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Cytology-based cervical cancer screening programs have been difficult to implement and scale up in developing countries. Thus, the World Health Organization recommends a ‘see and treat’ approach by way of hr-HPV testing and visual inspection. We aimed to evaluate concurrent HPV DNA testing and visual inspection in a real-world low-resource setting by comparing the detection rates of concurrent visual inspection with dilute acetic acid (VIA) or mobile colposcopy and hr-HPV DNA testing to standalone hr-HPV DNA testing (using the careHPV, GeneXpert, AmpFire, or MA-6000 platforms). We further compared their rates of loss to follow-up. This retrospective, descriptive cross-sectional study included all 4482 women subjected to cervical precancer screening at our facility between June 2016 and March 2022. The rates of EVA and VIA ‘positivity’ were 8.6% (95% CI, 6.7–10.6) and 2.1 (95% CI, 1.6–2.5), respectively, while the hr-HPV-positivity rate was 17.9% (95% CI, 16.7–19.0). Overall, 51 women in the entire cohort tested positive on both hr-HPV DNA testing and visual inspection (1.1%; 95% CI, 0.9–1.5), whereas a large majority of the women tested negative (3588/4482, 80.1%) for both and 2.1% (95% CI, 1.7–2.6) tested hr-HPV-negative but visual inspection ‘positive’. In total, 191/275 (69.5%) participants who tested hr-HPV positive on any platform, as a standalone test for screening, returned for at least one follow-up visit. In light of factors such as poor socioeconomic circumstances, additional transportation costs associated with multiple screening visits, and lack of a reliable address system in many parts of Ghana, we posit that standalone HPV DNA testing with recall of hr-HPV positives will be tedious for a national cervical cancer prevention program. Our preliminary data show that concurrent testing (hr-HPV DNA testing alongside visual inspection by way of VIA or mobile colposcopy) may be more cost-effective than recalling hr-HPV-positive women for colposcopy.

Sleep tracking has been rapidly developing alongside wearable technologies and digital trackers are increasingly being used in research, replacing diaries and other more laborious methods. In this work, we describe the user expectations and experiences of four different sleep tracking devices used simultaneously during week-long field deployment. The sensor-based data collection was supplemented with qualitative data from a 2-week long daily questionnaire period which overlapped with device usage for a period of 1 week. We compare the sleep data on each of the tracking nights between all four devices, and showcase that while each device has been validated with the polysomnography (PSG) gold standard, the devices show highly varying results in everyday use. Differences between devices for measuring sleep duration or sleep stages on a single night can be up to an average of 1 h 36 min. Study participants provided their expectations and experiences with the devices, and provided qualitative insights into their usage throughout the daily questionnaires. The participants assessed each device according to ease of use, functionality and reliability, and comfortability and effect on sleep disturbances. We conclude the work with lessons learned and recommendations for researchers who wish to conduct field studies using digital sleep trackers, and how to mitigate potential challenges and problems that might arise regarding data validity and technical issues.

Type 2 diabetes (T2D) with increasing prevalence is a significant global public health challenge. Obesity, unhealthy diet, and low physical activity are one of the major determinants of the rise in T2D prevalence. In addition, family history and genetic risk of diabetes also play a role in the process of developing T2D. Therefore, solutions for the early identification of individuals at high risk for T2D for early targeted detection of T2D, prevention, and intervention are highly preferred. Recently, novel genomic-based polygenic risk scores (PRSs) have been suggested to improve the accuracy of risk prediction supporting the targeting of preventive interventions to those at highest risk for T2D. Therefore, the aim of the present study was to assess the cost-utility of an additional PRS testing information (as a part of overall risk assessment) followed by a lifestyle intervention and an additional medical therapy when estimated 10-year overall risk for T2D exceeded 20% among Finnish individuals screened as at the high-risk category (i.e., 10%–20% 10-year overall risk of T2D) based on traditional risk factors only. For a cost-utility analysis, an individual-level state-transition model with probabilistic sensitivity analysis was constructed. A 1-year cycle length and a lifetime time horizon were applied in the base-case. A 3% discount rate was used for costs and QALYs. Cost-effectiveness acceptability curve (CEAC) and estimates for the expected value of perfect information (EVPI) were calculated to assist decision makers. The use of the targeted PRS strategy reclassified 12.4 percentage points of individuals to be very high-risk individuals who would have been originally classified as high risk using the usual strategy only. Over a lifetime horizon, the targeted PRS was a dominant strategy (i.e., less costly, more effective). One-way and scenario sensitivity analyses showed that results remained dominant in almost all simulations. However, there is uncertainty, since the probability (EVPI) of cost-effectiveness at a WTP of 0€/QALY was 63.0% (243€) indicating the probability that the PRS strategy is a dominant option. In conclusion, the results demonstrated that the PRS provides moderate additional value in Finnish population in risk screening leading to potential cost savings and better quality of life when compared with the current screening methods for T2D risk.

