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Public Health Action Jun 2024To identify individual-level early warning indicators of virologic failure in HIV patients receiving antiretroviral therapy (ART) in South Africa.
OBJECTIVE
To identify individual-level early warning indicators of virologic failure in HIV patients receiving antiretroviral therapy (ART) in South Africa.
DESIGN
A matched case-control study of individuals with and without virologic failure (VF) (>5 months on ART and HIV-1 plasma viral load >1,000 copies/mL) was conducted between June 2014 and June 2018. Of the 1,000 participants enrolled in the parent cohort, 96 experienced VF, and 199 additional controls were identified from the parent cohort and matched 1:2 (some matched 1:3) for sex, age, ART duration, and site. Participants were interviewed while clinical, pharmacy refill, laboratory, and objective pharmacological data were obtained. Multivariate conditional logistic regression models were constructed using model selection to identify factors associated with VF. Significant determinants of VF were identified using an alpha level of 0.05.
RESULTS
In a full conditional model, higher cumulative ART adherence, quantified using tenofovir-diphosphate concentrations in dried blood spots (OR 0.26) and medication possession ratio (OR 0.98) were protective against VF, whereas an increase in total depression score (OR 1.20) was predictive of VF.
CONCLUSION
This analysis demonstrates the importance of depression as a key individual-level early warning indicator of VF. Efforts to address mental health concerns among patients with people living with HIV could improve virologic suppression.
PubMed: 38957503
DOI: 10.5588/pha.24.0017 -
Ethiopian Journal of Health Sciences Jan 2024Children with disability have a risk of poor dental health because of their mental and physical limitations. They depend on caregivers in their daily life Parents have... (Observational Study)
Observational Study
BACKGROUND
Children with disability have a risk of poor dental health because of their mental and physical limitations. They depend on caregivers in their daily life Parents have an important role in maintaining children's dental health. Parents attitudes can be influenced by parents' perceptions of children's dental health. This study explored parental perceptions regarding the dental and oral health of children with special needs in Bandung City.
METHODS
This study utilized a descriptive observational research using a cross-sectional survey. The subjects in this study were 239 parents who had children aged 0-18 years who were taken from 9 special schools. The variables of this study were parents' perceptions and the dental and oral health status of children with disability. Primary data were obtained through a validated questionnaire.
RESULTS
Parents' perceptions of the dental and oral health of children with disability consists of 84.94% good enough perceptions, 12.13% good perceptions, and 2.93% bad perceptions.
CONCLUSION
Most parents have a fairly good perception of the dental and oral health of children with special needs.
Topics: Humans; Parents; Oral Health; Child; Female; Male; Child, Preschool; Cross-Sectional Studies; Disabled Children; Adolescent; Infant; Surveys and Questionnaires; Adult; Health Knowledge, Attitudes, Practice; Infant, Newborn; Perception
PubMed: 38957342
DOI: 10.4314/ejhs.v34i1.8 -
Ethiopian Journal of Health Sciences Jan 2024Children's growth is increasingly considered a key mediator of later life outcomes. When examining weight growth, the correlation between repeated observations on the...
BACKGROUND
Children's growth is increasingly considered a key mediator of later life outcomes. When examining weight growth, the correlation between repeated observations on the same subject must be regarded as well-modelled. This study aimed to analyze children's weight growth variations and associated factors in Ethiopia, India, Peru, and Vietnam using a fractional polynomial mixed-effects model.
METHODS
This study used longitudinal data from the Young Lives Cohort Study conducted from 2002 to 2016 in Ethiopia, India, Peru, and Vietnam. The study included 7,140 children of 1 to 15 years old A fractional polynomial mixed-effects model was used to analyze the data.
RESULTS
Ethiopian, Peruvian, and Vietnamese children had significantly higher average body weights than children in India (1.426, P<0.001; 1.992, P<0.001; 1.334, P<0.001, respectively). Girl children's average body weight was significantly 0.15 times less than that of boys (-0.148; P=0.027). The average weight of rural children was significantly 0.671 times less than that of urban children (0.671, P<0.001). Children from Peru and Vietnam had higher rates of weight change than those from India. However, the rate of weight change was lower in Ethiopian children than in Indian children. Children from urban areas had a significantly higher rate of weight gain than those from rural areas.
