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Pyrethrin and pyrethroid are a relatively new class of pesticides with potent insecticidal properties. Pyrethrins are naturally occurring pesticides obtained from the Chrysanthemum cinerariaefolium flower, while pyrethroids are their synthetic derivatives. They are widely used as the insecticides of choice in agriculture, veterinary medicine, public health programs, and household activities. Pyrethrin, being a broad-spectrum insecticide kills a wide range of pests, while pyrethroids last longer in the environment owing to low susceptibility to sunlight, and greater stability and efficacy than parent molecules. Humans can be exposed through inhalation, ingestion, and dermal routes. Indoor usage of an insecticide poses a serious risk to human health, especially to women, children, and stay-at-home people. Although pyrethrin and pyrethroid are generally considered safe, sustained skin or inhalation exposure or direct contact with open wounds results in higher toxicity to mammals. There is a paucity of data on the impact of pyrethrin and pyrethroid on overall pulmonary health. The respiratory system, from the nose, nasal passages, airways, and bronchi to the pulmonary alveoli, is vulnerable to environmental contaminants such as pesticides because of its anatomical location as well as being a highly blood profused organ. Under and over-functioning of the respiratory system triggers diverse pathologies such as serious infections, allergies, asthma, metastatic malignancies, and auto-immune conditions. While the association between workplace-related pesticide exposures and respiratory diseases and symptoms is well documented, it is important to understand the adverse health impact of pyrethrin and pyrethroid on the general population for awareness and also for better regulation and implementation of the law. [ABSTRACT FROM AUTHOR]

In Africa, measles epidemics are frequently reported, despite numerous preventive measures, such as vaccination, which targets children under 5 years of age. Unfortunately, the Republic of the Congo is not an exception to this major health concern. Indeed, many cases are reported annually. Here, we provide an overview of the epidemiological characteristics of laboratory‐confirmed measles cases from January 2019 to October 2022 as well as the risk factors associated with the occurrence of measles outbreak. Samples from suspected measles cases were collected across the country and sent to the National Laboratory of Public Health for confirmation. Specific IgM was tested using the enzyme‐linked immunosorbent assay (ELISA). Data were analyzed using descriptive and analytic statistics (p < 0.05 was statistically significant). A total of 1330 samples were collected and analyzed. Over those 4 years, 537 samples were confirmed to be positive (40.3%) but with important disparities between years. A relatively low frequency of cases was reported in 2020. Overall, a progressive and significant evolution of positive cases was observed between 2019 and 2022, increasing from 16.8% in 2019 to 65.9% in 2022 (p < 0.0001). We report a low vaccination rate among children (44.8%) and a significantly high positivity rate in this group (46.6%) (p < 0.0008). No difference was reported according to the completeness of the vaccination scheme (p = 0.094). Females were slightly more exposed to this infection than males (p = 0.04; adjusted odds ratio [aOR]: 1.25 [1.01–1.6]), with an increased risk of exposure in rural areas (p = 0.0001; aOR: 0.41 [0.32–0.53]). The department of Pointe‐Noire had the highest positivity rate, while three other departments were considered high‐risk areas: Likouala (p = 0.0001; aOR: 3.18 [1.80–5.61]), Pool (p = 0.0001; aOR: 2.90 [1.70–4.95]), and Brazzaville (p = 0.0005; aOR: 0.52 [0.36–0.75]). This study calls for strengthening the epidemiological surveillance system and vaccination strategy in the country. It remains important to research factors that induce a high positive rate among vaccinated children by biological verification of the immunization. [ABSTRACT FROM AUTHOR]

While simian immunodeficiency virus (SIV) infection is non-pathogenic in naturally infected African nonhuman primate hosts, experimental or accidental infection in rhesus macaques often leads to AIDS. Baboons, widely distributed throughout Africa, do not naturally harbor SIV, and experimental infection of baboons with SIVmac results in transient low-level viral replication. Elucidation of mechanisms of natural immunity in baboons could uncover new targets of antiviral intervention. We tested the hypothesis that an SIVmac adapted to replicate in baboon primary cells will gain the capacity to establish chronic infections in vivo. Here, we generated SIVmac variants in baboon cells through serial passage in PBMC from different donors (SIVbn-PBMC s1), in PBMC from the same donors (SIVbn-PBMC s2), or in isolated CD4 cells from the same donors used for series 2 (SIVbn-CD4). While SIVbn-PBMC s1 and SIVbn-CD4 demonstrated increased replication capacity, SIVbn-PBMC s2 did not. Pharmacological blockade of CCR5 revealed SIVbn-PBMC s1 could more efficiently use available CCR5 than SIVmac, a trait we hypothesize arose to circumvent receptor occupation by chemokines. Sequencing analysis showed that all three viruses accumulated different types of mutations, and that more non-synonymous mutations became fixed in SIVbn-PBMC s1 than SIVbn-PBMC s2 and SIVbn-CD4, supporting the notion of stronger fitness pressure in PBMC from different genetic backgrounds. Testing the individual contribution of several newly fixed SIV mutations suggested that is the additive effect of these mutations in SIVbn-PBMC s1 that contributed to its enhanced fitness, as recombinant single mutant viruses showed no difference in replication capacity over the parental SIVmac239 strain. The replicative capacity of SIVbn-PBMC passage 4 (P4) s1 was tested in vivo by infecting baboons intravenously with SIVbn-PBMC P4 s1 or SIVmac251. While animals infected with SIVmac251 showed the known pattern of transient low-level viremia, animals infected with SIVbn-PBMC P4 s1 had undetectable viremia or viral DNA in lymphoid tissue. These studies suggest that adaptation of SIV to grow in baboon primary cells results in mutations that confer increased replicative capacity in the artificial environment of cell culture but make the virus unable to avoid the restrictive factors generated by a complex multicellular organism. [ABSTRACT FROM AUTHOR]

