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Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.

The acquisition of soft skills is increasingly recognized as a crucial component of higher education, essential for preparing students to meet the challenges of the modern workforce. This study investigates the process of acquiring soft skills through Paideia Patristic Education (PPE) in universities in Machakos County, Kenya. This quantitative study aims to evaluate the effectiveness of the PPE framework in promoting key soft skills such as communication, teamwork, critical thinking, and flexibility. Purposive sampling technique was used to target specific faculty members and students. Data was collected using structured and semi-structured questionnaires. The study's results show that PPE has a positive effect on students' soft skills, particularly in enhancing their ability to work effectively in teams and collaborate. Universities in Machakos County and beyond should strongly consider incorporating Paideia Patristic Education principles into their curricula. This would help cultivate crucial soft skills in students, better equipping them for the challenges of the contemporary job market.

Hoseah M Akala, Angela O Achieng, Fredrick L Eyase, Dennis W Juma, Luiser Ingasia, Agnes C Cheruiyot, Charles Okello, Duke Omariba, Eunice A Owiti, Catherine Muriuki, Redemptah Yeda, Ben Andagalu, Jacob D Johnson, Edwin Kamau Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya Background: The renewed malaria eradication efforts require an understanding of the seasonal patterns of frequency of polymorphic variants in order to focus limited funds productively. Although cross-sectional studies in holoendemic areas spanning a single year could be useful in describing parasite genotype status at a given point, such information is inadequate in describing temporal trends in genotype polymorphisms. For Plasmodium falciparum isolates from Kisumu District Hospital, Plasmodium falciparum chloroquine-resistance transporter gene (Pfcrt-K76T) and P. falciparum multidrug resistance gene 1 (PfMDR1-N86Y), were analyzed for polymorphisms and parasitemia changes in the 53 months from March 2008 to August 2012. Observations were compared with prevailing climatic factors, including humidity, rainfall, and temperature. Methods: Parasitemia (the percentage of infected red blood cells per total red blood cells) was established by microscopy for P. falciparum malaria-positive samples. P. falciparum DNA was extracted from whole blood using a Qiagen DNA Blood Mini Kit. Single nucleotide polymorphism identification at positions Pfcrt-K76T and PfMDR1-N86Y was performed using real-time polymerase chain reaction and/or sequencing. Data on climatic variables were obtained from http://www.tutiempo.net/en/. Results: A total of 895 field isolates from 2008 (n=169), 2009 (n=161), 2010 (n=216), 2011 (n=223), and 2012 (n=126) showed large variations in monthly frequency of PfMDR1-N86Y and Pfcrt-K76T as the mutant genotypes decreased from 68.4%±15% and 38.1%±13% to 29.8%±18% and 13.3%±9%, respectively. The mean percentage of parasitemia was 2.61%±1.01% (coefficient of variation 115.86%; n=895). There was no correlation between genotype or parasitemia and climatic factors. Conclusion: This study shows variability in the frequency of Pfcrt-K76T and PfMDR1-N86Y polymorphisms during the study period, bringing into focus the role of cross-sectional studies in describing temporal genotype trends. The lack of correlation between genotypes and climatic changes, especially precipitation, emphasizes the cost of investment in genotype change. Keywords: PfMDR1-N86Y, Pfcrt-K76T, polymorphism, parasitemia

This study investigated non-revenue water (NRW) dynamics in Rwanda from 1 July 2014, to 30 June 2023, utilizing panel data and cross-sectional datasets. It aimed to assess progress towards achieving the government's target of 25% NRW. Through panel data analysis and machine learning models, it examined water supply variations, NRW levels, and associated risks across fiscal years and regions. The observed average NRW of 41.24% underscores the need for targeted interventions to meet the set target. Regional disparities, exemplified by Kigali City's water network's 38.61% average NRW compared to Nyagatare's 55.31%, emphasize the importance of tailored strategies. Machine learning models indicated low and inconsistent progress across networks. Notably, no single water supply managed to meet the target in more than 20% of the 36 quarters studied. Comparison with existing literature highlighted excessive NRW in Rwanda, aligning with global trends. Achieving the 25% NRW target requires region-specific approaches, necessitating infrastructure improvements, leak detection, and capacity building. The positive correlation between water loss risk and household access to improved water sources accentuated the complexity in NRW reduction efforts. This study contributes to understanding NRW dynamics and informs sustainable water management strategies tailored to Rwanda's context. HIGHLIGHTS Need for balancing NRW reduction and access to improved water sources.; NRW is a region-specific issue.; WASAC is progressing slowly in the attainment of the target NRW of 25%.; Need to leverage panel data analysis and machine learning algorithms to understand NRW.; Most instances of 25% NRW or below were uncertain (due to issues of overlaps identified in all NRW classes), thus the need for a specific investigation on them.;