BackgroundChronic pain is a prolonged condition that deteriorates one's quality of life. Treating chronic pain requires a multicomponent approach, and in many cases, there are no “silver bullet” solutions. Mobile health (mHealth) is a rapidly expanding category of solutions in digital health with proven potential in chronic pain management. ObjectiveThis study aims to contrast the viewpoints of 2 groups of people with chronic pain concerning mHealth: people who have adopted the use of mHealth and those who have not. We highlight the benefits of mHealth solutions for people with chronic pain and the perceived obstacles to their increased adoption. We also provide recommendations to encourage people to try mHealth solutions as part of their self-care. MethodsThe Prolific crowdsourcing platform was used to collect crowdsourced data. A prescreening questionnaire was released to determine what type of pain potential participants have and whether they are currently using mHealth solutions for chronic pain. The participants were invited based on their experience using mHealth to manage their pain. Similar questions were presented to mHealth users and nonusers. Qualitative and quantitative analyses were performed to determine the outcomes of this study. ResultsIn total, 31 responses were collected from people (aged 19-63 years, mean 31.4, SD 12.1) with chronic pain who use mHealth solutions. Two-thirds (n=20, 65%) of the users identified as female and 11 (35%) as male. We matched these mHealth users with an equal number of nonusers: 31 responses from the pool of 361 participants in the prescreening questionnaire. The nonusers’ ages ranged from 18 to 58 years (mean 30.8, SD 11.09), with 15 (50%) identifying as female and 15 (50%) as male. Likert-scale questions were analyzed using the Mann-Whitney-Wilcoxon (MWW) test. Results showed that the 2 groups differed significantly on 10 (43%) of 23 questions and shared similar views in the remaining 13 (57%). The most significant differences were related to privacy and interactions with health professionals. Of the 31 mHealth users, 12 (39%) declared that using mHealth solutions has made interacting with health or social care professionals easier (vs n=22, 71%, of nonusers). The majority of the nonusers (n=26, 84%) compared with about half of the users (n=15, 48%) expressed concern about sharing their data with, for example, third parties. ConclusionsThis study investigated how mHealth is currently used in the context of chronic pain and what expectations mHealth nonusers have for mHealth as a future chronic pain management tool. Analysis revealed contrasts between mHealth use expectations and actual usage experiences, highlighting privacy concerns toward mHealth solutions. Generally, the results showed that nonusers are more concerned about data privacy and expect mHealth to facilitate interacting with health professionals. The users, in contrast, feel that such connections do not exist.

Overweight and obesity are linked to the severity of infections and the development of chronic conditions among children and adolescents in Ghana. Hence, estimating the current prevalence and its determinants is imperative to guide public health interventions. This review mapped evidence on the prevalence and determinants of overweight and obesity among in‐school children and adolescents (aged 5–19 years) in Ghana. Three main databases (PubMed, Central, and JSTOR) were searched for studies conducted in Ghana. Also, the study included only studies published online between 2010 and 2022. The search produced 1214 records, with an additional 23 identified through a search conducted in Google, Google Scholar, the WHO library, HINARI, and institutional repositories. After a thorough screening, 24 records were synthesized. The prevalence of overweight/obesity among the 23,663 in‐school children and adolescents in Ghana was 0.5%–47.06%. Females have higher odds of being overweight than males. In addition, lack of nutrition and physical activity (PA) knowledge and low participation in school sports and physical activities exposed in‐school children and adolescents in Ghana to overweight and obesity. Consumption of unhealthy foods, late bed, smoking, loneliness, watching television, and playing computer games exposed schoolchildren and adolescents in Ghana to overweight and obesity. There are relatively high levels of overweight and obesity among school‐going children and adolescents in Ghana. Addressing sex gaps in PA, ensuring healthy eating, and limiting sedentary lifestyles is the surest way to promote healthy weight among in‐school children and adolescents in Ghana. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic Kidney Disease (DKD) is the main cause of end-stage renal disease in the developed world. The current treatment of the DKD with reninangiotensin system (RAS) blockade does not totally halt the progression to end stage kidney disease. Currently, several drugs have shown to delay DKD progression such as sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like-1 receptor agonists (GLP-1RA). We hypothesized that by combining several drugs that prevent DKD progression on top of RAS blockade a synergistic effect would be achieved in terms of cardiorenal protection. In the present study, we analysed if the combination of a RAS blocker (ramipril) with a SGLT2i (empagliflozin) and/or GLP-1RA (semaglutide) in a type 2 diabetic mouse model could have add-on effects in kidney and heart protection. Methods: Male and female uninephrectomized type 2 diabetic db/db mice were treated with empagliflozin and/or semaglutide on top of ramipril during 8 weeks. During the study body weight, water and food intake were weekly monitored, glycaemia biweekly and albuminuria and glomerular filtration rate (GFR) before and after the treatment. At the end of the experiment, kidney and heart were isolated for histological and gene expression studies as well as for intrarenal RAS state assessment. Results: Semaglutide combined with ramipril and/or empagliflozin significantly decreased albuminuria but only when combined with both compounds, semaglutide further decreased blood glucose, glomerular hyperfiltration in male mice and glomerular mesangial matrix expansion. In kidney, only the triple treatment with empagliflozin, semaglutide and ramipril reduced the expression of the proinflammatory and profibrotic genes ccl2 and TGFß1. In addition, the combination of empagliflozin and semaglutide on top of RAS blockade was superior in decreasing cardiomyocyte hypertrophy and heart fibrosis in db/db mice. Discussion: Our results suggest that the combination of SGLT2i with GLP-1RA is superior in cardiorenal protection in DKD than the drugs administered alone on top of RAS blockade. [ABSTRACT FROM AUTHOR]