Understanding the underlying mechanisms of HIV pathogenesis is critical for designing successful HIV vaccines and cure strategies. However, achieving this goal is complicated by the virus's direct interactions with immune cells, the induction of persistent reservoirs in the immune system cells, and multiple strategies developed by the virus for immune evasion. Meanwhile, HIV and SIV infections induce a pandysfunction of the immune cell populations, making it difficult to untangle the various concurrent mechanisms of HIV pathogenesis. Over the years, one of the most successful approaches for dissecting the immune correlates of protection in HIV/SIV infection has been the in vivo depletion of various immune cell populations and assessment of the impact of these depletions on the outcome of infection in non-human primate models. Here, we present a detailed analysis of the strategies and results of manipulating SIV pathogenesis through in vivo depletions of key immune cells populations. Although each of these methods has its limitations, they have all contributed to our understanding of key pathogenic pathways in HIV/SIV infection. [ABSTRACT FROM AUTHOR]

Loadshedding is a deliberate and temporary interruption of electricity supply intended to reduce the demand for electricity during periods of high demand. While loadshedding affects various sectors of the economy, its impact on Research Animal Facilities (RAF) is particularly concerning and this has not been systematically reviewed. We discuss the implications of loadshedding on Animal Health and Welfare, the quality of experimental data and compliance with RAF regulatory requirements. RAF are designed for the housing laboratory animals that are being used in research that benefits humans, animals and the environment. Scientific data emanating from these facilities needs to be credible and the housing environment should be maintained constantly. Laboratory animals may experience stress when there is disruption to the environmental conditions caused by electricity supply interruptions to the equipment used to maintain a stable and constant facility environment. Constant environmental parameters are essential for maintaining a comfortable working environment for personnel working in the facility as well. [ABSTRACT FROM AUTHOR]

Background: Data on the characteristics of individuals with mild and asymptomatic infections with different SARS-CoV-2 variants are limited. We therefore compared the characteristics of individuals infected with ancestral, Beta and Delta SARS-CoV-2 variants in South Africa. Methods: We conducted a prospective cohort study in a rural and an urban site during July 2020-August 2021. Mid-turbinate nasal swabs were collected twice-weekly from household members irrespective of symptoms and tested for SARS-CoV-2 using real-time reverse transcription polymerase chain reaction (rRT-PCR). Differences in demographic and clinical characteristics, shedding and cycle threshold (Ct) value of infection episodes by variant were evaluated using multinomial regression. Overall and age-specific incidence rates of infection were compared by variant. Results: We included 1200 individuals from 222 households and 648 rRT-PCR-confirmed infection episodes (66, 10% ancestral, 260, 40% Beta, 322, 50% Delta). Symptomatic proportion was similar for ancestral (7, 11%), Beta (44, 17%), and Delta (46, 14%) infections (p=0.4). After accounting for previous infection, peak incidence shifted to younger age groups in successive waves (40-59 years ancestral, 19-39 years Beta, 13-18 years Delta). On multivariable analysis, compared to ancestral, Beta infection was more common in individuals aged 5-12 years (vs 19-39)(adjusted odds ratio (aOR) 2.6, 95% confidence interval (CI)1.1-6.6) and PCR cycle threshold (Ct) value <30 (vs >35)(aOR 3.2, 95%CI 1.3-7.9), while Delta was more common in individuals aged <5 (aOR 6.7, 95%CI1.4-31.2) and 5-12 years (aOR 6.6 95%CI2.6-16.7)(vs 19-39) and Ct value <30 (aOR 4.5, 95%CI 1.3-15.5) and 30-35 (aOR 6.0, 95%CI 2.3-15.7)(vs >35). Conclusions: Consecutive SARS-CoV-2 waves with Beta and Delta variants were associated with a shift to younger individuals. Beta and Delta infections were associated with higher peak viral loads, potentially increasing infectiousness. [ABSTRACT FROM AUTHOR]

