Candida auris: A Systematic Review of a Globally Emerging Fungal Pathogen in Africa.

Candida auris is a World Health Organization critical priority fungal pathogen. We conducted a systematic review to describe its epidemiology in Africa. PubMed and Google scholar databases were searched between January 2009 and September 2023 for clinical studies on C. auris cases and/or isolates from Africa. Reviews were excluded. We included 19 studies, involving at least 2529 cases from 6 African countries with the most, 2372 (93.8%), reported from South Africa. Whole-genome sequencing of 127 isolates identified 100 (78.7%) as clade III. Among 527 isolates, 481 (91.3%) were resistant to fluconazole, 108 (20.5%) to amphotericin B, and 9 (1.7%) to micafungin. Ninety of 211 (42.7%) patients with clinical outcomes died. C. auris is associated with high mortality and antifungal resistance, yet this critical pathogen remains underreported in Africa. Collaborative surveillance, fungal diagnostics, antifungals, and sustainable infection control practices are urgently needed for containment.

Prevalence of Chronic Pulmonary Aspergillosis in Two (2) Tuberculosis Treatment Clinics in Lagos, Nigeria: A Prospective Longitudinal Study.

Background: Chronic pulmonary aspergillosis (CPA) is an underrecognized but common complication of pulmonary tuberculosis. In Nigeria, a tuberculosis-endemic country, there is currently no provision to monitor the development of CPA in patients treated for tuberculosis. This study determined the prevalence and incidence of CPA in Lagos, Nigeria. Methods: A prospective longitudinal study of patients with previously managed tuberculosis was conducted between June 2021 and May 2022. The study cohorts were assessed at 3-month intervals, and the following were collected: sociodemographic data, chest radiographic findings, sputum samples for fungal culture, and venous blood samples for Aspergillus immunoglobulin G estimation. CPA cases were determined using the case definition for resource-constrained countries. Descriptive and inferential statistics were used, and significance was set at a probability of 5% (P < .05). Results: Of the 141 patients recruited, 79 (56.0%) were in the retreatment and 62 (44.0%) in the posttreatment tuberculosis group. The median age (interquartile range) was 40 (30-52) years, with a male-to-female ratio of 1.1:1. Ninety-seven patients (69%) had a GeneXpert test done, of whom 63 (64.9%) were GeneXpert negative. Cough was the most common symptom, with 15 (11%) patients having hemoptysis. The rate of CPA increased steadily as the study progressed: 44 (31.2%) at commencement, 45 (34.9%) at 3 months, 49 (42.6%) at 6 months, and 51 (54.3%) at 9 months. Thus, the overall prevalence of CPA was 49.7%, and the incidence was 6.1%. Conclusions: CPA is common in Nigeria and its true burden may still be underestimated. Increased awareness of CPA as a posttuberculosis lung disease is advocated. Evaluation for CPA should be incorporated in patients' work-up for tuberculosis.

Development of an Automated Ultrasound Signal Indicator of Lung Interstitial Syndrome.

OBJECTIVES: The number and distribution of lung ultrasound (LUS) imaging artifacts termed B-lines correlate with the presence of acute lung disease such as infection, acute respiratory distress syndrome (ARDS), and pulmonary edema. Detection and interpretation of B-lines require dedicated training and is machine and operator-dependent. The goal of this study was to identify radio frequency (RF) signal features associated with B-lines in a cohort of patients with cardiogenic pulmonary edema. A quantitative signal indicator could then be used in a single-element, non-imaging, wearable, automated lung ultrasound sensor (LUSS) for continuous hands-free monitoring of lung fluid. METHODS: In this prospective study a 10-zone LUS exam was performed in 16 participants, including 12 patients admitted with acute cardiogenic pulmonary edema (mean age 60 ± 12 years) and 4 healthy controls (mean age 44 ± 21). Overall,160 individual LUS video clips were recorded. The LUS exams were performed with a phased array probe driven by an open-platform ultrasound system with simultaneous RF signal collection. RF data were analyzed offline for candidate B-line indicators based on signal amplitude, temporal variability, and frequency spectrum; blinded independent review of LUS images for the presence or absence of B-lines served as ground truth. Predictive performance of the signal indicators was determined with receiving operator characteristic (ROC) analysis with k-fold cross-validation. RESULTS: Two RF signal features-temporal variability of signal amplitude at large depths and at the pleural line-were strongly associated with B-line presence. The sensitivity and specificity of a combinatorial indicator were 93.2 and 58.5%, respectively, with cross-validated area under the ROC curve (AUC) of 0.91 (95% CI = 0.80-0.94). CONCLUSION: A combinatorial signal indicator for use with single-element non-imaging LUSS was developed to facilitate continuous monitoring of lung fluid in patients with respiratory illness.

