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Introduction: An adequate health workforce (HWF) is essential to achieving the targets of the Sustainable Development Goals (SDG), including universal health coverage. However, weak HWF planning and constrained fiscal space for health, among other factors in the WHO Africa Region, has consistently resulted in underinvestment in HWF development, shortages of the HWF at the frontlines of service delivery and unemployment of qualified and trained health workers. This is further compounded by the ever-evolving disease burden and reduced access to essential health services along the continuum of health promotion, disease prevention, diagnostics, curative care, rehabilitation and palliative care., Methods: A stock and flow model based on HWF stock in 2022, age structure, graduation and migration was conducted to project the available stock by 2030. To estimate the gap between the projected stock and the need, a population needs-based modelling was conducted to forecast the HWF needs by 2030. These estimations were conducted for all 47 countries in the WHO African Region. Combining the stock projection and needs-based estimation, the modelling framework included the stock of health workers, the population's need for health services, the need for health workers and gap analysis expressed as a needs-based shortage of health workers., Results: The needs-based requirement for health workers in Africa was estimated to be 9.75 million in 2022, with an expected 21% increase to 11.8 million by 2030. The available health workers in 2022 covered 43% of the needs-based requirements and are anticipated to improve to 49% by 2030 if the current trajectory of training and education outputs is maintained. An increase of at least 40% in the stock of health workers between 2022 and 2030 is anticipated, but this increase would still leave a needs-based shortage of 6.1 million workers by 2030. Considering only the SDG 3.c.1 tracer occupations (medical doctors, nurses, midwives, pharmacists and dentists), the projected needs-based shortage is 5.3 million by 2030. In sensitivity analysis, the needs-based shortage is most amenable to the prevalence of diseases/risk factors and professional standards for service delivery CONCLUSIONS: The WHO African Region would need to more than double its 2022 HWF stock if the growing population's health needs are to be adequately addressed. The present analysis offers new prospects to better plan HWF efforts considering country-specific HWF structure, and the burden of disease., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Elucidating the molecular driving forces underlying liquid–liquid phase separation is a key objective for understanding biological function and malfunction. Here the authors show that a wide range of cellular proteins, including FUS, TDP-43, Brd4, Sox2, and Annexin A11, which form condensates at low salt concentrations, can reenter a phase-separated regime at high salt concentrations.

Background: The HIV/AIDS epidemic has disproportionately affected Black individuals in the USA, and this health disparity has increased over time. Despite the effectiveness of pre-exposure prophylaxis (PrEP) as a prevention tool for HIV, there are disparities in its use, and uptake of this intervention remains low among racial and ethnic minorities, including Haitians/Haitian Americans. In this study, factors influencing PrEP use among Haitians/Haitian Americans in Miami, FL, are explored to provide necessary data to address disparities., Methods: The research team collaborated with local organizations to recruit 30 individuals (Haitians/Haitian Americans) between February 4 and October 1, 2021, and conducted semi-structured interviews. All interviews were audio-recorded and transcribed, and NVivo® was used to analyze the transcripts for emergent themes., Results: The study sample comprised 30 adults of Haitian descent in Miami, FL (50% female, approximately 67% with a high school education or more, mean age = 43.7 ± 13 years, and 74.2% born in Haiti). Four primary themes emerged from the analysis: (1) limited PrEP awareness, (2) underutilization of PrEP, (3) inadequate discussion of HIV prevention strategies, and (4) PrEP delivery encompassing barriers and facilitators for PrEP delivery and promotion strategies., Conclusion: This study indicated that there is a critical need to increase Haitians/Haitian Americans' knowledge regarding PrEP. Health communication interventions tailored specifically for Haitians/Haitian Americans that target stigma, attitudes toward HIV, and risk perception may be significant in increasing PrEP in this population., Competing Interests: Declarations Ethics Approval The University of Miami Institutional Review Board approved this study. Consent to Participate All study participants gave verbal consent to participate. Consent for Publication N/A Competing Interests Unrelated to data in this manuscript, Dr. Dale is a co-investigator on a Merck & Co. funded project on “A Qualitative Study to Explore Biomedical HIV Prevention Preferences, Challenges and Facilitators among Diverse At-Risk Women Living in the United States” and has served as a workgroup consultant on engaging people living with HIV for Gilead Sciences, Inc. All other authors declare no competing interests., (© 2023. W. Montague Cobb-NMA Health Institute.)

