Systematic Inference of Multi-scale Chromatin Sub-compartments Using Calder2.

The compartmentalization of chromatin reflects its underlying biological activities. Inferring chromatin sub-compartments using Hi-C data is challenged by data resolution constraints. Consequently, comprehensive characterizations of sub-compartments have been limited to a select number of Hi-C experiments, with systematic comparisons across a wide range of tissues and conditions still lacking. Our original Calder algorithm marked a significant advancement in this field, enabling the identification of multi-scale sub-compartments at various data resolutions and facilitating the inference and comparison of chromatin architecture in over 100 datasets. Building on this foundation, we introduce Calder2, an updated version of Calder that brings notable improvements. These include expanded support for a wider array of genomes and organisms, an optimized bin size selection approach for more accurate chromatin compartment detection, and extended support for input and output formats. Calder2 thus stands as a refined analysis tool, significantly advancing genome-wide studies of 3D chromatin architecture and its functional implications.

Assessment of acute, subacute genetic toxicities and immunomodulatory activity of palm (Trachycarpus fortunei) buds.

ETHNOPHARMACOLOGY RELEVANCE: Palm buds are a natural green resource of the forest, which are not only rich in nutrients but contain a large number of phenolic acids and flavonoids, among other components. It has a variety of biological activities such as antioxidant and uterine smooth muscle stimulation. AIM OF THE STUDY: To evaluate the safety of palm buds for use as a nutraceutical product and food by evaluating the toxicity, subacute toxicity and genotoxicity of the young palm buds. Also studied for its immune-enhancing activity. MATERIALS AND METHODS: Acute toxicity tests were performed in mice using the maximum tolerance method, and the manifestations of toxicity and deaths were recorded after administration of 10,000 mg/mL for 14 consecutive d (days) of observations. To assess subacute toxicity, mice were treated with palm buds (750, 1500, or 3000 mg/mL) daily for 28 days. The teratogenicity of palm buds was assessed by the Ames test, the mouse bone marrow cell micronucleus test, and the mouse spermatozoa malformation test. In addition, we evaluated the immune-enhancing ability of palm buds by the mouse carbon profile test, delayed-type metamorphosis reaction, and serum hemolysin assay. RESULTS: In the acute toxicity study, the Median Lethal Dose (LD50) was greater than 10,000 mg/kg bw in both male and female rats. There were also no deaths or serious toxicities in the subacute study. The no-observed-adverse-effect level (NOAEL) was 3000 mg/kg bw. However, the mice's food intake decreased after one week. The medium and high dose groups had a reducing effect on body weight in mice of both sexes. In addition, the changes in organ coefficients of the liver, kidney and stomach in male mice were significantly higher in the high-dose group (3.23 ± 0.35, 0.75 ± 0.05, 0.57 ± 0.05 g) than in the control group (2.94 ± 0.18, 0.58 ± 0.05, 0.50 ± 0.02 g). Hematological analyses showed that all the indices of the rats in each palm sprout dose group were within the normal range. The results of blood biochemical indicators showed that there was a significant reduction in TP in the blood of male mice in the high-dose group (44.6 ± 7.8 g/L) compared to the control group (58.3 ± 15.1 g/L). In histopathological analysis, none of the significant histopathological changes were observed. The results of the immunological experiment in mice showed that the liver coefficient and thymus coefficient of the high-dose group (8400 mg/kg) were significantly lower than the control group. There was no remarkable difference in auricle swelling between each dose palm bud group (1400, 2800, or 8400 mg/kg) and the control group. The anti-volume number of the high-dose group was significantly increased. CONCLUSION: Palm buds have non-toxic effects in vivo and have little effect on non-specific and cellular immunity in the test mice within the dose range of this experiment. The immunoenhancement in mice is mainly achieved through humoral immunity. In conclusion, our results suggest that palm buds are safe for use as healthcare products and food.

Prevalence and molecular characteristics of carbapenem-resistant Escherichia coli isolated from dogs in South Korea.