Comparative Study of Histotripsy Pulse Parameters Used to Inactivate Escherichia coli in Suspension.

OBJECTIVE: Bacterial loads can be effectively reduced using cavitation-mediated focused ultrasound, or histotripsy. In this study, gram-negative bacteria (Escherichia coli) in suspension were used as model bacteria to evaluate the effectiveness of two regimens of histotripsy treatments: cavitation histotripsy (CH) and boiling histotripsy (BH). METHODS: Ten-milliliter volumes of Escherichia coli were treated at different negative focal pressure amplitudes and over time periods up to 40 min. Cavitation activity was characterized with coaxial passive cavitation detection (PCD) and synchronized plane wave B-mode imaging. RESULTS: CH treatments exhibited a threshold behavior that was consistent with PCD metrics of cavitation. Above the threshold, bacterial inactivation followed a monotonically increasing log-linear relationship that indicated an exponential inactivation rate. BH exhibited no threshold, but instead followed a different monotonically increasing inactivation rate. Inactivation rates were larger for BH at or below the CH threshold, and larger for CH substantially above the threshold. CH studies performed at different pulse lengths at the same duty cycle had similar inactivation rates, suggesting that at any given pressure amplitude, the "on time" was the most important variable for inactivating E. coli. The maximum inactivation was produced by CH at the highest pressure amplitudes used, leading to a log reduction >4.2 for a 40 min treatment. CONCLUSION: The results of this study suggest that both CH and BH can be used to inactivate E. coli in suspension, with the optimal regimen depending on the attainable peak negative focal pressure at the target.

Mucormycosis in Africa: Epidemiology, diagnosis and treatment outcomes.

Mucorales fungi cause mucormycosis, an invasive and rapidly progressive disease which increasingly affects mostly immunocompromised but also immunocompetent individuals. The objective of this study was to highlight the epidemiology, diagnostic modalities, treatment and overall survival of mucormycosis in Africa. We searched for relevant publications in PubMed, Google Scholar and African Journal Online databases covering the period 1960-2022. A total of 147 articles were identified, of which 66 were included in the review, detailing 408 individual cases from 12 African countries; 330 (80.9%) from North Africa, 63 (15.4%) from Southern Africa, seven (1.7%) from East Africa, seven (1.7%) from West Africa and a single case (0.2%) from Central Africa. The most frequently described clinical forms were rhino-orbital-cerebral (n = 307, 75.2%) and gastrointestinal (n = 51, 12.5%). Diabetes mellitus, COVID-19, malignancies and neutropaenia were the commonest underlying risks in 203 (49.8%), 101 (24.8%), 65 (15.9%) and 53 (13.0%) cases respectively. Most cases, 296 (72.5%) were diagnosed by histopathology. Fungal aetiology was identified in 38 (9.3%), of which the commonest was Rhizopus oryzae/arrhizus (27/38, 71.1%). Of the 408 cases, 334 (81.9%) patients received antifungal therapy, while 244 (59.8%) had surgery. In cases with a specified outcome, survival rate was 59.1% (228/386). Based on case reporting, a substantial burden of mucormycosis occurs in North Africa but the disease is rarely reported in most of the sub-Saharan region. Establishing a comprehensive registry for standardised data collection could improve understanding of the epidemiology of mucormycosis in the region.

A multicenter survey of asymptomatic cryptococcal antigenemia among patients with advanced HIV disease in Nigeria.

