EFFECTIVE USE OF NANOTECHNOLOGY IN DESALINATION

Master's Thesis in Process TechnologyPRO399MAMN-PR

SUPREME-HN: a retrospective biomarker study assessing the prognostic value of PD-L1 expression in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck.

BACKGROUND:Programmed cell death ligand-1 (PD-L1) expression on tumor cells (TCs) is associated with improved survival in patients with head and neck squamous cell carcinoma (HNSCC) treated with immunotherapy, although its role as a prognostic factor is controversial. This study investigates whether tumoral expression of PD-L1 is a prognostic marker in patients with recurrent and/or metastatic (R/M) HNSCC treated with standard chemotherapy. METHODS:This retrospective, multicenter, noninterventional study assessed PD-L1 expression on archival R/M HNSCC tissue samples using the VENTANA PD-L1 (SP263) Assay. PD-L1 high was defined as PD-L1 staining of ≥ 25% TC, with exploratory scoring at TC ≥ 10% and TC ≥ 50%. The primary objective of this study was to estimate the prognostic value of PD-L1 status in terms of overall survival (OS) in patients with R/M HNSCC. RESULTS:412 patients (median age, 62.0 years; 79.9% male; 88.2% Caucasian) were included from 19 sites in seven countries. 132 patients (32.0%) had TC ≥ 25% PD-L1 expression; 199 patients (48.3%) and 85 patients (20.6%) had TC ≥ 10% and ≥ 50%, respectively. OS did not differ significantly across PD-L1 expression (at TC ≥ 25% cutoff median OS: 8.2 months vs TC < 25%, 10.1 months, P = 0.55) or the ≥ 10% and ≥ 50% cutoffs (at TC ≥ 10%, median OS: 9.6 months vs TC < 10%, 9.4 months, P = 0.32, and at TC ≥ 50%, median OS 7.9 vs TC < 50%, 10.0 months, P = 0.39, respectively). CONCLUSIONS:PD-L1 expression, assessed using the VENTANA PD-L1 (SP263) Assay, was not prognostic of OS in patients with R/M HNSCC treated with standard of care chemotherapies. Trial registration ClinicalTrials.gov, NCT02543476. Registered September 4, 2015

Assessment of Agricultural Advisory Messages from Farmer-to-Farmer in Making a Case for Scaling Up Production: A Qualitative Study

Inadequate access to agricultural extension services often results in poor farm practices, affecting yields and subsequently the income and wellbeing of smallholder farmers. Given the high demand for agricultural information and the limited capacity of extension services, a farmer-to-farmer extension approach has been explored by many underserved farmers. In this study, we use a qualitative case study approach explore how cassava farmers who had limited access to agricultural advisory services from public extension agents managed to up-scale their farming business. Our research question was: what lessons can be learned from the lived experience of these farmers to address current challenges of cassava farming? The results of our study revealed diversity in advisory messages from farmer to farmer and agricultural extension agents. Farmers’ messages focused on encouraging farmers’ commitment and motivation towards farming business, availability of needed financial resources for the entire production season, willingness to reinvest profits, and access to farmland for future expansion. In contrast, the traditional messages from agricultural extension agents focused on encouraging group formation to address marketing challenges, diversification of farm operations, and good agricultural practices. These results show the need for pluralistic extension approaches to ensure farmers get access to necessary information

Using participatory videos in understanding farmers experiences with climate smart agricultural practices: reflections from Ghana

Climate-smart agriculture (CSA) has gained traction as one of the effective strategies in tackling the climate crisis. Many CSA practices have been promoted by development agencies to smallholder farmers based on the assumption that farmers would adopt these innovations for their potential benefits. However, the adoption of CSA practices in Ghana and much of Africa remains low and decision making and on-farm innovation processes are poorly understood. This study seeks to provide empirical and participatory insight into how smallholder farmers innovate. Based on a novel application of a participatory video methodology, in farming communities in the Upper West Region of Ghana, that have been exposed to multiple CSA intervention programmes, the paper analyses farmers’ own self-curated accounts of experiences with CSA innovation. The findings show that farmer’s motivation to adopt CSA innovations is driven by their concerns for food security, economic gains, and the environmental impact of climate change on their farming activities and livelihood. The study reveals a mismatch between the CSA technologies and practices advanced by the development agencies and what farmers perceive as relevant and important in addressing their farming challenges. In particular, the findings show that in a pool of more than 12 CSA technologies and practices that had been promoted through three donor-driven intervention programmes in the communities, farmers selected less labour intensive, less costly, and CSA technologies and practices that fitted to their current farming practices and the local context. Agricultural extension agents served as an important information source on the CSA innovation and their practical implementation and farmers’ social groups played a crucial role in facilitating learning about the CSA technologies and practices. There is the need to integrate farmers voices using innovative methodologies such as participatory videos to better understand farmers’ experiences in the innovation process which will help inform the design of effective interventions and promote adoption of innovations aimed at enhancing the productivity of smallholder farmers and reducing environmental impacts in African food systems. By focusing on the innovations that farmers perceive as beneficial and adaptable to their local contexts, development organizations can use their resources more efficiently and promote adoption of contextually appropriate CSA innovations

