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The availability of potable water has decreased in recent times due to the extensive discharge of effluents from some industries. This contaminated water poses a great danger to both human and aquatic life. Senna fistula was activated using phosphoric acid, H3PO4 and its ability to remove Safranin O from aqueous solution was investigated. The characterization of Senna fistula activated carbon was done by Scanning Electron Microscopy and Fourier Transform Infrared Spectroscopy. The impacts of pH, initial dye concentration, contact time, and effect of temperature were investigated. Results showed that the optimum pH for the removal of Safranin O was 4.4. The adsorption capacity increased as the initial dye concentration increased from 30 - 130 mg/L. The dye adsorption equilibrium data were properly fitted to both Freundlich and Langmuir isotherms. The maximum uptake capacity for Safranin O was 22.1 mg/g. The kinetic studies indicated rapid sorption dynamics via a second-order kinetic model. The thermodynamic parameter shows that the sorption of Safranin O on Senna fistula activated carbon was feasible, spontaneous and endothermic. Senna fistula-activated carbon was found to be cheap and efficient adsorbents for the removal of Safranin O dye from aqueous solutions. [ABSTRACT FROM AUTHOR]

The Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria, with support from its NIH Planning Grant organized a two Day workshop on "Ethics and Responsible Conduct of Research" at the University of Ibadan Centre for Sustainable Development (CESDEV). There were 8 facilitators and 78 participants. The workshop concluded that responsible conduct of research (RCR) is the practice of scientific investigation or research with integrity involving but not limited to the awareness and application of established professional norms and ethical principles in the performance of all activities related to scientific research. [ABSTRACT FROM AUTHOR]

This study explored teenagers' knowledge and perceptions regarding teenage pregnancy by using the Johnson Behavioural System Model. The increase in the termination of pregnancies in the study area, and the lack of guidelines for registered professional nurses to prevent teenage pregnancies, were reasons for undertaking this study. The research design was contextual, exploratory and qualitative in nature. The study participants were female teenagers using the participating primary healthcare (PHC) clinic's services. Semi-structured interviews were conducted with 30 teenagers. The findings indicated that most teenagers' sexuality education occurred at school and at home but on a very superficial and non-specific level. Although schools offered sexuality education, some teenagers became sexually active before they received any such education. Teenagers had unprotected sexual intercourse despite their awareness of contraceptives to prevent pregnancy. Most pregnant participants regarded their pregnancies as mistakes and the lack of communication about sexual issues with their parents presented problems. Recommendations and guidelines, addressing factors contributing to teenage pregnancies, are provided. These focus on the four chosen subsystems of the Johnson Behavioural System Model including the attachment system, dependency subsystem, achievement subsystem and sexual subsystem and guide the registered nurse to assess the drive, set and choices the teenager has and not just the observable behaviour, the pregnancy. If the registered nurse does not understand the drive underpinning the behaviour of the teenager, her counselling might focus only on the behaviour and be ineffective. [ABSTRACT FROM AUTHOR]

Wilson disease (WD) is a rare autosomal recessive condition with protean clinical manifestations that result from biallelic ATP7B mutations. However, nondestructive tissue tests to be applied clinically to tissue specimens are not widely available to effectively assess patients for possible WD. Previously, we showed that metallothionein (MTH) immunohistochemistry (IHC) has a high sensitivity and specificity for WD diagnosis and, thus, represents a potentially powerful diagnostic tool that can be used in routine histologic sections. This study aimed to validate this finding in a large cohort of bona fide patients with WD and to correlate metallothionein expression with other histologic features. We identified 91 cases of WD, which included 28 needle biopsies and 64 explants from 14 centers worldwide. Histologic features were evaluated, and a histopathological pattern was assigned to each case. All cases were evaluated with Masson trichrome and MTH IHC (clone UC1MT, Abcam) using a previously published technique. Liver tissues from chronic cholestatic diseases (n = 42) were used as controls. The median age of the cohort was 28.5 years. Of the 91 total cases, 83 were positive for MTH immunostain. In the controls, all 42 cases were negative for MTH immunostain. The sensitivity and specificity of MTH immunostain for WD were 91.20% and 100%, respectively. MTH IHC is a highly sensitive and specific cost-effective screening tool for WD. It can be used for patients across age groups, varied histologic patterns, and fibrosis stages. This marker could prove to be a valuable tool in the evaluation of patients with possible WD., (Copyright © 2024 United States & Canadian Academy of Pathology. Published by Elsevier Inc. All rights reserved.)