This study in Rwanda offers a comprehensive analysis of water quality, reliability, and cost-effectiveness, departing from previous research by utilizing panel data analysis for a nuanced understanding of spatiotemporal dynamics. Unlike earlier studies focusing on specific aspects, this research adopts a holistic approach, examining factors crucial for water supply, quality, and cost, thus providing an integrated view of Rwanda's water sector. By analyzing data from various sources, including the Water and Sanitation Corporation (WASAC), the study evaluates the reliability, quality, and cost-effectiveness of drinking water. It identifies cost-effective water treatment plants and studies determinants such as production cost, raw water quality, and supply between 2017 and 2022, introducing novel metrics such as performance scores and a drinking water quality index. Despite an increase in lost water, WASAC notably improves water supply, resulting in a higher water access rate by 2022. The study highlights the influence of factors such as performance scores and raw water quality on water supply and quality. It emphasizes continuous monitoring, targeted interventions, and community engagement for sustainable water service delivery. The findings provide actionable insights for policymakers, stakeholders, and practitioners, aiming to enhance water management strategies and improve water access in Rwanda. HIGHLIGHTS Panel data analysis offers nuanced spatiotemporal insights departing from cross-sectional methods.; Holistic approach examines water supply, quality, and cost, unlike prior single-focus studies.; Innovative metrics introduced include performance score and water quality index.; Practical insights help identify cost-effective water treatment plants and key determinants.; Sustainability focus emphasizes continuous monitoring and community engagement.;

Abstract The protection of the replication fork structure under stress conditions is essential for genome maintenance and cancer prevention. A key signaling pathway for fork protection involves TRPV2-mediated Ca2+ release from the ER, which is triggered after the generation of cytosolic DNA and the activation of cGAS/STING. This results in CaMKK2/AMPK activation and subsequent Exo1 phosphorylation, which prevent aberrant fork processing, thereby ensuring genome stability. However, it remains poorly understood how the TRPV2 channel is activated by the presence of cytosolic DNA. Here, through a genome-wide CRISPR-based screen, we identify TRPM8 channel-associated factor 1 (TCAF1) as a key factor promoting TRPV2-mediated Ca2+ release under replication stress or other conditions that activate cGAS/STING. Mechanistically, TCAF1 assists Ca2+ release by facilitating the dissociation of STING from TRPV2, thereby relieving TRPV2 repression. Consistent with this function, TCAF1 is required for fork protection, chromosomal stability, and cell survival after replication stress.

Abstract Background Community and individual participation are crucial for the success of schistosomiasis control. The World Health Organization (WHO) has highlighted the importance of enhanced sanitation, health education, and Mass Drug Administration (MDA) in the fight against schistosomiasis. These approaches rely on the knowledge and practices of the community to be successful; however, where the community knowledge is low and inappropriate, it hinders intervention efforts. Hence, it is essential to identify barriers and misconceptions related to awareness of schistosomiasis, sources of infection, mode of transmission, symptoms, and control measures. Methods This was a mixed-method cross-sectional study involving 1200 pre-school children randomly selected and examined for Schistosoma mansoni infection using the Kato-Katz technique. All parents/guardians of selected children were enrolled for a pre-tested questionnaire survey, while 42 were engaged in focus group discussions (FGDs). The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children. Results Among pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7–48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant’s level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection. Conclusions Despite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.

