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Benjamin T Prince,1 Beth K Thielen,2 Kelli W Williams,3 Erinn S Kellner,4 Danielle E Arnold,5 Wilfredo Cosme-Blanco,6 Margaret T Redmond,1 Nicholas L Hartog,7 Hey J Chong,8 Steven M Holland9 1Division of Allergy and Immunology, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA; 2Division of Pediatric Infectious Diseases and Immunology, University of Minnesota, Minneapolis, MN, USA; 3Department of Pediatrics, Division of Pediatric Pulmonology, Allergy & Immunology, Medical University of South Carolina, Charleston, SC, USA; 4Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA; 5Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 6Department of Allergy and Immunology, Veteran Affairs Caribbean Healthcare System, San Juan, Puerto Rico; 7Department of Allergy and Immunology, Spectrum Health Helen DeVos Children’s Hospital, Michigan State University College of Human Medicine, Grand Rapids, MI, USA; 8Division of Allergy and Immunology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA; 9National Institute of Allergy and Infectious Diseases, Bethesda, Maryland National Institutes of Health, Bethesda, MD, USACorrespondence: Benjamin T PrinceNationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USATel +1 (614) 722-4404Fax +1 (614) 722-4423Email Benjamin.Prince@Nationwidechildrens.orgAbstract: Chronic granulomatous disease (CGD) is a rare but serious primary immunodeficiency with varying prevalence and rates of X-linked and autosomal recessive disease worldwide. Functional defects in the phagocyte nicotinamide adenine dinucleotide phosphate oxidase complex predispose patients to a relatively narrow spectrum of bacterial and fungal infections that are sometimes fastidious and often difficult to identify. When evaluating and treating patients with CGD, it is important to consider their native country of birth, climate, and living situation, which may predispose them to types of infections that are atypical to your routine practice. In addition to recurrent and often severe infections, patients with CGD and X-linked female carriers are also susceptible to developing many non-infectious complications including tissue granuloma formation and autoimmunity. The DHR-123 oxidation assay is the gold standard for making the diagnosis and it along with genetic testing can help predict the severity and prognosis in patients with CGD. Disease management focuses on prophylaxis with antibacterial, antifungal, and immunomodulatory medications, prompt identification and treatment of acute infections, and prevention of secondary granulomatous complications. While hematopoietic stem-cell transplantation is the only widely available curative treatment for patients with CGD, recent advances in gene therapy may provide a safer, more direct alternative.Keywords: CGD, primary immunodeficiency diseases, nicotinamide adenine dinucleotide phosphate oxidase complex, DHR-123 oxidation assay

This study investigates convergence between developed and developing countries' GDP during the pre-COVID-19 era (1960–2019) and post-COVID-19 era (2020–2023) using World Bank data and the Augmented Dickey-Fuller (ADF) test. For the pre-COVID period, results show no significant convergence, with an ADF statistic of -1.78 and a p-value of 0.39, likely due to disparities in industrialization and governance. Similarly, post-COVID results (ADF statistic -1.2, p-value 0.67) also suggest no convergence, possibly exacerbated by pandemic-related challenges. The study highlights that structural barriers and the pandemic have hindered economic convergence.

This study examines the mediating role of financial literacy between savings attitudes and generational poverty in Ghana. Generational poverty is a significant issue in Ghana, with a multidimensional poverty rate of 45.6% and a consumer expenditure poverty rate of 23.4%. The problem persists due to low financial literacy and poor savings attitudes, which hinder economic growth and development. The research employed a quantitative methodology, utilizing a series of regression analyses to test the mediation effects of financial literacy. A correlational design was adopted to assess the relationships between the variables. The study’s population included 400 individuals from the five regions in the northern part of Ghana, particularly focusing on rural areas with high poverty rates. A stratified random sampling technique was used to select participants, ensuring diverse representation. Results indicated that a positive savings attitude significantly reduces generational poverty, with financial literacy playing a substantial mediating role. The findings revealed that financial literacy accounted for 21.1% of the total effect, highlighting its importance in fostering effective saving behaviors. The study concludes that enhancing financial literacy is crucial for improving savings attitudes and reducing generational poverty. Practice recommendations include implementing comprehensive financial education programs, conducting community-based financial literacy workshops, and integrating financial literacy into school curricula. Policy recommendations advocate for a national financial literacy strategy, creating incentives for saving and supporting financial education initiatives. Theoretically, future research should incorporate financial literacy into economic models, conduct longitudinal studies to assess long-term impacts and explore cultural influences on saving behaviors.

Based on the assertion that not all social ties promote entrepreneurship, this study investigated the correlation between social support and entrepreneurial intentions among 352 2019/2020 graduating university students sampled from private and public universities in Ghana. This study adopted a quantitative approach using questionnaires and a correlational analysis. The finding was that social support and entrepreneurial intentions have a moderate, significant positive effect on entrepreneurial intention among Ghanaian tertiary students; there was no statistically significant difference between students’ sex (male or female), birth order, and exposure to entrepreneurship on entrepreneurial intention. This study’s conclusions suggest that families and friends/peers are capable or willing to provide support to become entrepreneurs or are willing to use social support for venture creation. The findings have implications for practicing entrepreneurs, entrepreneurship educators, and policymakers.

This study explores the mediating effect of financial literacy on the relationship between blockchain technology application and financial risk among financial institution professionals in Ghana. Utilizing a correlational research design, data were collected from a sample of 336 professionals through a self-constructed Likert-scale questionnaire. The analysis was conducted using path analysis and mediation techniques. The findings reveal that financial literacy had a significant partial mediating effect between blockchain technology application and financial risk, accounting for 26.0% of the total effect. The direct negative effect of blockchain technology applications on financial risk also remained significant, highlighting the independent contribution of blockchain technology applications to reducing financial risk. These results underscore the importance of financial literacy in enhancing the effectiveness of blockchain technology applications in mitigating financial risks. The study emphasizes the need for comprehensive financial literacy programs to maximize the benefits of technological advancements in the financial sector. Empirical evidence from related literature supports the findings, indicating that higher financial literacy enables better utilization of blockchain technology applications, thereby reducing financial risk. The research provides insights for policymakers aiming to improve financial literacy and leverage blockchain technology applications for financial risk management.