Background and Aims: For patients with obesity and metabolic syndrome, bariatric procedures such as vertical sleeve gastrectomy (VSG) have a clear benefit in ameliorating metabolic dysfunction-associated steatohepatitis (MASH). While the effects of bariatric surgeries have been mainly attributed to nutrient restriction and malabsorption, whether immuno-modulatory mechanisms are involved remains unclear., Approach and Result: Using murine models, we report that VSG ameliorates MASH progression in a weight loss-independent manner. Single-cell RNA sequencing revealed that hepatic lipid-associated macrophages (LAMs) expressing the triggering receptor expressed on myeloid cells 2 (TREM2) repress inflammation and increase their lysosomal activity in response to VSG. Remarkably, TREM2 deficiency in mice ablates the reparative effects of VSG, suggesting that TREM2 is required for MASH resolution. Mechanistically, TREM2 prevents the inflammatory activation of macrophages and is required for their efferocytic function., Conclusions: Overall, our findings indicate that bariatric surgery improves MASH through a reparative process driven by TREM2+ macrophages, providing insights into the mechanisms of disease reversal that may result in new therapies and improved surgical interventions., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Anaemia is a serious global public health problem with high prevalence (>40%) in children particularly in low- and middle-income countries including Namibia with a current 46.1% prevalence rate., Aim: This study was aimed at examining the sociodemographic factors influencing the occurrence of childhood anaemia levels in Namibia., Method: A multivariate ordinal regression model was applied to statistically identify potential sociodemographic factors associated with anaemia levels among children under-5 years old using data collected from the 2013 NDHS., Results: The odds of having mild anaemia level was lower for sociodemographic characteristics such as mother's age, total children ever born, health insurance coverage, child's residency, child's age and main language spoken at home. The odds of having moderate anaemia level was higher for characteristics such as mother's age, place of residence, highest education level and child's diarrhoea status, while it was lower for characteristics such as age of head of household, total children ever born, health insurance coverage and sex of child. Similarly, the odds of having severe anaemia level was higher for characteristics such as region, place of residence, highest education level, number of household members, wealth index, health insurance coverage, child's residency and child's diarrhoea status, while it was lower for characteristics such as total children ever born and sex of child., Conclusion: It is therefore recommended that the policies and practices concerning anaemia diagnosis, treatment and prevention in the country be substantially revised by policy-makers, starting with the known prevalent causes and identified sociodemographic factors from this study., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Banff Working Group on Liver Allograft Pathology met in September 2022. Participants included hepatologists, surgeons, pathologists, immunologists, and histocompatibility specialists. Presentations and discussions focused on the evaluation of long-term allograft health, including noninvasive and tissue monitoring, immunosuppression optimization, and long-term structural changes. Potential revision of the rejection classification scheme to better accommodate and communicate late T cell-mediated rejection patterns and related structural changes, such as nodular regenerative hyperplasia, were discussed. Improved stratification of long-term maintenance immunosuppression to match the heterogeneity of patient settings will be central to improving long-term patient survival. Such personalized therapeutics are in turn contingent on a better understanding and monitoring of allograft status within a rational decision-making approach, likely to be facilitated in implementation with emerging decision-support tools. Proposed revisions to rejection classification emerging from the meeting include the incorporation of interface hepatitis and fibrosis staging. These will be opened to online testing, modified accordingly, and subject to consensus discussion leading up to the next Banff conference., Competing Interests: Declaration of competing interest The authors of this manuscript have conflicts of interest to disclose as described by the American Journal of Transplantation. Annette Jackson: HLA consultant (Hansa Biopharma); Research reagents/grant (CareDx); Speaker bureau (One Lambda/ThermoFisher). Josh Levitsky: Advisor (Eurofins; eGenesis); Speaker for Takeda; Mallinckrodt. Richard Taubert: Research grant (Oncocyte/Chronix Biomedical). The other authors have no conflict of interest to disclose., (Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.)

