Determining the disability status of adult patients post general intensive care unit (ICU) discharge at the Aga Khan university hospital, Nairobi using the world health organization disability assessment schedule 2.0(WHODAS).

Background: Critical care has evolved throughout the years since the polio outbreak when the first ICU was set up in the USA. There is an increasing number of survivors of critical illness. The survivors have been shown to have prolonged physical, cognitive, and psychological impairments. There is no current information on the status of this patient post-ICU in Africa. Objectives: To measure the disability status of adult patients post general Intensive Care Unit (ICU) Discharge Using WHODAS 2.0.To determine the factors associated with the degree of disability. Methodology: This was a cross-sectional analytical study. Patients admitted to AKUHN ICU, were on mechanical ventilation for more than 48 hours, and survived hospital discharge were called on the phone. Once they were found to be alive and consented to the study, the WHODAS 2.0 questionnaire was used. The level of disability was measured using the WHODAS 2.0 which has 12 items, where each item was scored between 0 and 4; and the total score was displayed as a percentage. Factors associated with the degree of disability were retrieved from the patient’s files. Data analysis was done using SPSS version 2.0. Results: 92 patients were enrolled in the study where 62.6% (n=57) were females. The disability status in our respondents was as follows; n=26(28.6%) of them had no disability, n=26(28.6%) mild disability and n=22(24.2%) had moderate disability, n=17(18.7%) of the patients reported severe disability while no participant had complete disability. Median age of 60 and length of ICU stay were found to be associated with moderate to severe disability. Other factors like; duration of mechanical ventilation, number of comorbid, use of muscle relaxant/steroids, and admission diagnosis were not found to be statistically significant in the degree of disability. Conclusion: In this study, 57.2% of patients had no disability to mild disability while 42.8% were found to have moderate to severe disability. Patients who were found to have moderate to severe disability had longer ICU stays and were in the older population

Hyperactive TORC1 Sensitizes Yeast Cells to Endoplasmic Reticulum Stress by Compromising Cell Wall Integrity

The disruption of protein folding homeostasis in the endoplasmic reticulum (ER) results in an accumulation of toxic misfolded proteins and activates a network of signaling events collectively known as the unfolded protein response (UPR). While UPR activation upon ER stress is well characterized, how other signaling pathways integrate into the ER proteostasis network is unclear. Here, I sought to investigate how the target of rapamycin complex 1 (TORC1) signaling cascade acts in parallel with the UPR to regulate ER stress sensitivity. Using S. cerevisiae, I found that TORC1 signaling is attenuated during ER stress and constitutive activation of TORC1 increases sensitivity to ER stressors such as tunicamycin and inositol deprivation. This phenotype is independent of the UPR. Transcriptome analysis revealed that TORC1 hyperactivation results in cell wall remodeling. Conversely, hyperactive TORC1 sensitizes cells to cell wall stressors, including the antifungal caspofungin. Elucidating the crosstalk between the UPR, cell wall integrity, and TORC1 signaling may uncover new paradigms through which the response to protein misfolding is regulated, and thus have crucial implications for the development of novel therapeutics against pathogenic fungal infections

Genomics study of anti-tuberculosis drug-induced hypersensitivity reactions

Introduction: All first-line anti-tuberculosis drugs can be associated with all phenotypes of cutaneous adverse drug reactions (CADR). Second-line drugs are associated with much poorer outcomes. Thus, identifying the offending drug in poly-pharmacy is difficult. Re -challenge with the drug is the gold standard in identifying the offender, however poses unacceptably high risk of CADR recurrence. Population and drug-specific genomics help identify those susceptible to adverse reactions to a drug facilitating avoidance of the drug. Objective: To investigate the genomic susceptibility in patients with confirmed rifampicin and or isoniazid-associated hypersensitivity reactions using both genome- wide association studies and candidate gene approaches. Methods: A case control study using 14 patients with previous tuberculosis-associated CADR who were re-challenged with first-line anti-tuberculosis drugs and subsequently developed re-challenge reactions to either isoniazid or rifampicin as cases. These were compared with 30 controls who had tolerated rifampicin and isoniazid during the re- challenge process (12 patients, Group 1a) and consecutive patients who had been on TB treatment for at least 12 weeks without developing any adverse drug reaction (1 8 patients, Group 1b) and 200 black South Africans from the general population. HLA genotypes of the samples were determined by SeCore® HLA Sequence based typing (Invitrogen, Life technologies, USA), and potential ambiguities were resolved by sequencing-based typing. Results: We found HLA-B*58:02 (OR=3.6; 95% CI: 1.4-8.99) and HLA-DRB1*09:01 (OR=15.3; 95% CI: 2.1-113.1) to be significantly more prevalent in patients who developed rifampicin and isoniazid-associated CADR as compared to black South African general population. However, we found no significant associations between HLA genotype and rifampicin/isoniazid-associated CADR when we compared the cases to our study controls that had tolerated rifampicin and isoniazid. HLA-B *58.02 was not found to be statistically associated with HIV positive status (p=0.42) and DRESS phenotype ( p= 0.6279). The majority of our cases were black Africans. Approximately 80% of our cases and controls were HIV-infected. DRESS/DIHS was the prevalent phenotype of CADR, accounting for approximately 80% of cases and controls. Discussion: To our knowledge, this is the first study to show an association between HLA-B*58:02 and HLA-DRB1*09:01 alleles and severe cutaneous adverse drugs reactions secondary to rifampicin and isoniazid in an African population. We identify 2 candidate HLA alleles that need confirmation of their association in African patients who develop rifampicin or isoniazid-associated CADR in larger studies. The value of identifying candidate alleles could lead to CADR preventative screening prior to initiating anti-tuberculosis therapy in black South Africans. The HLA-B*58:02 noted in our cases and controls tolerant of the drugs might not be associated with CADR but could be a reflection of the HIV status and control in HIV-TB co-infected persons. Conclusion: HLA-B*58:02 and HLA-DRB1*09:01 may be associated with rifampicin and isoniazid-associated CADR. Alternately HLA-B*58:02 may be associated with HIV status rather than CADR. A sufficiently powered study is needed to confirm this association

