest PAF, followed by physical inactivity, alcohol and tobacco use and hypertension (for CVD mortality). Conclusion This African population suffers from a quadruple burden of disease. Urban locality, high SES, prevalent disease (HIV and hypertension) and lifestyle factors (physical inactivity, tobacco and alcohol use) all contributed in varying degrees to all-cause and cause-specific mortalities. Our data confirm the public health importance of addressing HIV and hypertension, but also highlights the importance of physical inactivity, tobacco use and alcohol consumption as focal points for public health strategies to produce the most efficient mortality reduction outcomes.

Like many Black intellectuals that came of age as apartheid was tightening its grip in the 1950s, Lewis Nkosi (1936-2010) left South Africa on a one-way ticket. Although he outlived apartheid and returned to his native land on and off after 1991, he lived abroad in the United States in the 1990s and in Europe in the 2000s. Although allied with the African National Congress in exile, he wrote skeptically about emphatic anti-apartheid writing. His essays from the 1950s on reflect his preference for cosmopolitan and experimental authors from Dostoyevsky to Kafka, in other words for modernism broadly speaking, and his creative writing reflects this preference in the ironic and satirical rather than the usual earnest treatment of the struggle. While several critics have noted this modernist preference, none have examined the influence of Black American authors on Nkosi's writing. This omission demands attention, as Nkosi's creative writing, especially drama for stage and radio, draws deeply from Black Americans, even when he steals themes, phrases, and characters without acknowledging sources. The Rhythm of Violence written and performed during his first US sojourn 1960-61, borrows style and phrasing from Black Beat poet Ted Joans, the radio drama 'We Can't All Be Martin Luther King,' broadcast on BBC 4 in 1971, lifts title and tone--unacknowledged--from activist-writer Julian Bond's ironic poem responding to expectations that all Black intellectuals emulate Dr. King, and The Black Psychiatrist borrows from the decidedly unironic Black nationalist Amiri Baraka. Like Bond and essayist James Baldwin, Nkosi balanced a commitment to struggle--in his case, presenting Black African and Caribbean writers to the BBC and to readers abroad--with an ironic attitude to what he called the absurdity of apartheid and other forms of racism., Like many African intellectuals who came of age as apartheid was tightening its grip, Lewis Nkosi (1936-2010) left South Africa on a one-way ticket, in his case for the United [...]