IMPORTANCE: Carbapenem-resistant Enterobacteriaceae are emerging as a global public health risk. Therefore, assessing the prevalence of carbapenem-resistant Escherichia coli (CRE) in both humans and animals is important. OBJECTIVE: We aimed to ascertain the occurrence and characteristics of CRE isolated from companion animals, dogs and cats. METHODS: E. coli strains were tested for antimicrobial susceptibility using the broth microdilution technique. Antimicrobial resistance genes were detected by polymerase chain reaction and sequencing analysis. The molecular characteristics of CRE were determined using multi-locus sequence typing, replicon typing, and pulsed-field gel electrophoresis (PFGE). RESULTS: In total, 13 CRE isolates (0.13%) were identified from dogs possessing blaNDM-5 along with ß-lactamase genes, mostly blaCMY-2 (92.2%) and blaTEM-1 (53.8%). The commonly observed mutations were S83L and D87N in gyrA, S80I in parC, and S458A in parE. CRE carried non-beta-lactam resistance genes, with the majority being tet(B) (100%), sul (84.6%), and aac(3)-II (53.8%). Nine different PFGE patterns (P1-P9), IncX3-type plasmids (69.2%), and ST410 (84.6%) were predominantly detected. CONCLUSIONS AND RELEVANCE: This investigation provides significant insight into the prevalence and molecular characteristics of blaNDM-5-carrying E. coli in dogs. The co-existence of blaNDM-5 and other antimicrobial resistance genes in E. coli potentially poses severe health hazards to humans.

Nutritional status and its associated factors among infants and young children aged 6-23 months in Addis Ababa, Central Ethiopia, 2021: a cross-sectional study.

The aim of this study is to assess nutritional status and associated factors among infants and young children aged 6-23 months in Yeka sub-city, Ethiopia, 2021. An institution-based cross-sectional study was conducted in selected health centres found in the Yeka sub-city from May 2021 to July 2021. In total, 396 systematically selected infants and young children aged 6-23 months attended the selected health centres were included in the study. Data were collected by using a structured questionnaire and anthropometric measurements. A multinomial logistic regression model was used. The overall magnitude of undernutrition and overnutrition among infants and young children were 24.7% and 5.5%, respectively. Dietary diversity score (DDS) ((adjusted odd ratio (AOR) = 5.65; 95% CI = 2.301, 10.87; P value = 0.003), minimum meal frequency (MMF) (AOR = 5.435; 95% CI = 2.097, 11.09; P value = 0.0052), and diarrhoea (AOR = 2.52; 95% CI = 1.007, 6.310; P value = 0.002) were statistically significantly associated factors for nutritional status among infants and young children. Malnutrition (undernutrition and overnutrition) is a public health problem among infants and young children in Yeka sub-city, Ethiopia. DDS, MMF, and diarrhoeal disease were associated with higher odds of undernutrition.

Anion-Driven Bandgap Tuning of AgIn(SxSe1-x)2 Quantum Dots.

Accurate tuning of the electronic and photophysical properties of quantum dots is required to maximize the light conversion efficiencies in semiconductor-assisted processes. Herein, we report a facile synthetic procedure for AgIn(SxSe1-x)2 quantum dots with S content (x) ranging from 1 to 0. This simple approach allowed us to tune the bandgap (2.6-1.9 eV) and extend the absorption of AgIn(SxSe1-x)2 quantum dots to lower photon energies (near-IR) while maintaining a small QD size (∼5 nm). Ultraviolet spectroscopy studies revealed that the change in the bandgap is modulated by the electronic shifts in both the valence band and the conduction band positions. The negative overall charge of the as-synthesized quantum dots enabled us to make films of quantum dots on mesoscopic TiO2. Excited state studies of the AgIn(SxSe1-x)2 quantum dot films demonstrated a fast charge injection to TiO2, and the electron transfer rate constant was found to be 1.5-3.5 × 1011 s-1. The results of this work present AgIn(SxSe1-x)2 quantum dots synthesized by the one-step method as a potential candidate for designing light-harvesting assemblies.

Unveiling the susceptibility mechanism of Microcystis to consecutive sub-lethal oxidative stress-Enhancing oxidation technology for cyanobacterial bloom control.

