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Abstract Background Creating a healthy and conducive nursing work environment is a universal global nursing concern. Work-Related Stress, global nursing and a public health problem that has continued to bedevil the world healthcare systems is of a particular interest. It has not only compromised the quality of patient care but also negatively impacted nurses’ quality of work life and adversely affected global healthcare management. Organizational culture is an important determinant of nurses’ work-related stress, yet it remains systematically under-researched. Despite a plethora of research on work-related stress in nursing environments, there are few dedicated systematic literature reviews, and this study aimed to fill this gap. Objective To determine the scientific evidence in the literature, on the impact of organizational culture on work-related stress among nurses and provide valuable insights to mitigation of work-related stress among nurses. Design A Systematic literature review. Methods The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive literature search was conducted in major electronic databases, including PubMed, Scopus, Web of Science, Ovid Medline, Embase and CINAHL in July 2023. Studies that met the inclusion criteria set were screened using Rayyan and Covidence. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality and risk of bias. Results The search generated a total of 2,113 records, and 13 were included. Thematic analysis generated three main themes: types of organizational culture, organizational climate, and organizational politics, each with distinct effects on nurses’ work-related stress. We found overall that, positive organizational culture, positive organizational climate and positive organizational politics were consistently associated with nurse’s happiness and joy at the workplace and lower levels of work-related stress while negative organizational culture, climate and politics were strongly associated with nurses’ work-related stress. Conclusions This review underscores the crucial role of organizational culture in nursing work environments and its impact on nurses’ stress levels, offering valuable insights for the mitigation of work-related stress and the transformation of the nursing profession.

Abstract Spectrum allocation has gained a lot of attention in cognitive wireless networks and research as one of the key problems for enhancing spectrum quality in the communication processes in the contemporary communication-dependent wireless environment. By effectively managing the restricted spectrum resources, adjusting to dynamic network conditions, lowering interference, and increasing energy efficiency, the study on dynamic spectrum allocation in wireless sensor networks seeks to improve packet transmission. In a variety of applications, this improves network performance, dependability, and quality of service. This is the reason we apply the dynamic source allocation to the sensor nodes in the network visualization for the packet transmission performance study in the 5G spectrum region. The primary goal of the study conducted for this article is to improve packet delivery ratios and data packet throughputs from the source to the destinations. Compared to previous research, this work has achieved 100% of its aims. In this context, certain DRL concerns are also addressed. The spectrum is allotted such that, in the event of phishing or malicious nodal assaults on the cluster groups of the wireless sensor nodal points in the WSN, efficient packet transmission will occur, beginning at the source and terminating at the sink. The simulation results demonstrate the efficacy of the approach described in the research paper and its application to data transmission.

Abstract In sub-Saharan Africa, children with severe malnutrition (SM) and HIV have substantially worse outcomes than children with SM alone, facing higher mortality risk and impaired nutritional recovery post-hospitalisation. Biological mechanisms underpinning this risk remain incompletely understood. This case-control study nested within the CHAIN cohort in Kenya, Uganda, Malawi, and Burkina Faso examined effect of HIV on six months post-discharge growth among children with SM and those at risk of malnutrition, assessed proteomic signatures associated with HIV in these children, and investigated how these systemic processes impact post-discharge growth in children with SM. Using SomaScanTM assay, 7335 human plasma proteins were quantified. Linear mixed models identified HIV-associated biological processes and their associations with post-discharge growth. Using structural equation modelling, we examined directed paths explaining how HIV influences post-discharge growth. Here, we show that at baseline, HIV is associated with lower anthropometry. Additionally, HIV is associated with protein profiles indicating increased complement activation and decreased insulin-like growth factor signalling and bone mineralisation. HIV indirectly affects post-discharge growth by influencing baseline anthropometry and modulating proteins involved in bone mineralisation and humoral immune responses. These findings suggest specific biological pathways linking HIV to poor growth, offering insights for targeted interventions in this vulnerable population.

