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Objective: This study aimed to describe the exposure levels to Dengue and Chikungunya viruses among individuals presenting with febrile illnesses in Ghana between January 2016 to June 2018. Methods: The study was conducted in health facilities in seven selected regions in Ghana; namely, Ashanti, Greater Accra, Northern, Upper West, Volta, and Western regions. Patients who met the case definition were enrolled in the study. A total of 1105 blood samples were collected from patients from 2016 to 2018 and serological analysis of Dengue and Chikungunya viruses were performed with ELISA IgM and IgG commercial kits (Abcam, Cambridge, UK). Results: Analysed results indicated that Dengue and Chikungunya viruses showed seropositivity of 62.0 % and 40.0 % respectively. All processed samples tested negative for Dengue and Chikungunya using the Polymerase Chain Reaction (PCR) assay. Greater Accra and Ashanti regions recorded the highest positivity for Chikungunya and Dengue fever viruses respectively. Conclusion: Though no detection of Dengue and Chikungunya using molecular tools, the seropositivity suggests the need for an established surveillance for arboviruses to monitor transmission of these pathogens for epidemic preparedness and response.

Background: Data on the asymptomatic burden of malaria in endemic areas is essential for Ghana's malaria elimination efforts. Consequently, the situation of asymptomatic malaria in the Fanteakwa South District (FSD) is determined in this study. The FSD is predominantly forested with more rural than peri-urban communities. Additionally, artisanal mining is prevalent in the district. Despite that the forgoing could promote high incidence of malaria, the burden of asymptomatic malaria and associated factors in the district have never been determined. Methods: This community-based cross-sectional study was conducted in four randomly selected communities in the FSD in the Eastern region of Ghana. The participating households were systematically selected, of which one household member was randomly enrolled in the study. With prior consent, 2 mL of whole blood was collected from the participants. Subsequently, the study variables were obtained from the enrolees using a structured questionnaire. The malaria status of the enrolled participants was determined using the CareStart™ malaria rapid diagnostic test kit (mRDT) (USA). The multiple logistic regression model was used to fit the model to predict the groups at risk of P. falciparum infection in the district. Results: In total, 412 study participants were enrolled. The overall prevalence of asymptomatic malaria in the district was 43.4 % (179/412). The prevalence rate was 36.9 %, 27.7 %, 50 % and 58.8 % (37.5 °C (

Background: Cannabis is the most commonly used federally illicit substance during pregnancy. Yet, little is known about women’s lived experiences of being screened for cannabis use during pregnancy. Objective: To explore perceptions of cannabis use during pregnancy and childbirth, including experiences of being screened for cannabis use during the intrapartum period. Methods: We conducted a phenomenological qualitative study using semi-structured, online interviews with 16 English-speaking women who gave birth at a U.S. hospital within the past three months. After transcription of interview recordings, two coders analyzed data using inductive thematic analysis. We also generated descriptive statistics for sociodemographic characteristics and cannabis use behaviors. Findings: Most participants were 25–34 years of age (75 %, n=12), Black (75.00 %. n=12), and had less than a bachelor’s degree (68.75 %, n=14). Participants reported low-risk perceptions of cannabis use during pregnancy and often used cannabis to alleviate mental health conditions and pain during pregnancy and childbirth. Women reported mixed perceptions of harm, using cannabis as a medicine and because they were addicted, being fearful of disclosing cannabis use due to potential involvement of child welfare and protective services, and perceiving negative provider communication a barrier to disclosing cannabis use. Conclusions: Findings underscore the importance of patient education about adverse maternal and neonatal health outcomes of prenatal cannabis use, regardless of whether disclosure occurs. To facilitate disclosure of use, close attention should be paid to verbal and non-verbal communication when screening and counseling women during pregnancy and childbirth. Additional studies are needed to further examine patient-provider cannabis-related communication, with a focus on identifying discriminatory behaviors and practices resulting in health inequities.

