Articoli di riviste: "20.52 African art"

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El Bouzidi, Kate, Rawlings P. Datir, Vivian Kwaghe, Sunando Roy, Dan Frampton, Judith Breuer, Obinna Ogbanufe et al. "Deep sequencing of HIV-1 reveals extensive subtype variation and drug resistance after failure of first-line antiretroviral regimens in Nigeria". Journal of Antimicrobial Chemotherapy 77, n. 2 (6 novembre 2021): 474–82. http://dx.doi.org/10.1093/jac/dkab385.

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Abstract Background Deep sequencing could improve understanding of HIV treatment failure and viral population dynamics. However, this tool is often inaccessible in low- and middle-income countries. Objectives To determine the genetic patterns of resistance emerging in West African HIV-1 subtypes during first-line virological failure, and the implications for future antiretroviral options. Patients and methods Participants were selected from a Nigerian cohort of people living with HIV who had failed first-line ART and subsequently switched to second-line therapy. Whole HIV-1 genome sequences were generated from first-line virological failure samples with Illumina MiSeq. Mutations detected at ≥2% frequency were analysed and compared by subtype. Results HIV-1 sequences were obtained from 101 participants (65% female, median age 30 years, median 32.9 months of nevirapine- or efavirenz-based ART). Thymidine analogue mutations (TAMs) were detected in 61%, other core NRTI mutations in 92% and NNRTI mutations in 99%. Minority variants (<20% frequency) comprised 18% of all mutations. K65R was more prevalent in CRF02_AG than G subtypes (33% versus 7%; P = 0.002), and ≥3 TAMs were more common in G than CRF02_AG (52% versus 24%; P = 0.004). Subtype G viruses also contained more RT cleavage site mutations. Cross-resistance to at least one of the newer NNRTIs, doravirine, etravirine or rilpivirine, was predicted in 81% of participants. Conclusions Extensive drug resistance had accumulated in people with West African HIV-1 subtypes, prior to second-line ART. Deep sequencing significantly increased the detection of resistance-associated mutations. Caution should be used if considering newer-generation NNRTI agents in this setting.

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Hibbard, Aime, Kate Flanaghan, Ali Judd e Katia Prime. "P174 Clinical outcomes in adolescents with perinatally acquired HIV (PAH) transitioning from paediatric to adult care in a large regional HIV clinic in london". Sexually Transmitted Infections 93, Suppl 1 (giugno 2017): A73.3—A74. http://dx.doi.org/10.1136/sextrans-2017-053232.217.

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IntroductionWe assessed outcomes in PaH adolescents transitioning from paediatric to adult care within a regional HIV clinic.MethodsRetrospective case-note review 10/02/04–31/12/15. Data collected: demographics, CDC stage, viral loads (VL), CD4 counts, antiretroviral therapy (ART), resistance and loss to follow up; using a standardised database. Pre- and post-transition outcomes were compared using paired T-tests for means and McNemar’s Exact tests for proportions.Results57 patients; 29(51%) male, 34(60%) born outside UK, 51(89%) black African. Median age at diagnosis 3 years [range 0–18]; at transition 18 years [15–20]. Median time since transition 5 years [1 month–13 years]. At transition CDC B 27/57(47%), CDC C 18/57(32%), post transition 28/57(49%), 20/57(35%), respectively, including one suicide. Of those with ≥2 years data post-transition, 31/48(65%) had two consecutive VL>40c/mL or one VL>10,000c/mL in the 2 years pre-transition, compared with 22/48(46%) post-transition (p=0.035). Mean CD4 count 12 months pre/post-transition 520 c/mm3, 500 c/mm3, respectively (p=0.4). At transition 52/57(91%) on ART (vs. 55(96%) at last visit, p=0.1), 10/46(22%) 1st line (5/55(9%) last visit), median duration of ART 7 years [0–18]. Resistance: 18/46(39%) nil, 13/46(28%) ≥1, 13/46(28%) ≥2, 1/46(2%) ≥3 drug classes. 4 patients were lost to follow-up (LTFU), all returning within 5 years [1-5].DiscussionThere was no difference in mean CD4 pre or post-transition, but the proportion who were suppressed improved post-transition. CDC stage progressed in 3 adolescents. All patients had options for suppressive ART although few were on 1stline. There was no long-term LTFU.

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Jamieson, Lise, Leigh F. Johnson, Katleho Matsimela, Linda Alinafe Sande, Marc d'Elbée, Mohammed Majam, Cheryl Johnson et al. "The cost effectiveness and optimal configuration of HIV self-test distribution in South Africa: a model analysis". BMJ Global Health 6, Suppl 4 (luglio 2021): e005598. http://dx.doi.org/10.1136/bmjgh-2021-005598.

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BackgroundHIV self-testing (HIVST) has been shown to be acceptable, feasible and effective in increasing HIV testing uptake. Novel testing strategies are critical to achieving the UNAIDS target of 95% HIV-positive diagnosis by 2025 in South Africa and globally.MethodsWe modelled the impact of six HIVST kit distribution modalities (community fixed-point, taxi ranks, workplace, partners of primary healthcare (PHC) antiretroviral therapy (ART) patients), partners of pregnant women, primary PHC distribution) in South Africa over 20 years (2020–2039), using data collected alongside the Self-Testing AfRica Initiative. We modelled two annual distribution scenarios: (A) 1 million HIVST kits (current) or (B) up to 6.7 million kits. Incremental economic costs (2019 US$) were estimated from the provider perspective; assumptions on uptake and screening positivity were based on surveys of a subset of kit recipients and modelled using the Thembisa model. Cost-effectiveness of each distribution modality compared with the status-quo distribution configuration was estimated as cost per life year saved (estimated from life years lost due to AIDS) and optimised using a fractional factorial design.ResultsThe largest impact resulted from secondary HIVST distribution to partners of ART patients at PHC (life years saved (LYS): 119 000 (scenario A); 393 000 (scenario B)). However, it was one of the least cost-effective modalities (A: $1394/LYS; B: $4162/LYS). Workplace distribution was cost-saving ($52–$76 million) and predicted to have a moderate epidemic impact (A: 40 000 LYS; B: 156 000 LYS). An optimised scale-up to 6.7 million tests would result in an almost threefold increase in LYS compared with a scale-up of status-quo distribution (216 000 vs 75 000 LYS).ConclusionOptimisation-informed distribution has the potential to vastly improve the impact of HIVST. Using this approach, HIVST can play a key role in improving the long-term health impact of investment in HIVST.

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Ray, Mia, Isaiah Osei-Gyening, Kwabena Acheampong, Marisa Riebesell e Khadijah A. Mitchell. "Abstract 4830: Predicting drug treatment response in African American lung cancer patients who smoke". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 4830. http://dx.doi.org/10.1158/1538-7445.am2024-4830.

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Abstract Background: Lung cancer is the third most commonly diagnosed cancer in the US and the leading cause of cancer-related death. African Americans (AAs) have higher lung cancer incidence and mortality rates, and lower survival rates, when compared to their European American (EA) counterparts. It is widely known that cigarette smoking is the strongest risk factor for lung cancer development, but it also plays a significant role in clinical outcome. Cigarette smoking after lung cancer diagnosis (up to 30% patients) comes with several risks, including increased secondary tumors and mortality rates (by 20%), as well as poor treatment outcomes (higher radiation and chemotherapy failure and higher drug clearance). There are limited transcriptomic studies that describe molecular characterizations of AA smokers with lung cancer to predict treatment outcomes. Hypothesis: Cigarette smoking leads to greater drug resistance-related gene expression in AA lung cancer patients. Methods: mRNA expression changes in an AA (NCI-H2172) and EA (NCI-H1944) lung cancer cell line pair exposed to liquid cigarette smoke condensate (CSC) were profiled. The cell lines were matched based on age (62 years), sex (female), histology (lung adenocarcinoma, LUAD, the most common subtype), and culture properties (adherent). The CSC was derived from Murty Pharmaceuticals and prepared by smoking University of Kentucky's 3R4F Standard Research Cigarette on an FTC Smoke Machine. A total of 500,000 cells per well were treated for one hour under standard incubation conditions (37°C, pH 7.0, 5% CO2). Cells were pelleted, RNAs were isolated, treated with DNAse-I to remove contaminating genomic DNA, quantified, and sent for bulk mRNA-sequencing (Novogene Co). Three biological replicates and technical triplicates were performed. Partek Flow and Partek Genomics Suite workflows were used to identify population-specific differentially expressed gene (DEG) signatures and pathway enrichment after CSC exposure. DEG were profiled in LUAD tissues from current smokers in an AA and EA TCGA cohort (n = 18 AAs, 86 EAs). Results: Population-specific gene expression changes were discovered (n = 52 AA DEGs, n = 31 EA DEGs; P <0.001). All of the DEGs were mutually exclusive with no overlap. Some pathways were shared between both populations and others were unique. PI3K/Akt/mTOR signaling pathway enrichment was unique in AA LUAD cells and ECM receptor interactions were distinct in EA LUAD cells. AKT2 (which activates mTOR) had significantly higher expression in LUAD tumor tissues from current AA smokers compared to current EA smokers. Conclusion: Population-specific PI3K/Akt/mTOR pathway alterations may help explain drug resistance in LUAD tumors from AA patients. PI3K signaling is considered a significant cause of resistance to chemotherapy, targeted therapy, and immunotherapy. Future Directions: Expose AA and EA LUAD cell lines to CSC and PI3K/Akt/mTOR pathway inhibitors. Citation Format: Mia Ray, Isaiah Osei-Gyening, Kwabena Acheampong, Marisa Riebesell, Khadijah A. Mitchell. Predicting drug treatment response in African American lung cancer patients who smoke [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4830.

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Hamdy Abdellatif Mohammed, R., H. Lotfy Fayed e N. Emara. "AB0297 MORTALITY AND DISEASE RELATED COMORBIDITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS: DATA FROM AN EGYPTIAN COHORT WITH SYSTEMIC LUPUS ERYTHEMATOSUS- PHASE I". Annals of the Rheumatic Diseases 80, Suppl 1 (19 maggio 2021): 1175.1–1175. http://dx.doi.org/10.1136/annrheumdis-2021-eular.149.

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Background:Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with considerably high mortality.Objectives:To investigate the survival rates 5, 10, 15 and 20 years and the impact of disease related morbidity and mortality among Egyptians patients afflicted by SLE.Methods:This is a single center observational study performed in one of the leading medical school governmental hospital for teaching and training in the north African region and middle east sectors Kasr Alainy School of Medicine- Cairo University. Medical records of adult SLE patients ≥ 16 years (classified according to ACR 1997 SLE classification criteria set forth by Hochberg, 1997) who received longitudinal clinical care during the time period from 1999 to 2019 were included. Data analysis: causes of mortality, damage score and survival were determined from the time of SLE diagnosis to the last contact or date of death.Results:Records of two hundred and two SLE patients were included, 91.1% were females and 8.9% patients were males (ratio is 10:1). The mean age at diagnosis 26.71 ± 7.93 years with a mean follow up between mean: 6.6 ± 4.58 years, 34.15% had damage in at least one of the organ systems by SLICC/ACR-DI in the first 6 months. Considering an outcome label of dead or alive at the end of follow up period, results showed a total of 52 mortalities, 88.5% were females, the mean age at death onset was 30.9±8.8 years. Results identified the following death causalities in the studied SLE patients in order of frequency: Septic shock and disseminated intravascular coagulation in 11.5 %, acute respiratory distress syndrome ARDS in 11.5 %, congestive heart failure in 9.6%, thrombotic microangiopathy 5.7%, cerebritis, acute renal failure 5.7%, intracranial hemorrhage 5.7%, hypertensive encephalopathy in 5.7%. Alveolar hemorrhage, infection, intraoperative deaths each contributed to deaths in 3.8%. Hypovolemic shock, acute liver failure, brain edema, thrombotic thrombocytopenic purpura, end stage kidney disease, pulmonary renal syndrome, suicide and acute hydrocephalus contributed to fatalities in 1.9%. The cause of death was unclearly identified in 26.9%. Results of the Kaplan Meier survival curve in the studied SLE cohort showed an overall cumulative probability of survival at 5, 10, 15 and 20 years after SLE diagnosis was 82.9%, 68.8%,51.4% and 20.4%, respectively. Multivariate regression analysis revealed psychosis, chronic kidney disease and heart failure were independent predictors of survival (HR= 4.3 times, 3.58 times and 3 times respectively, p < 0.001), while the use of hydroxychloroquine and AZA showed a protective effect.Figure 1.Kaplan-Meier estimated survival function, starting at date of SLE diagnosis.Conclusion:The cumulative probability of survival at 5, 10, 15 and 20 years after SLE diagnosis was 82.9%, 68.8%,51.4% and 20.4%, respectively. The presence of renal manifestations, neuropsychiatric lupus and heart failure were independent predictors of poor survival in our cohort. The use of hydroxychloroquine and AZA were protective.Corresponding author: Reem Hamdy Abdellatif Mohammed (Reem H A Mohammed), e-mail: rmhamdy@yahoo.com,. https://orcid.org/0000-0003-4994-7687, Scopus Author ID: 35280107100.References:[1]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997 Sep;40(9):1725. doi: 10.1002/art.1780400928. PMID: 9324032.[2]Kasitanon N, Magder LS, Petri M. Predictors of survival in systemic lupus erythematosus. Medicine (Baltimore) 2006;85:147–56.[3]Gladman D, Ginzler E, Goldsmith C, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum 1996;39:363–9.Disclosure of Interests:None declared

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Pope, C. E., M. C. Gómez, A. Cole, C. Dumas e B. L. Dresser. "229 OOCYTE RECOVERY, IN VITRO FERTILIZATION AND EMBRYO TRANSFER IN THE SERVAL (LEPTAILURUS SERVAL)". Reproduction, Fertility and Development 18, n. 2 (2006): 223. http://dx.doi.org/10.1071/rdv18n2ab229.

