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A software developed called Expeditor, which can be used to combine human gene structure information and animal coding sequence information for primer design is presented. The unique feature of Expeditor is that it takes inputs directly from known human genes/sequences, takes into account the intron sizes in assessing amplicon sizes and permits consensus sequences from multiple animal species to be used as part of the template.

Background: One's socialization greatly impacts their sexual behavior. Young people's understanding of sex is influenced by prescribed social scripts which are learnt from peers, parents, media, among other sources. Nyamira County has the fourth highest burden of teenage pregnancy and motherhood in Kenya, standing at 28% against a national average of 18%. It's therefore very important to understand the drivers of sexual debut among adolescents in Nyamira County. Objective: To establish the socio-cultural determinants of sexual debut among in-school adolescents in Nyamira County through the lens of the Social Learning theory. Design: A mixed method study design employing the collection of both quantitative and qualitative data. Setting: Mixed day, girls-only boarding and boys-only boarding secondary schools in Nyamira county. Study participants: These included 400 respondents, 200 males and 200 females, aged 14-18 years from mixed-day secondary schools and single-sex boarding secondary schools. Twenty-four key informants were also interviewed. Results: Of the 400 students, 61% had ever had sex. More students (63.5%) in mixed day schools had ever had sex compared to single sex schools (58.5%). Gender, age, marital status and coming from polygamous homes were found to be associated with ever having sex. Older sexual partners were seen to provide parental love. Peer pressure was reported by most male students as a driver towards initiating sex, while most female students reported poverty. Conclusion: Polygamous upbringing, peer pressure and watching pornography came out as strong determinants of sexual debut among in-school adolescents in Nyamira County. [ABSTRACT FROM AUTHOR]

We present results on the first principle study of the elastic constants and the phonon dispersion of EuFe2As2 at zero pressure. The ground-state energy calculations were performed within Density Functional Theory (DFT) and the generalized gradient approximation using the pseudopotential method with plane-wave basis sets. The projector augmented-wave (PAW) pseudopotentials were used in our calculation. The open source code QUANTUM ESPRESSSO was used with its pseudopotential database. The study on the elastic constants at zero pressure was a clear indication that the compound is mechanically stable, and the phonon dispersion study also indicated that the compound is dynamically stable. The elastic constants and mechanical properties also led to the conclusion that the compound is ductile and anisotropic. [ABSTRACT FROM AUTHOR]

We report the results of pressure-induced semiconductor-metal phase transition of the semiconducting chalcogenide compound KPSe6 under high pressure using the ab initio methods. The ground-state energy calculations were performed within density functional theory and the generalized gradient approximation using the pseudopotential method with plane-wave basis sets. The projector augmented-wave (PAW) pseudopotentials were used in our calculation. The optimized lattice parameters were found from total energy calculations as 13 Bohr, 1.6 Bohr, and 1.8 Bohr for cell dimensions one, two, and three, respectively, which are in good agreement with experimental calculations. At zero pressure, the material portrayed a semiconducting property with a direct bandgap of ≈1.7 eV. As we subjected the material to pressure, the band gap was observed to reduce until it disappeared. The phase transition from the semiconductor to metal was found to occur at ∼45 GPa, implying that the material underwent metallization as pressure was increased further. [ABSTRACT FROM AUTHOR]

We report the results of pressure-induced semiconductor-metal phase transition of the semiconducting chalcogenide compound KPSe6 under high pressure using the ab initio methods. The ground-state energy calculations were performed within density functional theory and the generalized gradient approximation using the pseudopotential method with plane-wave basis sets. The projector augmented-wave (PAW) pseudopotentials were used in our calculation. The optimized lattice parameters were found from total energy calculations as 13 Bohr, 1.6 Bohr, and 1.8 Bohr for cell dimensions one, two, and three, respectively, which are in good agreement with experimental calculations. At zero pressure, the material portrayed a semiconducting property with a direct bandgap of ≈1.7 eV. As we subjected the material to pressure, the band gap was observed to reduce until it disappeared. The phase transition from the semiconductor to metal was found to occur at ∼45 GPa, implying that the material underwent metallization as pressure was increased further. [ABSTRACT FROM AUTHOR]

