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Electronic-cigarette (e-cig) vaping is a serious concern, as many pregnant women who vape consider it safe. However, little is known about the harmful effects of prenatal e-cig exposure on adult offspring, especially on extracellular-matrix (ECM) deposition and myogenesis in the lungs of offspring. We evaluated the biochemical and molecular implications of maternal exposure during pregnancy to e-cig aerosols on the adult offspring of both sexes, with a particular focus on pulmonary ECM remodeling and myogenesis. Pregnant CD-1 mice were exposed to e-cig aerosols with or without nicotine, throughout gestation, and lungs were collected from adult male and female offspring. Compared with the air-exposed control group, female mice exposed to e-cig aerosols, with or without nicotine, demonstrated increased lung protein abundance of LEF-1 (lymphoid enhancer-binding factor 1), fibronectin, and E-cadherin, whereas altered E-cadherin and PPARγ (peroxisome proliferator-activated receptor γ) levels were observed only in males exposed to e-cig aerosols with nicotine. Moreover, lipogenic and myogenic mRNAs were dysregulated in adult offspring in a sex-dependent manner. PAI-1 (plasminogen activator inhibitor-1), one of the ECM regulators, was significantly increased in females exposed prenatally to e-cig aerosols with nicotine and in males exposed to e-cig aerosols compared with control animals exposed to air. MMP9 (matrix metalloproteinase 9), a downstream target of PAI-1, was downregulated in both sexes exposed to e-cig aerosols with nicotine. No differences in lung histology were observed among any of the treatment groups. Overall, adult mice exposed prenatally to e-cig aerosols could be predisposed to developing pulmonary disease later in life. Thus, these findings suggest that vaping during pregnancy is unsafe and increases the propensity for later-life interstitial lung diseases.

Nicotine inhalation via electronic cigarettes (e-cigs) is an emerging concern. However, little is known about the acute toxicity in the lungs following inhalation of nicotine-containing e-cig aerosols. We hypothesized that acute exposure to aerosolized nicotine causes lung toxicity by eliciting inflammatory and dysregulated repair responses. Adult C57BL/6J mice were exposed 2 h daily for 3 days to e-cig aerosols containing propylene glycol (PG) with or without nicotine. Acute exposure to nicotine-containing e-cig aerosols induced inflammatory cell influx (neutrophils and CD8a+ T-lymphocytes), and release of pro-inflammatory cytokines in bronchoalveolar lavage fluid in a sex-dependent manner. Inhalation of e-cig aerosol containing PG alone significantly augmented the lung levels of various homeostasis/repair mediators (PPARγ, ADRP, ACTA2, CTNNB1, LEF1, β-catenin, E-cadherin, and MMP2) in a sex-dependent manner when compared to air controls. These findings were accompanied by an increase in protein abundance and altered gene expression of lipogenic markers (PPARγ, ADRP) and myogenic markers (fibronectin, α-smooth muscle actin and β-catenin), suggesting a dysregulated repair response in mouse lungs. Furthermore, exposure to nicotine containing e-cig aerosols or PG alone differentially affected the release of pro-inflammatory cytokines in healthy and COPD human 3D EpiAirway tissues. Overall, acute exposure to nicotine containing e-cig aerosols was sufficient to elicit a pro-inflammatory response and altered mRNA and protein levels of myogenic, lipogenic, and extracellular matrix markers in mouse lung in a sex-dependent manner. Thus, acute exposure to inhaled nicotine via e-cig leads to dysregulated repair and inflammatory responses, which may lead to airway remodeling in the lungs.

Medical misinformation (false health or medical‐related information) has seen a rapid increase in volume recently, with the global surge in social media usage and further exacerbation by the COVID‐19 pandemic. This may put more lives at stake, as misinformation is an often‐cited reason that people make dangerous health choices, engage in harmful practices and reject beneficial health treatments. In this article, we explore the drivers and consequences, as well as suggest several strategies at the personal, educational and systemic level, for physicians to guide and communicate with patients who subscribe to medical misinformation. [ABSTRACT FROM AUTHOR]