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Servals are medium size (9 to 18 kg) spotted cats found in sub-Saharan Africa that are protected by CITES under Appendix II regulations. There are at least six sub-species, one of which is listed as Endangered by the U.S. Endangered Species Act. In vitro-derived embryos have been produced in at least one-half of the 36 species of nondomestic cats, and kittens have been born after embryo transfer in six species. In the present study we evaluated (1) ovarian response of servals to repeated exogenous gonadotropin stimulation, and (2) in vitro and in vivo developmental ability of in vitro-derived embryos. One two-year-old and one five-year-old female were treated six and three times, respectively, over a 3.5-year period, with a total of 20 or 25 IU of porcine FSH (i.m.; Sioux Biochem, Sioux City, IA, USA) administered daily over four days during interestrus. On Day 5, 15 IU of porcine LH (i.m.; Sioux Biochem) was given, and laparoscopic oocyte retrieval was performed 24 h later. A total of 234 preovulatory oocytes were recovered: 182 (mean = 30.3) from the two-year-old and 52 (mean = 17.3) from the five-year-old female. A total of 91 and 91 oocytes were recovered at retrievals 1 through 3 and 4 through 6, respectively, from the two-year-old donor. Eighty oocytes from the two-year-old donor were inseminated with cooled (24 h, 4°C) semen. Frozen semen from the same male was used to inseminate 102 oocytes from the two-year-old female and 52 oocytes from the five-year-old female. Overall, 136 embryos (58% cleavage frequency) were produced: 119 (65% cleavage frequency) from the two-year-old and 17 (33% cleavage frequency) from the five-year-old female. Cleavage frequency of oocytes from the two-year-old female inseminated with cooled or frozen semen was similar, 68% (54/80) and 64% (65/102), respectively. Embryos were cultured for 5 or 6 days before controlled rate cryopreservation or uterine transfer (Gómez et al. 2003 Theriogenology 60, 239–251). On Day 5, 66 early to mid-stage morulae were cryopreserved at a slow controlled rate. Sixty Day 5 and 18 Day 6 embryos were auto-transferred to a recipient (8 to 26/transfer) in a total of six surgical procedures, of which five were with fresh embryos (n = 70) and one was with cryopreserved embryos (n = 8). The sixth embryo transfer procedure (26 fresh embryos) resulted in the unassisted birth of a live male kitten on Day 77 of gestation. We have shown that in vitro-derived embryos can be generated in the serval and that oocyte retrieval rates and cleavage frequencies are comparable to those reported for other species of mid-sized nondomestic cats. The nominal incidence of pregnancy and frequency of embryo survival may be improved by transferring early cleavage staged embryos into the oviduct, as demonstrated in the African wildcat (Felis silvestris lybica; Gómez et al. 2004 Cloning and Stem Cells 6, 247–258). This work was partially funded by the Dan Heard Conservation Challenge Grant.

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Woets, Rhoda. "THE RECREATION OF MODERN AND AFRICAN ART AT ACHIMOTA SCHOOL IN THE GOLD COAST (1927–52)". Journal of African History 55, n. 3 (22 settembre 2014): 445–65. http://dx.doi.org/10.1017/s0021853714000590.

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AbstractThe formative influence of colonial art education on modern art movements in Africa has not attracted a great deal of scholarly attention. Yet, European art teachers in the Gold Coast challenged colonial prejudice that Africans were incapable of mastering European aesthetic forms. This article analyses the art education provided at the Teacher Training College at Achimota School where pupils learned both to revalue African art forms and to draw and paint in European, representational art styles. Modern artists built on and reshaped what they had learned at Achimota in order to respond to changing social and political conditions. The last section of this article explores the impact of colonial art education on the work of two of the earliest modern artists in Ghana: Kofi Antubam and Vincent Kofi.

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Kulkarni, Abhigna, Rithikaa Ellangovan, Nithya Ramesh e Edward Ruby. "ODP106 Mystery of the Calcium: A Case of Exclusive Cutaneous Sarcoidosis presenting with Symptomatic Hypercalcemia". Journal of the Endocrine Society 6, Supplement_1 (1 novembre 2022): A170. http://dx.doi.org/10.1210/jendso/bvac150.349.

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Abstract The skin is the second most involved organ after the lung in sarcoidosis. It could be an early manifestation that may progress to systemic disease later. Exclusive cutaneous disease is more frequently seen in females. Specific lesions include erythema nodosum, skin plaques, subcutaneous nodules, maculopapular rashes, lupus pernio, scar lesions, and psoriasiform lesions. Most with cutaneous sarcoidosis need no treatment unless there is associated cosmetic disfigurement. We present a unique case of cutaneous sarcoidosis presenting with symptomatic hypercalcemia without systemic disease. A 75-year-old African American female was admitted with generalized weakness. She had no other symptoms. On arrival, she was bradycardic with other normal vitals. Physical examination was normal. EKG showed sinus bradycardia with RBBB. She was found to have AKI with creatinine of 4.3 mg/dL (0.6-1.3 mg/dL) and a corrected calcium of 12.2 mg/dL (8.6-10.2 mg/dL). TSH was 4.64 uIU/mL (0.35-5.50 uIU/mL). Chest X-ray showed no abnormalities. Renal ultrasound revealed bilateral medical renal disease, with several non-obstructing calculi in the right kidney. The patient was managed with intravenous fluids. Her creatinine improved to 3.1 mg/dL; however, the calcium remained elevated at 11.8 mg/dL. PTH was 31 pg/mL (12-88 pg/mL) and urine 24-hr calcium was elevated at 470 mg (35-250 mg). 25-OH vitamin D level was 40 ng/mL (30-100 ng/mL). With no response to intravenous hydration, IV bisphosphonates were initiated. Despite that, her calcium remained at 11.9 mg/dL. On obtaining a more detailed history, it was revealed that a skin punch biopsy performed six years prior showed sarcoid granulomatous dermatitis. The 1, 25 dihydroxy vitamin D was 93 pg/mL (20-79 pg/mL). The ACE level was high at 64 U/L (8-52 U/L). CT chest showed no evidence of granulomatous disease, including the absence of hilar adenopathy. The patient was started on prednisone 20 mg/day. Her calcium trended down to 10.7 mg/dL over the next three days. Although cutaneous sarcoidosis may not be life-threatening, it may have substantial psychological and social impacts. Hypercalcemia is a high prevailing complication of systemic sarcoidosis. It occurs due to the uncontrolled synthesis of 1,25-OH D3 by macrophages in the sarcoid granulomata. As a result, there is increased calcium absorption in the intestine and calcium resorption in the bone. Glucocorticosteroids act by inhibiting the 1alpha-hydroxylase activity of macrophages. Prednisone 20 to 40 mg/day followed by a taper is the recommended dose. Other medications that may be used include antimalarials, thalidomide, methotrexate, and other immunomodulatory agents. Hypercalcemia in a patient with cutaneous sarcoidosis and no pulmonary involvement is a rare presentation. It is essential to recognize that long-term follow-up is advised for those with cutaneous sarcoidosis, as some may develop systemic involvement subsequently. Presentation: No date and time listed

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Shanmugam, Sridevi, Praveen Kumar e Blaga Carr. "Acute mania with psychotic symptom in post COVID-19 patient". BJPsych Open 7, S1 (giugno 2021): S50—S51. http://dx.doi.org/10.1192/bjo.2021.182.

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AimsCOVID-19 is an on-going pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent evidence suggests that SARS-CoV-2 may be associated with various neuropsychiatric symptoms, including mania. We present a case of a middle aged man presenting with acute mania with psychotic symptoms 20 days post COVID infection in the absence of prior psychiatric illness. This report highlights the need for rigorous neuropsychiatric assessment in patient with symptoms of SARS-CoV-2 infection.MethodA 52-year-old man of West African origin with past history of hypertension and no previous history of mental health illness presented with acute manic symptoms on background of two weeks of high fever, diarrhoea, mild headache, dry cough and anosmia. He was tested positive for SARS-CoV-2 infection on COVID PCR test. He was under self-isolation along with his family members who exhibited mild symptoms of SARS-CoV-2, none of them required hospital admission. He was initially fearful to seek medical attention but was brought in by family after exhibiting behaviour changes, obsession with toilet cleaning, reckless spending and getting aggressive approximately two weeks after the onset of acute upper respiratory symptoms. He presented elated in mood with pressure of speech and grandiose ideas. Investigations like neuroimaging and bloods were unremarkable. Initial psychiatric assessment found symptoms consistent with acute mania and he was detained under the Mental Health Act. During admission, he was sexually disinhibited and agitated on the ward requiring IM antipsychotics. He was treated with high dose of Olanzapine and Sodium valproate and his symptoms subsided within two weeks.ResultThis case emphasises the manifestation of neuropsychiatric illness post COVID-19 without a background of psychiatric illness, hypoxemia and cerebral infarction.Based on the CORONERVE Programme and latest retrospective Lancet cohort studies, the period between 14 and 90 days after diagnosis, 5.8% COVID-19 survivors had their first recorded diagnosis of psychiatric illness.It is also important to consider other organic disease given the simultaneous diagnosis of COVID-19. Although it is not yet possible to confirm here due to the lack of a validated CSF-PCR assay, previous reports have implicated SARS-CoV-2 in the development of viral encephalitis, and this remains an important differential.ConclusionClinicians should be alert to the possibility of patients with COVID-19 developing neuropsychiatric complications post SARS-CoV-2 infection, mandating the need for vigilant initial neuropsychiatric assessment and possibly follow-up care in 3 months.

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Painschab, Matthew, Kate Westmoreland, Edwards Kasonkanji, Takondwa Zuze, Bongani Kaimila, Tamiwe Tomoka, Maurice Mulenga, Nathan D. Montgomery, Yuri Fedoriw e Satish Gopal. "Burkitt Lymphoma in Adolescents and Adults in Malawi: A Prospective Cohort Study". Blood 132, Supplement 1 (29 novembre 2018): 4225. http://dx.doi.org/10.1182/blood-2018-99-114915.

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Abstract INTRODUCTION: Burkitt lymphoma (BL) is the most common pediatric cancer in sub-Saharan Africa (SSA), and also occurs frequently in adolescents and adults, often associated with human immunodeficiency virus (HIV). BL is highly curable in high-income countries, but outcomes are worse for children in SSA due to advanced disease and inability to achieve cytotoxic intensity comparable to high-income countries. Moreover, unlike pediatric BL, there are few high-quality prospective studies describing non-pediatric BL in SSA. METHODS: We prospectively enrolled patients with newly diagnosed BL from 2013 to 2018 in Malawi, a low-income country in SSA, and restricted analyses to patients aged ≥15 years. Diagnoses were confirmed using local performed immunohistochemistry, real-time telepathology, and subsequent secondary review in the United States. Participants received standardized treatment according to local pediatric or adult standards of care, with concurrent antiretroviral therapy (ART) if HIV+. RESULTS: 36 patients ≥15 years with BL were enrolled, with median age 21 years (range 15-61), and 44% being HIV+. Five (14%) participants were over 40 years of age. At diagnosis, 23 (64%) participants presented with abdominal disease, 5 (14%) had CNS disease, and 5/23 (22%) had bone marrow involvement. 25 (69%) participants had B symptoms, 27 (75%) had stage 3/4 disease, and 19 (56%) had ECOG performance status >1. Among 16 HIV+ participants, 9 (56%) were aware of their HIV diagnosis for a median of 1.4 years (range 0.4-9.4) prior to BL diagnosis, and 8 (50%) were on ART for a median of 1.1 years (range 0.4-2.6). Among all HIV+ BL patients, median CD4 count was 134 (range 29-2235), and 8 (50%) had HIV VL <400 copies/mL. Four patients (11%) died before chemotherapy initiation. First-line chemotherapy consisted of bolus anthracycline-based chemotherapy (CHOP) in 25 (78%), infusional anthracycline-based chemotherapy (EPOCH) in four (12%), and high-dose methotrexate-based chemotherapy (COPADM) in two (6%). Only one participant received rituximab with CHOP as part of a clinical trial, since rituximab is not otherwise routinely available in Malawi. Participants received a median of 4 cycles of first-line chemotherapy (range 1-8). 14/29 (48%) evaluable participants achieved a complete response, 7 (24%) had a partial response and 8 (28%) were refractory. Median overall survival (OS) was 7 months and one-year OS was 36% (95% CI 20-52%). In a multivariate Cox proportional hazards model, death was associated with stage 3/4 disease (HR 6.3 [95% CI 1.4-27.2]; p=0.01) and ECOG performance status >1 (HR 7.4 [95% CI 1.5-35.1]; p=0.01) with a trend toward worse survival in HIV+ participants (HR 5.9 [95% CI 0.9-39.4]; p=0.07). There were no clear differences in outcome observed based on choice of first-line chemotherapy. Of 23 deaths during the follow-up period, six (26%) were classified as treatment-related. CONCLUSIONS: This is one of the best characterized prospective cohorts of non-pediatric BL in SSA, which occurred primarily among adolescents and young adults. Outcomes were worse than pediatric cohorts from the region, with most deaths due to progressive BL. This study highlights the need to develop effective treatments for non-pediatric BL with and without HIV in resource-limited settings, where high-intensity strategies from high-income countries may have limited applicability. Disclosures Fedoriw: ALEXION PHARMACEUTICALS: Consultancy, Honoraria.

