49 results on '"Mensah KA"'
Search Results
2. Baseline study of the ReachUHC project to assess acceptability of mobile-phone-based interventions to improve health insurance coverage in Ghana
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Kwawukume, M, Nübler, L, Mensah, KA, Owusu-Dabo, E, Siegel, M, Kwawukume, M, Nübler, L, Mensah, KA, Owusu-Dabo, E, and Siegel, M
- Published
- 2023
3. Development of a multisectoral governance framework for health security: Lessons from the COVID-19 response strategy implementation in Sub-Saharan Africa with a focus on Ghana
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Nyakutsey, B, Opoku, D, Busse, R, Mensah, KA, Struckmann, V, Nyakutsey, B, Opoku, D, Busse, R, Mensah, KA, and Struckmann, V
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- 2023
4. Socio-demographic factors associated with medication adherence among People Living with HIV in the Kumasi Metropolis, Ghana
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Adu, C, Mensah, KA, Ahinkorah, BO, Osei, D, Tetteh, AW, and Seidu, A-A
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Cross-Sectional Studies ,1107 Immunology ,Virology ,Humans ,HIV Infections ,Ghana ,Demography ,Medication Adherence - Abstract
BACKGROUND: Medication adherence is important to the survival of People Living with HIV (PLHIV) globally. Although, HIV viral load is reduced by antiretroviral therapy (ART), the number of people on ART continues to rise in Ghana. In the Kumasi Metropolis, Ghana, we looked at the socio-demographic factors associated with medication adherence among PLHIV. METHODS: A quantitative study involving 420 PLHIV who sought healthcare at the Kumasi South Regional Hospital was conducted utilizing a cross-sectional study design. We employed a structured questionnaire to collect data on medication adherence using the eight-item Morisky Medication Adherence Scale (MMAS) and socio-demographic factors that influence medication adherence. The data were analysed using Stata 14.2. Frequencies and percentages were used to present the descriptive data. The association between socio-demographic factors and medication adherence among PLHIV was investigated using both univariate and multivariate analyses. RESULTS: More than half (53.10%) of PLHIV adhered to ART. Place of residence was significantly established to be influencing medication adherence among PLHIV. PLHIV who were residing in urban centers (aOR = 3.61; CI = 2.24-5.82) were more likely to adhere to medication as compared to those who resided in rural areas. CONCLUSION: Slightly more than half of PLHIV took their medicines as prescribed. Government and Policymakers such as the Ghana AIDS Commission, Ministry of Health, and Ghana Health Service should incorporate socio-demographic factors such as place of residence while creating and executing medication adherence initiatives to evaluate HIV management regimen for PLHIV.
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- 2022
5. Variation between hospitals in outcomes following cardiac surgery in the UK
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Soppa, G, primary, Theodoropoulos, P, additional, Bilkhu, R, additional, Harrison, DA, additional, Alam, R, additional, Beattie, R, additional, Bleetman, D, additional, Hussain, A, additional, Jones, S, additional, Kenny, L, additional, Khorsandi, M, additional, Lea, A, additional, Mensah, Ka, additional, Hici, TN, additional, Pinho-Gomes, AC, additional, Rogers, L, additional, Sepehripour, A, additional, Singh, S, additional, Steele, D, additional, Weaver, H, additional, Klein, A, additional, Fletcher, N, additional, and Jahangiri, M, additional
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- 2019
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6. Factors Impeding Anti-corruption Policy Implementation in Africa - The Case Study of Ghana’s Zero-tolerance for Corruption Policy
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Sakyi, EK, primary, Azunu, R, additional, and Mensah, KA, additional
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- 2011
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7. Mediation of nonerosive arthritis in a mouse model of lupus by interferon-alpha-stimulated monocyte differentiation that is nonpermissive of osteoclastogenesis.
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Mensah KA, Mathian A, Ma L, Xing L, Ritchlin CT, and Schwarz EM
- Abstract
OBJECTIVE: In contrast to rheumatoid arthritis (RA), the joint inflammation referred to as Jaccoud's arthritis that occurs in systemic lupus erythematosus (SLE) is nonerosive. Although the mechanism responsible is unknown, the antiosteoclastogenic cytokine interferon-alpha (IFNalpha), whose transcriptome is present in SLE monocytes, may be responsible. This study was undertaken to examine the effects of IFNalpha and lupus on osteoclasts and erosion in the (NZB x NZW)F(1) mouse model of SLE with K/BxN serum-induced arthritis. METHODS: Systemic IFNalpha levels in (NZB x NZW)F(1) mice were elevated by administration of AdIFNalpha. SLE disease was marked by anti-double-stranded DNA (anti-dsDNA) antibody titer and proteinuria, and Ifi202 and Mx1 expression represented the IFNalpha transcriptome. Microfocal computed tomography was used to evaluate bone erosions. Flow cytometry for CD11b and CD11c was used to evaluate the frequency of circulating osteoclast precursors (OCPs) and myeloid dendritic cells (DCs) in blood. RESULTS: Administration of AdIFNalpha to (NZB x NZW)F(1) mice induced osteopetrosis. (NZB x NZW)F(1) mice without autoimmune disease were fully susceptible to focal erosions in the setting of serum-induced arthritis. However, (NZB x NZW)F(1) mice with high anti-dsDNA antibody titers and the IFNalpha transcriptome were protected against bone erosions. AdIFNalpha pretreatment of NZW mice before K/BxN serum administration also resulted in protection against bone erosion (r(2) = 0.4720, P < 0.01), which was associated with a decrease in the frequency of circulating CD11b+CD11c- OCPs and a concomitant increase in the percentage of CD11b+CD11c+ cells (r(2) = 0.6330, P < 0.05), which are phenotypic of myeloid DCs. CONCLUSION: These findings suggest that IFNalpha in SLE shifts monocyte development toward myeloid DCs at the expense of osteoclastogenesis, thereby resulting in decreased bone erosion. [ABSTRACT FROM AUTHOR]
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- 2010
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8. Atypical femoral fractures: what do we know about them?: AAOS Exhibit Selection.
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Unnanuntana A, Saleh A, Mensah KA, Kleimeyer JP, Lane JM, Unnanuntana, Aasis, Saleh, Anas, Mensah, Kofi A, Kleimeyer, John P, and Lane, Joseph M
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- 2013
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9. Climate change impacts on worldwide ecological niche and invasive potential of Sternochetus mangiferae.
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Aidoo OF, Amaro GC, Souza PGC, Picanço MC, Awuah-Mensah KA, and Silva RSD
- Abstract
Background: Present climate studies on invasive species imply that climate change will alter the habitat suitability of invasive pests, especially given the projected rise in average global temperatures by the end of 2100. However, globally, limited information exists on the habitat suitability of the mango stone weevil, Sternochetus mangiferae Fabricius, which impedes the development of early detection and preventive measures. Herein, we used the MaxEnt model to estimate the potential global geographical distribution of S. mangiferae., Results: Our results revealed that thermal conditions played a significant role in explaining the invasion risk of S. mangiferae. Habitat suitability was found in all continents, except Antarctica. Under the present condition, habitat suitability covered 5.67 × 10
7 km2 . For ssp126, habitat suitability will decrease from the 2060s (5.58 × 107 km2 ) and 2080s (5.57 × 107 km2 ). Similarly, under ssp585, suitable areas will decrease from 5.62 × 107 to 5.51 × 107 km2 for the 2060s and 2080s, respectively., Conclusion: Our study has estimated variability in the habitat suitability of S. mangiferae which establishes a foundation for determining global risk assessment and response plans for the pest. This study also identifies areas where the pest is inherently more vulnerable to the impacts of changing climates and enables forecasting of its potential distribution in a dynamic world. © 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2024 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)- Published
- 2024
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10. Estimating and forecasting suppressed electricity demand in Ghana under climate change, the informal economy and sector inefficiencies.
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Dramani JB, Ofori-Mensah KA, Otchere NO, Frimpong PB, Adu-Poku A, Kemausuor F, and Yazdanie M
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Suppressed demand arises from inadequate energy access, resulting in unmet basic needs. Therefore, this study investigates the impact of the informal economy, rising temperatures, and electricity transmission losses on suppressed demand in Ghana from 2000 to 2020, using a quantile autoregressive distributed lag (QARDL) approach. The study forecasts suppressed demand using Shared Socioeconomic Pathway (SSP) scenarios, offering insights for energy system planning. The results indicate that all the variables significantly affect suppressed demand in the mid-quantiles. Notably, transmission losses and growth of informal economy variables significantly impact suppressed demand within the 50th to 75th quantiles but have minimal impact before the 50th and after the 75th quantiles in the long run. Additionally, rising temperatures substantially increase suppressed demand by increasing electricity demand for cooling. All future scenarios project this growth trend will continue through 2050, albeit at varying rates. In the business-as-usual (BAU) case, suppressed demand is expected to steadily increase from 1782 MW in 2020 to 8636 MW in 2050. This trajectory aligns well with historical growth trends, which saw suppressed demand increase from 659 GWh to 1782 GWh between 2000 and 2020. SSP scenarios suggest that suppressed demand could grow substantially through 2050, driven by high losses and informal sector growth. Despite sustainable development narratives like SSP1, suppressed demand remains high without major grid and governance improvements. Comparing the results with past studies shows that our findings align with previous research but provide more nuanced insights by incorporating the effects of the informal economy and using advanced forecasting techniques. Practical policy implications include investing in green infrastructure, upgrading grid infrastructure, and formalising the informal economy to alleviate suppressed demand. These actions are critical for sustainable energy access and meeting future electricity needs effectively., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)
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- 2024
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11. Repellent and larvicidal properties of selected indigenous plants in the control of Anopheles mosquitoes.
