Stereoselective Synthesis of Organoboron Reagents and their Application Toward the Synthesis of Amphidinolides C and F:

Thesis advisor: James P. MorkenThis dissertation details three main projects that focus on stereoselective synthesis of organoboron reagents and their application to total synthesis studies. The first chapter describes the development of an enantioselective palladium-catalyzed conjuntive cross-coupling of bis(alkenyl)borates to access chiral allylboron reagents. These reagents are of high synthetic value that is demonstrated through various applications. The second chapter describes the development of a diastereoselective amine-modified boron-Wittig reaction with ketone electrophiles to access trisubstituted alkenyl boronic esters. The synthetic utility of these trisubstituted alkenyl boronic esters is demonstrated through a novel palladium-catalyzed cross-coupling reaction. The third chapter encompassess studies toward the total synthesis of natural products amphidinolides C and F. It highlights the application of methods developed in the Morken laboratory in the context of challenging total synthesis. It also highlights the potential for newly developed conjunctive cross-coupling and boron-Wittig reactions to solve problems in total synthesis.Thesis (PhD) — Boston College, 2020.Submitted to: Boston College. Graduate School of Arts and Sciences.Discipline: Chemistry

Overcoming religious and cultural obstacles to organ donation : a rights-based approach

The transplantation of human tissue, cells and organs has saved and improved the lives of hundreds of thousands of individuals who suffer from organ failure. Advancements in organ transplant technologies have resulted in an increased demand for viable organs for transplantation - a demand which South Africa is unable to meet. Religious beliefs, cultural practices and the system for organ procurement currently used in South Africa are some of the obstacles to donation. The thesis debunks religious and cultural misconceptions about organ donation and transplantation, basing its arguments in a human rights-based approach. Ways in which human rights norms may be used in the promotion of organ donation, whilst still respecting the cultural and religious beliefs of the individuals involved, are interrogated. It is concluded that religious and cultural norms, in fact, support organ donation. The introduction in South Africa of a mandated choicesystem as an alternative for the procurement and allocation of organs is recommended by the thesis.Thesis (LLD)--University of Pretoria, 2018.Public LawLLDUnrestricte

Predictors of oral pre-exposure prophylaxis (PrEP) uptake among individuals in a HIV vaccine preparedness cohort in Masaka, Uganda

Oral pre-exposure prophylaxis (PrEP) significantly reduces human immunodeficiency virus (HIV) acquisition risk. However, data on predictors of PrEP uptake in sub-Saharan Africa are limited. We assessed predictors of PrEP uptake among HIV-uninfected high risk individuals enrolled in a HIV vaccine preparedness study in Masaka, Uganda.Between July 2018 and October 2020, we recruited adults (18-40 years) from sex work hotspots along the trans-African highway and Lake Victoria fishing communities. We collected baseline data on socio-demographics and PrEP awareness, and provided HIV counselling and testing, information on PrEP, and PrEP referrals at quarterly visits. Urine pregnancy tests (women) and data collection on sexual risk behaviour and PrEP uptake were performed every 6 months. We analysed PrEP uptake among participants who had completed 6 months of follow-up.Of the 588 cohort participants, 362 (62%) were included in this analysis. Of these, 176 (49%) were female, 181 (50%) were aged ≤24 years, 104 (29%) worked in sex work hotspots, 74 (20%) were fisher folk. Only 75 (21%) participants initiated PrEP. Predictors of PrEP uptake included having ≥6 sex partners (adjusted odds ratio [aOR] = 2.29; 95% confidence interval [CI] 1.26-4.17), engaging in transactional sex (aOR = 2.23; 95% CI 0.95-5.20), and residence in a nonfishing community (aOR = 2.40; 95% CI 1.14-5.08). The commonest reasons for not starting PrEP were pill burden (38%) and needing more time to decide (27%).PrEP uptake was low and associated with HIV risk indicators in this cohort. Interventions are needed to improve access to PrEP especially in fishing communities

Quality of life and associated factors among HIV positive patients after completion of treatment for Cryptococcal meningitis.