As of 2018, cryptococcal antigen (CrAg) screening in patients with advanced human immunodeficiency virus (HIV) disease (AHD) was not routinely implemented in Nigeria despite being recommended in the national HIV treatment guidelines. Our aim was to determine the prevalence and risk factors for asymptomatic cryptococcal antigenemia in adult people living with HIV (PLHIV) in Nigeria to advocate for the implementation of routine CrAg screening. A descriptive cross-sectional study and CrAg screening of consecutive adult PLHIV with CD4 counts ≤200 cells/µL was conducted from April 2018 to April 2019 at HIV clinics in eleven tertiary hospitals spread across Nigeria's six geopolitical regions. Prevalence of asymptomatic cryptococcal antigenemia was estimated by facility and geopolitical zone. Logistic regression was conducted to identify risk factors for cryptococcal antigenemia. In total, 1,114 patients with AHD were screened. The overall prevalence of asymptomatic cryptococcal antigenemia was 3.9% with wide variation across facilities (range: 0/75 [0%]- 15/122 [12.3%]) and geopolitical zones (range: 0/75 [0%]-19/279 [6.8%]). Prevalence of antigenemia was highest in the South-West (19/279 [6.8%]) and lowest in the North-East (0/75 [0%]). Prevalence was 5.2% (26/512) and 3.2% (18/561) in patients with CD4<100 and CD4 of 101-200, respectively. Of all patients with antigenemia, 50% were on antiretroviral therapy (ART) at the time of having a positive CrAg test. In adjusted analysis, cryptococcal antigenemia was significantly less in patients on ART and patients who had completed any formal education. The survey showed a high overall burden of cryptococcal antigenemia in Nigeria, with variable prevalence across geopolitical regions. We provided valuable evidence for implementing routine CrAg screening of AHD patients in Nigeria which has commenced in selected centres.

Suicide attempts among students of higher education, Nelson Mandela Bay Municipality, South Africa.

BACKGROUND: Worldwide, death by suicide is a leading cause of death among young people, and students of higher educational institutions constitute a vulnerable group. This study aimed to determine the lifetime prevalence and associated factors of suicide attempt among students of a higher education institution in Nelson Mandela Municipality. METHODS: A cross sectional study was conducted among students of East Cape Midland College in Nelson Mandela Municipality. The participants were selected by stratified random sampling and a standardised self-administered questionnaire was used to collect data. RESULTS: The prevalence of lifetime suicide attempts was 16.0% among the participants. Multivariate logistic regression analysis revealed higher odds of suicide attempts among participants who: experienced bullying (OR: 1.66, CI: 1.05-2.61; p  0.001), had underlying medical conditions (OR: 3.27, CI: 2.08-5.14; p  0.001), had abnormal body weight perceptions (OR: 1.64, CI: 1.03-2.62; p  0.05), had experienced sexual abuse (OR: 5.72, CI: 2.86-11.45; p  0.001), or had someone very close who had experienced sexual abuse (OR: 1.77, CI: 1.02-3.05; p  0.05). CONCLUSION: This study identified history of sexual abuse, bullying, perceptions of abnormal body weight and underlying medical conditions as associated risk factors of suicide attempts among the participants. The high prevalence of suicide attempts among the participants (16%) demonstrates the urgent need for campus-based interventions and prevention strategies aimed at addressing the identified associated factors.

Invasive Fungal Diseases in Africa: A Critical Literature Review.

Invasive fungal diseases (IFDs) are of huge concern in resource-limited settings, particularly in Africa, due to the unavailability of diagnostic armamentarium for IFDs, thus making definitive diagnosis challenging. IFDs have non-specific systemic manifestations overlapping with more frequent illnesses, such as tuberculosis, HIV, and HIV-related opportunistic infections and malignancies. Consequently, IFDs are often undiagnosed or misdiagnosed. We critically reviewed the available literature on IFDs in Africa to provide a better understanding of their epidemiology, disease burden to guide future research and interventions. Cryptococcosis is the most encountered IFD in Africa, accounting for most of the HIV-related deaths in sub-Saharan Africa. Invasive aspergillosis, though somewhat underdiagnosed and/or misdiagnosed as tuberculosis, is increasingly being reported with a similar predilection towards people living with HIV. More cases of histoplasmosis are also being reported with recent epidemiological studies, particularly from Western Africa, showing high prevalence rates amongst presumptive tuberculosis patients and patients living with HIV. The burden of pneumocystis pneumonia has reduced significantly probably due to increased uptake of anti-retroviral therapy among people living with HIV both in Africa, and globally. Mucormycosis, talaromycosis, emergomycosis, blastomycosis, and coccidiomycosis have also been reported but with very few studies from the literature. The emergence of resistance to most of the available antifungal drugs in Africa is yet of huge concern as reported in other regions. IFDs in Africa is much more common than it appears and contributes significantly to morbidity and mortality. Huge investment is needed to drive awareness and fungi related research especially in diagnostics and antifungal therapy.