Pyrethroids, which are derived from natural insecticides found in chrysanthemum flowers, are widely utilized in various sectors, including agriculture, forestry, horticulture, and personal insect protection. Due to their widespread use, concerns have arisen regarding their potential estrogenic effects on female reproductive health. This review aims to address data gaps and inconsistencies in previous studies by defining molecular initiating events and key events within the adverse outcome pathway associated with pyrethroid-induced estrogenic effects. To achieve this, we propose utilizing Integrated Approaches to Testing and Assessment (IATA), which incorporate in vitro assays and in vivo assessments to comprehensively investigate the estrogenic effects of pyrethroids. An initial search was conducted in the PubMed database to identify relevant articles. Subsequently, the findings were classified according to the IATA strategy. This review provides an overview of the current understanding of pyrethroids and their estrogenic effects, identifies data gaps, and highlights the use of IATA in existing studies on the estrogenic effects of various pyrethroids. It emphasizes the urgent need for comprehensive research on the estrogenic effects of pyrethroids and highlights the importance of standardized testing methods like IATA to accurately assess their impact on human and environmental health. By promoting the use of Integrated Testing Strategies (ITSs) and addressing data gaps, researchers and regulators can enhance the accuracy of assessments, ensuring better protection of human and environmental health from the potential estrogenic effects of pyrethroid exposure. [ABSTRACT FROM AUTHOR]

Background: Since the Start Free, Stay Free, and AIDS-Free launch, UNAIDS targets intended to promote interventions to prevent HIV transmission and promote access to ART among adolescents and children, of which none were achieved in 2020. In the sub-Saharan African region, the number of adolescents initiated on ART drugs remained consistently low, with approximately100 000 adolescents succumbing to AIDS-related causes in 2022. Although HIV prevalence among adolescents had been reduced, several HIV- positive adolescents died without being initiated on ART drugs. Therefore, this scoping review protocol aims to map factors influencing the initiation of ART drugs among adolescents living with HIV in sub-Saharan Africa. Methods: The methodological framework for scoping reviews will guide this scoping protocol. A search strategy will be used to search literature in electronic databases, including EBSCOhost (PubMed/MEDLINE), Google Scholar, Science Direct, Scopus, BioMed Central, and the World Health Organization library for citations and literature using keywords and the Medical Subjects Heading (MeSH). The electronic databases will be supplemented by hand-searching references on the included studies. The search will be from Jan 01, 2012, to Dec 31, 2022. Articles will be searched and assessed for eligibility by two screeners uploaded on the Endnote software, and duplicates will be identified and removed before the abstract screening. The two screeners will assess the eligibility of the abstracts and the complete articles of the selected studies using the inclusion and exclusion criteria. A third screener will intervene when there is a lack of consensus between the two screeners. The selection process will be documented by following and using the PRISMA flow diagram (Fig 1). A thematic content analysis will present a narrative account of the extracted data. Discussion: The results of this review will identify and describe factors influencing the initiation of Antiretroviral treatment among adolescents living with HIV in the Sub-Saharan African region. The findings will guide future research and inform tailored interventions and strategies for initiating ART among adolescents. Trial registration: Open Science Framework. https://doi.org/10.17605/OSF.IO/RNF2T. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare that they have no conflicts of interest to disclose.

Background: There is a clear paucity of literature regarding the conceptual frameworks for self-advocacy by people with Intellectual Disability (ID). The aim of this scoping review was to identify and explore the existing conceptual frameworks that support self-advocacy by people with ID and to identify key concepts relevant to enhancing direct political participation by people with ID. Methods: Strict eligibility criteria as well as the guidelines relative to the Preferred Reporting Items for Systematic Review and Meta-Analysis for scoping reviews (PRISMA-ScR) were followed. Results: There were 168 eligible articles but only 20 were included in the final analysis. The studies included addressed the conceptual/theoretical frameworks for self-advocacy by people with disabilities (including ID and other developmental disabilities), which had been published between 2000 and 2020. Three conceptual frameworks for self-advocacy were identified and the following four main themes were identified: (a) essence of self-advocacy, (b) conceptual/theoretical frameworks, (c) inclusive citizenship through self-advocacy, and (d) self-advocacy experiences. Conclusions: This scoping review sheds light on the limited literature on conceptual frameworks for self-advocacy by people with Intellectual Disability. The findings highlight the need for specific conceptual frameworks to support people with ID in advocating for their rights, particularly in the South African context, ultimately seeking more inclusive and equitable political participation. [ABSTRACT FROM AUTHOR]