BACKGROUND: Cryptococcal meningitis (CCM) remains one of the leading causes of mortality among HIV infected patients. Due to factors such as the severity of CCM pathology, the quality of life (QOL) of patients post-treatment is likely to be poor. Few studies have reported on QOL of CCM patients post treatment completion. We used data collected among patients in the CryptoDex trial (ISRCTN59144167) to determine QOL and associated factors at week 10 and six months from treatment initiation. METHODOLOGY: CryptoDex was a double-blind placebo-controlled trial of adjunctive dexamethasone in HIV infected adults with CCM, conducted between 2013 and 2015 in six countries in Asia and Africa. QOL was determined using the descriptive and Visual Analog Scales (VAS) of the EuroQol Five-Dimension-Three-Level (EQ-5D-3L) tool. We derived index scores, and described these and the VAS scores at 10 weeks and 6 months; and used linear regression to determine the relationship between various characteristics and VAS scores at both time points. VAS scores were interpreted as very good (81-100), good (51-80), normal (31-50) and bad/very bad (0-30). RESULTS: Of 451 patients enrolled in the trial, 238 had QOL evaluations at week 10. At baseline, their mean age (SD) was 35.2(8.5) years. The mean index scores (SD) were 0.785(0.2) and 0.619(0.4) among African and Asian patients respectively at week 10, and 0.879(0.2) and 0.731(0.4) among African and Asian patients respectively at month six. The overall mean VAS score (SD) at 10 weeks was 57.2 (29.7), increasing significantly to 72(27.4) at month six (p<0.001). At week 10, higher VAS score was associated with greater weight (p = 0.007) and being African (p<0.001), while lower VAS score was associated with positive yeast culture at day 14 (p = 0.026). At month six, higher VAS score remained associated with African origin (p = 0.006) while lower VAS score was associated with positive yeast culture (p = 0.006). Lower VAS scores were associated with higher number of inpatient days at 10 weeks and 6 months (p = 0.003 and 0.002 respectively). CONCLUSION: QOL was good among patients that had completed therapy for CCM, but below perfect. Strategies to improve QOL among CCM survivors are required

The International Market for Illicit Organ Trading : Towards Regulation or Abolition?

No abstractDissertation (LLM)--University of Pretoria, 2013.Public LawLLMUnrestricte

Debunking religious and cultural misconceptions of organ donation and transplantation

Organ transplantation is a life-saving procedure that is arguably the most viable treatment option for individuals who are faced with end-stage organ failure. Owing to a shortage of organs for transplantation, however, patients suffering from chronic organ failure often succumb to their illness while on a waiting list. Research has shown that the underlying reason for a lack of motivation to donate stems from inter alia religious and cultural views and practices that are believed to go against organ donation and/or transplantation. This article offers an analysis of specific religious and cultural beliefs which are native to South Africa and discusses the convictions that are both for and against donation. The article further explores the possibility of gaining clarity with regard to these misapprehensions and suggests possible solutions to bringing awareness to the public through the use of a modified version of the Traditional Health Practitioners Act 22 of 2007, as a suggestion. It also advocates education for medical personnel about the different religious and cultural traditions and rituals which accompany death, leading to an atmosphere of respect for the deceased and the deceased’s loved-ones.http://www.journals.co.za/content/journal/sapr1https://upjournals.co.za/index.php/SAPL2021-06-01hj2021Public La

Prenatal dietary diversity may influence underweight in infants in a Ugandan birth‐cohort

Abstract Growth faltering in early childhood is prevalent in many low resource countries. Poor maternal dietary diversity during pregnancy has been linked with increased risk of fetal growth failure and adverse birth outcomes but may also influence subsequent infant growth. Our aim is to assess the role of prenatal maternal dietary diversity in infant growth in rural Uganda. Data from 3291 women and infant pairs enrolled in a birth cohort from 2014 to 2016 were analysed (NCT04233944). Maternal diets were assessed using dietary recall in the second or third trimesters of pregnancy. Maternal dietary diversity scores (DDS) were calculated using the FAO Minimum Dietary Diversity for Women (MDD‐W). Cox regression models were used to evaluate associations of the DDS with the incidence of underweight, stunting and wasting in infants from 3 to 12 months, adjusting for confounding factors. The median DDS for women was low, at 3.0 (interquartile range 3.0–4.0), relative to the threshold of consuming five or more food groups daily. Infants of women in highest quartile of DDS (diverse diets) were less likely to be underweight (adjusted hazard ratio: 0.70, 95% confidence interval: 0.61, 0.80) compared with infants of women in Quartile 1 (p for trend <0.001) in models controlling for maternal factors. There was no significant association between DDS and stunting or wasting. Our findings suggest a relationship between higher maternal dietary diversity and lower risk of underweight in infancy. These findings suggest that programmes to improve infant growth could additionally consider strengthening prenatal dietary diversity to improve child outcomes globally