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Abstract 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.

BackgroundNational movement behavior guidelines offer evidence-informed recommendations for how to obtain health benefits. However, their impact on practice and policy has been limited. Factors at multiple levels determine the effective mobilization of knowledge into practice. Historically, little attention has been paid to assessing the social, organizational, and economic factors that influence the uptake of national movement behavior guidelines; potentially contributing to their blunted impact on public health outcomes. The purpose of this study was to explore the barriers and facilitators experienced by intermediary organizations to disseminating national movement behavior guidelines.MethodsRepresentatives from organizations involved in the development and dissemination of the Canadian 24-Hour Movement Guidelines for Adults 18–64 Years and Adults 65 Years or Older were invited to participate in semi-structured interviews to explore barriers and facilitators to national movement behavior guideline dissemination. Interview guides were informed by the Consolidated Framework for Implementation Research (CFIR). Fourteen interviews were conducted, and transcripts were analyzed using inductive thematic analysis. Identified barriers and facilitators were mapped onto the CFIR.ResultsParticipants identified several elements that have the potential to influence the dissemination of national movement behavior guidelines, such as organizational alignment, resources (i.e., time, human, financial), and ownership of the guidelines.ConclusionThis study provides insight into the breadth of barriers and facilitators to guideline dissemination that may be experienced by intermediary organizations. Findings may be used to inform interventions designed to improve the dissemination and uptake of national movement behavior guidelines among health-promoting organizations.

Industrial activities, particularly from abattoirs without effluent treatment facilities, threaten ecosystems, releasing a spectrum of potentially toxic elements (PTEs) into the environment. With a defunct wastewater treatment plant (WTP), exploring a low-cost but efficacious and eco-friendly adsorbent for the Kumasi Abattoir Ghana (KAG) effluent treatment is warranted. The study is the first attempt to utilize activated carbon (AC), such as the P-32 Powdered AC (PAC) brand, to detoxify PTEs—Cadmium (Cd), Copper (Cu), Zinc (Zn), Iron (Fe), and Lead (Pb)—in Ghana’s abattoir effluent. The adsorbent was manufactured and supplied by the Climate/Environmental Research and Technology (CLERET) Laboratory, one of the Research and Development (R&D) departments of Explore Scientific Innovations (ESI) Ltd., Ghana, using palm nutshell wastes as precursor. The study systematically evaluated the efficiency and adsorption prowess using incremental masses of 0.5, 1.0, 1.5, 2.0, and 2.5 g of the adsorbent/100 ml effluent, with three replicates per experimental unit in one cycle application of the adsorbent. The PTE concentrations were determined using standard methods before and after applying the adsorbent. Three adsorption isotherm models Langmuir, Freundlich, and Elovich, were applied to investigate the adsorption mechanisms governing the PTEs. The model performance was evaluated using R2 and Root Mean Squared Error (RMSE) metrics. The findings unveiled varied percentage removal efficiencies (% Rs), with Zn exhibiting the highest (79.64 %) at 2.5 g and Cd the least (7.8 %) at 0.5 g, of the carbon. The Freundlich isotherm emerged as the most robust model, consistently exhibiting the highest coefficient of determination (R2) with the lowest RSME values. Fe and Cd had the highest and lowest adsorption capacity (Kf) of 0.181 and 0.001, respectively. The Freundlich exponent (nf) values were within the favorability range of 1–10. The PTE adsorptions were physical rather than chemical. P-32 PAC provided a promising avenue for abattoir effluent management.

It has been widely documented that good governance reduces income inequality when it creates a conducive environment for quality human capital development. This study investigates the unconditional effects of human capital on income inequality and explores whether institutional quality mechanisms for corruption control and government effectiveness moderate the relationship. Results from the instrumental variable generalised method of moments estimator and data for an unbalanced panel data of 36 African over the period 2010-2020, shows that human capital increases income inequality. However, robust evidence from the interactive analysis reveals that corruption control and government effectiveness mitigate the income inequality-enhancing effect of human capital. This study underscores the need to improve structures and system government effectiveness and corruption control for human capital development to equalise income in Africa.

Abstract 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.

The role of indigenous knowledge in disaster risk reduction (DRR) and climate change adaptation cannot be underestimated. It acts as a preparedness and response tool to climate change-related impacts such as floods, droughts and strong winds. However, inadequate studies about indigenous knowledge in Malawi is a major challenge when dealing with extreme climatic conditions. Learning from indigenous knowledge systems, by investigating first what local communities know and have, can improve the understanding of local conditions and can provide a productive context for activities designed to help communities reduce vulnerability to climate change impacts. This paper assessed the role of indigenous knowledge systems in DRR and climate change variability and adaptation strategies in Chikwawa district. The study used a participatory research approach involving interactive research methods such as focus group discussions (FGDs), key informant interviews and participant observations. Data from key informants and FGDs were analysed thematically. The study revealed various indigenous knowledge which communities in the Chikwawa district use to respond to climate-related impacts such as floods. Some of these include hippopotamus relocating from the river to the village, extreme hissing of pythons in nearby forests, buffaloes and zebras wreaking havoc in the villages and crocodiles flocking to the village. Contribution: The study concludes that indigenous knowledge provides the basis for problem-solving approaches for local communities, hence, a need to document it at a wider scale.

Indoor air quality (IAQ) in confined spaces like bank vaults and basements is influenced by complex factors such as building layout and HVAC systems. This study examines how mechanical ventilation impacts IAQ in a bank building's occupied basement vault, addressing significant challenges posed by pollutant exposure in these air-tight environments. This study advances safe IAQ in confined spaces, crucial for occupant health and safety, using CFD (ANSYS Fluent Workbench 16.0) and CONTAM 3.2 software for multi-zone ventilation and air quality analysis. It analysed three indoor pollutants: Radon (Rn), Carbon dioxide (CO2), and Particulate Matter (PM2.5), enhancing the reliability and applicability of the findings. The findings indicated that the simulated indoor pollutants concentrations did not exceed the indoor air quality guideline levels. The CFD simulations predicted average steady-state values of 27.2 Bq/m3 for Radon, 574.80 ppm for CO2, and 69.36 µg/m3 for PM2.5 in the basement. For different outdoor air floor rates, an optimal ventilation rate of 4.7 ACH and a cooling load of 17 kW were determined to maintain Radon concentrations below 15 Bq/m3. This provides a practical and actionable solution for maintaining safe IAQ in confined spaces, which is a significant step forward compared to similar studies. These results align with other experimental research, validating the use of numerical techniques in indoor air quality studies. By optimizing HVAC systems to maintain IAQ and minimize energy consumption, the study supports SDG 7 (Affordable and Clean Energy) by enhancing energy efficiency, SDG 3 (Good Health and Well-being) by reducing exposure to indoor pollutants, and SDG 11 (Sustainable Cities and Communities) by improving air quality management in confined spaces. The findings are particularly relevant for Africa, offering practical solutions, informing policy direction, and supporting the African Union's Agenda 2063 and SDGs 3, 7, and 11.

The invasive Anopheles stephensi mosquito has rapidly expanded in range in Africa over the past decade. Consistent with World Health Organization guidelines, routine entomologic surveillance of malaria vectors in Accra, Ghana, now includes morphologic and molecular surveillance of An. stephensi mosquitoes. We report detection of An. stephensi mosquitoes in Ghana.