Abstract Understanding the dynamics of movements between different demographic events is essential for informing effective population management strategies. This study aims to characterize the trajectories of demographic and other vital events within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Thus, it intends to unravel patterns and trends that can guide the development of targeted policies and interventions to address the population’s evolving needs. Using a continuous-time homogeneous multi-state Markov model, longitudinal data from 223,350 individuals in Korogocho and Viwandani urban slums, we study the enumeration, births, deaths, and migrations among urban poor in Nairobi, shedding light on population dynamics and movements over time, disaggregated by gender. Findings indicate a positive net migration in population per thousand in 2002, dropping in 2004, with Viwandani consistently showing higher birth rates than Korogocho. Males generally have higher death rates than females. Females from Viwandani are 39.0% more likely to exit after enumeration compared to Korogocho, while males are 35.6% more likely to move from enumeration to exit compared to males from Korogocho. Both genders from Viwandani have a decreased likelihood of moving from birth to death compared to Korogocho. Our findings provide unique insights into migration in urban Kenya, the frequency and movement to different demographic events and any gender differences that warrant strategic policies for effective population and health planning in Africa. These findings can inform the design of effective health interventions that are often affected by migration and population growth.

Abstract Background Significant effort and resources have been invested to control malaria transmission in sub-Saharan Africa, but it remains a major public health problem. For the parasite to be transmitted, the female Anopheles vector must survive 10–14 days following an infective bite to allow Plasmodium gametocytes to develop into infectious sporozoites. The goal of this study was to assess factors associated with wild-caught Anopheles survival and infection following host-seeking and indoor resting. Methods The study was conducted between January 2020 to March 2022 in a longitudinal cohort of 75 households in 5 villages including a total of 755 household members in Bungoma County, Kenya. Monthly adult mosquito collection was conducted by attenuated aspiration in all enrolled households, and mosquitoes were reared for 7 days. The daily mortality rate was determined through day 7. All mosquitoes were morphologically identified. Female Anopheles were dissected, and species-level members of the Anopheles gambiae complex were resolved by molecular methods. The abdomens of all samples were processed for Plasmodium falciparum oocyst detection by PCR. Results Within a 25-month period, the total numbers of non-Anopheles and Anopheles mosquitoes collected indoors were 12,843 and 712, respectively. Anopheles gambiae and An. funestus were the major vectors, though their distributions varied between different villages; 61.2% (n = 436/712) of the Anopheles mosquitoes survived up to day 7, with the lowest mortality rate recorded on day 5 of captivity. The survival rate also varied between the different Anopheles species. Six hundred eighty-three of 712 mosquito abdomens were tested for P. falciparum; 7.8% (53/683) tested positive for P. falciparum, with An. funestus having a higher (10%) prevalence than An. gambiae s.s. (6.0%, p = 0.095, Pearson Chi-square test). The proportion of household members sleeping under a bednet the night before mosquito collection varied across time and village. Anopheles funestus survival times were refractory to household ITN usage, and An. gambaie s.s. survival was reduced only under very high (100%) ITN usage. Conclusions Despite ITN usage, mosquitoes still acquired blood meals and P. falciparum infections. Survival differed across species and was inversely correlated with high ITN usage in the household but not oocyst development. Graphical Abstract

Abstract Background The role of animal-assisted therapy (AAT) in complementary and alternative medicine is well acknowledged. AAT is widely patronized, in developed countries such as USA, Canada, and many European countries, but less so in developing countries in Africa including Ghana. For persons in developing African countries and elsewhere to benefit from AAT, healthcare professionals must be acquainted with it recommend it to their patients when necessary. This study therefore assessed the perspectives of clinical-level medical students on AAT. Method A semi-structured questionnaire was used to collect data in a cross-sectional study from 206 randomly selected clinical-level medical students of the University for Development Studies, Tamale, Ghana. The data was analyzed using Microsoft Excel and SPSS (Version 26) and the results were presented in Tables and charts. The association between demographic variables and the knowledge and attitude of the students were determined using ANOVA, while bivariate Pearson’s correlation was used to measure the relationships between continuous variables. Associations were considered significant when p-value

Abstract Background There are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic. Methods We conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) and progression to inpatient mortality among patients admitted with SARI, using a test-negative case control design. Results Of the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10–1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24–1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27–0.77). Conclusion We have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.