CONCLUSION
Country, sex, residence, parental education, household size, wealth, good drinking water, and reliable power affected children's longitudinal weight growth. Therefore, WHO and the nation's health ministry should monitor children's weight growth status and these associated factors to plan future action.
Topics: Humans; Ethiopia; Vietnam; Peru; Male; Female; Child; India; Child, Preschool; Adolescent; Infant; Rural Population; Body Weight; Longitudinal Studies; Urban Population; Child Development; Weight Gain; Cohort Studies
PubMed: 38957340
DOI: 10.4314/ejhs.v34i1.4 -
Ethiopian Journal of Health Sciences Jan 2024The Antenatal Care (ANC) Center is a conventional facility that caters for the prenatal healthcare needs of expectant mothers and ensures proper management by healthcare...
BACKGROUND
The Antenatal Care (ANC) Center is a conventional facility that caters for the prenatal healthcare needs of expectant mothers and ensures proper management by healthcare professionals; however, expectant mothers seek healthcare support from other sources. This study aimed to examine the utilization of social media for healthcare information among expectant mothers in the capital city of Ghana and explore the factors that influence its adoption.
METHOD
This study employed a non-experimental survey design. The study used a questionnaire to gather data from expectant mothers. Using 580 valid responses, SmartPLS structural equation modeling (SEM) was used to analyze the study model.
RESULTS
The study findings demonstrated the significant influence of performance expectancy of social media (PESM) and facilitating conditions of social media (FCSM) on social media healthcare information usage (SMHLU). The results also revealed that emotional support on social media and perceived vulnerability were influential factors that shaped expectant mothers' choices to use social media for healthcare information. However, the study showed that perceived severity and the relative advantage of social media had no significant effects on SMHIU. Interestingly, FCSM was found to be significantly associated with PESM, emphasizing that social media support enhances performance expectancy.
CONCLUSION
This study showed that information is important to expectant mothers, which compels them to seek digital healthcare. With these findings, healthcare providers can incorporate digital health services into their ANC service to support women during pregnancy.
Topics: Humans; Female; Social Media; Ghana; Pregnancy; Prenatal Care; Adult; Young Adult; Surveys and Questionnaires; Mothers; Information Seeking Behavior; Patient Acceptance of Health Care; Social Support; Adolescent
PubMed: 38957339
DOI: 10.4314/ejhs.v34i1.6 -
Ghana Medical Journal Mar 2024Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However,...
OBJECTIVE
Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However, associated ethico-legal challenges have not received the needed policy attention. This study explored the legal and ethical challenges of ART practice in Ghana.
DESIGN
The study employed an exploratory phenomenological approach to examine ART in Ghana, focusing on ethics and law governing this practice.
PARTICIPANTS
Respondents were ART practitioners, managers, facility owners, representatives of surrogacy/gamete donor agencies, and regulatory body representatives.
METHODS
A semi-structured interview guide was used to collect data.The in-depth interviews were audiotaped, and responses transcribed for analysis through coding, followed by generation of themes and sub-themes, supported with direct quotes.
RESULTS
It emerged that there are no ethical and legal frameworks for ART practice in Ghana, and this adversely affects ART practice. Ethical challenges identified border on informed consent, clients' privacy and clinical data protection, gamete donation issues, multiple gestations, single parenting, and social and religious issues. The legal challenges identified include the non-existence of a legal regime for regulating ART practice and the absence of a professional body with clear-cut guidelines on ART practice. In the absence of legal and ethical frameworks in Ghana, practitioners intimated they do comply with internationally accepted principles and general ethics in medical practice.
CONCLUSION
There are no regulations on ART in Ghana. Legal and ethical guidelines are essential to the provision of safe and successful ART practices to protect providers and users. Governmental efforts to regulate Ghana need to be prioritized.
FUNDING
This study had no external funding support. It was funded privately from researchers' contributions.
Topics: Humans; Ghana; Reproductive Techniques, Assisted; Female; Informed Consent; Male; Interviews as Topic; Pregnancy; Infertility; Qualitative Research
PubMed: 38957285
DOI: 10.4314/gmj.v58i1.11 -
Ghana Medical Journal Mar 2024To explore factors associated with adolescents' sexual and reproductive health (SRH) knowledge and their engagement with educational and clinical services.