PAVON has developed a malaria microscopy competency training scheme to augment competency in malaria microscopy. Here, data accrued from training activities between 2020 and 2023 in Botswana are presented. Three trainings were done for 37 central and peripheral level technicians for a two-week period. The scheme consisted of basic theory on Plasmodium parasites, malaria epidemiology and diagnosis. The practicals focused on standard slide preparation, staining, parasite detection, speciation and counting. Scores were assessed by the Wilcoxon signed rank test. Participants who excelled joined the WHO External Competency Assessment for Malaria Microscopy (ECAMM). The median competency scores for the three trainings were detection: 100 (IQR = 94–100), 100 (IQR = 94–100) and 92 (IQR = 92–100), respectively, from pre-test scores of 40 (IQR = 27–54), 44 (IQR = 32–52) and 20 (IQR = 10–40) (z = 2.937, p < 0.003, z = 3.110, p = 0.002 and (z = 2.251, p = 0.024), respectively. Speciation: 93 (IQR = 86–96), 81 (IQR = 73–96) and 88, (IQR = 88–100) from pre-test scores of 50 (IQR = 30–50), 36 (IQR = 20–45) and 17 (IQR = 17–50) (z = 2.936, p < 0.003, z = 3.152, p = 0.002 and z = 3.237, p = 0.001). The competency scores achieved in the ECAMM were 98/98 and 97/98 for sensitivity and specificity pre- and post-tests detection. The training was effective in raising the competency skills of participants and is open to NMPs (National Malaria Programs) for critical capacity building.

Ebola is a serious disease that affects people; in many cases, it results in death. Ebola outbreaks have also occurred in communities where residents keep pets, particularly dogs. Due to a lack of food, the dogs must hunt for food. Dogs eat the internal organs of wildlife that the locals have killed and eaten, as well as small dead animals that are found within the communities which may contain the Ebola virus. This study introduces a mathematical model based on the Caputo–Fabrizio derivative to describe the Ebola transmission dynamics between dogs and humans. The model’s existence and the uniqueness of its solution were investigated using fixed-point theory. Furthermore, through the Sumudu transform criterion, we established that the Caputo–Fabrizio Ebola model is Picard stable. Some qualitative analysis was also carried out to investigate the Ebola propagation trend in the dog-to-human model. The proposed model is fitted to the reported Ebola incidence in Uganda between October 15, 2022, and November 2, 2022. The Ebola reproduction number obtained using the cumulative data was 2.65. It is noticed that as the fractional order reduces, the Ebola reproduction number also reduces. We derived a numerical scheme for our model using the two-step Lagrange interpolation. It has been discovered that the fractional orders significantly influence the model, indicating that natural occurrences could affect the dynamics of Ebola. It is observed that when the recovery rate is enhanced, such as through the hospitalisation of Ebola-infected individuals, the disease will reduce. Finally, as we ensure a reduction in the contact rate among the dog’s compartments, the disease does not spread adiabatically. Therefore, we urge that quarantine measures be put in place to control interactions among the dogs during the outbreak.

Objective: The first COVID-19 pandemic wave was a period of reduced surgical activity and redistribution of resources to only those with late stage or critical presentations. This Vascular and Endovascular Research Network COVID-19 Vascular Service (COVER) study aimed to describe the six-month outcomes of patients who underwent open surgery and or endovascular interventions for major vascular conditions during this period. Methods: In this international, multicentre, prospective, observational study, centres recruited consecutive patients undergoing vascular procedures over a 12-week period. The study opened in March 2020 and closed to recruitment in August 2020. Patient demographics, procedure details, and post-operative outcomes were collected on a secure online database. The reported outcomes at 30 days and six months were post-operative complications, re-interventions, and all cause in-hospital mortality rate. Multivariable logistic regression was used to assess factors associated with six-month mortality rate. Results: Data were collected on 3 150 vascular procedures, including 1 380 lower limb revascularisations, 609 amputations, 403 aortic, 289 carotid, and 469 other vascular interventions. The median age was 68 years (interquartile range 59, 76), 73.5% were men, and 1.7% had confirmed COVID-19 disease. The cumulative all cause in-hospital, 30-day, and six-month mortality rates were 9.1%, 10.4%, and 12.8%, respectively. The six-month mortality rate was 32.1% (95% CI 24.2–40.8%) in patients with confirmed COVID-19 compared with 12.0% (95% CI 10.8–13.2%) in those without. After adjustment, confirmed COVID-19 was associated with a three times higher odds of six-month death (adjusted OR 3.25, 95% CI 2.18–4.83). Increasing ASA grade (3–5 vs. 1–2), frailty scores 4–9, diabetes mellitus, and urgent and or immediate procedures were also independently associated with increased odds of death by six months, while statin use had a protective effect. Conclusion: During the first wave of the pandemic, the six-month mortality rate after vascular and endovascular procedures was higher compared with historic pre-pandemic studies and associated with COVID-19 disease.

Abstract Background Clothianidin, an insecticide with a novel mode of action, has been deployed in the annual indoor residual spraying programme in northern Ghana since March 2021. To inform pragmatic management strategies and guide future studies, baseline data on local Anopheles gambiae sensu lato (s.l.) susceptibility to the clothianidin insecticide were collected in Kpalsogu, a village in the Northern region, Ghana. Methods Phenotypic susceptibility of An. gambiae mosquitoes to clothianidin was assessed using the World Health Organization (WHO) insecticide resistance monitoring bioassay. The WHO cone bioassays were conducted on mud and cement walls sprayed with Sumishield 50 wettable granules (WG) (with clothianidin active ingredient). Daily mortalities were recorded for up to 7 days to observe for delayed mortalities. Polymerase chain reaction (PCR) technique was used to differentiate the sibling species of the An. gambiae complex and also for the detection of knock down resistance genes (kdr) and the insensitive acetylcholinesterase mutation (ace-1). Results The WHO susceptibility bioassay revealed a delayed killing effect of clothianidin. Mosquitoes exposed to the cone bioassays for 5 min died 120 h after exposure. Slightly higher mortalities were observed in mosquitoes exposed to clothianidin-treated cement wall surfaces than mosquitoes exposed to mud wall surfaces. The kdr target-site mutation L1014F occurred at very high frequencies (0.89–0.94) across all vector species identified whereas the ace-1 mutation occurred at moderate levels (0.32–0.44). Anopheles gambiae sensu stricto was the most abundant species observed at 63%, whereas Anopheles arabiensis was the least observed at 9%. Conclusions Anopheles gambiae s.l. mosquitoes in northern Ghana were susceptible to clothianidin. They harboured kdr mutations at high frequencies. The ace-1 mutation occurred in moderation. The results of this study confirm that clothianidin is an effective active ingredient and should be utilized in malaria vector control interventions.

Hypothesis-driven experiments have been conducted to explore the spatial variability and potential ecological risk indices (RIs) of potentially toxic elements (PTEs) in untreated in situ effluent continuously discharged downstream by the Kumasi Abattoir Ghana (KAG). The study focused on seven PTEs  nickel (Ni), lead (Pb), cadmium (Cd), manganese (Mn), zinc (Zn), copper (Cu), and iron (Fe), based on these hypotheses: (i) Variations in PTE levels may be significant in the effluent; (ii) Comparative RI assessments based on the three background values  natural background values (NBVs) for freshwater, maximum admissible concentrations (MACs), and reference values (RVs) provide objective evaluations; and (iii) PTEs’ cluster distances are linked to RIs. Effluent samples were randomly collected in quintuplicates from the drainage receptacle and analyzed using standard methods. The spatial variability of PTEs was investigated using divisive hierarchical cluster analysis (DHCA). The RIs and their uncertainties were computed using Hakanson's equations and standard deviation (SD). PTE dispersion was analyzed using the coefficient of variation (CV). Analysis of variance (ANOVA) was employed to test for the significance of hypotheses 1 and 2, complemented by Scheffé's post-hoc test where significance was detected. Hypothesis 3 was investigated by analyzing PTE cluster distances and RIs based on Pearson's correlation metric. The DHCA produced two clusters Cd–Cu–Mn–Ni and Zn-(Fe)-Pb. The CVs (< 50 %) indicated medium variability, relatively uniform spatial distributions, and minimal fluctuations. High to very high RIs ± SDs obtained were 300 ± 57.5 (MACs), 2900 ± 500 (RVs), and 7666 ± 2980 (NBVs). The ANOVA yielded significant results for both hypotheses, while moderate to high correlations were obtained for the third hypothesis. While RIs provided compelling evidence of inimical effluent, the study highlights the influence of background values on RIs. It further suggests that the PTE cluster distances may be used as surrogates for the RIs.