Background: Depression and diabetes mellitus are important comorbid conditions with serious health consequences. When depression and diabetes are comorbid, depression negatively affects self-management activities of diabetes with serious consequences. Relationship between treatment regimens of diabetes, the adequacy of glycemic control, and occurrence of comorbid depression is not known among our patients. Patients and methods: This was a cross-sectional descriptive study at the outpatient diabetes clinic of the Kenyatta National Hospital where 220 ambulatory patients with type 2 diabetes on follow-up were systematically sampled. Sociodemographic data and clinical information were documented. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression. Ethylenediaminetetraacetic acid-anticoagulated blood was used for glycated hemoglobin (HbA1C) assay on automated system, COBAS INTEGRA machine. Results: Two hundred twenty patients with type 2 diabetes were enrolled. The prevalence of comorbid depression by PHQ-9 was 32.3% (95% confidence interval: 26.4%-38.6%). The majority, 69.5%, had poor glycemic control, HbA1C >7.0%, mean HbA1C was 8.9%±2.4%. Half, 50.4%, of the study subjects were on insulin-containing regimens. Over 8% (84.5%) of the participants with comorbid depression had poor glycemic control, which worsened with increasing severity of depression. There was significant correlation between comorbid depression and poor glycemic control, which is more consistent in the insulin-treated patients. However, patients on oral agents only, both with and without comorbid depression, were similar in their glycemic control. Conclusion: Among our type 2 diabetic population with comorbid depression, a large proportion had poor glycemic control, which worsened with increasing severity of depression. The insulin treatment increased the odds of comorbid depression and poor glycemic control in patients. It is justifiable to screen for comorbid depression in patients with type 2 diabetes who are in poor glycemic control, especially the insulin-treated, and then provide specific and appropriate interventions that are necessary to optimize their metabolic outcomes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Health Information Systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. METHODS: information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. RESULTS: information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. CONCLUSION: the challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers.

Objectives: To determine whether gut permeability is associated with post-discharge growth and systemic inflammation among hospitalized children in low- and middle-income countries., Methods: Children aged 2-23 months being discharged from Civil Hospital Karachi (Pakistan) and Migori County Referral Hospital (Kenya) underwent lactulose-rhamnose ratio (LRR) permeability testing and were compared to age-matched children from their home communities. Linear mixed effect models estimated the associations between LRR among discharged children with change in length-for-age (LAZ) and weight-for-age z score (WAZ) at 45, 90, and 180 days after discharge. Linear regression tested if relationships between LRR, systemic inflammation [C-reative protein (CRP), Cluster of Differentiation 14 (CD14), Tumour Necrosis Factor Alpha (TNFα), Interleukin-6 (IL-6)], and enterocyte damage [Intestinal Fatty-Acid Binding protein (I-FABP)] differed between the hospitalized and community groups., Results: One hundred thirty-seven hospitalized and 84 community participants were included. The hospitalized group had higher log-LRR [0.43, 95% confidence interval (CI): 0.15-0.71, P = 0.003] than the community children. Adjustment for weight-for-length z score at discharge attenuated this association (0.31, 95% CI: 0.00-0.62, P = 0.049). LRR was not associated with changes in WAZ or LAZ in the post-discharge period. Associations between LRR and CRP (interaction P = 0.036), TNFα ( P = 0.017), CD14 ( P = 0.078), and IL-6 ( P = 0.243) differed between community and hospitalized groups. LRR was associated with TNFα ( P = 0.004) and approached significance with CD14 ( P = 0.078) and IL-6 ( P = 0.062) in community children, but there was no evidence of these associations among hospitalized children., Conclusions: Although increased enteric permeability is more prevalent among children being discharged from hospital compared to children in the community, it does not appear to be an important determinant of systemic inflammation or post-discharge growth among hospitalized children., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Background: Young adult cigarillo users often cite flavor as a primary reason for initiating and sustaining product use and are more likely to concurrently use other tobacco products such as menthol cigarettes. This study examines substitution with menthol cigarettes among cigarillo users facing a hypothetical ban on flavored cigarillos., Methods: Current young adult (21-28 years) cigarillo users were recruited from October 2020 to April 2021 for an online survey about cigarillo and other tobacco use behaviors. Participants (n = 500) self-reported past or current menthol cigarette experience, and if they would switch to menthol cigarettes if they could not get flavored cigarillos. Logistic regression was used to test differences in switching behaviors by level of experience with menthol cigarettes., Results: Most young adult cigarillo users (76.8 %) had ever used a menthol cigarette and 46.6 % reported current use of menthol cigarettes. No participant who had never used menthol cigarettes reported they would switch to menthol cigarettes. Current users were 4.2 times as likely to say they would switch after controlling for demographic characteristics and nicotine dependence., Conclusion: Most young adult cigarillo users reported they would not switch to menthol cigarettes if flavored cigarillos became unavailable. However, participants who currently use or have used menthol cigarettes were more likely to report their intention to switch products than those who had never used menthol cigarettes. There may be a subsequent increase in menthol cigarette use among past menthol cigarette users if policies restricting flavored tobacco products exclude menthol cigarettes, diluting these policies' intended population health impact., Competing Interests: Conflict of Interest The authors have no interests to declare., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Live bird markets (LBMs) provide integral hubs for 95% of poultry produced for food. Surveillance systems in LBMs serving smallholder farmers in sub-saharan Africa are often non-functional, and data about public health risks and emerging pathogens are lacking. Studies in Kenya have reported 29-44% Campylobacter prevalence in poultry. We analysed such LBMs in Kenya for likely transmission of Campylobacter from poultry to humans. We conducted a cross-sectional survey among 186 live poultry traders (LPTs) in 14 LBMs in a region with widespread backyard poultry systems. A pretested structured questionnaire was administered to all LPTs having regular contacts with poultry to gather market data and risk information on campylobacteriosis. Campylobacter was detected in individual cloacal cultures and identified through PCR. The median score obtained from the outcome of risk assessment dichotomized respondents into high and low risk categories. We performed logistic regression at 95% confidence interval (CI) to compare market characteristics and Campylobacter positivity to risk categories to identify LBM-associated public health risks. Markets had a median of 13 traders, and mean age of 46.3 ± 13.7 years. Majority 162/186 (87.1%) were males. Market behavioural processes by LPTs varied: Only 58.6% LPTs held bird species separate; onsite slaughter (38.7%); encountered sick-bird (93%) and dead-bird (83%) amidst limited health inspection (31.2%). Campylobacter positivity in live birds was 43/112 (38.4%, 95% CI: 29.4-48.1). Risk information on campylobacteriosis was low 41/114 (36%, 95% CI: 27.2-45.5). Sanitary risks were related to accumulation of litter (adjusted prevalence odds ratio [aPOR]: 19.67, 95% CI: 3.01-128.52). Accessing hand-wash facilities (aPOR: .32, 95% CI: .13-.78) and access to information (aPOR: .24, 95% CI: .09-.61) were protective. Sanitary risks were related to poor hygiene. LBMs could be central surveillance sites for Campylobacter. Public health authorities/actors should consider appropriate targeting to improve sanitary measures and Campylobacter control strategies., (© 2022 The Authors. Transboundary and Emerging Diseases published by Wiley-VCH GmbH.)