Subspecialty consultations are becoming highly prevalent in hospital medicine, due to an ageing population with multimorbid conditions and increasingly complex care needs, as well as medicolegal fears that lead to widespread defensive medical practices. Although timely subspecialty consultations in the appropriate clinical context have been found to improve clinical outcomes, there remains a significant proportion of specialty referrals in hospital medicine which are inappropriate, excessive, or do not add value to patient care. In this article, we sought to provide an overview of the common problems pertaining to excessive quantity and suboptimal quality of inpatient subspecialty consultations made in real-world practice and highlight their implications for healthcare financing and patient care. In addition, we discuss the underlying contributing factors that predispose to inappropriate use of the specialist referral system. Finally, we offer a practical, multitiered approach to help rationalize subspecialty consultations, through (i) a systematic model ('WISE' template) for individual referral-making, (ii) development of standardized healthcare institutional referral guidelines with routine clinical audits for quality control, (iii) adopting an integrated generalist care model, and (iv) incorporating training on effective referral-making in medical education. [ABSTRACT FROM AUTHOR]

Clinical reasoning is a crucial skill and defining characteristic of the medical profession, which relates to intricate cognitive and decision-making processes that are needed to solve real-world clinical problems. However, much of our current competency-based medical education systems have focused on imparting swathes of content knowledge and skills to our medical trainees, without an adequate emphasis on strengthening the cognitive schema and psychological processes that govern actual decision-making in clinical environments. Nonetheless, flawed clinical reasoning has serious repercussions on patient care, as it is associated with diagnostic errors, inappropriate investigations, and incongruent or suboptimal management plans that can result in significant morbidity and even mortality. In this article, we discuss the psychological constructs of clinical reasoning in the form of cognitive 'thought processing' models and real-world contextual or emotional influences on clinical decision-making. In addition, we propose practical strategies, including pedagogical development of a personal cognitive schema, mitigating strategies to combat cognitive bias and flawed reasoning, and emotional regulation and self-care techniques, which can be adopted in medical training to optimize physicians' clinical reasoning in real-world practice that effectively translates learnt knowledge and skill sets into good decisions and outcomes. [ABSTRACT FROM AUTHOR]

The advent of social media (SM) platforms has transformed communications, information dissemination, and interpersonal relationships on a global scale. As SM continues to evolve and proliferate, its impact on various aspects of society has become increasingly complex and multifaceted. For this reason and over the past decades, several controversies have been held about whether SM is good or bad. However, the mathematical modeling technique inculcating SM impacts (positive and negative) has not been studied in the existing works. This article considers a mathematical model approach using the ABC‐fractional derivative technique to study the dynamics of SM impacts. We provide the various definitions and the properties needed to study the model. Also, we use the fixed point theorem and a nonlinear analytic approach to demonstrate the theoretical solutions of the existence of solutions for the proposed model. Furthermore, the fundamental reproduction number is computed, and the stability of the model is achieved using the Ulam–Hyers (HU) criteria. We again perform a sensitivity study for the SM impact model and the effects of the sensitive parameters are presented in 3D and contour plots. In addition, a numerical algorithm of the predictor–corrector type of the Adams–Bashforth method for determining the approximate solution of the model is developed and the results are discussed. The effects of the most sensitive parameters on affected individuals in the model with a constant fractional order are shown and discussed. The simulation results indicate that as individuals become aware of the negative impacts of SM, the number of positively impacted individuals rises. [ABSTRACT FROM AUTHOR]

This study examines the contingency effect of infrastructure (disaggregated into physical and digital) in the relationship between foreign aid and inclusive growth in Sub‐Saharan Africa (SSA). We employ macro data for 41 SSA countries and the dynamic system GMM estimator for the empirical analysis. We find that (i) foreign aid promotes inclusive growth in SSA, (ii) whereas transport infrastructure enhances inclusive growth, energy infrastructure, sanitation infrastructure, and digital infrastructure are statistically insignificant, and (iii) only transport infrastructure amplifies the inclusive growth‐enhancing effect of foreign aid. Across the digital and physical infrastructure domains, we find that the contingency effect of the latter is rather remarkable. Our threshold analysis also indicates that for digital infrastructure and transport infrastructure to condition complementary policies to foster inclusive growth in SSA, minimum thresholds of 22% and 57.8% are required. We conclude that comprehensive transport infrastructural development is key if foreign aid is to enhance inclusive growth in SSA. [ABSTRACT FROM AUTHOR]