Chronic cavitary pulmonary aspergillosis in an immunocompetent child.

Chronic pulmonary aspergillosis (CPA) is a progressive and destructive disease of the lung parenchyma. We report a 9-year-old boy diagnosed with CPA with a positive Aspergillus IgG and chest imaging of cavitary lung lesions. He was treated with oral Itraconazole with significant improvement. This shows that an index of suspicion should be heightened in the paediatric population with cavitary lung lesions because not all cavitary lung lesions are caused by Mycobacterium tuberculosis.

Relationship between placenta location and adverse pregnancy outcomes in a nigerian tertiary health facility.

Background: There is evidence that placenta site location might be associated with some adverse maternal and fetal outcomes, however, there is lack of information on this observation in Nigeria and many other developing countries where routine ultrasound is performed as part of antenatal care. Aim: To determine the relationship between placenta location on ultrasonography and adverse pregnancy outcomes among a cohort of women with singleton pregnancies. Materials and Methods: In a longitudinal study among pregnant women from the antenatal clinic of a tertiary health institution in Nigeria. The demographic, clinical parameters, the ultrasonographic placenta location, and pregnancy outcomes of women followed until delivery, or pregnancy termination were documented and analyzed; P > 0.05 was statistically significant. Result: One hundred and fifty singleton pregnant women (43 high risk and 107 normal gestations) were studied. The placenta location was anterior in 72 (48%), posterior in 59 (39.3%), fundal in 10 (6.7%) and lateral in 9 (6.0%) cases. Pregnancies with fundal placenta 8/10 (80%) had more preterm birth compared to 23/72 (31.9%), 11/59 (18.6%) and 2/9 (22.2%) that had anterior, posterior and lateral placenta (P = 0.001) respectively. The mean gestational age (GA) at delivery in those with fundal (34.0 ± 3.9 weeks), anterior (37.0 ± 2.7 weeks), lateral (37.7 ± 1.8 weeks), and posterior placenta (37.7 ± 1.8 weeks) was significantly different P < 0.001. In addition, there was a significant difference in the mean birth weight at delivery in women with fundal (2.09 ± 0.99 kg), anterior (2.84 ± 0.7 kg), posterior (3.0 ± 0.65 kg) and lateral placenta (3.0 ± 0.65 kg) respectively P = 0.002. Conclusion: This study showed that placenta location by ultrasound may be associated with some adverse pregnancy outcomes. The placenta located in the fundus was more likely to be associated with preterm birth and prematurity.

Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management.

Fungal infections commonly present with myriad symptoms that mimic other clinical entities, notable amongst which is tuberculosis. Besides histoplasmosis and chronic pulmonary aspergillosis, which can mimic TB, this review has identified several other fungal infections which also do. A total of 80 individual cases misdiagnosed as TB are highlighted: aspergillosis (n = 18, 22.5%), histoplasmosis (n = 16, 20%), blastomycosis (n = 14, 17.5%), cryptococcosis (n = 11, 13.8%), talaromycosis (n = 7, 8.8%), coccidioidomycosis (n = 5, 6.3%), mucormycosis (n = 4, 5%), sporotrichosis (n = 3, 3.8%), phaeohyphomycosis (n = 1, 1.3%) and chromoblastomycosis (n = 1, 1.3%). Case series from India and Pakistan reported over 100 cases of chronic and allergic bronchopulmonary aspergillosis had received anti-TB therapy before the correct diagnosis was made. Forty-five cases (56.3%) had favorable outcomes, and 25 (33.8%) died, outcome was unclear in the remainder. Seventeen (21.3%) cases were infected with human immunodeficiency virus (HIV). Diagnostic modalities were histopathology (n = 46, 57.5%), culture (n = 42, 52.5%), serology (n = 18, 22.5%), cytology (n = 2, 2.5%), gene sequencing (n = 5, 6.3%) and microscopy (n = 10, 12.5%) including Gram stain, India ink preparation, bone marrow smear and KOH mount. We conclude that the above fungal infections should always be considered or ruled out whenever a patient presents with symptoms suggestive of tuberculosis which is unconfirmed thereby reducing prolonged hospital stay and mortalities associated with a delayed or incorrect diagnosis of fungal infections.