Biostimulants (Bio-effectors, BEs) comprise plant growth-promoting microorganisms and active natural substances that promote plant nutrient-acquisition, stress resilience, growth, crop quality and yield. Unfortunately, the effectiveness of BEs, particularly under field conditions, appears highly variable and poorly quantified. Using random model meta-analyses tools, we summarize the effects of 107 BE treatments on the performance of major crops, mainly conducted within the EU-funded project BIOFECTOR with a focus on phosphorus (P) nutrition, over five years. Our analyses comprised 94 controlled pot and 47 field experiments under different geoclimatic conditions, with variable stress levels across European countries and Israel. The results show an average growth/yield increase by 9.3% (n=945), with substantial differences between crops (tomato > maize > wheat) and growth conditions (controlled nursery + field (Seed germination and nursery under controlled conditions and young plants transplanted to the field) > controlled > field). Average crop growth responses were independent of BE type, P fertilizer type, soil pH and plant-available soil P (water-P, Olsen-P or Calcium acetate lactate-P). BE effectiveness profited from manure and other organic fertilizers, increasing soil pH and presence of abiotic stresses (cold, drought/heat or salinity). Systematic meta-studies based on published literature commonly face the inherent problem of publication bias where the most suspected form is the selective publication of statistically significant results. In this meta-analysis, however, the results obtained from all experiments within the project are included. Therefore, it is free of publication bias. In contrast to reviews of published literature, our unique study design is based on a common standardized protocol which applies to all experiments conducted within the project to reduce sources of variability. Based on data of crop growth, yield and P acquisition, we conclude that application of BEs can save fertilizer resources in the future, but the efficiency of BE application depends on cropping systems and environments.

The environmental and human health risks of potentially toxic elements (PTEs) – iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), lead (Pb), nickel (Ni), and cadmium (Cd), in the Kumasi Abattoir Ghana (KAG) untreated effluent have been investigated. PTEs' spatial variability was analyzed using principal component analysis (PCA). Environmental risk assessments were investigated using three novel indices Effluent Pollution Index (EPI), Effluent Discharge Quality Index (EDQI), and modified Heavy Metal Pollution Index (mHPI), which incorporated eigenvectors from the two PCs. Carcinogenic and non-carcinogenic health risks were evaluated for children and adults using standard methods. The high signal-to-noise ratio (SNR) in the PCA was attributed to PC1 (54.2 %) and PC2 (26.2 %), accounting for 80.4 % of the total variance. The eigenvectors of Cu and Zn (both non-carcinogenic) for PC1 and Mn (non-carcinogenic) and Pb (carcinogenic and non-carcinogenic) for PC2 exerted the most effects. PC1 and PC2 corresponded to the effluent temperature and chemical oxygen demand (COD), respectively. The highest EPIpc1 = 61.20 and EPIpc2 = 46.48 were attributed to Fe. Ni had the lowest values (EPIpc1 = 0.02, EPIpc2 = 0.01). EDQIpc1 = 9.52, EDQIpc2 = 7.30 and mHPIpc1 = 474.97 and mHPIpc2 = 267.94 depicted major environmental threats. These indices corresponded to the effluent nitrate (NO3−). Major health threats emerge through ingestion non-carcinogenic (child = 31.42; adult = 18.88) and carcinogenic risk (child = 8.25 × 10−1; adult = 4.96 × 10−1). The dermal health risks were negligible non-carcinogenic (child = 6.25 × 10−4; adult = 3.91 × 10−4) and carcinogenic (child = 1.36 × 10−6; adult = 8.52 × 10−7). Limited by national exposure values, this study provides scientific evidence of potential dangers associated with PTE exposure in the KAG's effluent. It also serves as a critical bridge between environmental quality and health risk of vulnerable communities, calling for actionable intervention.

Background: The effect of hypertension is aggravated by lifestyle factors such as alcohol consumption. This study sought to determine the association between alcohol consumption and the level of blood pressures among HIV seronegative and seropositive cohorts. Methods: This secondary analysis was performed on a cross-sectional survey data of 17 922 participants during the period between 2018 and 2020. A questionnaire was used to obtain participants’ alcohol consumption history, which was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy alcohol consumers. A linear regression model was used to establish relationships among participants with raised blood pressure (BP ≥ 140/90 mmHg). Results: Out of the total participants, 3553 (19.82%) were hypertensives. Almost 13% of the hypertensives (n = 458; 12.89%) were undiagnosed, and 12.44 % (442) had uncontrolled hypertension. About 14.52% of the hypertensives (3553) were not on any antihypertensive medication. Male non-consumers of alcohol had the highest systolic and diastolic BP; uncontrolled systolic BP (165.53 ± 20.87 mmHg), uncontrolled diastolic BP (102.28 ± 19.21mmHg). Adjusted for covariates, moderate alcohol consumption was associated with HTN among participants who were HIV seropositive [unadjusted (RR = 1.772, P = .006, 95% CI (1.178-2.665)], [RR = 1.772, P = .005, 95% CI (1.187-2.64)]. [unadjusted RR = 1.876, P = .036, 95% CI (1.043-3.378)], adjusted RR = 1.876, P = .041, 95% CI (1.024-3.437). Both moderate and heavy alcohol consumption were significantly related to hypertension among HIV sero-negative [unadjusted model, moderate consumption RR = 1.534 P = .003, 95% CI (1.152-2.044)], [adjusted model, moderate alcohol consumption RR = 1.535, P = .006, 95% CI (1.132-2.080)], [unadjusted model, heavy alcohol consumption, RR = 2.480, P = .030, 95% CI (1.091-5.638)], [adjusted model RR = 2.480, P = .034, 95% CI (1.072-5.738)]. Conclusion: Alcohol consumption is significantly related to increase BP regardless of HIV infection.

The historicity and versatility of activated carbons (ACs) and other carbon derivatives (OCDs) date back to antiquity. This article reviews the recent advances in synthesis, characterization, and environmental applications of these demand-driven adsorbents from biomass and non-biomass sources. It first identifies relevant literature sources and knowledge gaps and then segmentalizes and scrutinizes the theme to elucidate contemporary carbon-based adsorbents. Conventional and advanced syntheses are highlighted. Current trends in adsorbents' characterization and remediation are also presented. The conventional AC synthesis includes one-step or two-step chemical or physical activation or a combinatorial synthesis of the two. Issues in the combinatorics are examined. Advanced techniques such as hydrothermal carbonization/activation and microwave-assisted irradiation are described, which may also involve one-step or two-step procedures. OCDs, including carbon nanotubes, carbon nanofibers, and carbon dots, mainly employ advanced syntheses, for example, nanotechnology. Currently, ACs and OCDs are mainly characterized using advanced techniques like scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), nitrogen (N2) adsorption, and X-ray diffraction (XRD), which elucidate their structures, properties, and potential efficacies. Their applications for removing water, soil, and air pollutants are evaluated. The highest percent removal efficiency was activation type-specific, reflecting the precursor's nature, synthesis method, product properties, and quality. For instance, the chemical activation of neem leaves by H3PO4 activation and Fe nanoparticles from tea extracts were 100% successful for Pb2+and Cr6+, respectively, whereas physical activation of rice husk produced 91.8% success for Cr3+. However, their differential adsorptivities for other metals were moderate, with H3PO4 activation the lowest. Due to the high cost, tedious processes in producing and restoring ACs, and their non-selectiveness, researchers continually search for suitable alternatives, which this review considers. Also, applying artificial intelligence (AI) techniques in advancing novel ACs and OCDs for environmental remediation is discussed. Finally, future research dimensions are proposed.

