Caregiver burden and its sociodemographic determinants in family caregivers of patients with schizophrenia attending a psychiatric tertiary hospital in South Africa.

Background: Chronic mental illnesses such as schizophrenia affect patients' functioning, making caregiving necessary although burdensome. Aim: This study aimed to determine caregiver burden and its sociodemographic determinants in family caregivers of patients with schizophrenia attending a Psychiatric Outpatient Department (POD). Setting: Tertiary hospital in Northern Pretoria, South Africa. Methods: In this cross-sectional study conducted over 3 months, 300 consecutive family caregivers who attended the POD were administered a 22-item Zarit Burden Interview (ZBI-22), which has a score of 0-88, with higher values indicating more burden. Their sociodemographic characteristics were ascertained. Linear and ordinal logistic regression analyses were performed to identify determinants or predictors of total and severe burdens, respectively. Results: Most caregivers were aged 46.0 ± 14 years, females (62%), parents (39%), of low-income status (93.7%), had secondary education (70%), resided with the patient (87%), and helped with all troublesome activities (95.3%). The median ZBI-22 score was 19.0 (interquartile range: 13.0-30.5). The determinants of both total and severe burdens were: caregiver age ≥ 50 years adjusted odds ratio (aOR): 2.55, confidence interval (CI): 1.49-4.36; residential area farther away from the hospital aOR: 1.76, CI: 1.3-2.99; increasing months of caregiving aOR: 1.0, CI: 1.001-1.009, p = 0.006; and not having another family member that needs care aOR: 0.43, CI: 0.24-0.78. Conclusion: Having mental healthcare facilities close to residential areas and assisting caregivers aged ≥ 50 years who have multiple family members who need care may alleviate the burden. Contribution: Predicting total and severe caregiver burdens contemporaneously is effective for identifying potential burden interventions.

Non-conventional yeast strains: Unexploited resources for effective commercialization of second generation bioethanol.

The conventional yeast (Saccharomyces cerevisiae) is the most studied yeast and has been used in many important industrial productions, especially in bioethanol production from first generation feedstock (sugar and starchy biomass). However, for reduced cost and to avoid competition with food, second generation bioethanol, which is produced from lignocellulosic feedstock, is now being investigated. Production of second generation bioethanol involves pre-treatment and hydrolysis of lignocellulosic biomass to sugar monomers containing, amongst others, d-glucose and D-xylose. Intrinsically, S. cerevisiae strains lack the ability to ferment pentose sugars and genetic engineering of S. cerevisiae to inculcate the ability to ferment pentose sugars is ongoing to develop recombinant strains with the required stability and robustness for commercial second generation bioethanol production. Furthermore, pre-treatment of these lignocellulosic wastes leads to the release of inhibitory compounds which adversely affect the growth and fermentation by S. cerevisae. S. cerevisiae also lacks the ability to grow at high temperatures which favour Simultaneous Saccharification and Fermentation of substrates to bioethanol. There is, therefore, a need for robust yeast species which can co-ferment hexose and pentose sugars and can tolerate high temperatures and the inhibitory substances produced during pre-treatment and hydrolysis of lignocellulosic materials. Non-conventional yeast strains are potential solutions to these problems due to their abilities to ferment both hexose and pentose sugars, and tolerate high temperature and stress conditions encountered during ethanol production from lignocellulosic hydrolysate. This review highlights the limitations of the conventional yeast species and the potentials of non-conventional yeast strains in commercialization of second generation bioethanol.

Relation of hyperparathyroidism and hypercalcemia to bipolar and psychotic disorders.

Primary hyperparathyroidism (PHPT) is characterized by hypercalcemia and an elevated level of serum parathyroid hormone. PHPT leads to hypercalcemia and presents with renal, skeletal, and neuropsychiatric symptoms. Neuropsychiatric manifestations of PHPT such as psychotic, depressive, and anxiety disorders are rare. Delirium may also be present in patients with PHPT. Parathyroidectomy is the treatment of choice for patients with physically symptomatic PHPT, but it remains unclear if parathyroidectomy is indicated for its psychiatric manifestations. It is unclear if parathyroidectomy should be performed as a treatment for medication-refractory psychiatric symptoms or deferred until psychiatric symptoms have been better controlled. We present two cases of hyperparathyroidism (HPT)-associated hypercalcemia-one with lithium-associated HPT-in which psychiatric manifestations resolved with parathyroidectomy.