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Botha, Ferdi, Jen Snowball e Brett Scott. "Art investment in South Africa: Portfolio diversification and art market efficiency". South African Journal of Economic and Management Sciences 19, n. 3 (5 settembre 2016): 358–68. http://dx.doi.org/10.4102/sajems.v19i3.1397.

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Art has been suggested as a good way to diversify investment portfolios during times of financial uncertainty. The argument is that art exhibits different risk and return characteristics to conventional investments in other asset classes. The new Citadel art price index offered the opportunity to test this theory in the South African context. Moreover, this paper tests whether art prices are efficient. The Citadel index uses the hedonic regression method with observations drawn from the top 100, 50 and 20 artists by sales volume, giving approximately 29 503 total auction observations. The Index consists of quarterly data from the period 2000Q1 to 2013Q3. A vector autoregression of the art price index, Johannesburg stock exchange all-share index, house price index, and South African government bond index were used. Results show that, when there are increased returns on the stock market in a preceding period and wealth increases, there is a change in the Citadel art price index in the same direction. No significant difference was found between the house price index and the art price index, or between the art and government bond price indices. The art market is also found to be inefficient, thereby exacerbating the risk of investing in art. Overall, the South African art market does not offer the opportunity to diversify portfolios dominated by either property, bonds, or shares.

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Makenga, Geofrey, Vito Baraka, Filbert Francis, Daniel T. R. Minja, Samwel Gesase, Edna Kyaruzi, George Mtove et al. "Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania". PLOS ONE 17, n. 5 (26 maggio 2022): e0268654. http://dx.doi.org/10.1371/journal.pone.0268654.

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In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a ‘20 metre Shuttle run’ and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10–15 years), not sleeping under a bednet, low socioeconomic status, parents’ or guardians’ with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7–0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0–0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72–76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents’ or guardians’ illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control.

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Hansra, Damien Mikael, Amber Moran, Becky Slawik, Shirelle Clark, Vicki Doctor, Ankur Rasik Parikh, Pamela A. Crilley et al. "Evaluation of pathologic and genomic characteristics in female breast cancer patients." Journal of Clinical Oncology 39, n. 15_suppl (20 maggio 2021): e13001-e13001. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e13001.

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e13001 Background: The genomic landscape of female breast cancer is rapidly evolving partially owing to advancements in next generation sequencing (NGS). Here we report the genomic characteristics of female breast cancer patients with locally recurrent inoperable and metastatic disease. Methods: IRB approval was obtained for a retrospective analysis of archived pathology on patients treated at Cancer Treatment Centers of America. Comprehensive genomic profiling of tumors was derived from Foundation One (F1) and Guardant 360 NGS. Clinical information was derived from retrospective chart review. Inclusions: adult females with breast cancer with stage IV metastatic disease or locally recurrent inoperable disease. Exclusions: Males, missing genomic and pathologic information. Results of clinical, pathologic, and genomic data were summarized. Results: 1788 patients met study criteria. Median age: 48 yrs., range 20-79 yrs. Race: Caucasian 1029/1788 (58%), African American 582/1788 (32%), Hispanic 77/1788 (4%), Asian 26/1788 (1%), other 73/1788 (4%). Receptor status: Hormone receptor ER(+) &/or PR(+) 950/1788 (53.1%); Triple negative 390/1788 (21.8%); HER2(+) 205/1788 (11.5%); missing/incomplete: 243/1788 (13.6%). Ki-67 status: High 548/705 (77.7%)/Low 57/705 (8.1%)/Intermediate (INT) 100/705 (14.2%). PD-L1 status: PD-L1(-) 346/544 (63.6%)/ PD-L1(+) 179/544 (32.9%)/PD-L1 (indeterminate or QNS) 19/544 (3.5%). NGS test total (1984 tests): F1 1023/1984 (52%), F1 CDx 703/1984 (35%), F1 Act 91/1984 (6%), F1 Liquid 82/1984 (6%), Guardant 360 85/1984 (4%). Biomarkers (1096 results): Microsatellite Instability (MSI) High 4/1096 (0.3%), MSI- Intermediate (INT) 2/1096 (0.1%), MS-stable 1017/1096 (93%), Cannot be determined (CBD) 73/1096 (7%). Tumor Mutation Burden (TMB) (842 results): TMB high 22/842 (3%), TMB INT 233/842 (28%), TMB low 513/842 (61%), CBD 74/842 (9%). Genomic abnormalities (% alterations per patient): TP53 999/1783 (56.03%), PIK3CA 610/1783 (34.21%), MYC 425/1783 (23.84%), CCND1 318/1783 (17.84%), FGF19 298/1783 (16.71%), FGF3 296/1783 (16.60%), FGF4 293/1783 (16.43%), ESR1 266/1783 (14.92%), FGFR1 276/1783 (15.48%), PTEN 239/1783 (13.40%), ZNF703 251/1783 (14.08%), ERBB2 218/1783 (12.23%), GATA3 178/1783 (9.98%), CDH1 165/1783 (9.25%), RAD21 157/1783 (8.81%). Pathway defects (expressed as total % of alterations): Alterations in FGF genes 10.64%, mTOR pathway 8.36%, HHR pathway 3.17%. Conclusions: Female breast cancer patients display a heterogeneous variety of complex genomic alterations. Mutations in FGF genes were most common. The single most common alteration was in TP53. Other common alterations include PIK3CA, MYC, CCND1, and ESR1.

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de Waal, Reneé, Helena Rabie, Karl-Günter Technau, Brian Eley, Nosisa Sipambo, Mark Cotton, Andrew Boulle et al. "Abacavir safety and effectiveness in young infants with HIV in South African observational cohorts". Antiviral Therapy 28, n. 2 (febbraio 2023): 135965352311684. http://dx.doi.org/10.1177/13596535231168480.

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Background WHO guidelines recommend abacavir in first-line antiretroviral treatment for children and neonates. However, there is no approved dose <3 months of age, and data in neonates are limited. Methods We included infants who initiated ART aged <3 months, between 2006 and 2019, in nine South African cohorts. In those who received abacavir or zidovudine, we described antiretroviral discontinuation rates; and 6- and 12-month viral suppression (<400 copies/mL). We compared infants aged <28 and ≥28 days, those weighing <3 and ≥3 kg. Results Overall 837/1643 infants (51%) received abacavir and 443 (27%) received zidovudine. Median (interquartile range, IQR) age was 52 days (23–71), CD4 percentage was 27.9 (19.2–38.0), and weight was 4.0 kg (3.0–4.7) at ART initiation. In those with ≥1 month’s follow-up, 100/718 (14%) infants discontinued abacavir, at a median of 17.5 months (IQR 6.5–39.5). Abacavir discontinuations did not differ by age or weight category ( p = 0.4 and 0.2, respectively); and were less frequent than zidovudine discontinuations (adjusted hazard ratio 0.14, 95% confidence interval 0.10–0.20). Viral suppression at 12 months occurred in 43/79 (54%) and 130/250 (52%) of those who started abacavir aged <28 and ≥28 days, respectively ( p = 0.8); 11/19 (58%) and 31/60 (52%) in those who weighed <3 and ≥3 kg, respectively ( p = 0.6); and 174/329 (53%) in those on abacavir versus 77/138 (56%) in those on zidovudine (adjusted odds ratio 1.8, 95% confidence interval 1.0–3.2). Conclusion Our data suggest that abacavir may be used safely in infants <28 days old or who weigh <3 kg.

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Wethington, Stephanie L., David Cibula, Linda R. Duska, Leslie Garrett, Christine H. Kim, Dennis S. Chi, Yukio Sonoda e Nadeem R. Abu-Rustum. "An International Series on Abdominal Radical Trachelectomy: 101 Patients and 28 Pregnancies". International Journal of Gynecologic Cancer 22, n. 7 (settembre 2012): 1251–57. http://dx.doi.org/10.1097/igc.0b013e318263eee2.

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ObjectivesAbdominal radical trachelectomy (ART) is a type C resection (uterine vessels ligated at origin from the hypogastric vessels). Questions arise as to whether fertility is maintained after ART, particularly when uterine vessels are sacrificed. We report an international series on ART to describe fertility and oncologic outcomes.MethodsDatabases at 3 institutions were queried to identify patients planned for ART from 1999 to 2011. Clinical and demographic data were gathered.ResultsOne hundred one patients underwent ART. Mean age was 31 years (range, 19–43 years). Histologic classifications were adenocarcinoma (n = 54), squamous cell carcinoma (n = 40), adenosquamous carcinoma (n = 6), and clear cell carcinoma (n = 1). Twenty patients (20%) required conversion to hysterectomy (10 margins and 10 nodes). Eight patients underwent completion hysterectomy owing to the following: positive margins on final pathology (n = 3), patient’s choice (n = 4), or recurrence (n = 1). Postoperatively, 20 patients (20%) received adjuvant chemotherapy and/or radiation (4 final pathology margins and 16 nodes). Four patients (4%) had recurrence and lived 22 to 35 months after diagnosis. Of the 70 women who had neither hysterectomy nor adjuvant therapy, 38 (54%) attempted pregnancy and 28 (74%) achieved pregnancy. Thirty-one pregnancies resulted in 16 (52%) third trimester deliveries. Six patients are currently pregnant with outcomes pending.ConclusionsThese data demonstrate that ART preserves fertility and maintains excellent oncologic outcomes. Most women (74%) attempting pregnancy after ART are able to achieve pregnancy and deliver in the third trimester (52%). Preservation of the uterine vasculature is not necessary for fertility; obstetrical outcomes are similar to those of the historical vaginal radical trachelectomy cohorts.

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LILIAN, R. R., B. MUTASA, J. RAILTON, W. MONGWE, J. A. McINTYRE, H. E. STRUTHERS e R. P. H. PETERS. "A 10-year cohort analysis of routine paediatric ART data in a rural South African setting". Epidemiology and Infection 145, n. 1 (9 settembre 2016): 170–80. http://dx.doi.org/10.1017/s0950268816001916.

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SUMMARYSouth Africa's paediatric antiretroviral therapy (ART) programme is managed using a monitoring and evaluation tool known as TIER.Net. This electronic system has several advantages over paper-based systems, allowing profiling of the paediatric ART programme over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15 years who had initiated ART in a rural district of South Africa between 2005 and 2014. We performed Kaplan–Meier survival analysis to assess outcomes over time. Records of 5461 children were available for analysis; 3593 (66%) children were retained in care. Losses from the programme were higher in children initiated on treatment in more recent years (P < 0·0001) and in children aged ≤1 year at treatment initiation (P < 0·0001). For children aged <3 years, abacavir was associated with a significantly higher rate of loss from the programme compared to stavudine (hazard ratio 1·9, P < 0·001). Viral load was suppressed in 48–52% of the cohort, with no significant change over the years (P = 0·398). Analysis of TIER.Net data over time provides enhanced insights into the performance of the paediatric ART programme and highlights interventions to improve programme performance.

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Glendinning, Elizabeth, Johanna Spiers, Jonathan A. Smith, Jane Anderson, Lucy J. Campbell, Vanessa Cooper e Rob Horne. "A Qualitative Study to Identify Perceptual Barriers to Antiretroviral Therapy (ART) Uptake and Adherence in HIV Positive People from UK Black African and Caribbean Communities". AIDS and Behavior 23, n. 9 (settembre 2019): 2514–21. http://dx.doi.org/10.1007/s10461-019-02670-x.

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Abstract To inform the development of interventions to increase uptake and adherence to antiretroviral therapy (ART), we explored perceptions of ART in semi-structured interviews with 52 men and women from UK black African and black Caribbean communities. Verbatim transcripts were analyzed using framework analysis. Perceptions of ART could be grouped into two categories: doubts about the personal necessity for ART and concerns about potential adverse effects. Doubts about necessity stemmed from feeling well, doubts about the efficacy of ART, religious beliefs and the belief that treatment was futile because it could not cure HIV. Concerns about adverse effects included the fear that attending HIV services and taking treatment would lead to disclosure of HIV, feeling overwhelmed at the prospect of starting treatment soon after diagnosis, fears about side effects and potential long-term effects, and physical repulsion. The findings will facilitate the development of interventions to increase uptake and adherence to ART.

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Kasonkanji, Edwards, Yolanda Gondwe, Morgan Dewey, Joe Gumulira, Matthew Painschab, Mina Hosseinipour e Dirk Dittmer. "Prospective cohort study of Kaposi sarcoma treated under real-world conditions in Malawi." Journal of Clinical Oncology 39, n. 15_suppl (20 maggio 2021): 11569. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.11569.