Management of self-harm, suicidal ideation and suicide attempts.

The strategic location of primary care providers (PCPs) in clinics, private general practices and emergency departments is critical to the detection and appropriate management of patients with suicidal behaviour. Their position within the primary care setting and responsibility for preventive and promotive care require PCPs to possess good clinical skills and evidence-based knowledge to assist patients presenting with suicidal ideation and behaviour. The objective of this article is to provide guidelines for the management of suicidal behaviour within the primary care setting, with the goal of reducing deaths from suicide, and the frequency and intensity of suicide attempts. The priority in the management of patients presenting at health facilities following suicide attempts is medical resuscitation and stabilisation. As soon as the patient is medically stable, a thorough suicide risk assessment, which evaluates suicidal ideation/intent, preceding circumstances, predisposing and protective factors, should be conducted. An assessment of current and ongoing suicide risk will assist in determining the safest place to manage the patient. For those with a low level of suicide risk, outpatient management may be considered in the presence of a good social support system at home and a well-documented safety plan. Measures should be put in place to address the modifiable psychosocial risk factors for suicide, whilst appropriate pharmacotherapy is instituted for co-existing mental illness. Post-discharge care such as referral to psychologist, psychiatrist or social worker should be initiated by the primary care practitioner to ensure continuity of care. Support and psycho-education should also be extended to immediate family members of patients with suicidal behaviour for their own well-being and their ability to support the patient.

Serum Levels of Micronutrients, Magnesium, and Markers of Immunity (CD4+ ) in Antiretroviral-naïve HIV-infected Individuals: Relationships and Predictors.

BACKGROUND: HIV/AIDS may lead to micronutrient deficiencies and low CD4+ count. OBJECTIVES: We assessed the correlation of CD4+ count in antiretroviral-naïve patients with the serum levels of micronutrients as measures of the relationship between immunity and nutrition/malnutrition. METHODS: A case-control study of ninety consecutive newly diagnosed HIV/AIDS patients and ninety blood donors. Blood collected from controls and patients before HAART treatment were assayed for serum zinc, selenium, copper, manganese, and magnesium. RESULTS: The participants had non-significantly lower zinc (14.25±2.93µmol/l versus 14.58±3.69µmol/l, p=0.493), significantly lower selenium (0.38±0.08µmol/l versus 0.78±0.22µmol/l, p<0.001), manganese (7.06±0.87µmol/l versus 11.23±3.27µmol/l, p<0.001), and magnesium (1.02±0.21mmol/l versus 1.21±0.28mmol/l, p<0.001) when compared with the controls. The mean copper level was similar in both groups (18.88±3.1µmol/l and 18.82±5.12µmol/l, p=0.921). There was no correlation between the micronutrients and CD4+ count; however, there were strong positive correlations between the levels of zinc and copper, selenium, magnesium; copper and magnesium (p<0.001 respectively). Multivariate regression showed that all micronutrients were independent predictors of one another (p<0.001). CONCLUSION: HIV/AIDS results in serum micronutrient depletion with strong positive correlations between their levels; all micronutrients were independent predictors of one another. This significant positive relationships between the micronutrients, and magnesium; and all other micronutrients being independent predictors of each other signifies a synergistic or supportive relationship between micronutrient deficiencies and HIV/AIDS disease morbidity and progression. Serum micronutrients may not be qualified as direct markers or surrogates for CD4+ count in antiretroviral-naïve HIV-infected patients.