Good water, sanitation, and hygiene (WASH) enhance healthy living and safe environments for child development. The study aimed to evaluate the impact of an educational intervention on WASH status, knowledge, attitudes and practices in early child development (ECD) centres in low socio-economic areas in the Nelson Mandela Bay in 2021. This quasi-experimental, one group, pre-post-test study elicited responses from 51 ECD practitioners (1 per ECD centre). Telephonic structured knowledge, attitude and practices (KAP) questionnaires were used. KAP was good among participants. The educational intervention significantly improved mean knowledge (p<0.001, 95% CI: 0.58-1.11) attitudes (p<0.001, 95% CI: 0.39-0.67) and practices (p = 0.001, 95% CI: 0.20-0.74). WASH knowledge was significantly impacted by toilet facilities ventilation status (p = 0.083) while WASH attitudes scores were significantly impacted by ventilation where the potties are kept (p = 0.041). WASH practice scores were significantly impacted by across the bush/field (no facility) (p = 0.021) and plastic potties usage (p = 0.057). The educational intervention significantly improved WASH-related knowledge, attitudes, and practices among ECD practitioners. WASH conditions in the ECD centres in the study area require additional interventions targeted to sustainable strategies to enhance behavioural modifications for acceptability and sustainability of intervention strategies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Melariri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Hospital-acquired infections (HAI) are a leading cause of morbidity and mortality globally. These infections are diverse, but the majority are lower respiratory tract infection (LRTI), surgical site infection (SSI), bloodstream infection (BSI), and urinary tract infection (UTI). For most sub-Saharan African countries, studies revealing the burden and impact of HAI are scarce, and few systematic reviews and meta-analysis have been attempted. We sought to fill this gap by reporting recent trends in HAI in sub-Saharan Africa (SSA) with attention to key patient populations, geographic variation, and associated mortality., Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a literature search of six electronic databases (Web of Science, Pubmed, APA PsycInfo, CINAHL, Embase, and the Cochrane Library) to identify studies assessing the prevalence of HAI in SSA countries. Studies published between 01 January 2014 and 31 December 2023 were included. We applied no language or publication restrictions. Record screening and data extractions were independently conducted by teams of two or more reviewers. Using the R software (version 4.3.1) meta and metafor packages, we calculated the pooled prevalence estimates from random-effect meta-analysis, and further explored sources of heterogeneity through subgroup analyses and meta-regression. This study is registered with PROSPERO, CRD42023433271., Findings: Forty-one relevant studies were identified for analysis, consisting of 15 from West Africa (n = 2107), 12 from Southern Africa (n = 2963), 11 from East Africa (n = 2142), and 3 from Central Africa (n = 124). A total of 59.4% of the patient population were associated with paediatric admissions. The pooled prevalence of HAI was estimated at 12.9% (95% CI: 8.9-17.4; n = 7336; number of included estimates [k] = 41, p < 0.001). By subregions, the pooled current prevalence of HAI in the West Africa, Southern Africa, East Africa and Central Africa were estimated at 15.5% (95% CI: 8.3-24.4; n = 2107; k = 15), 6.5% (95% CI: 3.3-10.7; n = 2963; k = 12), 19.7% (95% CI: 10.8-30.5; n = 2142; k = 11) and 10.3% (95% CI: 1.1-27.0; n = 124; k = 3) of the patient populations respectively. We estimated mortality resulting from HAI in SSA at 22.2% (95% CI: 14.2-31.4; n = 1118; k = 9)., Interpretation: Our estimates reveal a high burden of HAI in SSA with significant heterogeneity between regions. Variations in HAI distribution highlight the need for infection prevention and surveillance strategies specifically tailored to enhance prevention and management with special focus on West and East Africa, as part of the broader global control effort., Funding: No funding was received for this study., Competing Interests: The authors declare no competing interests., (© 2024 The Authors.)

Background: Macrophage activation syndrome is a rare disorder leading to unregulated immune activity manifesting with nonspecific constitutional symptoms, laboratory abnormalities, and multiorgan involvement. We report the case of a patient who presented with acute hepatitis secondary to macrophage activation syndrome diagnosed by liver biopsy and successfully treated with intravenous immune globulin, anakinra, and rituximab., Case Presentation: A 42-year-old Laotian woman with adult-onset immunodeficiency with anti-interferon gamma antibodies presented with a fever, headache, generalized myalgia, dark urine, and reduced appetite in the setting of family members at home with similar symptoms. Her laboratory workup was notable for evidence of acute hepatitis without acute liver failure. After an unrevealing comprehensive infectious and noninvasive rheumatologic workup was completed, a liver biopsy was performed ultimately revealing the diagnosis of macrophage activation syndrome. She was successfully treated with intravenous immune globulin, anakinra, and rituximab., Conclusion: This case highlights the importance of maintaining macrophage activation syndrome on the differential of a patient with acute hepatitis of unknown etiology in the correct clinical context and the value of a liver biopsy in making a diagnosis when noninvasive testing is unrevealing., (© 2023. The Author(s).)