Single-use, disposable, point-of-care diagnostic devices carry great promise for global health, including meeting urgent needs for testing and diagnosis in places with limited laboratory facilities. Unfortunately, the production and disposal of single-use devices, whether in lateral flow assay, cartridges, cassettes, or lab-on-chip microfluidic format, also poses significant challenges for environmental and human health. Point-of-care devices are commonly manufactured from unsustainable polymeric materials derived from fossil sources. Their disposal often necessitates incineration to reduce infection risk, thereby creating additional release of CO 2 . Many devices also contain toxic chemicals, such as cyanide derivatives, that are damaging to environmental and human health if not disposed of safely. Yet, in the absence of government regulatory frameworks, safe and sustainable waste management for these novel medical devices is often left unaddressed. There is an urgent need to find novel solutions to avert environmental and human harm from these devices, especially in low- and middle-income countries where waste management infrastructure is often weak and where the use of point-of-care tests is projected to rise in coming years. We review here common materials used in the manufacture of single-use point-of-care diagnostic tests, examine the risks they pose to environmental and human health, and investigate replacement materials that can potentially reduce the impact of microfluidic devices on the production of harmful waste. We propose solutions available to point-of-care test developers to start embedding sustainability at an early stage in their design, and to reduce their non-renewable plastic consumption in research and product development.

We present the results of groundwater quality assessment that was done during the rainy season in November 2018 in the Manga region of Nyamira County, Kenya. Water samples were collected from three springs, Kiangoso, Kerongo, and Tetema, for the assessment. Water quality index was calculated based on pH, turbidity, nitrate, phosphate, calcium, magnesium, chloride, sulphates, fluoride, iron, total phosphorous, total hardness, total alkalinity, total dissolved solids, and total coliform. These fifteen parameters were analyzed and characterized according to standard methods and with reference to the World Health Organization and Kenya Bureau of Standards for physiochemical and bacteriological parameters which were then used in the calculation of water quality index. The water quality index was 21.32 for Kiangoso, 29.66 for Kerongo, and 25.64 for Tetema. The water quality index was found to be of excellent quality status at Kiangoso, while of good quality status at Kerongo and Tetema. The water quality index of Manga groundwater represented by the three springs therefore is less than 30 and can be used for drinking, irrigation, and industrial purpose. The present results are crucial for future management of groundwater in the Manga region., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Alice Makonjo Wekesa and Calford Otieno.)