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11569 Background: Kaposi sarcoma (KS) is the leading cancer in Malawi (34% of cancers). Outside of clinical trials, prospective KS studies from sub-Saharan Africa (SSA) are few and limited by loss to follow up. We conducted a prospective KS cohort study of standard of care bleomycin/vincristine (BV) at Lighthouse HIV clinic, in Lilongwe, Malawi. Methods: We enrolled pathologically confirmed, newly diagnosed, HIV+ KS patients from Feb 2017 to Jun 2019. We collected clinical and treatment characteristics, toxicity, and outcomes of KS with follow-up censored Jun 2020. Patients were treated with bleomycin (25 mg/m2) and vincristine (0.4 mg/m2) every 14 days for a planned maximum of 16 cycles. STATA v13.0 was used to calculate descriptive statistics and Kaplan Meier survival analysis. Toxicity was graded using NCI CTCAE v5.0. Results: We enrolled 138 participants, median age 36 (IQR 32-44) and 110 (80%) male. By ACTG staging, 107 (78%) were T1 (tumour severity), 46 (33%) were S1 (illness severity) and 46 (33%) had Karnofsky performance status ≤70. Presenting symptoms included edema in 69 (53%), visceral disease in 9 (7%), and oral involvement in 43 (33%). Prior to KS diagnosis, 70 (51%) participants were aware of being HIV+ for median 17 months (IQR 6-60) and had been on ART for median 16 months (IQR 6-60). Median CD4 count was 197 (IQR 99-339), median HIV-viral load was 2.6 log copies/mL (IQR 1.6 – 4.8) and 57% were HIV-suppressed ( < 1000 HIV copies/ml). The median number of cycles was 16 (IQR 7-16). 62 (45%) participants missed at least one dose due to stock out. Amongst patients with missed doses, the median number was 3 (IQR 2-4) for bleomycin and 2 (IQR 1-3) for vincristine. 14 (10%) participants experienced at least one reduced dose due to toxicity. 5 (4%) participants suffered grade ≥3 anaemia, 13 (9%) grade ≥3 neutropenia, and one participant had grade 4 bleomycin-induced dermatitis. There was no reported grade ≥3 bleomycin lung toxicity or vincristine-induced neuropathy. Of 115 evaluable participants, responses at the end of therapy were: complete response in 52 (45%), partial response in 27 (23%) stable disease in 5 (4%), and progressive disease in 31 (28%). Median duration of follow-up was 20 months. At censoring, 69 (50%) were alive, 36 (26%) dead, and 33 (24%) lost to follow-up. Overall survival is shown Table as crude and worst-case scenario; worst-case assumes all participants lost to follow up died. Conclusions: Here, we present one of the most complete characterizations of KS presentation and treatment from SSA. As in other studies from the region, the majority of patients presented with advanced disease, chemotherapy stock-outs and loss to follow up were common, and mortality was high. Studies are planned to understand the virologic characteristics, improve therapies, and better implement existing therapies.[Table: see text]

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Allgulander, Christer, Orlando Alonso Betancourt, David Blackbeard, Helen Clark, Franco Colin, Sarah Cooper, Robin Emsley et al. "16th National Congress of the South African Society of Psychiatrists (SASOP)". South African Journal of Psychiatry 16, n. 3 (1 ottobre 2010): 29. http://dx.doi.org/10.4102/sajpsychiatry.v16i3.273.

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List of abstracts and authors:1. Antipsychotics in anxiety disordersChrister Allgulander2. Anxiety in somatic disordersChrister Allgulander3. Community rehabilitation of the schizophrenic patientOrlando Alonso Betancourt, Maricela Morales Herrera4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative careDavid Blackbeard5. The emotional language of the gut - when 'psyche' meets 'soma'Helen Clark6. The Psychotherapy of bipolar disorderFranco Colin7. The Psychotherapy of bipolar disorderFranco Colin8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and ZambiaSara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund9. The importance of relapse prevention in schizophreniaRobin Emsley10. Mental Health care act: Fact or fiction?Helmut Erlacher, M Nagdee11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?Lennart Eriksson12. The incidence and risk factors for dementia in the Ibadan study of ageingOye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona13. Is depression a disease of inflammation?Angelos Halaris14. Paediatric bipolar disorder: More heat than light?Sue Hawkridge15. EBM: Anova ConundrumElizabeth L (Hoepie) Howell16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unitBernard Janse van Rensburg17. Dual diagnosis units in psychiatric facilities: Opportunities and challengesYasmien Jeenah18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophreniaGerhard Jordaan, D G Nel, R Hewlett, R Emsley19. Anxiety disorders: the first evidence for a role in preventive psychiatryAndre F Joubert20. The end of risk assessment and the beginning of startSean Kaliski21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern UgandaE Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern CapeN K Kirimi, C Visser23. Mental Health service user priorities for service delivery in South AfricaSharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium24. The nature and extent of over-the-counter and prescription drug abuse in cape townLiezl Kramer25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies HospitalChrista Kruger26. Suicide risk in Schizophrenia - 20 Years later, a cohort studyGian Lippi, Ean Smit, Joyce Jordaan, Louw Roos27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-NatalCrick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution28. Mental health aspects of South African emigrationMaria Marchetti-Mercer29. What services SADAG can offer your patientsElizabeth Matare30. Culture and language in psychiatryDan Mkize31. Latest psychotic episodePovl Munk-Jorgensen32. The Forensic profile of female offendersMo Nagdee, Helmut Fletcher33. The intra-personal emotional impact of practising psychiatryMargaret Nair34. Highly sensitive persons (HSPs) and implications for treatmentMargaret Nair35. Task shifting in mental health - The Kenyan experienceDavid M Ndetei36. Bridging the gap between traditional healers and mental health in todya's modern psychiatryDavid M Ndetei37. Integrating to achieve modern psychiatryDavid M Ndetei38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinicA Parkinson39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future researchCharles Parry40. Global mental health - A new global health discipline comes of ageVikram Patel41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South AfricaInge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium42. Personality disorders -The orphan child in axis I - Axis II DichotomyWillie Pienaar43. Case Studies in Psychiatric EthicsWillie Pienaar44. Coronary artery disease and depression: Insights into pathogenesis and clinical implicationsJanus Pretorius45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trialsSuvira Ramlall, Jennifer Chipps46. Biological basis of addicationSolomon Rataemane47. Genetics of SchizophreniaLouw Roos48. Management of delirium - Recent advancesShaquir Salduker49. Social neuroscience: Brain research on social issuesManfred Spitzer50. Experiments on the unconsciousManfred Spitzer51. The Psychology and neuroscience of musicManfred Spitzer52. Mental disorders in DSM-VDan Stein53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal studyUgashvaree Subramaney54. Eating disorders: An African perspectiveChristopher Szabo55. An evaluation of the WHO African Regional strategy for mental health 2001-2010Thandi van Heyningen, M Majavu, C Lund56. A unitary model for the motor origin of bipolar mood disorders and schizophreniaJacques J M van Hoof57. The origin of mentalisation and the treatment of personality disordersJacques J M Hoof58. How to account practically for 'The Cause' in psychiatric diagnostic classificationC W (Werdie) van StadenPOSTER PRESENTATIONS59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz61. Lessons learnt from a modified assertive community-based treatment programme in a developing countryUlla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen62. Perceptions of psychologists regarding the use of religion and spirituality in therapyOttilia Brown, Diane Elkonin63. Resilience in families where a member is living with schizophreniOttilia Brown, Jason Haddad, Greg Howcroft64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the selfWilliam Griffiths, D Macklin, Loray Daws65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the selfWilliam Griffiths, D Macklin, Loray Daws66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programmeVolker Hitzeroth67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case seriesTerri Henderson68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literatureBernard Janse van Rensburg69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenariosBernard Janse van Rensburg70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder populationMarinda Joubert, J L Roos, J Jordaan71. A role for structural equation modelling in subtyping schizophrenia in an African populationLiezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley72. Caregivers of disabled elderly persons in NigeriaLola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profileChristina Kruger, M P Henning, L Fletcher74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profileChristina Kruger, M P Henning, L Fletcher75. 'The Great Suppression'Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes76. Not being allowed to grow up - The Mastersonian approach to the borderline personalityDaleen Macklin, W Griffiths77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system studyDaleen Macklin, Loray Daws, M Aronstam78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital T G Magagula, M M Mamabolo, C Kruger, L Fletcher79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies HospitalM M Mamabolo, T G Magagula, C Kruger, L Fletcher80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelinesCarina Marsay, C P Szabo81. Reported rapes at a hospital rape centre: Demographic and clinical profilesLindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatryMpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan83. Trends of suicide in the Transkei region of South AfricaBanwari Meel84. Functional neuro-imaging in survivors of tortureThriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South AfricaDinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilienceUgashvaree Subramaney88. Drugs and other therapies under investigation for PTSD: An international databaseSharain Suliman, Soraya Seedat89. Frequency and correlates of HIV Testing in patients with severe mental illnessHendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric HospitalStephan van Wyk, Zukiswa Zingela91. A brief report on the current state of mental health care services in the Eastern CapeStephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso92. An integrated mental health care service model for the Nelson Mandela Bay MetroStephan van Wyk, Zukiswa Zingela, Kiran Sukeri93. Traditional and alternative healers: Prevalence of use in psychiatric patientsZukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche

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Brand, Handré J. "Reliability of the Frostig Test of Visual Perception in a South African Sample". Perceptual and Motor Skills 69, n. 1 (agosto 1989): 273–74. http://dx.doi.org/10.2466/pms.1989.69.1.273.

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The Marianne Frostig Developmental Test of Visual Perception was administered to 31 preschool children (19 boys and 12 girls) whose mean age was 68 mo. An item analysis showed that 52% of the test items satisfied the requirements with regard to degree of difficulty and discrimination. KR-20 reliability coefficients varied between 0.31 and 0.58 for the different subtests, with r = 0.72 for the full scale.

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Kamtchum-Tatuene, Joseph, Henry Mwandumba, Zaid Al-Bayati, Janet Flatley, Michael Griffiths, Tom Solomon e Laura Benjamin. "HIV is associated with endothelial activation despite ART, in a sub-Saharan African setting". Neurology - Neuroimmunology Neuroinflammation 6, n. 2 (21 dicembre 2018): e531. http://dx.doi.org/10.1212/nxi.0000000000000531.

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ObjectiveTo study the relationship between endothelial dysfunction, HIV infection, and stroke in Malawians.MethodsUsing a cross-sectional design, we measured plasma levels of intercellular adhesion molecule-1 (ICAM-1), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), and soluble thrombomodulin (sTM) in stroke patients and controls, stratified by HIV status. These biomarkers were measured using ELISA. After dichotomization, each biomarker was used as the dependent variable in a multivariable logistic regression model. Primary independent variables included HIV and stroke status. Adjustment variables were age, sex, hypertension, diabetes mellitus, tobacco and alcohol consumption, personal/family history of stroke, antiretroviral therapy status, and hypercholesterolemia.ResultsSixty-one stroke cases (19 HIV+) and 168 controls (32 HIV+) were enrolled. The median age was 55 years (38.5–65.0) for controls and 52 years (38.0–73.0) for cases (p = 0.38). The median CD4+ T-cell count was 260.1 cells/mm3 (156.3–363.9) and 452 cells/mm3 (378.1–527.4) in HIV-infected cases and controls, respectively. HIV infection was independently associated with high levels of ICAM-1 (OR = 3.6, 95% CI: 1.3–10.6, p = 0.018) in controls but not in stroke cases even after excluding patients with a viral load >1,000 RNA copies/mL (OR = 4.1, 95% CI: 1.3–13.1, p = 0.017). There was no association between the clinical profiles of HIV-positive controls or HIV-positive stroke and high levels of PAI-1, VEGF, and sTM.ConclusionsHIV infection is associated with endothelial activation despite antiretroviral treatment. Our findings underscore the need for larger clinical cohorts to better understand the contribution of this perturbation of the endothelial function to the increasing burden of cardiovascular diseases in sub-Saharan Africa.

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Uzodike, Nnaemeka, Andrew Ross e Ogbonnaya Harbor. "Adherence by a primary healthcare clinic in KwaZulu-Natal to the national HIV guidelines". South African Family Practice 57, n. 3 (1 maggio 2015): 5. http://dx.doi.org/10.4102/safp.v57i3.3940.

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Background: The decentralisation of antiretroviral therapy (ART) to primary health care (PHC) was rolled-out in South Africa in March 2010. PHC staff members are expected to initiate ART, monitor patients, and detect and refer patients with adverse events or virological failure to designated referral hospitals. The aim of this study was to assess the monitoring and referral of patients on ART who were being managed at a PHC clinic.Method: This was a cross-sectional, retrospective study on 488 adult patients attending a PHC ART clinic selected by systematic random sampling between June 2011 and June 2012. Data were extracted from the patient files using a standardised data collection sheet, based on the South African national HIV guidelines for 2010.Results: Pill count, CD4 count and viral load (VL) were all well assessed by June 2011. Thirty-one per cent of patients being followed-up at the clinic had developed virological failure, of whom 84% were referred. By June 2012, 49% of the patients had developed virological failure, of whom only 52% were referred for further management.Conclusion: The PHC nurses were excellent at monitoring pill count, CD4 count and VL, but were unable to detect and appropriately refer patients with virological failure. This is of great concern, and needs urgent intervention and further research.