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.

Malaria continues to pose a health challenge globally, and its elimination has remained a major topic of public health discussions. A key factor in eliminating malaria is the early and accurate detection of the parasite, especially in asymptomatic individuals, and so the importance of enhanced diagnostic methods cannot be overemphasized. This paper reviewed the advances in malaria diagnostic tools and detection methods over recent years. The use of these advanced diagnostics in lower and lower-middle-income countries as compared to advanced economies has been highlighted. Scientific databases such as Google Scholar, PUBMED, and Multidisciplinary Digital Publishing Institute (MDPI), among others, were reviewed. The findings suggest important advancements in malaria detection, ranging from the use of rapid diagnostic tests (RDTs) and molecular-based technologies to advanced non-invasive detection methods and computerized technologies. Molecular tests, RDTs, and computerized tests were also seen to be in use in resource-limited settings. In all, only twenty-one out of a total of eighty (26%) low and lower-middle-income countries showed evidence of the use of modern malaria diagnostic methods. It is imperative for governments and other agencies to direct efforts toward malaria research to upscale progress towards malaria elimination globally, especially in endemic regions, which usually happen to be resource-limited regions.

Background: Mist Campa-T (MCT) is a mono-herbal formulation has gained popularity in Ghana for its acclaimed effectiveness in improving sexual function in men. Its main active ingredient is Thoningia sanguinea, a plant known for its aphrodisiac property in folk medicine. This research focused on investigating the aphrodisiac effect of (MCT) and its toxicological profile. Methods: The effect of MCT on sexual function was investigated by the mounting and mating frequency assays followed by serum testosterone and sperm analysis. The toxicological assessment was performed by the acute and sub-acute toxicity assays. Microbial load and elemental/heavy metal content analysis of the product was ascertained. Results: MCT (250, 500, 1000 mg/kg/day) exhibited significant (P ≤ 0.0001) increase in mounting and mating frequencies, in male rats. There was a significant (P ≤ 0.0001) rise in testosterone level for the MCT-treated rats. The LD50 of Mist Campa-T was found to be above 2000 mg/kg bodyweight. There was no significant variation (P > 0.05) in haematological indices as well as renal or hepatic enzymes in the treated groups compared to the untreated group after 28 days of treatment with MCT. There was a notable increase (P

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.

In the absence of effective drugs, vaccines constitute the cornerstone for the prevention of Newcastle disease (ND). Different strategies have been implemented to increase vaccination, but uptake remains low, underscoring the need for novel vaccine delivery methods. We designed and assessed the effectiveness of a community-centered ND vaccine delivery model in southeastern Kenya. Under the model, we sensitized smallholder chicken farmers (SCFs) through structured training on chicken husbandry, biosecurity, ND, and its vaccination, among other aspects. We subsequently engaged trained community vaccinators (CVs) to deliver vaccines and/or provide vaccination services to SCFs at a cost on one hand and, at no cost on the other, in selected sites to address challenges of inadequate service providers, vaccine unavailability, and inaccessibility. We tested this model under paid and free vaccination frameworks over one year and assessed the model's effect on vaccine uptake, ND-related deaths, and vaccine accessibility, among other aspects. Overall, we vaccinated more chickens at free sites compared to paid sites. However, we vaccinated a significantly higher mean number of chickens per household at paid (49.4±38.5) compared to free (28.4±25.9) sites (t = 8.4, p

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.

Change in land use affects the conservation of medicinal plants. We assessed the abundance and richness of medicinal plants under different land-use systems in Ghana. The land-use types consisted of protected area (PA), Fallowed Land (FL) and Farmed area (FA). A total of 45 quadrats (30 m × 30 m) were laid randomly and medicinal plants identified. Soil samples (0–15 cm) were also collected from nested quadrats for physiochemical analysis. Additionally, ethnobotanical survey of 210 key informants was carried out using Snowball sampling method to identify plant parts used and ailments treated. The result identified 107 species of medicinal plants, and the roots (34.4%) and bark (33.3%) were mostly used. PA had higher (P

BackgroundIntestinal helminth infections are among the most common infections worldwide and have a negative impact on the health, education, nutrition and economic development of affected populations. This study aimed to estimate the prevalence of intestinal helminthiasis, including T. solium taeniasis, using a large-scale community-based study in Chiparamba area of Chipata District in the Eastern province of Zambia.Methods/principal findingsA cross-sectional study was conducted between June 2019 and December 2022 in a rural community of 25 randomly selected villages known to be at risk for T. solium infection. Stool samples were examined for intestinal helminths using the formol-ether concentration technique and further tested for taeniasis by copro antigen-ELISA (copro Ag-ELISA). Descriptive statistical analyses were conducted, and associations between the disease prevalence of active infections and individual- and village-level variables were determined using the chi-square or Fisher's exact test. Predictors of an individual being positive for either taeniasis or other soil-transmitted helminths were determined using binary logistic regression. A total of 2762 stool samples were examined. One hundred ninety-five (7.1%) tested positive for at least one helminthic parasite on microscopy, with hookworm being the most frequent 84 (3.0%), followed by S. mansoni, 66 (2.4%). For taeniasis, 11 (0.4%) participants were positive for Taenia spp. microscopically, while 241 (8.7%) tested positive via copro Ag-ELISA. On bivariate analysis, male sex was significantly associated with the prevalence of intestinal parasites (p = 0.012) but not with that of taeniasis based on copro Ag-ELISA results. Village level differences were significant for infection with intestinal helminths as well as for taeniasis positivity on copro Ag-ELISA (p ConclusionIntestinal helminths, including T. solium taeniasis, are prevalent in Chiparamba area of Chipata district in the eastern province of Zambia, supporting the clear need for further targeted public health interventions for surveillance and control.

Yona Mbalibulha,1 Bernard Natukunda,1 Andrew Livex Okwi,2 Joan N Kalyango,3 Kajja Isaac,4 Sam Ononge5 1Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pathology, College of Health Science, Makerere University, Kampala, Uganda; 3Director, Clinical and Epidemiology Unit, School of Medicine, College of Health Science, Makerere University, Kampala, Uganda; 4Deputy Principal, College of Health Sciences, Makerere University, Kampala, Uganda; 5Department of Obstetrics & Gynaecology, Makerere University College of Health Sciences, Kampala, UgandaCorrespondence: Yona Mbalibulha, Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, PO Box 1410, Mbarara, Uganda, Tel +256 773018980, Email ymbalibulha@must.ac.ugIntroduction: Maternal red cell alloimmunization to Rh antigen in pregnant women occurs when the immune system is sensitized by foreign red blood cell surface antigens, in this case fetal red blood cells, inducing an immune response. Various antigens of blood group systems may cause alloimmunization, especially the Rh, Kel, Fy, JK, and MNS systems. This study aimed to determine alloimmunization to the different frequencies of Rh antigen among pregnant women in South Western Uganda.Methods: A total of 1369 pregnant women consented and were recruited into a cross-sectional study during their regular antenatal visits during the period August 2020 to July 2021. Samples (4 mL) of anticoagulated and coagulated blood were obtained, and Rh blood grouping including Rh antigen and the indirect antiglobulin test (IAT) was carried out using the agglutination technology of the LISS ID-Card technique in the Ortho Biovue ID-Micro Typing System.Results: Out of 1369 participants recruited to the study, 78 (5.7%) were D−, 1291 were D+, and 134 (9.8%) had alloantibodies. Among those with alloantibodies, 115 (85.8%) were D+ and 19 (14.2%) D−. The percentage alloimmunization according to the Rh antigens was highest in e (9.72%), c (2.48%), C (2.34%) and E (0.94%) antigens. With the ABO system, alloimmunization was highest in blood group B (10.7%), followed by A (10.6%), O (9.2%) and then AB (7.1%). Alloimmunization was more prevalent in D− (24%) than in D+ participants (8.9%). Rhesus antigen e was the most prevalent antigen (99.8%), followed by c. The alloimmunization rate of 9.8% among these participants is high, and appears in both D+ and D− women. The other Rhesus antigens are seen to cause alloimmunization, with antigen e causing the highest prevalence. In conclusion, there is a need to identify antibodies and study the outcome for clinical significance, especially in D+ women, to facilitate proper pregnancy management.Keywords: Rh alloimmunization, Rh antigens, hemolytic disease of the fetus and newborn, pregnant women, Western Uganda