OBJECTIVE
To explore factors associated with adolescents' sexual and reproductive health (SRH) knowledge and their engagement with educational and clinical services.
DESIGN
Regression analysis of secondary data collected during a community survey.
SETTING
Adaklu district, Volta Region, Ghana.
PARTICIPANTS
221 adolescent caregiver pairs.
MAIN OUTCOME MEASURES
The study employed three main outcome measures: (1) adolescents' level of SRH knowledge (assessed via questionnaire), (2) membership in district-sponsored adolescent health clubs (AHCs), and (3) ever-utilization of clinical SRH services.
RESULTS
Greater SRH knowledge was significantly associated with older age, AHC membership, and relying primarily on teachers or friends for SRH information. Increased odds of AHC membership were observed among females (AOR = 2.38, 95% CI 1.14-4.95); those who had communicated with one parent about sexual issues (OR 2.70, 95% CI 1.17-6.21); and those with a history of transactional sex (OR 5.53, 95% CI 1.04-29.37). Decreased odds were observed among adolescents whose caregivers were educated to the primary level (AOR = 0.24, 95% CI = 0.07-0.79). Overall, utilization of clinical SRH services was low, but higher odds were detected among individuals reporting a history of forced sex (AOR = 117.07, 95% CI 3.82-3588.52) and those who had discussed sexual issues with both of their parents (AOR = 13.11, 95% CI 1.85-92.93).
CONCLUSIONS
Awareness of the predictors of knowledge, AHC involvement, and clinical service utilization can empower adolescent SRH initiatives-both present and future-to enhance their teaching, develop targeted outreach to underserved groups, and promote engagement with key clinical resources.
FUNDING
This work has been supported by grants from the International Development Research Centre [108936] (IDRC), Canada.
Topics: Humans; Adolescent; Ghana; Female; Male; Health Knowledge, Attitudes, Practice; Sexual Health; Reproductive Health; Surveys and Questionnaires; Reproductive Health Services; Sexual Behavior; Patient Acceptance of Health Care; Young Adult; Cross-Sectional Studies
PubMed: 38957278
DOI: 10.4314/gmj.v58i1.9 -
Organic & Biomolecular Chemistry Jul 2024We describe the synthesis of two tetra-α aryl-extended calix[4]pyrroles (C[4]Ps) 4a-b bearing four terminal carboxylic groups in their -propyl chains defining the lower...
We describe the synthesis of two tetra-α aryl-extended calix[4]pyrroles (C[4]Ps) 4a-b bearing four terminal carboxylic groups in their -propyl chains defining the lower rims. The synthesized C[4]Ps became soluble (1-3 mM) in water at pD = 10. We probed the interaction of 4a towards tetra-methylammonium (G1) chloride in water using H NMR spectroscopy. The C[4]P 4a includes G1 in the shallow aromatic cavity defined by the pyrrole rings in cone conformation forming a 1 : 1 complex G1⊂4a. Pyridine--oxide (PNO) binding in the larger polar aromatic cavity of 4a results in the quantitative self-assembly of the supramolecular receptor PNO@4a featuring the pyrrole rings preorganized in cone conformation. The PNO@4a receptor displays improved binding properties towards G1 than the parent C[4]P 4a. We thermodynamically characterized (H NMR titrations and ITC experiments) the 1 : 1 complexes of PNO@4a with a series of tetra-alkylammonium salts, including biologically relevant examples. The PNO@4a supramolecular receptor displays significant affinity (log = 3-4) but lacks selectivity in water binding of methyl trialkyl ammonium cations. Cation-π and coulombic interactions are the main intermolecular forces stabilizing the complexes. We also performed DFT calculations to gain some insights into the complexes' structures.
PubMed: 38957010
DOI: 10.1039/d4ob00843j -
Molecular Pharmaceutics Jul 2024Nalbuphine (NAL) is a κ-agonist/μ-antagonist opioid being developed as an oral extended formulation (ER) for the treatment of chronic cough in idiopathic pulmonary...