Self-confidence and knowledge of suicide assessment and prevention amongst first-line health professionals in Nelson Mandela Bay, South Africa.

BACKGROUND: First-line health professionals are uniquely positioned to recognise suicidal behaviours in patients. However, the opportunities are often missed or poorly managed. Self-confidence and knowledge of suicide prevention and assessment by health professionals can lead to prompt recognition and management of at-risk individuals. This study evaluates the first-line health professionals' self-confidence and knowledge of suicide assessment in Nelson Mandela Bay Municipality (NMBM), South Africa. METHODS: A cross-sectional study was conducted in six healthcare facilities across NMBM between January 2020 and March 2020. Five hundred first-line healthcare professionals were recruited to respond to a validated self-administered questionnaire to collect demographic characteristics, self-confidence levels and knowledge of suicide assessment and associated factors. RESULTS: A total of 344 first-line health professionals completed the questionnaire (68.8% response rate); 40% of the respondents work in emergency units and 77.3% reported frequent encounters with patients who attempted suicide. Most participants had not received suicide assessment training during their undergraduate or postgraduate years (59.6% and 81.1%, respectively). They also lacked adequate knowledge and self-confidence in suicide assessment. Younger age, minimal work experience and attendance of two or more hours of suicide prevention training were associated with higher knowledge of suicide assessment. CONCLUSION: Findings revealed gaps in self-confidence and knowledge of suicide management, attributed to lack of training in suicide management. Health authorities should prioritise upskilling of front-line workers in suicide prevention and assessment, specifically targeting older nurses in the region.

Sequence analysis for SNP detection and phylogenetic reconstruction of SARS-cov-2 isolated from Nigerian COVID-19 cases.

BACKGROUND: Coronaviruses are a group of viruses that belong to the Family Coronaviridae, genus Betacoronavirus. In December 2019, a new coronavirus disease (COVID-19) characterized by severe respiratory symptoms was discovered. The causative pathogen was a novel coronavirus known as 2019-nCoV and later as SARS-CoV-2. Within two months of its discovery, COVID-19 became a pandemic causing widespread morbidity and mortality. METHODOLOGY: Whole genome sequence data of SARS-CoV-2 isolated from Nigerian COVID-19 cases were retrieved by downloading from GISAID database. A total of 18 sequences that satisfied quality assurance (length ≥29,700 nts and number of unknown bases denoted as "N" ≤ 5%) were used for the study. In addition, genome sequence of SARS-CoV-2 obtained from Nigeria's COVID-19 index case (Accession ID: EPI_ISL_413550) and the reference genome (Accession NC_ 045512.2) were obtained from GISAID and the GenBank databases, respectively. Multiple sequence alignment (MSA) was done in MAFFT (Version 7.471) while SNP calling was implemented in DnaSP (Version 6.12.03), respectively and then visualized in Jalview (Version 2.11.1.0). Phylogenetic analysis was with MEGA X software. RESULTS: Nigerian SARS-CoV-2 had 99.9% genomic similarity with four large conserved genomic regions. A total of 66 SNPs were identified out of which 31 were informative. Nucleotide diversity assessment gave Pi = 0.00048 and average SNP frequency of 2.22 SNPs per 1000 nts. Non-coding genomic regions particularly 5'UTR and 3'UTR had a SNP density of 3.77 and 35.4, respectively. The region with the highest SNP density was ORF10 with a frequency of 8.55 SNPs/1000 nts). This value was significantly higher (P < 0.01) than that of the spike gene, the region of greatest interest in SARS-CoV-2 genomics. Majority (72.2%) of viruses in Nigeria are of L lineage with preponderance of D614G mutation which accounted for 11 (61.1%) out of the 18 viral sequences. Nigeria SARS-CoV-2 revealed 3 major clades namely Oyo, Ekiti and Osun on a maximum likelihood phylogenetic tree. CONCLUSION AND RECOMMENDATION: There was a preponderance of L lineage (to include the new lineage scheme) and D614G mutants. Nigerian SARS-CoV-2 genome revealed ORF1ab as the region containing the highest SNP density as compared to the spike gene. The implication of this distribution of SNPs for the empirical lower infectivity of SARS-CoV-2 in Nigeria is discussed. This also underscores the need for more aggressive testing and treatment of COVID-19 in Nigeria. Additionally, attempt to produce testing kits for COVID-19 in Nigeria should consider the conserved regions identified in this study. Strict adherence to COVID-19 preventive measure is recommended in view of Nigerian SARS-CoV-2 phylogenetic clustering pattern, which suggests intensive community transmission possibly rooted in communal culture characteristic of many ethnicities in Nigeria.