Understanding Physical and Mental Sexual Harassment of Women In Sub-Saharan Politics: A Comparative Analysis Of Nigeria And Uganda (1999-2019)

Recent studies have shown that violence against women politicians in sub-Saharan Africa is increasingly recognized globally as a key impediment to their participation in politics. This follows the troubling increase in documented cases of abuse, threat, harassment and intimidation aimed at women politicians on the continent. Consequently, bias toward women occupying political positions originates from the structural, cultural and symbolic violence, which differentiates this practice from other forms of political violence. This study provides an extensive understanding of the physical and mental sexual harassment of women in sub-Saharan African politics. It draws attention comparatively to this conundrum by drawing on the experience of women in Nigeria and Uganda. While it is a known that sexual harassment pervades the Nigerian and Ugandan political space, available data are very slim since cases are often underreported and when they do, are not pursued to a logical conclusion. A major impact of this is that women are reluctant to participate and be involved in the political and decision-making framework of their respective countries. In this study, primary and secondary sources were adopted and critically examined and analysed. The methodology adopted is based on content analysis of the sources used. Part of the results of the study shows that sexual harassment is associated with sexuality, patriarchy and gender power differences which is a huge factor that helps to perpetuate the conduct in sub-Saharan Africa. Secondly, gender-based violence against women has become normalised accounting for why women are often the victims of the conduct. Keyword: Sexual harassment, Nigeria/Uganda, Gender-based violence, Women in politics, Sub-Saharan Africa DOI: 10.7176/JAAS/80-07 Publication date:July 31st 202

Regulation of endoplasmic reticulum stress sensitivity by TORC1 signalling in yeast

Incorrect folding of secretory proteins in the endoplasmic reticulum (ER) results in an aberrant accumulation of misfolded proteins (ER stress) and activates a coping mechanism known as the unfolded protein response (UPR). While the mechanisms of UPR activation have been well established, how it integrates with other stress responses remains unclear. Given that TORC1 is an important regulator of cell growth during protein misfolding stress, we sought to investigate how TORC1 signalling acts in parallel with the UPR to regulate ER stress sensitivity. Our studies employ the budding yeast, Saccharomyces cerevisiae, a biochemically traceable model organism that allows for extensive genetic manipulation. Our results indicate that yeast cells carrying a hyperactive allele of TORC1 (TOR1L2134M) have increased sensitivity to canonical ER stressors and are inositol auxotrophs. Both phenotypes can be linked to a defective response to ER stress. Surprisingly, UPR activation and downregulation of ribosome biogenesis, two major consequences of ER stress, are equivalent between cells carrying a wild-type and hyperactive TOR1 allele, suggesting that TORC1 controls other signalling events required to cope with secretory protein misfolding. Interestingly, ER stress tolerance in yeast depends on the activation of the cell wall integrity pathway, which is regulated by TORC1. Our results indicate that hyperactive TOR1L2134M mutants are more sensitive to cell wall stressors and that the addition of sorbitol, a cell wall stabilizer, rescues ER stress sensitivity in hyperactive TOR1L2134M mutants. Overall, our studies in yeast may uncover new paradigms by which the response to protein misfolding is regulated

Mobile Phone to Youngsters: Necessity or Addiction

This study focuses on exploring the pattern of mobile phone usage among youngsters in Pakistan to delineate the extent of addictive behavior towards its usage. For this purpose questionnaires were used to elicit the responses. University students were selected as population and simple random sampling technique was used. Sample was consisting of 500 students out of which 400 students responded back comprising 80% response rate for this research. Findings of this study revealed that majority respondents are able to have definite priorities between their responsibilities & commitments and their cell phone usage. Very few are those who always exhibit the extreme addictive behaviors and rest is the majority who are not frequently involved in addictive usage patterns. Thus, youngsters use their cell phones under reasonable limits and do not tend towards extreme behaviors leading towards addictive cell phone usage