AbstractGeofence mobile technology can offer significant benefits to all stakeholders in the retail property sector ecosystem. This paper investigated the opportunities and challenges associated with the adoption of geofence mobile technology by retailers in South Africa. The paper adopted a qualitative research approach and interviewed property management professionals who have several years of work experiences in the retail sector in the country. As key stakeholders, retail property managers significantly contribute to the retail environment, especially with the integration of technology. Findings revealed that targeted marketing, shopper engagement and increased sales are opportunities presented by geofencing mobile technology to retailers. These opportunities potentially encourage retailers, and by implication property owners and property portfolio managers, to have management buy in and invest in employees’ skills for the adoption of geofence mobile technology. Additionally, the presence of vendor support and clear and assured data privacy and regulations are needed for the adoption of geofence mobile technology. These results represent a solid attempt to extend knowledge – in terms of research, policy, and practice – of the impact that new technologies have on the retail sector within a developing country, which is ripe for the adoption of geofence technology across its many economic sectors.

Voluntary male medical circumcision (VMMC) reduces HIV acquisition by up to 60%. Kenya has successfully scaled up VMMC to an estimated 91% of eligible men and boys in certain regions in combination due to VMMC and cultural circumcisions. VMMC as a program is implemented regionally in traditionally non-circumcising counties where the prevalence is still below 91%, ranging from 56.4% to 66.7%. Given that funding toward VMMC is expected to decline in the coming years, it is important to identify what models of service delivery are most appropriate and efficient to sustainably meet the VMMC needs of new cohorts' eligible men. To this end, we compared the costs of facility-based VMMC and one within a rapid results initiative (RRI), a public health service scheduled during school holidays to perform many procedures over a short period. We employed activity-based micro-costing to estimate the costs, from the implementer perspective, of facility-based VMMC and RRI-based VMMC conducted between October 2017 and September 2018 at 41 sites in Kisumu County, Kenya supported by the Family AIDS care & Education Services (FACES). We conducted site visits and reviewed financial ledger and programmatic data to identify and quantify resources consumed and the number of VMMC procedures performed during routine care and RRIs. Ledger data were used to estimate fixed costs, recurring costs, and cost per circumcision (CPC) in United States dollar (USD). A sensitivity analysis was done to estimate CPC where we allocated 6 months of the ledger to facility-based and 6 months to RRI. Overall, FACES spent $3,092,891 toward VMMC services and performed 42,139 procedures during the funding year. This included $2,644,910 in stable programmatic costs, $139,786 procedure costs, and $308,195 for RRI-specific activities. Over the year, 49% (n = 20,625) of procedures were performed as part of routine care and 51% (n = 21,514) were performed during the RRIs. Procedures conducted during facility-based cost $99.35 per circumcision, those conducted during the RRIs cost $48.51 per circumcision, and according to our sensitivity analysis, CPC for facility-based ranges from $99.35 to $287.24 and for RRI costs ranged from $29.81 to $48.51. The cost of VMMC during the RRI was substantially lower than unit costs reported in previous costing studies. We conclude that circumcision campaigns, such as the RRI, offer an efficient and sustainable approach to VMMC.

Lablab (Lablab purpureus L.) is an important food and livestock feed legume that can also enhance soil fertility. However, its production is limited by insect pests, notably the black bean aphid (Aphis fabae). The present field study was conducted to determine the difference in the contribution of lablab genotypes and natural field margin vegetation (FMV) to the abundance and diversity of natural enemies and the damage, incidence, and abundance of bean aphids. Eighteen lablab genotypes were planted in the presence or absence of FMV in a randomized complete block design experiment replicated four times. Data on aphid abundance, incidence, and severity of damage were collected at four growth stages of the crop. Lablab genotypes significantly influenced aphid incidence, suggesting some level of tolerance to aphid colonization. Findings showed that lablab genotypes were a significant influence on natural enemy species richness with no statistical difference for abundance and natural enemy species diversity. However, the genotypes did not vary significantly in their influence on the number of aphid natural enemies. FMV was associated with low bean aphid damage. Overall, the presence or absence of FMV did not influence the number of natural enemies caught on the crop. This concurs with recent work that shows a similar number of natural enemies with field margin plants but may reflect the reduced number of pest insects. Cropping seasons influenced aphid abundance and damage severity, with the populations developing at the early stages of lablab development and decreasing as the crop advanced. This pattern was similar both in the presence or absence of FMV. The findings of this study highlight the important contribution of crop genotype together with the presence of field margin species in the regulation of aphids and their natural enemies in lablab.