We present results on the first principle study of the elastic constants and the phonon dispersion of EuFe 2 As 2 at zero pressure. The ground-state energy calculations were performed within Density Functional Theory (DFT) and the generalized gradient approximation using the pseudopotential method with plane-wave basis sets. The projector augmented-wave (PAW) pseudopotentials were used in our calculation. The open source code QUANTUM ESPRESSSO was used with its pseudopotential database. The study on the elastic constants at zero pressure was a clear indication that the compound is mechanically stable, and the phonon dispersion study also indicated that the compound is dynamically stable. The elastic constants and mechanical properties also led to the conclusion that the compound is ductile and anisotropic., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 N. K. Omboga et al.)

Construction sand is naturally polluted with radionuclides of terrestrial origin. In this study, specific activities of 238 U, 232 Th, and 40 K in 30 sand samples collected along the Ekalakala River, Machakos County, Kenya, were measured using a high-purity germanium γ -ray spectrometer. The specific activities ranged between 9.7 Bqkg -1 and 24.0 Bqkg -1 , 11.5 Bqkg -1 and 26.2 Bqkg -1 , and 820 Bqkg -1 and 1850 Bqkg -1 for 238 U, 232 Th, and 40 K, respectively. While the mean specific activities for 238 U and 232 Th were less than half of the world average values of 33 Bqkg -1 and 45 Bqkg -1 , respectively, the average specific activity of 40 K was significant since it was three times the global mean value of 420 Bqkg -1 . A calculated absorbed radiation dose rate for the sand varied between 46.8 nGyh -1 and 94.2 nGyh -1 with a mean of 68.5 ± 13.3 nGyh -1 . This is not significantly different from the world average dose rate of 60 nGyh -1 for geological samples. The AEDR and H ex had maximum values of 0.29 mSvy -1 and 0.52, respectively, both within the recommended limits of radiation exposure for members of the general public. Based on these results, the sand from Ekalakala River does not pose significant health implication to the sand harvesters as well as the inhabitants of the houses constructed using this sand., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Lucia Nyiva Munyao et al.)

Background: The aim of this study was to determine cultural factors associated with prostate cancer screening intent among adult Kenyan African men., Methods: A cross-sectional quantitative study with an analytic design was carried out in a randomly selected sample of 155 adult men aged 25-98 years living in a rural community in Kenya. Constructs from the Theory of Planned Behaviour were used to guide this study. A 5 -point Likert scale was used to assess fatalistic beliefs, fear, perceived benefits, and family influence. A structured questionnaire was used to collect quantitative data at the household level., Results: Only 2.4% of the study participants had been screened for prostate cancer. About 2/3rd (64%) of the participants felt that they were at risk of getting prostate cancer; 44% intended to be screened within the following 6 months. Mean scores on a 5-point Likert scale indicated: strong beliefs in the benefits of prostate screening (4.2 (±SD .8), men aged over 40 were not perceived to be at risk of getting prostate cancer (1.3 ± .6), relatively high fatalistic beliefs of prostate cancer screening (3.6 (±SD .8), high degree of fear or apprehension of prostate cancer screening (3.2 (±SD 1.2), and a high level of influence of family members in prostate cancer screening (3.9 (±SD 1.0). The Wald criterion demonstrated that only family influence made a significant contribution to the intent to screen for prostate cancer (p = 0.031). Age, education, marital status, fatalism, fear, and benefit of screening were not associated with the intent to screen for prostate cancer., Conclusions: Strong beliefs of the benefits of prostate screening tended to be surpassed by relatively high fatalistic beliefs and fear or apprehension in prostate cancer screening. The family plays an important role in influencing decision making related to prostate cancer screening in Africans.

Background: Health related quality of life (HRQOL) is increasingly being recognised as a primary outcome measure in the treatment of end stage renal disease. In addition to being an important surrogate marker of quality of care in patients on maintenance haemodialysis, HRQOL measures have being shown to be robust predictors of mortality and morbidity., Objective: To determine the health related quality of life and its determinants in patients on maintenance haemodialysis at the Kenyatta National Hospital., Design: A cross-sectional descriptive study., Setting: Renal unit, Kenyatta National Hospital., Subjects: Adult patients with end stage renal disease on maintenance haemodialysis., Results: The mean physical composite summary and mental composite summary scores were 39.09 ± 9.49 and 41.87 ± 10.56 respectively. The burden of kidney disease sub-scale, symptom and problems sub-scale and effect of kidney disease on daily life sub-scale scores were 16.15 ± 21.83, 73.46 ± 18.06 and 67.63 ± 23.45 respectively. No significant correlations were found between the health-related quality of life scores, socio-demographic and clinical factors assessed., Conclusion: The health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. No independent determinants of health-related quality of life were identified.