Exploring the experiences of Canadian medical students with a background in the arts and humanities

Background: Arts and Humanities (A/H) training is a powerful strategy to help medical students develop key competencies which align with the CanMEDS roles that Canadian physicians are expected to embody. Students with backgrounds in A/H may enter medical school with the skills and dispositions that A/H training provides. This paper explores the varied experiences of medical students with prior A/H backgrounds, with an emphasis on how they navigate relationships with their student cohorts and participate in undergraduate medical training environments. Methods: Descriptive qualitative research methodology was used to conduct and analyze semi-structured interviews exploring the perspectives of Canadian medical students with either a A/H degree or training in A/H (n = 13). Domains such as identity, integration of interests, and challenges in maintaining A/H interests during medical training were explored. Results: Participants described their A/H identity as intertwined with their identity as medical trainees and described their sense of interconnection between the disciplines. Challenges included imposter syndrome and difficulties in relating with peers from science backgrounds. Participants described returning to their A/H interests as a tool for wellness amidst medical training. Conclusions: Medical students with a background in A/H training describe this background as offering both affordances and challenges for their sense of identity, belonging, and wellness. These students offer an untapped resource: they come with dispositions of value to medicine, and they perceive a positive, hidden A/H curriculum that supports their maintenance of these dispositions during training. Understanding more about these hidden treasures could help foster the development of well-rounded and humanistic physicians in the entire medical class

Factors affecting undergraduate students’ information sharing behaviour when dealing with COVID-19 misinformation: theory of reasoned action

Sharing misinformation has become a widespread phenomenon. Social media networks have significantly contributed to spreading and sharing misinformation, especially during crises and pandemics. However, little is known about why people share misinformation. The study aims to identify the factors affecting undergraduate students’ information sharing behaviour when dealing with unverified information. The study also seeks to discover any statistically significant differences (α=0.05) in students’ behaviour of sharing information related to COVID-19 without verification attributed to demographic variables, self-efficiency, attitude towards verifying information, individual’s beliefs, and subjective norms. The study adopted the theory of reasoned action. A quantitative research approach was adopted via the use of questionnaires. An e-mail was sent to all undergraduate students enrolled at Sultan Qaboos University during 2020-2021, yielding 407 valid answers from various colleges. The reliability of the survey is 0.916 as a whole, 0.741 for the individual’s self-efficacy scale, 0.312 for the attitude towards verifying information scale, 0.809 for the individual’s beliefs scale, 0.916 for the subjective norms scale, and 0.846 for the behaviour of using and sharing information related to COVID-19 without verification scale. The effect of self-efficacy, Attitude Towards Verifying Information, beliefs, and Subjective norms on the behaviour of sharing information related to COVID-19 without verification were tested. Quantitative data retrieved from the questionnaire were analysed using SPSS 24. Several analysis tests such as frequencies, T-test, and multiple regression tests were conducted.Results. The findings support that there’s a significant effect of demographic variables, self-efficacy, attitude towards verifying information, individual’s beliefs, and subjective norms on students’ behaviour of sharing information related to COVID-19 without verification. This research showed that many factors affect information sharing behaviour. The research concluded that the students’ information behaviour could be enhanced by focusing on information literacy skills.Peer Reviewe

Performance of Wheat in Five Soils of Different Textures under Freshwater and Wastewater Irrigation

This study investigated the effects of five soils of different textures on wheat cultivation under irrigation with freshwater (FW) and municipal wastewater (WW). The experimental design was a split-plot with irrigation water quality as main factor and soil texture as sub-factor in three replications. These factors respectively comprised 2 and 5 treatments. Soil texture significantly (p£0.05) influenced plant height, leaf area index (LAI), spike length, number of grains per spike, above ground dry matter (ADM), grain yield, straw yield and biomass yield of wheat in most cases both under FW and WW irrigation. The harvest index (HI) of wheat responded significantly under FW irrigation only. Under FW, treatment T5 (silt loam) produced the highest grain yield (4.2 t ha–1) followed by T3 (loam-1) (3.1 t ha–1); the lowest yield (2.0 t ha–1) was in the control treatment, T1 (loamy sand). Under WW, treatment T2 (sandy loam) produced the highest grain yield (5.0 t ha–1) followed by T4 (loam-2) (4.5 t ha–1) both of which are statistically similar; the lowest yield (3.4 t ha–1) was in the control treatment. Treatments T2 and T4 provided the highest straw yield (5.6 t ha–1) and treatment T2 provided the highest biomass yield (10.6 t ha–1), both under WW; both T2 and T4 produced invariant biomass yields. Compared to other treatments, T2 and T4 gave statistically similar but significantly higher water productivity with respect to straw and grain yields. The lowest water productivity was in treatment T1 under both water qualities. The results of this study provided sound criteria in selecting suitable lands for wheat cultivation based on irrigation water quality, specifically in alluvial plains where soil texture is prone to high variations. Also, the observed facts of improved productivity of lower quality coarse-textured soils due to addition of easily available and inexpensive clay would provide guidance to bring unproductive sandy soils under production by clay amendments