The study presents an in-depth analysis of the COVID-19 pandemic’s effect on Ghana’s gross domestic product (GDP), balance of payments and international investment position (BPM6), and inflation (INFL). Employing a pre-and post-COVID-19 comparison (2017-2022) through repeated measures ANOVA and tests of between-subject effects, it investigates whether the government’s economic performance was significantly impacted. Key findings show a notable decrease in GDP and BPM6, alongside a major increase in inflation rates post-pandemic. The study concludes that the COVID-19 pandemic had a statistically significant impact on Ghana’s economic performance in terms of GDP and BPM6, but not inflation. Recommendations include implementing economic stabilization policies, managing the balance of payments, controlling inflation, and focusing on sustainable growth. These insights are crucial for policymakers and stakeholders in navigating Ghana’s post-COVID-19 economic situation.

Abstract Background Morbidities and mortalities due to malaria can be prevented by the use of insecticide-treated mosquito bed nets (ITN), which has been proven for malaria control and elimination. The purpose of this study was to assess the critical factors that predict the use of ITN among children under-fives in Ghana. Methods The study utilized data from the 2019 Ghana Malaria Indicator Survey (GMIS). The outcome variable was mosquito bed net use among children under-fives. To determine critical factors that independently predict ITN use, multilevel multivariable logistic regression was employed using Stata version 16. Odds ratios and associated 95% confidence intervals and p-values were reported. A p

This study joins the debate about whether capitalism or socialism best shows how the Bible sees economic interactions between people and, by extension, provides insights into how a Christian should live. Capitalism is based on the private ownership and control of resources and profit, which spread with the migration process of the Protestants. Socialism is based on the idea that the group or community should own the means of production and distribution to benefit everyone equally. This paper argues that biblical principles point neither to socialism nor capitalism as the appropriate economic framework for economic interactions and the organization of economic life in society. This assertion is based on how Jesus lived His life and various statements He made while here on earth, as presented in the Bible. The study demonstrates that Jesus is variously portrayed as a revolutionary socialist and a compassionate capitalist and that Christians are called to responsibly manage the resources entrusted to them by God, for there is accountability for every economic choice and preference.

Abstract The analysis of the high volume of data spawned by web search engines on a daily basis allows scholars to scrutinize the relation between the user’s search preferences and impending facts. This study can be used in a variety of economics contexts. The purpose of this study is to determine whether it is possible to anticipate the unemployment rate by examining behavior. The method uses a cross-correlation technique to combine data from Google Trends with the World Bank's unemployment rate. The Autoregressive Integrated Moving Average (ARIMA), Autoregressive Integrated Moving Average with eXogenous variables (ARIMAX) and Vector Autoregression (VAR) models for unemployment rate prediction are fit using the analyzed data. The models were assessed with the various evaluation metrics of mean absolute error (MAE), root mean square error (RMSE), mean absolute percentage error (MAPE), median absolute error (MedAE), and maximum error (ME). The average outcome of the various evaluation metrics proved the significant performance of the models. The ARIMA (MSE = 0.26, RMSE = 0.38, MAE = 0.30, MAPE = 7.07, MedAE = 0.25, ME = 0.77), ARIMAX (MSE = 0.22, RMSE = 0.25, MAE = 0.29, MAPE = 6.94, MedAE = 0.25, ME = 0.75), and VAR (MSE = 0.09, RMSE = 0.09, MAE = 0.20, MAPE = 4.65, MedAE = 0.20, ME = 0.42) achieved significant error margins. The outcome demonstrates that Google Trends estimators improved error reduction across the board when compared to model without them.

This study aimed to investigate the mediating effect of the COVID-19 pandemic on the relationship between technology and organizational performance, using evidence from the Ghana banking industry. The study adopted a correlation and mediation research design, with 232 respondents conveniently sampled from eight indigenous Ghanaian Banks. The data were analyzed using correlation, regression, and mediation techniques. The results show that technology serves as a catalyst for improving organizational performance and alleviating the negative effects of COVID-19 on organizational performance. The findings also revealed that the COVID-19 pandemic highly mediates technology and organizational performance with a significant positive relationship between technology and COVID-19 pandemic; technology and organizational performance. Additionally, there is a significant positive high relationship between COVID-19 pandemic and organizational performance, with technology and COVID-19 pandemic predicting organizational performance. The COVID-19 pandemic moderately mediates organizational performance. Banks in Ghana need to secure technological solutions to remain competitive in this era of stiff competition and disasters to ensure customer satisfaction, optimize costs, remain profitable, and, above all, increase shareholder wealth.

The purpose of the study was to establish the impact of audit committee characteristics on audit fees from listed companies in Ghana. Audit committee size, gender diversity, meeting, and financial expertise were adopted to measure audit committee characteristics against the fees charged by the audit firms. The study utilized a different set of empirical specifications on standard panel data, particularly to address the endogeneity issues of the extant literature on the audit fees-audit committee characteristics nexus condone. Applying the IV-2SLS and two-step dynamic GMM estimators, which are robust to endogeneity issues, we present evidence that audit committee size, gender diversity, audit meetings, and financial expertise are associated with lower audit fees. We also find evidence that the magnitude of the impact of the audit committee characteristics on audit fees is more pronounced in financial firms than non-financial firms. We interpret this insight as suggesting that highly regulated firms such as financial firms with audit committees incur relatively lower audit costs.