Aim. We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center. Methods. We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality. Results. A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis. Conclusion. The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis. [ABSTRACT FROM AUTHOR]

South Africa is faced with a high HIV and STI prevalence and incidence, respectively, with pockets of high burden areas driving these diseases. Localised monitoring of the HIV epidemic and STI endemic would enable more effective targeted prevention strategies. We assessed spatial variations in curable STI incidence among a cohort of women enrolled in HIV prevention clinical trials between 2002 and 2012. STI incidence rates from 7557 South African women enrolled in five HIV prevention trials were geo-mapped using participant household GPS coordinates. Age and period standardised incidence rates were calculated for 43 recruitment areas and Bayesian conditional autoregressive areal spatial regression (CAR) was used to identify significant patterns and spatial patterns of STI infections in recruitment communities. Overall age and period standardised STI incidence rate were estimated as 15 per 100 PY and ranged from 6 to 24 per 100 PY. We identified five significant STI high risk areas with higher-than-expected incidence of STIs located centrally (three-locations) and southern neighbouring areas of Durban (two-locations). Younger age (<25), not married/cohabitating, parity <3 and poor education were all significant correlates of high STI communities. Findings demonstrate sustained STI incidence rates across the greater Durban area. The role of STI incidence in HIV acquisition in high HIV endemic areas need to be revisited as current highly effective PrEP interventions do not protect from STI acquisition. In these settings there is an urgent need for integrative HIV and STI prevention and treatment services. [ABSTRACT FROM AUTHOR]

In 1994, the African National Congress (ANC)-ledgovernment implemented a Reconstruction and Development Programme (RDP) program that entailed providing South Africans with stable and regular electricity supplies. Government through the state president declared COVID-19 a pandemic in 2019. Institutions of higher education resorted to introduce online teaching and learning as a method of ensuring that section 27(1) (a) (b) of the Constitution of the republic of South Africa was executed. Load shedding brought numerous challenges in the education settings in the institutions of higher learning. The crisis led to institutional economy and disrupted academic performance at institutions of higher learning. The purpose of this paper is to examine whether load shedding can be regarded as a pandemic post COVID-19. Access the impact of load shedding at institutions of higher learning. Therefore, this is a conceptual paper and it relied on existing data for analysis and interpretation. The paper recommends that institution of higher learning should invest in alternative sources of energy, and develop an effective communication strategy. [ABSTRACT FROM AUTHOR]

Background: Golf is a moderate‐intensity physical activity that provides positive physical and mental health benefits. However, the inclusiveness of the sport for individuals with disabilities globally is unknown. Objective: To characterize the demographics and disability characteristics of individuals engaging in disability golf globally. It was hypothesized that the majority of participants would be middle‐aged, male, and from countries with higher gross domestic product, similar to the nondisabled population. Design: Descriptive, cross‐sectional analysis using European Disability Golf Association (EDGA) database. Setting Various international golf tournaments. Participants: Golfers (n = 1734) with disability from 44 countries registered with the EDGA (2017–2021). Interventions: Not applicable. Main Outcomes Descriptive analyses of frequencies, distributions, and means differences of demographic characteristics (age, gender, type of disability, level of handicap, golf cart use, and country of origin) of golfers with disability were performed. Data provided analysis of the association between number of participants and a country's gross domestic product (GDP). Results: Individuals had a mean age of 52.5 (±15.6) years: 1589 (91.6%) male and 145 (8.4%) female. Twenty‐three countries had female participation. The most commonly reported primary disability diagnoses were neurologic (24.8%), orthopedic (21.4%), and amputation below the knee (14.4%). Neurologic impairments (24.7%) were most common in men and orthopedic impairments (29.7%) were most common in women. Individuals with neurological impairments (27.4%) most frequently required golf carts to play. The GDP of a country had a positive correlation (r = 0.68) with the number of registered golfers with disability. Conclusion: Golf is played by individuals with a variety of disabilities and provides numerous benefits. However, there is an underrepresentation of youth, women, and individuals with certain impairments and from lower‐income countries. These are the potential areas of opportunity to improve engagement and inclusiveness of golf. [ABSTRACT FROM AUTHOR]

