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Physiological changes during pregnancy may alter the pharmacokinetics (PK) of antituberculosis drugs. The International Maternal Pediatric Adolescent AIDS Clinical Trials Network P1026s was a multicenter, phase IV, observational, prospective PK and safety study of antiretroviral and antituberculosis drugs administered as part of clinical care in pregnant persons living with and without HIV. We assessed the effects of pregnancy on rifampin, isoniazid, ethambutol, and pyrazinamide PK in pregnant and postpartum (PP) persons without HIV treated for drug-susceptible tuberculosis disease. Daily antituberculosis treatment was prescribed following World Health Organization-recommended weight-band dosing guidelines. Steady-state 12-hour PK profiles of rifampin, isoniazid, ethambutol, and pyrazinamide were performed during second trimester (2T), third trimester (3T), and 2-8 of weeks PP. PK parameters were characterized using noncompartmental analysis, and comparisons were made using geometric mean ratios (GMRs) with 90% confidence intervals (CI). Twenty-seven participants were included: 11 African, 9 Asian, 3 Hispanic, and 4 mixed descent. PK data were available for 17, 21, and 14 participants in 2T, 3T, and PP, respectively. Rifampin and pyrazinamide AUC0-24 and C max in pregnancy were comparable to PP with the GMR between 0.80 and 1.25. Compared to PP, isoniazid AUC0-24 was 25% lower and C max was 23% lower in 3T. Ethambutol AUC0-24 was 39% lower in 3T but limited by a low PP sample size. In summary, isoniazid and ethambutol concentrations were lower during pregnancy compared to PP concentrations, while rifampin and pyrazinamide concentrations were similar. However, the median AUC0-24 for rifampin, isoniazid, and pyrazinamide met the therapeutic targets. The clinical impact of lower isoniazid and ethambutol exposure during pregnancy needs to be determined.

Until recently, no research has ever been done on user attitudes to Afrikaans taboo language. To address this shortcoming, a multidisciplinary research project was initiated to investigate, among others, user attitudes to swearwords. Online single-word surveys (SWSs) for individual swearwords have been posted periodically on the project website.1 Volunteer respondents are recruited through respondent-driven opportunistic sampling and snow-ball sampling via social media. Respondents firstly give their informed consent, and then once-off provide some sociodemographic information. Thereafter, each swearword is judged on at least seven attitudinal dimensions. All data are stored in a relational database, and then extracted to create a single UTF-8 encoded CSV file. The dataset holds great potential for perusal in numerous language-specific (i.e., Afrikaans) sociopragmatic and/or sociolinguistic investigations and applications, as well as for comparative linguistic research and general statistical modelling.

There has been a long-standing debate about the applicability of different statistical tests to Likert-type data. This work contributes to this debate by comparing the results of three statistics, Analysis of Variance, Kruskal-Wallis H test, and ordinal logistic regression, in the context of self-reported attitude and usage of swearwords. The aims of this comparison are to determine how similar the results of the different statistics are, which of the statistical test are most appropriate for sociopragmatic linguistic investigations, and how the results influence the interpretation possibilities of the same data. An analysis of the results for the different statistics shows some overlap between the three statistics, but that the parametric ANOVA is substantially more conservative in identifying significant relationships between sociodemographic factors and the usage and attitude toward swearwords, while the H test and ordinal logistic regression models are mostly identical, except where the assumptions of the regression model are violated. Based on our results, we argue that the Kruskal-Wallis H test, with the associated post-hoc test, is the most appropriate test for Likert-type data, with sufficient descriptive power to allow for detailed and informed analysis of this data.