This research aims at identifying the factors precipitating corruptible tendencies. The study was guided by the Fraud Triangle Theory. The study used an exploratory and descriptive research design methods of investigation, and a simple random sampling technique was used to select a sample size of 179 from a population of 325 people using the Taro Yamane method of sample size determination from the practitioners in Imo state. The study employed a well-structured standardised questionnaire designed in Likert five-point scales, in addition to personal observations to elicit responses from construction firms and projects situated in Imo State, Nigeria. The questionnaires underwent pre-testing and validation to ensure their reliability. The study utilised various statistical tools such as charts, figures, and descriptive statistics to present the collected data. Additionally, Factor Analysis was employed to analyse the data. The results show that out of the ten (10) variables tested for factor analysis, the findings revealed four clusters named in other of significance as a weak system; lack of transparency; phantom bidding and bid rigging. The study recommends that procurement procedure in Imo State must be tightened to reduce corruption in the construction industry and to also ensure a fraud-free procurement system, public sector agencies must ensure regulations are complied with, apply better procurement policies, and support and encourage industry practitioners to execute procurement functions by procurement regulations and policies. [ABSTRACT FROM AUTHOR]

This study evaluates the obstacles to implementing efficient lean systems in offshore facility maintenance projects in Nigeria's oil and gas industry. The study utilised descriptive and survey research design methods, along with purposive and convenience sampling methodology, to select a sample size from a population of 122 practitioners employed in eleven (11) oil servicing enterprises in the Niger Delta region of South-South Nigeria. The data collection and survey instrument utilised a comprehensive range of methods, including a well-structured questionnaire, semi-structured/focused group discussions, personal observations, and site visits. These approaches were employed to gather information from a diverse range of sources, including respondents, oil and gas servicing firms, and projects. The acquired data was analysed using Exploratory Factor Analysis, IBM SPSS Statistics version 25.0, and the Severity Index. The study categorised 31 obstacles to the implementation of efficient systems into eleven decision matrix variables, with the most important factor being a shortage of technical expertise, training, and familiarity with efficient principles. Other significant obstacles include a lack of dedicated leadership, lengthy decision-making procedures caused by a complex organisational structure, government bureaucracy, and resistance from employees towards change. The report recommends that the Nigerian oil and gas industry focus on implementing lean practices in offshore facility maintenance projects. It suggests using lean tools and involving the government to increase the chances of success. [ABSTRACT FROM AUTHOR]

Text-to-image generation has become very popular in various domains requiring creativity. This article investigates the potential of text-to-image generators in supporting creativity during the early stages of the architectural design process. We conducted a laboratory study with 17 architecture students, who developed a concept for a culture center using three popular text-to-image generators: Midjourney, Stable Diffusion, and DALL-E. Through standardized questionnaires and group interviews, we found that image generation could be a meaningful part of the design process when design constraints are carefully considered. Generative tools support serendipitous discovery of ideas and an imaginative mindset, enriching the design process. We identified several challenges of image generators and provided considerations for software development and educators to support creativity and emphasize designers' imaginative mindset. By understanding the limitations and potential of text-to-image generators, architects and designers can leverage this technology in their design process and education, facilitating innovation and effective communication of concepts. [ABSTRACT FROM AUTHOR]

Lean production can be used to overcome serious organisational performance issues in the oil and gas industry, affecting both production and service delivery. This study will look into the extent and understanding of lean concept adoption in offshore facility maintenance projects in Nigeria's oil and gas industry. The study employed descriptive and survey research design methods of investigation, as well as a purposive and convenience sampling methodology, to pick a sample size from a population of 122 practitioners working in eleven (11) oil servicing enterprises in the Niger Delta region of South-South Nigeria. The data collection and survey instrument included a well-structured questionnaire, semi-structured/focused group discussions, personal observations, and site visits to gather information from respondents, oil and gas servicing firms, and projects. The collected data was displayed using frequency distribution in the form of tables and Cronbach's Alpha test using IBM SPSS Statistics version 26.0. A survey of 113 respondents found that 34.51% are involved in major offshore facility maintenance projects, with the majority (24%) working on pipe and structural maintenance. The study also found that 19.48% of respondents were unaware of lean in offshore facility maintenance projects, with the remainder (45.82%, 18.58%) being slightly knowledgeable. The study also found that 22.12% of respondents were unaware of lean tools for waste reduction in offshore facility maintenance projects, while the remaining respondents (45.13%) were only marginally knowledgeable. [ABSTRACT FROM AUTHOR]