Introduction: The customs of widow cleansing and widow inheritance are practiced in several communities throughout sub-Saharan Africa. In the Nyanza Province of Kenya, according to tradition, Luo widows are expected to engage in sexual intercourse with a "cleanser," without the use of a condom, in order to remove the impurity ascribed to her after her husband's death. Luo couples, including widows, are also expected to engage in sex preceding specific agricultural activities, building homes, funerals, weddings, and other significant cultural and social events. Widows who are inherited for the purpose of fulfilling cultural obligation have a higher prevalence of HIV than those who remain un-inherited or are inherited for the purpose of companionship., Methods: As part of a larger descriptive qualitative study to inform study procedures for FEM-PrEP, an HIV prevention pre-exposure prophylaxis clinical trial, we conducted 15 semi-structured interviews (SSIs) with widows, 15 SSIs with inheritors, and four focus group discussions with widows in the Bondo and Rarieda districts in Nyanza Province to explore the HIV risk context within widow cleansing and inheritance practices. Thematic qualitative analysis was used to analyze the data., Results: The majority of widows reported in the demographic questionnaire being inherited, and most widows in the SSIs described participating in the cleansing ritual. We identified two main themes related to HIV prevention within the context of widow cleansing and inheritance: 1) widows must balance limiting their risk for HIV infection with meeting cultural expectations and ensuring that their livelihood needs are met, and 2) sexual abstinence undermines cultural expectations in widowhood while the use of condoms is deemed inappropriate in fulfilling culturally prescribed sexual rituals, and is often beyond the widow's ability to negotiate., Conclusions: Women-controlled HIV prevention methods such as antiretroviral-based oral pre-exposure prophylaxis, vaginal gels, and vaginal rings are needed for HIV-negative widows who engage in sexual rituals related to widowhood.

The media play a key role in forming opinions by influencing people´s understanding and perception of a topic. People gather information about topics of interest from the internet and print media, which employ various news frames to attract attention. One example of a common news frame is the human-interest frame, which emotionalizes and dramatizes information and often accentuates individual affectedness. Our study investigated effects of human-interest frames compared to a neutral-text condition with respect to perceived risk, emotions, and knowledge acquisition, and tested whether these effects can be "generalized" to common variants of the human-interest frame. Ninety-one participants read either one variant of the human-interest frame or a neutrally formulated version of a newspaper article describing the effects of invasive species in general and the Asian ladybug (an invasive species) in particular. The framing was achieved by varying the opening and concluding paragraphs (about invasive species), as well as the headline. The core text (about the Asian ladybug) was the same across all conditions. All outcome variables on framing effects referred to this common core text. We found that all versions of the human-interest frame increased perceived risk and the strength of negative emotions compared to the neutral text. Furthermore, participants in the human-interest frame condition displayed better (quantitative) learning outcomes but also biased knowledge, highlighting a potential dilemma: Human-interest frames may increase learning, but they also lead to a rather unbalanced view of the given topic on a "deeper level".

Background: Health related quality of life is increasingly being recognised as a primary outcome measure in treatment of end-stage renal disease. The health related quality of life of patients on maintenance haemodialysis is reduced. Several interventions directed at modifiable risk factors have been shown to improve quality of life of patients on haemodialysis., Objective: To assess the health-related quality of life of patients on maintenance haemodialysis at the Kenyatta National Hospital., Design: Cross sectional descriptive study., Setting: Kenyatta National Hospital, Renal Unit., Subjects: The study was conducted on 96 patients with end-stage renal disease on maintenance haemodialysis. Socio-demographic and clinical factors were recorded for all patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life-36 questionnaire. Two summary scores and three subscale scores were calculated., Results: The mean physical composite summary andmental composite summary scores were 39.09 ± 9.49 and 41.87 ± 10.56 respectively. The burden of kidney disease subscale, symptom and problems subscale and effect of kidney disease on daily life subscale scores were 16.15 ± 21.83, 73.46 ± 18.061 and 67.63 ± 23.45 respectively., Conclusion: Health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. The burden of kidney disease subscale is the most affected subscale score.