BackgroundSeveral studies on Taenia solium taeniosis / cysticercosis (TSTC) have been conducted in Zambia. However, none has assessed community knowledge, attitudes and practices related to TSTC and epilepsy.MethodsA community-based cross-sectional study was conducted between November and December 2022. The design consisted of a questionnaire-based survey conducted in each of the 25 purposely selected villages in Chiparamba Rural Health Centre (RHC) catchment area in Chipata district of the Eastern Province.ResultsA total of 588 participants comprising 259 (44%) males and 329 (56%) females with median age of 42 years (range 17 to 92 years) were interviewed. Awareness of the signs and symptoms of taeniosis and human cysticercosis (HCC), including transmission and prevention measures was very low. Whilst the majority had heard about epilepsy, they were not able to link HCC to epilepsy. Most participants were aware of cysticerci in pigs (PCC) including its predilection sites but were not aware of mode of transmission and prevention measures. The pork meat inspection by trained professionals was also not a common practice in the area. Risk perception of T. solium infections was thus very low. Overall knowledge, attitude and practice scores related to T. solium infections and to epilepsy were very low with median scores of 0.38 (IQR 0.25-0.54) for knowledge, 0.25 (0.25-0.50) for attitudes, and 0.31 (0.25-0.44) for practices. Males had better knowledge on TSTC (median = 0.42, p = 0.017, r = 0.098) and better practice scores (median = 0.38, p = < 0.001, r = 0.154) compared to females though the effect size was small. With regards to sanitation and hygiene washing with soap and water was reported by many but only few had a hand washing facility near their latrines.ConclusionThe study shows overall poor knowledge, attitudes and practices related to TSTC among the community of Chiparamba RHC in Chipata district of the Eastern Province of Zambia. This poses a serious challenge for control and elimination of T. solium infections and thus efforts to improve knowledge, attitudes and practices should be made using a One Health approach for the control and elimination of TSTC. Educational programs about TSTC transmission, signs and symptoms, prevention, management and control need to be scaled up in the study area and Zambia as a whole.

Indigenous chickens (IC) contribute significantly to nutrition and socioeconomic wellbeing of rural households. However, despite their potential, production remains low. Attempts to improve IC production among smallholder farmers in Makueni county, Eastern Kenya have achieved little success due to a variety of constraints. This paper explores IC production characteristics and compares the ranks assigned to production and marketing constraints across geographic regions and in male and female-headed households. A descriptive quantitative household survey of 1217 respondents drawn from IC rearing households was conducted and the results integrated with qualitative findings from 22 informants. Results showed an average flock size of 14.9 ± 15.94 IC per household, with female- headed households having relatively fewer chicken than male-headed households. However, relatively more chicken (15.9 ± 18.9) were lost per household during the last disease outbreak compared to the number kept at the time of study. Production system was largely free-range in nature with minimal provision of supplementary feeds. Disease (1.13±0.5), predation (3.16±1.9) and low market prices (3.89±1.9) were three top ranked (Mean Rank±SD) constraints in that order. Lack of capital, high cost of inputs, poor access to extension services and poor access to knowledge ranked significantly higher in female-headed households and in remote areas, while low market price ranked higher in male-headed households. Failure to agree on the selling price was the major constraint to marketing, while rejection of IC due to diseases, inability to agree on selling price and rejection due to size ranked higher in female-headed households compared to male-headed households. Interventions modeled towards improving biosecurity measures to curb diseases, financial empowerment and facilitating access to markets for smallholder farmers should be prioritized.

Cocoa production has been one of the main drivers of forest loss in West Africa. In the resulting post-forest landscapes, agroforestry has often been recognised as a solution to reconcile the preservation of trees and agriculture. Thus, a large number of tree plantation programs have been carried out in cocoa fields. Despite these major investments, the success of these plantations as a tool for ''reforestation'' of landscapes and sustainable timber production has never really been evaluated in fields where remnant trees, spontaneous trees and (trans)planted trees coexist. To quantify the current and future timber resource, we inventoried all trees in 150 cocoa fields distributed along the bioclimatic and historical gradients of the cocoa production area of Côte d'Ivoire, the world's leading producer. Our results show that (i) 19.6% of all associated trees are timber species, (ii) in plots where farmers actually introduced trees by planting, only 13.1% of trees have been (trans)planted, (iii) 69.7% of the current timber volume comes from remnant trees and (iv) spontaneous trees constitute 77% of the future timber resource. Based on our results, we propose 23 species along with their cultivation methods for the renewal of timber resource in cocoa fields. Overall, our results show the failure of plantation programs in cocoa fields and suggest to bet on natural regeneration to sustainably provide timber wood. Consequently, private companies supplying trees to farmers should focus on species that are complementary to those already present in natural regeneration. At the landscape level, remnant trees and residual forests should be preserved to maintain propagule sources. Finally, investments in reforestation of cocoa fields should be redirected towards training small farmers in silvicultural management techniques such as assisted natural regeneration and tree pruning.

Aim Distinct subtypes of Alzheimer’s disease (AD) and related dementias (RD) might have different effects on dental care usage and economic burden. To determine the effects of AD and RD on specific types of dental care usage (preventive and treatment visits) and dental care costs from different payers (total and out-of-pocket costs).Methods A cross-sectional study was conducted using the Medicare Current Beneficiary Survey in 2016. This study identified 4268 community dwelling older adults with and without Alzheimer’s disease and related dementias (ADRD) from a nationally representative sample of Medicare beneficiaries. Dental care usage and costs are based on self-reported data. Preventive dental events included preventive and diagnosis events. Treatment dental events included restorative, oral surgery and other events.Results This study identified 4268 (weighted N=30 423 885) older adults, including 94.48% without ADRD, 1.90% with AD and 3.63% with RD. Compared with older adults without ADRD, those with AD had similar dental care usage, but those with RD were 38% less likely to have treatment visit (OR: 0.62; 95% CI: 0.41 to 0.94) and had a 40% reduced number of total treatment visits (incidence rate ratio: 0.60; 95% CI: 0.37 to 0.98). RD was not associated with dental care costs, but AD was associated with higher total costs (β: 1.08; 95% CI: 0.14 to 2.01) and higher out-of-pocket costs (β: 1.25; 95% CI: 0.17 to 2.32).Conclusions Patients with ADRD were more likely to have adverse dental care outcomes. Specifically, RD was associated with lower treatment dental care usage and AD was associated with higher total and out-of-pocket dental care costs. Effective patient-centred strategies should be used to improve dental care outcomes in patients with distinct subtypes of ADRD.