The nitrates produced after mineralization from compost may be prone to leaching, especially in tropical sandy soils, because of the increased rate of nitrification and the porous nature of such soils. This may result in low nitrogen (N) use efficiency and adverse environmental effects. Inorganic nitrification inhibitors are costly and mostly unavailable in Ghana. Research on simple but effective local materials for use as nitrification inhibitors is therefore a priority. Two such materials are neem materials and biochar. Neem materials can suppress nitrifying bacteria due to their antimicrobial properties. Biochar can hold ammonium in the soil, making it temporarily unavailable to nitrifying bacteria. This study aimed to determine the efficacy of neem materials and biochar as nitrification inhibitors and their influence on nitrate leaching. In preliminary studies: 1) pot incubation was conducted for 60 days to estimate the nitrification rate with manure, compost, and NH4Cl as the N source (150 kg N/ha) in one set and neem seeds, bark, and leaves (1.25 µg azadirachtin/g) in another set, using nitrate concentrations; and 2) the ammonium sorption and desorption capacities of sawdust, rice husk, and groundnut husk biochar were determined. In the main study, pot incubation with compost as the N source but treated with milled neem seeds or bark (1.25 µg azadirachtin/g) or sawdust biochar (20 t/ha) was conducted for 60 days, in which the nitrification inhibition was determined using nitrate concentrations. A leaching experiment in columns with similar treatments and maize sown was then conducted to quantify the nitrate in leachates. A high nitrification rate was recorded in compost-amended soil, almost half that of the standard (NH4Cl). The use of sawdust biochar, which showed the highest ammonium sorption and desorption capacity, resulted in 40% nitrification inhibition that lasted the entire incubation period. The use of neem seeds with an azadirachtin concentration of 3.92 mg/g resulted in a similar nitrification inhibition, but this only lasted 40 days. Inhibition caused by both materials resulted in about a 60% reduction in nitrate leached. Thus, neem seeds (498 kg/ha) and sawdust biochar (20 mt/ha) could be used to control nitrate leaching for short-duration and long-duration crops, respectively.

Abstract Background Limited financial, human and material health resources coupled with increasing demand for new-born care services require efficiency in health systems to maximize the available sources for improved health outcomes. Making Every Baby Count Initiative (MEBCI) implemented by local and international partners in 2013 in Ghana aimed at attaining neonatal mortality of 21 per 1000 livebirths by 2018 in four administrative regions in Ghana. MEBCI interventions benefited 4027 health providers, out of which 3453 (86%) were clinical healthcare staff. Objective Determine the per capita cost of the MEBCI interventions towards enhancing new-born care best practices through capacity trainings for frontline clinical and non-clinical staff. Methods Parameters for determining per capita cost of the new-born care interventions were estimated using expenditure on trainings, supervisions, monitoring and evaluation, advocacy, administrative/services and medical logistics. Data collection started in October 2017 and ended in September 2018. Data sources for the per capita cost estimations were invoices, expense reports and ledger books at the national, regional and district levels of the health system. Results Total of 4027 healthcare providers benefited from the MEBCI training activities comprising of 3453 clinical staff and 574 non-clinical personnel. Cumulative cost of implementing the MEBCI interventions did not necessarily match the cost per capita in staff capacity building; average cost per capita for all staff (clinical and non-clinical staff) was approximately US$ 982 compared to a per capita cost of US$ 799 for training only core clinical staff. Average cost per capita for all regions was approximately US$ 965 for all staff compared to US$ 777 per capita cost for only clinical staff. Per capita cost of training was relatively lower in regions with more staff than regions with lower numbers, perhaps due to economies of scale. Conclusion The MEBCI intervention had a wide coverage in terms of training for frontline healthcare providers albeit the associated cost may be potentially unsustainable for Ghana’s health system. Emerging digital training platforms could be leveraged to reduce per capita cost of training. Large-scale on-site batch-training approach could also be replaced with facility-based workshops using training of trainers (TOTs) approach to promote efficiency.

Abstract Background Elevated atmospheric CO2 has direct and indirect influences on ecosystem processes. The impact of elevated atmospheric CO2 concentration on carbon and nitrogen transformations, together with the microbial community, was evaluated with water hyacinth (Eichhornia crassipes) in an open-top chamber replicated wetland. The responses of nitrogen and carbon pools in water and wetland soil, and microbial community abundance were studied under ambient CO2 and elevated CO2 (ambient + 200 μL L−1). Results Total biomass for the whole plant under elevated CO2 increased by an average of 8% (p = 0.022). Wetlands, with water hyacinth, showed a significant increase in total carbon and total organic carbon in water by 7% (p = 0.001) and 21% (p = 0.001), respectively, under elevated CO2 compared to that of ambient CO2. Increase in dissolved carbon in water correlates with the presence of wetland plants since the water hyacinth can directly exchange CO2 from the atmosphere to water by the upper epidermis of leaves. Also, the enrichment CO2 showed an increase in total carbon and total organic carbon concentration in wetland soil by 3% (p = 0.344) and 6% (p = 0.008), respectively. The total nitrogen content in water increased by 26% (p = 0.0001), while total nitrogen in wetland soil pool under CO2 enrichment decreased by 9% (p = 0.011) due to increased soil microbial community abundance, extracted by phospholipid fatty acids, which was 25% larger in amount than that of the ambient treatment. Conclusion The study revealed that the elevated CO2 would affect the carbon and nitrogen transformations in wetland plant, water, and soil pool and increase soil microbial community abundance.