Deep learning (DL) algorithms require massive amounts of data in diverse variations to attain close to human recognition accuracy. This enables them to perform well on unseen in-distribution viewpoints. However, critical areas such as health face a challenge in generating large data. This is mainly attributed to regulatory policies surrounding the collection of such data. Hence, the domain of health is known to have smaller datasets. This limitation, therefore, requires algorithms that can derive maximum benefit from the small-size dataset. An example of such an algorithm is Capsule Network (CapsNet). Though Capsule Networks perform well on smaller datasets, they attain low performance on datasets consisting of complex real-life images. This challenge is attributed to their weak encoders. This paper, therefore, proposes a feature enhancement technique termed patch-and-amplify to improve the feature extraction task and enhance extracted features in the encoder layer. A model-specific squash function is proposed to enhance the coupling of capsules between the higher and lower capsule layers and reduce the impact of polarization. To evaluate the network's robustness and generalizability, the proposed model was evaluated on CIFAR-10, Fashion-MNIST, and Kvasir-V2 datasets achieving recognition accuracies of 85.50 %, 98.40 %, and 93.40 %. Extensive visualizations were explored to assist in understanding the predictions and internal structure of the network. The proposed model performs well compared with the state-of-the-art in the literature and can serve as a helpful tool in assisting medical practitioners in diagnosing gastrointestinal diseases.

BACKGROUND: With an aging population, older adults are increasingly serving as caregivers to others, which may increase their risk of adverse interpersonal experiences. OBJECTIVE: To investigate the prevalence and types of elder mistreatment experienced by older caregiving adults. DESIGN: Cross-sectional analysis PARTICIPANTS: National sample of community-dwelling US adults over age 60 in 2015-2016. MAIN MEASURES: Caregiving (assisting another adult with day-to-day activities) was assessed by interviewer-administered questionnaires. Experience of elder mistreatment was assessed by participant-reported questionnaire in three domains: emotional, physical, and financial. Multivariable logistic regression models examined associations between caregiving status and each domain of elder mistreatment, adjusting for age, race, ethnicity, gender, education, marital status, concomitant care-receiving status, overall physical and mental health, and cognitive function. Additional logistic regression models examined associations between being the primary caregiver (rather than a secondary caregiver) and each domain of mistreatment among older caregivers. KEY RESULTS: Of the 1898 participants over age 60 (including 1062 women and 836 men, 83% non-Hispanic white, and 64% married or partnered), 14% reported serving as caregivers for other adults, including 8% who considered themselves to be the primary caregiver. Among these older caregivers, 38% reported experiencing emotional, 32% financial, and 6% physical mistreatment after age 60. In multivariable models, caregiving was associated with experiencing both emotional mistreatment (AOR 1.61, 95% CI 1.15-2.25) and financial mistreatment (AOR 1.72, 95% CI 1.18-2.50). In analyses confined to caregiving older adults, those who served as primary rather than secondary caregivers for other adults had an over two-fold increased odds of emotional mistreatment (AOR 2.17, 95% CI 1.07, 4.41). CONCLUSION: In this national cohort of older community-dwelling adults, caregiving was independently associated with experiencing emotional and financial mistreatment after age 60. Findings suggest that efforts to prevent or mitigate elder mistreatment should put more emphasis on vulnerable older caregivers.