Reporting of adverse events following immunizations in Ghana–Using disproportionality analysis reporting ratios

Background: Timely reporting of safety information post vaccination is pivotal for the success of any vaccination program. Reports of adverse events following immunization (AEFI) of 6 different vaccinations from Ghana were analysed for signals. Methods: De-identified data from active surveillance for AEFIs after 2009 AH1N1 influenza, yellow fever, meningitis, measles-rubella, pneumococcal-rotavirus and human papilloma virus vaccinations were used. All vaccinations occurred between January 2010 and December 2013. The ten most occurring events for each vaccination were captured and arranged using Medical Dictionary for Regulatory Authorities (MedDRA) Preferred Term (PT) and System Organ Classification (SOC) codes. Adverse event incidence rates were calculated for each vaccine type, and signals were generated using proportional reporting ratios (PRR). Results: A total number of 5,141 reports were analysed ranging from 33 (human papilloma virus) to 1958 (measles-rubella). Between 22% and 55% of all AEFIs per vaccine type were collected on the day of vaccination. For each vaccine type, at least 87% of all reported AEFIs occurred in the first 7 days post-vaccination. Multiple reports were received per vaccine type. For the MR vaccine, urticarial recorded the highest attack rate of 6.6 (95% CI 6.2, 7.1) per 100,000 vaccines. The AEFI with the highest PRR for both human papilloma and measles-rubella vaccines was abdominal pain, recording a PRR of 8.15 (95% CI 3.46, 19.23) and 43.75 (95% CI 17.81, 107.45) respectively. Conclusion: These results underscore the competency of public health systems in sub-Saharan African countries (like Ghana) to identify most frequently occurring and important vaccine related safety issues

Using participatory videos in understanding farmers experiences with climate smart agricultural practices : reflections from Ghana

DATA AVAILABILITY STATEMENT : The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.Climate-smart agriculture (CSA) has gained traction as one of the effective strategies in tackling the climate crisis. Many CSA practices have been promoted by development agencies to smallholder farmers based on the assumption that farmers would adopt these innovations for their potential benefits. However, the adoption of CSA practices in Ghana and much of Africa remains low and decision making and on-farm innovation processes are poorly understood. This study seeks to provide empirical and participatory insight into how smallholder farmers innovate. Based on a novel application of a participatory video methodology, in farming communities in the Upper West Region of Ghana, that have been exposed to multiple CSA intervention programmes, the paper analyses farmers’ own self-curated accounts of experiences with CSA innovation. The findings show that farmer’s motivation to adopt CSA innovations is driven by their concerns for food security, economic gains, and the environmental impact of climate change on their farming activities and livelihood. The study reveals a mismatch between the CSA technologies and practices advanced by the development agencies and what farmers perceive as relevant and important in addressing their farming challenges. In particular, the findings show that in a pool of more than 12 CSA technologies and practices that had been promoted through three donor-driven intervention programmes in the communities, farmers selected less labour intensive, less costly, and CSA technologies and practices that fitted to their current farming practices and the local context. Agricultural extension agents served as an important information source on the CSA innovation and their practical implementation and farmers’ social groups played a crucial role in facilitating learning about the CSA technologies and practices. There is the need to integrate farmers voices using innovative methodologies such as participatory videos to better understand farmers’ experiences in the innovation process which will help inform the design of effective interventions and promote adoption of innovations aimed at enhancing the productivity of smallholder farmers and reducing environmental impacts in African food systems. By focusing on the innovations that farmers perceive as beneficial and adaptable to their local contexts, development organizations can use their resources more efficiently and promote adoption of contextually appropriate CSA innovations.The Food Systems Research Network for Africa (FSNet-Africa). FSNet-Africa is funded by the Global Challenges Research Fund (GCRF) as a Research Excellence project under the partnership between UK Research and Innovation (UKRI) and the African Research Universities Alliance (ARUA). FSNet-Africa is a flagship project in the ARUA Centre of Excellence in Sustainable Food Systems (ARUA-SFS), which is hosted by the University of Pretoria (South Africa) in collaboration with the University of Nairobi (Kenya) and University of Ghana (Ghana).https://www.frontiersin.org/journals/sustainable-food-systemsam2024Centre for the Advancement of ScholarshipSDG-02:Zero Hunge

Antihypertensive medicine use differs between Ghana and Nigeria.