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Opoku-Bamfoh O, Kwarteng SA, Owusu FAN, Akpanya R, Mensah KA, Badu M, Gyamfi FY, Sogbo V, Belford EJD, Boakye A, Morrison HM, Obuam PK, and Coleman S
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- Animals, Moringa oleifera chemistry, Mosquito Vectors drug effects, Morinda chemistry, Gas Chromatography-Mass Spectrometry, Biological Assay, Oils, Volatile pharmacology, Oils, Volatile chemistry, Plant Oils pharmacology, Plant Oils chemistry, Anopheles drug effects, Larva drug effects, Plant Extracts pharmacology, Plant Extracts chemistry, Insect Repellents pharmacology, Ocimum basilicum chemistry, Insecticides pharmacology, Mosquito Control methods
- Abstract
Background Objectives: Widespread pyrethroid resistance and plastic-feeding behaviour of most malaria vectors across Africa threaten the efficacy of current insecticide-based vector control interventions like Insecticide-Treated Nets (ITNs) and Indoor Residual Spraying (IRS). This study examined the larvicidal activity ofMorinda citrifolia against Anopheles gambiae larvae and the repellent properties of Morinda citrifolia (Noni), Moringa oleifera (Moringa), and Ocimum basilicum (Basil) as complementary vector control tools against Anopheles gambiae sensu lato (s.l.)., Methods: Noni, Basil, and Moringa oil extracts were obtained with the extraction techniques; Soxhlet, steam distillation and maceration respectively, using hexane and ethanol. The effectiveness of the extracts was assessed using the WHO standard larval susceptibility bioassay and guidelines for repellent efficacy. Following bioassays, effective doses (ED) and lethal concentrations (LC) were determined. Gas Chromatography-Mass Spectroscopy analysis was performed to identify the bioactive chemical components of the extracts of Moringa oleifera and Ocimum basilicum., Results: Emulsified Morinda citrifolia seed oil had LC50=68.3, LC90=130.9 and LC99.9=222.5, and ED99. 9=308.3%v/v, the ethanolic extract of Moringa oleifera leaves had ED99.9= 1.25g/ml, and essential oil of Ocimum basilicum leaves had ED99.9=0.28g/ml against Anopheles gambiae., Interpretation Conclusion: The results obtained indicated that seed oil of Morinda citrifolia, essential oil of Ocimum basilicum, and crude extract of Moringa oleifera have repellent activity against An. gambiae s.l. The complete protection time (CPT) of Morinda citrifolia, Moringa oleifera, and Ocimum basilicum was 120 min, 72 min and 84 min at ED99.9 respectively. Morinda citrifolia oil exhibited larvicidal effects against the larvae of An. gambiae s.l. The results provide valuable information for the use of the plants as biocides., (Copyright © 2024 Copyright: © 2024 Journal of Vector Borne Diseases.)
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- 2024
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12. Development and Psychometric Evaluation of a Food Resource Acceptability Questionnaire.
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Hardin-Fanning F, Mensah KA, and Sha S
- Abstract
The stigma associated with food assistance is a significant barrier to resolution of food insecurity. Interventions and policies aimed at reducing food insecurity would benefit from the inclusion of strategies aimed at minimizing food assistance stigma. We developed the Food Resource Acceptability Questionnaire (FRAQ), a scale that measures the perceptions of stigma associated with food assistance. Qualitative interviews, modified Delphi technique, and exploratory factor analysis were used to develop and evaluate the 17-item scale. The FRAQ consists of two subscales (stigma and the belief that food is a basic right) to measure the likelihood of individuals perceiving food assistance as socially and culturally acceptable. Cronbach's alphas were 0.85, 0.80, and 0.89 for the Stigma subscale, Food as a Basic Right subscale, and the overall FRAQ, respectively. Additional research is needed to determine the applicability of the FRAQ in diverse populations., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2023
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13. Macrophage susceptibility to infection by Ghanaian Mycobacterium tuberculosis complex lineages 4 and 5 varies with self-reported ethnicity.
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Osei-Wusu S, Tetteh JKA, Musah AB, Ntiamoah DO, Arthur N, Adjei A, Arbues A, Ofori EA, Mensah KA, Galevo SEA, Frempong AF, Asare P, Asante-Poku A, Otchere ID, Kusi KA, Lenz TL, Gagneux S, Portevin D, and Yeboah-Manu D
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- Humans, Animals, Female, Sheep, Ethnicity, Ghana epidemiology, Self Report, Leukocytes, Mononuclear, Macrophages, Mycobacterium tuberculosis, Latent Tuberculosis
- Abstract
Background: The epidemiology of Mycobacterium tuberculosis complex (MTBC) lineage 5 (L5) infections in Ghana revealed a significantly increased prevalence in Ewes compared to other self-reported ethnic groups. In that context, we sought to investigate the early phase of tuberculosis (TB) infection using ex vivo infection of macrophages derived from the blood of Ewe and Akan ethnic group volunteers with MTBC L4 and L5 strains., Methods: The study participants consisted of 16 controls, among which self-reported Akan and Ewe ethnicity was equally represented, as well as 20 cured TB cases consisting of 11 Akans and 9 Ewes. Peripheral blood mononuclear cells were isolated from both healthy controls and cured TB cases. CD14
+ monocytes were isolated and differentiated into monocyte-derived macrophages (MDMs) before infection with L4 or L5 endemic strains. The bacterial load was assessed after 2 hours (uptake) as well as 3 and 7 days post-infection., Results: We observed a higher capacity of MDMs from Ewes to phagocytose L4 strains (p < 0.001), translating into a higher bacillary load on day 7 (p < 0.001) compared to L5, despite the higher replication rate of L5 in Ewe MDMs (fold change: 1.4 vs. 1.2, p = 0.03) among the controls. On the contrary, within macrophages from Akans, we observed a significantly higher phagocytic uptake of L5 (p < 0.001) compared to L4, also translating into a higher load on day 7 (p = 0.04). However, the replication rate of L4 in Akan MDMs was higher than that of L5 (fold change: L4 = 1.2, L4 = 1.1, p = 0.04). Although there was no significant difference in the uptake of L4 and L5 among cured TB cases, there was a higher bacterial load of both L4 (p = 0.02) and L5 (p = 0.02) on day 7 in Ewe MDMs., Conclusion: Our results suggest that host ethnicity (driven by host genetic diversity), MTBC genetic diversity, and individual TB infection history are all acting together to modulate the outcome of macrophage infections by MTBC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer VF declared a past collaboration with the author SG to the handling editor., (Copyright © 2023 Osei-Wusu, Tetteh, Musah, Ntiamoah, Arthur, Adjei, Arbues, Ofori, Mensah, Galevo, Frempong, Asare, Asante-Poku, Otchere, Kusi, Lenz, Gagneux, Portevin and Yeboah-Manu.)- Published
- 2023
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14. Determinants of handwashing behaviour among primary school teachers in a district of Ghana.
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Gbolu S, Appiah-Brempong E, Okyere P, Vampere H, Obeng Nyarko G, and Mensah KA
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Background: Hand hygiene practise is an effective school-based measure for infectious disease prevention, especially in developing countries. School children model their behaviour through the observation of significant others, including teachers. However, little is known about the handwashing behaviour and factors influencing the handwashing practises of teachers at the primary school level in Ghana. Methods: A quantitative cross-sectional study was conducted among 214 primary school teachers, recruited by convenience sampling. Data were collected using a structured questionnaire which were designed based on selected constructs in the Theory of Planned Behaviour and the Health Belief Model. Data analyses was done with the aid of STATA software, version 14.0. To identify determinants of hand washing with soap (HWWS) among participants, correlation and multiple linear regression analysis were used. Results: The participants' mean SD age was 34.7 7.6 years, ranging from 20 to 51 years. The majority were males (87.9%). The majority (84.0% and 86.0%) of the teachers, respectively, reported HWWS practises after using the toilet and before eating with bare hands. A correlation was found between reported HWWS practise and toilet use ( r = 0.64; p = 0.001) and eating with bare hands ( r = 0.84; p = 0.001). A multiple linear regression analysis found that knowledge ( p = 0.001), attitude toward HWWS ( p = 0.002), and teachers' perception of the severity of diarrhoea ( p = 0.009) were determinants of teachers' reported HWWS behaviours. Conclusion: Teachers' perceptions of their susceptibility to and severity of diarrhoea, and their knowledge and attitude towards HWWS at critical times should be focus areas for handwashing programmes to achieve the desired outcomes., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)
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- 2023
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15. Socio-demographic factors associated with medication adherence among People Living with HIV in the Kumasi Metropolis, Ghana.
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Adu C, Mensah KA, Ahinkorah BO, Osei D, Tetteh AW, and Seidu AA
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- Humans, Cross-Sectional Studies, Ghana epidemiology, Medication Adherence, Demography, HIV Infections drug therapy, HIV Infections epidemiology
- Abstract
Background: Medication adherence is important to the survival of People Living with HIV (PLHIV) globally. Although, HIV viral load is reduced by antiretroviral therapy (ART), the number of people on ART continues to rise in Ghana. In the Kumasi Metropolis, Ghana, we looked at the socio-demographic factors associated with medication adherence among PLHIV., Methods: A quantitative study involving 420 PLHIV who sought healthcare at the Kumasi South Regional Hospital was conducted utilizing a cross-sectional study design. We employed a structured questionnaire to collect data on medication adherence using the eight-item Morisky Medication Adherence Scale (MMAS) and socio-demographic factors that influence medication adherence. The data were analysed using Stata 14.2. Frequencies and percentages were used to present the descriptive data. The association between socio-demographic factors and medication adherence among PLHIV was investigated using both univariate and multivariate analyses., Results: More than half (53.10%) of PLHIV adhered to ART. Place of residence was significantly established to be influencing medication adherence among PLHIV. PLHIV who were residing in urban centers (aOR = 3.61; CI = 2.24-5.82) were more likely to adhere to medication as compared to those who resided in rural areas., Conclusion: Slightly more than half of PLHIV took their medicines as prescribed. Government and Policymakers such as the Ghana AIDS Commission, Ministry of Health, and Ghana Health Service should incorporate socio-demographic factors such as place of residence while creating and executing medication adherence initiatives to evaluate HIV management regimen for PLHIV., (© 2022. The Author(s).)