The escalating public debt in African nations has sparked global discussions regarding the sustainability within the region. This concern primarily stems from China's increasing role as a significant financier of African infrastructure projects, raising fears that China might be using debt to gain geopolitical leverage by ensnaring impoverished nations in unmanageable loan agreements. To address this issue, we employ three distinct approaches: a descriptive trend analysis, an examination of the debt-to-GDP ratio, and a modelling approach.For the modelling, we utilize a panel Autoregressive Distributed Lag model to assess the short and long-term relationships between economic growth and specified independent variables, including loans. We choose this model because it allows for panel data analysis encompassing the African countries over a span of 20 years and accounts for potential autocorrelation through the inclusion of lagged terms.Our key findings indicate that, based on the debt-to-GDP ratio, some African countries have sustainable debt levels, while others are at risk of facing financial distress. Furthermore, the results of the Autoregressive Distributed Lag model suggest that Chinese loans contribute to long-term economic growth in the region. Therefore, our study recommends that African governments implement robust debt management strategies to avoid default. Additionally, they should recognize that debt can stimulate economic growth when utilized to enhance infrastructure and production capacity.

As of August 2023, >340,000 test-confirmed COVID-19 cases and 5,689 COVID-19-related deaths had been reported in Kenya (1). Seropositivity rates in rural and urban populations were high, and vaccine uptake [...]

Abstract Background The non-pharmaceutical interventions (NPIs) implemented to curb the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) early in the coronavirus disease 2019 (COVID-19) pandemic, substantially disrupted the activity of other respiratory viruses. However, there is limited data from low-and-middle income countries (LMICs) to determine whether these NPIs also impacted the transmission of common enteric viruses. Here, we investigated the changes in the positivity rate of five enteric viruses among hospitalised children who presented with diarrhoea to a referral hospital in coastal Kenya, during COVID-19 pandemic period. Methods A total of 870 stool samples from children under 13 years of age admitted to Kilifi County Hospital between January 2019, and December 2022 were screened for rotavirus group A (RVA), norovirus genogroup II (GII), astrovirus, sapovirus, and adenovirus type F40/41 using real-time reverse-transcription polymerase chain reaction. The proportions positive across the four years were compared using the chi-squared test statistic. Results One or more of the five virus targets were detected in 282 (32.4%) cases. A reduction in the positivity rate of RVA cases was observed from 2019 (12.1%, 95% confidence interval (CI) 8.7–16.2%) to 2020 (1.7%, 95% CI 0.2–6.0%; p

Polychlorinated dibenzo-p-dioxin/dibenzofuran (PCDD/F) emissions during the roasting of green Arabica coffee and coffee formulations containing alcohol, sugar, and honey were investigated in this study. Fast and slow roasting methods, which took 5.62 and 9.65 min to achieve a light roast, respectively, were used to evaluate the emissions. The concentrations in the flue gas during the fast roasting of green coffee (0.0296 ng Nm−3 and 0.00364 ng WHO-TEQ Nm−3) were 13.9% and 70.5% higher than during slow roasting, respectively. However, this was only the trend for some formulations, and no significant differences in concentrations were found between the methods at p = 0.05. Thus, the slow roasting method might not necessarily reduce formation when additives are included. The emission factors were 2.86 ng kg−1 and 0.352 ng WHO-TEQ kg−1, and 4.17 ng kg−1 and 0.176 ng WHO-TEQ kg−1 for the fast and slow roasting of green coffee, respectively. Further investigations are warranted to understand the formation mechanism, assess potential health risks, and explore mitigation strategies. These findings have implications for both coffee processing industries and regulatory bodies, as understanding the impact of roasting methods and additives could inform the development of cleaner production practices and targeted emission reduction policies.