Abstract Introduction It is well known that social contact patterns differ from country to country. This variation coincides with significant socioeconomic heterogeneity that complicates the design of effective nonpharmaceutical interventions. This study examined how socioeconomic heterogeneity in selected African countries might be factored in to explain better patterns of social contact mix between countries. Methods We used a standardized contact matrix for 32 African countries, estimated in (Prem et al. in PLoS Comput Biol 17(7):e1009098, 2021). We scaled the matrices using an epidemic model from (Röst et al. in Viruses 12(7):708, 2020). We also analyzed aggregated data from the World Bank country website. The data includes 28 variables; social, economic, environmental, institutional, governance, health and well-being, education, gender inequality, and other development-related indicators that describe countries. Principal component analysis was used to visualize socioeconomic similarities between countries and identify the indicators for maximum variation. The ( 2 D ) 2 P C A $(2D)^{2} PCA$ approach was used to reduce the dimension of synthetic contact matrices for each country to avoid the dimensionality curse. Then, hierarchical aggregate clustering was used to identify groups of countries with similar social patterns, taking into account the country’s socioeconomic performance. Results Our model yielded four meaningful clusters, each with a few distinguishing features. Social contacts varied between groups, but were generally similar within each set. The socioeconomic performance of the country influenced the clusters. Conclusions Our results suggest that integrating socioeconomic factors into social contacts can better explain infectious disease transmission dynamics and that similar interventions can be implemented in countries within the cluster

Abstract Background Tungiasis, an ectoparasitic disease caused by sand fleas, causes suffering to millions of people in the tropics. Although the Kenyan National Policy Guidelines list tungiasis treatments as including disinfectants, flea repellents, and botanical oil, the insufficient knowledge and financial constraints of affected communities have led to neglect and inappropriate self-treatment. Current reports show insignificant progress on educational activities at the community level. Therefore, we investigated community residents’ treatment-seeking behaviour concerning tungiasis, using an endemic area of Kenya as the research setting. Methods A cross-sectional mixed-methods design was employed. Quantitative data were collected from the participants—410 adults who had experienced tungiasis—using a questionnaire, while qualitative data were collected from 20 older adults to 10 medical staffs using semi-structured individual interviews. The study was conducted in two sub-counties of Homa Bay County, Kenya. Results Factors significantly correlated with using non-guideline-listed treatments for tungiasis were ‘not knowing the causse of tungiasis’, ‘not seeking treatment from healthcare facilities and traditional healers’, and ‘wait and see to prevent infection in non-affected members’. The interviews with the older adults revealed 19 self-treatment options for tungiasis, and 40% of the participants opted for self-removal using sharp objects. Only two of these treatments were listed in the guidelines. The most frequently mentioned reason for using a self-treatment option was ‘Someone else’s idea’. The most frequently mentioned reason for choosing the best self-treatment option was ‘Effectiveness’. Interviews with medical staff revealed 11 treatment options; only five of these treatments are listed in the guidelines. The most frequently mentioned reason for selecting/using the treatment was ‘Supply situation’. Conclusions Residents’ socioeconomic factors, cultural factors, and access to appropriate treatment, as well as knowledge of medical staff were significant factors that influenced the residents’ tungiasis treatment-seeking behaviours. This study provides feasibility and baseline data to establish an effective, safe, and sustainable treatment for tungiasis.