The use of H2O2 to mitigate cyanobacterial blooms has gained popularity due to its selectivity. Previous research has shown that consecutive low-dose H2O2 are far more effective in suppressing cyanobacteria than a single higher dose, minimizing damage to co-existing organisms in the aquatic ecosystem. However, the underlying mechanism remains unclear. This study aimed to investigate the mechanism underlying this sensitivity by monitoring the progression from oxidative stress to cell death in Microcystis induced by consecutive low doses of H2O2 (3 + 5 mg/L, with an interval time of 4 h). The initial application of H2O2 (3 mg/L) resulted in a rapid increase in the transcription of antioxidant genes (gpx, 2-cys prx, trxA and sod) within 1 h, and returned to baseline levels within 8 h. The addition of a second H2O2 led to a significant increase in glutathione peroxidase (gene and product) and glutathione within 24 h. The cell death following consecutive H2O2 stress was classified as regulated cell death (RCD), characterized by the upregulated metacaspase genes, increased caspase-like activity, modulation of the mazEF system, DNA fragmentation, cell vacuolization, and membrane disruption. Interestingly, the RCD process coincided with the fluctuation of glutathione cycle. Validation experiments demonstrated that exogenous glutathione can promote the gene expression and activity of metacaspase, while inhibition of glutathione biosynthesis led to decreased intracellular glutathione and suppressed metacaspase activity and gene expression. Therefore, glutathione may play a vital role in the connection between oxidative stress and RCD during consecutive H2O2 treatment. These results reveal the inherent vulnerability of Microcystis to consecutive oxidative stress, providing a biological mechanism for a sustainable strategy to mitigate cyanobacterial bloom.

Delineating morphological traits of oceanic micro-phytoplankton as potential ecological indicators.

The micro-phytoplankton (>20 µm) adaptations and resilience were assessed using morphological traits (shape, surface-to-volume ratio; S:V, and greatest-axial-linear-dimension; GALD) from sea-surface and different SCML-depths (shallow:20-50 m, intermediate:50-100 m, and deep:100-140 m) across different bioregions of Indian Ocean. The dominant simple elongated phytoplankton-geometric-shapes (PGSs) and morphological traits showed distinct north-south distribution and varied with light and nutrient availability. Further, SCML and corresponding sea-surface PGS will be similar or dissimilar if the former is located within or deeper than mixed-layer depth. Also, simple and complex PGS contribution gradually decreases and increases with increasing depth. Additionally, shallow SCML-PGS showed low-S:V and high-GALD while vice-versa for intermediate/deep SCML-PGS due to phenotypic plasticity behavior. Overall, only simple-PGS (cylinder, elliptic-prism, and prism-on-parallelogram) showed strong adaptive behavior through phenotypic plasticity and were highlighted as potential ecological tracers to address ecological impact of oceanographic processes (including coastal eutrophication, and aerosol deposition) linked to nutrient and light availability in predicted ocean change scenarios.

Survival and recurrence rates following SBRT or surgery in medically operable Stage I NSCLC.

OBJECTIVES: Surgery is the standard of care for early-stage non-small cell lung cancer (NSCLC), with SBRT reserved for patients who are not surgical candidates. We hypothesized overall survival (OS), lung cancer-specific survival (LCSS), progression free survival (PFS), and recurrence rates following SBRT or surgery in medically operable patients with Stage I NSCLC from the Veterans' Health Care System (VAHS) would be equivalent. MATERIALS AND METHODS: Medically operable patients diagnosed with Stage I NSCLC between 2000-2020 from the VAHS, determined by an FEV1 or DLCO > 60 % of predicted and Charlson comorbidity index (CCI) of 0 or 1, treated with SBRT or surgery were identified. SBRT patients were propensity score matched in a 1:1:1 ratio to those undergoing resection (SBRT:lobectomy:sub-lobar resection). OS, LCSS, and PFS and site of recurrence were determined. RESULTS: 103 patients were included in each cohort. With a median follow-up of 7.9 years 5-year OS for all patients was 51 % (95 % CI 46-57 %). After propensity score matching, OS (HR 2.08, 1.59), LCSS (HR 2.28, 1.97), and PFS (1.97, 1.45) were significantly worse with SBRT compared to either lobectomy or sub-lobar resection, respectively, (p < 0.05 for each comparison). Regional recurrence was significantly higher following SBRT (15.5 % vs 6.8 % or 4.9 %; p < 0.05), but there was no significant difference in local (28.2 % vs 21.4 % or 21.4 %; p > 0.05) or distant recurrence (10.7 % vs 9.7 % or 13.6 %; p > 0.05) when compared to lobectomy or sub-lobar resection, respectively. CONCLUSION: In medically operable patients, OS, LCSS, and PFS following either lobectomy or sub-lobar resection were superior to that for SBRT for Stage I NSCLC, likely due in part to higher regional recurrence following SBRT. This suggests that pulmonary function test results and CCI alone are insufficient to define a cohort of medically operable patients suited for SBRT. These data support strategies to overcome regional recurrences seen with SBRT.

Incident cardiovascular disease risk among older Asian, Native Hawaiian and Pacific Islander liver cancer survivors.