The changes in landscape structure and functioning due to unprecedented human interference are hastening across the globe and it is thus a compelling necessity to preserve and restore our ecosystems. This study aimed to characterize levels of landscape fragmentation, habitat structure, driving forces, and perceptions of the residents on the most preferred reconfiguration approaches. The land use/land cover [LULC] change was first determined by interpreting the 1973, 1986, 1995, 2002, 2014, and 2022 Landsat images using the QGIS 3.26 while the selected landscape fragmentation metrics were analyzed using FRAGSTATS 4.2. Forests, shrubs, and grasslands showed a declining trend, except for agriculture, water, and built-up areas, which depicted high increases for the study periods [1973 to 2022]. The landscape of the study area is characterized as progressively fragmenting as signified by high escalated values of patch number [374 %], edge density [7828 %] between 1986 and 2002, contagion [10.3%], and a declined value of Shannon Diversity Index [SHDI] [-17.42%], Shannon evenness index [SHEI] [-25.8 %] and connectedness [-43.3%]. Considering these results, high losses of forests and grasslands coupled with expansive farmlands and built-up areas have led to unprecedented landscape fragmentation From field surveys and oral interviews, this has not only left streams vulnerable to massive sediment loads but has also triggered annual floods which occur during wet months even though change in onset of rainfall seasons was also reported. The findings call for restoration and integrated and sustainable restoration efforts, especially for the forests, grasslands, and riparian corridors along with sustainable urban planning and community-based sensitization on watershed management.

Mast cells are essential immune cells involved in the host’s defence against gastrointestinal nematodes. To evade the immune response, parasitic nematodes produce a variety of molecules. Galectin 1, produced by Teladorsagia circumcincta (Tci-gal-1), reduces mast cell degranulation and selectively regulates mediator production and release in an IgE-dependent manner. To uncover the activity of Tci-gal-1, we have examined the effect of the protein on gene expression, protein production, and apoptosis in activated basophilic leukaemia RBL-2H3 cells. Rat RBL-2H3 cells were activated with anti-DNP IgE and DNP-HSA, and then treated with Tci-gal-1. Microarray analysis was used to examine gene expression. The levels of several apoptosis-related molecules and cytokines were determined using antibody arrays and ELISA. Early and late apoptosis was evaluated cytometrically. Degranulation of cells was determined by a β-hexosaminidase release assay. Treatment of activated RBL-2H3 cells with Tci-gal-1 resulted in inhibited apoptosis and decreased degranulation, although we did not detect significant changes in gene expression. The production of pro-apoptotic molecules, receptor for advanced glycation end products (RAGE) and Fas ligand (FasL), and the cytokines IL-9, IL-10, IL-13, TNF-α, and IL-2 was strongly inhibited. Tci-gal-1 modulates apoptosis, degranulation, and production of cytokines by activated RBL-2H3 cells without detectable influence on gene transcription. This parasite protein is crucial for modulation of the protective immune response and the inhibition of chronic inflammation driven by mast cell activity.

Single nucleotide polymorphisms (SNPs) in the Plasmodium falciparum multi-drug resistance protein 1 (Pfmrp1) gene have previously been reported to confer resistance to Artemisinin-based Combination Therapies (ACTs) in Southeast Asia. A total of 300 samples collected from six sites between 2008 and 2019 under an ongoing malaria drug sensitivity patterns in Kenya study were evaluated for the presence of SNPs at Pfmrp1 gene codons: H191Y, S437A, I876V, and F1390I using the Agena MassARRAY® platform. Each isolate was further tested against artemisinin (ART), lumefantrine (LU), amodiaquine (AQ), mefloquine (MQ), quinine (QN), and chloroquine (CQ) using malaria the SYBR Green I-based method to determine their in vitro drug sensitivity. Of the samples genotyped, polymorphism at Pfmrp1 codon I876V was the most frequent, with 59.3% (163/275) mutants, followed by F1390I, 7.2% (20/278), H191Y, 4.0% (6/151), and S437A, 3.3% (9/274). A significant decrease in median 50% inhibition concentrations (IC50s) and interquartile range (IQR) was noted; AQ from 2.996 ng/ml [IQR = 2.604-4.747, n = 51] in 2008 to 1.495 ng/ml [IQR = 0.7134-3.318, n = 40] (P