While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term sleep trajectories in a cohort of Black individuals and White individuals predominantly from low-income communities. We used data from the Southern Community Cohort Study (N = 28,759 Black individuals and 16,276 White individuals). Sleep duration was self-reported at baseline and after an average of five years of follow-up, based on which we constructed nine sleep trajectories: normal–normal (optimal, reference), short–short, long–long, short–long, long–short, normal–short, normal–long, short–normal, and long–normal. LAN and nighttime noise were derived from satellite imagery and model-based estimates, respectively. Multinomial logistic regression was used to determine the relationship between LAN and noise exposures and sleep trajectories. Higher exposures to LAN and nighttime noise were associated with multiple suboptimal long-term sleep trajectories. In the total sample, higher LAN was associated with higher odds of long–long (OR Q5 vs. Q1 = 1.23 (CI = 1.02, 1.48)) and long–short (OR = 1.35 (CI = 1.06, 1.72)) trajectories, while higher nighttime noise was associated with short–short (1.19 (1.07, 1.31)), long–short (1.31 (1.05, 1.64)), and normal–song (1.16 (1.01, 1.34)) trajectories. Black and White individual-specific results showed qualitatively similar patterns between Black individuals and White individuals, although we also observed suggestive evidence for Black–White individual differences. In conclusion, elevated LAN and nighttime noise levels were associated with various suboptimal long-term sleep trajectories. However, it is noteworthy that the light and noise measures in our study may not accurately reflect individual-level exposures, and residual confounding from other factors is a concern. Future studies should use more accurate exposure measurements, collect information on and control for a wider range of factors, and examine whether reductions in neighborhood light and noise levels may contribute to improved long-term sleep health.

Abstract Background Despite efforts made to reduce morbidity and mortality associated with malaria, especially in sub-Saharan Africa, malaria continues to be a public health concern that requires innovative efforts to reach the WHO-set zero malaria agenda. Among the innovations is the use of artemisinin-based combination therapy (ACT) that is effective against Plasmodium falciparum. Generic artemether–lumefantrine (AL) is used to treat uncomplicated malaria after appropriate diagnosis. AL is metabolized by the cytochrome P450 family of enzymes, such as CYP2B6, CYP3A4 and CYP3A5, which can be under pharmacogenetic influence. Pharmacogenetics affecting AL metabolism, significantly influence the overall anti-malarial activity leading to variable therapeutic efficacy. This study focused on generic AL drugs used in malarial treatment as prescribed at health facilities and evaluated pharmacogenomic influences on their efficacy. Methods Patients who have been diagnosed with malaria and confirmed through RDT and microscopy were recruited in this study. Blood samples were taken on days 1, 2, 3 and 7 for parasite count and blood levels of lumefantrine, artemisinin, desbutyl-lumefantrine (DBL), and dihydroartemisinin (DHA), the active metabolites of lumefantrine and artemether, respectively, were analysed using established methods. Pharmacogene variation analysis was undertaken using iPLEX microarray and PCR–RFLP. Results A total of 52 patients completed the study. Median parasite density from day 1 to 7 ranged from 0–2666/μL of blood, with days 3 and 7 recording 0 parasite density. Highest median plasma concentration for lumefantrine and desbutyl lumefantrine, which are the long-acting components of artemisinin-based combinations, was 4123.75 ng/mL and 35.87 ng/mL, respectively. Day 7 plasma lumefantrine concentration across all generic ACT brands was ≥ 200 ng/mL which potentially accounted for the parasitaemia profile observed. Monomorphism was observed for CYP3A4 variants, while there were observed variations in CYP2B6 and CYP3A5 alleles. Among the CYP3A5 genotypes, significant differences in genotypes and plasma concentration for DBL were seen on day 3 between 1/*1 versus *1/*6 (p = 0.002), *1/*3 versus *1/*6 (p = 0.006) and *1/*7 versus *1/*6 (p = 0.008). Day 7 plasma DBL concentrations showed a significant difference between *1/*6 and *1/*3 (p = 0.026) expressors. Conclusions The study findings show that CYP2B6 and CYP3A5 pharmacogenetic variations may lead to higher plasma exposure of AL metabolites.