Nalbuphine (NAL) is a κ-agonist/μ-antagonist opioid being developed as an oral extended formulation (ER) for the treatment of chronic cough in idiopathic pulmonary fibrosis and itch in prurigo nodularis. NAL is extensively glucuronidated and likely undergoes enterohepatic recirculation (EHR). The purpose of this work is to develop pharmacokinetic models for NAL absorption and enterohepatic recirculation (EHR). Clinical pharmacokinetic (PK) data sets in healthy subjects from three trials that included IV, oral solution, and ER tablets in fed and fasted state and two published trials were used to parametrize a novel partial differential equation (PDE)-based model, termed "PDE-EHR" model. Experimental inputs included in vitro dissolution and permeability data. The model incorporates a continuous intestinal absorption framework, explicit liver and gall bladder compartments, and compartments for systemic drug disposition. The model was fully PDE-based with well-stirred compartments achieved by rapid diffusion. The PDE-EHR model accurately reproduces NAL concentration-time profiles for all clinical data sets. NAL disposition simulations required inclusion of both parent and glucuronide recirculation. Inclusion of intestinal P-glycoprotein efflux in the simulations suggests that NAL is not expected to be a victim or perpetrator of P-glycoprotein-mediated drug interactions. The PDE-EHR model is a novel tool to predict EHR and food/formulation effects on drug PK. The results strongly suggest that even intravenous dosing studies be conducted in fasted subjects when EHR is suspected. The modeling effort is expected to aid in improved prediction of dosing regimens and drug disposition in patient populations.
PubMed: 38956965
DOI: 10.1021/acs.molpharmaceut.4c00424 -
International Journal of Occupational... Jul 2024Lobstering industry workers are known to have poor overall health and low safety records, but there is still a gap in information concerning Canadian lobster fishers....
Lobstering industry workers are known to have poor overall health and low safety records, but there is still a gap in information concerning Canadian lobster fishers. This study aimed to report occupational health and safety characteristics of an Atlantic Canada community of lobster fishers and to assess differences between captains and deckhands. Twenty-eight participants (10 captains, 18 deckhands) were questioned and self-reported on lifestyle, general health status, work-related musculoskeletal disorders and traumatic injuries. The data collected reveal both groups' high prevalence of cardiometabolic and musculoskeletal health issues. Captains reported more occupational exposition and health issues, and showed poorer lifestyle habits than deckhands. Fishers reported potential solutions to reduce occupational risks, presented as three types: lifestyle, working behaviours and leadership. This study evaluated a community of Canadian lobster fishers regarding their occupational health and safety. Potential avenues for mitigating occupational risk specific to this community will nurture future implementation.
PubMed: 38956927
DOI: 10.1080/10803548.2024.2366634 -
Molecular Plant Jul 2024The discovery of a wild abortive-type cytoplasmic male sterile line and the breeding of its restorer line have led to the commercialization of three-line hybrid rice,...
The discovery of a wild abortive-type cytoplasmic male sterile line and the breeding of its restorer line have led to the commercialization of three-line hybrid rice, which has contributed greatly to global food security. However, the molecular mechanisms underlying fertility abortion and the restoration of wild abortive-type cytoplasmic male sterile lines largely remain elusive. In this study, we cloned a restorer gene, Rf20, following a genome-wide association study analysis of the core parent lines of three-line hybrid rice. We found that Rf20 was present in all core parental lines, but different haplotypes and structural variants of its gene resulted in differences in Rf20 expression levels between sterile and restored lines. Rf20 could restore fertility in the wild abortive-type cytoplasmic male sterile line and was found to be responsible for fertility restoration in some cytoplasmic male sterile lines under high temperature. In addition, we found that Rf20 encodes a pentatricopeptide repeat protein that competes with WA352 for binding with COX11. This interaction enhances COX11's function as a scavenger of reactive oxygen species, which in turn restores pollen fertility. In this study, a new model of pentatricopeptide repeat proteins involved in the fertility recovery of cytoplasmic male sterile lines was proposed, which provides an important theoretical basis for the breeding of strong restorer lines and for overcoming high-temperature fertility recovery of some three-line sterile lines.
PubMed: 38956872
DOI: 10.1016/j.molp.2024.07.001