BACKGROUND: Cardiovascular disease (CVD) is a significant global health concern, particularly among Asian, Native Hawaiian, and Pacific Islander (ANHPI) communities that face unique health challenges. Liver cancer disproportionately affects ANHPI populations and has intricate associations with CVD risks due to shared pathophysiological mechanisms and metabolic disturbances. However, the specific CVD risk profile of ANHPI liver cancer patients remains poorly understood. METHODS: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified and matched 1150 ANHPI and 2070 Non-Hispanic White (NHW) liver cancer patients diagnosed between 2000 and 2017. We used the Fine-Gray sub-distribution hazard model to estimate hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) for CVD risks, including ischemic heart disease (IHD), heart failure, and stroke, among ANHPI liver cancer patients compared to NHW counterparts and among ANHPI subgroups. RESULTS: ANHPI liver cancer patients demonstrated a lower risk of IHD compared to NHW counterparts (HR, 0.65, 95 % CI, 0.50, 0.86), aligning with broader trends. Subgroup analysis revealed notable heterogeneity within ANHPI populations, with Southeast Asian (HR, 0.65, 95 % CI, 0.42, 1.00) and Chinese patients (HR, 0.53, 95 % CI, 0.33-0.83) exhibiting lower IHD risks compared to their NHW counterparts. However, Native Hawaiian and Pacific Islander liver cancer patients showed elevated risks of heart failure (HR, 3.16, 95 % CI, 1.35-7.39) and IHD (HR, 5.64, 95 % CI, 2.19-14.53) compared to their Chinese counterparts. CONCLUSION: Our study highlights the complexity of CVD risks among ANHPI liver cancer patients. Addressing these disparities is crucial for improving cardiovascular outcomes and reducing the burden of CVD among ANHPI liver cancer patients.

Sub-Internship Academy: Implementation and Evaluation of Single-Day Resident-Driven Focused Sub-Internship Preparation Course.

OBJECTIVE: Strong performance in neurosurgical sub-internships is a vital component of a successful residency application and requires adequate familiarity with clinical knowledge and technical skills that may not be covered in standard medical school curricula. Accordingly, a need exists for immersive and comprehensive sub-internship preparation programs that respect time and resource limitations, are optimized based on longitudinal student feedback, provide opportunities for mentorship, and foster enthusiasm for neurosurgery. Therefore, residents at a single institution designed and implemented a comprehensive curriculum for a one-day sub-internship academy. METHODS: Academy curriculum involved hands-on and discussion-based elements split into three workshops. Anonymous surveys were conducted immediately following the academy and upon completion of sub-internships to evaluate participant perceptions on the utility of the academy. RESULTS: Twelve medical students participated in the inaugural neurosurgery sub-internship academy. Nine responded to the immediate post-survey, which revealed the following ratings: the overall program was rated as having maximal impact on sub-internship readiness and enthusiasm for neurosurgery by eight (88.9%) and seven (77.8%) respondents, respectively. A largely positive impact on access to mentorship was observed. Six participants responded to a post-sub-internship survey, and all six indicated they agreed or strongly agreed that the academy prepared them to perform well. CONCLUSIONS: Student perceptions of the relevance and utility of the sub-internship academy were positive, and the program fostered enthusiasm for neurosurgery and provided opportunities for mentorship. The participants indicated the academy positively impacted their sub-internship performance, and areas for improvement to guide future iterations of the academy were identified.

Link between pregnancy planning and antenatal care utilization in sub-Saharan Africa: An analysis of DHS data (2010-2023).

This study aims to analyse the relationship between pregnancy planning and antenatal care in sub-Saharan Africa and to identify which categories of mothers are most likely to make inadequate use of antenatal care in the event of a mistimed or unwanted pregnancy. The latest data from the Demographic and Health Surveys of 32 countries were analysed using bivariate and multivariate descriptive methods. The results show that compared with planned births, mistimed and unwanted births are respectively 27% (OR=0.733) and 29% (OR=0.711) less likely to have an antenatal visit in the first three months of pregnancy, and 25% (OR=0.752) and 29% (OR=0.705) less likely to have the four recommended antenatal visits. In addition, the births of the most privileged women (richest, educated and exposed to the media) are the least likely to have an adequate prenatal visit in the event of mistimed or unwanted pregnancies, probably due to an increased psychosocial impact linked to school dropouts, damage to professional projects and a desire to hide the pregnancy from those around her.