Introduction: Avulsion fractures of the ischial tuberosity (AFIT) are uncommon injuries that sometimes require operative fixation with screws, suture anchors, or cortical suspensory buttons. This study reviewed a series of surgically managed AFITs at a single institution and compared outcomes among fixation strategies. We hypothesized there would be no difference in outcomes between fixation types., Methods: We conducted a retrospective review of all patients treated operatively at a single institution from 2010 to 2022 for AFIT identified by CPT code (27215). We collected patient demographics, injury characteristics, Revised Modified Oxford Bone Score, radiographic measures, fracture classification (type 1-lateral vs. type 2-complete), surgical fixation technique, postoperative complications (Modified Clavien-Dindo-Sink [M-CDS] Complication Classification), and time to return to sport (RTS). Descriptive statistics and univariate analyses were performed., Results: Study criteria identified 16 patients with surgically treated AFITs during the study period. Patients were predominantly male (88%) with a mean age of 14.8±0.8 years. Injured patients most commonly participated in soccer (38%), with the most common mechanism of injury being running/sprinting (50%). The avulsed fracture fragments were a mean of 42.6 mm in size, with an average maximal displacement of 21.1 mm and predominantly type 1-lateral (75%). Surgical constructs included: screws (4), suture anchors (5), cortical suspensory buttons (6), and combined (1, screw and suture anchor). Postoperative complications occurred in 8 patients (50%) including 7 type 1 and 1 type 3 M-CDS. No statistically significant difference was found between fixation types among the studied outcome variables; however, re-fracture (1 case [M-CDS type 3]) was only observed with a combined (screw and suture anchor) construct., Conclusions: This retrospective cohort study demonstrated that postoperative complications after ORIF for AFIT were not infrequent but were largely low in severity. Refracture occurred only with a combined screw and suture anchor construct. Consistent return to sport was achieved across all fixation types, with no significant difference in complication rate between constructs, although the available study sample limited robust analysis. This study is also, of note, one of the first to report outcomes from cortical suspensory buttons (CSB)-a relatively novel intervention for AFIT. Findings from this retrospective case series of multiple surgical techniques serve to bolster the limited literature base regarding the operative treatment of AFITs in adolescents., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To explore and describe the experiences of Haitians/Haitian Americans in Miami-Dade County, Florida during the COVID-19 pandemic, including their attitudes and practices towards vaccination., Design: We interviewed 15 community members and 15 stakeholders in the Haitian/Haitian American community in Miami-Dade County, Florida using a semi-structured interview guide. The qualitative interviews were conducted between February 4, 2021, and October 1, 2021. They were conducted in both English and Haitian Creole, audio recorded transcribed/translated, and coded using thematic content analysis., Results: The analyses revealed 9 major themes: (1) thoughts about the pandemic, (2) concerns about the COVID-19 vaccines, (3) healthcare access, February-October 2021, (4) intrapersonal relationship dynamics, (5) thoughts about individuals diagnosed with COVID-19, (6) thoughts about prevention measures (e.g., wearing masks, hand hygiene, social distancing, vaccination), (7) mental health struggles and coping, (8) food insecurity, and (9) overall experiences of the pandemic. The findings reveal that the COVID-19 public health emergency negatively affected Haitians/Haitian Americans across several domains, including employment, healthcare access, personal relationships, and food security., Conclusion: This research echoes the compounding negative experiences reported by multiple disadvantaged groups during the COVID-19 pandemic. From loss of employment to healthcare barriers, the pandemic forced many Haitians/Haitian Americans into greater economic and social instability. Interventions addressing these issues should recognize how these factors may interact and compound the experiences of this group. Health and public health agencies should work alongside community partners to build trust so that preventive efforts will be more readily accepted during public health emergencies., Competing Interests: AF was employed by Family Action Network Movement. MT is the President/CEO of the Community Health and Empowerment Network. SD is a co-investigator on a Merck & Co. funded project on “A Qualitative Study to Explore Biomedical HIV Prevention Preferences, Challenges and Facilitators among Diverse At-Risk Women Living in the United States” and has served as a workgroup consultant on engaging people living with HIV for Gilead Sciences, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sternberg, Richard, Daniel, Chery, Beauvoir, Marcelin, Francois, Titus, Mann, Alcaide and Dale.)