Ruth Plummer,1 Alastair Greystoke,1 Gregory Naylor,2 Debashis Sarker,3,4 ANM Kaiser Anam,4 Hans Prenen,5 Laure-Anne Teuwen,5 Eric Van Cutsem,6 Jeroen Dekervel,6 Beate Haugk,1 Thomas Ness,1 Sujata Bhoi,7 Malene Jensen,7 Tom Morris,7 Pia Baumann,7 Niclas Sjögren,8 Karin Tunblad,7 Hans Wallberg,7 Fredrik Öberg,7 Thomas R Jeffry Evans2 1Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK; 2Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, UK; 3School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK; 4Department of Medical Oncology, Guy’s Hospital, London, UK; 5Department of Oncology, Antwerp University Hospital, Edegem, Belgium; 6Department of Oncology, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium; 7Medivir AB, Huddinge, Sweden; 8SDS Life Science, Stockholm, SwedenCorrespondence: Pia Baumann, Medivir AB, Box 1086, SE-141 22, Huddinge, Sweden, Tel +46 739163897, Email pia.baumann@medivir.comPurpose: To evaluate safety, preliminary efficacy, pharmacokinetics, and pharmacodynamics, of fostroxacitabine bralpamide (fostrox, MIV-818), a novel oral troxacitabine nucleotide prodrug designed to direct exposure to the liver, while minimizing systemic toxicity.Patients and Methods: Fostrox monotherapy was administered in an open-label, single-arm, first-in-human, phase 1a/1b study, in patients with hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, or solid tumor liver metastases. The first part (1a) consisted of intra/inter-patient escalating doses (3 mg to 70 mg) QD for up to 5 days, and the second part (1b), doses of 40 mg QD for 5 days, in 21-day cycles. Safety and tolerability were evaluated by the Safety Review Committee, and efficacy was assessed every 6 weeks with CT or MRI using RECIST 1.1 and mRECIST.Results: Nineteen patients were treated with fostrox. Most common adverse events (AEs) were hematological and increased AST. Grade 3 treatment related AEs (TRAE) were seen in 53% of the patients, with transient neutropenia and thrombocytopenia as the most common. No grade 5 AE was observed. Recommended Phase 2 dose of fostrox was 40 mg QD for 5 days in 21-day cycles. Preliminary efficacy showed a clinical benefit rate in the liver of 53% and stable disease (SD) as best response in 10 patients. Liver targeting with fostrox was confirmed with higher exposure of troxacitabine and its metabolites in liver compared to plasma. Systemic exposure of fostrox was generally low with troxacitabine as main analyte. Biopsies demonstrated tumor-selective, drug-induced DNA damage.Conclusion: The phase 1a/1b monotherapy study of fostrox, in patients with liver tumors, showed a tumor selective effect in the liver and that 40 mg QD for 5 days in 21-day cycles is safe and tolerable. Safety and preliminary efficacy in patients with advanced HCC supports clinical development of fostrox in combination with other modes of action in HCC.Keywords: phase 1, fostrox, hepatocellular carcinoma, nucleotide prodrug, pharmacokinetics, pharmacodynamics

Abstract Diabetes Mellitus (DM) is a serious worldwide health issue that has put pressure on the global economy. The study examined the knowledge of complication prevention among patients living with Diabetes Mellitus (DM) in Ghana. The research was a quantitative study which involved the use of descriptive cross-sectional survey design. In all, 301 DM patients were included in the study. Data were processed using the Statistical Package for the Social Sciences (SPSS) version 25. The study recorded 66.12% (n = 199) good knowledge level. Therefore, educational intervention programme should be organized by the health professionals at Twifo-Atti Morkwa hospital so every DM patient would have optimum knowledge about the disease that would ensure prevention of the DM complications.

Foreign body aspiration in an uncommon entity in adults which often leads to delays in diagnosis. Adults with long-standing foreign bodies in the airway can result in various complications including bronchiectasis, atelectasis and lung fibrosis. We describe the case of a primary school teacher who was diagnosed with foreign body aspiration 11 years after the aspiration event. Delays in diagnosis led to her receiving multiple doses of antibiotics including a course of antituberculous therapy.

Abstract Background Honey bees are the principal commercial pollinators. Along with other arthropods, they are increasingly under threat from anthropogenic factors such as the incursion of invasive honey bee subspecies, pathogens and parasites. Better tools are needed to identify bee subspecies. Genomic data for economic and ecologically important organisms is increasing, but in its basic form its practical application to address ecological problems is limited. Results We introduce HBeeID a means to identify honey bees. The tool utilizes a knowledge-based network and diagnostic SNPs identified by discriminant analysis of principle components and hierarchical agglomerative clustering. Tests of HBeeID showed that it identifies African, Americas-Africanized, Asian, and European honey bees with a high degree of certainty even when samples lack the full 272 SNPs of HBeeID. Its prediction capacity decreases with highly admixed samples. Conclusion HBeeID is a high-resolution genomic, SNP based tool, that can be used to identify honey bees and screen species that are invasive. Its flexible design allows for future improvements via sample data additions from other localities.