This study focuses on the fabrication and analysis of the mechanical behaviour of unidirectional (UD) glass fibre-reinforced polymer (GFRP) facesheet and polyvinyl chloride (PVC) foam core sandwich structures fabricated by a vacuum-assisted resin infusion method (VARIM). These sandwich structures are commonly used in marine and wind turbine blade applications. To date, relatively little knowledge about the functional behaviour of UD GFRP compared to composites reinforced with bidirectional mats is available for day-to-day applications. The effects of the facesheet orientation, facesheet thickness, and core thickness on the mechanical behaviour of the specimens were examined. The UD fibres were oriented in cross-ply (0/90), angle-ply (+45/−45), and quasi-isotropic orientations. Various mechanical properties such as tensile, flexural, flatwise compression, and edgewise compression tests were examined. Characterization of the tensile properties of the facesheet showed that the cross-ply orientation had a higher strength than the angle-ply and quasi-isotropic orientations. The flexural load-carrying capacity of the cross-ply facesheet orientation was superior to the other orientations. The increase in the core thickness changed the flexural failure mode from face yield and core shear to core indentation. Flatwise compression (FWC) was tested to determine the core characteristics of the sandwich structure, and the peak loads of 4.90, 1.81, and 3.90 kN were obtained for 10-, 15-, and 20 mm core thicknesses, respectively. Edgewise compression (EWC) exhibited stable end crushing for thinner facesheet, whereas thicker facesheet showed core crushing and buckling. When the facesheet thickness was increased from 1.5 mm to 3 mm in the EWC, the buckling load increase ranged from 2.53% to 44.83% for core thicknesses 10-, 15-, and 20 mm, respectively.

Research increasingly involves cross-cultural work with non-English-speaking populations, necessitating translation and cultural validation of research tools. This paper describes the process of translating and criterion validation of the Client Diagnostic Questionnaire (CDQ) for use in a multisite study in Kenya and Uganda. The English CDQ was translated into Swahili, Dholuo (Kenya) and Runyankole/Rukiga (Uganda) by expert translators. The translated documents underwent face validation by a bilingual committee, who resolved unclear statements, agreed on final translations and reviewed back translations to English. A diagnostic interview by a mental health specialist was used for criterion validation, and Kappa statistics assessed the strength of agreement between non-specialist scores and mental health professionals' diagnoses. Achieving semantic equivalence between translations was a challenge. Validation analysis was done with 30 participants at each site (median age 32.3 years (IQR = (26.5, 36.3)); 58 (64.4%) female). The sensitivity was 86.7%, specificity 64.4%, positive predictive value 70.9% and negative predictive value 82.9%. Diagnostic accuracy by the non-specialist was 75.6%. Agreement was substantial for major depressive episode and positive alcohol (past 6 months) and alcohol abuse (past 30 days). Agreement was moderate for other depressive disorders, panic disorder and psychosis screen; fair for generalized anxiety, drug abuse (past 6 months) and Post Traumatic Stress Disorder (PTSD); and poor for drug abuse (past 30 days). Variability of agreement between sites was seen for drug use (past 6 months) and PTSD. Our study successfully adapted the CDQ for use among people living with HIV in East Africa. We established that trained non-specialists can use the CDQ to screen for common mental health and substance use disorders with reasonable accuracy. Its use has the potential to increase case identification, improve linkage to mental healthcare, and improve outcomes. We recommend further studies to establish the psychometric properties of the translated tool.