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- 2022
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16. Pharmaceutical Assessment of Watermelon Rind Pectin as a Suspending Agent in Oral Liquid Dosage Forms.
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Owusu FWA, El Boakye-Gyasi M, Bayor MT, Osei-Asare C, Johnson R, Osei YA, Asare VA, Mensah KA, Acquah PG, Otu DAB, and Asante R
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- Excipients chemistry, Pectins, Acetaminophen, Suspensions, Citrullus, Tragacanth
- Abstract
Pectin is a high molecular weight polymer which is present in virtually all plants where it contributes to the cell structure. Pectin is a high valuable food ingredient widely used as a gelling agent and thickening agent with limited use in the pharmaceutical industry. The objective of this study is to evaluate the suspending properties of pectin from watermelon rind. Tragacanth was used as a standard suspending agent to which the suspending properties of pectin from watermelon rinds were compared with. The extracted pectin was subjected to phytochemical and physiochemical characterization for its safety and suitability to use as a suspending agent. Paracetamol suspensions were formulated using tragacanth concentrations of 0.5% w/v, 1% w/v, and 2% w/v and compared with paracetamol suspensions containing the same concentrations of watermelon pectin. The suspensions were all tested for their pH, sedimentation rate, sedimentation volume, flow rate, and ease of redispersibility over a period of 4 weeks. At the end of the 4-week period, all formulated suspensions had no changes in their pH values. Suspensions containing the extracted pectin had a lower rate of sedimentation and ease of redispersibility compared to that of tragacanth. In addition, their sedimentation volumes as well as flow rates were comparable to that of the tragacanth formulations. Ultimately, pectin from watermelon rind can serve as a suitable alternative to tragacanth in formulation of pharmaceutical suspensions., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2022 Frederick William Akuffo Owusu et al.)
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- 2022
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17. Discovery of CC-99677, a selective targeted covalent MAPKAPK2 (MK2) inhibitor for autoimmune disorders.
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Malona J, Chuaqui C, Seletsky BM, Beebe L, Cantin S, Kalken DV, Fahnoe K, Wang Z, Browning B, Szabo H, Koopman LA, Oravecz T, McDonald JJ, Ramirez-Valle F, Gaur R, Mensah KA, Thomas M, Connarn JN, Hu H, Alexander MD, and Corin AF
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- Adenosine Triphosphate, Animals, Anti-Inflammatory Agents, Cysteine, HSP27 Heat-Shock Proteins metabolism, Humans, Intracellular Signaling Peptides and Proteins, Lipopolysaccharides, Protein Serine-Threonine Kinases, Rats, Sulfur, Tumor Necrosis Factor-alpha, p38 Mitogen-Activated Protein Kinases metabolism, Autoimmune Diseases drug therapy, Spondylitis, Ankylosing
- Abstract
As an anti-inflammatory strategy, MAPK-activated protein kinase-2 (MK2) inhibition can potentially avoid the clinical failures seen for direct p38 inhibitors, especially tachyphylaxis. CC-99677, a selective targeted covalent MK2 inhibitor, employs a rare chloropyrimidine that bonds to the sulfur of cysteine 140 in the ATP binding site via a nucleophilic aromatic substitutions (S
N Ar) mechanism. This irreversible mechanism translates biochemical potency to cells shown by potent inhibition of heat shock protein 27 (HSP27) phosphorylation in LPS-activated monocytic THP-1 cells. The cytokine inhibitory profile of CC-99677 differentiates it from known p38 inhibitors, potentially suppressing a p38 pathway inflammatory response while avoiding tachyphylaxis. Dosed orally, CC-99677 is efficacious in a rat model of ankylosing spondylitis. Single doses, 3 to 400 mg, in healthy human volunteers show linear pharmacokinetics and apparent sustained tumor necrosis factor-α inhibition, with a favorable safety profile. These results support further development of CC-99677 for autoimmune diseases like ankylosing spondylitis., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2022
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18. The effect of the capitation policy withdrawal on maternal health service provision in Ashanti Region, Ghana: an interrupted time series analysis.
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Yambah JK, Mensah KA, Kuunibe N, Laar K, Atinga RA, Ofori Boateng M, Opoku D, and Quentin W
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- Female, Humans, Pregnancy, Ghana, Hemoglobins, Interrupted Time Series Analysis, Policy, Maternal Health Services
- Abstract
Background: Payment methods are known to influence maternal care delivery in health systems. Ghana suspended a piloted capitation provider payment system after nearly five years of implementation. This study aimed to examine the effects of Ghana's capitation policy on maternal health care provision as part of lesson learning and bridging this critical literature gap., Methods: We used secondary data in the District Health Information Management System-2 and an interrupted time series design to assess changes in level and trend in the provision of ANC4+ (visits of pregnant women making at least the fourth antenatal care attendance per month), HB36 (number of hemoglobin tests conducted for pregnant women who are at the 36th week of gestation) and vaginal delivery in capitated facilities-CHPS (Community-based Health Planning and Services) facilities and hospitals., Results: The results show that the capitation policy withdrawal was associated with a statistically significant trend increase in the provision of ANC4+ in hospitals (coefficient 70.99 p < 0. 001) but no effect in CHPS facilities. Also, the policy withdrawal resulted in contrasting effects in hospitals and CHPS in the trend of provision of Hb36; a statistically significant decline was observed in CHPS (coefficient - 7.01, p < 0.05) while that of hospitals showed a statistically significant trend increase (coefficient 32.87, p < 0.001). Finally, the policy withdrawal did not affect trends of vaginal delivery rates in both CHPS and hospitals., Conclusions: The capitation policy in Ghana appeared to have had a differential effect on the provision of maternal services in both CHPS and hospitals; repressing maternal care provision in hospitals and promoting adherence to anemia testing at term for pregnant women in CHPS facilities. Policy makers and stakeholders should consider the possible detrimental effects on maternal care provision and quality in the design and implementation of per capita primary care systems as they can potentially impact the achievement of SDG 3., (© 2022. The Author(s).)
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- 2022
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19. Author Correction: Multi-block data integration analysis for identifying and validating targeted N-glycans as biomarkers for type II diabetes mellitus.
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Adua E, Afrifa-Yamoah E, Peprah-Yamoah E, Anto EO, Acheampong E, Awuah-Mensah KA, and Wang W
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- 2022
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20. CC-99677, a novel, oral, selective covalent MK2 inhibitor, sustainably reduces pro-inflammatory cytokine production.
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Gaur R, Mensah KA, Stricker J, Adams M, Parton A, Cedzik D, Connarn J, Thomas M, Horan G, Schafer P, Mair S, Palmisano M, and Ramírez-Valle F
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- Cytokines metabolism, Humans, Leukocytes, Mononuclear metabolism, RNA, Messenger, Tumor Necrosis Factor-alpha metabolism, p38 Mitogen-Activated Protein Kinases metabolism, Intracellular Signaling Peptides and Proteins, Protein Serine-Threonine Kinases
- Abstract
Background: Mitogen-activated protein kinase (MAPK)-activated protein kinase-2 (MK2) is activated downstream of p38 MAPK and regulates stability of mRNAs encoding inflammatory cytokines. CC-99677 is a novel, irreversible, covalent MK2 inhibitor under development for the treatment of ankylosing spondylitis (AS) and other inflammatory diseases. As part of a phase I clinical trial to assess safety and tolerability, we evaluated target engagement, pharmacokinetics, and pharmacodynamics of CC-99677., Methods: The MK2 inhibitor CC-99677 was evaluated for its effect on cytokine expression in vitro in peripheral blood mononuclear cells (PBMCs) from healthy donors and patients with a definitive AS diagnosis. A novel in vitro model was developed to compare the potential for tachyphylaxis of CC-99677 and p38 inhibitors in THP-1 cells. The effect of CC-99677 on tristetraprolin (TTP) and cytokine mRNA was assessed in stimulated human monocyte-derived macrophages. In a first-in-human study, thirty-seven healthy volunteers were randomly assigned to daily oral doses of CC-99677 or placebo, and blood was collected at pre-specified time points before and after dosing. CC-99677 concentrations were assessed in the plasma, and CC-99677 binding to MK2 was evaluated in PBMCs. Ex vivo stimulation of the whole blood was conducted from participants in the first-in-human study to assess the pharmacodynamic effects., Results: In vitro, CC-99677 inhibited tumor necrosis factor (TNF), interleukin (IL)-6, and IL-17 protein production in samples of monocytes and macrophages from AS patients and healthy volunteers via an mRNA-destabilization mechanism. In the in vitro model of tachyphylaxis, CC-99677 showed a differentiated pattern of sustained TNF protein inhibition compared with p38 inhibitors. CC-99677 reduced TTP phosphorylation and accelerated the decay of inflammatory cytokine mRNA in lipopolysaccharide-stimulated macrophages. Administration of CC-99677 to healthy volunteers was safe and well-tolerated, with linear pharmacokinetics and sustained reduction of ex vivo whole blood TNF, IL-6, and chemokine synthesis., Conclusions: CC-99677 inhibition of MK2 is a promising approach for the treatment of inflammatory diseases and may overcome the limitations of p38 MAPK inhibition., Trial Registration: ClinicalTrials.gov NCT03554993 ., (© 2022. The Author(s).)
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- 2022
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21. Effect of fear appeal mobile phone messaging on health behaviors of caregivers with children under-five in Ghana.