The paper aims to analyze the Technical Efficiency of 70 Commercial banks from 19 African countries from 2009-2020. Using the Data Envelopment Analysis (DEA) method of the two main approaches, Variable Return to Scale (VRS) and Constant Return to Scale (CRS) technique on a Panel Data. We find that African banks have a higher efficacy assessment with the VRS than the CRS technique, thus, with a Pure Technical Efficiency (PTE) score than Technical Efficiency (TE) . Our findings show that the majority of the banks are operating at very low levels of efficiency (not technically efficient), and inability to optimize the conversion of bank assets and liabilities into loan production for customers. Furthermore, the banks are operating inefficiently in scale, economic, and allocative manner due to mismatches in scale of production. Considering these findings, the implications of these inefficiencies extend to the overall economic development and financial stability of the region.

Introduction Hepatitis C virus (HCV) infection is a silent epidemic that needs a comprehensive and contextualised approach to manage. Access to readily available, affordable and acceptable HCV point-of-care (POC) in vitro diagnostics (IVDs) is equally required to meet the global HCV goals. However, most guidelines for evaluating these IVDs such as the WHO prequalification process and country-specific standards disproportionately focus on diagnostic performance. The real-time connectivity, ease of specimen collection, affordability, sensitivity, specificity, user-friendliness, rapidity and robustness, equipment-free or simplicity and deliverability to end-users (REASSURED) criteria provide a holistic and user-oriented evaluation of the IVDs in the populations they are meant to be used. Therefore, as part of a multinational study in sub-Saharan Africa, we will conduct an evaluation of the Bioline HCV POC test for diagnosing HCV infection in primary healthcare settings of Ghana using the REASSURED criteria.Methods and analysis This field evaluation will be conducted in three phases. The first phase will use a cross-sectional field evaluation study design to evaluate the diagnostic performance of the Bioline HCV POC test. The second phase will use mixed methods to ascertain operational characteristics and users’ perceptions. In the third phase, a cross-sectional survey will be used to estimate the costs of accessing HCV diagnostics services using three proposed HCV testing models to inform the affordability of the testing pathways and linkage to care in the primary healthcare clinics. This phase will run concurrently with the second phase of the study. Thematic content analysis and quantitative data analysis will be performed using ATLAS.ti V.23.0.6 and StataCorp LLC’s Stata statistical software V.16.0, respectively.Ethics and dissemination The study protocol has been reviewed and fully approved by the Faculty of Health Sciences Research Ethics Committee, University of Pretoria (281/2023) and the Ghana Health Service Ethics Review Committee (GHS-ERC013/08/23). This diagnostic trial has also been registered in the Pan African Clinical Trial Registry (PACTR202410837698664). The findings of the study will be presented in relevant peer-reviewed journals, at local and international conferences, and to all stakeholders involved.

Abstract This study investigates how various soil management practices can enhance soil fertility and pest control, ultimately increasing crop yields among farming households in Nigeria. Utilizing descriptive statistics, logit regression and propensity score matching on data from the 2019 Living Standard Measurement Study, the findings reveal that households using herbicides experience higher agricultural productivity. The use of pesticides and certified crops also positively influences productivity. Key determinants of soil technology access include cooperative membership and the age of household heads, both of which significantly affect access to herbicides, pesticides, organic fertilizers, and certified crops. Education plays a vital role, positively impacting the use of organic and inorganic fertilizers as well as certified crops. Additionally, larger farm sizes correlate with better access to these resources. Conversely, the gender of the household head negatively affects access to certified crops. The study emphasizes the importance of capacity building and knowledge transfer to encourage the adoption of effective soil technology practices among farmers, thereby enhancing agricultural productivity and addressing food security issues.