Background: Only a few epidemiological studies have illuminated the association between pesticide exposure and female infertility. However, evidence of the available data is restricted and also controversial. Vitamin D supplement was considered as having a beneficial effect on fertility. So, the purpose of our study is to assess the effect of dietary vitamin D consumption on the relationship between pesticide exposure in home and female infertility. Methods: There were a total of 2,968 subjects from the National Health and Nutrition Examination Survey (NHANES), 2011 - 2018. The daily vitamin D intake was divided into two groups high intake (= 6 µg/d) and low intake (< 6 µg/d). Multi-variable logistic regression analysis was used to assess the relationship among vitamin D intake, pesticide exposure, and female infertility. Results: We found a significant association between household pesticide exposure and infertility on a basis of a fully-adjusted model (OR 1.61; 95% CI 1.1 - 2.37). Furthermore, the relationship between pesticide exposure and infertility differed from low vitamin D intake group (OR 3.96; 95% CI 1.77 - 8.86) and high intake group (OR 1.36, 95% CI: 0.86 - 2.16), and p for interaction is 0.043 stratified by vitamin D intake. Conclusions: A significant association of female infertility with pesticide exposure in home is modified by dietary vitamin D consumption. This was the first study to demonstrate that dietary vitamin D may alter associations of human female infertility with pesticide exposure in home. [ABSTRACT FROM AUTHOR]

BackgroundNumerous reviews of the epidemiology and risk factors for breast cancer have been published previously which heighted different directions of breast cancer.AimThe present review examined the likelihood that incidence, prevalence, and particular risk factors might vary by geographic region and possibly by food and cultural practices as well.MethodsA systematic review (2017-2022) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, reporting on epidemiological and risk factor reports from different world regions. Medical Subject Heading (MeSH) terms: “Breast neoplasm” “AND” country terms such as “Pakistan/epidemiology”, “India/epidemiology”, “North America/epidemiology”, “South Africa/epidemiology” were used to retrieve 2068 articles from PubMed. After applying inclusion and exclusion terms, 49 papers were selected for systematic review.ResultsResults of selected articles were summarized based on risk factors, world regions and study type. Risk factors were classified into five categories: demographic, genetic and lifestyle risk factors varied among countries. This review article covers a variety of topics, including regions, main findings, and associated risk factors such as genetic factors, and lifestyle. Several studies revealed that lifestyle choices including diet and exercise could affect a person’s chance of developing breast cancer. Breast cancer risk has also been linked to genetic variables, including DNA repair gene polymorphisms and mutations in the breast cancer gene (BRCA). It has been found that most of the genetic variability links to the population of Asia while the cause of breast cancer due to lifestyle modifications has been found in American and British people, indicating that demographic, genetic, and, lifestyle risk factors varied among countries.ConclusionThere are many risk factors for breast cancer, which vary in their importance depending on the world region. However, further investigation is required to better comprehend the particular causes of breast cancer in these areas as well as to create efficient prevention and treatment plans that cater to the local population.

Many infectious pathogens are shared through social interactions, and examining host connectivity has offered valuable insights for understanding patterns of pathogen transmission across wildlife species. African buffalo are social ungulates and important reservoirs of directly‐transmitted pathogens that impact numerous wildlife and livestock species. Here, we analyzed African buffalo social networks to quantify variation in close contacts, examined drivers of contact heterogeneity, and investigated how the observed contact patterns affect pathogen invasion likelihoods for a wild social ungulate. We collected continuous association data using proximity collars and sampled host traits approximately every 2 months during a 15‐month study period in Kruger National Park, South Africa. Although the observed herd was well connected, with most individuals contacting each other during each bimonthly interval, our analyses revealed striking heterogeneity in close‐contact associations among herd members. Network analysis showed that individual connectivity was stable over time and that individual age, sex, reproductive status, and pairwise genetic relatedness were important predictors of buffalo connectivity. Calves were the most connected members of the herd, and adult males were the least connected. These findings highlight the role susceptible calves may play in the transmission of pathogens within the herd. We also demonstrate that, at time scales relevant to infectious pathogens found in nature, the observed level of connectivity affects pathogen invasion likelihoods for a wide range of infectious periods and transmissibilities. Ultimately, our study identifies key predictors of social connectivity in a social ungulate and illustrates how contact heterogeneity, even within a highly connected herd, can shape pathogen invasion likelihoods. [ABSTRACT FROM AUTHOR]