Objectives: Using a systematic meta-analysis, we investigated if patients with type 2 diabetes (T2D) and with varying baseline blood pressure (BP) differ in the cardiorenal benefits received from sodium–glucose co-transporter 2 inhibitors (SGLT-2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs). Design: Randomized, placebo-controlled, cardiovascular outcome trials (CVOTs) of SGLT-2is and GLP-1RAs were identified from MEDLINE, Embase, and the Cochrane Library up to April 2024. Hazard ratios (HRs) with 95% CIs were pooled. The differential treatment effect by baseline BP category within each trial was estimated as the ratio of the HR (RHR) and pooled. Results: Seventeen publications based on 9 unique CVOTs (4 SGLT-2is and 5 GLP-1RAs) were eligible. In participants with normal baseline BP, comparing SGLT-2is with placebo, the HRs (95% CIs) were 0.88 (0.79-0.97) for major adverse cardiovascular events (MACE), 0.73 (0.59-0.91) for heart failure (HF) hospitalization, 0.78 (0.65-0.94) for composite CVD death/HF hospitalization, and 0.55 (0.41-0.73) for composite renal outcome. The corresponding estimates for participants with higher baseline BP were 0.88 (0.81-0.96), 0.67 (0.57-0.79), 0.73 (0.65-0.82), and 0.61 (0.48-0.77), respectively. In participants with normal baseline BP, GLP-RAs had no strong effect on MACE, stroke and nephropathy, but reduced stroke and nephropathy risk in those with higher baseline BP. Estimated RHRs showed no statistical evidence that baseline BP modified the cardiorenal benefits of SGLT-2is and GLP-1RAs. Conclusions: In patients with T2D, the cardiorenal benefits of treatment with SGLT2-Is and GLP1-RAs were similar in patients with normal baseline BP compared to those with a higher baseline BP. : [ABSTRACT FROM AUTHOR]

Radical organic ions can be stabilized by complexation with neutral organics via interactions that can resemble chemical bonds, but with much diminished bond energies. Those interactions are a key factor in cluster growth and polymerization reactions in ionizing environments such as regions of the interstellar medium and solar nebulae. Such radical cation complexes between naphthalene (Naph) and pyridine (Pyr) are characterized using mass-selected ion mobility experiments. The measured enthalpy of binding of the Naph+•(Pyr) heterodimer (20.9 kcal/mol) exceeds that of the Naph+•(Naph) homodimer (17.8 kcal/mol). The addition of 1-3 more pyridine molecules to the Naph+•(Pyr) heterodimer gives 10-11 kcal/mol increments in binding enthalpy. A rich array of Naph+•(Pyr) isomers are characterized by electronic structure calculations. The calculated Boltzmann distribution at 400 K yields an enthalpy of binding in reasonable agreement with experiment. The global minimum is a distonic cation formed by Pyr attack on Naph+• at the α-carbon, changing its hybridization from sp2 to distorted sp3. The measured collision cross section in helium for the Naph+•(Pyr) heterodimer of 84.9 ± 2.5 Å2 at 302 K agrees well with calculated angle-averaged cross sections (83.9-85.1 Å2 at 302 K) of the lowest energy distonic structures. A remarkable 16 kcal/mol increase in the binding energy between Naph+•(Pyr) and Bz+•(Pyr) (Bz is benzene) is understood by energy decomposition analysis. A similar increase in binding from Naph+•(NH3) to Naph+•(Pyr) (as well as between Bz+•(NH3) and Bz+•(Pyr)) is likewise rationalized.

The importance of girl-child education is largely documented and initiatives to promote girl-child education are widespread. However, studies on service delivery methods, processes and the impacts are limited in the literature. This study assessed the Plan Ghana's girl-child educational project. According to the findings, the project has helped to improve the girls' confidence level and performance in examination. They associated more with their colleagues from affluent homes, and the financial burdens on their parents were also lessened. However, more girls need to be supported and boys with the same socio-economic backgrounds of the girls also need to be assisted by such educational projects/programs.

The victim devaluation thesis posits that crimes against minorities are less likely to be cleared than those against White victims. Tests of the victim devaluation thesis on violent crimes are inconclusive, and either focuses on homicides or non-lethal violent crimes. Using data from the National Incident-Based Reporting System, this study estimated the effect a victim's race has on lethal and non-lethal (rape, robbery, and aggravated assault) violent crime arrests. The results provide partial support for the victim devaluation thesis. Although non-lethal violent crimes against Blacks were less likely to be cleared than those against Whites, homicides against Blacks were more likely to be cleared than those against Whites. Further, extralegal variables and the seriousness of the crime affected arrest outcomes. [ABSTRACT FROM AUTHOR]