Cette étude vise à analyser la relation entre planification de la grossesse et recours aux soins prénataux en Afrique subsaharienne et à déterminer les catégories de mères les plus enclines à ne pas recourir adéquatement aux soins prénataux en cas de grossesse mal planifiée ou non désirée. Les dernières données en date des enquêtes démographiques et de santé de 32 pays ont été analysées à travers des méthodes descriptives bivariées et multivariées. Les résultats obtenus indiquent que comparativement aux naissances planifiées, celles mal planifiées et non désirées ont respectivement 27% (OR=0,733) et 29% (OR=0,711) moins de chances de recourir à une visite prénatale dans les trois premiers mois de la grossesse et 25% (OR=0,752) et 29% (OR=0,705) moins de chances de recourir aux quatre visites prénatales recommandées. En outre, les naissances des femmes les plus favorisées (riches, instruites et exposées aux médias) sont celles qui bénéficient le moins de visites prénatales adéquates en cas de grossesse mal planifiées ou non désirée du fait probablement d'un impact psychosocial accru liés aux abandons scolaires, atteintes aux projets professionnels et volontés de cacher la grossesse à son entourage.

The Addis Ababa toxicology curriculum project: educational needs assessment for the toxicology modules of an emergency medicine training program.

BACKGROUND: The Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) is a bi-institutional partnership between the University of Toronto (UofT) and Addis Ababa University (AAU) focused on addressing the need for emergency medicine (EM) postgraduate training and care in Ethiopia. Toxicology is a key competency in EM. EM physicians are often the first and sole clinicians to identify and treat patients presenting with a wide range of intoxications. The goal of this project was to conduct an educational needs assessment to inform the development of a context-specific toxicology curriculum for the AAU EM training program. METHODS: Our needs assessment employed a survey (available electronically and in paper format) and face-to-face interviews conducted with Ethiopian EM faculty (all graduates of the AAU EM residency training program) and current AAU EM residents. The survey was distributed in October 2018 and the interviews were conducted in November 2018. RESULTS: Of the 63 surveys distributed, we received 17 complete responses and completed 11 interviews with AAU EM faculty and residents. The survey conducted on toxicology training highlighted overall satisfaction with current training, with thematic analysis revealing key areas for growth. System-related themes focused on resource availability, healthcare access, and public health education. Provider-related themes emphasized the need for context-specific training, including common local toxins, and for advanced toxicology training such as poison center rotations. Patient-related themes centered on specific toxicological presentations in Ethiopia, highlighting the importance of public health advocacy, education on safe handling, and governmental regulation of toxic substances. Both survey and interview data highlighted challenges stemming from inconsistent availability of resources and underscored the need for tailored education to manage poisoned patients with locally available resources. CONCLUSIONS: Our findings indicate the need to focus on the most prevalent local toxicological presentations and practical management challenges in local contexts, including resource limitations and delayed presentations. Moreover, it emphasizes the importance of public health initiatives such as regulation of the sale and promotion of safe handling of toxic substances to mitigate toxicological risks. These findings are likely relevant to other resource-constrained settings outside of Ethiopia.

Treatment failure among Sub-Sahara African children living with HIV: a systematic review and meta-analysis.

BACKGROUND: Antiretroviral treatment failure is a global issue, particularly in developing countries such as Sub-Saharan Africa. Prior research findings were highly variable and inconsistent across areas. As a result, the goal of this systematic review and meta-analysis was to determine the pooled prevalence of treatment failure among children receiving antiretroviral medication in Sub-Saharan Africa. METHODS: To find qualifying papers, we searched databases (such as PubMed, Google Scholar, African Journals Online, Scopus, and the Cochrane Library). The data were retrieved using Microsoft Excel and exported to STATA Version 14 for analysis. To check for publication bias, we employed Egger and Begg's regression tests. A random-effects model was used to assess the pooled prevalence of treatment failure due to high levels of variability. RESULTS: Following the removal of duplicated articles and quality screening, a total of 33 primary articles were determined to be appropriate for inclusion in the final analysis for this study. Overall, the pooled prevalence of treatment failure among HIV-infected children was 25.86% (95% CI: 21.46, 30.26). There is great variety across the included studies, with the majority of them being conducted in Ethiopia. Cameroon had the greatest pooled prevalence of treatment failure among HIV-infected children, at 39.41% (95% CI: 21.54, 57.28), while Ethiopia had the lowest, at 13.77% (95% CI: 10.08, 17.47). CONCLUSIONS: The pooled estimate prevalence of treatment failure among HIV-infected children in Sub-Saharan Africa was high. The implementation of national and international policies and strategies on ART clinic care services should be given special focus in order to reduce treatment failure in children living with HIV/AIDS. TRIAL REGISTRATION: The protocol has been registered in the PROSPERO database under the registration number CRD-429011.

