Dihydroartemisinin-piperaquine versus artesunate-amodiaquine for treatment of malaria infection in pregnancy in Ghana: an open-label, randomized, non-inferiority trial.

To determine whether dihydroartemisinin-piperaquine (DHA-PPQ) is non-inferior to artesunate-amodiaquine (ASAQ) for treating uncomplicated malaria infection in pregnancy. 417 second/ third trimester pregnant women with confirmed asymptomatic Plasmodium falciparum parasitaemia were randomized to receive DHA-PPQ or ASAQ over 3 days. Women were followed up on days 1, 2, 3, 7, 14, 28 and 42 after treatment start and at delivery for parasitological, haematological, birth outcomes and at 6-weeks post-partum to ascertain the health status of the babies. Parasitological efficacy (PE) by days 28 and 42 were co-primary outcomes. Analysis was per-protocol (PP) and modified intention-to-treat (ITT). Non-inferiority was declared if the two-sided 95% confidence interval for PE at the endpoints excluded 5% lower efficacy for DHA-PPQ. Secondary outcomes were assessed for superiority. In PP analysis, PE was 91.6% for DHA-PPQ and 89.3% for ASAQ by day 28 and 89.0% and 86.5% respectively by day 42. DHA-PPQ was non-inferior to ASAQ with respect to uncorrected PE {adjusted difference by day 28 (DHA-PPQ-ASAQ); 3.5% (95%CI: -1.5, 8.5) and day 42: 3.9% (95%CI: -2.7, 10.4)}. ITT analysis gave similar results. PCR to distinguish recrudescence and reinfection was unsuccessful. DHA-PPQ recipients had fewer adverse events of vomiting, dizziness and general weakness compared to ASAQ. Both drugs were well-tolerated and there was no excess of adverse birth outcomes. DHA-PPQ was non-inferior to ASAQ for treatment of malaria infection during pregnancy. No safety concerns were identified. Our findings contribute to growing evidence that DHA-PPQ is useful for control of malaria in pregnancy. This article is protected by copyright. All rights reserved

Amplified EQCM-D detection of extracellular vesicles using 2D gold nanostructure arrays fabricated by block copolymer self-assembly

Extracellular vesicles (EVs) are routinely released from nearly all cell types as transport vehicles and for cell communication. Crucially, they contain biomolecular content for the identification of health and disease states that can be detected from readily accessible physiological fluids, including urine, plasma, or saliva. Despite their clinical utility within noninvasive diagnostic platforms such as liquid biopsies, the currently available portfolio of analytical approaches are challenged by EV heterogeneity in size and composition, as well as the complexity of native biofluids. Quartz crystal microbalance with dissipation monitoring (QCM-D) has recently emerged as a powerful alternative for the phenotypic detection of EVs, offering multiple modes of analyte discrimination by frequency and dissipation. While providing rich data for sensor development, further progress is required to reduce detection limits and fully exploit the technique's potential within biosensing. Herein, we investigate the impact of nanostructuring the sensor electrode surface for enhancing its detection capabilities. We employ self-assembly of the block copolymer polystyrene-block-poly(4-vinylpyridine) to create well defined 2D gold islands via selective impregnation of the pyridine domain with gold precursors and subsequent removal of the template. When matched to the EV length scale, we find a 4-fold improvement in sensitivity despite a 4-fold reduction in area for analyte and ligand anchoring in comparison to a flat sensor surface. Creation of tailored and confined sensing regions interspersed by non-binding silica provides optimal spatial orientation for EV capture with reduced steric effects and negative cooperativity of grafted antibodies, offering a promising route for facilitated binding and enhanced performance of sensor platforms

Novel approaches to acoustic immunosensing of extracellular vesicles

Extracellular vesicles (EVs) constitute a promising source of biomarkers for disease diagnostics and can be obtained via liquid biopsies from various bodily fluids. While much progress has been made in recent years, challenges remain on the sensitivity, specificity and clinical implementation of current analytical workflows

Amplified EQCM-D detection of extracellular vesicles using 2D gold nanostructure arrays fabricated by block copolymer self-assembly

Extracellular vesicles (EVs) are routinely released from nearly all cell types as transport vehicles and for cell communication. Crucially, they contain biomolecular content for the identification of health and disease states that can be detected from readily accessible physiological fluids, including urine, plasma, or saliva. Despite their clinical utility within noninvasive diagnostic platforms such as liquid biopsies, the currently available portfolio of analytical approaches are challenged by EV heterogeneity in size and composition, as well as the complexity of native biofluids. Quartz crystal microbalance with dissipation monitoring (QCM-D) has recently emerged as a powerful alternative for the phenotypic detection of EVs, offering multiple modes of analyte discrimination by frequency and dissipation. While providing rich data for sensor development, further progress is required to reduce detection limits and fully exploit the technique’s potential within biosensing. Herein, we investigate the impact of nanostructuring the sensor electrode surface for enhancing its detection capabilities. We employ self-assembly of the block copolymer polystyrene-block-poly(4-vinylpyridine) to create well defined 2D gold islands via selective impregnation of the pyridine domain with gold precursors and subsequent removal of the template. When matched to the EV length scale, we find a 4-fold improvement in sensitivity despite a 4-fold reduction in area for analyte and ligand anchoring in comparison to a flat sensor surface. Creation of tailored and confined sensing regions interspersed by non-binding silica provides optimal spatial orientation for EV capture with reduced steric effects and negative cooperativity of grafted antibodies, offering a promising route for enhanced binding efficiency and performance of sensor platforms

Mixed reactions of Africa regional stock markets to COVID-19 pandemic: events study analysis