BackgroundRandomized-trial data on the risks and benefits of antiretroviral therapy (ART) as compared with zidovudine and single-dose nevirapine to prevent transmission of the human immunodeficiency virus (HIV) in HIV-infected pregnant women with high CD4 counts are lacking.MethodsWe randomly assigned HIV-infected women at 14 or more weeks of gestation with CD4 counts of at least 350 cells per cubic millimeter to zidovudine and single-dose nevirapine plus a 1-to-2-week postpartum "tail" of tenofovir and emtricitabine (zidovudine alone); zidovudine, lamivudine, and lopinavir-ritonavir (zidovudine-based ART); or tenofovir, emtricitabine, and lopinavir-ritonavir (tenofovir-based ART). The primary outcomes were HIV transmission at 1 week of age in the infant and maternal and infant safety.ResultsThe median CD4 count was 530 cells per cubic millimeter among 3490 primarily black African HIV-infected women enrolled at a median of 26 weeks of gestation (interquartile range, 21 to 30). The rate of transmission was significantly lower with ART than with zidovudine alone (0.5% in the combined ART groups vs. 1.8%; difference, -1.3 percentage points; repeated confidence interval, -2.1 to -0.4). However, the rate of maternal grade 2 to 4 adverse events was significantly higher with zidovudine-based ART than with zidovudine alone (21.1% vs. 17.3%, P=0.008), and the rate of grade 2 to 4 abnormal blood chemical values was higher with tenofovir-based ART than with zidovudine alone (2.9% vs. 0.8%, P=0.03). Adverse events did not differ significantly between the ART groups (P>0.99). A birth weight of less than 2500 g was more frequent with zidovudine-based ART than with zidovudine alone (23.0% vs. 12.0%, P

Uterine balloon tamponade (UBT) should be attempted once emergency measures have been applied and medical treatment for post-partum haemorrhage (PPH) resulting from an atonic uterus has failed. Sinapi Biomedical (Pty) Ltd developed the Ellavi UBT, a free-flow pressure-controlled UBT unit. The device is affordable for use in lesser-resourced countries. A case series of Ellavi UBT used by medical officers in a rural regional hospital without specialist supervision was conducted. This case series was conducted in St Elizabeth’s Hospital in Lusikisiki, South Africa. The hospital serves as the regional hospital for the Ingquza Hill Subdistrict in the Eastern Cape Province. The Nelson Mandela Academic Hospital (NMAH) in Mthatha is the tertiary referral hospital. Workshops were conducted on the use of Ellavi UBT, and devices were made freely available to the hospital. The case series included 10 patients. Six patients delivered by caesarean section, and four had normal vertex deliveries. All patients had additional oxytocin infusions, and eight patients received misoprostol. Following the insertion and inflation of the Ellavi UBT, the PPH stopped in seven patients, was much reduced in one patient and reduced in one patient. In one case, the Ellavi UBT had no effect on the bleeding. All 10 patients were referred to the NMAH. All patients in the case series had good outcomes. The insertion of the Ellavi UBT and subsequent referral proved to be feasible in a rural regional hospital. All patients included in the case series arrived at the referral hospital and had a good outcome.

The national human immunodeficiency virus (HIV) mother-to-child transmission rate at 6–10 weeks post-partum was 0.9% in 2016. There is a paucity of data about the intrapartum transmission rate after lifelong antiretroviral therapy was implemented in 2015. We assessed all pregnant women living with HIV who delivered at Tygerberg Hospital in 2017. Positive polymerase chain reactions (PCRs) at birth indicated an in utero transmission rate of 0.8%. One infant with a negative PCR at birth tested positive at 6–10 weeks. The intrapartum transmission rate was low (0.08%). About 25% of infants were lost to follow-up after birth.

BackgroundPlay Kindly is a gamified animated app designed to address common behavioral problems in childhood. The interface is designed to appeal to Pacific people, a population group with a higher risk of developing clinically significant behavioral problems than most other ethnic groups in New Zealand. ObjectiveThe aim of this study is to explore the opinions of parents and professionals about the acceptability, usability, and content of Play Kindly. MethodsWe used qualitative and Pacific and Māori research methodologies. A total of five focus groups with 45 parents and 12 individual interviews with professionals were conducted. The five focus groups consisted of 2 pan-Pacific groups, 1 Māori group, 1 open group, and 1 group of young Pacific adults or prospective parents. The professionals were from a range of disciplines, and the majority had expertise in early childhood, parenting interventions, or research in this field. ResultsPlay Kindly appealed to both parents and professionals. Participants related to the scenarios, which were created in collaboration with a playwright and animator. Although most participants liked the Pacific feel, there was some disagreement about how culturally specific the app should be. A range of issues with usability and gamification techniques were highlighted, likely attributed to the low budget and lack of initial co-design with parents as well as professionals with specific expertise in parenting. A number of parents and professionals felt that the parenting strategies were overly simplified and did not take into account the context in which the behavior occurred. Professionals suggested narrowing the focus of the app to deliver two important parenting messages: playing with your child and positively reinforcing desired behaviors. ConclusionsPlay Kindly is the first culturally adapted parenting app of its kind designed for Pacific parents and other New Zealanders with children 2-5 years of age. This app has potential in Pacific communities where there are limited culturally specific parenting resources. The results of this study will guide improvements of the app prior to testing it in an open trial.