Cardiomyopathy and heart failure secondary to anabolic-androgen steroid abuse.

Bodybuilders often use anabolic-androgenic steroids to improve performance. We report a case of a 30-year-old male bodybuilder with anabolic-androgen steroid abuse while getting ready for a bodybuilding contest. He had New York Heart Association class IV heart failure, severe nonischemic dilated cardiomyopathy, new-onset atrial fibrillation, cardiogenic pulmonary edema, and acute respiratory distress requiring mechanical ventilation. After 6 months of heart failure guideline-directed medical therapy, cessation of anabolic steroids, and maintenance of sinus rhythm, his ejection fraction improved.

Sociodemographic and socioeconomic correlates of learning disability in preterm children in the United States.

BACKGROUND: In 2019, 1 in every 10 infants born in the United States was preterm. Prematurity has life-threatening consequences and causes a range of developmental disabilities, of which learning disability is a prevalent complication. Despite the availability of special services for children living with learning disability, gaps still exist in terms of access due to socioeconomic factors. The aim of this study is to evaluate socioeconomic and sociodemographic correlates of learning disability in preterm children. METHODS: This cross-sectional study used data from the 2016-2018 National Survey of Children's Health. Weighted multivariable analyses were conducted to ascertain the association of sociodemographic and socioeconomic factors on learning disability among preterm children. The main outcome variable was the presence of learning disability. RESULTS: Among 9555 preterm children in our study population, 1167 (12%) had learning disability. Learning disability was significantly associated with health insurance, food situation, and poverty level after adjustment for other variables. Children currently insured had lower odds of having learning disability compared to those without health insurance (OR = 0.79, 95% C.I. = 0.70-0.91). Also, children living in households that cannot afford nutritious meals are more likely to have learning disability compared to those that can afford nutritious meals at home (OR = 1.55, 95% C.I. = 1.22-1.97). CONCLUSION: These findings highlight the need for intervention efforts to target these children living with a learning disability to achieve the 2004 Individuals with Disabilities Education Act of promoting educational equality and empowerment of children living with a learning disability.

Local knowledge in inclusive education policies in Africa: informing sustainable outcomes.

BACKGROUND: This article presents on the outcomes of a study that focused on an analysis of inclusive education (IE) policies in South Africa, Ghana and Uganda. Persons with disabilities live within communities and are raised by the values that apply within their communal context. Policymaking is intricately linked to policy implementation, and the inclusion of local knowledge strengthens policy influence, impacting on implementation processes. OBJECTIVES: This research study explored the definition and foci of inclusion, whether local knowledge is included and how it is represented within the national inclusive education policy in South Africa, Ghana and Uganda. This study reports on the outcomes of the second objective on inclusion of local knowledge. METHOD: A qualitative, critical, interpretative and constructivist approach was utilised for the study. Data were gathered through a desktop review and in-depth, individual interviews. RESULTS: There is inclusion of some local knowledge within the national policies; however, this is minimal and insufficient. Participants argue that even when it is included, it is often embedded or implied, that local knowledge should be made more prominent within inclusive education policies as local knowledge is a community resource that supports policy implementation. CONCLUSION: The inclusion of local community knowledge and ways of knowing within inclusive education policies is viewed as a critical and an integral aspect of policymaking. It will help to address the challenges of stigma and negative attitudes, promoting a continuity of knowledge that supports local values and well-being of children with disabilities and their communities.

In Vivo Genotoxicity of Rice Husk Biochar on Eudrilus eugeniae in Soil.