KCNE3 is a single-pass integral membrane protein that regulates numerous voltage-gated potassium channel functions such as KCNQ1. Previous solution NMR studies suggested a moderate degree of curved α-helical structure in the transmembrane domain (TMD) of KCNE3 in lyso-myristoylphosphatidylcholine (LMPC) micelles and isotropic bicelles with the residues T71, S74 and G78 situated along the concave face of the curved helix. During the interaction of KCNE3 and KCNQ1, KCNE3 pushes its transmembrane domain against KCNQ1 to lock the voltage sensor in its depolarized conformation. A cryo-EM study of KCNE3 complexed with KCNQ1 in nanodiscs suggested a deviation of the KCNE3 structure from its independent structure in isotropic bicelles. Despite the biological significance of KCNE3 TMD, the conformational properties of KCNE3 are poorly understood. Here, all atom molecular dynamics (MD) simulations were utilized to investigate the conformational dynamics of the transmembrane domain of KCNE3 in a lipid bilayer containing a mixture of POPC and POPG lipids (3:1). Further, the effect of the interaction impairing mutations (V72A, I76A and F68A) on the conformational properties of the KCNE3 TMD in lipid bilayers was investigated. Our MD simulation results suggest that the KCNE3 TMD adopts a nearly linear α helical structural conformation in POPC-POPG lipid bilayers. Additionally, the results showed no significant change in the nearly linear α-helical conformation of KCNE3 TMD in the presence of interaction impairing mutations within the sampled time frame. The KCNE3 TMD is more stable with lower flexibility in comparison to the N-terminal and C-terminal of KCNE3 in lipid bilayers. The overall conformational flexibility of KCNE3 also varies in the presence of the interaction-impairing mutations. The MD simulation data further suggest that the membrane bilayer width is similar for wild-type KCNE3 and KCNE3 containing mutations. The Z-distance measurement data revealed that the TMD residue site A69 is close to the lipid bilayer center, and residue sites S57 and S82 are close to the surfaces of the lipid bilayer membrane for wild-type KCNE3 and KCNE3 containing interaction-impairing mutations. These results agree with earlier KCNE3 biophysical studies. The results of these MD simulations will provide complementary data to the experimental outcomes of KCNE3 to help understand its conformational dynamic properties in a more native lipid bilayer environment.

This review, which presents recent advancements in production and applications in environmental remediation of chitosan and chitosan derivatives, covers relevant literature in the last 7–8 years, which is nearly half-term of the 15-year period where the global agenda focuses on achieving the United Nations Sustainable Development Goals (SDGs) by 2030. Chitosan is a natural, non-toxic, polycationic polymer synthesized by deacetylating chitin, using several methods for producing its derivatives. The polycationic nature of chitosan and its derivatives offers them huge prospects as adsorbents due to their extraordinary and diverse properties of biocompatibility, biodegradability, non-hazardousness and chemical versatility. As such, they are very useful in environmental remediation. Chitosan and its derivatives have stood the test of time. They effectively remove fine suspended particles and heavy metals from polluted water and wastewater. Also, the marine environment is usually heavily polluted by hydrocarbons through oil spills with an effectual removal by these adsorbents. Soil, water, and air remediation techniques using chemical methods have the propensity to generate secondary pollution by modifying their chemical structures, which significantly impact the environment, ecosystem integrity, and health. Hence, the need for less costly, efficacious, and environmentally benign methods, such as using chitosan and its derivatives, is warranted. The current review first identifies relevant literature sources and knowledge gaps, such as a rare exposition of issues in the order of the first two stages of the traditional and industrial chitosan production process. It presents an overview of its sources and then examines recent advancements in chitosan chemistry. Chitosan transformation and applications in environmental remediation are also highlighted. Finally, the review identifies research gaps and future dimensions to clear issues about the chitosan production process and promote sustainable production and utilization as the world has embraced a paradigm shift toward circular and green economies, particularly during the period of the SDGs.

Introduction: “Excited delirium” (ExD) is purported to represent a certain type of agitated state that can lead to unexpected death. The 2009 “White Paper Report on Excited Delirium Syndrome,” authored by the American College of Emergency Medicine (ACEP) Excited Delirium Task Force, continues to play a pivotal role in defining ExD. Since that report was produced, there has been an increasing appreciation that the label has been applied more often to Black people. Methods: Our aim was to analyze the language of the 2009 report, the role of potential stereotypes, and the mechanisms that may potentially encourage bias. Results: Our evaluation of the diagnostic criteria for ExD proposed in the 2009 report shows that it relies on persistent racial stereotypes: eg, unusual strength, decreased sensitivity to pain, and bizarre behavior. Research indicates that use of such stereotypes could encourage biased diagnosis and treatment. Conclusion: We suggest that the emergency medicine community avoid use of the concept ExD and that ACEP withdraw implicit or explicit support of the report.

The detailed mechanisms of COVID-19 infection pathology remain poorly understood. To improve our understanding of SARS-CoV-2 pathology, we performed a multi-omics and correlative analysis of an immunologically naïve SARS-CoV-2 clinical cohort from blood plasma of uninfected controls, mild, and severe infections. Consistent with previous observations, severe patient populations showed an elevation of pulmonary surfactant levels. Intriguingly, mild patients showed a statistically significant elevation in the carnosine dipeptidase modifying enzyme (CNDP1). Mild and severe patient populations showed a strong elevation in the metabolite L-cystine (oxidized form of the amino acid cysteine) and enzymes with roles in glutathione metabolism. Neutrophil extracellular traps (NETs) were observed in both mild and severe populations, and NET formation was higher in severe vs. mild samples. Our correlative analysis suggests a potential protective role for CNDP1 in suppressing PSPB release from the pulmonary space whereas NET formation correlates with increased PSPB levels and disease severity. In our discussion we put forward a possible model where NET formation drives pulmonary occlusions and CNDP1 promotes antioxidation, pleiotropic immune responses, and vasodilation by accelerating histamine synthesis.

BackgroundTaenia solium is a tapeworm that causes taeniosis in humans and cysticercosis in humans and pigs. Within Eastern and Southern Africa (ESA), information on the presence of human taeniosis and cysticercosis seems scarce. This systematic review aimed to describe the current information available and gaps in the epidemiology of human T. solium infections in ESA.Methods/principle findingsScientific literature published between 1st January 2000 and 20th June 2022 in international databases [MEDLINE (Ovid), Embase (Ovid), Global Health (Ovid), Scopus (Elsevier), African Index Medicus (via WHO Global Index Medicus), and Open Grey] was systematically reviewed for ESA. The study area included 27 countries that make up the ESA region. Information on either taeniosis, cysticercosis or NCC was available for 16 of 27 countries within the region and a total of 113 reports were retained for the review. Most case reports for cysticercosis and NCC were from South Africa, while Tanzania had the most aggregated cysticercosis reports. Eleven countries reported on NCC with seven countries reporting data on NCC and epilepsy. Unconfirmed human T. solium taeniosis cases were reported in nine countries while two countries (Madagascar and Zambia) reported confirmed T. solium cases. The cysticercosis seroprevalence ranged between 0.7-40.8% on antigen (Ag) ELISA and between 13.1-45.3% on antibody (Ab) ELISA. Based on immunoblot tests the Ab seroprevalence was between 1.7-39.3%, while the proportion of NCC-suggestive lesions on brain CT scans was between 1.0-76% depending on the study population. The human taeniosis prevalence based on microscopy ranged between 0.1-14.7%. Based on Copro Ag-ELISA studies conducted in Kenya, Rwanda, Tanzania, and Zambia, the highest prevalence of 19.7% was reported in Kenya.ConclusionsDespite the public health and economic impact of T. solium in ESA, there are still large gaps in knowledge about the occurrence of the parasite, and the resulting One Health disease complex, and monitoring of T. solium taeniosis and cysticercosis is mostly not in place.