Generic pharmaceuticals should have very little price dispersion. Economics' Law of One Price suggests that identical goods, in the absence of trade frictions and under conditions of free competition and price flexibility, should sell for the same price, and the FDA ensures that generics are identical. In this study, we examine whether generic pharmaceuticals indeed have the low price dispersion that theory predicts, and if not, whether the dispersion seen for pharmaceuticals used to treat neuropsychiatric conditions is substantially higher than that of other drugs. Such a difference may offer an explanation for the price dispersion seen: namely, a strategy that takes advantage of buyers' cognitive constraints and impaired ability to comparison shop. We thus assembled a list of generic pharmaceuticals and their prices using www.GoodRx.com, based on a convenience sample of the 5 most popular drugs for 10 common medical conditions listed there. Three neuropsychiatric diagnoses were used: Alzheimer's disease, depression and schizophrenia. Seven other diagnoses served as controls: asthma; diabetes mellitus-type II; high cholesterol; hypertension; osteoarthritis; osteoporosis; and urinary tract infection. For each drug, we identified the highest and lowest prices and calculated the mean, median and coefficient of variation (CV). We further calculated the ratios of the highest price to the median price and of the highest to lowest price. We found that the mean price CV was 43%. For neuropsychiatric drugs and controls, it was 61% and 35%, respectively. The mean high-to-median ratio was3.7 for neuropsychiatric drugs and 1.9 for controls. The mean high-to-low ratio was 5.9 for neuropsychiatric drugs and 2.8 for controls. In short, generic medications have high price dispersion, despite public availability of prices. Although our study did not examine why this price dispersion is present, the especially large high-to-low price ratio for neuropsychiatric medications suggests a strategy that exploits vulnerable patients.

A corpus exploration of huidiglik. In tandem with Van Huyssteen (2018a), this article examines the current usage of the word huidiglik (‘currently’) (an alleged Anglicism), together with other associated words (e.g. its base, huidig ‘current’). Based on a comprehensive literature review, Van Huyssteen (2018a) concludes that apart from stylistic preferences, none of the linguistic arguments against huidiglik holds water. In this article, a corpus exploration of some of the issues pertaining to huidiglik is undertaken. Based on evidence from a large variety of corpora, we conclude that huidiglik has become well-established in Afrikaans over the past four decades, both in formal texts and informal chat language. Since it does not displace any of its often-prescribed synonyms (like tans, deesdae, or teenswoordig), it confirms that arguments for its status as an Anglicism is rather thin. Although the inflected form huidige is mostly used as prenominal adjective, its uninflected form is also used with noticeable frequency as adverb and predicative adjective. Huidiglik, however, is used almost exclusively as adverb, rarely as inflected attributive adjective, but never as predicative adjective. Lastly, it is shown that adverbialising ⋅lik occurs with high frequency in Afrikaans, but it is not very productive. In addition, it is illustrated that ⋅ig⋅lik is an entrenched suffix pairing.

Norms of huidiglik. In Afrikaans, huidiglik is a truly Janus-faced word: it is being used with high frequency in especially spoken language, while at the same time being one of the biggest language pet-peeves of language practitioners (and even ordinary speakers of Afrikaans). When asked why huidiglikshould be avoided, these language practitioners and language users often cannot provide any reasoning about it. A comprehensive literature review also reveals that linguists and language practitioners often give contradictory, or even linguistically incorrect reasons for why huidiglik is supposedly not acceptable in (standard) Afrikaans. By comparing a variety of normative grammaticographic sources (such as reference guides and prescriptive grammars), this article shows that: (1) huidiglik originated, on a balance of probability, in the 1970s in the South African Parliament; and (2) apart from stylistic preferences (e.g. that it sounds pretentious, feigned and affectatious), none of the linguistic arguments against huidiglik holds water. In a supplementary article in this issue of the journal it is being illustrated that huidiglik is alive and well in written (Standard) Afrikaans.