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Allers, Eugene, Christer Allgulander, Sean Exner Baumann, Charles L. Bowden, P. Buckley, David J. Castle, Beatrix J. Coetzee et al. "13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004". South African Journal of Psychiatry 10, n. 3 (1 ottobre 2004): 17. http://dx.doi.org/10.4102/sajpsychiatry.v10i3.150.

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List of abstacts and authors:1. Integrating the art and science of psychiatryEugene Allers2. Chronic pain as a predictor of outcome in an inpatient Psychiatric populationEugene Allers and Gerhard Grundling3. Recent advances in social phobiaChrister Allgulander4. Clinical management of patients with anxiety disordersChrister Allgulander5. Do elephants suffer from Schizophrenia? (Or do the Schizophrenias represent a disorder of self consciousness?) A Southern African perspectiveSean Exner Baumann6. Long term maintenance treatment of Bipolar Disorder: Preventing relapseCharles L. Bowden7. Predictors of response to treatments for Bipolar DisorderCharles L. Bowden8. Aids/HIV knowledge and high risk behaviour: A Geo-graphical comparison in a schizophrenia populationP Buckley, S van Vuuren, L Koen, J E Muller, C Seller, H Lategan, D J H Niehaus9. Does Marijuana make you go mad?David J Castle10. Understanding and management of Treatment Resistant SchizophreniaDavid J Castle11. Workshop on research and publishingDavid J Castle12. From victim to victor: Without a self-help bookBeatrix Jacqueline Coetzee13. The evaluation of the Gender Dysphoric patientFranco Colin14. Dissociation: A South African modelA M Dikobe, C K Mataboge, L M Motlana, B F Sokudela, C Kruger15. Designated smoking rooms...and other "Secret sins" of psychiatry: Tobacco cessation approaches in the severely mentally illCharl Els16. Dual diagnosis: Implications for treatment and prognosisCharl Els17. Body weight, glucose metabolism and the new generation antipsychoticsRobin Emsley18. Neurological abnormalities in first episode Schizophrenia: Temporal stability and clinical and outcome correlatesRobin Emsley, H Jadri Turner, Piet P Oosthuizen, Jonathan Carr19. Mythology of depressive illnesses among AfricansSenathi Fisha20. Substance use and High school dropoutAlan J. Flisher, Lorraine Townsend, Perpetual Chikobvu, Carl Lombard, Gary King21. Psychosis and Psychotic disordersA E Gangat 22. Vulnerability of individuals in a family system to develop a psychiatric disorderGerhard Grundling and Eugene Allers23. What does it Uberhaupt mean to "Integrate"?Jürgen Harms24. Research issues in South African child and adolescent psychiatryS M Hawkridge25. New religious movements and psychiatry: The Good NewsV H Hitzeroth26. The pregnant heroin addict: Integrating theory and practice in the development and provision of a service for this client groupV H Hitzeroth, L Kramer27. Autism spectrum disorderErick Hollander28. Recent advances and management in treatment resistanceEric Hollander29. Bipolar mixed statesM. Leigh Janet30. Profile of acute psychiatric inpatients tested for HIV - Helen Jospeh Hospital, JohannesburgA B R Janse van Rensburg31. ADHD - Using the art of film-making as an education mediumShabeer Ahmed Jeeva32. Treatment of adult ADHD co-morbiditiesShabeer Ahmed Jeeva33. Needs and services at ward one, Valkenberg HospitalDr J. A. Joska, Prof. A.J. Flisher34. Unanswered questions in the adequate treatment of depressionModerator: Dr Andre F JoubertExpert: Prof. Tony Hale35. Unanswered questions in treatment resistant depressionModerator: Dr Andre F JoubertExpert: Prof. Sidney Kennedy36. Are mentally ill people dangerous?Sen Z Kaliski37. The child custody circusSean Z. Kaliski38. The appropriatenes of certification of patients to psychiatric hospitalsV. N. Khanyile39. HIV/Aids Psychosocial responses and ethical dilemmasFred Kigozi40. Sex and PsychiatryB Levinson41. Violence and abuse in psychiatric in-patient institutions: A South African perspectiveMarilyn Lucas, John Weinkoove, Dean Stevenson42. Public health sector expenditure for mental health - A baseline study for South AfricaE N Madela-Mntla43. HIV in South Africa: Depression and CD4 countM Y H Moosa, F Y Jeenah44. Clinical strategies in dealing with treatment resistant schizophreniaPiet Oosthuizen, Dana Niehaus, Liezl Koen45. Buprenorphine/Naloxone maintenance in office practice: 18 months and 170 patients after the American releaseTed Parran Jr, Chris Adelman46. Integration of Pharmacotherapy for Opioid dependence into general psychiatric practice: Naltrexone, Methadone and Buprenorphine/ NaloxoneTed Parran47. Our African understanding of individulalism and communitarianismWillie Pienaar48. Healthy ageing and the prevention of DementiaFelix Potocnik, Susan van Rensburg, Christianne Bouwens49. Indigenous plants and methods used by traditional African healers for treatinf psychiatric patients in the Soutpansberg Area (Research was done in 1998)Ramovha Muvhango Rachel50. Symptom pattern & associated psychiatric disorders in subjects with possible & confirmed 22Q11 deletional syndromeJ.L. Roos, H.W. Pretorius, M. Karayiorgou51. Duration of antidepressant treatment: How long is long enough? How long is too longSteven P Roose52. A comparison study of early non-psychotic deviant behaviour in the first ten years of life, in Afrikaner patients with Schizophrenia, Schizo-affective disorder and Bipolar disorderMartin Scholtz, Melissa Janse van Rensburg, J. Louw Roos53. Treatment, treatment issues, and prevention of PTSD in women: An updateSoraya Seedat54. Fron neural networks to clinical practiceM Spitzer55. Opening keynote presentation: The art and science of PsychiatryM Spitzer56. The future of Pharmacotherapy for anxiety disordersDan J. Stein57. Neuropsychological deficits pre and post Electro Convulsive Therapy (ECT) thrice a week: A report of four casesUgash Subramaney, Yusuf Moosa58. Prevalence of and risk factors for Tradive Dyskinesia in a Xhosa population in the Eastern CapeDave Singler, Betty D. Patterson, Sandi Willows59. Eating disorders: Addictive disorders?Christopher Paul Szabo60. Ethical challenges and dilemmas of research in third world countriesGodfrey B. Tangwa61. The interface between Neurology and Psychiatry with specific focus on Somatoform dissociative disordersMichael Trimble62. Prevalence and correlates of depression and anxiety in doctors and teachersH Van der Bijl, P Oosthuizen63. Ingrid Jonker: A psychological analysisL. M. van der Merwe64. The strange world we live in, and the nature of the human subjectVasi van Deventer65. Art in psychiatry: Appendix or brain stem?C W van Staden66. Medical students on what "Soft skills" are about before and after curriculum reformC W van Staden, P M Joubert, A-M Bergh, G E Pickworth, W J Schurink, R R du Preez, J L Roos, C Kruger, S V Grey, B G Lindeque67. Attention deficit hyperactivity disorder (ADHD) - Medical management. Methylphenidate (Ritalin) or Atomoxetine (Strattera)Andre Venter68. A comprehensive guide to the treatment of adults with ADHDW J C Verbeeck69. Treatment of Insomnia: Stasis of the Art?G C Verster70. Are prisoners vulnerable research participants?Merryll Vorster71. Psychiatric disorders in the gymMerryl Vorster72. Ciprales: Effects on anxiety symptoms in Major Depressive DisorderBruce Lydiard

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Chan, Yen-Ming, Susanne Aufreiter, Stephen J. O’Keefe e Deborah L. O’Connor. "Switching to a fibre-rich and low-fat diet increases colonic folate contents among African Americans". Applied Physiology, Nutrition, and Metabolism 44, n. 2 (febbraio 2019): 127–32. http://dx.doi.org/10.1139/apnm-2018-0181.

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How dietary patterns impact colonic bacterial biosynthesis of vitamins and utilization by humans is poorly understood. Our aim was to investigate whether a reciprocal dietary switch between rural South Africans (traditionally high fibre, low fat) and African Americans (Western diet of low fibre, high fat) affects colonic folate synthesis. Colonic evacuants were obtained from 20 rural South Africans and 20 African Americans consuming their usual diets at baseline. For 2 weeks thereafter, rural South Africans were provided with a Western diet (protein, 27%; fat, 52%; carbohydrate, 20%; and fibre, 8 g/day) and African Americans were provided with a high fibre, low-fat diet (protein, 16%; fat, 17%; carbohydrate, 63%; and fibre, 43 g/day). Colonic evacuants were again collected. No difference between groups at baseline in the folate content of 3-h evacuants was observed. The high-fibre, low-fat diet consumed by African Americans during the intervention produced a 41% increase in mean total folate content compared with baseline values (p = 0.0037). No change was observed in rural South Africans consuming a Western diet. Mean total folate content of colonic evacuants was higher among African Americans at the end of the dietary switch (3107 ± 1811 μg) compared with rural South Africans (2157 ± 1956 μg) (p = 0.0409). In conclusion, consistent with animal studies, switching from a Western diet to one higher in fibre and lower in fat can be expected to result in greater colonic folate content. Future research should confirm that these observations are not transitory and understand the contribution of transit-time to the findings.

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Rudenko-Kraevska, Natalia. "Educational methods of Ukrainian theatrical design schools of the ХХ century in the context of European theatrical practice". Bulletin of Lviv National Academy of Arts, n. 52 (11 luglio 2024): 80–87. http://dx.doi.org/10.37131/2524-0943-2024-52-8.

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The article examines the conditions for the formation and development of Ukrainian theatrical design schools of the XX century in the context of the revolutionary processes of European and Ukrainian theatre art. The causes and consequences of the introduction into European and Ukrainian theatrical design practice of two theatre reforms of the XX century are determined, as well as the impact on the educational process of changing the function of the theatre in society, the tasks of theatrical design and the role of the theatrical designer in creating a performance. The conditions of emergence and development, creative platforms and pedagogical methods of the largest Ukrainian theatrical design schools are analyzed: the model workshop at the «Berezil» theatre of Les Kurbas and Vadym Meller in the 20-s — 30-s of the ХХ century; academic school of theatrical design at the Boris Kosarev Kharkov Art Institute of the 20-s — 60-s of the ХХ century; theatrical design laboratories at the theatre society and at the Kyiv Art Institute of Danylo Lider in the 70-s —80-s of the XX century and the Lvov school of practical theatrical design at the end of the 20th century. It has been found that no systematic scientific studies of the art of theatrical design, as a special type of fine art, are being conducted in Ukraine today. It is noted that one educational program is critically insufficient to meet the needs of Ukrainian theatres for professional theatrical designers. Especially, taking into account the significant change in the arsenal of theatrical designers' tools: the replacement of picturesque backdrops with video projections; expansion of possibilities of light equipment, development of digital 3d technologies, etc.; as well as the «de-dramatization» of the performance — the replacement of the plot with a chronic image, montage, collage, and bringing the theatre art closer to the happening, the performance of the environment, where the emphasis is shifted from the work to the process of art activity itself. Thus, the article proves that new realities require an urgent increase in the number of professional theatrical designers and the updating of educational methods of the modern Ukrainian school of theatrical design, both taking into account the methodological experience of previous national theatrical design schools, and in accordance with the new challenges of the time. The opening of the new educational program «Theatrical design» is an urgent need for the successful development of Ukrainian theatrical art and further integration into the European cultural space.

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Barrios M.S, Dulce M., Sarah J. Noor e Mario E. Lacouture. "Cutaneous pigmentary changes related to anticancer therapy in African Americans." Journal of Clinical Oncology 38, n. 15_suppl (20 maggio 2020): 12074. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.12074.

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12074 Background: Pigmentary disorders are known to disproportionately affect individuals with darker skin, including African Americans (AAs)— a historically underrepresented population in oncology research. However, reports on the prevalence and characterization of anticancer-therapy related cutaneous pigmentary changes in this population are lacking. Methods: A retrospective analysis of AA cancer patients that ever received a hematopoietic stem cell transplantation (HSCT) and/or systemic oncologic therapy within six months prior to diagnosis of cutaneous hypo- or hyperpigmentation at our institution between 4/18/2012 and 8/26/2019 was conducted. Clinical and management characteristics were summarized; severity of pigmentary changes was assessed using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v.5.0). Results: From a total of 1342 AA patients evaluated by oncodermatologists during the study period, 121 (9%) met inclusion criteria. Average age in this cohort was 52, and 102 (84%) were women. Breast (63, 52%), gastrointestinal (14, 12%), and hematologic malignancies (13, 11%) comprised the majority of cancer diagnoses. Most (93, 77%) patients had skin hyperpigmentation (84, 69%) or hypopigmentation (9, 7%) as a primary CTCAE diagnosis; the rest had secondary post-inflammatory hyperpigmentation (28, 23%). A higher proportion (105, 87%) of pigmentary alterations was attributed to single agents [i.e. chemo- (55, 46%), radiation (16, 13%), targeted (12, 10%), endocrine (9, 7%), and supportive oncologic (6, 5%) therapy] versus combination treatment (16, 13%). Five (4%) patients had graft versus host disease associated with allogeneic HSCT, four (80%) of which presented as cutaneous hypopigmentation. Hand foot syndrome (24, 20%), acneiform rash (24, 20%), and radiation dermatitis (16, 13%) were commonly diagnosed dermatologic adverse events (dAEs), generally classified as mild/grade 1 (67, 55%) in severity. For management, skin lightening agents +/- emollients (36, 30%) or emollients alone (25, 21%) were highly recommended. Topical corticosteroids +/- emollients were prescribed just as frequently as reassurance and/or avoidance of sun exposure (22, 18%). Conclusions: Cutaneous pigmentary changes related to cytotoxic chemotherapy, radiation and/or targeted oncologic therapy are common in AA cancer patients. Undertreatment of these dAEs, possibly due to under-recognition in darker skin, warrants further investigation to assess impact on quality of life and help improve management in this population.