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ABSTRACT Aim Design Methods Data Sources Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution The aim of this study is to provide conceptual clarity on psychosocial distress among African American and Latine men who have sex with men living with human immunodeficiency virus.Concept analysis.The 8‐step Walker and Avant framework guided the concept analysis of psychosocial distress tailored to this patient population.A literature review was conducted using the research databases PubMed/Medline, PsycINFO, the Cumulated Index of Nursing and Allied Health Literature and Scopus with the selected search terms.A total of 7 articles were retrieved and analysed to explicate the antecedents, attributes, and consequences of psychosocial distress in this population. Four cases were developed to further clarify the concept of psychosocial distress; a model case, borderline case, related case and contrary case.As experienced by African American and Latine men who have sex with men living with human immunodeficiency virus, psychosocial distress is defined as a state of suffering due to uncontrollable structural and/or social factors that threaten the individual's existence and/or livelihood based on their social identity as a racial/ethnic, sexual minority.The concept analysis of psychosocial distress can be useful to guide future theory and measurement development to enhance disease‐specific and general health outcomes for sexual and racial/ethnic minoritised men who have sex with men.Not applicable.No patient or public contribution. [ABSTRACT FROM AUTHOR]

The use of herbal products for the treatment of malaria, has increased globally. However, inadequate scientific studies about the safety and effectiveness of such herbal products have been raised. Also, the reduced sensitivity of the malaria parasites to artemisinin-based combination therapies is of concern. There is therefore the need for new antimalarial medications including those from alternative sources such as herbal medicinal products. In this study, a prospective, comparative parallel group randomized, clinical study was done to assess the safety and effectiveness of Mist Amen Fevermix and Mist Edhec Malacure with Artemether/Lumefantrine as control at the Tafo Government Hospital, Kumasi between July and November 2019, after Committee on Human Research, Publication and Ethics approval (CHRPE/AP/424/19). The study was conducted in accordance with Good Clinical and Laboratory Practice (GCLP) and registered with the Pan African Clinical Trials Registry with trial number PACTR202109664146698. Participant completed an informed consent form. Randomization was based on a single sequence to allocate participants to a group. SPSS version 19. One-way ANOVA test and exploratory statistics was used for data analysis. Total sample size was 150 participants with 50 on each arm of the group. Male and female patients aged 15–45 years and meet inclusion criteria with clinically established malaria were treated with Mist Amen Fevermix and Mist Edhec Malacure, at the specified doses of 45 mls (0.1063 g) and 30 mls (0.0521 g) three times daily after meals for three days. Artemether/Lumefantrine was administered at a dose of 80/480 mg/kg twice daily after meals for three days. Baseline data was taken on day 0. Patients were then followed up on Day 3, 7 and 28 to establish treatment outcomes and any side effect using a checklist for signs and symptoms and Karnofsky's scale to assess the quality of life. Mist Amen Fevermix was effective with a cure rate of 95.89%. Mist Edhec Malacure was also effective with a cure rate of 91.87%. The cure rate of Artemether/Lumefantrine was 97.25%. Kidney and liver panels were within normal reference range at the end of the 28-day study. This study supports the use of Mist Amen Fevermix and Mist Edhec Malacure, two multi-component products as safe and effective for the treatment of uncomplicated malaria. Both products achieved a comparable clinical treatment outcome with Artemether/Lumefantrine. [ABSTRACT FROM AUTHOR]

Tomato paste is the most consumed tomato product on the Ghanaian market, the majority of which are imported into the country. This food product is easily adulterated, and thus, routine quality checks are necessary. Therefore, the current study is aimed at assessing the quality of eight tomato paste products on the Ghanaian market and checking for the presence of starch and artificial colourant erythrosine as possible adulterants. Routine quality metrics such as the pH, titratable acidity, total solids, and total soluble solids were assessed using standard methods. An HPLC method was employed to detect the presence of the colourant erythrosine, whereas starch content was determined by an enzymatic method using α‐amylase and then amyloglucosidase. Fifty percent of the products did not qualify to be called tomato paste based on total solid estimation. All the sampled products contained some amount of starch, with three having more than 10 g/100 g of this thickener. Additionally, the banned colourant erythrosine was detected in two of the products. All other parameters were consistent with regulatory standards. The present study has shown that some tomato paste products on the Ghanaian market contain additives that are not permitted under any circumstance and fall short of regulatory standards. [ABSTRACT FROM AUTHOR]