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Mohammed A, Desu AP, Acheampong PR, Mensah KA, Osei FA, Yeboah EO, Amanor E, and Owusu-Dabo E
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- Caregivers, Child, Fear, Ghana, Health Behavior, Humans, Cell Phone, Malaria prevention & control
- Abstract
Social and Behavior Change Communication is a vital strategy in the control of malaria. However, the effectiveness of fear appeal tactic as a preventive strategy remains uncertain. This study examined the influence of a fear appeal mobile phone-based intervention, guided by Witte's Extended Parallel Process model, on malaria prevention among caregivers with children under-five. We conducted a quasi-experimental study of a 12-month intervention using a sample of 324 caregivers from two rural districts, assigned to either an intervention or control group. The intervention group received fear appeal voice Short Message Service (SMS), once a week for twelve (12) months, while caregivers in the control group received none. The results showed that exposure to the messages was associated with an increased odds of positive attitude [adjusted Odds ratio (aOR) = 2.58; 95% CI 1.61-4.15] and behavioral changes (aOR = 2.03, 95% CI 1.29-3.19). The intervention group exhibited lower odds of defensive avoidance (aOR = 0.44, 95% CI 0.29-0.68) and message minimization (aOR = 0.51, 95% CI 0.33-0.78) compared with the control group. These findings highlight the importance of communicating health messages via mobile phones using fear appeal for improving the health behaviors of caregivers. This strategy, however, may not be useful for influencing the intention of caregivers to engage in positive health practices to protect their children from malaria., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2022
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22. Multi-block data integration analysis for identifying and validating targeted N-glycans as biomarkers for type II diabetes mellitus.
- Author
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Adua E, Afrifa-Yamoah E, Peprah-Yamoah E, Anto EO, Acheampong E, Awuah-Mensah KA, and Wang W
- Subjects
- Biomarkers, Chromatography, High Pressure Liquid, Data Analysis, Humans, Polysaccharides, Diabetes Mellitus, Type 2
- Abstract
Plasma N-glycan profiles have been shown to be defective in type II diabetes Mellitus (T2DM) and holds a promise to discovering biomarkers. The study comprised 232 T2DM patients and 219 healthy individuals. N-glycans were analysed by high-performance liquid chromatography. The multivariate integrative framework, DIABLO was employed for the statistical analysis. N-glycan groups (GPs 34, 32, 26, 31, 36 and 30) were significantly expressed in T2DM in component 1 and GPs 38 and 20 were related to T2DM in component 2. Four clusters were observed based on the correlation of the expressive signatures of the 39 N-glycans across T2DM and controls. Cluster A, B, C and D had 16, 16, 4 and 3 N-glycans respectively, of which 11, 8, 1 and 1 were found to express differently between controls and T2DM in a univariate analysis [Formula: see text]. Multi-block analysis revealed that trigalactosylated (G3), triantennary (TRIA), high branching (HB) and trisialylated (S3) expressed significantly highly in T2DM than healthy controls. A bipartite relevance network revealed that HB, monogalactosylated (G1) and G3 were central in the network and observed more connections, highlighting their importance in discriminating between T2DM and healthy controls. Investigation of these N-glycans can enhance the understanding of T2DM., (© 2022. The Author(s).)
- Published
- 2022
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23. Presentation and outcome of COVID-19 in HIV patients with high viral loads and opportunistic infections: a case series.
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Hardy YO, Amenuke DA, Hutton-Mensah KA, Chadwick DR, and Larsen-Reindorf R
- Subjects
- Adult, Africa South of the Sahara, COVID-19 complications, Coinfection complications, Female, HIV Infections complications, Humans, Male, Middle Aged, Opportunistic Infections complications, Viral Load, COVID-19 virology, Coinfection virology, HIV, HIV Infections virology, Opportunistic Infections virology, SARS-CoV-2
- Abstract
Coronavirus disease 2019 (COVID-19) is especially severe in patients with underlying chronic conditions, with increased risk of mortality. There is concern that people living with HIV (PLWH), especially those with severe immunosuppression, and COVID-19 may have severe disease and a negative clinical outcome. Most studies on COVID-19 in PLWH are from Asia, Europe and America where population dynamics, antiretroviral treatment coverage and coexisting opportunistic infections may differ from that in sub-Saharan Africa. We report on the clinical profile and outcome of three cases of PLWH co-infected with SARS-CoV-2. They all presented with fever, cough and breathlessness and also had advanced HIV infection as evidenced by opportunistic infections, high HIV viral loads and low CD4 counts. The patients responded favourably to the standard of care and were discharged home. Our findings suggest that PLWH with advanced immunosuppression may not necessarily have an unfavourable disease course and outcome. However, case-controlled studies with a larger population size are needed to better understand the impact of COVID-19 in this patient population., Funding: Not declared., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)
- Published
- 2020
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24. Use of tocilizumab in a patient with severe COVID-19 in a Teaching Hospital in Ghana: a case report.
- Author
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Hardy YO, Hutton-Mensah KA, Amenuke DAY, and Amoah-Dankwah J
- Subjects
- COVID-19 diagnosis, Ghana, Hospitals, Teaching, Humans, Male, Middle Aged, Severity of Illness Index, Antibodies, Monoclonal, Humanized therapeutic use, COVID-19 Drug Treatment
- Abstract
The outbreak of coronavirus disease 2019 (COVID-19) in December 2019 has rapidly spread globally with significant negative impact on health. There is an urgent need for a drug or vaccine certified for treating and preventing COVID-19 respectively. Tocilizumab, an interleukin-6 monoclonal receptor antibody, has been used in some centers for mitigating the severe inflammatory response seen in patients with severe COVID-19 with encouraging results. To the best of our knowledge, reports detailing the outcomes of patients with severe COVID-19 undergoing treatment with tocilizumab are sparse in sub-Saharan Africa. We describe the clinical and laboratory profile, chest Computed Tomography (CT) scan findings and clinical outcome in a Ghanaian patient with severe COVID-19 pneumonia treated with tocilizumab. A 54-year-old hypertensive male presented with fever, productive cough, pleuritic chest pain and breathlessness. He tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by polymerase chain reaction analysis done on a nasopharyngeal swab sample. His respiratory symptoms worsened while on admission despite receiving standard of care. His C-reactive protein (CRP) was elevated to 80.59mg/L and chest CT scan findings were indicative of severe COVID-19 pneumonia. He was treated with a single 400mg dose of intravenous tocilizumab with a positive clinical outcome, rapid decline in CRP and improvement in chest CT findings. Our experience shows that tocilizumab shows great promise as drug therapy for COVID-19 pneumonia., Competing Interests: The authors declare no competing interests., (Copyright: Yasmine Oladele Hardy et al.)
- Published
- 2020
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25. Impaired ATM activation in B cells is associated with bone resorption in rheumatoid arthritis.
- Author
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Mensah KA, Chen JW, Schickel JN, Isnardi I, Yamakawa N, Vega-Loza A, Anolik JH, Gatti RA, Gelfand EW, Montgomery RR, Horowitz MC, Craft JE, and Meffre E
- Subjects
- Animals, Arthritis, Rheumatoid physiopathology, Ataxia Telangiectasia Mutated Proteins antagonists & inhibitors, Bone Density, Bone Resorption physiopathology, Cell Survival immunology, Humans, Immunoglobulins immunology, Joints pathology, Lymphocyte Count, Mice, Middle Aged, Osteogenesis, Osteoprotegerin metabolism, Phenotype, RANK Ligand metabolism, Receptors, Complement 3d metabolism, Recombination, Genetic genetics, Arthritis, Rheumatoid immunology, Ataxia Telangiectasia Mutated Proteins metabolism, B-Lymphocytes metabolism, Bone Resorption immunology
- Abstract
Patients with rheumatoid arthritis (RA) may display atypical CD21
-/lo B cells in their blood, but the implication of this observation remains unclear. We report here that the group of patients with RA and elevated frequencies of CD21-/lo B cells shows decreased ataxia telangiectasia-mutated (ATM) expression and activation in B cells compared with other patients with RA and healthy donor controls. In agreement with ATM involvement in the regulation of V(D)J recombination, patients with RA who show defective ATM function displayed a skewed B cell receptor (BCR) Igκ repertoire, which resembled that of patients with ataxia telangiectasia (AT). This repertoire was characterized by increased Jκ1 and decreased upstream Vκ gene segment usage, suggesting improper secondary recombination processes and selection. In addition, altered ATM function in B cells was associated with decreased osteoprotegerin and increased receptor activator of nuclear factor κB ligand (RANKL) production. These changes favor bone loss and correlated with a higher prevalence of erosive disease in patients with RA who show impaired ATM function. Using a humanized mouse model, we also show that ATM inhibition in vivo induces an altered Igκ repertoire and RANKL production by immature B cells in the bone marrow, leading to decreased bone density. We conclude that dysregulated ATM function in B cells promotes bone erosion and the emergence of circulating CD21-/lo B cells, thereby contributing to RA pathophysiology., (Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)- Published
- 2019
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26. Naphthalene induced acute kidney injury in an African patient in Ghana: a case report.
- Author
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Tannor EK and Hutton-Mensah KA
- Subjects
- Acute Kidney Injury physiopathology, Acute Kidney Injury therapy, Adult, Ghana, Humans, Male, Urethritis therapy, Acute Kidney Injury chemically induced, Naphthalenes poisoning, Renal Dialysis methods
- Abstract
Naphthalene is commonly used in Ghana as an insecticide and there have been occasional ingestion unintentionally ingestion in children. Naphthalene use has been associated with intravascular haemolysis especially in patients with glucose-6-phoshate dehydrogenase (G6PD) deficiency but its unorthodox use for the treatment of urethritis in a young man and its associated acute kidney injury has not been described in Ghana. This case report bring to fore the indiscriminate use of complementary medicines and the multiple adverse effects on the kidneys after the ingestion of a combination of naphthalene, alcohol and aluminium sulphate (Alum) as a treatment for urethritis upon a friend's suggestion requiring intermittent haemodialysis but recovered completely of his renal functions. Naphthalene ingestion can cause acute tubular necrosis from haemoglobinuria and timely interventions are necessary to restore renal and maintain good renal functions., Competing Interests: The authors declare no competing interests.