Background: Corona Virus Disease 2019 (COVID-19), an infection caused by the SARS-CoV-2 virus, has been the largest global pandemic since the turn of the 21st century. With emerging research on this novel virus, studies from the African continent have been few. Corona Virus Disease 2019 has been shown to affect various organs including the lungs, gut, nervous system, and the kidneys. Acute kidney injury (AKI) is an independent risk factor for mortality and increases the health care burden for patients with persistent kidney dysfunction and maintenance dialysis. Sub-Saharan Africa has a high number of poorly controlled chronic illnesses, economic inequalities, and health system strains that may contribute to higher cases of kidney injury in patients with COVID-19 disease. Objectives: The objective of this study was to determine the incidence, associated factors, and outcomes of AKI in patients hospitalized with COVID-19 in Kenya. Methods: This retrospective cohort study included 1366 patients with confirmed COVID-19 illness hospitalized at the Aga Khan University Hospital in Nairobi, Kenya, between April 1, 2020 and October 31, 2021. Data were collected on age, sex, the severity of COVID-19 illness, existing pregnancy and comorbid conditions including human immunodeficiency virus (HIV), diabetes mellitus, hypertension, and functioning kidney transplant patients. Univariate analysis was carried out to determine the association of clinical and demographic factors with AKI. To determine independent associations with AKI incidence, a logistic regression model was used and the relationship was reported as odds ratios (ORs) with a 95% confidence interval (CI). The outcomes of AKI including the in-hospital mortality rate, renal recovery rate at hospital discharge, and the duration of hospital stay were reported and stratified based on the stage of AKI. Results: The median age of study patients was 56 years (interquartile range [IQR] = 45-68 years), with 67% of them being male (914 of 1366). The AKI incidence rate was 21.6% (n = 295). Patients with AKI were older (median age = 64 years vs 54 years; P < .001), majority male (79% of men with AKI vs 63.6% without AKI; P < .001), and likely to have a critical COVID-19 (OR = 8.03, 95% CI = 5.56-11.60; P < .001). Diabetes and hypertension, with an adjusted OR of 1.75 (95% CI = 1.34-2.30; P < .001) and 1.68 (95% CI = 1.27-2.23; P < .001), respectively, were associated with AKI occurrence in COVID-19. Human immunodeficiency virus, pregnancy, and a history of renal transplant were not significantly associated with increased AKI risk in this study. Patients with AKI had significantly higher odds of mortality, and this effect was proportional to the stage of AKI (OR = 11.35, 95% CI = 7.56-17.03; P < .001). 95% of patients with stage 1 AKI had complete renal recovery vs 33% of patients with stage 3 AKI. Of the patients with stage 3 AKI (n = 64), 10 underwent hemodialysis, with 1 recovery in renal function and 3 patients requiring ongoing dialysis after discharge. Conclusions: This study was conducted at a single private tertiary-level health care facility in Kenya and only up to the time of hospital discharge. It is one of the first large studies from sub-Saharan Africa looking at the associated factors and outcomes of AKI in COVID-19 and forms a foundation for further analysis on the long-term consequences of COVID-19 on the kidneys. A major limitation of the study is the lack of baseline pre-admission creatinine values for most patients; thus, the impact of chronic kidney disease/baseline creatinine values on the incidence of AKI could not be established.

IntroductionPopulations of natural enemies of insect pests are declining owing to agricultural intensification and indiscriminate use of pesticides, and this may be exacerbated in agricultural systems that clear all margin plants after the cropping season for other uses such as fodder. Retaining a diversity of non-crop flowering vegetation outside the cropping season may support more resilient and effective natural pest regulation.MethodsWe tested the potential for non-crop vegetation to support natural enemies in fields across two locations after harvesting the primary crops of lablab and maize.ResultsA total of 54 plant species were recorded across the sites in Kenya with 59% of them being annuals and 41% perennials. There was a significant seasonal variation in plant species richness (ANOVA: F1, 16 = 33. 45; P< 0.0001) and diversity (ANOVA: F1, 16 = 7.20; P = 0.0511). While time since harvesting was a significant factor influencing the overall abundance of natural enemies (ANOVA: F2, 1,133 = 8.11; P< 0.0001), they were generally higher in abundance in locations with margin plants or where a diversity of margin plants was observed.DiscussionThese findings demonstrate that flowering plants in agricultural systems offer refuge and alternative food for natural enemies and potentially other beneficial insects between cropping seasons. The conservation of natural enemies between crops may lead to more effective natural pest regulation early in the following crop, thus reducing reliance on insecticides application.