This study uses machine learning techniques to identify the key drivers of financial development in Africa. To this end, four regularization techniques – the Standard lasso, Adaptive lasso, the minimum Schwarz Bayesian information criterion lasso, and the Elasticnet– are trained based on a dataset containing 86 covariates of financial development for the period 1990 - 2019. The results show that variables such as cell phones, economic globalization, institutional effectiveness, and literacy are crucial for financial sector development in Africa. Evidence from the Partialing-out lasso instrumental variable regression reveals that while inflation and agricultural sector employment suppress financial sector development, cell phones and institutional effectiveness are remarkable in spurring financial sector development in Africa. Policy recommendations are provided in line with the rise in globalization, and technological progress in Africa.

The exploitation of the full benefits of chicken rearing by smallholder farmers in Sub-Saharan (SSA) Africa is often impeded by poultry diseases which is compounded by limited uptake of vaccination. We interrogate the structural and socioeconomic factors associated with vaccine uptake by women farmers in Southeastern Kenya. A mixed methods design with a convergent approach for comparison of quantitative and qualitative findings was adopted. This involved the administration of a cross section survey to 1274 households, conduct of 23 Focus Groups Discussions (FGDs) and 7 Key informant Interviews (KIIs). Chi Square and t-tests were used to identify factors associated with vaccine uptake. Logistics regression analysis was used to identify the influence of the structural and socioeconomic barriers to vaccine uptake. Findings indicate that having knowledge of Newcastle disease (ND) vaccine increases the likelihood of farmers vaccinating their chicken by up to 32.5 times (95% CI [8.46-124.53]) with a 1 unit increase in vaccine knowledge. A farmer's distance away from the nearest ND vaccine vendor was found to reduce the likelihood of farmers vaccinating their chicken by up to 4% (95% CI ([0.93-1.00]) for every 1-kilometre increase in distance away from the vaccine vendors. Farmers who considered vaccines to be effective in preventing ND were 39 times (95% CI [6.23-239.8]) more likely to use ND vaccines than those that did not consider ND vaccine to effective. We surmise that a comprehensive approach that addresses increased ND vaccine knowledge among smallholder women chicken farmers, proximity of ND vendors, as well as cost holds the potential for regular and increased ND vaccine uptake.

AbstractLand use change has been a major global challenge since the twentieth century, especially the conversion of natural forests to agricultural and other uses. Such land use changes are considered to be among the major threats to soil quality and sustainability. In this study, we hypothesized that the physiochemical properties of soils in the Guinea Savanna zone of Northern Ghana would vary based on the land use type; with the protected area (PA) having better soil physiochemical properties than farmlands (FL) and fallowed areas (FA). Three communities (Mognori, Jagbo-Apleyi, Tugu) with different land use types (PA, FA and FL) were selected. A total of ninety-nine composite soil samples at three depths (0–15, 15–30, 30–45 cm) were collected for physiochemical analysis. The results indicated that the soil organic carbon, nitrogen, extractable bases (Ca, Mg, K) and effective cation exchange capacity were higher (P

Lithium-ion batteries prove to be a promising technology for achieving present and future goals regarding energy resources. However, a few cases of lithium-ion battery fires and failures caused by thermal runaway have been reported in various news articles; therefore, it is important to enhance the safety of the batteries and their end users. The early detection of thermal runaway by detecting gases/volatile organic compounds (VOCs) released at the initial stages of thermal runaway can be used as a warning to end users. An interdigitated platinum electrode spin-coated with a sub-micron thick layer of poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT: PSS) showed sensitivity for two VOCs (ethyl-methyl carbonate and methyl formate) released from Li-ion batteries during thermal runaway, as well as their binary mixtures at elevated temperatures, which were measured using impedance spectroscopy over a frequency range of 1 MHz to 1 Hz. The sensor response was tested at three different high temperatures (40 °C, 55 °C, and 70 °C) for single analytes and binary mixtures of two VOCs at 5 ppm, 15 ppm, and 30 ppm concentrations. Equivalent electrical parameters were derived from impedance data. A machine learning approach was used to classify the sensor’s response. Classification algorithms classify the sensor’s response at elevated temperatures for different analytes with an accuracy greater than 70%. The success of the reported sensors will enhance battery safety via the early detection of thermal runaway.

Abstract Background The determination of the shooting distance using gunshot residue (GSR) analysis is crucial in the investigation and reconstruction of firearm-related crimes. However, the conventional chemographic method for GSR analysis is destructive and has limited sensitivity and selectivity. While the spectroscopic method has potential in GSR analysis for crime investigation, there is a current lack of consistency in the spectroscopic results obtained for shooting distance estimation via GSR analysis. Addressing such limitations will enhance the forensic capabilities of law enforcement and provide an added advantage to crime laboratories during an investigation. It will also reinforce the use of such spectroscopic data in a criminal investigation. Main text We obtained all peer-reviewed articles relevant to shooting distance estimation from searching Scopus, Web of Science, PubMed, and Google Scholar databases. We specifically searched the databases using the keywords “shooting distance,” “range of fire,” “gunshot residue,” “firearm discharge residue,” and “firearm-related crime” and obtained 3811 records. We further filtered these records using a combination of two basic keywords “gunshot residue” and “shooting distance estimations” yielding 108 papers. Following a careful evaluation of the titles, abstracts, and full texts, 40 original peer-reviewed articles on shooting distance estimation via GSR analysis were included in the study. The forgoing included additional sources (n = 5) we obtained from looking through the reference lists of the forensic articles we found. Short conclusion This paper discusses the current scope of research concerning the chemographic and spectroscopic analysis of GSR for shooting distance estimation. It also examines the challenges of these techniques and provides recommendations for future research.

Abstract Background This study sought to determine how institutional environments, including values, policies, and their implementation, shape inequities in scientific career progression for women and men, and their disadvantages in relation to their multiple social identities in sub-Saharan Africa (SSA). The findings are drawn from a wider research study that was aimed at gaining an in-depth understanding of the barriers and enablers of gender-equitable scientific career progression for researchers in SSA. This was nested within the context of the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) programme—a health-based scientific research capacity-strengthening initiative. Methods The study adopted an exploratory qualitative cross-sectional study design. In-depth interviews (IDIs) with trainees/research fellows at various career stages supported and/or affiliated to three purposively selected DELTAS Africa Research Consortia were the main method of data collection. In addition, key informant interviews (KIIs) with consortia research leaders/directors, co-investigators, and the consortia management team were also conducted to corroborate information gathered from the IDIs, and also to provide additional insights on the drivers of intersectional gender-inequitable career progression. In total, 58 IDIs (32 female and 26 male) and 20 KIIs (4 female and 16 male) were conducted. The interviews were carried out in English between May and December 2018. The data were analysed inductively based on emergent themes. Results Three interrelated themes were identified: first, characterization of the institutional environment as highly complex and competitive with regard to advancement opportunities and funding structure; second, inequitable access to support systems within institutions; third, informal rules—everyday experiences of negative practices and culture at the workplace, characterized by negative stereotypical attitudes, gender biases, sexual harassment, and bullying and intimidation. Conclusions We contend that understanding and addressing the social power relations at the meso-institutional environment and macro-level contexts could benefit career progression of both female and male researchers by improving work culture and practices, resource allocation, and better rules and policies, thus fostering positive avenues for systemic and structural policy changes.