Biochar (char-product), generated by pyrolyzing organic materials, is produced for the intended use of land application to promote carbon sequestration, soil improvement and crop-yield. Despite the benefits biochar applications offers, scientific probing on impacts that may result from amendments with biochar is still fragmented. In this study, impact of biochar on Eudrilus eugeniae DNA was investigated. Rice-husk biochar was applied to soil at rates up to 80% d/w and earthworms were exposed for 35-day. Impact on DNA was measured using electrophoresis-gel-extraction-method. Data obtained showed that biochar application over 25% resulted in decreased survival. Electrophoresis-gel-analysis showed that DNA decreased from 450 to 300 bp in biochar soils (p = 0.002). Biochar rates (5%-25%) induced DNA damage. The DNA showed smeared bands or tail; indicating DNA degradation and/or damage. DNA damage is a clear evidence of negative impact of biochar(s) to soil-biota; suggesting that loading of soil with biochar could have serious consequences on soil-fauna.

Report of high prevalence of schistosome infection in Biomphalaria snails from a geographic area with no previous prevalence of human schistosomiasis in Nigeria.

Previous study using the traditional method of screening snails for infection reported shedding of Schistosoma cercaria by Biomphalaria snails from a river in Nkalagu, southeastern Nigeria. This is contrary to published reports that Biomphalaria from this part of the country does not shed schistosome cercaria. Here, we employed the use of polymerase chain reaction (PCR) methods to screen and characterize the Biomphalaria snails from Nkalagu. Snails were collected from the River Uzuru in dry season, identified and subjected to molecular assays. Genomic DNA (gDNA) was extracted from whole tissues of the 212 Biomphalaria snails and amplified using conventional PCR to check for the schistosome infection level. Assay for the detection of S. mansoni infection was further done using a nested PCR (nPCR). We amplified the entire internal transcribed spacer 2 (ITS2) regions from gDNA of the 212 snails. The representative samples were sequenced and subjected to BLAST searches to confirm snail species. Of the 212 snails screened, 164 (77.4%) of the snails were infected with schistosomes, but only 16 (9.76%) of the snails were positive for S. mansoni infection. Amplification of the snails' ITS2 region yielded a product of 460 bp, and BLAST searches confirmed the snails to be B. pfeifferi, and BLAST searches confirmed the snails to be B. pfeifferi. This paper reports for the first time the presence of S. mansoni positive B. pfeifferi in Nkalagu, which suggest there may be cases of intestinal schistosomiasis in this part of Nigeria.

Urinary schistosomiasis in Ebonyi State, Nigeria from 2006 to 2017.

Urinary schistosomiasis, caused by Schistosoma haematobium is very common in Nigeria, with Ebonyi State implicated to have the highest prevalence in the southeastern part of the country. The aim of this review was to estimate the status of urinary schistosomiasis in the State with regards to the elimination goals of World Health Organization (WHO). A comprehensive search of published articles on urinary schistosomiasis in Ebonyi State, Nigeria from 2006 to 2017 was conducted using Google Scholar, PubMed and African Journals Online (AJOL) databases. Out of 26 retrieved articles, 15 met the inclusion criteria. The MetaXL software was used to compute the pooled prevalence of urinary schistosomiasis using the random effect model and results are presented as forest plot. Based on meta-analysis output, the pooled prevalence of urinary schistosomiasis was 26.02% [95% Confidence Interval (CI) = 17.91-35.04%]. The pooled prevalence was higher before 2014, the year when treatment with praziquantel (PZQ) was started. Of the senatorial zones, Ebonyi North had the highest pooled prevalence of 34.57% (95% CI = 10.50-61.32%). In addition, the prevalence of the disease was higher when all the age groups were sampled (31.33%; 95% CI = 12.75-51.98%) than when only schoolchildren were used as sampling population (25.23%; 95% CI = 15.66-35.93%). The pooled prevalence revealed that despite the mass drug distribution (MDA) of PZQ in the State, there is continued transmission of urinary schistosomiasis. Hence, if the WHO elimination goal of the disease has to be met, focused control and elimination programmes along with intense complementary public-health interventions are necessary.

Filifactor alocis collagenase can modulate apoptosis of normal oral keratinocytes.

