Revisiting the internal consistency and factorial validity of the 8-item Morisky Medication Adherence Scale

Objective: To assess the internal consistency and factorial validity of the adapted French 8-item Morisky Medication Adherence Scale in assessing adherence to noninsulin antidiabetic drug treatment.Study Design and Setting: In a cross-sectional web survey of individuals with type 2 diabetes of the Canadian province of Quebec, self-reported adherence to the antidiabetes drug treatment was measured using the Morisky Medication Adherence Scale-8. We assessed the internal consistency of the Morisky Medication Adherence Scale-8 with Cronbach’s alpha, and factorial validity was assessed by identifying the underlying factors using exploratory factor analyses.Results: A total of 901 individuals completed the survey. Cronbach’s alpha was 0.60. Two factors were identified. One factor comprised five items: stopping medication when diabetes is under control, stopping when feeling worse, feeling hassled about sticking to the prescription, reasons other than forgetting and a cross-loading item (i.e. taking drugs the day before). The second factor comprised three other items that were all related to forgetfulness in addition to the cross-loading item.Conclusion: Cronbach’s alpha of the adapted French Morisky Medication Adherence Scale-8 was below the acceptable value of 0.70. This observed low internal consistency of the scale is probably related to the causal nature of the items of the scale but not necessarily a lack of reliability. The results suggest that the adapted French Morisky Medication Adherence Scale-8 is a two-factor scale assessing intentional (first factor) and unintentional (second factor) non-adherence to the noninsulin antidiabetes drug treatment. The scale could be used to separately identify these outcomes using scores obtained on each of the sub-scale

Effects of seed fermentation method on seed germination and vigor in the oleaginous gourd Lagenaria siceraria (Molina) Standl.

Supplying high quality seed to rural farmers is the basic requirement for the sustainable development of agriculture in developing countries. The present study was conducted to examine the influence of Lagenaria siceraria seed fermentation method on seed germination and vigor. Three seed fermentation methods (fermented in ambient air, plastic bag stored in ambient or in plastic bag buried) were tested on two cultivars during two years. Seed germination and vigor were better when fermentation was conducted in anaerobic, darkness, and at low temperature. Low seed quality was observed in unfermented seed, suggesting the occurrence of postharvest maturity in L. siceraria. Seed quality did not vary between cultivars. Regardless of the fermentation process and cultivars used, the best seed and seedling qualities were observed when the amount of rainfall during the experiment period was high, suggesting that wet soil is necessary for an on farm reliable evaluation of seed fermentation method in the bottle gourd L. siceraria.Keywords: Cucurbit, egussi, maturity, minor crops, oilseed, seedling, viability

Co-composting of sewage sludge and Echinochloa pyramidalis (Lam.) Hitchc. & Chase plant material from a constructed wetland system treating domestic wastewater in Cameroon

Trials were conducted at the Cité-Verte domestic wastewater treatment station (Yaoundé-Cameroon) in order to assess the effect of three sewage sludge: Macrophyte ratios on the co-composting process and compost quality. The ratios were T1: 25 kg of plant material (Echinochloa pyramidalis) and 75 kg sludge; T2: 50 kg of plant material and 50 kg sludge, and T3: 75 kg of plant material and 25 kg of sludge. The assessment parameters of the co-composting process included the daily evolution of temperature, the pH and water content for each month. The quality of the mature compost obtained was analysed based on their C/N ratio, Ca, Mg, P, K, trace elements and helminth eggs content. During cocomposting, maximum temperatures ranged from 45.3 ± 4.7°C (T1) to 70.77 ± 2.76°C (T3). Mature cocompost was obtained after 3 months (T1), 4 months (T2) and 5 months (T3). Mean pH and C/N ratio of co-composts respectively ranged from 7.26 to 7.62 and from 10 to 15. In mature compost, the average values of organic matter, N and P respectively were 3323 ± 405 mg/kg, 165 ± 32 mg/kg and 36 ± 5 mg/kg for T1; 2945 ± 128 mg/kg, 152 ± 30 mg/kg and 27 ± 6 mg/kg for T2; and 228 ± 103 mg/kg, 105 ± 48 mg/kg and 7 ± 1 mg/kg for T3. K content was 1 mg/kg in all three co-composts. Heavy metals were found at trace levels. Helminth eggs concentration in compost was 0.2 ± 0.03 egg/g (T1), 0.1 ± 0.02 egg/g (T2) and 0.007 ± 0.01 egg/g (T3). All these co-composts did not present a significant hygienic risk with regards to WHO guidelines (2006) for safe reuse of faecal matter or faecal sewage in agriculture (less than 1 egg/g TS). For a given amount of plant harvested, it was concluded that the quickest way to produce a compost safe of parasites will be to mix them with 3/4 of sludge from the digestion tank.Key words: Co-composting, Cameroon, compost quality, Echinochloa pyramidalis, hygienic risk, sewage sludge

Improvement of the growth of Arthrospira (Spirulina) platensis from Toliara (Madagascar): Effect of agitation, salinity and CO2 addition

Arthrospira (Spirulina) platensis Toliara isolated from alkaline and salt lakes in the south-western area of Madagascar is a potential source of proteins that could efficiently fight against food deficiency in developing countries like Madagascar. Up to now, productivity in this country has been low, so a better understanding of the growth conditions of this species is needed to improve its production. Growth experiments were undertaken in bubble columns at laboratory scale. The influence of agitation of the culture, medium salinity (ranging from 13 to 35gL−1) and CO2 addition (ranging from 0 to 2%, v/v) on growth and protein content was examined. Because Arthrospira cells are fragile, a bubble column without additional mixing gave the best growth. Arthrospira (Spirulina) platensis showed higher specific growth rate (μmax) and protein content for lower salinity. Addition of 1% of CO2 improved the productivity by near 60%. The feasability of semi-continuous culture was demonstrated and optimal culture conditions led to a mean productivity of 0.22±0.03gL−1d−1, a mean specific growth rate of 0.015±0.002h−1 and a protein content of 53±2% of total dry weight

Association of the PHACTR1/EDN1 genetic locus with spontaneous coronary artery dissection

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene. Objectives: This study sought to test the association between the rs9349379 genotype and SCAD. Methods: Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD. Results: The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence. Conclusions: The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD

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