Abstract Background Responding to stagnating neonatal mortality rates in Ghana, a five-year collaboration called Making Every Baby Count Initiative (MEBCI) was undertaken to improve the quality of newborn care provided around the time of birth. A multi-pronged approach was used to build health worker (HW) capacity in resuscitation, essential newborn care, and infection prevention using a curriculum built on the American Academy of Pediatric’s (AAP) Helping Babies Breathe (HBB) and Essential Care for Every Baby (ECEB) modules with an added section on infection prevention (IP). Methods MEBCI used a training of trainer’s approach to train 3688 health workers from district-level facilities in four regions in Ghana between June 2015 and July 2017. Prior to training, HWs familiarized themselves with the learning materials. Concurrently, MEBCI worked to improve enabling environments that would sustain the increased capacity of trained health workers. Knowledge and skills gained were tested using AAP’s Knowledge checklist and validated single-scenario Objective Structured Clinical Examinations (OSCEs) tools. Findings: Majority of HWs trained were midwives (58.8%) and came from district-level hospitals (88.4%). Most HWs passed the HBB OSCE (99.9%, 3436/3440). Age of doctors was negatively associated with HBB scores (r = − 0.16, p = 0.0312). Similarly, older midwives had lower HBB scores (r = − 0.33, p value

Abstract Fabrication of the heterojunction composites photocatalyst has attained much attention for solar energy conversion due to their high optimization of reduction-oxidation potential as a result of effective separation of photogenerated electrons-holes pairs. In this review, the background of photocatalysis, mechanism of photocatalysis, and the several researches on the heterostructure graphitic carbon nitride (g-C3N4) semiconductor are discussed. The advantages of the heterostructure g-C3N4 over their precursors are also discussed. The conclusion and future perspectives on this emerging research direction are given. This paper gives a useful knowledge on the heterostructure g-C3N4 and their photocatalytic mechanisms and applications. Impact Statements The paper on g-C3N4 Nano-based photocatalysts is expected to enlighten scientists on precise management and evaluating the environment, which may merit prospect research into developing suitable mechanism for energy, wastewater treatment and environmental purification.

Abstract Background With the rise in graduate unemployment and the poor linkage between university education and industry, competency-based training (CBT) is gaining popularity in Ghana’s universities as a way of producing business-oriented and well-grounded graduates for industry who are ready to make use of knowledge acquired in university education to establish businesses that will help reduce unemployment in the country as well as working effectively in the nation’s industry and service sectors. With CBT yet to be introduced in most Ghanaian tertiary institutions, information about academics’ perception and willingness to adopt the methodology is crucial. This study examined the perception and adoption of CBT by academics in Ghana using cross-sectional data collected from 300 faculty members of Kwame Nkrumah University of Science and Technology (KNUST) using a structured questionnaire. Descriptive statistics, 5-point Likert scale, perception index, and the logit model were the methods of analysis employed. Results The results of the survey showed that the overall perception index was 0.49, indicating that generally faculty members of KNUST agreed and had a positive perception of the potential of CBT in instilling in students employable skills. The logit results also showed that the probability of adoption of CBT is positively influenced by participation in CBT workshops, effective supervision of faculty members by university authorities, availability of teaching aids, and availability of incentives. Conversely, adoption was found to be negatively influenced by teaching load and number of undergraduate students per class. Conclusions We conclude that provision of appropriate teaching and learning resources that complement adoption of CBT, incentives, and competency-based education training for academics by university authorities and stakeholders in Ghana’s tertiary education will enhance the adoption of CBT methodologies.

Nucleolar organiser regions (NORs) are loops of DNA which are responsible for ribosomal RNA (rRNA) transcription in the nucleus of cells. NORs can be selectively stained by silver methods. The NORs agyrophilia is due to a group of nucleolar proteins, which have affinity for silver (Agyrophilic Nucleolar Organizer Regions, AgNOR proteins). The aim of the present study is to assess proliferative index in different grades of invasive ductal carcinoma (IDC) by using AgNOR as a marker. A total of 18 formalin fixed paraffin-embedded breast tissue blocks were retrieved from the archives of the histopathology department of the Komfo Anokye Teaching Hospital, Ghana. The tissue blocks included 17 IDC, (with 8 as grade 2 IDC, 9 as grade 3 IDC) and 1 normal breast tissues. Tissue sections were diagnosed and graded following haematoxylin and eosin (H&E) staining. Silver staining was used to demonstrate the presence of AgNOR. The AgNOR dots were manually counted in 50 and 100 cells. The mean AgNOR count (mAgNOR) and proliferative index, (pAgNOR, percentage of cells with ≥5 AgNOR dots per nucleus), significantly increased with increasing grade of IDC. The mAgNOR and pAgNOR were low in normal breast, (at p-value less than 0.05). There was no significant difference in the mAgNOR and pAgNOR score for counting 50 and 100 cells (at a p-value of 0.01). mAgNOR and pAgOR increases with increase in grade of IDC and hence can be used to assess proliferative index of IDC. Keywords: Nucleolar organiser regions (NORs), Agyrophilic Nuclear Organizer Region (AgNOR), Proliferative activity, Breast Cancer

Abstract Graphite carbon nitride (g-C3N4) is well known as one of the most promising materials for photocatalytic activities, such as CO2 reduction and water splitting, and environmental remediation through the removal of organic pollutants. On the other hand, carbon nitride also pose outstanding properties and extensive application forecasts in the aspect of field emission properties. In this mini review, the novel structure, synthesis and preparation techniques of full-bodied g-C3N4-based composite and films were revealed. This mini review discussed contemporary advancement in the structure, synthesis, and diverse methods used for preparing g-C3N4 nanostructured materials. The present study gives an account of full knowledge of the use of the exceptional structural and properties, and the preparation techniques of graphite carbon nitride (g-C3N4) and its applications.