Abstract Background Sub-Saharan Africa (SSA) suffers from a dearth of concrete information on the causes of women’s under-representation in scientific research workforce particularly at higher levels compared with the wealth of information that exists in the global north. The goal of this study was to illuminate familial and socio-cultural drivers that contribute to intersectional gender inequities in scientific career progression in SSA to inform strategies that could promote career equity for African scientific researchers. Methods This study was nested within the context of ‘Developing Excellence in Leadership, Training and Science in Africa’ (DELTAS Africa)—a health-based scientific research capacity strengthening initiative. It adopted an exploratory qualitative cross-sectional study design. In-depth interviews were conducted among 58 (32 Female and 26 Male) trainees/research fellows at various career stages, affiliated to three purposively selected African Research Consortia. The interviews were conducted between May and December 2018 in English. The data were analysed inductively based on emergent themes. Results The study participants were nationals of thirteen SSA countries. More female than male participants had young children. Four themes were identified. They illustrate women’s and men’s characterisation of the normative career pathway and progression requirements which calls for significant ‘time’ commitments (theme 1), and how social power relations of gender within the family and wider society shapes their participation in scientific research activities (theme 2). This culminates in researchers'' differential experiences of navigating between the ‘two different lives’—family and career, and the resultant implications for their career progression and personal well-being (theme 3). Women researchers made different and conscious trade-offs for navigating the ‘two different lives’ by utilising various metaphors such as the ‘biological clock and career clock’, the ‘glass ball and rubber ball’, and the concept of ‘sacrifice’ (theme 4). Conclusions This study is the first of its kind to demonstrate how intersectional gender analysis through use of qualitative research methods may provide novel insights into the hidden familial and socio-cultural drivers of gender inequitable scientific research career progression. It offers important policy and practice measures and approaches for fostering career equity for women and men scientists within research capacity strengthening initiatives in SSA.

Abstract Background Diagnostic test evaluation includes measures of performance and assessment of operational characteristics. The latter focuses on end-user understanding of instructions to perform the test, ease of use, test turnaround time and ease of result interpretation. This study aimed to assess user comprehension of training for and ease of use of a Taenia solium point of care test (TS POC) evaluated in a community and hospital setting in Zambia and Tanzania, respectively. Methods The TS POC is a three-step in-house-produced rapid diagnostic test (RDT) for the simultaneous detection of taeniosis (TST) and cysticercosis (TSCC) antibodies. Data collected by administering questionnaires to 29 end-users and from the main evaluation database was analyzed quantitatively. Results End-users (28/29, 97%) perceived that the training they received for performing the test was sufficient. They performed 4080 tests, of which 80 were invalid. The community-based study and TST tests had higher invalid rates. The overall result interpretation was within the acceptable range of RDTs with an overall disagreement between readers of 3.3%. The Kappa coefficient of agreement was 85 and 82% for TSCC and TST, respectively. There was more disagreement among readers in the community-based study. Conclusion End-users rated the TS POC kit moderate in terms of ease of use citing long test turnaround time and difficulties in using the blood transfer device. Overall, the operational performance of the TS POC kit and end-users was within the established acceptable performance range.

The global malaria community has picked up the theme of malaria elimination in more than 90% of the world’s population in the next decade. Recent reports of Plasmodium vivax (P. vivax) in sub-Saharan Africa, including in Duffy-negative individuals, threaten the efforts aimed at achieving elimination. This is not only in view of strategies that are tailored only to P. falciparum elimination but also due to currently revealed biological characteristics of P. vivax concerning the relapse patterns of hypnozoites and conservation of large biomasses in cryptic sites in the bone marrow and spleen. A typical scenario was observed in Botswana between 2008 and 2018, which palpably projects how P. vivax could endanger malaria elimination efforts where the two parasites co-exist. The need for the global malaria community, national malaria programs (NMPs), funding agencies and relevant stakeholders to engage in a forum to discuss and recommend clear pathways for elimination of malaria, including P. vivax, in sub-Saharan Africa is warranted.

Abstract An understanding of the mode of inheritance is fundamental to plant breeding. The choice of an appropriate selection method considers the number of genes involved and their modes of action. In plant breeding, markers can overcome the false resistance that may arise from greenhouse screening. The goal of this study was to facilitate the better use of cowpea genotypes resistant to aphids. Specifically, we sought to determine the number of genes involved in the ability of cowpeas to survive aphid infestation and identify single sequence repeat (SSR) markers linked to aphid resistance genes. Two pairs of parents (Tiligre × KVX295‐124‐2‐99 and Tiligre × IT97K556‐6) were used to generate two F2 populations. Each of these populations was screened with aphids to determine the mode of inheritance of resistance to aphids in cowpeas. SSR markers were used to screen parent, F1, and F2 individuals to locate polymorphic markers and markers linked to the genes involved in resistance to aphids. The results showed that the ability to survive under aphid infestation in KVX295‐2‐124‐99 and IT97K556‐6 is controlled by two nonallelic genes. The markers MA61 and MA70 were found linked to aphid resistance in cowpea.

This study employs macrodata on 42 African countries to examine whether remittances and financial development (including its sub-components of access, depth and efficiency) contribute to the equalisation of incomes across the continent. Robust evidence based on the dynamic GMM estimator shows that: (i) remittances heighten income inequality in Africa, (ii) Africa’s financial system is not potent enough for propelling remittances towards the equalisation of incomes, and (iii) vis-à-vis financial access and depth, inefficiencies characterising Africa’s financial institutions is the main reason remittances contribute to the widening of the income disparity gap. Nonetheless, the optimism which we provide by way of threshold analysis shows that channelling resources into the development of Africa’s financial sector could yield shared income distribution dividends. In particular, efforts should be made to achieve a minimum threshold of 23.05 (index) for financial access, and 3.02 (index) for that of financial institutions efficiency if Africa’s financial sector is to repackage remittances towards the equalisation of incomes. A few policy recommendations are provided in the end.

Abstract Electronic cigarette (e-cig) vaping is increasing rapidly in the United States, as e-cigs are considered less harmful than combustible cigarettes. However, limited research has been conducted to understand the possible mechanisms that mediate toxicity and pulmonary health effects of e-cigs. We hypothesized that sub-chronic e-cig exposure induces inflammatory response and dysregulated repair/extracellular matrix (ECM) remodeling, which occur through the α7 nicotinic acetylcholine receptor (nAChRα7). Adult wild-type (WT), nAChRα7 knockout (KO), and lung epithelial cell-specific KO (nAChRα7 CreCC10) mice were exposed to e-cig aerosol containing propylene glycol (PG) with or without nicotine. Bronchoalveolar lavage fluids (BALF) and lung tissues were collected to determine e-cig induced inflammatory response and ECM remodeling, respectively. Sub-chronic e-cig exposure with nicotine increased inflammatory cellular influx of macrophages and T-lymphocytes including increased pro-inflammatory cytokines in BALF and increased SARS-Cov-2 Covid-19 ACE2 receptor, whereas nAChRα7 KO mice show reduced inflammatory responses associated with decreased ACE2 receptor. Interestingly, matrix metalloproteinases (MMPs), such as MMP2, MMP8 and MMP9, were altered both at the protein and mRNA transcript levels in female and male KO mice, but WT mice exposed to PG alone showed a sex-dependent phenotype. Moreover, MMP12 was increased significantly in male mice exposed to PG with or without nicotine in a nAChRα7-dependent manner. Additionally, sub-chronic e-cig exposure with or without nicotine altered the abundance of ECM proteins, such as collagen and fibronectin, significantly in a sex-dependent manner, but without the direct role of nAChRα7 gene. Overall, sub-chronic e-cig exposure with or without nicotine affected lung inflammation and repair responses/ECM remodeling, which were mediated by nAChRα7 in a sex-dependent manner.