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Peltzer, Karl. "Health-Related Quality of Life and Antiretroviral Therapy in Kwazulu-Natal, South Africa". Social Behavior and Personality: an international journal 40, n. 2 (1 marzo 2012): 267–82. http://dx.doi.org/10.2224/sbp.2012.40.2.267.

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In studies conducted with African and Asian cohorts researchers have shown the clinical efficacy of antiretroviral therapy (ART) in resource-limited settings. However, studies on the longer term changes in health-related quality of life (HRQoL) with patients receiving ART in these settings are still scarce. The aim in this study was to assess HIV patients' HRQoL, clinical, psychosocial, and sociodemographic factors at 3 public hospitals in KwaZulu-Natal, South Africa over 20 months. Patients (N = 735) who attended 3 HIV clinics completed interview assessments prior to initiation of antiretroviral therapy; 519 after 6 months, 557 after 12, and 499 after 20 months on ART. Results indicate that total HRQoL increased, as did general quality of life, general health, independence, social relationships, and environment. HIV symptoms, depression symptom ratings, and internalized stigma reduced over time, whereas CD4 cell counts (number of helper T cells per cubic milliliter of blood), adherence to ART, and social support increased. Total HRQoL, the physical and psychological HRQoL domains, and internalized stigma improved at first and then deteriorated almost to baseline levels. Significant independent predictors of good HRQoL were low internalized stigma, being employed, earning wages, higher CD4 cell counts, and fewer and less severe HIV and depressive symptoms. In order to maximize gains in HRQoL for patients on ART, interventions are needed that address and reduce stigmatization and enhance the economic and employment opportunities.

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Pereira, Miguel Frauzino. "Funcionário Público - Redução de proventos - Vantagem pessoal". Revista de Direito Administrativo 201 (1 luglio 1995): 100–106. http://dx.doi.org/10.12660/rda.v201.1995.46572.

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- A norma do art. 17 do ADCT/88 impõe a imediata redução de proventos auferidos em desacordo com os preceitos constitucionais, vedada a alegação de direito adquirido ou percepção de excesso a qualquer título.- Matéria que, de resto, está disciplinada no art. 42, caput, da Lei nº 8.112/90, o qual, em consonância com o disposto no art. 37, XI, da C onstituição, definiu como limite-teto de remuneração do servidor, no âmbito do Poder Executivo, a soma dos valores percebidos como remuneração, em espécie, a qualquer título, pelos Ministros de Estado.- De computarem-se, no cálculo respectivo, por não configurarem vantagem que contemplem condição pessoal do servidor, a Retribuição Adicional Variável - RA V, instituída pela Lei nº 7.711/88 e a Gratificação de Estímulo à Fiscalização e à Arrecadação prevista no art. 13 da Lei Delegada nº 13/92.- Tratamento diverso, relativamente à vantagem de caráter pessoal denominada adicional por tempo de serviço, ao salário-família e ao acréscimo de 20% previsto no art. 184, II, da lei nº 1.711/52, verbas consideradas vantagem pessoal, por corresponder a particular situação do servidor.- Recurso parcialmente provido.

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Andersen, Camilla Eline. "Becoming Through an Encounter With an Artistic Congo Village Event in Norway". Qualitative Inquiry 25, n. 7 (28 novembre 2018): 700–707. http://dx.doi.org/10.1177/1077800418806617.

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Through Mohamed Ali Fadlabi and Lars Cuzner’s processual art project European Attraction Limited, I learned that there was a human zoo at a jubilee exhibition in the capital city of Norway around 100 years ago. This human zoo was set up as a “Congolese village” including 20 “primitive” huts built of reeds covered with palm leaves. Within the “village”, 80 presumably Congolese children, women, and men were performing “authentic African life” as a partly entertaining display to spectators. In the article, I explore what emerges when encountering this project, not as an art critique but as an educational researcher in Norway interested in race and racialization and how to invent different ways of creating more livable worlds.

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Maskew, Mhairi, Matthew P. Fox, Denise Evans, Darshini Govindasamy, Lise Jamieson, Given Malete, Constance Mongwenyana e Karl Technau. "Insights into Adherence among a Cohort of Adolescents Aged 12–20 Years in South Africa: Reported Barriers to Antiretroviral Treatment". AIDS Research and Treatment 2016 (2016): 1–12. http://dx.doi.org/10.1155/2016/4161738.

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Adolescents experience disproportionately high rates of poor ART outcomes compared to adults despite prolonged use of antiretroviral therapy in Southern African treatment programs, presenting a significant challenge to national attempts to meet the UNAIDS 90-90-90 targets for 2020. This cohort study among adolescents aged 12–20 years accessing ART care at two urban public-sector clinics in Johannesburg between September and November 2013 aimed to identify factors potentially associated with poor attendance at clinic visits. Patients were followed up through routine medical records to identify missed visits (failing to attend clinic within 30 days of scheduled visit date) up to 2 years after enrolment. We enrolled 126 adolescents on ART for a median of 6.3 years (IQR: 2.7–8.4). A total of 47 (38%) adolescents missed a scheduled visit within 24 months of enrolment. Older adolescents (18–20 years) were more likely to miss a visit compared to adolescents aged 12–14 years (risk ratio (RR) = 1.72; 95% CI: 1.00–2.95). Those who were identified to have difficulty in taking medication (RR = 1.57; 95% CI: 1.13–2.18) as a barrier to care were more likely to miss a visit compared to adolescents who did not. Awareness of treatment fatigue, challenges to taking ART, and caregiver difficulties is important when considering interventions to improve treatment outcomes among adolescents.

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Harper, Gary, Darnell Motley, April Timmons Tyler, Donald Tyler, Joseph Catania e M. Dolcini. "“You’ve Gotta be Careful”: Familial Messages Regarding Sexual Behavior and Sexual Relationships among African American Adolescents". International Journal of Environmental Research and Public Health 16, n. 7 (30 marzo 2019): 1146. http://dx.doi.org/10.3390/ijerph16071146.

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Background: Research on the sexual behaviors of African American youth has primarily focused on associated risks, with a dearth of studies examining a fuller representation of African American adolescents’ sexual lives. This study explored the range of messages African American adolescents receive from family members regarding sexual behavior and sexual relationships. Methods: Participants were 52 sexually experienced African American youth (male = 32, female = 20) between the ages of 15 and 17 recruited from community-based organizations in the United States. Youth participated in individual in-depth qualitative interviews, and data were analyzed using a phenomenological framework. Results: Participants received a variety of messages about sexual behavior and sexual relationships from a range of family members including parents, siblings, grandmothers, aunts/uncles, and cousins. Types of messages clustered into three domains: sexual decision-making, quantity and quality of sexual activity, and sexual health promotion; with themes and sub-themes emerging within each area. Conclusion: Gender differences in the types of messages received are explored, and applications of the findings to the development of family-involved community interventions that promote sexual and reproductive health are discussed.

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Reidy, William, Hervé Nzereka Kambale, Allison B. Hughey, Tengetile Tezzy Nhlengethwa, Janki Tailor, Nomthandazo Lukhele, Simangele Mthethwa, Anita Hettema, Peter Preko e Miriam Rabkin. "Client and healthcare worker experiences with differentiated HIV treatment models in Eswatini". PLOS ONE 17, n. 5 (25 maggio 2022): e0269020. http://dx.doi.org/10.1371/journal.pone.0269020.

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Introduction Universal access to antiretroviral therapy (ART) is a cornerstone of Eswatini’s national HIV strategy, and the number of people on ART in the country more than tripled between 2010 and 2019. Building on these achievements, the Ministry of Health (MOH) is scaling up differentiated service delivery, including less-intensive differentiated ART (DART) models for people doing well on treatment. We conducted a mixed-methods study to explore client and health care worker (HCW) perceptions of DART in Eswatini. Methods The study included structured site assessments at 39 purposively selected health facilities (HF), key informant interviews with 20 HCW, a provider satisfaction survey with 172 HCW and a client satisfaction survey with 270 adults. Results All clients had been on ART for more than a year; 69% were on ART for ≥ 5 years. The most common DART models were Fast-Track (44%), Outreach (26%) and Community ART Groups (20%). HCW and clients appreciated DART, noting that the models often decrease provider workload and client wait time. Clients also reported that DART models helped them to adhere to ART, 96% said they were “very satisfied” with their current model, and 90% said they would recommend their model to others, highlighting convenience, efficiency and cost savings. The majority of HCW (52%) noted that implementation of DART reduced their workload, although some models, such as Outreach, were more labor-intensive. Each model had advantages and disadvantages; for example, clients concerned about stigma and inadvertent disclosure of HIV status were less interested in group models. Conclusions Clients in DART models were very satisfied with their care. HCW were also supportive of the new approach to HIV treatment delivery, noting its advantages to HF, HCW and to clients. Given the heterogeneous needs of people living with HIV, no single DART model will suit every client; a diverse portfolio of DART models is likely the best strategy.

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Varenov, Andrey V. "Book Publications and Research of Petrogyphs of Northern Regions of China in the Last Quarter of the 20th Century". Oriental Studies 20, n. 4 (2021): 37–52. http://dx.doi.org/10.25205/1818-7919-2021-20-4-37-52.

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In China, rock art is spread mainly in the border regions – carvings and engravings in the north of the country and paintings in the south. Before the beginning of the 21st century, research books and albums of petroglyphs were published in four administrative units at provincial level in the north-west of the county: Inner Mongolia, Ningxia, Xinjiang and Qinghai. Petroglyphs of Inner Mongolia were studied and published by Gai Shanlin, Liang Zhenhua and N. Dalengurib. The earliest and the latest books by Gai Shanlin available to us (published in 1985 and 2002 respectively) were entirely devoted to the interpretation of rock carvings and searches for their analogies. All four monographs on Ningxia rock art – by Zhou Xinghua, Li Xiangshi and Zhu Cunshi, Xu Cheng and Wei Zhong were published almost simultaneously, at the beginning of the 1990s. Ancient rock art of Xinjiang was published in albums by Zhao Yangfeng, Wang Linshan and Wang Bo and in books by Wang Binghua and Su Beihai. The monograph by Tang Huisheng and Zhang Wenhua was devoted to the description of Qinghai petroglyphs and the problems of their interpretation. The album of photos “The Rock Arts of China” is a kind of a guide to the main rock art sites known by 1993 in all the Chinese provinces. Generally, it can be stated that modern Chinese scientific rock art research was born in the first half of the 1980s, when the first articles on rock carvings started to appear in Chinese archaeological periodicals and flourished in the second half of the 1980s and the 1990s, when quite a number of monographs were published.

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Jasinskis, Vladislavs, Oksana Koļesova, Aleksandrs Koļesovs, Baiba Rozentāle, Inga Ažiņa, Ksenija Kramiča, Ludmila Vīksna e Jeļena Eglīte. "Human Leukocyte Antigens Class II Alleles Affecting the Response to 5–7 Year Antiretroviral Therapy in A Latvian Cohort". Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 73, n. 2 (1 maggio 2019): 84–88. http://dx.doi.org/10.2478/prolas-2019-0014.

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Abstract Antiretroviral therapy (ART) aims at suppressing viral replication and strengthening immune system in patients with HIV-1. Human Leukocyte Antigens (HLA) are among factors responsible for effectiveness of ART. The aim of this study was to determine the effect of HLA Class II alleles on the response to long-time ART, assessed by a change in CD4+ T-cell count in relation to viral load. The sample included 69 patients (17 females and 52 males) aged 20 to 50 with HIV-1 infection, who were undergoing ART in the Latvian Centre of Infectious Diseases. The median period of observation was 5.7 years. CD4+ T-cell count and viral load were analysed at the baseline and end of the period of observation. HLA typing was performed by polymerase chain reaction with low resolution sequence specific primers. Multiple hierarchical linear regression analysis confirmed that an increase in HIV-1 viral load was associated with a decrease in the level of CD4+ T-cell count. In addition, HLA-DRB1*04 and HLA-DQB1*06:01 alleles contributed negatively to the level of CD4+ T-cell count.

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Wango, Kamau. "Role of Statues in the Artistic Commemoration of African Political Leaders: Analysis of 20 Selected National Statues in African Countries". East African Journal of Interdisciplinary Studies 3, n. 1 (11 marzo 2021): 40–77. http://dx.doi.org/10.37284/eajis.3.1.295.