The second wave of COVID-19 occurred in South America in early 2021 and was mainly driven by Gamma and Lambda variants. In this study, we aimed to describe the emergence and local genomic diversity of the SARS-CoV-2 Lambda variant in Argentina, from its initial entry into the country until its detection ceased. Molecular surveillance was conducted on 9356 samples from Argentina between October 2020 and April 2022, and sequencing, phylogenetic, and phylogeographic analyses were performed. Our findings revealed that the Lambda variant was first detected in Argentina in January 2021 and steadily increased in frequency until it peaked in April 2021, with continued detection throughout the year. Phylodynamic analyses showed that at least 18 introductions of the Lambda variant into the country occurred, with nine of them having evidence of onward local transmission. The spatial–-temporal reconstruction showed that Argentine clades were associated with Lambda sequences from Latin America and suggested an initial diversification in the Metropolitan Area of Buenos Aires before spreading to other regions in Argentina. Genetic analyses of genome sequences allowed us to describe the mutational patterns of the Argentine Lambda sequences and detect the emergence of rare mutations in an immunocompromised patient. Our study highlights the importance of genomic surveillance in identifying the introduction and geographical distribution of the SARS-CoV-2 Lambda variant, as well as in monitoring the emergence of mutations that could be involved in the evolutionary leaps that characterize variants of concern. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder and intellectual disability are associated with psychiatric comorbidities, yet a 2009 study of US child and adolescent psychiatry program directors indicated that psychiatry residents receive insufficient training in autism spectrum disorder/intellectual disability. This follow-up study surveyed child and adolescent psychiatry and general psychiatry program directors to assess (1) the current extent of residency training in autism spectrum disorder/intellectual disability, (2) program director perceptions of educational topics and resident competency in autism spectrum disorder/intellectual disability, and (3) preferred resources to strengthen autism spectrum disorder/intellectual disability training. As in 2009, many child and adolescent psychiatry program directors reported few lecture hours, although current child and adolescent psychiatry residents saw slightly more patients with autism spectrum disorder but not intellectual disability. General psychiatry program directors reported fewer lecture hours in autism spectrum disorder/intellectual disability and fewer patients with autism spectrum disorder than child and adolescent psychiatry program directors. Both child and adolescent psychiatry and general psychiatry program directors recognized the importance of a range of educational topics in autism spectrum disorder/intellectual disability. Child and adolescent psychiatry program directors reported higher resident competency, and lecture hours and patients seen moderately correlated with resident competency. Program directors indicated that online videos and other resources would help improve autism spectrum disorder/intellectual disability training in their programs. Collectively, these findings suggest minimal improvements in autism spectrum disorder/intellectual disability training over the past decade and highlight the urgent need to advance psychiatry training in this field through dissemination of resources. Children, adolescents, and adults with autism spectrum disorder and intellectual disability experience high rates of co-occurring psychiatric conditions throughout their lifetime. However, there is a shortage of psychiatrists to treat these populations. We evaluated how much education psychiatrists-in-training receive on how to care for individuals with autism spectrum disorder/intellectual disability. We found that in many psychiatry programs, residents receive limited training experiences in autism spectrum disorder/intellectual disability involving lectures and patient contact and that psychiatry program directors would benefit from more resources to strengthen education in autism spectrum disorder/intellectual disability. [ABSTRACT FROM AUTHOR]

Globally, Giardia lamblia is the most common intestinal protozoa parasite with about 200 million yearly infections in Africa, Asia, and Latin America. The parasite is common in third-world countries with poor living conditions. The current surge in terrorism across Nigeria has forced people to migrate into relatively peaceful regions and Nsukka has been one of the cities in Nigeria that have witnessed the influx of migrants. This migration aids the spread of G. lamblia and thus puts the public health of the inhabitants of Nsukka metropolis at risk. The current state of G. lamblia infection in Nsukka metropolis is not known and this knowledge gap hampers effective planning by public health officers and policymakers to safeguard the public health of the inhabitants. The objectives of this study were to provide information on the prevalence of G. lamblia infection among pupils and students from selected schools within Nsukka metropolis and to provide data on the age group that is more vulnerable to the parasitic infection among the studied population for public health campaign against the parasite. Faecal samples were collected from 170 individuals from five different schools. The faecal samples were examined for G. lamblia under the microscope using formol-ether concentration and direct smear methods. The prevalence of G. lamblia is 38.2%. The prevalence is higher in males (40.3%) than in females (36.7%). El-Shaddai Nursery and Primary School (ENPS) and University of Nigeria Nsukka (UNN) recorded the highest prevalence of 53.3% each. Children in the age groups 3 - 7 years had the highest prevalence of 66.7%. Giardia lamblia is widespread among children and university students in Nsukka metropolis. [ABSTRACT FROM AUTHOR]

The electricity crisis, or power outages, has been a global phenomenon for decades and South Africa is part of this crisis. The SA economy has been impacted immensely by its effects, resulting in industry shutdowns, a steep decline in productivity, unemployment, negative healthcare impacts and an education crisis, to name but a few. In 2022 there was more loadshedding than in all the previous years together. The intention of this paper is to shed light on the devastating impact of loadshedding on the South African economy. A literature review was used, coupled with a documentary research design. It was found that the current loadshedding crisis in South Africa is the culmination of poor leadership, poor management, an aging energy infrastructure and a complex regulatory environment that has hampered economic growth and the livelihoods of its citizens. It has a devastating effect on every sphere of the socio-economic life of the country, with vast industries shutting down, lack of international investments, unemployment, collapsing health and education systems, the continuous darkness that citizens experience daily, the alternative resources needed to survive the loadshedding, etc. The following key pillars are needed to avoid worsening the situation: to upgrade or build new energy infrastructure, find alternative energy sources such wind, solar and green energy, make energy prices fair and market related, and prioritise energy efficiency technologies to reduce demand and outsourcing to independent power producers. [ABSTRACT FROM AUTHOR]