Morphology of the face depends on many factors such as sex, ethnicity, race, climate, nutrition, genetic constitution and socio-economic status. The goal of cephalometrics, at its most fundamental level, is to compare the patient or victim with a normal reference group, so that differences between the person's actual facial morphology and those expected for his or her racial or ethnic group are revealed. This study therefore, was designed to examine the review on a preliminary cephalometric study of the relationship between facial morphology and ethnicity. Here, we review contemporary advancement in the importance of cephalometry, cephalometric analysis, cephalometric methods and cephalometric indices in relation to facial morphology and ethnicity. The present study gives an account of full knowledge of the use of the outstanding knowledge of preliminary cephalometric study of the relationship between facial morphology and ethnicity in anatomy, forensic study and related. Keywords: Preliminary cephalometric, Facial morphology, Cephalometric analysis, Cephalometrics indices, Cephalometrics methods

Morphology of the face depends on many factors, such as sex, ethnicity, race, climate, nutrition, genetic constitution and socio-economic status. In the developed countries, there is well established database on facial anthropometry and for the purpose of identification. In Ghana however, there is very little documented information on cephalometric indices for biometric and forensic purposes. This study therefore, aimed at establishing baseline data to assess the relationship between sex using upper, lower and total cephalometric indices. One hundred participants made up of sixty males and forty females from KNUST were recruited for the study. Linear facial anthropometry were taken using calibrated Shahe digital calipers whiles participants sat with head in natural position. The facial anthropometric measurements were generally higher in males than in females. Upper facial height, facial width, nasal width, biocular diameter, lower facial height, lip length and total facial height were statistically significant and (p

The synthesis of photocatalysts with high charge separation and transfer efficiency are of immense significance in the process of using photocatalysis technology for wastewater treatment. In this study core shell g-C3N4@ZnO, and ZnO defects photocatalysts presented an improved morphology in its characterization using techniques such as SEM, DRS, PL, MS, EIS, and XRD, and enhanced photodegradation of sulfamethoxazole, Nitenpyram and Tetracycline. Different composites were obtained as confirmed by the various characterization techniques studied, including core shell g-C3N4@ZnO, and ZnO defects photocatalyst. The synthesized photocatalysts showed high visible light absorption efficiency within a range of ~655 to 420 nm. Core shell g-C3N4@ZnO, and ZnO defects photocatalysts demonstrated high photocatalytic activity ascribed to high load separation and transition as shown in PL, Photocurrent reaction and EIS. It is understandable that core shell g-C3N4@ZnO, and ZnO defects photocatalysts have been confirmed to be one of the ultimate promising entrants for photocatalyst scheming.

The recirculatory microbial desalination cell–microbial electrolysis cell (MDC–MEC) coupled system is a novel technology that generates power, treats wastewater, and supports desalination through eco-friendly processes. This study focuses on the simultaneous efficient removal of Fe2+ and Pb2+ in the MEC and ammonium ions in the MDC. It also evaluates the performances of dual-chambered MEC (DCMEC) and single-chambered MEC (SCMEC), coupled with MDC with Ferricyanide as catholyte (MDCF) in heavy metals (Pb2+ and Fe2+) removal, in addition to the production of voltage, current, and power within a 48-h cycle. The SCMEC has a higher Pb2+ (74.61%) and Fe2+ (85.05%) removal efficiency during the 48-h cycle than the DCMEC due to the simultaneous use of microbial biosorption and the cathodic reduction potential. The DCMEC had a higher current density of 753.62 mAm−2 than that of SCMEC, i.e., 463.77 mAm−2, which influences higher desalination in the MDCF than in the SCMEC within the 48-h cycle. The MDCF produces a higher voltage (627 mV) than Control 1, MDC (505 mV), as a power source to the two MECs. Stable electrolytes’ pH and conductivities provide a conducive operation of the coupled system. This study lays a solid background for the type of MDC–MEC coupled systems needed for industrial scale-up.

Past studies indicated that overall Basic Combat Training (BCT) attrition (discharge) was associated with various risk factors. BCT has changed considerably since many of these studies were conducted. This study examined Soldiers medically attrited from BCT. Potential attrition risk factor data on recruits (n = 4,005) were collected from medical records, BCT unit records, and questionnaires. Attrition data from Fort Jackson, South Carolina, showed 203 medical discharges. Cox regression (univariate and multivariate) obtained hazard ratios and 95% confidence intervals for attrition risk factors. Higher attrition risk was associated with female gender. Higher attrition risk for men was associated with cigarette smoking, injury during BCT, and less exercise before BCT. Higher attrition risk for both genders was associated with failure on the initial 2-mile run test and separated or divorced marital status. Attrition risk factors found in this study were similar to those previously identified despite changes in BCT. [ABSTRACT FROM AUTHOR]

Inborn errors of immunity (IEIs) are a rapidly expanding group of monogenetic disorders affecting the immune system. Advancements in genetic testing and functional validation studies have accelerated the pace of IEI gene discovery and mechanism of disease, particularly in the past 5 years. To keep up with this rapid expansion, the International Union of Immunological Societies Expert Committee has periodically, since 1999, released updated IEI classifications with corresponding genotypic and phenotypic catalogues with its most recent update in 2022. Now, there are more than 485 monogenetic disorders of the immune system described among 10 main groups of classification. This article reviews recent clinical developments in IEI, including a closer look at some of the more recently described IEI disorders. In particular, we highlight a few disorders with the following clinical phenotypes of IEI: severe atopy, immunodeficiency with immune dysregulation, immune dysregulation with lymphoproliferation, autoinflammation, and innate phenotype. To aid the clinician, we also provide a diagnostic approach to use when there is suspicion of IEI and a discussion of management and treatment., Competing Interests: Disclosures Dr Williams has received research support from GlaxoSmithKline, ADMA Biologics, and Cogent Biosciences; serves as a consultant and speaker with Amgen and Pharming Healthcare; and has been on medical advisory boards with Kenota Health, Amgen, Pharming Healthcare, and Blueprint Medicines. Dr Tsoulis has no conflicts of interest to disclose., (Copyright © 2024 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Increased arcuate proopiomelanocortin (POMC) neuron activity improves glucose metabolism and reduces appetite, facilitating weight loss. We recently showed that arcuate POMC neurons are activated by exercise. However, the role of excitatory glutamatergic input in these neurons and the metabolic outcomes of exercise remains undefined. To investigate this, we developed a mouse model with NMDA receptors (NMDARs) selectively deleted from POMC neurons of adult mice. We performed metabolic assessments, including the monitoring of body weight, body composition analysis, and glucometabolic tolerance tests. We also examined the metabolic outcomes of these mice in response to exercise, including changes in arcuate POMC neuronal activity and insulin sensitivity. Loss of NMDARs in POMC neurons failed to alter body weight or body composition. Notably, however, we did observe a marked impairment in glucose tolerance and insulin sensitivity. Additionally, exercise resulted in activation of arcuate POMC neurons and a sustained improvement in insulin sensitivity, an effect that was abrogated in mice deficient for NMDARs in POMC neurons when compared with their respective sedentary controls. This underscores an important link among exercise, hypothalamic neuron function, and metabolic health. Moreover, this highlights an underappreciated role of hypothalamic POMC neurons in mediating beneficial effects of exercise on glucose metabolism., (© 2024 by the American Diabetes Association.)