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Artistic commemoration of leaders and other iconic personalities has been in existence for centuries. Statues in particular have been used as a fitting avenue for the commemoration of political leaders and other luminaries in many fields. The premise upon which statues are made is that the subjects featured initiated and attained, in their lifetimes, concrete achievements that significantly impacted upon the lives of their fellow human beings. Other criteria for commemoration include proven integrity, dedication and selflessness in the service of the country and citizens. Statues as an integral part of public art have often generated substantial controversy on various fronts in many countries. Some of these gravitate around issues such as disputed likeness, queries about the fundamental achievements cited of the subject, at times open protests on the actions, character and integrity of the subject as well as the location of the statues. Other areas of contention include the implication of the presence of statues upon the political psyche of the country and their long-time impact on history, the youth and posterity. This paper examines the extent to which African countries have embraced this mode of artistic rendition to commemorate African political leaders in a way that is commensurate to their achievements. It is outside the scope of this paper to delve into the intricate web of back-and-forth arguments about the ‘concreteness’ of the legacies of the featured leaders who are mainly founding political figures of the respective countries. The paper, however, analyses the artistic essence of the selected statues in terms of their visual impact and whether they are indeed useful in articulating the legacies of the subjects and further, whether they ultimately bear ‘enduring visual value’ that spurs conversation and insight into these legacies. Statues must, at the very least, spur debate and conversation into the legacy of the featured subject. It becomes a form of constant interrogation as history itself takes its course; controversy is not necessarily a negative occurrence since it forms part of this discourse. The concept of immortalization, which is what initiators of statues often hope for is much harder to achieve and difficult to define. The paper examines 20 statues of African political leaders in different African Countries.

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He, Rong, e Linxin Liang. "The Peking Opera or the Beijing Opera? An International Usage Frequency Analysis Based on the Corpus of Global Web-based English (GLoWbE)". IRA International Journal of Education and Multidisciplinary Studies 17, n. 2 (9 luglio 2021): 108. http://dx.doi.org/10.21013/jems.v17.n2.p10.

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The regional differences in the frequency of synonym use reflect the social cognition of various speech groups. Both Peking opera and Beijing opera refer to an identical Chinese cultural entity, but they differ considerably in international usage frequency in the GLoWbE where disparity can be manifested among 20 English-speaking communities. Beijing opera enjoys a slightly higher frequency than Peking opera in total, and several Asian and African countries even have no relevant data concerning this art. Besides, we explore some potential reasons for interpreting these phenomena.

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Costandius, Elmarie, e Christine Fourie. "Critical Citizenship Education as Praxis: A Contribution to Decolonize the Art Curriculum at a South African University". International Journal of Arts Education 15, n. 2 (2020): 1–20. http://dx.doi.org/10.18848/2326-9944/cgp/v15i02/1-20.

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Adams-Price, Carolyn. "CULTURAL CONSIDERATIONS AND ATTACHMENT TO PLACE FOR RURAL-DWELLING OLDER ADULTS". Innovation in Aging 7, Supplement_1 (1 dicembre 2023): 132–33. http://dx.doi.org/10.1093/geroni/igad104.0432.

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Abstract Mississippi is the only state in the United States where the majority of African Americans live in rural areas. African Americans have lived in rural Mississippi for many generations, despite few resources and health inequities. However, it is a mistake to look at older rural African Americans and see only poverty and illness. Previous research by Rowles and others in Appalachia has indicated that older adults tend to be satisfied with homes in impoverished rural areas. This study examined attachment to home and community in older African Americans living in rural parts of two counties in north Mississippi. Participants were 47 African Americans between 52 and 79 (20 male), with a mean age of 65. Phenomenological analysis for attachment to home yielded 6 themes: home as a peaceful/safe place, legacy/historical roots, attachment to natural features, ownership/I’ve made it my own, and everyday functionality. The first two themes (peaceful/safe and legacy/historical roots) were far more prevalent than the theme of everyday functionality; these findings will be discussed in the context of other researchers’ findings on attachment to place in later life. However, although our participants have experienced discrimination in the larger environment, home is for most of them a place of safety, warmth, and meaning. Attachment to features of the land is also important.

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Fofana, Djeneba B., Houdou Diarra, Ibrahima Guindo, Mahamadou K. Savadogo, Marceline d’Almeida, Fatoumata I. Diallo, Aliou Baldé et al. "Prevalence of HIV-1 Natural Polymorphisms and Integrase-Resistance-Associated Mutations in African Children". Viruses 15, n. 2 (16 febbraio 2023): 546. http://dx.doi.org/10.3390/v15020546.

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Integrase inhibitors (INIs) are a potent option for HIV treatment. Limited data exist on INI resistance in West Africa, particularly in children living with HIV/AIDS. We determined the prevalence of integrase gene polymorphisms and the frequency of naturally occurring amino acid (aa) substitutions at positions associated with INI resistance. Dried blood spot (DBS) samples were obtained from one hundred and seven (107) HIV-1-infected children aged less than 15 years old in two West African countries, Benin and Mali. All children were naïve to INI treatment, 56 were naïve to anti-retroviral therapy (ART), and 51 had received ART. Genetic sequencing of HIV integrase was successful in 75 samples. The aa changes at integrase positions associated with INI resistance were examined according to the Stanford HIV Genotypic Resistance database. The median ages were 2.6 and 10 years for ART-naïve and -treated children, respectively. The most common subtypes observed were CRF02_AG (74.7%) followed by CRF06_cpx (20%). No major INI-resistance mutations at positions 66, 92, 121, 143, 147, 148, 155, and 263 were detected. The most prevalent INI accessory resistance mutations were: L74I/M (14/75, 18.6%) followed by E157Q (8/75, 10.6%), G163E/N/T/Q (5/75, 6.6%), Q95A/H/P (2/75, 2.6%), and T97A (4/75, 5.3%). Other substitutions observed were M50I/L/P, H51E/P/S/Q, I72V, T112V, V201I, and T206S. Polymorphisms at positions which may influence the genetic barrier and/or drive the selection of specific INI-resistance pathways were detected. However, no transmitted drug resistance (TDR) to INI was detected among samples of INI-naïve patients. These findings support the use of this treatment class for children with HIV-1, particularly in West Africa.

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Li, Jonathan Z., Natalia Stella, Manish C. Choudhary, Aneela Javed, Katherine Rodriguez, Heather Ribaudo, Mahomed-Yunus Moosa et al. "Impact of pre-existing drug resistance on risk of virological failure in South Africa". Journal of Antimicrobial Chemotherapy 76, n. 6 (10 marzo 2021): 1558–63. http://dx.doi.org/10.1093/jac/dkab062.

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Abstract Objectives There is conflicting evidence on the impact of pre-existing HIV drug resistance mutations (DRMs) in patients infected with non-B subtype virus. Methods We performed a case–cohort substudy of the AIDS Drug Resistance Surveillance Study, which enrolled South African patients initiating first-line efavirenz/emtricitabine/tenofovir. Pre-ART DRMs were detected by Illumina sequencing of HIV pol and DRMs present at <20% of the viral population were labelled as minority variants (MVs). Weighted Cox proportional hazards models estimated the association between pre-ART DRMs and risk of virological failure (VF), defined as confirmed HIV-1 RNA ≥1000 copies/mL after ≥5 months of ART. Results The evaluable population included 178 participants from a randomly selected subcohort (16 with VF, 162 without VF) and 83 additional participants with VF. In the subcohort, 16% of participants harboured ≥1 majority DRM. The presence of any majority DRM was associated with a 3-fold greater risk of VF (P = 0.002), which increased to 9.2-fold (P < 0.001) in those with <2 active drugs. Thirteen percent of participants harboured MV DRMs in the absence of majority DRMs. Presence of MVs alone had no significant impact on the risk of VF. Inclusion of pre-ART MVs with majority DRMs improved the sensitivity but reduced the specificity of predicting VF. Conclusions In a South African cohort, the presence of majority DRMs increased the risk of VF, especially for participants receiving <2 active drugs. The detection of drug-resistant MVs alone did not predict an increased risk of VF, but their inclusion with majority DRMs affected the sensitivity/specificity of predicting VF.

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Metekie, Assefa Berihun. "Adherence to Antiretroviral Treatment Among Adult HIV Patients in Addis Ababa, Ethiopia: A Facility-Based Cross-Sectional Study". Indian Journal of Health Studies 05, n. 01 (2023): 57–79. http://dx.doi.org/10.56490/ijhs.2023.5104.

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Adherence to Antiretroviral Treatment (ART) has paramount significance to reduce HIV replication, warding off viral resistance, and decrease HIV – related morbidity and mortality. HIV patients have been challenged to attain the optimal level of adherence to ART owing to a variety of social, psychological, spiritual, and medical reasons.To examine factors associated with adherence among HIV patients taking antiretroviral treatment at five government hospitals in Addis Ababa, Ethiopia.A survey was conducted in ART clinics of five randomly selected hospitals in Addis Ababa from January 21, 2018 to February 25, 2018. Data collected using six standardized scales were entered and analyzed using SPSS version 20. Descriptive statistics was used to summarize socio-demographic information, estimate the prevalence of alcohol use, depression, and adherence to antiretroviral treatment. ANOVA and t tests were used to examine mean differences, and multiple regression was used to identify the contribution of the independent variables on the dependent variables at95% confidence Interval and a statistical significance p< .001. Adult HIV patients consisting of 64% were fully adhered to ART, 52% reported current use of alcohol, and 55.6% reported having some degree of depressive symptoms. Alcohol use (𝛽= -.059), depressive symptoms (𝛽= -.022) and HIV disclosure stigma (𝛽= -.034) were associated with adherence. In conclusion, ART adherence was significantly associated with alcohol use, depressive symptoms and HIV disclosure stigma. Addressing psychosocial factors related to ART adherence would help Adult HIV patients to improve their level of adherence.

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Scotte, Florian, Christian Herve, Roland Bugat, Fadila Farsi, Moise Namer, Jean-Marc Tourani, Christophe Tournigand et al. "Supportive care in cancer organization in France: State of the art." Journal of Clinical Oncology 30, n. 15_suppl (20 maggio 2012): e19640-e19640. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e19640.

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e19640 Background: Second Cancer Act was defined in France in December 2009 including enhancement of supportive care in Cancer (SCC). How are supportive care organized in France? Are patients informed about supportive treatment side effects? Methods: The AFSOS (French Speaking Association for Supportive Care in Cancer) conducted this observational study to evaluate practices, organizations and informations given to patients (pts) about SCC. Among 1621 french medical doctors (MD) caring cancer pts who were sent an adhoc questionnaire, 20% (330 MD including 44% medical oncologists) answered. Results: Three different organizations were described: Single MD, transversal team and specific structure specialized in global care (specifically developed in comprehensive cancer centers-CCC). Psycho-oncology, palliative care, nutrition and pain care were the four main items considered as supportive care. During their disease, 68% of pts are receiving SCC, presented by their MD (88%) or nurse devoted to announcement of disease and SCC information (57%). Supportive care is more dispensed during palliative period (90%) than at diagnosis (44%). Patients information is rather supplied during palliative care (85%) than at diagnosis (52%) using a specific questionnaire for outpatient (20%) or specific supportive care session (17%). 71% of cancer department have a cross team to provide supportive care, with specific SCC team particularly in CCC (62%; p=0.01)). 37% have inpatient specific units. Only 40% have a specific organization in home care connection, more in CCC than in public or private centers (respectively 69%, 45%, 20%; p=0.01). 73% use specific financial valorization of CSC activity. Adverse events information is dispensed to 54% of the pts for erythropoiesis stimulating agents (ASE), 74% for biphosphonates and 94% for opioids treatments, rather by medical oncologist than other specialists (p=0.01). Conclusions: Specific organization developed especially in comprehensive cancer centers seems to facilitate SCC organization and information to pts. In the mean time, recommendations include this information, involvement in supportive care team and methods have to be enhanced. Further results compared with patient point of views are expected.

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Orrell, Catherine, Guy Harling, Stephen D. Lawn, Richard Kaplan, Matthew McNally, Linda-Gail Bekker e Robin Wood. "Conservation of First-Line Antiretroviral Treatment Regimen where Therapeutic Options are Limited". Antiviral Therapy 12, n. 1 (gennaio 2007): 83–88. http://dx.doi.org/10.1177/135965350701200106.

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Objectives To determine rates and causes of switching from first- to second-line antiretroviral treatment (ART) regimens in a large treatment-naive cohort (a South African community-based ART service) where a targeted adherence intervention was used to manage initial virological breakthrough. Methods ART-naive adults ( n=929) commencing first-line non-nucleoside-based ART [according to WHO (2002) guidelines] between September 2002 and August 2005 were studied prospectively. Viral load (VL) and CD4+ T-cell counts were monitored every 4 months. All drug switches were recorded. Counsellor-driven adherence interventions were targeted to patients with a VL >1,000 copies/ml at any visit (virological breakthrough) and the VL measurement was repeated within 8 weeks. Two consecutive VL measurements >1,000 copies/ml was considered virological failure, triggering change to a second-line regimen. Results During 760 person-years of observation [median IQR) 189 (85–441) days], 823 (89%) patients were retained on ART, 2% transferred elsewhere, 7% died and 3% were lost to follow-up. A total of 893 (96%) patients remained on first-line therapy and 16 (1.7%) switched to second-line due to hypersensitivity reactions ( n=9) or lactic acidosis ( n=7). A Kaplan-Meier estimate for switching to second-line due to toxicity was 3.0% at 32 months. Virological breakthrough occurred in 67 (7.2%) patients, but, following use of a targeted adherence intervention, virological failure was confirmed in just 20 (2.2%). Kaplan-Meier estimates at 32 months were 20% for virological breakthrough but only 5.6% for confirmed virological failure. Conclusion Regimen switches were due to virological failure or toxicity. Although follow-up time was limited, over 95% of individuals remained on first-line ART using a combination of viral monitoring and a targeted adherence intervention.