Abstract Prostate cancer (PCa) metastasis significantly influences treatment decisions and prognosis. This study evaluated the individual and combined diagnostic ability of apparent diffusion coefficient (ADC), Gleason score and prostate‐specific antigen (PSA) in detecting metastasis. The study included data from 120 biopsy‐confirmed PCa patients treated from 2019 to 2023. Whole‐body MRI images, incorporating high‐resolution T2 and axial DWI sequences, were evaluated by experienced radiologists. Receiver operating characteristic (ROC) curves and logistic regression models were used to assess the diagnostic performance of ADC, Gleason score, and PSA in detecting metastasis. The prevalence of PCa metastasis was 25.0%, with pelvic lymph node metastasis (16.7%) and bony metastasis (12.5%) being most prevalent. Patients with PCa metastasis had significantly lower ADC values, higher Gleason scores, and higher PSA levels compared to those without metastasis. Individually, an ADC cut‐off of ≤549.00 mm2/s was the best marker for detecting metastasis. The combined bioscore model including PSA, ADC values and Gleason score was the best independent predictor, correlating with a 159‐fold increased likelihood of detecting PCa metastasis. This study demonstrated the prognostic ability of PCa markers in detecting metastasis. ADC was an independent, sensitive, specific, and accurate diagnostic marker. The combined bioscore model of ADC, PSA and Gleason score significantly enhanced the identification of patients with PCa metastasis.

Abstract Agricultural activities in many sub-Saharan African (SSA) countries are subject to various risk factors that the COVID-19 compounds. Earlier studies on the effect of COVID-19 on smallholders neglect the issue of comparison with non-farm households. The study uses micro-level household datasets to explore the impact of the COVID-19 pandemic on household welfare, with a focus on farm households relative to their non-farm counterparts. We employed a binary probit model and Propensity Score Matching (PSM) approach and demonstrated that farm households witnessed important income reductions during the COVID-19 pandemic in Uganda. The study contributes to the design of evidence-based approaches to reducing farmers’ vulnerabilities to agricultural risks and pandemic-related shocks.

This study compared the effects of three supplementary diets—egg yolk, Artemia, and commercial pellets with 48% crude protein—on the growth performance and survival rate of redbreast tilapia (Coptodon rendalli) under intensive culture conditions at the Kamutjonga Inland Fisheries Institute in the Kavango East region of Namibia. The study was conducted from December 2023 to January 2024 using a complete randomized design replicated thrice. Results showed that fish fed with commercial pellets exhibited the highest specific growth rate (1.39 ± 0.80%) compared to egg yolk (0.94 ± 0.54%) and Artemia (0.33 ± 0.19%). Commercial pellets also had the best survival rate (76.19 ± 43.099), compared to egg yolk and Artemia (70.47 ± 40.69; 33 ± 19.05), respectively. However, egg yolk had the best feed conversion ratio (0.20 ± 0.05) compared to the commercial pellets (0.22 ± 0.04) and Artemia (0.26 ± 0.07). Critical water quality parameters were maintained within acceptable survival ranges for C. rendalli across all treatments. These findings highlight the importance of dietary protein content in optimizing the growth and survival of C. rendalli under intensive culture conditions and provide insights for effective feeding strategies. However, commercial pellets are expensive and inaccessible to small-scale fish farmers. As an alternative, egg yolk emerged as a viable and affordable feed option, promoting fish growth and supporting the establishment of small-scale farming practices in the region.

Abstract Background Diabetes mellitus is a metabolic disease characterized by prolonged elevated blood glucose levels. It is a common health problem with a high mortality and morbidity to the human race. A number of medicinal plants such as rosemary (Rosmarinus officinalis) have been used for the treatment of diabetes. Most of the anti-diabetic conventional drugs have been found to have some side effects and there is therefore need to explore new sources of anti-diabetic drugs. The aim of the current study was to investigate the possibility of getting anti-diabetic compounds from R. officinalis that can be used as leads for drug discovery. Methodology R. officinalis leaves were macerated in 50% methanol in dichloromethane and the crude extract fractionated by column chromatography. The obtained fractions were subjected to an in-vitro alpha-amylase inhibition assay. The anti-hyperglycemic potential of the fractions was evaluated in diabetic induced Wistar rats. The most potent fractions were analyzed by gas chromatography-mass spectrophotometry (GC-MS) for identification of the compounds. Results A total of 21 chromatographic fractions were assembled with different alpha- amylase inhibition activity. Eleven of the fractions had more than 30% alpha-amylase inhibition activity. The ethyl acetate fraction had the highest inhibition potential (LC50 of 2.8 μg/mL). The anti-diabetic assay in rats showed that fractions (F1) and (F4) had highest blood glucose reduction of 44.5 ± 0.4 and 52.8 ± 1.3%, respectively (p