Landscape of tissue-specific RNA Editome provides insight into co-regulated and altered gene expression in pigs (Sus-scrofa).

RNA editing generates genetic diversity in mammals by altering amino acid sequences, miRNA targeting site sequences, influencing the stability of targeted RNAs, and causing changes in gene expression. However, the extent to which RNA editing affect gene expression via modifying miRNA binding site remains unexplored. Here, we first profiled the dynamic A-to-I RNA editome across tissues of Duroc and Luchuan pigs. The RNA editing events at the miRNA binding sites were generated. The biological function of the differentially edited gene in skeletal muscle was further characterized in pig muscle-derived satellite cells. RNA editome analysis revealed a total of 171,909 A-to-I RNA editing sites (RESs), and examination of its features showed that these A-to-I editing sites were mainly located in SINE retrotransposons PRE-1/Pre0_SS element. Analysis of differentially edited sites (DESs) revealed a total of 4,552 DESs across tissues between Duroc and Luchuan pigs, and functional category enrichment analysis of differentially edited gene (DEG) sets highlighted a significant association and enrichment of tissue-developmental pathways including TGF-beta, PI3K-Akt, AMPK, and Wnt signaling pathways. Moreover, we found that RNA editing events at the miRNA binding sites in the 3'-UTR of HSPA12B mRNA could prevent the miRNA-mediated mRNA downregulation of HSPA12B in the muscle-derived satellite (MDS) cell, consistent with the results obtained from the Luchuan skeletal muscle. This study represents the most systematic attempt to characterize the significance of RNA editing in regulating gene expression, particularly in skeletal muscle, constituting a new layer of regulation to understand the genetic mechanisms behind phenotype variance in animals.Abbreviations: A-to-I: Adenosine-to-inosine; ADAR: Adenosine deaminase acting on RNA; RES: RNA editing site; DEG: Differentially edited gene; DES: Differentially edited site; FDR: False discovery rate; GO: Gene Ontology; KEGG: Kyoto Encyclopaedia of Genes and Genomes; MDS cell: musclederived satellite cell; RPKM: Reads per kilobase of exon model in a gene per million mapped reads; UTR: Untranslated coding regions.

Efficacy of Vermiremediation to Remove Contaminants from Soil.

BACKGROUND: In addition to improving soil fertility and crop production, earthworms have been found to be useful in the removal of contaminants from soil, known as vermiremediation. Previous studies on vermiremediation have focused primarily on organic wastes, with relatively less attention paid to inorganic contaminants. In addition, some basic terms used in environmental health studies have often not been properly clarified. OBJECTIVES: The present study is a review of the state of the literature on the effectiveness of using earthworms to remediate organic and inorganic (metal) soil contaminants. Earthworms' actions in remediation of organic and inorganic contaminants are described. Some terms that are used interchangeably in environmental health are clarified. The challenges and limitations of vermiremediation are highlighted. METHODS: A systematic literature search was conducted to access online academic publications indexed in Google Scholar, PubMed, Scopus, Clarivate Analytics (Web of Science), ScienceDirect, ResearchGate and Springer Link. A total of 165 publications on the subject matter were accessed, out of which 47 were used for the review. DISCUSSION: Empirical and theoretical information from the literature showed evidence of the significant contributions of earthworms to the removal of soil organic contaminants and metals. Earthworms indirectly facilitate the conversion of organic contaminants by promoting microbial and enzyme activities. Some organic contaminants are directly taken up through dermal and intestinal absorption and accumulated by preferential sequestration in sub-organismic and tissue fractions of earthworms. Metals are directly removed and accumulated by the mechanism of detoxification and sequestration, via metallothioneins induction. The terms 'contaminants' and 'pollutants' have different meanings and should not be used interchangeably. Although vermiremediation presents an ideal clean-up technique, it is limited in application to only mildly contaminated soil environments. Ethical concerns should not pose a serious issue because vermiremediation simply takes advantage of earthworms' natural soil-conditioning abilities. Many vermiremediation processes, especially of organic wastes, are harmless to earthworms, improving the soil for their growth and survival. CONCLUSIONS: Vermiremediation presents a good long-term biological option to clean up mildly contaminated soil. It may be deployed as a secondary measure to rid the soil of residual contaminants after applying physicochemical remediation techniques to an overtly polluted soil environment. COMPETING INTERESTS: The authors declare no competing financial interests.