In Afrikaans and other Germanic languages there is a subcategory of exocentric compounds that can be used evaluatively as personal names. The focus of this article is on such exocentric compounds that are used pejoratively as epithets (i.e., epithetic exocentric compounds (EECs)), and even more specifically on EECs that are based on one of two conceptual metonymies: BODY PART FOR PERSON (for example, skinder÷bek gossip÷mouth 'gossiper') and (PART OF) GARMENT FOR PERSON (for example, slaap÷kous sleep÷sock 'sleepy head'). These kinds of metonymic exocentric compounds are also sometimes referred to in the literature as bahuvrihi or possessive compounds (Booij, 2020). The article empirically examines the potential offensiveness of EECs. An online questionnaire with nine questions was filled out by 98 respondents, of which 92 respondents' responses were usable. In this questionnaire, respondents had to rank the items (words) from least offensive to most offensive. For each of the nine questions, the rankings were converted to numerical values, so that the median per word could be quantified as a relative offensiveness value. Next, a Friedman test was performed for each question, which showed that there were indeed statistically significant (p < 0.05) differences between the items in each question. To determine where exactly the differences lie (i.e., which word pairs' medians differ statistically significantly), Wilcoxon's signed-rank test was used, and the p-values were adjusted with the Bonferroni method (for adjusted *p-values). This information could then be used to accept or reject the null hypotheses. The first research question was: "Are metonymic EECs more or less offensive than semantically equivalent non-EECs?" The null hypothesis, which stated that there is no distinction to be made between the potential offensiveness of EECs and semantically equivalent non-EECs, could be rejected in a few cases (for example, that vet÷gat (fat÷hole 'fatso'), and dik÷gat (thick÷hole 'fatso') are more offensive than seekoei ('hippopotamus') and vark ('pig') (question 1), as well as dik÷sak (thick÷sack 'fatso') and vet÷sak (fat÷sack 'fatso'), versus dikk·erd (thick·NMLZ 'fatso') and vett·ie (fat·DIM 'fatso') (question 5). Nevertheless, there was not enough convincing evidence to be able to say with the necessary certainty that non-EECs are less offensive than EECs. One of the possible reasons for this is that non-EECs such as dwaas ('fool') and ghwar ('fool') also have other, additional, negative meaning elements than their EEC counterparts (dwaas÷kop foolish÷head 'fool', and dom÷kop stupid÷head 'fool'). Our conclusion is therefore that non-EECs ≈ EECs. The second research question was: "Are suffixoids that are references to body parts more or less offensive than suffixoids referring to articles of clothing?" To compare the potential offensiveness value of suffixoids, it was stated as a null hypothesis that there is no distinction to be made between suffixoids referring to body parts versus suffixoids referring to articles of clothing. Although we could here too not simply reject the null hypothesis, we could still order the investigated suffixoids on a spectrum of potential offensiveness, namely: ÷nose ≈ ÷trousers < ÷sack < ÷hole. [ABSTRACT FROM AUTHOR]

Following Den Besten’s (2009) desiderata for historical linguistics of Afrikaans, this article aims to contribute some modern evidence to the debate regarding the founding dialects of Afrikaans. From an applied perspective (i.e. human language technology), we aim to determine which West Germanic language(s) and/or dialect(s) would be best suited for the purposes of recycling speech resources for the benefit of developing speech technologies for Afrikaans. Being recognised as a West Germanic language, Afrikaans is first compared to Standard Dutch, Standard Frisian and Standard German. Pronunciation distances are measured by means of Levenshtein distances. Afrikaans is found to be closest to Standard Dutch. Secondly, Afrikaans is compared to 361 Dutch dialectal varieties in the Netherlands and North-Belgium, using material from the Reeks Nederlandse Dialectatlassen, a series of dialect atlases compiled by Blancquaert and Pée in the period 1925-1982 which cover the Dutch dialect area. Afrikaans is found to be closest to the South-Holland dialectal variety of Zoetermeer; this largely agrees with the findings of Kloeke (1950). No speech resources are available for Zoetermeer, but such resources are available for Standard Dutch. Although the dialect of Zoetermeer is significantly closer to Afrikaans than Standard Dutch is, Standard Dutch speech resources might be a good substitute.