Abstract The absence of biodegradability exhibited by plastics is a matter of significant concern among environmentalists and scientists on a global scale. Therefore, it is essential to figure out potential pathways for the use of recycled plastics. The prospective applications of its utilisation in concrete are noteworthy. The use of recycled plastic into concrete, either as a partial or complete substitution for natural aggregates, addresses the issue of its proper disposal besides contributing to the preservation of natural aggregate resources. Furthermore, the use of agricultural wastes has been regarded as a very promising waste-based substance in the industry of concrete manufacturing, with the aim of fostering the creation of an environmentally sustainable construction material. This paper illustrates the impact of nano sunflower ash (NSFA) and nano walnut shells ash (NWSA) on durability (compressive strength and density after exposure to 800 °C and sulphate attack), mechanical properties (flexural, splitting tensile and compressive strength) and fresh characteristics (slump flow diameter, T50, V-funnel flow time, L-box height ratio, segregation resistance and density) of lightweight self-compacting concrete (LWSCC). The waste walnut shells and local Iraqi sunflower were calcinated at 700 ± 50 °C for 2 h and milled for 3 h using ball milling for producing NSFA and NWSA. The ball milling succeeded in reducing the particle size lower than 75 nm for NSFA and NWSA. The preparation of seven LWSCC concrete mixes was carried out to obtain a control mix, three mixtures were created using 10%, 20% and 30% NWSA, and the other three mixtures included 10%, 20% and 30% NSFA. The normal weight coarse aggregates were substituted by the plastic waste lightweight coarse aggregate with a ratio of 75%. The fresh LWSCC passing capacity, segregation resistance, and filling capability were evaluated. The hardened characteristics of LWSCC were evaluated by determining the flexural and splitting tensile strength at 7, 14 and 28 days and the compressive strength was measured at 7, 14, 28 and 60 days. Dry density and compressive strength were measured after exposing mixes to a temperature of 800 °C for 3 h and immersed in 10% magnesium sulphate attack. The results demonstrated that the LWSCC mechanical characteristics were reduced when the percentages of NWSA and NSFA increased, except for 10% NWSA substitution ratio which had an increase in splitting tensile strength test and similar flexural strength test to the control mixture. A minor change in mechanical characteristics was observed within the results of LWSCC dry density and compressive strength incorporating various NSFA and NWSA` contents after exposing to temperature 800 °C and immersed in 10% magnesium sulphate attack. Furthermore, according to the findings, it is possible to use a combination of materials consisting of 10–20% NSFA and 10–20% NWSA to produce LWSCC.

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.

Purpose – The current study aimed to examine the moderating role of perceived supervisor support in the nexus between employee empowerment and organizational commitment in the Ghanaian hospitality industry. Design/methodology/approach – A quantitative research design was adopted, and data were collected from 274 frontline workers from 4-star and 5-star hotels at two different waves within a 7-month interval. The data received were analyzed using descriptive and inferential statistics with the aid of Statistical Package for Social Sciences (SPSS V. 23.0) and SmartPLS (V.4.0), respectively. Findings – As hypothesized in the study, employee empowerment was significantly related to organizational commitment. Furthermore, the results revealed that perceived supervisor support moderated the nexus between employee empowerment and affective and continuance commitment but did not moderate the nexus between employee empowerment and normative commitment. Originality/value – Arguably, support from supervisors has been theoretically identified as a key construct in enhancing subordinates' commitment to an organization. However, less is known in the literature about the moderating role of perceived supervisory support in the nexus between employee empowerment and organizational commitment, especially in the Ghanaian hospitality industry.

Abstract Background Obesity is a classified risk factor for several of the world’s leading causes of death. In this study, we combined information contained in body mass index (BMI), total percentage body fat (TPBF) and relative fat mass (RFM) to estimate obesity prevalence and examine the risk factors associated with obesity. Methods The study recruited 1027 undergraduate students aged between 16 and 25 years using a cross-sectional study design and two-stage stratified random sampling between January and April 2019 from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Demographic, lifestyle, and family history of chronic disease data, were collected using a structured questionnaire. Bioelectrical impedance, along with height, weight, age, and gender, were used to estimate BMI and TPBF. The RFM was calculated using a published equation. The TPBF and RFM ranges were evaluated based on standard BMI thresholds and an informative combined obesity prevalence estimated in a Bayesian framework. Multiple logistic regression analysis was used to evaluate potential risk factors of overweight/obesity. Results Concordance between BMI, TPBF and RFM for obesity classification was 84% among female and 82.9% among male students. The Bayesian analysis revealed a combined prevalence means of obesity of 9.4% (95%CI: 6.9-12.2%) among female students and 6.7% (95%CI:4.3-9.5%) among male students. The odds of obesity were increased between 1.8 and 2.5 for females depending on the classification index. A significant increasing trend of obesity was observed with university-level. A family history of obesity was associated with a high estimate of general, central, and high TPBF. Conclusion Using multiple adiposity indicators conjointly in a Bayesian framework offers a greater power to examine obesity prevalence. We have applied this and reported high obesity prevalence, especially among female students. University level and family history of obesity were key determinants for obesity among the student population.