Diversity training for health professionals in South Africa has traditionally been conceptualized as differences in gender, race or ethnicity, culture and sexual orientation. More recently physical disability and mental illness was included as a dimension. Intellectual disabilities received lip service as a diversity concern. This paper reports on health professionals' perceptions of the extent to which diversity training prepared them to competently deal with intellectual disabilities. This explorative study included a purposive sample of 18 health care professionals experienced in intellectual disability services. Two focus groups were facilitated over three sessions. Transcripts were analysed thematically. Health professionals felt inadequately prepared to consider intellectual disabilities as a diversity issue. They could not effectively advocate for reasonable accommodation. There was a differential familiarity with issues related to diversity and intellectual disability with profession constituting an additional intersecting dimension of diversity. Health professions did not perceive their diversity training to prepare them to deal competently with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Vaccines against SARS-CoV-2 have been pivotal in overcoming the COVID-19 pandemic yet understanding the subsequent outcomes and immunological effects remain crucial, especially for at-risk groups e.g., people living with human immunodeficiency virus (HIV) (PLWH). In this study we report the longitudinal IgA and IgG antibody titers, as well as antibody-mediated angiotensin converting enzyme 2 (ACE2) binding blockade, against the SARS-CoV-2 spike (S) proteins after 1 and 2 doses of the ChAdOx1 nCoV-19 vaccine in a population of Black PLWH. Here, we report that PLWH (N = 103) did not produce an anti-S IgA response after infection or vaccination, however, anti-S IgG was detected in response to vaccination and infection, with the highest level detected for infected vaccinated participants. The anti-IgG and ACE2 blockade assays revealed that both vaccination and infection resulted in IgG production, however, only vaccination resulted in a moderate increase in ACE2 binding blockade to the ancestral S protein. Vaccination with a previous infection results in the greatest anti-S IgG and ACE2 blockade for the ancestral S protein. In conclusion, PLWH produce an anti-S IgG response to the ChAdOx1 nCoV-19 vaccine and/or infection, and ChAdOx1 nCoV-19 vaccination with a previous infection produced more neutralizing antibodies than vaccination alone. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the top cause of mortality and a main contributor to disability globally. The evidence so far is varied on whether cold or heat modifies the CVD effects of air pollution. Weather conditions and air pollution sources and levels are different in different countries. Studies in low-and middle-income countries are lacking. Mortality data were obtained from Statistics South Africa. Air pollution and meteorological data were obtained from the South African Weather Service. A time-stratified case–crossover epidemiological design was applied. The association between air pollutants (PM10, NO2 and SO2) and CVD mortality was investigated using conditional logistic regression models. Susceptibility by sex and age groups was investigated. In total, 54,356 CVD deaths were included in the 10-year study. The daily PM10, NO2 and SO2 levels exceeded the daily WHO guidelines on 463, 421 and 8 days of the 3652 days, respectively. Higher air pollution risks were observed in this study compared to those reported in meta-analyses. In general, the elderly and females seemed to be vulnerable to air pollutants, especially at high and moderate apparent temperature levels. Harvesting effects were observed at longer lags. The results can be used to develop an early warning system for the city. [ABSTRACT FROM AUTHOR]

HIV emerged following cross-species transmissions of simian immunodeficiency viruses (SIVs) that naturally infect non-human primates (NHPs) from Africa. While HIV replication and CD4+ T-cell depletion lead to increased gut permeability, microbial translocation, chronic immune activation, and systemic inflammation, the natural hosts of SIVs generally avoid these deleterious consequences when infected with their species-specific SIVs and do not progress to AIDS despite persistent lifelong high viremia due to long-term coevolution with their SIV pathogens. The benign course of natural SIV infection in the natural hosts is in stark contrast to the experimental SIV infection of Asian macaques, which progresses to simian AIDS. The mechanisms of non-pathogenic SIV infections are studied mainly in African green monkeys, sooty mangabeys, and mandrills, while progressing SIV infection is experimentally modeled in macaques: rhesus macaques, pigtailed macaques, and cynomolgus macaques. Here, we focus on the distinctive features of SIV infection in natural hosts, particularly (1): the superior healing properties of the intestinal mucosa, which enable them to maintain the integrity of the gut barrier and prevent microbial translocation, thus avoiding excessive/pathologic immune activation and inflammation usually perpetrated by the leaking of the microbial products into the circulation; (2) the gut microbiome, the disruption of which is an important factor in some inflammatory diseases, yet not completely understood in the course of lentiviral infection; (3) cell population shifts resulting in target cell restriction (downregulation of CD4 or CCR5 surface molecules that bind to SIV), control of viral replication in the lymph nodes (expansion of natural killer cells), and anti-inflammatory effects in the gut (NKG2a/c+ CD8+ T cells); and (4) the genes and biological pathways that can shape genetic adaptations to viral pathogens and are associated with the nonpathogenic outcome of the natural SIV infection. Deciphering the protective mechanisms against SIV disease progression to immunodeficiency, which have been established through long-term coevolution between the natural hosts and their species-specific SIVs, may prompt the development of novel therapeutic interventions, such as drugs that can control gut inflammation, enhance gut healing capacities, or modulate the gut microbiome. These developments can go beyond HIV infection and open up large avenues for correcting gut damage, which is common inmany diseases. [ABSTRACT FROM AUTHOR]