- Published
- 2019
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27. Clinical characteristics of males with systemic lupus erythematosus (SLE) in an inception cohort of patients in Ghana.
- Author
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Dey D, Ofori E, Hutton-Mensah KA, Akutek MLK, Okine R, Amoaba I, Agyemang-Duah K, and Kwarko H
- Subjects
- Adolescent, Adult, Ghana, Humans, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Sex Factors, Young Adult, Lupus Erythematosus, Systemic physiopathology, Lupus Nephritis physiopathology
- Abstract
Background: Systemic Lupus Erythematosus (SLE) is said to be rare in Sub-Saharan Africa and even rarer in males worldwide. SLE is mostly considered a disease of women, though men may also be affected, and this may lead to a delay in diagnosis in men. The result is a greater burden of inflammation and subsequent organ damage over time., Method: Data from the medical records of 13 male patients diagnosed with SLE at the Rheumatology Clinic of Korle- Bu Teaching Hospital between January 2014 and January 2017 was retrospectively analyzed., Results: A total of 13 male patients out of a total of 134 SLE patients were included in our analysis. The mean age was 30.62 ± SD 8.47 years (range of 17 to 46 years). All of them (100%) presented with constitutional features. The most common ACR criteria observed was 61.5 % rash, 54.5 % oral ulcers, 92.3% arthritis, 61.5 % serositis and 38.5% renal involvement, 46.2 % CNS involvement. Looking at their serological profile, 91.7 % had a positive antinuclear antibody (ANA). 33.3 % had positive anti-dsDNA and 58.3 % extractable nuclear antigens. The mean duration from onset of symptoms to diagnosis was 21.31 months. Five patients were diagnosed with lupus nephritis, all at the time of diagnosis. There were no mortalities., Conclusion: Male SLE patients in Ghana are comparable to other populations, with arthritis and constitutional features being predominant early features and lupus nephritis being the main early indicator of organ damage. This should warrant aggressive management in male patients., Funding: None declared., Competing Interests: Conflict of interest: None declared
- Published
- 2019
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28. A novel ATM mutation associated with elevated atypical lymphocyte populations, hyper-IgM, and cutaneous granulomas.
- Author
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Minto H, Mensah KA, Reynolds PR, Meffre E, Rubtsova K, and Gelfand EW
- Subjects
- Ataxia Telangiectasia immunology, B-Lymphocytes immunology, Child, Preschool, Codon, Nonsense, Female, Granuloma immunology, High-Throughput Nucleotide Sequencing, Humans, Hyper-IgM Immunodeficiency Syndrome immunology, Immunologic Memory, Sequence Analysis, DNA, Skin Diseases immunology, T-Lymphocytes immunology, Ataxia Telangiectasia genetics, Ataxia Telangiectasia Mutated Proteins genetics, B-Lymphocyte Subsets immunology, Granuloma genetics, Hyper-IgM Immunodeficiency Syndrome genetics, Skin Diseases genetics, T-Lymphocyte Subsets immunology
- Abstract
Ataxia-Telangiectasia (AT) is an immunodeficiency most often associated with T cell abnormalities. We describe a patient with a hyper-IgM phenotype and immune cell abnormalities that suggest a distinct clinical phenotype. Significant B cell abnormalities with increased unswitched memory B cells, decreased naive transitional B cells, and an elevated frequency of CD19
+ CD38lo CD27- CD10- CD21-/low B cells expressing high levels of T-bet and Fas were demonstrated. The B cells were hyporesponsive to in vitro stimulation through the B cell receptor, Toll like receptors (TLR) 7 and 9, and CD40. T cell homeostasis was also disturbed with a significant increase in γδ T cells, circulating T follicular helper cells (Tfh), and decreased numbers of T regulatory cells. The ATM mutations in this patient are posited to have resulted in the perturbations in the frequencies and distributions of B and T cell subsets, resulting in the phenotype in this patient. KEY MESSAGES: A novel mutation creating a premature stop codon and a nonsense mutation in the ATM gene are postulated to have resulted in the unique clinical picture characterized by abnormal B and T cell populations, lymphocyte subset dysfunction, granuloma formation, and a hyper-IgM phenotype. CAPSULE SUMMARY: A patient presented with ataxia-telangiectasia, cutaneous granulomas, and a hyper-IgM phenotype; a novel combination of mutations in the ATM gene was associated with abnormal distributions, frequencies, and function of T and B lymphocyte subsets., (Copyright © 2019 Elsevier Inc. All rights reserved.)- Published
- 2019
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29. Access and utilization of maternal healthcare in a rural district in the forest belt of Ghana.
- Author
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Nuamah GB, Agyei-Baffour P, Mensah KA, Boateng D, Quansah DY, Dobin D, and Addai-Donkor K
- Subjects
- Adult, Cross-Sectional Studies, Female, Ghana, Humans, Pregnancy, Surveys and Questionnaires, Young Adult, Health Facilities statistics & numerical data, Health Services Accessibility statistics & numerical data, Maternal Health Services statistics & numerical data, Patient Acceptance of Health Care statistics & numerical data, Rural Population statistics & numerical data
- Abstract
Background: Poor maternal health delivery in developing countries results in more than half a million maternal deaths during pregnancy, childbirth or within a few weeks of delivery. This is partly due to unavailability and low utilization of maternal healthcare services in limited-resource settings. The aim of this study was to investigate the access and utilization of maternal healthcare in Amansie-West district in the Ashanti Region of Ghana., Methods: An analytical cross-sectional study, involving 720 pregnant women systematically sampled from antenatal clinics in five sub-districts was conducted from February to May 2015 in the Amansie-West district. Data on participants' socio-economic characteristics, knowledge level and access and utilization of maternal health care services were collected with a structured questionnaire. Odds ratios were estimated to describe the association between explanatory variables and maternal healthcare using generalized estimating equations (GEE)., Results: 68.5, 83.6 and 33.6% of the women had > 3 antenatal care visits, utilized skilled delivery and postnatal care services respectively. The mothers' knowledge level of pregnancy emergencies and newborn danger signs was low. Socio-economic characteristics and healthcare access influenced the utilization of maternal healthcare. Compared to the lowest wealth quintile, being in the highest wealth quintile was associated with higher odds of receiving postnatal care (adjusted odds ratio [aOR]; 95%CI: 2.84; 1.63, 4.94). Use of health facility as a main source of healthcare was also associated with higher odds of antenatal care and skilled delivery., Conclusion: This study demonstrates suboptimal access and utilization of maternal healthcare in rural districts of Ghana, which are influenced by socio-economic characteristics of pregnant mothers. This suggests the need for tailored intervention to improve maternal healthcare utilization for mothers in this and other similar settings.
- Published
- 2019
- Full Text
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30. Household Willingness-to-Pay for Improved Solid Waste Management Services in Four Major Metropolitan Cities in Ghana.
- Author
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Boateng KS, Agyei-Baffour P, Boateng D, Rockson GNK, Mensah KA, and Edusei AK
- Subjects
- Adult, Cities, Cross-Sectional Studies, Female, Ghana, Humans, Logistic Models, Male, Socioeconomic Factors, Surveys and Questionnaires, Family Characteristics, Refuse Disposal economics, Refuse Disposal statistics & numerical data
- Abstract
Introduction: Waste management is an important developmental issue globally, especially in developing countries like Ghana. A key challenge of waste management in developing countries is sustainable financing. This study assesses the willingness-to-pay, an integral attribute of sustainable financing mechanism for improved solid waste management (SWM) services in Ghana., Methods: A cross-sectional multicenter study was conducted in Ghana from January to August 2017 among 1560 households in four regional capitals in Ghana; Accra, Takoradi, Kumasi, and Tamale. Data were collected by using a structured interview questionnaire. Logistic regression models were used to determine the predictors of willingness-to-pay for SWM services in Ghana., Results: Overall, 53.7% of the households were willing to make additional payment for improved services, with difference across study sites: 54.5%, 53.1%, 61.7%, and 46.6% in Takoradi, Tamale, Accra, and Kumasi, respectively. Willingness-to-pay for improved SWM was predicted by educational level, marital status, type of employment, and region of residence. Compared to women who had no formal education, those having senior high school (aOR (adjusted odds ratio): 2.53; 95% CI: 1.48, 4.30), postsecondary (aOR: 1.97; 95% CI: 1.08, 3.60), and tertiary education (aOR: 3.30; 95% CI: 1.91, 5.69) were associated with higher odds of willingness-to-pay for improved SWM services., Conclusion: This study provides important evidence on important attribute of financing mechanism, willingness-to-pay for improved SWM services. Findings would contribute to efforts at finding sustainable financing mechanism for waste management services in Ghana.
- Published
- 2019
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31. Granulomatosis With Polyangiitis in a Young Adult With Down Syndrome: Therapeutic Challenges and Clues to Immunopathogenesis.
- Author
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Mensah KA, Malek Pascha V, Moeckel G, and Danve A
- Subjects
- Acute Kidney Injury diagnosis, Acute Kidney Injury etiology, Acute Kidney Injury therapy, Adult, Biopsy methods, Blood Transfusion methods, Diagnosis, Differential, Humans, Immunologic Factors administration & dosage, Kidney pathology, Male, Patient Care Management methods, Patient Selection, Respiration, Artificial methods, Tomography, X-Ray Computed methods, Treatment Outcome, Antibodies, Antineutrophil Cytoplasmic blood, Down Syndrome complications, Down Syndrome immunology, Glucocorticoids administration & dosage, Granulomatosis with Polyangiitis complications, Granulomatosis with Polyangiitis immunology, Granulomatosis with Polyangiitis physiopathology, Granulomatosis with Polyangiitis therapy, Hemoptysis diagnosis, Hemoptysis etiology, Hemoptysis therapy, Immunoglobulins, Intravenous administration & dosage, Respiratory Insufficiency diagnosis, Respiratory Insufficiency etiology, Respiratory Insufficiency therapy, Rituximab administration & dosage
- Published
- 2018
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32. Pulmonary arterial hypertension in the setting of scleroderma is different than in the setting of lupus: A review.