Abstract Introduction The fundamental transformation of food systems and retail environments in low-income countries is influencing consumers' food choices and dietary habits in unfavourable directions through the consumption of highly processed, energy-dense foods, predominantly manufactured by multinational food corporations. This study aims to identify the principal factors driving consumers' preference for multinational foods over local foods in the urban Accra region of Ghana. Method This cross-sectional survey involving a random sample of 200 consumers conducted in March/April 2023 using interviewer-administered questionnaires employed a maximum difference scaling approach to investigate the drivers of urban Ghanaian consumer food choices for multinational food corporations' products over local foods. The maximum difference scaling modelling analysis utilized in this study identifies the primary drivers of multinational food corporations' product preferences and the associated trade-offs. Result The study discovered that food quality and safe packaging, perceived healthiness, taste and flavour, and nutritional value were the most significant factors driving consumer preference for multinational food corporations' products over local foods in Ghana. The criterion food quality and safe packaging had the significantly highest utility than all other attributes in terms of consumer preference for products/meals from multinational food corporations over local foods. Conclusion The results of this study provide significant contributions to the existing body of research, as previous studies have not identified these factors as primary drivers of multinational food products. Public health authorities and nutritionists can use the study's findings to implement targeted quality assurance measures in local markets and to address the drivers in health education campaigns.

This study sought to explore the practice and philosophical foundation of Kwaku Asaku-Gyapon (1932 – 2018), an artist educationist of the African modernist stock, from the 1960s to the 1980s that shaped the Kwame Nkrumah University of Science and Technology (KNUST) artistic traditions and generally the Ghanaian sculptural representation. The study seeks to contribute to existing literature on African modernism, following up on karî’kachä Seid’ou’s “J. C. Okyere’s Bequest of Concrete Statuary in the KNUST Collection: Special Emphasis on “Lonely Woman” which sheds light on the artist’s ethos and practice in the midst of seeming erasure and wrong attributions. The study looked at the artist’s three-decade practice, in mainly concrete statuary, terra cotta, wood, and metal (rarely), as part of mid-20th century Ghanaian nationalist repositioning. This is part of the African art that evolved by blending foreign materials and techniques with native African concepts in which artists used revolutionary tools and methods, along with indigenous storytelling practices, to tell their stories in various forms. The study adopted archival research and interviews of the artist as well as descriptive-analytic research methods of the qualitative approach. The study revealed that the artist’s concepts and themes emerged from his personal experiences, sociocultural environment, and political events of his era. It also shows the artist’s practice as commission-dependent in which personal explorations of materials (cement, metal, terrazzo, wood, clay) and techniques in life modelling, casting, and carving were prioritized. The Authors conclude that Kwaku Asaku-Gyapon was a prolific but less exposed Ghanaian modernist artist educationist, in the light of how he adopted the indigenous Asante storytelling approaches through the application of traditional and non-traditional materials and techniques.

The priests and scribes were familiar with the process of applying a manuscript or prophecy to a current context to produce relevant material for the era. It is most probable that the scribes and/or priests during the post-exilic Persian period reinterpreted the prophecies of Isaiah and Amos against the moral and social decay of the women of the Hebrew nation during the 8th century BCE to create an antithesis of that situation in the form of the virtuous woman of Proverbs 31:10–31. The similarity of words in the poem and the writings of Ezra could suggest that Ezra might have had a hand in the writing or editing of the poem in Proverbs 31:10–31. Intradisciplinary and/or interdisciplinary implications: The study brings Old Testament and Ancient Near Eastern studies together, with both elucidating each other.