No impact of cyantraniliprole on the hibernation success of bumble bees (Bombus terrestris audax) in a soil-mediated laboratory exposure study.

Increasing evidence shows that wild bees, including bumble bees, are in decline due to a range of stressors, including pesticides. Our knowledge of pesticide impacts has consequently grown to enable the design of increasingly realistic risk assessment methods. However, one area where knowledge gaps may still hinder our ability to assess the full range of bee-pesticide interactions is the field of exposure. Exposure has historically been linked to either direct contact with pesticides or the ingestion of contaminated pollen and nectar by bees. However, bumble bees, and other wild bees, may also be exposed to pesticides while using contaminated soil as an overwintering substrate. Yet knowledge of how soil-mediated exposure affects bumble bee health is lacking. Here we take one of the first steps towards addressing this knowledge gap by designing a method for testing the effects of soil-mediated pesticide exposure on bumble bee queen hibernation success. We measured hibernation survival, body weight change and abdominal fat content and found that none of these responses were affected by a field realistic soil exposure to the novel insecticide cyantraniliprole. Our study may help in developing a standardised method to test the effects of the soil-mediated pesticide exposure route in bumble bee queens.

Suppressing Hole Accumulation Through Sub-Nanometer Dipole Interfaces in Hybrid Perovskite/Organic Solar Cells for Boosting Near-Infrared Photon Harvesting.

The potential of hybrid perovskite/organic solar cells (HSCs) is increasingly recognized owing to their advantageous characteristics, including straightforward fabrication, broad-spectrum photon absorption, and minimal open-circuit voltage (VOC) loss. Nonetheless, a key bottleneck for efficiency improvement is the energy level mismatch at the perovskite/bulk-heterojunction (BHJ) interface, leading to charge accumulation. In this study, it is demonstrated that introducing a uniform sub-nanometer dipole layer formed of B3PyMPM onto the perovskite surface effectively reduces the 0.24 eV energy band offset between the perovskite and the donor of BHJ. This strategic modification suppresses the charge recombination loss, resulting in a noticeable 30 mV increase in the VOC and a balanced carrier transport, accompanied by a 5.0% increase in the fill factor. Consequently, HSCs that achieve power conversion efficiency of 24.0% is developed, a new record for Pb-based HSCs with a remarkable increase in the short-circuit current of 4.9 mA cm-2, attributed to enhanced near-infrared photon harvesting.

The Fertility Transition in Sub-Saharan Africa: The Role of Structural Change.

Despite recent economic growth and reductions in child mortality in many African countries, the region has experienced a slow fertility transition. In this study, we explore whether the slow structural economic change on the continent can explain this discrepancy. We construct a unique panel dataset combining Demographic and Health Surveys and nighttime light intensity data (an indicator of industrialization) from 57 countries at the subnational region level over three decades to analyze the drivers of fertility transitions across low- and middle-income countries. Our results confirm that household wealth, reduced child mortality, and female primary education are crucial for fertility declines. However, our analysis also highlights the importance of indicators of structural economic change, including the share of labor in nonagricultural occupations, industrialization, the share of women with higher education, and the formalization of the economy. Our simulations suggest that if high-fertility countries in sub-Saharan Africa underwent structural economic transformations comparable to those of other low- and middle-income countries with low fertility rates, their fertility levels could fall by 1 to 1.6 children.

Factors affecting Kaposi's sarcoma-associated herpesvirus transmission in rural Ugandan households, a longitudinal study.