- Author
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Bazan IS, Mensah KA, Rudkovskaia AA, Adonteng-Boateng PK, Herzog EL, Buckley L, and Fares WH
- Subjects
- Humans, Hypertension, Pulmonary drug therapy, Hypertension, Pulmonary epidemiology, Immunologic Factors therapeutic use, Lupus Erythematosus, Systemic drug therapy, Lupus Erythematosus, Systemic epidemiology, Scleroderma, Systemic drug therapy, Scleroderma, Systemic epidemiology, Hypertension, Pulmonary etiology, Lupus Erythematosus, Systemic complications, Scleroderma, Systemic complications
- Abstract
Pulmonary hypertension (PH) is a clinical syndrome that is subdivided into five groups per the World Health Organization (WHO) classification, based largely on hemodynamic and pathophysiologic criteria. WHO Group 1 PH, termed pulmonary arterial hypertension (PAH), is a clinically progressive disease that can eventually lead to right heart failure and death, and it is hemodynamically characterized by pre-capillary PH and increased pulmonary vascular resistance in the absence of elevated left ventricular filling pressures. PAH can be idiopathic, heritable, or associated with a variety of conditions. Connective tissue diseases make up the largest portion of these associated conditions, most commonly systemic sclerosis (SSc), followed by mixed connective tissue disease and systemic lupus erythematous. These etiologies (namely SSc and Lupus) have been grouped together as connective tissue disease-associated PAH, however emerging evidence suggests they differ in pathogenesis, clinical course, prognosis, and treatment response. This review highlights the differences between SSc-PAH and Lupus-PAH. After introducing the diagnosis, screening, and pathobiology of PAH, we discuss connective tissue disease-associated PAH as a group, and then explore SSc-PAH and SLE-PAH separately, comparing these 2 PAH etiologies., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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33. Barriers and facilitators to Electronic Medical Records usage in the Emergency Centre at Komfo Anokye Teaching Hospital, Kumasi-Ghana.
- Author
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Gyamfi A, Mensah KA, Oduro G, Donkor P, and Mock CN
- Abstract
Introduction: The use of paper for record keeping (or a manual system) has been the order of the day in almost all health care facilities in resource poor countries. This system has presented numerous challenges, which the use of Electronic Medical Records (EMR) seeks to address. The objectives of the study were to identify the facilitators and barriers to EMR implementation in Komfo Anokye Teaching Hospital's (KATH) Emergency Centre (EC) and to identify lessons learned. These will help in implementation of EMR in ECs in similar settings., Methods: This was a non-interventional, descriptive cross-sectional and purely qualitative study using a semi-structured interview guide for a study population of 24. The interviews were manually recorded and analysed thematically. EMR implementation was piloted in the EC. Some of the EC staff doubled as EMR personnel. An open source EMR was freely downloaded and customised to meet the needs of the EC. The EMR database created was a hybrid one comprising of digital bio-data of patients and scanned copies of their paper EC records., Results: The facilitators for utilising the system included providing training to staff, the availability of some logistics, and the commitment of staff. The project barriers were funding, full-time information technology expertise, and automatic data and power backups. It was observed that with the provision of adequate human and financial resources, the challenges were overcome and the adoption of the EMR improved., Discussion: The EMR has been a partial success. The facilitators identified in this study, namely training, provision of logistics, and staff commitment represent foundations to work from. The barriers identified could be addressed with additional funding, provision of information technology expertise, and data and power back up. It is acknowledged that lack of funding could substantially limit EMR implementation.
- Published
- 2017
- Full Text
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34. Cyanosis of the foot.
- Author
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Shi VJ, Leventhal JS, Mensah KA, Galan A, and Choate KA
- Subjects
- Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones therapeutic use, Antiphospholipid Syndrome drug therapy, Antiphospholipid Syndrome pathology, Cyanosis drug therapy, Cyanosis pathology, Diagnosis, Differential, Drug Therapy, Combination, Fondaparinux, Foot Diseases drug therapy, Foot Diseases pathology, Humans, Immunoglobulins, Intravenous administration & dosage, Immunoglobulins, Intravenous therapeutic use, Male, Middle Aged, Plasmapheresis, Polysaccharides administration & dosage, Polysaccharides therapeutic use, Antiphospholipid Syndrome diagnosis, Cyanosis diagnosis, Foot Diseases diagnosis, Venous Thrombosis
- Published
- 2017
35. Factors influencing the practice of exclusive breastfeeding among nursing mothers in a peri-urban district of Ghana.
- Author
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Mensah KA, Acheampong E, Anokye FO, Okyere P, Appiah-Brempong E, and Adjei RO
- Subjects
- Adolescent, Adult, Cross-Sectional Studies, Female, Ghana ethnology, Humans, Infant, Young Adult, Breast Feeding ethnology, Health Knowledge, Attitudes, Practice ethnology, Infant Formula
- Abstract
Background: Exclusive breastfeeding (EBF) is one of the optimal infant and young child feeding practices. Globally, <40% of infants under 6 months of age are exclusively breastfed. In Ghana, 63% of children <6 months are exclusively breastfed which is far less than the 100% recommended by the United Nation Children Emergency Fund. This study was carried out to find out the factors that influence the practice of exclusive breastfeeding in the district., Methods: A cross-sectional quantitative study was conducted using structured questionnaires. A convenience sampling technique was employed to select 380 nursing mothers who attended postnatal care at the postnatal clinic in all the 13 health facilities with child welfare clinics (both public and private) and were available on the day of data collection. Data were analysed using frequency and CHISQ tables., Results: There was a significant association between socio-demographic characteristics of mothers such as age (p = 0.129), religion (p = 0.035) type of employment (p = 0.005) and the practice of exclusive breastfeeding. Again, there was significant relationship between mothers' knowledge on EBF in terms of sources of information about EBF (p = 0.000), steps taken by mothers who perceived not to have breast milk (p = 0.000), some medical conditions of nursing mothers (p = 0.000) and the practice of EBF., Conclusion: Most nursing mothers use infant formula feeds as either supplement or substitute for breast milk based on their perception that breast milk may not be sufficient for the babies despite the high cost of these artificial milk. This puts the babies at a higher risk of compromised health and malnutrition which has the potential of increasing infant mortality. Most mothers are not practicing exclusive breastfeeding because their spouses and family members do not allow them.
- Published
- 2017
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36. Association between maternal depression and child stunting in Northern Ghana: a cross-sectional study.
- Author
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Wemakor A and Mensah KA
- Subjects
- Adolescent, Adult, Child, Preschool, Cross-Sectional Studies, Depression epidemiology, Depressive Disorder epidemiology, Female, Ghana epidemiology, Growth Disorders epidemiology, Humans, Infant, Infant, Newborn, Logistic Models, Male, Pregnancy, Pregnancy Complications epidemiology, Pregnancy Complications psychology, Prevalence, Risk Factors, Surveys and Questionnaires, Young Adult, Child Health, Depression complications, Depressive Disorder complications, Growth Disorders etiology, Infant Health, Mothers psychology, Nutritional Status
- Abstract
Background: Stunting indicates failure to attain genetic potential for height and is a well-documented indicator for poor growth. Depression is common in women of reproductive age and women's mental health problems may affect the growth of young children. We examined the association between maternal depression and stunting in mother-child pairs attending Child Welfare Clinic (CWC) in Northern Ghana., Methods: An analytical cross-sectional study was performed involving mothers (15-45 years) and their children (0-59 months) who attended CWC at Bilpeila Health Centre, Tamale, Ghana. Socio-demographic data were collected using a semi-structured questionnaire, maternal depression was measured using Centre for Epidemiological Studies Depression Screening Scale, and anthropometry was conducted on children following standard procedures. The association between maternal depression and child stunting was examined in logistic regression adjusting for potential confounders., Results: Prevalence rates of child stunting and maternal depression were estimated at 16.1 and 27.8 % respectively in Northern Ghana. Mothers with depression when compared with those without depression tended to be younger, be currently unmarried, belong to the poorest household wealth tertile, and were more likely to have low birth weight babies, so these characteristics were adjusted for. In an adjusted multivariate logistic regression model, children of depressed mothers were almost three times more likely to be stunted compared to children of non-depressed mothers (Adjusted OR = 2.48, 95 % CI 1.29-4.77, p = 0.0011)., Conclusions: There is a high prevalence of depression among mothers in Northern Ghana which is associated with child stunting. Further studies are needed to identify the determinants of maternal depression and to examine its association with child stunting to inform nutrition programming.
- Published
- 2016
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37. Benefits of Disclosure of HIV Status to Infected Children and Adolescents: Perceptions of Caregivers and Health Care Providers.
- Author
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Gyamfi E, Okyere P, Appiah-Brempong E, Adjei RO, and Mensah KA
- Subjects
- Adolescent, Adult, Antiretroviral Therapy, Highly Active, Child, Child, Preschool, Cross-Sectional Studies, Ghana, HIV Infections diagnosis, Humans, Interviews as Topic, Male, Middle Aged, Qualitative Research, Social Support, Socioeconomic Factors, Young Adult, Caregivers psychology, HIV Infections psychology, Health Personnel psychology, Medication Adherence, Perception, Truth Disclosure
- Abstract
The rate of disclosure of HIV status to infected children and adolescents remains low in developing countries. We used a mixed-method approach to determine the perceptions of caregivers and health care providers about the benefits of HIV status disclosure to infected children and adolescents and to assess the support needed by caregivers during disclosure. We recruited a convenience sample of 118 caregivers of HIV-infected children and adolescents for the quantitative component of the study and completed in-depth qualitative interviews with 10 purposefully sampled key informants, including health care providers and volunteer workers. The main benefits of disclosure included improved medication adherence and healthier, more responsible adolescent sexual behavior. The main supports required by caregivers during disclosure included biomedical information, emotional and psychological support, and practical guidelines regarding disclosure. We confirmed the importance of disclosure to HIV-infected children and adolescents and the need to develop culturally specific disclosure guidelines., (Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
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38. An evaluation of a community-based food supplementation for people living with HIV in Ghana: implications for community-based interventions in Ghana.