Purpose: Psychosocial distress negatively impacts coping and adaptation among young men (aged 18 to 44 years) who have sex with men (YMSM) with, or at risk of acquiring, HIV. However, the stressors and risky behaviors associated with psychosocial distress that impair viral suppression have not been clearly explicated. The current scoping review was conducted to explore the extant literature and identify research gaps. Method: PubMed and CINAHL were searched for peer-reviewed publications, with a total of eight articles meeting inclusion criteria. Results: Stressors that contributed to psychosocial distress included HIV+ status, stigma, discrimination, insufficient resources, exposure to community violence, and incarceration. Risky behaviors impacting viral suppression were condomless anal sex, drug use, and medication nonadherence. Conclusion: Understanding and addressing psychosocial distress is imperative for providing holistic care tailored to the unique health care needs of YMSM. A better understanding of stressors and associated risky behaviors will aid efforts to mitigate psychosocial distress and reduce viral load among YMSM. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 11–17.] [ABSTRACT FROM AUTHOR]

The COVID-19 epidemic had a profound impact on global health and the economy and Ghana was no exception to its far-reaching consequences. Regarding detection of the causative agent—the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reverse-transcription–qPCR (RT–qPCR) is widely recognized as a very sensitive and reliable diagnostic technique used globally. There are, however, high operational costs in acquiring test kits, equipment, and accessories for RT–qPCR testing, which pose significant challenges in resource-limited settings. Hence, this proof-of-concept study set out to develop a more affordable COVID-19 protocol for use in low or lower-middle-income settings, such as Ghana, that would bypass the traditional extraction process using inexpensive reagents and evaluate the possibility of processing samples collected using wooden shaft swabs. Several less expensive media were used for the extraction-free process. Results demonstrated that direct RT–qPCR assay after 5 min heat inactivation of virus at 95 °C in 0.1× PBS or molecular grade water resulted in viral detection with quantification cycle (Cq) values that are comparable to results obtained following the extraction process. Also, wooden shaft swabs could be used for sampling if incubation times are kept to less than 6 h. The study demonstrates that extraction-free protocols are one way to minimize the cost of COVID-19 testing by RT–qPCR. [ABSTRACT FROM AUTHOR]

Background: This study aimed at describing the epidemiology of (neuro)cysticercosis as well as its clinical and radiological characteristics in a Taenia solium endemic district of Zambia. Methods: This was part of a cross-sectional community-based study conducted in Sinda district to evaluate an antibody-detecting T. solium point-of-care (TS POC) test for taeniosis and (neuro)cysticercosis. All TS POC cysticercosis positive (CC+) participants and a subset of the TS POC cysticercosis negative (CC-) received a clinical evaluation and cerebral computed tomography (CT) examination for neurocysticercosis (NCC) diagnosis and staging. Results: Of the 1249 participants with a valid TS POC test result, 177 (14%) were TS POC CC+. Cysticercosis sero-prevalence was estimated to be 20.1% (95% confidence intervals [CI] 14.6–27.0%). In total, 233 participants received a CT examination (151 TS POC CC+ , 82 TS POC CC-). Typical NCC lesions were present in 35/151 (23%) TS POC CC+ , and in 10/82 (12%) TS POC CC- participants. NCC prevalence was 13.5% (95% CI 8.4–21.1%) in the study population and 38.0% (95% CI 5.2–87.4%) among people reporting epileptic seizures. Participants with NCC were more likely to experience epileptic seizures (OR = 3.98, 95% CI 1.34–11.78, p = 0.01) than those without NCC, although only 7/45 (16%) people with NCC ever experienced epileptic seizures. The number of lesions did not differ by TS POC CC status (median: 3 [IQR 1–6] versus 2.5 [IQR 1–5.3], p = 0.64). Eight (23%) of the 35 TS POC CC+ participants with NCC had active stage lesions; in contrast none of the TS POC CC- participants was diagnosed with active NCC. Conclusion: NCC is common in communities in the Eastern province of Zambia, but a large proportion of people remain asymptomatic. [ABSTRACT FROM AUTHOR]

The purpose of this research is to explore empirically the mediation effect of firm innovation on the relationship between external knowledge and firm performance. Using cross-sectional data from the World Bank Enterprise Survey in ten sub-Saharan African (SSA) countries, a range of analysis was conducted to test for the mediation effect. We used Baron and Kenny's (1986) triple test for mediation to understand the nature of mediation and the product of the coefficient approach to compute three different mediation tests (the Sobel test and the Aroian and Goodman tests) including the bootstrapping confidence interval. The result confirms innovation mediates the relationship between external advice and firm performance. The study contributes to the limited literature on the mechanism through which external knowledge could positively influence firm performance, especially in a developing country context (Africa) where existing literature has focused more on how external knowledge influences firm innovation. [ABSTRACT FROM AUTHOR]