BACKGROUND: Non-communicable diseases are a growing burden in many African countries; cardiovascular disease is the main disease. Antihypertensive medicines (AHM) are a common treatment option but we know little about community use in most low- and medium-income countries (LMIC). We aimed to describe the use of antihypertensive medicines (AHM) in Ghana and Nigeria using a novel data source. METHODS: We used data from mPharma-a health and pharmaceutical company which distributes pharmaceuticals to hospital and retail pharmacies. We extracted data using the anatomical therapeutic chemical (ATC) classification codes and calculated use in defined daily doses and explored patterns by class, medicines, dose, and originator or generic product. RESULTS: AHM use differed between Ghana and Nigeria. The most used classes in Ghana were angiotensin receptor blockers (ARB) followed by calcium channel blockers (CCB) and angiotensin-converting-enzyme inhibitors (ACEi). The five most used products were 16 mg candesartan, 30 mg nifedipine, 10 mg lisinopril, 5 mg amlodipine and 50 mg losartan. In Nigeria ARB, CCB and diuretics were widely used; the top five products were 50 mg losartan, 10 mg lisinopril, 30 mg nifedipine, 40 mg furosemide, and 5 mg amlodipine. More originator products were used in Ghana than Nigeria. CONCLUSION: The differences between Ghana and Nigeria may result from a combination of medical, contextual and policy evidence and reflect factors related to clinical guidance (e.g. standard treatment guidelines), accessibility to prescribers and the role of community pharmacies, and structure of the health system and universal health coverage including funding for medicines. We show the feasibility of using novel data sources to gain insights on medicines use in the community

A CRYPTOLEPIS SANGUINOLENTA-BASED PREPARATION REDUCED HOSPITAL STAY AND MORTALITY OF COVID-19 PATIENTS DURING THE PANDEMIC

Background: In 2020, the World Health Organization urged nations to take domestic steps to curb the spread and contain the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, also referred to as coronavirus disease 2019 (COVID-19). In the meantime, there was growing clinical evidence that reported favourable effects of using herbal medicine in managing COVID-19. We, therefore, repurposed Nibima (a Cryptolepis sanguinolenta-based herbal preparation) as an adjunct to conventional therapy for COVID-19. This was premised on our previous in vitro investigations that showed that Nibima has both antiviral and anti-inflammatory activities. Materials and Methods: This trial (FDA/CT/11) was an open-label, randomised controlled phase II pilot study, which was conducted from March 2021 to October 2022 among hospitalised COVID-19 patients in the Ashanti Region of Ghana. Participants were either randomised to aqua (water) or Nibima, the investigational product as adjunct to COVID therapy. Results: Nibima was well tolerated by the study participants, and the patients who were administered that together with the standard COVID-19 therapy had rapid clinical recovery compared to those taking aqua and the standard or conventional COVID-19 therapy. The evidence obtained provides a strong basis for future studies with large numbers of hospitalised patients with COVID-19 and other viral respiratory infections. Conclusion: Though COVID-19 is no longer a pandemic, it is still a public health challenge. We recommend that Nibima be further investigated for its broad-spectrum antiviral and immunomodulatory activities against SARS-COV-2 and other viral infections in preparedness for the re-emergence of future pandemics

Practical Pharmacist-Led Interventions to Improve Antimicrobial Stewardship in Ghana, Tanzania, Uganda and Zambia.

The World Health Organisation (WHO) and others have identified, as a priority, the need to improve antimicrobial stewardship (AMS) interventions as part of the effort to tackle antimicrobial resistance (AMR). An international health partnership model, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, was established between selected countries in Africa (Ghana, Tanzania, Zambia and Uganda) and the UK to support AMS. This was funded by UK aid under the Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET). The primary aims were to develop local AMS teams and generate antimicrobial consumption surveillance data, quality improvement initiatives, infection prevention and control (IPC) and education/training to reduce AMR. Education and training were key components in achieving this, with pharmacists taking a lead role in developing and leading AMS interventions. Pharmacist-led interventions in Ghana improved access to national antimicrobial prescribing guidelines via the CwPAMS mobile app and improved compliance with policy from 18% to 70% initially for patients with pneumonia in one outpatient clinic. Capacity development on AMS and IPC were achieved in both Tanzania and Zambia, and a train-the-trainer model on the local production of alcohol hand rub in Uganda and Zambia. The model of pharmacy health partnerships has been identified as a model with great potential to be used in other low and middle income countries (LMICs) to support tackling AMR