- Author
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Mensah KA, Okyere P, and Doku PN
- Subjects
- Adult, Female, Ghana, Humans, Male, Regression Analysis, Risk Factors, Weight Gain, Dietary Supplements, Food, HIV Infections therapy, Residence Characteristics
- Abstract
Background: Community-based care and support services are limited in sub-Saharan Africa and as a result a high number of people living with HIV (PLHIV) are not getting the required care and support services. The aim of this study was to assess the impact of food supplementation services for PLHIV in Ghana on weight gained and factors associated with weight gained., Methods: The study employed mixed methods study design involving quantitative and qualitative techniques. These were structured questionnaire administered to 200 PLHIV selected through simple random sampling and a qualitative component consisting of 14 semi-structured interviews with purposefully selected stakeholders and eight focus group discussions with the beneficiaries., Results: The analysis of the quantitative data showed on average, beneficiaries had gained weight [mean difference in weight was 2 kg with 95 % CI (1.1, 2.9), P value <0.001]. Multivariate analysis showed that the support group to which the beneficiary belonged was the most important determinant of gaining weight. Through the qualitative interviews, beneficiaries indicated that the anti-retroviral drugs were making them hungry and the food helped to alleviate that effect. Notwithstanding, they indicated that the food was nutritious, made them healthy and strong, contributed to their weight gain and was their main sources of hope at home when they had no money., Conclusions: A broad strategy of food supplementation for PLHIV should be implemented in different ways for different support groups taking into account the differences between different support groups when planning such an intervention.
- Published
- 2015
- Full Text
- View/download PDF
39. Perceived social support disparities among children affected by HIV/AIDS in Ghana: a cross-sectional survey.
- Author
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Doku PN, Dotse JE, and Mensah KA
- Subjects
- Acquired Immunodeficiency Syndrome psychology, Adolescent, Child, Cross-Sectional Studies, Female, Ghana, Health Services, Humans, Male, Perception, Socioeconomic Factors, Surveys and Questionnaires, Caregivers psychology, Caregivers statistics & numerical data, Child, Orphaned psychology, Child, Orphaned statistics & numerical data, HIV Infections psychology, Social Support
- Abstract
Background: The study investigated whether perceived social support varied among children who have lost their parents to AIDS, those who have lost their parents to other causes, those who are living with HIV/AIDS-infected caregivers and children from intact families (comparison group)., Method: This study employed cross-sectional, quantitative survey that involved 291 children aged 10-18 years in the Lower Manya Krobo District of Ghana and examined their social support disparities., Results: Multivariate linear regressions indicate that children living with HIV/AIDS-infected caregivers reported significantly lower levels of social support compared with AIDS-orphaned children, other-orphaned children and non-orphaned children independent of socio-demographic covariates. Children who have lost their parents to other causes and other-orphaned children reported similar levels of social support. In terms of sources of support, all children orphans and vulnerable children were more likely to draw support from friends and significant others rather than from the family., Conclusion: The findings indicate a need to develop interventions that can increase levels of social support for orphaned and vulnerable children within the context of HIV/AIDS in Ghana, particularly networks that include the family.
- Published
- 2015
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40. Lupus-Associated Pulmonary Arterial Hypertension: Variable Course and Importance of Prompt Recognition.
- Author
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Mensah KA, Yadav R, Trow TK, Brunet CM, and Fares WH
- Abstract
We describe a critically ill young woman with systemic lupus erythematosus (SLE) presenting with circulatory shock, multiorgan dysfunction, and elevated right-sided heart pressures. She was found to have recurrent acute severe pulmonary arterial hypertension (PAH) in the setting of an SLE flare. Our report highlights the variable course that SLE-associated PAH can take in the same patient and the implications of this for instituting the most effective treatment approach with each episode. This report also highlights the potential for SLE-associated PAH to present with life-threatening symptoms requiring critical care level interventions. We also describe evidence-based therapies, which can result in significant improvement in symptoms, function, and long-term outcomes.
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- 2015
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41. Regulation of human osteoclast development by dendritic cell-specific transmembrane protein (DC-STAMP).
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Chiu YH, Mensah KA, Schwarz EM, Ju Y, Takahata M, Feng C, McMahon LA, Hicks DG, Panepento B, Keng PC, and Ritchlin CT
- Subjects
- Adaptor Proteins, Signal Transducing immunology, Amino Acid Motifs, Animals, Antibodies, Monoclonal immunology, Antibody Specificity immunology, Biomarkers, Cell Line, Down-Regulation, Humans, Membrane Proteins immunology, Mice, Models, Biological, Monocytes metabolism, Osteogenesis, Signal Transduction, Stem Cells metabolism, Adaptor Proteins, Signal Transducing metabolism, Membrane Proteins metabolism, Osteoclasts cytology, Osteoclasts metabolism
- Abstract
Osteoclasts (OC) are bone-resorbing, multinucleated cells that are generated via fusion of OC precursors (OCP). The frequency of OCP is elevated in patients with erosive inflammatory arthritis and metabolic bone diseases. Although many cytokines and cell surface receptors are known to participate in osteoclastogenesis, the molecular mechanisms underlying the regulation of this cellular transformation are poorly understood. Herein, we focused our studies on the dendritic cell-specific transmembrane protein (DC-STAMP), a seven-pass transmembrane receptor-like protein known to be essential for cell-to-cell fusion during osteoclastogenesis. We identified an immunoreceptor tyrosine-based inhibitory motif (ITIM) in the cytoplasmic tail of DC-STAMP, and developed an anti-DC-STAMP monoclonal antibody 1A2 that detected DC-STAMP expression on human tumor giant cells, blocked OC formation in vitro, and distinguished four patterns of human PBMC with a positive correlation to OC potential. In freshly isolated monocytes, DC-STAMP(high) cells produced a higher number of OC in culture than DC-STAMP(low) cells and the surface expression of DC-STAMP gradually declined during osteoclastogenesis. Importantly, we showed that DC-STAMP is phosphorylated on its tyrosine residues and physically interacts with SHP-1 and CD16, an SH2-domain-containing tyrosine phosphatase and an ITAM-associated protein, respectively. Taken together, these data show that DC-STAMP is a potential OCP biomarker in inflammatory arthritis. Moreover, in addition to its effect on cell fusion, DC-STAMP dynamically regulates cell signaling during osteoclastogenesis., (Copyright © 2012 American Society for Bone and Mineral Research.)
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- 2012
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42. Actuation of elastomeric microvalves in point-of-care settings using handheld, battery-powered instrumentation.
- Author
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Addae-Mensah KA, Cheung YK, Fekete V, Rendely MS, and Sia SK
- Subjects
- Computers, Equipment Design, Membranes, Artificial, Elastomers, Electric Power Supplies, Microfluidic Analytical Techniques instrumentation, Point-of-Care Systems
- Abstract
Although advanced fluid handling using elastomeric valves is useful for a variety of lab-on-a-chip procedures, their operation has traditionally relied on external laboratory infrastructure (such as gas tanks, computers, and ground electricity). This dependence has held back the use of elastomeric microvalves for point-of-care settings. Here, we demonstrate that microfabricated microvalves, via liquid-filled control channels, can be actuated using only a handheld instrument powered by a 9 V battery. This setup can achieve on-off fluid control with fast response times, coordinated switching of multiple valves, and operation of a biological assay. In the future, this technique may enable the widely used elastomeric microvalves (made by multilayer soft lithography) to be increasingly adopted for portable sensors and lab-on-a-chip systems.
- Published
- 2010
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43. RANKL induces heterogeneous DC-STAMP(lo) and DC-STAMP(hi) osteoclast precursors of which the DC-STAMP(lo) precursors are the master fusogens.
- Author
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Mensah KA, Ritchlin CT, and Schwarz EM
- Subjects
- Acid Phosphatase genetics, Animals, Antigens, CD genetics, Biomarkers metabolism, Blotting, Western, CD47 Antigen genetics, Cells, Cultured, Flow Cytometry, Immunoproliferative Disorders, Isoenzymes genetics, Membrane Glycoproteins genetics, Membrane Proteins genetics, Mice, Mice, Inbred C57BL, Microscopy, Fluorescence, Phenotype, Protein Multimerization, RNA, Messenger metabolism, Reverse Transcriptase Polymerase Chain Reaction, Tartrate-Resistant Acid Phosphatase, Tetraspanin 29, Time Factors, Bone Marrow Cells metabolism, Cell Differentiation genetics, Cell Fusion, Macrophages metabolism, Membrane Proteins metabolism, Nerve Tissue Proteins metabolism, Osteoclasts metabolism, RANK Ligand metabolism, Stem Cells metabolism
- Abstract
Osteoclasts (OC) are multinucleated bone resorbing cells that form via RANKL-induced fusion of heterogeneous mononuclear OC precursors (OCP). Currently, there are no unique surface markers to distinguish these OCP populations, which are diagnostic for erosive and metabolic bone diseases using culture assays. Thus, we investigated expression of DC-STAMP, a surface receptor required for OCP fusion, during osteoclastogenesis in vitro using a novel monoclonal antibody (1A2). Immunoprecipitation-Western blot analysis of OCP membrane proteins detected 106 kDa dimeric and 53 kDa monomeric DC-STAMP in non-denaturing and denaturing conditions, respectively, with greater sensitivity versus rabbit anti-sera (KR104). 1A2 also detected 99.9% of undifferentiated monocytes as a single population by flow cytometry with a MFI 100-fold over background, while KR104 was not useful in this assay. Functionally, 1A2 inhibited OCP fusion in vitro. RANKL stimulation of OCP induced DC-STAMP(lo) and DC-STAMP(hi) cells, which mature into OC and mononuclear cells respectively as determined by fluorescent microscopy and TRAP assays. Addition of DC-STAMP(hi) cells to purified DC-STAMP(lo) cultures produced larger, more nucleated OC vs. pure DC-STAMP(lo) cultures. RT-qPCR analysis of these two populations showed that OC markers (Trap and Oc-stamp) and fusogenic gene expression (Cd9 and Cd47), were significantly increased in DC-STAMP(lo) vs. DC-STAMP(hi) cells. Collectively, these results demonstrate that DC-STAMP is expressed on OCP as a dimer, which is efficiently detected by 1A2 via flow cytometry. RANKL induces osteoclastogenesis by stimulating DC-STAMP internalization in some OCP, and these DC-STAMP(lo) cells display the "master fusogen" phenotype. In contrast, DC-STAMP(hi) OCP can only act as mononuclear donors., (J. Cell. Physiol. 223: 76-83, 2010. (c) 2009 Wiley-Liss, Inc.)