To successfully colonize host cells, pathogenic bacteria must circumvent the host's structural barrier such as the collagen-rich extracellular matrix (ECM), as a preliminary step to invasion and colonization of the periodontal tissue. Filifactor alocis possesses a putative Peptidase U32 family protein (HMPREF0389_00504) with collagenase activity that may play a significant role in colonization of host tissue during periodontitis by breaking down collagen into peptides and disruption of the host cell. Domain architecture of the HMPREF0389_00504 protein predicted the presence of a characteristic PrtC-like collagenase domain, and a peptidase domain. Our study demonstrated that the recombinant F. alocis peptidase U32 protein (designated PrtFAC) can interact with, and degrade, type I collagen, heat-denatured collagen and gelatin in a calcium-dependent manner. PrtFAC decreased viability and induced apoptosis of normal oral keratinocytes (NOKs) in a time and dose-dependent manner. Transcriptome analysis of NOK cells treated with PrtFAC showed an upregulation of the genes encoding human pro-apoptotic proteins: Apoptotic peptidase activating factor 1 (Apaf1) cytochrome C, as well as caspase 3 and caspase 9, suggesting the involvement of the mitochondrial apoptotic pathway. There was a significant increase in caspase 3/7 activity in NOK cells treated with PrtFAC. Taken together, these findings suggest that F. alocis PrtFAC protein may play a role in the virulence and pathogenesis of F. alocis.

The Association Between Body Mass Index and Presenting Symptoms in African American Women with Ovarian Cancer.

BACKGROUND: Ovarian cancer, the most lethal gynecologic malignancy, typically comes to clinical attention due to nonspecific gastrointestinal or pelvic symptoms. African Americans with ovarian cancer have a greater mortality burden than whites and are also much more likely to be obese. The objective of this study is to explore whether the presentation and duration of symptoms differ by body mass index (BMI) in African Americans with ovarian cancer. METHODS: We conducted a case-only analysis using data from a multicenter population-based study of invasive epithelial ovarian cancer in African American women. Information on risk factors and symptoms leading to diagnosis was obtained in a telephone interview. Frequency and duration of symptoms by BMI categories were compared using logistic regression and linear regression analyses. RESULTS: Of the 326 women, ∼60% was obese (BMI ≥30), with 30.8% having a BMI ≥35 kg/m(2). Ninety-four percent of women reported ≥1 symptom during the year before diagnosis. We observed differences in frequency of symptoms by BMI categories, with most being reported more frequently by the heaviest women. The reported duration of symptoms was longer in women with higher BMI, with statistically significant trend tests for 6 of the 10 symptoms evaluated. CONCLUSION: BMI appears to impact ovarian cancer symptomatology. Women with higher BMI report having symptoms for a longer period of time before diagnosis of ovarian cancer. Healthcare providers should be vigilant and consider ovarian cancer in the differential diagnosis for obese women presenting with abdominal and pelvic symptoms.

Filifactor alocis: The Newly Discovered Kid on the Block with Special Talents.

Infection-induced periodontal disease has been primarily focused on a small group of periodontal pathogens. A paradigm shift, based on data emerging from the oral microbiome project, now suggests the involvement of as-yet-unculturable and fastidious organisms. Collectively, these studies have demonstrated that there are changes in the periodontal status associated with shifts in the composition of the bacterial community in the periodontal pocket. In addition, it is likely that the emerging new pathogens may play a more significant role in the disease. One of the organisms previously unrecognized is Filifactor alocis. While this Gram-positive anaerobic rod has been identified in peri-implantitis, in endodontic infections, and in patients with localized aggressive periodontitis, its presence is now observed at significantly higher levels in patients with adult periodontitis or refractory periodontitis. Its colonization properties and its potential virulence attributes support the proposal that F. alocis should be included as a diagnostic indicator of periodontal disease. Moreover, these emerging characteristics would be consistent with the polymicrobial synergy and dysbiosis (PSD) periodontal pathogenesis model. Here, unique characteristics of F. alocis are discussed. F. alocis has specific factors that can modulate multiple changes in the microbial community and host cell proteome. It is likely that such variations at the molecular level are responsible for the functional changes required to mediate the pathogenic process.