Physical activity among adults with diabetes mellitus in Rwanda

Diabetes mellitus is one of the most common non-communicable diseases, and is the fifth leading cause of death in most developing countries. Regular physical activity is strongly recommended for individuals with diabetes for its beneficial effects in the improvement of blood glucose control and insulin sensitivity, prevention and reduction of morbidities and complications, as well as for its cardiovascular benefits. Using a cross-sectional design, this study examined the demographic, social and health-related factors associated with physical activity participation among adults with diabetes mellitus in Kigali, Rwanda. One hundred-and-fifty six (156) adults with diabetes mellitus participated in the study. More than a third (39%) of the participants was categorized as inactive. Active participants were significantly younger than those categorized as inactive. Age, marital status, level of education and self-efficacy for diabetes were all significantly associated with levels of physical activity. Common barriers to participation in physical activity were cited as poor health status, lack of motivation and lack of awareness about the importance of physical activity. It is thus clear that efforts should be made to educate adults with diabetes mellitus about the benefits of integrating regular physical activity in their daily routine.Department of HE and Training approved lis

Assessment of the Riparian Vegetation Changes Downstream of Selected Dams in Vhembe District, Limpopo Province on Based on Historical Aerial Photography

Dams have been associated with various impacts on downstream river ecosystems, including a decrease in stream flow, species biodiversity, water quality, altered hydrology and colonisation of the area by invasive alien plant species. The impacts normally interfere with the ecosystem functioning of riparian and aquatic environments, thereby leading to decreased biodiversity. This study aims to assess the impacts of dams on downstream river ecosystems, using data from aerial photographs and orthophotos, supplemented by field work. Five dams in Limpopo Province, South Africa, were selected (Albasini, Damani, Mambedi, Nandoni and Vondo), and photographs from different years were used. The area devoid of trees of certain species both downstream and upstream of the dams was calculated using grids of predetermined square sizes on each available photograph. Aerial photographs and orthophoto data were supplemented by field work. The nearest-individual method was used in the field to determine tree density of particular tree species. The environments downstream of the dams show a loss of obligate riparian vegetation and an increase of obligate terrestrial vegetation (Acacia Karroo, Acacia Ataxacantha and Bauhinia galpinii). Treeless area increased in all cases, especially in the case of Mambedi and Vondo dams, indicating lower resilience and higher fragility there

The Effect of Geometrical Isomerism of 3,5-Dicaffeoylquinic Acid on Its Binding Affinity to HIV-Integrase Enzyme: A Molecular Docking Study

A potent plant-derived HIV-1 inhibitor, 3,5-dicaffeoylquinic acid (diCQA), has been shown to undergo isomerisation upon UV exposure where the naturally occurring 3trans,5trans-diCQA isomer gives rise to the 3cis,5trans-diCQA, 3trans,5cis-diCQA, and 3cis,5cis-diCQA isomers. In this study, inhibition of HIV-1 INT by UV-induced isomers was investigated using molecular docking methods. Here, density functional theory (DFT) models were used for geometry optimization of the 3,5-diCQA isomers. The YASARA and Autodock VINA software packages were then used to determine the binding interactions between the HIV-1 INT catalytic domain and the 3,5-diCQA isomers and the Discovery Studio suite was used to visualise the interactions between the isomers and the protein. The geometrical isomers of 3,5-diCQA were all found to bind to the catalytic core domain of the INT enzyme. Moreover, the cis geometrical isomers were found to interact with the metal cofactor of HIV-1INT, a phenomenon which has been linked to antiviral potency. Furthermore, the 3trans,5cis-diCQA isomer was also found to interact with both LYS156 and LYS159 which are important residues for viral DNA integration. The differences in binding modes of these naturally coexisting isomers may allow wider synergistic activity which may be beneficial in comparison to the activities of each individual isomer

Incremental dialysis for preserving residual kidney function-Does one size fit all when initiating dialysis?

While many patients have substantial residual kidney function (RKF) when initiating hemodialysis (HD), most patients with end stage renal disease in the United States are initiated on 3-times per week conventional HD regimen, with little regard to RKF or patient preference. RKF is associated with many benefits including survival, volume control, solute clearance, and reduced inflammation. Several strategies have been recommended to preserve RKF after HD initiation, including an incremental approach to HD initiation. Incremental HD prescriptions are personalized to achieve adequate volume control and solute clearance with consideration to a patient's endogenous renal function. This allows the initial use of less frequent and/or shorter HD treatment sessions. Regular measurement of RKF is important because HD frequency needs to be increased as RKF inevitably declines. We narratively review the results of 12 observational cohort studies of twice-weekly compared to thrice-weekly HD. Incremental HD is associated with several benefits including preservation of RKF as well as extending the event-free life of arteriovenous fistulas and grafts. Patient survival and quality of life, however, has been variably associated with incremental HD. Serious risks must also be considered, including increased hospitalization and mortality perhaps related to fluid and electrolyte shifts after a long interdialytic interval. On the basis of the above literature review, and our clinical experience, we suggest patient characteristics which may predict favorable outcomes with an incremental approach to HD. These include substantial RKF, adequate volume control, lack of significant anemia/electrolyte imbalance, satisfactory health-related quality of life, low comorbid disease burden, and good nutritional status without evidence of hypercatabolism. Clinicians should engage patients in on-going conversations to prepare for incremental HD initiation and to ensure a smooth transition to thrice-weekly HD when needed

Investments in the digital silk road

This chapter discusses opportunities for the new digital economy, a strategically important factor of the economic growth for contributing to the Central Asia Digital Silk Road concept. Focusing on new opportunities for international cooperation, including the development of digital technologies, the chapter also draws attention to the fact that technology advancement causes changes in the economic system which may result in digital inequality. It argues that the O&G industry can become a key driver of growth and development and could potentially boost competitiveness across all sectors. The authors consider a set of public policies in ICT-related sectors in Kazakhstan. These policies are focusing on diversification from the O&G sector, supporting domestic companies and research, encouraging export-oriented projects, and pushing companies to join international initiatives

Influenza surveillance in 15 countries in Africa, 2006-2010

BACKGROUND: In response to the potential threat of an influenza pandemic, several international institutions and governments, in partnership with African countries, invested in the development of epidemiologic and laboratory influenza surveillance capacity in Africa. METHODS: We used a standardized form to collect information on influenza surveillance system characteristics, the number and percent of influenza-positive patients with influenza-like illness (ILI) or severe acute respiratory infections (SARI) and virologic data. RESULTS: Between 2006 and 2010, the number of ILI and SARI sites in 15 African countries increased from 21 to 127 and from 2 to 98, respectively. Influenza was detected in 22% of ILI cases and 10% of SARI cases. Children 0-4 years accounted for 48% all ILI and SARI cases of which 20% and 10 respectively were positive for influenza. Influenza peaks were generally discernible in North and South Africa. Substantial co-circulation of influenza A and B occurred most years. CONCLUSIONS: Influenza is a major cause of respiratory illness in Africa, especially in children. Further strengthening influenza surveillance, along with conducting special studies on influenza burden, cost of illness, and role of other respiratory pathogens will help detect novel influenza viruses and inform and develop targeted influenza prevention policy decisions in the region.The work presented in this manuscript was funded completely or in part by host governments, Institute Pasteur, and cooperative agreements with the U.S. Centers for Disease Control and Prevention and/or the U.S. Department of Defense.http://www.journals.uchicago.edu/toc/jid/currenthb2013ay201

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century