Amphiphilic Janus silica particles, tunable with oleophobic-oleophilic properties and low fluorine content (8 wt % F), exhibited prominent foamability for a variety of aromatic alcohols at low particle concentrations (<1 wt %) compared to randomly functionalized silica particles. When selectively loaded with Pd nanoparticles on the oleophilic hemisphere, the particles displayed more than a 2-fold increase in catalytic activity for the aerobic oxidation of benzyl alcohol compared to nonfoam bulk catalysis under ambient O 2 pressure. The particles were conveniently recycled with high foamability and catalytic activity maintained for at least five consecutive runs., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Background: Androgen signaling is central to prostate cancer and men's health. Prior data indicates that increasing body fat is unfavorable in the localized setting yet associated with favorable outcomes in men with metastatic disease. Understanding the biological links between adiposity and prostate cancer may optimize the therapeutic index with ASI. We hypothesized that host adiposity and androgen synthesis are linked to the efficacy and toxicity of ASI for men with metastatic castration-resistant prostate cancer (mCRPC)., Methods: A post-hoc analysis was done of NCT02703623 where men with mCRPC (n = 186) were treated for 8 weeks with abiraterone acetate, prednisone, and apalutamide (AAPA), and a satisfactory response was defined as a PSA decline >50%. Body composition was measured on baseline CT scans. Germline DNA WES was performed with a focus on variants in steroidogenic genes. Adipokine levels were measured in pre-treatment plasma., Results: Germline polymorphisms in 3 genes involved in androgen synthesis (AKR1C3 rs12529, CYP17A1 rs6162, SRD5A2 rs523349) were associated with differences in body composition at baseline on ADT alone (prior to receipt of AAPA). Elevated subcutaneous adipose tissue index (SATi, p = 0.02), visceral adipose tissue index (VATi, p = 0.03), and BMI (p = 0.04) were associated with satisfactory response to AAPA. Leptin had positive correlation with VATi (r = 0.47) and SATi (r = 0.48)., Conclusion: Inherited polymorphisms in androgen synthesis correlated with differences in body composition after exposure to ADT and warrant further investigation as candidate markers for body composition toxicity. Elevated subcutaneous and visceral adiposity were associated with improved response to ASI., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

The purpose of this study was to ascertain the extent of current e-learning uptake in Tanzanian universities. The quantitative approach involving survey design was adopted in the collection of data. Data were collected through a questionnaire survey of 400 respondents, with a rate of return 85.5%. The average reliability of variables 0.949 was determined using Cronbach's Alpha. Fuzzy Logic model and t-test were adopted for data analysis. The findings revealed that the average extent of current e-learning uptake among students and academicians were less than half of threshold amounting to 50% (i.e. level of awareness was 16%, availability was 20.6%, accessibility was 17%, attitude was 15% as variables used). There was no statistically significant difference in e-learning uptake among students and academicians as the value of p > 0.05. The findings of this study established a base ground and guidelines to inform the e-learning stakeholders and policymakers to find and establish suitable policy as well as mechanism to adopt and encourage sustainable use of e-learning systems for life-long teaching and learning. The originality of this study is based on the addition of new variables and methodologies employed as empirical evidence based on the extent of e-learning uptake in Tanzanian universities. Keyword: ICTs, e-learning uptake, fuzzy logic model, students, academicians

Cells exposed to starvation have to adjust their metabolism to conserve energy and protect themselves. Protein synthesis is one of the major energy-consuming processes and as such has to be tightly controlled. Many mechanistic details about how starved cells regulate the process of protein synthesis are still unknown. Here, we report that the essential translation initiation factor eIF2B forms filaments in starved budding yeast cells. We demonstrate that filamentation is triggered by starvation-induced acidification of the cytosol, which is caused by an influx of protons from the extracellular environment. We show that filament assembly by eIF2B is necessary for rapid and efficient downregulation of translation. Importantly, this mechanism does not require the kinase Gcn2. Furthermore, analysis of site-specific variants suggests that eIF2B assembly results in enzymatically inactive filaments that promote stress survival and fast recovery of cells from starvation. We propose that translation regulation through filament assembly is an efficient mechanism that allows yeast cells to adapt to fluctuating environments.

Summary: How cells adapt to varying environmental conditions is largely unknown. Here, we show that, in budding yeast, the RNA-binding and stress granule protein Pub1 has an intrinsic property to form condensates upon starvation or heat stress and that condensate formation is associated with cell-cycle arrest. Release from arrest coincides with condensate dissolution, which takes minutes (starvation) or hours (heat shock). In vitro reconstitution reveals that the different dissolution rates of starvation- and heat-induced condensates are due to their different material properties: starvation-induced Pub1 condensates form by liquid-liquid demixing and subsequently convert into reversible gel-like particles; heat-induced condensates are more solid-like and require chaperones for disaggregation. Our data suggest that different physiological stresses, as well as stress durations and intensities, induce condensates with distinct physical properties and thereby define different modes of stress adaptation and rates of recovery. : Kroschwald et al. show that different environmental stresses induce Pub1 stress granule condensates with different material properties. The material properties define the rate of stress granule dissolution and the requirement for disaggregases. The stress granule constituents are released before reentry into the cell cycle. Keywords: phase separation, condensate, phase transition, stress granule, stress response, molecular chaperone, Hsp104, protein aggregation, cytosolic pH