BACKGROUND: We report the impact of HIV infection within a household on oral Kaposi's sarcoma-associated herpesvirus (KSHV) shedding. METHODS: We enrolled 469 individuals from 90 households. Mouthwash rinse samples collected at three monthly visits were analyzed for KSHV DNA using quantitative polymerase chain reaction (qPCR). Generalized linear mixed effects logistic models were applied to analyze factors associated with KSHV ever shedding, and among shedders, always versus intermittent shedding. Linear mixed effects models were applied to models of KSHV viral loads. Intraclass correlation coefficients (ICCs) were calculated to assess the contribution of household-level factors to variations in shedding probabilities. Hotspot analyses of geospatial feature clusters were calculated using Getis-Ord Gi* statistic and visualized using inverse distance weighted interpolation. RESULTS: Analyses included 340 KSHV seropositive individuals, aged 3 + years, with qPCR results from 89 households. Forty households had 1 + persons living with HIV (PLWH), while 49 had none. Among participants, 149(44%) were KSHV ever shedders. Of 140 who shed KSHV at two or more visits, 34(24%) were always shedders. Increasing number of KSHV seropositive household members was significantly associated with ever shedding [Odds ratio(OR) (95% Confidence Interval(95%CI)):1.14(1.03,1.26);p = 0.013]. Among KSHV shedders, a statistically significant age-related trend was identified with 10-19 years being more likely to be always shedders (type III test p = 0.039) and to have higher viral loads (type III test p = 0.027). In addition, higher viral loads were significantly associated with increasing number of household members [coefficient(95%CI):0.06(0.01,0.12);p = 0.042], increasing number of KSHV seropositive members [coefficient(95%CI):0.08(0.01,0.15);p = 0.021], and living in households with 1 + PLWH [coefficient(95%CI):0.51(0.04,0.98);p = 0.033]. Always shedders exhibited higher viral loads than intermittent shedders [coefficient(95%CI):1.62(1.19,2.05);p < 0.001], and viral loads increased with the number of visits where KSHV DNA was detected in saliva (type III test p < 0.001). Household-level factors attributed for 19% of the variability in KSHV shedding (ICC:0.191;p = 0.010). Geospatial analysis indicated overlapping hotspots of households with more KSHV seropositive individuals and KSHV shedders, distinct from areas where PLWH were clustered. DISCUSSION: KSHV oral shedding is influenced by multiple factors at the individual, household, and regional levels. To mitigate ongoing KSHV transmission a comprehensive understanding of factors contributing to oral KSHV reactivation and transmission within households is needed.

Utilization of birth companionship and its associated factors among laboring mothers during facilities birth in sub-Saharan Africa. Systematic review and meta-analysis.

Introduction: Birth companionship is one strategy for improving maternal and neonatal quality of care, as well as their outcomes. It is a low-cost and effective care that provide mothers with evidence-based practices throughout labor and delivery in health facilities. WHO has suggested that birth companionship can be given by a family member, spouse, friend, and doula. They support laboring mothers by offering comfort via touch, massage, warm baths, encouraging mobility, promoting fluid intake and output, supplying information about the status of labor and suggestions for coping strategies, and providing a communication channel between mothers and their caregivers that helps to reduce mother and newborn mortality on a globally and regionally. Despite this benefit, no systematic review and meta-analysis studies have been conducted on this topic in study area. Therefore, this study may give the pooled utilization and associated factors of birth companionship among laboring mothers during facility birth in Sub-Saharan Africa. Methods and materials: A systematic review and meta-analysis was conducted using preferred reporting items for systematic review and meta-analysis guidelines. Data base such as PubMed with Medline, Cochrane library, direct science, google scholar and different gray works of literature/email were used on the utilization of birth companionship and associated factors of studies from 2010 to 2023 in sub-Saharan Africa. A weighted inverse variance random effect model with DerSimonian-Laird method was used to estimate pooled utilization of birth companionship Cochrane Q-test, I 2, and p-value were computed to detect heterogeneity. Egger test and funnel plot were used to detect the evidence of publication bias. We did subgroup analysis, sensitivity analysis, and meta regression to identify source heterogeneity. The protocol has been registered in PROSPERO database "CRD42024503048." Results: In sub-Saharan Africa, laboring mothers giving delivery in a facility utilized birth companionship at a rate of 34% (95% CI: 26-42, I 2 = 98.90%, p < 0.01). Subgroup analysis revealed that South Africa had the largest pooled utilization of birth companionship (49%), while Rwanda had the lowest (14.5%). Having ANC (AOR = 2.69, 95% CI: 1.66-3.73, I 2 = 10.36%), having an obstetric complication (AOR = 2.55, 95% CI: 1.69-3.4, I 2 = 0%), desiring birth companionship (AOR = 2.46, 95% CI: 1.17-3.74, I 2 = 38.46%), and being prime para (AOR = 2.51, 95% CI: 1.83-3.19, I 2 = 0%) were significantly associated with pooled utilization of birth companionship. Conclusions: There is low pooled utilization of birth companionship among laboring mothers giving delivery in an institution in sub-Saharan Africa. Factors linked to the use of birth companionship included being primipara, having antenatal care, having complications during pregnancy, and desiring companionship. The management team and healthcare personnel must take the initiative to educate mothers during antenatal care about the benefits of having a birth companion.