Pancreatic [beta] cells are specialized for coupling glucose metabolism to insulin peptide production and secretion. Acute glucose exposure robustly and coordinately increases translation of proinsulin and proteins required for secretion of mature insulin peptide. By contrast, chronically elevated glucose levels that occur during diabetes impair [beta] cell insulin secretion and have been shown experimentally to suppress insulin translation. Whether translation of other genes critical for insulin secretion is similarly downregulated by chronic high glucose is unknown. Here, we used high-throughput ribosome profiling and nascent proteomics in MIN6 insulinoma cells to elucidate the genome- wide impact of sustained high glucose on [beta] cell mRNA translation. Before induction of ER stress or suppression of global translation, sustained high glucose suppressed glucose-stimulated insulin secretion and downregulated translation of not only insulin, but also mRNAs related to insulin secretory granule formation, exocytosis, and metabolism-coupled insulin secretion. Translation of these mRNAs was also downregulated in primary rat and human islets following ex vivo incubation with sustained high glucose and in an in vivo model of chronic mild hyperglycemia. Furthermore, translational downregulation decreased cellular abundance of these proteins. Our study uncovered a translational regulatory circuit during [beta] cell glucose toxicity that impairs expression of proteins with critical roles in [beta] cell function., Introduction Diabetes results from failure of pancreatic [beta] cells to secrete sufficient insulin to regulate glucose homeostasis. Progressive decline in [beta] cell function occurs in the setting of hyperglycemia during [...]

Tryptophan metabolites, such as 5-hydroxytryptophan (5-HTP), serotonin, and melatonin, hold significant promise as supplements for managing various mood-related disorders, including depression and insomnia. However, their chemical production via chemical synthesis and phytochemical extraction presents drawbacks, such as the generation of toxic byproducts and low yields. In this study, we explore an alternative approach utilizing S. cerevisiae STG S101 for biosynthesis. Through a series of eleven experiments employing different combinations of tryptophan supplementation, Tween 20, and HEPES buffer, we investigated the production of these indolamines. The tryptophan metabolites were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Notably, setups replacing peptone in the YPD media with tryptophan (Run 3) and incorporating tryptophan along with 25 mM HEPES buffer (Run 4) demonstrated successful biosynthesis of 5-HTP and serotonin. The highest 5-HTP and serotonin concentrations were 58.9 ± 16.0 mg L−1 and 0.0650 ± 0.00211 mg L−1, respectively. Melatonin concentrations were undetected in all the setups. These findings underscore the potential of using probiotic yeast strains as a safer and conceivably more cost-effective alternative for indolamine synthesis. The utilization of probiotic strains presents a promising avenue, potentially offering scalability, sustainability, reduced environmental impact, and feasibility for large-scale production.

Background There are limited data on the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in African populations. Here we report the immunogenicity and safety of the ChAdOx1 nCoV-19 (AZD1222) vaccine from a phase 1/2 single-blind, randomised, controlled trial among adults in Kenya conducted as part of the early studies assessing vaccine performance in different geographical settings to inform Emergency Use Authorisation. Methods We recruited and randomly assigned (1:1) 400 healthy adults aged ≥18 years in Kenya to receive ChAdOx1 nCoV-19 or control rabies vaccine, each as a two-dose schedule with a 3-month interval. The co-primary outcomes were safety, and immunogenicity assessed using total IgG enzyme-linked immunosorbent assay (ELISA) against SARS-CoV-2 spike protein 28 days after the second vaccination. Results Between 28th October 2020 and 19th August 2021, 400 participants were enrolled and assigned to receive ChAdOx1 nCoV-19 (n=200) or rabies vaccine (n=200). Local and systemic adverse events were self-limiting and mild or moderate in nature. Three serious adverse events were reported but these were deemed unrelated to vaccination. The geometric mean anti-spike IgG titres 28 days after second dose vaccination were higher in the ChAdOx1 group (2773 ELISA units [EU], 95% CI 2447, 3142) than in the rabies vaccine group (61 EU, 95% CI 45, 81) and persisted over the 12 months follow-up. We did not identify any symptomatic infections or hospital admissions with respiratory illness and so vaccine efficacy against clinically apparent infection could not be measured. Vaccine efficacy against asymptomatic SARS-CoV-2 infection was 38.4% (95% CI -26.8%, 70.1%; p=0.188). Conclusions The safety, immunogenicity and efficacy against asymptomatic infection of ChAdOx1 nCoV-19 among Kenyan adults was similar to that observed elsewhere in the world, but efficacy against symptomatic infection or severe disease could not be measured in this cohort. Pan-African Clinical Trials Registration PACTR202005681895696 (11/05/2020)