Abstract Background Improving maternal healthcare services is crucial to achieving the Sustainable Development Goal (SDG-3), which aims to reduce maternal mortality and morbidity. There is a consensus among different researchers that proper utilization of maternal healthcare services can improve the reproductive health of women, and this can be achieved by providing Antenatal Care (ANC) during pregnancy, Health Facility Delivery (HFD), and Postnatal Care (PNC) to all pregnant women. The main aim of this study was to investigate the utilization and factors associated with maternal and child healthcare services among women of reproductive age in the pastoralist communities in Kenya. Methods A cross-sectional survey was conducted among 180 pastoralist women who gave birth in the past two years across ten mobile villages in Marsabit County between 2nd January and 29th February 2019. Three key outcomes were analyzed, whether they attended ANC 4+ visits, delivered at HF, and received PNC. Pearson χ2 test and multivariate logistic regression analysis were conducted by IBM SPSS27.0 following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The significance level was set at p

Abstract Background In late 2021, Ghana was hit by a Yellow Fever outbreak that started in two districts in the Savannah region and spread to several other Districts in three regions. Yellow fever is endemic in Ghana. However, there is currently no structured vector control programme for Aedes the arboviral vector in Ghana. Knowledge of Aedes bionomics and insecticide susceptibility status is important to control the vectors. This study therefore sought to determine Aedes vector bionomics and their insecticide resistance status during a yellow fever outbreak. Methods The study was performed in two yellow fever outbreak sites (Wenchi, Larabanga) and two non-outbreak sites (Kpalsogu, Pagaza) in Ghana. Immature Aedes mosquitoes were sampled from water-holding containers in and around human habitations. The risk of disease transmission was determined in each site using stegomyia indices. Adult Aedes mosquitoes were sampled using Biogents Sentinel (BG) traps, Human Landing Catch (HLC), and Prokopack (PPK) aspirators. Phenotypic resistance to permethrin, deltamethrin and pirimiphos-methyl was determined with WHO susceptibility tests using Aedes mosquitoes collected as larvae and reared into adults. Knockdown resistance (kdr) mutations were detected using allele-specific multiplex PCR. Results Among the 2,664 immature Aedes sampled, more than 60% were found in car tyres. Larabanga, an outbreak site, was classified as a high-risk zone for the Yellow Fever outbreak (BI: 84%, CI: 26.4%). Out of 1,507 adult Aedes mosquitoes collected, Aedes aegypti was the predominant vector species (92%). A significantly high abundance of Aedes mosquitoes was observed during the dry season (61.2%) and outdoors (60.6%) (P

Jaimee K Miller, Simon L Evans School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UKCorrespondence: Jaimee K Miller, Email jaimeekmiller@outlook.comObjective: Poor sleep among young adults is prevalent, yet the mediating variables are largely understudied, and there is limited relevant work utilizing objective sleep measures. The present study investigated the mediating effects of perceived stress and rumination in the relationship between trait mindfulness and subjective and objective sleep quality in young adults.Methods: A total of 170 healthy adults (aged 18– 37, M = 20.8, SD = 2.9) self-reported on trait mindfulness, perceived stress, and rumination. The primary (N = 140) and secondary (N = 30) samples both completed the Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. The secondary sample (N = 30) additionally provided sleep diaries, as well as wrist-worn actigraphy data for assessing objective sleep quality. A mediation analysis was conducted to assess the effect of trait mindfulness on sleep quality with perceived stress and rumination as mediators.Results: Trait mindfulness was positively associated with better subjective sleep quality; this was fully mediated by perceived stress, b = − 0.08, 95% CI [− .12, − 0.06]. Rumination was negatively associated with subjective sleep quality but did not mediate the relationship between trait mindfulness and sleep quality, b = − 0.01, 95% CI [− .03, 0.02]. Only trait mindfulness was correlated with diary-based sleep ratings, and none of the measures were associated with actigraphy-based sleep quality.Conclusion: This study indicates that perceived stress is an important mediator in the relationship between trait mindfulness and subjective sleep quality among young adults, rather than rumination. These findings have implications for mindfulness-based therapeutic approaches to address the high prevalence of sleep disorders among young adults, adding mechanistic detail to the literature.Keywords: mindfulness, perceived stress, rumination, sleep