- Published
- 2010
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44. CD16 (FcRgammaIII) as a potential marker of osteoclast precursors in psoriatic arthritis.
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Chiu YG, Shao T, Feng C, Mensah KA, Thullen M, Schwarz EM, and Ritchlin CT
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- Biomarkers analysis, Cell Lineage, Cell Separation, Cytokines, Flow Cytometry, Humans, Monocytes cytology, Monocytes metabolism, Osteoclasts metabolism, Stem Cells metabolism, Arthritis, Psoriatic metabolism, Arthritis, Psoriatic pathology, Osteoclasts cytology, Receptors, IgG metabolism, Stem Cells cytology
- Abstract
Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis characterized by bone erosion mediated by osteoclasts (OC). Our previous studies showed an elevated frequency of OC precursors (OCP) in PsA patients. Here, we examined if OC arise from CD16-positive monocytes in PsA., Methods: Peripheral blood mononuclear cells (PBMC) or monocytes were isolated from human peripheral blood and sorted based on CD16 expression. Sorted cells were cultured alone or with bone wafers in the presence of receptor activator of nuclear factor kappa-B ligand (RANKL) and macrophage colony-stimulating factor (M-CSF). Enumeration and bone erosion activity of OC were examined after culture. The effects of tumor necrosis factor-alpha (TNFalpha), OC-promoting (M-CSF plus RANKL), and dendritic cell (DC)-promoting (GM-CSF plus interleukin (IL)-4) cytokines on CD16 surface expression were examined by flow cytometry., Results: PsA and psoriasis (Ps) subjects had a higher percentage of circulating inflammatory CD14+CD16+ cells than healthy controls (HC). Exposure of cells to OC-promoting, but not DC-promoting media, was associated with CD16 up-regulation. PBMC of Ps and PsA had a higher frequency of cells expressing intermediate levels of CD16. OC were mainly derived from CD16+ cells in PsA. Increased CD16 expression was associated with a higher bone erosion activity in PsA., Conclusions: An increased frequency of circulating CD14+CD16+ cells was noted in PsA compared to controls, and intermediate levels of CD16 may suggest a transitional state of OCP during osteoclastogenesis. Intriguingly, TNFalpha blocked CD16 expression on a subset of CD14+ monocytes. Collectively, our data suggest that CD16 has the potential to serve as an OCP marker in inflammatory arthritis.
- Published
- 2010
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45. Cryogenic Etching of Silicon: An Alternative Method For Fabrication of Vertical Microcantilever Master Molds.
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Addae-Mensah KA, Retterer S, Opalenik SR, Thomas D, Lavrik NV, and Wikswo JP
- Abstract
This paper examines the use of deep reactive ion etching (DRIE) of silicon with fluorine high-density plasmas at cryogenic temperatures to produce silicon master molds for vertical microcantilever arrays used for controlling substrate stiffness for culturing living cells. The resultant profiles achieved depend on the rate of deposition and etching of a SiO
x Fy polymer, which serves as a passivation layer on the sidewalls of the etched structures in relation to areas that have not been passivated with the polymer. We look at how optimal tuning of two parameters, the O2 flow rate and the capacitively coupled plasma (CCP) power, determine the etch profile. All other pertinent parameters are kept constant. We examine the etch profiles produced using e-beam resist as the main etch mask, with holes having diameters of 750 nm, 1 µm, and 2 µm.- Published
- 2009
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46. The emerging field of osteoimmunology.
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Mensah KA, Li J, and Schwarz EM
- Subjects
- Allergy and Immunology trends, Bone and Bones cytology, Bone and Bones metabolism, Humans, Immune System cytology, Immune System immunology, Immune System metabolism, Immunologic Factors pharmacology, Immunologic Factors therapeutic use, Osteoblasts metabolism, Signal Transduction drug effects, Signal Transduction immunology, Bone Remodeling immunology, Bone and Bones immunology, Osteoblasts immunology, Osteogenesis immunology
- Abstract
Recent studies have elucidated unanticipated connections between the immune and skeletal systems, and this relationship has led to the development of a new field known as osteoimmunology. The goal of research in this field is to: (1) further understand how the bone microenvironment influences immune cell ontogeny and subsequent effector functions, and (2) translate basic science findings in bone biology to clinical applications for autoimmune diseases that target the skeleton such as rheumatoid arthritis (RA). In this review, we will examine the recent findings of the interplay between the immune and skeletal systems. This discussion will focus on the cells and signaling pathways in osteoimmune interactions and how innate and adaptive immune effector cells as well as cytokines and chemokines play a role in the maintenance and dysregulation of skeletal-immune homeostasis. We will also discuss how immunomodulatory biologic drugs, which specifically target these cells and effector molecules, have transformed the treatment of autoimmune mediated inflammatory diseases (IMIDs) and metabolic bone diseases such as osteoporosis.
- Published
- 2009
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47. Altered bone remodeling in psoriatic arthritis.
- Author
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Mensah KA, Schwarz EM, and Ritchlin CT
- Subjects
- Arthritis, Psoriatic drug therapy, Humans, Immunologic Factors therapeutic use, Intercellular Signaling Peptides and Proteins physiology, Osteoblasts physiology, Osteoclasts physiology, Osteogenesis physiology, Tumor Necrosis Factor-alpha antagonists & inhibitors, Arthritis, Psoriatic physiopathology, Bone Resorption physiopathology, Tumor Necrosis Factor-alpha physiology
- Abstract
Bone is a highly dynamic organ that interacts with a wide array of cells and tissues. Recent studies have unveiled unanticipated connections between the immune and skeletal systems, and this relationship led to the development of a new field called osteoimmunology. This field will enable investigators to translate basic science findings in bone biology to clinical applications for inflammatory joint diseases such as psoriatic arthritis (PsA). This review examines the disruption of bone homeostasis in PsA and discusses the pivotal role of osteoclasts, osteoblasts, and signaling pathways in the altered remodeling observed in this inflammatory arthritis. It also discusses the effects of tumor necrosis factor inhibition on bone resorption and new bone formation in PsA.
- Published
- 2008
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- View/download PDF
48. Measurement techniques for cellular biomechanics in vitro.
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Addae-Mensah KA and Wikswo JP
- Subjects
- Animals, Biomechanical Phenomena, Cytological Techniques instrumentation, Humans, In Vitro Techniques, Microscopy, Atomic Force instrumentation, Microscopy, Atomic Force methods, Stress, Mechanical, Cell Physiological Phenomena, Cells cytology, Cytological Techniques methods
- Abstract
Living cells and tissues experience mechanical forces in their physiological environments that are known to affect many cellular processes. Also of importance are the mechanical properties of cells, as well as the microforces generated by cellular processes themselves in their microenvironments. The difficulty associated with studying these phenomena in vivo has led to alternatives such as using in vitro models. The need for experimental techniques for investigating cellular biomechanics and mechanobiology in vitro has fueled an evolution in the technology used in these studies. Particularly noteworthy are some of the new biomicroelectromechanical systems (Bio-MEMS) devices and techniques that have been introduced to the field. We describe some of the cellular micromechanical techniques and methods that have been developed for in vitro studies, and provide summaries of the ranges of measured values of various biomechanical quantities. We also briefly address some of our experiences in using these methods and include modifications we have introduced in order to improve them.
- Published
- 2008
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- View/download PDF
49. An examination of the effects of detergents on anaerobic digestion.
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Mensah KA and Forster CF
- Subjects
- Adsorption drug effects, Biodegradation, Environmental, Charcoal, Detergents chemistry, Water Pollutants, Chemical analysis, Water Pollutants, Chemical pharmacology, Anaerobiosis drug effects, Detergents pharmacology, Waste Disposal, Fluid methods
- Abstract
An anaerobic filter was used to examine the treatability of wastewater formulated to simulate that from the manufacture of detergents. The detergent element was a mixture (1:1:1 v/v) of concentrated washing up liquid, a non-biological hand washing detergent and a fabric softener and, thus contained a combination of cationic surfactants, anionic surfactants, non-ionic surfactants and amphoteric surfactants. A concentration of 2 ml/l caused a deterioration in the performance of the digester which was pronounced after 7 days. When the packing of the filter was modified to include two layers of granular activated carbon, 320 g in total, the reactor was capable of treating a feed containing 10 ml/l. The amount of detergent removed during this second trial was greater than the Langmuir monolayer capacity of the carbon, indicating that both adsorption and degradation were occurring. The results also showed that, at detergent concentrations greater than 1 ml/l, the theoretical COD removal was lower than the actual COD removal. This was compatible with there being an element of adsorption by the activated carbon.
- Published
- 2003
- Full Text
- View/download PDF
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