This study utilizes cross-country data from 2002 to 2019 from 60 selected developing countries to explore the impact of competition and financial inclusion on financial stability. Employing the system GMM estimator, compelling evidence is revealed, highlighting a number of key findings. Firstly, it is observed that financial inclusion has a weakening effect on financial stability within developing countries. Conversely, competition among these nations demonstrates a significant capacity to bolster financial stability. Additionally, the study underscores the pivotal role of financial development, identifying it as a primary driver that enables financial inclusion to positively influence financial stability within developing nations. Furthermore, the introduction of the square term of financial inclusion yields noteworthy insights, revealing a nonlinear relationship. Specifically, the findings suggest that strategic investments in the financial inclusion of developing countries have the potential to enhance financial stability up to a certain threshold. Therefore, for emerging economies seeking to fortify their financial stability, prioritizing efforts to augment financial inclusion is imperative. Over the long term, such endeavors have the potential to yield tangible improvements in financial stability.In conclusion, the research offers valuable policy implications. These include recommendations aimed at fostering greater financial inclusion within developing economies as a means of bolstering overall financial stability. By heeding these suggestions and implementing targeted policies, policymakers can work towards cultivating a more resilient and robust financial landscape within their respective nations.

Background: Evaluation in Africa and the Global South has been driven by external, often foreign, actors and focused on meeting donor funding needs, conducted through the lens of ‘others’ other than the affected populations. There is growing interest to change or decolonise this trend in the international development community. Objectives: To address the fundamental question of positionality in redefining the scope and understanding of locally-led evaluation. Method: This qualitative research article departs from the practice of externally driven evaluation and adopts a methodology called collaborative autoethnography. Its strength is that it is experiential and reflective, and the researcher is also the researched. The collaborative nature tampers the extreme subjectivity in the legitimate analysis of personal experiences to interpret wider cultural, political, and social phenomena. Results: We found that the notion of locally-led evaluation is highly nuanced and contested, and goes beyond a dichotomy between the ‘local’ and the ‘external’. Another arena of contestation which our research clarifies is the outcomes of locally-led evaluation. Local leadership of evaluation processes alone does not guarantee contextualised, participatory evaluation. Conclusion: The localised adaptation and application of evaluation principles and practices are essential for relevance. But there is no one-cap-fit-all checklist. Much comes down to the values, mindsets, and competencies of evaluators. Contribution: We propose that epistemology and methodology should go hand-in-hand with questions of identity or geography in evaluation, if relevance, robust application of indigenous methodologies, participation of the affected populations and uptake are the expected outcomes.

While often undetected and untreated, persistent seasonal asymptomatic malaria infections remain a global public health problem. Despite the presence of parasites in the peripheral blood, no symptoms develop. Disease severity is correlated with the levels of infected red blood cells (iRBCs) adhering within blood vessels. Changes in iRBC adhesion capacity have been linked to seasonal asymptomatic malaria infections, however how this is occurring is still unknown. Here, we present evidence that RNA polymerase III (RNA Pol III) transcription in Plasmodium falciparum is downregulated in field isolates obtained from asymptomatic individuals during the dry season. Through experiments with in vitro cultured parasites, we have uncovered an RNA Pol III-dependent mechanism that controls pathogen proliferation and expression of a major virulence factor in response to external stimuli. Our findings establish a connection between P. falciparum cytoadhesion and a non-coding RNA family transcribed by Pol III. Additionally, we have identified P. falciparum Maf1 as a pivotal regulator of Pol III transcription, both for maintaining cellular homeostasis and for responding adaptively to external signals. These results introduce a novel perspective that contributes to our understanding of P. falciparum virulence. Furthermore, they establish a connection between this regulatory process and the occurrence of seasonal asymptomatic malaria infections.