Aims. Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa. Methods. This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites. Results. The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach. Conclusions. By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice. [ABSTRACT FROM AUTHOR]

Purpose: Sustaining healthcare operations without adequate energy capacity creates significant challenges, especially during periods of constrained energy supply. This research develops a clinical and non-clinical activity-based hospital energy model for electrical load prioritization during periods of constrained energy supply. Design/methodology/approach: Discrete event modelling is adopted for development of the hospital energy model (HEM). The building block of the HEM is business process mapping of a hospitals clinical and non-clinical activities. The model prioritizes the electrical load demand as Priority 1, 2 and 3; Priority 1 activities are essential to the survival of patients, Priority 2 activities are critical activities that are required after one to four hours, and Priority 3 activities can run for several hours without electricity. Findings: The model was applied to small, medium, and large hospitals. The results demonstrate that Priority 2 activities have the highest energy demand, followed by Priority 1 and Priority 3 activities, respectively for all hospital sizes. For the medium and large hospitals, the top three contributors to energy demand are lighting, HVAC, and patient services. For the small hospital, it is patient services, lighting, and HVAC. Research limitations/implications: The model is specific to hospitals but can be modified for other healthcare facilities. Practical implications: The resolution of the electrical energy demand down to the business activity level enables hospitals to evaluate current practices for optimization. It facilitates multiple energy supply scenarios, enabling hospital management to conduct feasibility studies based on available power supply options. Social implications: Improved planning of capital expenditure and operational budgets. Improved operations during periods of constrained energy supply, which reduces the risk to hospitals and ensures consistent quality of service. Originality/value: Current hospital energy models are limited, especially for operations management under constrained energy supply. A simple to use model is proposed to assist in planning of activities based on available supply. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore the potential causes of HIV prevalence among young women in South Africa. Human immunodeficiency virus (HIV) is one of the leading causes of death in sub-Saharan Africa. South Africa (SA) has the largest HIV pandemic in the world with approximately 7.2 million people living with HIV as of 2017. There is a disproportionate incidence of HIV between women and men, particularly affecting young women 15–24 years of age. This paper reviewed 10 articles on the impact of HIV in SA among young women. Design/methodology/approach: A total of 10 articles on HIV in SA were selected for review using academic databases including Library One Search Pro, Google Scholar, the British Medical Journal and Elsevier. The search generated 11,095 articles, which were narrowed down to 10 by the criteria of being specific to gender and age and publication period. Findings: Five themes were identified from the findings as to the potential causes of HIV prevalence among young women these included age-disparate relationships, social factors and sexual behaviour. Impact of HIV on communities and individuals, gender and patriarchy including poverty and social isolation. Originality/value: The paper shows the impact of inequalities between men and women leading to HIV infection among young women. It also shows some gaps that require further research with regards to HIV infections among young women. [ABSTRACT FROM AUTHOR]

Studies have shown that electric power supply failures can induce customers' use of media for electric power–related communications. Nigeria is a country with considerably active users of social media but also with incessant electric power outages. However, no known study has been carried out on Nigeria's electric power–related communications based on social media data. The present study investigated comparatively, the behaviors of companies and customers, in their use of Twitter for enterprise–customer communication on electric power distribution services in Nigeria. Using the data-driven science methods, the study revealed that both companies and customers use Twitter to disseminate information on electric power distribution in Nigeria. Companies' corpora feature higher percentages of retweets while customers' corpora feature higher percentages of direct public responses (@replies). The study also revealed a disjoint in the expectations of the companies and customers in their use of Twitter for communicating electric power distribution matters. While companies appear to leverage on the information sharing ability of the medium, customers appear to perceive it as a tool for accessing improved service delivery. The study recommends that Nigeria's electric power distribution companies should incorporate Twitter into the customer service operation of their companies. This will enable information to get to the set of people who will process customers' complaints as soon as possible. [ABSTRACT FROM AUTHOR]