The molecular mechanisms underlying neuronal leptin and insulin resistance in obesity and diabetes are not fully understood. In this study, we show that induction of the unfolded protein response transcription factor, spliced X-box binding protein 1 (Xbp1s), in Agouti-Related Peptide (AgRP) neurons alone, is sufficient to not only protect against but also significantly reverse diet-induced obesity (DIO) as well as improve leptin and insulin sensitivity, despite activation of endoplasmic reticulum stress. We also demonstrate that constitutive expression of Xbp1s in AgRP neurons contributes to improved insulin sensitivity and glucose tolerance. Together, our results identify critical molecular mechanisms linking ER stress in arcuate AgRP neurons to acute leptin and insulin resistance as well as liver glucose metabolism in DIO and diabetes., Competing Interests: Declaration of competing interest No potential conflicts of interest relevant to this article were reported., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Physical inactivity represents a major health concern for older adults. Most social, at-home physical activity (PA) interventions use videoconference, email, or telephone communication for program delivery. However, evidence suggests that these platforms may hinder the social connection experienced by users. Recent advancements in virtual reality (VR) suggest that it may be a rich platform for social, at-home interventions because it offers legitimate options for intervention delivery and PA., Objective: This pilot study aims to determine the feasibility and acceptability of VR compared to videoconference as a medium for remote group-mediated behavioral intervention for older adults. The information generated from this investigation will inform the use of VR as a medium for intervention delivery., Methods: Nine low-active older adults (mean age 66.8, SD 4.8 y) were randomized to a 4-week home-based, group-mediated PA intervention delivered via VR or videoconference. Feasibility (ie, the total number of sessions attended and the number of VR accesses outside of scheduled meetings) and acceptability (ie, the number of participants reporting high levels of nausea, program evaluations using Likert-style prompts with responses ranging from -5=very difficult or disconnected to 5=very easy or connected, and participant feedback on immersion and social connection) are illustrated via descriptive statistics and quotes from open-ended responses., Results: None of the participants experienced severe VR-related sickness before randomization, with a low average sickness rating of 1.6 (SD 1.6) out of 27 points. Attendance rates for group meetings were 98% (59/60) and 96% (46/48) for the VR and videoconference groups, respectively. Outside of scheduled meeting times, participants reported a median of 5.5 (IQR 5.3-5.8, range 0-27) VR accesses throughout the entire intervention. Program evaluations suggested that participants felt personally connected to their peers (VR group: median 3.0, IQR 2.5-3.5; videoconference group: median 3.0, IQR 2.7-3.3), found that goals were easy to accomplish (VR group: median 3.0, IQR 2.8-3.3; videoconference group: median 3.0, IQR 2.6-3.4), and had ease in finding PA options (VR group: median 4.0, IQR 3.5-4.3; videoconference group: median 2.0, IQR 1.6-2.4) and engaging in meaningful dialogue with peers (VR group: median 4.0, IQR 4.0-4.0; videoconference group: median 3.5, IQR 3.3-3.8). Open-ended responses regarding VR use indicated increased immersion experiences and intrinsic motivation for PA., Conclusions: These findings suggest that VR may be a useful medium for social PA programming in older adults, given it was found to be feasible and acceptable in this sample. Importantly, all participants indicated low levels of VR-related sickness before randomization, and both groups demonstrated very high attendance at meetings with their groups and behavioral coaches, which is promising for using VR and videoconference in future interventions. Modifications for future iterations of similar interventions are provided. Further work using larger samples and longer follow-up durations is needed., Trial Registration: ClinicalTrials.gov NCT04756245; https://www.clinicaltrials.gov/study/NCT04756245., (©Kyle Kershner, David Morton, Justin Robison, Kindia Williams N'dah, Jason Fanning. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.11.2024.)

Hypothalamic neural circuits regulate instinctive behaviors such as food seeking, the fight/flight response, socialization, and maternal care. Here, we identified microdeletions on chromosome Xq23 disrupting the brain-expressed transient receptor potential (TRP) channel 5 (TRPC5). This family of channels detects sensory stimuli and converts them into electrical signals interpretable by the brain. Male TRPC5 deletion carriers exhibited food seeking, obesity, anxiety, and autism, which were recapitulated in knockin male mice harboring a human loss-of-function TRPC5 mutation. Women carrying TRPC5 deletions had severe postpartum depression. As mothers, female knockin mice exhibited anhedonia and depression-like behavior with impaired care of offspring. Deletion of Trpc5 from oxytocin neurons in the hypothalamic paraventricular nucleus caused obesity in both sexes and postpartum depressive behavior in females, while Trpc5 overexpression in oxytocin neurons in knock-in mice reversed these phenotypes. We demonstrate that TRPC5 plays a pivotal role in mediating innate human behaviors fundamental to survival, including food seeking and maternal care., Competing Interests: Declaration of interests I.S.F. has consulted for a number of companies developing weight loss drugs (including Eli Lilly, Novo Nordisk, and Rhythm Pharmaceuticals) and investors (Goldman Sachs, SV Health). I.S.F. is a member of the Advisory Board of Cell. J.R.B.P. is an employee and shareholder of Insmed, receives research funding from GSK, and is a paid consultant for WW International. K.W.W. holds shares in Novo Nordisk and Eli Lilly., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) are effective antiobesity drugs. However, the precise central mechanisms of GLP-1RAs remain elusive. We administered GLP-1RAs to patients with obesity and observed a heightened sense of preingestive satiation. Analysis of human and mouse brain samples pinpointed GLP-1 receptor (GLP-1R) neurons in the dorsomedial hypothalamus (DMH) as candidates for encoding preingestive satiation. Optogenetic manipulation of DMH GLP-1R neurons caused satiation. Calcium imaging demonstrated that these neurons are actively involved in encoding preingestive satiation. GLP-1RA administration increased the activity of DMH GLP-1R neurons selectively during eating behavior. We further identified that an intricate interplay between DMH GLP-1R neurons and neuropeptide Y/agouti-related peptide neurons of the arcuate nucleus (ARC NPY/AgRP neurons) occurs to regulate food intake. Our findings reveal a hypothalamic mechanism through which GLP-1RAs control preingestive satiation, offering previously unexplored neural targets for obesity and metabolic diseases.