Gas-liquid-solid catalytic reactions are widespread in nature and man-made technologies. Recently, the exceptional reactivity observed on (electro)sprayed microdroplets, in comparison to bulk gas-liquid systems, has attracted the attention of researchers. In this perspective, we compile possible strategies to engineer catalytically active gas-liquid-(solid) interfaces based on membrane contactors, microdroplets, micromarbles, microbubbles, and microfoams to produce commodity chemicals such as hydrogen peroxide, ammonia, and formic acid. In particular, particle-stabilized microfoams, with superior upscaling capacity, emerge as a promising and versatile platform to conceive high-performing (catalytic) gas-liquid-(solid) nanoreactors. Gas-liquid-(solid) nanoreactors could circumvent current limitations of state-of-the-art multiphase reactors (e.g., stirred tanks, trickle beds, and bubble columns) suffering from poor gas solubility and mass transfer resistances and access gas-liquid-(solid) reactors with lower cost and carbon footprint.

α,β-Unsaturated aldehydes are important building blocks for the synthesis of a wide range of chemicals, including polymers. The synthesis of these molecules from cheap feedstocks such as alkenes remains a scientific challenge, mainly due to the low reactivity of alkenes. Here we report a selective and metal-free access to α,β-unsaturated aldehydes from alkenes with formaldehyde. This reaction is catalyzed by dimethylamine and affords α,β-unsaturated aldehydes in yields of up to 80 %. By combining Density Functional Theory (DFT) calculations and experiments, we elucidate the reaction mechanism which is based on a cascade of hydride transfer, hydrolysis and aldolization reactions. The reaction can be performed under very mild conditions (30-50 °C), in a theoretically 100 % carbon-economical fashion, with water as the only by-product. The reaction was successfully applied to non-activated linear 1-alkenes, thus opening an access to industrially relevant α,β-unsaturated aldehydes from cheap and widely abundant chemicals at large scale., (© 2024 The Authors. Chemistry - A European Journal published by Wiley-VCH GmbH.)

Nonaqueous foams in low-surface tension solvents (<25 mN·m -1 ) are highly desired for applications in fire extinguishers and detoxification gels. However, their formation is a Holy Grail of the chemical industry due to the need for stabilizers with low surface energy and high recyclability. Herein, we disclose a new strategy to generate abundant foams in ethanol and a variety of low-surface tension solvents relying on the interfacial coadsorption of two different particles. The particles consist of surface-active fluorinated silica particles, used as a stabilizer, and a novel amphiphilic polyhedral oligomeric silsesquioxane (POSS) decorated with isobutyl cage substituents, used as a frother. The interaction between POSS and fluorinated particles at the ethanol-air interface was thoroughly investigated by combining physicochemical methods (contact angle, dynamic surface tension, and dynamic light scattering methods) and catalytic tests using the model aerobic oxidation reaction of benzyl alcohol. Both particles could be conveniently recycled for at least 5 consecutive runs with high foamability and catalytic activity.

Traditional on-site missions of plastic surgeons from "high-income countries" in "low- and middle-income countries" are often limited in time and lack proper follow-up. Regular digital collaboration could lead to a more impactful and durable exchange of knowledge for plastic surgeons and residents in both settings. The aim of this study was to evaluate the satisfaction of the first twelve months of weekly digital meetings, explore advantages/disadvantages, and to provide tools for similar initiatives. Weekly meetings started from August 2021. An encrypted digital connection allowed residents and plastic surgeons from Uganda and the Netherlands to discuss cases for educational purposes, where treatment options were considered. After twelve months, a survey was sent to participants from both countries to indicate the meetings' strengths, weaknesses, and possible improvements. A total of 18 participants responded to the questionnaire (ten plastic surgeons, six residents, and two researchers). The strengths of the meetings were the accessibility of the meetings, knowledge exchange and practice for residents' final exams. Possible improvements included having a clear format for patient discussion, a session moderator and better internet connectivity. Moreover, a database to assess the impact of the given intervention on the patient cases by evaluating postoperatively (e.g. three months), could further improve clinical care. Virtual patient discussions subjectively contributed to medical education at both locations. Improved digital infrastructure and a collaborative database could further maximize learning capacity. Furthermore, digital proctoring is a promising way to establish sustainable collaborations between high- and low-resource countries. [ABSTRACT FROM AUTHOR]