Elexis Hollingsworth,1,2 Benjamin H Shields,2,* Christopher Rutter,2,3,* Lynn Fox,4 Kelly N Evans,5 Jay Paul Willging,6 Amelia F Drake2 1School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 2Department of Otolaryngology/Head and Neck Surgery, UNC Hospitals, Craniofacial Center, University of North Carolina, Chapel Hill, NC, USA; 3University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA; 4Adams School of Dentistry, UNC Craniofacial Center, University of North Carolina, Chapel Hill, NC, USA; 5Division of Craniofacial Medicine, Seattle Children’s Hospital, Seattle, WA, USA; 6Division of Pediatric Otolaryngology - Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA*These authors contributed equally to this workCorrespondence: Elexis Hollingsworth, UVA Health, Department of Anesthesiology, 1215 Lee St. Box 800710, Charlottesville, VA, 22908‐0816, USA, Fax +1 434‐982‐0019, Email eh6cm@uvahealth.orgObjective: In the USA, the American Cleft Palate Association-Craniofacial Association (ACPA-CPF) specifies guidelines to ensure craniofacial teams function in a multidisciplinary fashion to provide care in a sequence that mirrors the patient’s needs. Among these guidelines is the expectation that teams hold regular multidisciplinary team meetings to discuss patient care. The purpose of this study was to identify factors that contribute to optimal team functioning during these meetings. The impact of the virtual format on meetings was also evaluated.Design: One-hour semi-structured interviews of craniofacial team members, queried on current and ideal team meetings, were conducted from December 2020 – January 2021. Interviews were recorded, transcribed, and coded to identify common themes until thematic saturation was achieved.Setting/Participants: Sixteen team members from three major American craniofacial centers were interviewed virtually.Results: Three major categories were identified as integral to successful meetings: (1) meeting content, (2) meeting processes, and (3) team dynamics. Within these categories are several factors that participants reported as important to optimize their multidisciplinary meetings: key content for discussions, integration of patient perspective, recognition of collaboration in determining proper sequence of treatments, an attentive discussion leader promoting equitable discussions, managing absences, and team diversity. Participants also identified benefits and pitfalls of hosting meetings in the virtual setting, including lack of engagement and awkward communication.Conclusion: Diverse groups of disciplines are expected to come together during craniofacial multidisciplinary meetings to formulate intricate care plans for complex patients. In this study, craniofacial team members have identified several key factors to optimize these meetings. The research group used these factors to propose a self-evaluation instrument for meeting quality improvement, provided in printable format. Further studies should evaluate how implementation of these factors affects meetings and ultimately guides patient care.Keywords: cleft lip-palate, multidisciplinary, interdisciplinary, teamwork, self-evaluation, virtual

Abstract Background Diarrheal disease is a significant cause of morbidity and mortality in under-fives in many low- and middle-income countries. Changes in food safety, hygiene practices, and nutrition around the weaning period may reduce the risk of disease and improve infant development. The MaaCiwara study aims to evaluate the effectiveness of a community-based educational intervention designed to improve food safety and hygiene behaviours, as well as child nutrition. This update article describes the statistical analysis plan for the MaaCiwara study in detail. Methods and design The MaaCiwara study is a parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures, involving 120 clusters of rural and urban communities. These clusters are randomised to either receive the community-based behaviour change intervention or to the control group. The study participants will be mother–child pairs, with children aged between 6 and 36 months. Data collection involves a day of observation and interviews with each participating mother–child pair, conducted at baseline, 4 months, and 15 months post-intervention. The primary analysis aims to estimate the effectiveness of the intervention on changes to complementary food safety and preparation behaviours, food and water contamination, and diarrhoea. The primary outcomes will be analysed generalised linear mixed models, at individual level, accounting for clusters and rural/urban status to estimate the difference in outcomes between the intervention and control groups. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. In addition, structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Trial registration International Standard Randomised Controlled Trial Number (ISRCTN) register: ISRCTN14390796 . Registered on 13 December 2021.