COVID-19 has caused severe disruptions in global economic activities, and its impacts on stock markets cannot be overemphasized. The study employs market model and event study approach with four events (WHO announcement of COVID-19 as a global health emergency, confirmed infections, confirmed deaths, and vaccination) to examine the reactions of four African regional blocs’ markets to the pandemic from September 1, 2019, to August 31, 2021, to estimate the average abnormal returns of each regional bloc. On the day of the WHO announcement, we document insignificant negative average abnormal returns in the Northern bloc. We also document significant negative average abnormal returns for infections in all but the Northern bloc on the event day. The Western bloc generated the highest significant negative average abnormal return (-43 per cent) on the day COVID-19 death was confirmed on the continent. We finally document insignificant average abnormal returns from weeks 1 to 20 after the first vaccination in the Northern and Eastern blocs. The study recommends that investors, portfolio managers, and speculators not panic during similar pandemics since they can generate significant abnormal returns and diversify their investment holdings across the four regional blocs in Africa, as demonstrated by the COVID-19 pandemic

Determinants of preterm survival in a tertiary hospital in Ghana: a ten-year review

Background Prematurity (gestational age <37 completed weeks) accounts for the majority of neonatal deaths worldwide and most of these occur in the low-resource countries. Understanding factors that determine the best chances of preterm survival is imperative in order to enhance the care of neonates and reduce adverse outcomes in such complicated births. Aim This was to find out the proportions of preterm babies who survived at the Special Care Baby Unit (SCBU) in the Cape Coast Teaching Hospital (CCTH) and the factors which influenced their survival. Method This was a retrospective review of data on all the live preterm babies seen at the SCBU of CCTH from 2010 to 2019. Data on 2,254 babies that met the inclusion criteria were extracted. Descriptive statistics were generated and tests of association done with chi-square and multivariable logistic regression. Outcome The main outcome measure was the proportion of live preterm neonates who were discharged after SCBU admissions. Results The CCTH had a total of 27,320 deliveries from 2010 to 2019. Of these, 1,282 were live preterm births, giving a prevalence of live preterm babies over the ten-year period of 4.7% (1,282/27,320). An increasing trend in prevalence was observed with 2019 recording the highest at 9% (271/3027). Most (48.8%) of the deliveries were vaginal, 39.2% were by caesarean section (CS); the mode of birth for 12% of the women were not documented. The mean gestational age was 31.8 (±2.77) weeks. Of the birth weights documented, 2500g made up only 3.7%. The average length of hospital stay was 8.3 (±9.88) days. Regarding the main outcome variable, 67.6% were discharged alive, 27.6% died and 4.9% were unaccounted for due to incomplete documentation. Factors which influenced survival were: birth weight (p <0.001); gestational age (p <0.001); mode and place of delivery (p <0.001 for both); APGAR scores at 1st and 5th minutes (p <0.001); and length of stay at the SCBU (p <0.001). No association was found for sex of the baby, maternal age and parity. Conclusion This study shows the possibility of achieving good preterm survival rates through the provision of specialised neonatal care, even in resource-constrained countries. This provides an updated benchmark for clinical decision-making and antenatal counselling. It also highlights the problem of inadequate data capture in our part of the world, which needs considerable improvement

Complying with Neoliberal Performative Techniques in Chinese Education

In this period where performance management has gotten to an abolishing degree of teacher quality and school viability; educational institutes, students and teachers are presently under pressure to compete for acknowledgment on the premise of evaluations, yearly audits, and ranking of tables: where teachers are now positioned as self-governing professionals with their work progressively measured against students’ performance on national and international tests. And teachers who are’ ethical subjects’ find their values have been tested by what Stephen Ball called ‘the terrors of performativity’. Further, the value placed on measuring, politicizing, and labeling teachers has caused emotional stress in transforming what it’s meant to be a teacher. The literature review results were based on one research question: Why do teachers still comply with neoliberal performative techniques? The literature search was based on the following primary keywords such as “teacher performativity,” “teacher + neoliberalism”, and “teacher + performance management”. The paper unravels that teachers are still complying with neoliberal performative techniques because it provides a stage to gain joy and social acknowledgment, which worked as a psychical motivating force persuading them to utilize them for their academic advantages.</jats:p

PERFORMANCE APPRAISAL SYSTEM AND TEACHER EFFECTIVENESS IN PUBLIC BASIC SCHOOLS IN GHANA

The secret to providing high-quality education in schools is the professionalism and diligence of teachers. Hence, teaching and learning can be improved through teacher appraisal. In light of Ghana’s Accountability for Learning Outcomes Project’s (GALOP) five-year plan that seeks to boost learning outcomes in underperforming basic education schools and increase transparency and accountability in the country’s education system, this empirical study sought to investigate the impact of the performance appraisal system on teacher effectiveness in public basic schools in Kwahu East district, in the Eastern Region of Ghana. This study used a quantitative, cross-sectional, descriptive, and correlational survey. Convenience sampling was used to sample 500 teachers and headteachers from the Basic school to participate in the study. SPSS version 26.0 and AMOS 23.0 were used for the statistical analyses. The findings of the study revealed that strengthening performance appraisal is a key element to improving teachers’ effectiveness which consequently improves students and school success, however, implementing performance management is the sure way to increase productivity and accountability in schools as it allows for a more all-encompassing assessment of an employee’s performance by incorporating coaching, goal planning, looking ahead to future growth, and 360-degree feedback. Keywords: Ghana Education Service, Performance, Self-evaluation, Teacher Effectiveness Appraisal System, Performance Review