Prevalence and factors associated with suicidal ideation amongst college students in the Nelson Mandela Bay Municipality, South Africa.

BACKGROUND: Suicidal behaviour amongst college students constitutes a significant social and public health problem globally. This study determined the prevalence and associated factors of suicidal ideation amongst students of higher education in the Nelson Mandela Bay Municipality (NMBM), South Africa. METHODS: In this institution-based cross-sectional study, a multistage cluster sampling of 826 participants, drawn from a college in NMBM, was conducted from January to March 2020. Data were collected with a standardised self-administered questionnaire. Multivariable logistic regression analysis was used to identify the factors associated with suicidal ideation. RESULTS: Participants' ages ranged from 18 to 24 years, with a mean age of 20.49 years (standard deviation, 1.88 years). The lifetime prevalence of suicidal ideation and plans in the preceding 12 months were 24.5% and 9.6%, respectively. The odds of suicidal ideation were higher in students who experienced bullying (adjusted odds ratio [AOR], 1.89; 95% confidence interval [CI], 1.35-2.65), mental illness (AOR, 1.89; 95% CI, 1.35-2.65), a history of sexual assault (AOR, 2.50; 95% CI, 1.20-5.21) and experience of sexual assault by or to a close family member (AOR, 1.69; 95% CI, 1.01-2.82). Underlying chronic illness was associated with a twofold risk for suicidal ideation in both sexes. CONCLUSION: About a quarter of the students sampled at the college had experienced suicidal ideation and some had had suicidal plans in the preceding 12 months. Screening for the identified risk factors amongst the student population coupled with prompt interventions would mitigate the risk of suicide in the study population.

Trends and Patterns of Homicides Arising From Interpersonal Violence in Nigeria (2006-2016).

Despite the considerable shift that has been recorded in the dimension and patterns of violence involving individuals in primary group relationships in Nigeria, available scholarly research on the phenomenon has been largely narrow with the majority concentrating on spousal abuse. To fill this gap, this study examined the incidence of homicides arising from interpersonal violence between 2006 and 2016. The descriptive design was employed, and social disorganization theory was adopted for its conceptual framework. Data were generated from the content review of a corpus of some Nigerian newspapers' coverage on cases of interpersonal violence that resulted into fatalities. Findings revealed that 516 cases of homicide occurring in a wide range of contexts were recorded in Nigeria between 2006 and 2016. Although instances of violent deaths due to interpersonal violence were recorded in all years considered, we found that the highest share (37%) of the fatalities occurred in 2012. Also, the majority of homicides (58%) due to interpersonal violence occurred in the South-West region. A multilayered approach involving relevant stakeholders is advocated as way of successfully containing the problem.

A RARE CASE OF PREPERITONEAL ABSCESS IN A NIGERIAN FEMALE: ULTRASOUND DIAGNOSIS AND PERCUTANEOUS CATHETER DRAINAGE.

A preperitoneal abscess is an uncommon manifestation of extraperitoneal collection. We present a case of an anterior abdominal wall preperitoneal abscess in a 30-year-old Nigerian female with abdominal pain and purulent abdominal wall discharge ten days after an initial admission for spontaneous bacterial peritonitis. This report underscores the role of ultrasound in diagnosis and follow-up and percutaneous ultrasound-guided continuous percutaneous catheter drainage and management of an extraperitoneal abscess.