ABSTRACT Background The major burden of cervical cancer occurs in low‐ and middle‐income countries. In Ghana, it is the second most common cancer among women. Infection with high‐risk human papilloma virus (HPV) has been established as the cause of cervical cancer. As such, it is important to identify risk factors that may affect progression from HPV infection to cancer. Aims We assessed the risk factors assocaited with cervical cancer in Ghana. Methods To identify the risk factors for cervical cancer, we conducted an unmatched case–control study in two hospitals in Ghana where most cervical cancer cases are diagnosed. Women with histologically confirmed cervical cancer were the cases, whereas women without cancer seeking care at the two hospitals were controls. A structured questionnaire was administered to the women, after which cervical samples were sent for HPV deoxyribonucleic acid (DNA) testing. Results Overall, 206 cases and 230 controls were recruited. After adjusting for possible confounders, women with the highest educational level had a significantly lower risk of cervical cancer than those with no or little formal education. Parity was a major risk factor (odd ratio [OR] for five or more children = 7.9; 95% CI: 2.3–27.6), with risk increasing with increasing parity (p for trend

Schistosomiasis, one of the neglected tropical diseases which affects both humans and animals, is caused by trematode worms of the genus Schistosoma. The disease is caused by several species of Schistosoma which affect several organs such as urethra, liver, bladder, intestines, skin and bile ducts. The life cycle of the disease involves an intermediate host (snail) and a mammalian host. It affects people who are in close proximity to water bodies where the intermediate host is abundant. Common clinical manifestations of the disease at various stages include fever, chills, headache, cough, dysuria, hyperplasia and hydronephrosis. To date, most of the control strategies are dependent on effective diagnosis, chemotherapy and public health education on the biology of the vectors and parasites. Microscopy (Kato-Katz) is considered the golden standard for the detection of the parasite, while praziquantel is the drug of choice for the mass treatment of the disease since no vaccines have yet been developed. Most of the previous reviews on schistosomiasis have concentrated on epidemiology, life cycle, diagnosis, control and treatment. Thus, a comprehensive review that is in tune with modern developments is needed. Here, we extend this domain to cover historical perspectives, global impact, symptoms and detection, biochemical and molecular characterization, gene therapy, current drugs and vaccine status. We also discuss the prospects of using plants as potential and alternative sources of novel anti-schistosomal agents. Furthermore, we highlight advanced molecular techniques, imaging and artificial intelligence that may be useful in the future detection and treatment of the disease. Overall, the proper detection of schistosomiasis using state-of-the-art tools and techniques, as well as development of vaccines or new anti-schistosomal drugs may aid in the elimination of the disease.

The oral microbiome, like the fecal microbiome, may be related to breast cancer risk. Therefore, we investigated whether the oral microbiome was associated with breast cancer and nonmalignant breast disease, and its relationship with the fecal microbiome in a case-control study in Ghana. A total of 881 women were included (369 breast cancers, 93 nonmalignant cases and 419 population-based controls). The V4 region of the 16S rRNA gene was sequenced from oral and fecal samples. Alpha-diversity (observed amplicon sequence variants [ASVs], Shannon index and Faiths Phylogenetic Diversity) and beta-diversity (Bray-Curtis, Jaccard and weighted and unweighted UniFrac) metrics were computed. MiRKAT and logistic regression models were used to investigate the case-control associations. Oral sample alpha-diversity was inversely associated with breast cancer and nonmalignant breast disease with odds ratios (95% CIs) per every 10 observed ASVs of 0.86 (0.83-0.89) and 0.79 (0.73-0.85), respectively, compared to controls. Beta-diversity was also associated with breast cancer and nonmalignant breast disease compared to controls (P ≤ .001). The relative abundances of Porphyromonas and Fusobacterium were lower for breast cancer cases compared to controls. Alpha-diversity and presence/relative abundance of specific genera from the oral and fecal microbiome were strongly correlated among breast cancer cases, but weakly correlated among controls. Particularly, the relative abundance of oral Porphyromonas was strongly, inversely correlated with fecal Bacteroides among breast cancer cases (r = -.37, P ≤ .001). Many oral microbial metrics were strongly associated with breast cancer and nonmalignant breast disease, and strongly correlated with fecal microbiome among breast cancer cases, but not controls.

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.