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Esber, Allahna, Christina Polyak, Francis Kiweewa, Jonah Maswai, John Owuoth, Lucas Maganga, Yakubu Adamu, Patrick W. Hickey, Julie A. Ake e Trevor A. Crowell. "Persistent Low-level Viremia Predicts Subsequent Virologic Failure: Is It Time to Change the Third 90?" Clinical Infectious Diseases 69, n. 5 (20 novembre 2018): 805–12. http://dx.doi.org/10.1093/cid/ciy989.

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Abstract Background World Health Organization (WHO) guidelines identify human immunodeficiency virus (HIV) viral load <1000 copies/mL as the goal of antiretroviral therapy (ART). However, the clinical implications of viremia below this threshold are unclear in the African context. We examined factors associated with persistent low-level viremia (pLLV) and quantified the risk of subsequent virologic. Methods The African Cohort Study enrolled HIV-infected adults at clinics in Uganda, Kenya, Tanzania, and Nigeria, with assessments every 6 months. We evaluated participants prescribed ART for at least 6 months without virologic failure for pLLV. We used multinomial logistic regression to evaluate associations between prespecified factors of interest and 3 levels of pLLV (<200, 200–499, and 500–999 copies/mL). We used Anderson-Gill extended Cox proportional hazards to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for viremia category associations with time to failure. Results We included 1511 participants with 4382 person-years of follow-up. PLLV <200 copies/mL was observed at 20% of visits while 2% of visits had pLLV 200–499 and 500–999 copies/mL each, with substantial variation by site. Protease inhibitor–containing ART was associated with increased risk of pLLV. Compared to undetectable viral load, pLLV ≥200 copies/mL doubled the risk of developing virologic failure (pLLV 200–499: HR, 1.81 [95% CI, 1.08–3.02]); pLLV 500–999: HR, 2.36 [95% CI, 1.52–3.67]). Conclusions Participants with pLLV ≥200 copies/mL were at increased risk of subsequent virologic failure. Optimized HIV care in this setting should target viral suppression <200 copies/mL.

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Lusamba-Dikassa, PS, D. Nsue-Milang, D. Okello, T. Ketsela, C. Sagoe-Moses, Frank Lule, A. Dushimimana e P. Mensah. "Framework for supporting countries to address the food crisis and malnutrition in the African region". African Journal of Food, Agriculture, Nutrition and Development 12, n. 52 (5 luglio 2012): 6305–16. http://dx.doi.org/10.18697/ajfand.52.who-5.

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Of the world's undernourished children, 80% live in 20 countries; nine of these are in sub-Saharan Africa. Africa is home to 15 of the 16 countries where prevalence of hunger exceeds 35 per cent. This precarious food security situation in Africa has been compounded by economic and food crises which began in 2007, resulting in a rise by about 83% in food commodity prices. When food is in short supply, safety is compromised resulting in the consumption of unsafe food. Assuring safe food and ending malnutrition require decisive actions in several areas. In line with its Core Functions, global and regional agreements and as a key player in health, the WHO’s vital role in addressing the food crisis is in preventing the effects of food insecurity, undernutrition and unsafe food. In order to scale-up actions to address the adverse effects of food insecurity and malnutrition in the African Region, the forty-fourth session of the Regional Programme Meeting (RPM44) discussed the topic Food Crisis in Africa: Implications for Nutrition and Food Safety Actions in the Region. A framework was therefore developed to facilitate joint actions in addressing the food crisis and malnutrition in the WHO African Region for better impact at country level. This paper provides a summary of the Framework which highlight WHO’s role in the area of nutrition. It has four guiding principles: Country- level interventions, Community involvement and ownership; Adoption of multi-sectoral approach; Protection of vulnerable groups; and Evidence- based interventions. The Framework proposes actions to be implemented in countries with support of WHO and partners to meet the immediate food and nutritional needs of the vulnerable and build longer-term resilience to contribute to national food security. The expected impact of the implementation of these actions with support from WHO and partners is prevention of morbidity, mortality and the irreversible long-term effects of malnutrition on health and cognitive development.

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Fateeva, I. A. "ON THE FIRST ATTEMPT TO COMMEMORATE THE SCIENTIFIC AND RESEARCH ACHIEVEMENTS OF THE STATE JOURNALISM INSTITUTE AS A CENTER OF NEWSPAPER STUDIES". Memoirs of NovSU, n. 1 (2024): 20–32. http://dx.doi.org/10.34680/2411-7951.2023.1(52).20-32.

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In the article, the author describes, analyzes and interprets documents related to the earliest attempt at professional and academic commemoration of the scientific research practices of newspaper scientists at the State Journalism Institute (SJI). This is primarily the correspondence (1964–1967, Russian State Archive of Literature and Art) of two active participants in the life of the first domestic educational institution for journalists of the 1920s: Tomsk journalist V. A. Kuzmichev (1903–1994), graduate of the post-graduate school of SJI, and his former supervisor M.S. Gus (1900–1984). On the basis of commenting on the correspondents’ personal letters introduced into scientific circulation, the author shows how toxic the topic of the formation and existence of the first scientific journalism school was, even three and a half decades after its liquidation.

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Kæstel, Pernille, Peter Aaby, Christian Ritz e Henrik Friis. "Markers of iron status are associated with stage of pregnancy and acute-phase response, but not with parity among pregnant women in Guinea-Bissau". British Journal of Nutrition 114, n. 7 (19 agosto 2015): 1072–79. http://dx.doi.org/10.1017/s0007114515001993.

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While prenatal Fe supplementation prevents maternal Fe deficiency and anaemia, it is uncertain whether it improves infant health outcomes, at least when taken by Fe-replete women. Inflammation as well as physiological changes complicates the assessment of Fe status during pregnancy. In the present study, we measured the concentrations of serum ferritin and soluble transferrin receptors (sTfR), Hb and the acute-phase proteins C-reactive protein (CRP) and α1-antichymotrypsin (ACT) in a cross-sectional study among 738 pregnant women attending antenatal care in Guinea-Bissau, West Africa. Multiple linear regression analysis was used to identify the predictors of Fe status markers. The mean gestational age was 23 (sd7) weeks. Serum ferritin values were lower with progressing gestation, from 27 % lower during weeks 16–20 of gestation up to 59 % lower after 29 weeks of gestation compared with early pregnancy. Using cut-off values for Fe deficiency as established in non-pregnant individuals, 52 % of the women had sTfR levels >2·3 mg/l, while only 25 % had serum ferritin levels < 12 μg/l. Serum ferritin but also sTfR levels were elevated at increased serum CRP and ACT levels. The proportion of sTfR >2·3 mg/l decreased to 47 % after adjustment for elevated serum CRP and ACT levels. On the contrary, the proportion of serum ferritin < 12 μg/l increased to 33 % after adjustment for ACT and CRP. The high proportion of elevated serum sTfR calls for pregnancy-specific cut-offs since increased erythropoiesis is expected in response to increased plasma volume of pregnancy. The present study further underlines the need to adjust for inflammation when serum sTfR and serum ferritin are used to assess Fe status in pregnancy.

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Grubbs, Elizabeth G., Ronald M. Lechan, Beth Edeiken-Monroe, Gilbert J. Cote, Chardria Trotter, Arthur S. Tischler e Robert F. Gagel. "HEREDITARY ENDOCRINE TUMOURS: CURRENT STATE-OF-THE-ART AND RESEARCH OPPORTUNITIES: Early thyroidectomy in multiple endocrine neoplasia: a four decade experience". Endocrine-Related Cancer 27, n. 8 (agosto 2020): T1—T8. http://dx.doi.org/10.1530/erc-20-0108.

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Forty years ago, physicians caring for the J-kindred, a 100+ member family with multiple endocrine neoplasia type 2A (MEN2A), hypothesized that early thyroidectomy based on measurement of the biomarker calcitonin could cure patients at risk for development of medullary thyroid carcinoma (MTC). We re-evaluated 22 family members with proven RET proto-oncogene mutations (C634G) who underwent thyroidectomy and central lymphadenectomy between 1972 and 1994 based on stimulated calcitonin abnormalities. Current disease status was evaluated by serum calcitonin measurement and neck ultrasound in 18 of the 22 prospectively screened patients. The median age of the cohort at thyroidectomy was 16.5 years (range 9–24). The median duration of follow-up at the time of examination was 40 years (range 21–43) with a median current age of 52 years (range 34–65). Fifteen of the 18 patients had no detectable serum calcitonin (<2 pg/mL). Three had detectable serum calcitonin measurements, inappropriately elevated following total thyroidectomy. None of the 16 patients imaged had an abnormal ultrasound. Survival analysis shows no MTC-related deaths in the prospectively screened patients, whereas there were many in prior generations. Early thyroidectomy based on biomarker testing has rendered 15 of 18 MEN2A patients (83%) calcitonin-free with a median follow-up period of 40 years. There have been no deaths in the prospectively screened and thyroidectomized group. We conclude that early thyroidectomy and central lymph node dissection is an effective prophylactic treatment for hereditary MTC.

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Dunham, Amy E. "Soil disturbance by vertebrates alters seed predation, movement and germination in an African rain forest". Journal of Tropical Ecology 27, n. 6 (30 settembre 2011): 581–89. http://dx.doi.org/10.1017/s0266467411000344.

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Abstract:Biopedturbation, or animal-caused soil disturbance, may be important for development and maintenance of small-scale heterogeneity in ecosystems with the potential to alter seed mortality and recruitment. However, its role in tropical forests has been largely ignored. This study explored effects of vertebrate biopedturbation on seed (1) microsite heterogeneity, (2) predation and (3) germination in a West African rain forest. Exclosure experiments were used to study how biopedturbation altered burial and movements of seeds of four common canopy species. Effect of seed burial on removal by seed predators was also examined. Germination of the dominant canopy species (Raphia palma-pinus) in swamp forest was tested within artificial disturbances mimicking that of a locally common but endangered mammal, the Liberian mongoose (Liberiictis kuhni), which was estimated to turn over the entire forest floor in this habitat in c. 8 mo. Seed exposure to biopedturbation for 20 d (n = 80) led to an overall 6.5-fold increase in small-scale horizontal movement and increased probability of burial (6–52% higher), varying by species. Burial effectively eliminated seed removal for all four species (n = 160) by seed predators over 20 d. Germination of Raphia palma-pinus seeds (n = 100) was enhanced by 17.5% on average over 4 mo in simulated disturbances. Results suggest biopedturbation may be important for seedling recruitment and that loss of species with this functional role could have underappreciated yet important impacts on tropical plant communities.

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Owusu, Cynthia, Nora Nock, Paul Hergenroeder, Kris Austin, Beth Bennett, Stephen Cerne, Halle C. F. Moore et al. "Improve: A community-based physical activity intervention to improve functional and health outcomes in older breast cancer survivors: Rationale, design, and methods." Journal of Clinical Oncology 37, n. 15_suppl (20 maggio 2019): TPS11629. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.tps11629.

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TPS11629 Background: African-Americans (AA) and lower socioeconomic status (SES) older breast cancer survivors (BCS) are more likely to experience poor functional and health outcomes. Promotion of healthy behaviors, such as physical activity (PA), is critical to addressing these health disparities. Here we describe the rationale, design and methods of a randomized controlled trial testing the effectiveness of a physical activity intervention among older BCS from diverse racial and SES backgrounds. Methods: The IMPROVE Study is a community-based randomized-controlled trial designed to recruit 320 BCS, 80 in each of four strata defined by race (AA vs. Non-Hispanic Whites [NHW]) and SES (low vs. high). Participants are aged ≥ 65 years, AA or NHW and are within five years from treatment completion for stage I-III breast cancer. Participants are recruited utilizing the Ohio Cancer Incidence and Surveillance System database or directly from three area hospitals in Cleveland, Ohio and randomized to one of two arms: a 52-week moderate intensity aerobic and resistance group training intervention (n = 160) versus attention-control (support group sessions), (n = 160). The first 20 weeks of the PA intervention includes 3x per week 60-minute supervised sessions. The last 32 weeks of the PA intervention are unsupervised. Each of the 60-minute supervised PA sessions include 30 minutes of moderate intensity aerobic activity at 50%-70% of HRmax (maximum heart rate) and 30 minutes of resistance training based on 1-RM (repetition maximum) for chest and leg press. The attention-control group attend a once per week 60-minute support group session for the first 20 weeks and have unsupervised group sessions during the last 32 weeks. Exit interviews are being conducted at 52 weeks. The primary outcome is change in Short Physical Performance Battery (SPPB) Scores at 20 weeks. Secondary outcomes include change in SPPB scores at 52 weeks, and change in body composition and biomarkers of breast cancer prognosis at 20 and 52 weeks. One hundred and seventy-four participants have been enrolled as of 02/07/2019. Discussion: This study includes three underserved populations, (older BCS in general, older AA BCS and older low SES BCS) in one study. Results may contribute to a better understanding of factors associated with recruitment, sustained participation and acceptability, and will inform physical activity programs that will optimally improve the functional and health outcomes for older women during breast cancer survivorship. Clinical trial information: CNCT02763228.

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