Innovative pre-exposure prophylaxis interventions among adolescent girls and young women during COVID-19 lockdown period in sub-Saharan Africa: A systematic review.

Adolescent girls and young women are key, and priority populations impacted by a higher risk of acquiring human immunodeficiency virus. In 2015, pre-exposure prophylaxis was introduced as a biomedical human immunodeficiency virus prevention tool. However, its uptake continues to be lower in sub-Saharan countries, particularly among adolescent girls and young women. The uptake may have worsened during the Coronavirus disease 2019 lockdown restrictions. Innovative interventions to improve its uptake were implemented, this review aimed to identify and describe these interventions in sub-Saharan Africa. We searched four electronic databases (PubMed, Scopus, Google Scholar, and MEDLINE) between 01 April 2019 and 30 April 2024 and 1212 articles were identified. Of these 287 full-text articles were assessed and ultimately, 14 articles were included since they reported on the pre-exposure prophylaxis interventions implemented before and during the lockdown period among adolescent girls and young women. Innovative interventions like using social media platforms and decentralizing pre-exposure prophylaxis through community delivery were identified across Sub-Saharan African countries. Irrespective of the challenges in implementing these interventions, improvements in pre-exposure prophylaxis uptake and adherence were observed. These interventions can potentially improve access to traditionally hard-to-reach individuals and address structural barriers to better access human immunodeficiency virus prevention service delivery.

Les adolescentes et les jeunes femmes constituent des populations clés et prioritaires exposées à un risque plus élevé de contracter le virus de l'immunodéficience humaine. En 2015, la prophylaxie pré-exposition a été introduite comme outil biomédical de prévention du virus de l'immunodéficience humaine. Cependant, son adoption continue d'être plus faible dans les pays subsahariens, en particulier chez les adolescentes et les jeunes femmes. L'adoption pourrait s'être aggravée pendant les restrictions de confinement liées à la maladie à coronavirus 2019. Des interventions innovantes pour améliorer son adoption ont été mises en œuvre, cette revue visait à identifier et décrire ces interventions en Afrique subsaharienne. Nous avons effectué des recherches dans quatre bases de données électroniques (PubMed, Scopus, Google Scholar et MEDLINE) entre le 1er avril 2019 et le 30 avril 2024 et 1 212 articles ont été identifiés. Parmi ces 287 articles en texte intégral ont été évalués et finalement, 14 articles ont été inclus car ils rendaient compte des interventions de prophylaxie pré-exposition mises en œuvre avant et pendant la période de confinement auprès des adolescentes et des jeunes femmes. Des interventions innovantes telles que l'utilisation des plateformes de médias sociaux et la décentralisation de la prophylaxie pré-exposition par le biais de la prestation communautaire ont été identifiées dans les pays d'Afrique subsaharienne. Indépendamment des difficultés liées à la mise en œuvre de ces interventions, des améliorations dans l'adoption et l'observance de la prophylaxie pré-exposition ont été observées. Ces interventions peuvent potentiellement améliorer l'accès aux personnes traditionnellement difficiles à atteindre et éliminer les obstacles structurels pour un meilleur accès à la prestation de services de prévention du virus de l'immunodéficience humaine.

Prevalence and management of cataracts among older adults in Sub-Saharan Africa: a scoping review.

INTRODUCTION: Cataract is a leading cause of visual impairment and blindness, mainly affecting older adults in sub-Saharan Africa (SSA). This scoping review aims to map evidence on the prevalence, contextual factors, and management strategies for cataracts among older adults in SSA. METHOD: Four central databases (PubMed, Scopus, Medline, and Google Scholar) were searched, yielding 383 records. Additional searches produced eight records. After screening and applying inclusion criteria, 26 full-text articles were eligible for further review. Finally, seven full-text records were included in the thematic analysis and synthesis. RESULTS: Cataract prevalence among older adults in SSA ranged from  13.5-62.5% across different countries. Surgery remains the primary management strategy, but cataract surgical coverage varies widely (12.1-96%). Significant barriers to effective management include lack of awareness, limited access to healthcare, economic constraints, gender disparities, and cultural misconceptions about cataract surgery. CONCLUSION: There is a significant burden of cataracts among older adults in SSA, with considerable variations in prevalence and surgical coverage across the region. Comprehensive strategies addressing awareness, accessibility, affordability, and cultural factors are needed to improve cataract management and reduce visual impairment in SSA.