The N-methyl-D-aspartate (NMDA) receptor is a glutamate-activated cation channel that is critical to many processes in the brain. Genome-wide association studies suggest that glutamatergic neurotransmission and NMDA receptor-mediated synaptic plasticity are important for body weight homeostasis 1 . Here we report the engineering and preclinical development of a bimodal molecule that integrates NMDA receptor antagonism with glucagon-like peptide-1 (GLP-1) receptor agonism to effectively reverse obesity, hyperglycaemia and dyslipidaemia in rodent models of metabolic disease. GLP-1-directed delivery of the NMDA receptor antagonist MK-801 affects neuroplasticity in the hypothalamus and brainstem. Importantly, targeting of MK-801 to GLP-1 receptor-expressing brain regions circumvents adverse physiological and behavioural effects associated with MK-801 monotherapy. In summary, our approach demonstrates the feasibility of using peptide-mediated targeting to achieve cell-specific ionotropic receptor modulation and highlights the therapeutic potential of unimolecular mixed GLP-1 receptor agonism and NMDA receptor antagonism for safe and effective obesity treatment., (© 2024. The Author(s).)

Abstract: Mutations in the small Rho-family guanosine triphosphate hydrolase RAC2, critical for actin cytoskeleton remodeling and intracellular signal transduction, are associated with neonatal severe combined immunodeficiency (SCID), infantile neutrophilic disorder resembling leukocyte adhesion deficiency (LAD), and later-onset combined immune deficiency (CID). We investigated 54 patients (23 previously reported) from 37 families yielding 15 novel RAC2 missense mutations, including one present only in homozygosity. Data were collected from referring physicians and literature reports with updated clinical information. Patients were grouped by presentation: neonatal SCID (n = 5), infantile LAD-like disease (n = 5), or CID (n = 44). Disease correlated to RAC2 activity: constitutively active RAS-like mutations caused neonatal SCID, dominant-negative mutations caused LAD-like disease, whereas dominant-activating mutations caused CID. Significant T- and B-lymphopenia with low immunoglobulins were seen in most patients; myeloid abnormalities included neutropenia, altered oxidative burst, impaired neutrophil migration, and visible neutrophil macropinosomes. Among 42 patients with CID with clinical data, upper and lower respiratory infections and viral infections were common. Twenty-three distinct RAC2 mutations, including 15 novel variants, were identified. Using heterologous expression systems, we assessed downstream effector functions including superoxide production, p21-activated kinase 1 binding, AKT activation, and protein stability. Confocal microscopy showed altered actin assembly evidenced by membrane ruffling and macropinosomes. Altered protein localization and aggregation were observed. All tested RAC2 mutant proteins exhibited aberrant function; no single assay was sufficient to determine functional consequence. Most mutants produced elevated superoxide; mutations unable to support superoxide formation were associated with bacterial infections. RAC2 mutations cause a spectrum of immune dysfunction, ranging from early onset SCID to later-onset combined immunodeficiencies depending on RAC2 activity. This trial was registered at www.clinicaltrials.gov as #NCT00001355 and #NCT00001467.

Background: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI., Objective: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI., Methods: We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022., Results: Physicians entered data on 1245 patients from 24 countries. The most common diagnoses were antibody deficiencies (63.7%). At least one COVID-19 vaccine was administered to 806 patients (64.7%), and 216 patients received vaccination prior to the development of COVID-19. The most common vaccines administered were mRNA-based (84.0%). Seventeen patients were reported to seek outpatient clinic or emergency room care for a vaccine-related complication, and one patient was hospitalized for symptomatic anemia. Eight hundred twenty-three patients (66.1%) experienced COVID-19 infection. Of these, 156 patients required hospitalization (19.0%), 47 required ICU care (5.7%), and 28 died (3.4%). Rates of hospitalization (9.3% versus 24.4%, p < 0.001), ICU admission (2.8% versus 7.6%, p = 0.013), and death (2.3% versus 4.3%, p = 0.202) in patients who had COVID-19 were lower in patients who received vaccination prior to infection. In adjusted logistic regression analysis, not having at least one COVID-19 vaccine significantly increased the odds of hospitalization and ICU admission., Conclusion: Vaccination for COVID-19 in the IEI population appears safe and attenuates COVID-19 severity., (© 2024. The Author(s).)

Purpose of Review: In the last 5 years, several new inborn errors of immunity (IEI) have been described, especially in the areas of immune dysregulation and autoinflammation. As a result, the clinical presentation of IEIs has broadened. We review the heterogeneous presentation of IEIs and detail several of the recently described IEIs with a focus on the noninfectious manifestations commonly seen., Recent Findings: IEIs may present with early onset and/or multiple autoimmune manifestations, increased risk for malignancy, lymphoproliferation, severe atopy, autoinflammation and/or hyperinflammation. Because of this, patients can present to a wide array of providers ranging from primary care to various pediatric subspecialists. The International Union of Immunological Societies (IUIS) expert committee has created a phenotypic classification of IEIs in order to help clinicians narrow their evaluation based on the laboratory and clinical findings., Summary: Both primary care pediatricians and pediatric subspecialists need to be aware of the common clinical features associated with IEI and recognize when to refer to allergy-immunology for further evaluation. Early diagnosis can lead to earlier treatment initiation and improve clinical outcomes for our patients., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: One's amount, intensity, and distribution of physical activity may have implications for whether it has positive or negative effects on pain and quality of life for older adults living with chronic pain. Thus, we investigated baseline patterns of stepping related to pain symptoms and health-related quality of life at baseline and over a 12-week follow-up period., Patients and Methods: Participants were low-active older adults (69.54±6.74 years) with obesity and chronic pain who enrolled in one of two randomized controlled trials. Participants completed measures of pain intensity, interference, and health-related quality of life and wore an accelerometer for 7 days at baseline and week 12. Functional principal components analysis identified patterns of within-day stepping behavior at baseline, and linear regressions were used to investigate how these component scores related to pain and health-related quality of life at baseline and over 12 weeks., Results: Two patterns were extracted; one describing more vs less stepping and the second capturing movement later vs earlier in the day. More baseline stepping was associated with better physical functioning (B=0.148, p<0.001) and energy (B=0.073, p=0.033), while a later start in the day was associated with worse social functioning (B=-0.193, p=0.031). More stepping at baseline predicted positive changes in physical functioning (B=0.094, p=0.019), emotional role limitations (B=0.132, p=0.049), energy (B=0.112, p<0.001), social functioning (B=0.086, p=0.043), pain (B=0.086, p=0.009), general health (B=0.081, p=0.003) and pain intensity (B=-0.039, p=0.003). A later start to the day was associated with worsening physical functioning (B=-0.229, p<0.001), physical (B=-0.282, p=0.047) and emotional role limitations (B=-0.254, p=0.048), general health (B=-0.108, p=0.041), and pain interference (B=0.055, p=0.043)., Conclusion: Findings suggest there is value in activity patterns as an indicator for additional behavioral intervention, as those who move little and/or delay daily movement are likely to experience subsequent decrements in quality of life and pain symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Fanning et al.)

Objective: The central melanocortin system is essential for the regulation of food intake and body weight. Agouti-related protein (AgRP) is the sole orexigenic component of the central melanocortin system and is conserved across mammalian species. AgRP is currently known to be expressed exclusively in the mediobasal hypothalamus, and hypothalamic AgRP-expressing neurons are essential for feeding. Here we characterized a previously unknown population of AgRP cells in the mouse hindbrain., Methods: Expression of AgRP in the hindbrain was investigated using gene expression analysis, single-cell RNA sequencing, immunofluorescent analysis and multiple transgenic mice with reporter expressions. Activation of AgRP neurons was achieved by Designer Receptors Exclusively Activated by Designer Drugs (DREADD) and by transcranial focal photo-stimulation using a step-function opsin with ultra-high light sensitivity (SOUL)., Results: AgRP expressing cells were present in the area postrema (AP) and the adjacent subpostrema area (SubP) and commissural nucleus of the solitary tract (cNTS) of the mouse hindbrain (termed AgRP Hind herein). AgRP Hind cells consisted of locally projecting neurons as well as tanycyte-like cells. Food deprivation stimulated hindbrain Agrp expression as well as neuronal activity of subsets of AgRP Hind cells. In adult mice that lacked hypothalamic AgRP neurons, chemogenetic activation of AgRP neurons resulted in hyperphagia and weight gain. In addition, transcranial focal photo-stimulation of hindbrain AgRP cells increased food intake in adult mice with or without hypothalamic AgRP neurons., Conclusions: Our study indicates that the central melanocortin system in the hindbrain possesses an orexigenic component, and that AgRP Hind neurons stimulate feeding independently of hypothalamic AgRP neurons., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Background: Neuroplasticity refers to the brain's ability to undergo functional and structural changes in response to diverse challenges. Converging evidence supports the notion that exercise serves as a metabolic challenge, triggering the release of multiple factors both in the periphery and within the brain. These factors actively contribute to plasticity in the brain, and in turn, regulate energy and glucose metabolism., Scope of Review: The primary focus of this review is to explore the impact of exercise-induced plasticity in the brain on metabolic homeostasis, with an emphasis on the role of the hypothalamus in this process. Additionally, the review provides an overview of various factors induced by exercise that contribute to energy balance and glucose metabolism. Notably, these factors exert their effects, at least in part, through actions within the hypothalamus and more broadly in the central nervous system., Major Conclusions: Exercise elicits both transient and sustained changes in metabolism, accompanied by changes in neural activity within specific brain regions. Importantly, the contribution of exercise-induced plasticity and the underlying mechanisms by which neuroplasticity influences the effects of exercise are not well understood. Recent work has begun to overcome this gap in knowledge by examining the complex interactions of exercise-induced factors which alter neural circuit properties to influence metabolism., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier GmbH.)

One in four unscheduled hospital admissions for children and adolescents in the United States occurs via direct admission, defined as hospital admission without first receiving care in the hospital's emergency department. The purpose of this policy statement is to present recommendations to optimize the quality and safety of this hospital admission approach for children. Recommendations included in this policy statement provide guidance related to: (i) direct admission written guidelines, (ii) clear systems of communication between members of the health care team and with families of children requiring admission, (iii) triage systems to identify patient acuity and disease severity, (iv) identification of hospital resources needed to support direct admission systems of care, (v) consideration of patient populations that may be at increased risk of adverse outcomes during the hospital admission process, (vi) addressing the relevance of local factors and resources, and (vii) ongoing evaluation of direct admission processes and outcomes. The recommendations included in this policy statement are intended to support the implementation of safe direct admission processes and to foster awareness of outcomes associated with this common portal of hospital admission., (Copyright © 2023 by the American Academy of Pediatrics.)