Potential of herbaceous plant species for copper (Cu) accumulation.

The removal of copper (Cu) in soils by green technology is less treated with urgency, as it is a plant micronutrient. We examined the efficiency of Cu shoot accumulation by herbaceous plants in Cu-contaminated and non-contaminated soils in Trhové Dusniky and Podles, respectively, in the Czech Republic. The total soil Cu content of 81 mg kg-1 in Trhové Dusniky indicated a slight contamination level compared to 50 mg kg-1, the permissible value by WHO, and < 35 in Podlesí, representing a clean environment. The Cu content was above the permissible value in plants (10 mg kg-1 by WHO) in herbaceous speciesat the control site without trees: Stachys palustris L. (10.8 mg kg-1), Cirsium arvense L. (11.3 mg kg-1), Achillea millefolium L. (12.1 mg kg-1), Anthemis arvense L. (13.2 mg kg-1), and Calamagrostis epigejos L. (13.7 mg kg-1). In addition, Hypericum maculatum Crantz (10.6 mg kg-1), Campanula patula L. (11.3 mg kg-1), C. arvense (15 mg kg-1), and the highest accumulation in shoot of Equisetum arvense L. (37.1 mg kg-1), all under the canopy of trees at the uncontaminated site, were above the WHO value. Leucanthemum Vulgare (Lam.) and Plantago lanceolata L. recorded 11.2 mg kg-1 and 11.5 mg kg-1, respectively, in the soil of the Cu-contaminated site. These herbaceous species can support the phyto-management of Cu-contaminated soils, especially E. arvense. Critical attention is well-required in the medicinal application of herbaceous plants in treating human ailments due to their Cu accumulation potentials above the threshold. Spontaneous surveys and analysis of Cu speciation in herbaceous species can reveal suitable plants to decontaminate soils and provide caution on consumable products, especially bioactive compounds.

Hospitalization Trends and Outcomes of Eosinophilic Esophagitis in the United States: A Decade-Long Nationwide Analysis.

Background Eosinophilic esophagitis (EoE) is a chronic antigen-mediated esophageal disease characterized by infiltration of the esophageal mucosa by eosinophils. The prevalence of EoE continues to rise worldwide. However, certain aspects of the epidemiology and pathogenesis remain unclear. Methods This study examined the hospitalization trends of EoE using an extensive inpatient database in the United States, the National (Nationwide) Inpatient Sample (NIS), to identify hospitalizations between 2010 and 2019. We assessed patient demographics as well as hospital-specific variables using the NIS. We obtained the prevalence rate of EoE for each year and used joinpoint regression analysis to obtain trends after adjusting the rate for age and gender. We also sought to characterize the outcomes of these hospitalizations by obtaining the mortality rate, length of stay (LOS), and total hospital charges (THC). Results Of 305 million hospitalizations included in the study, 33,878 were for EoE. The prevalence rate per 100,000 hospitalizations of EoE increased from 6.6 in 2010 to 15.5 in 2019. The annual percentage change obtained from the joinpoint regression analysis was 13.3% from 2010 to 2014 and 7.2% from 2014 to 2019. Most of the hospitalizations were among the male gender and young adults. Almost 95% of hospitalizations across the study period were seen in urban hospitals. We did not notice any significant trend in the mortality rates or length of stay over the study period. The THC increased significantly across the study period. Conclusion There has been an upward trend in the average prevalence rate of EoE over the decade from 2010 to 2019 which almost parallels that of inflammatory bowel disease. This represents a significant burden of disease for a condition that was initially recognized in the late 20th century.

The fate of secondary metabolites in plants growing on Cd-, As-, and Pb-contaminated soils-a comprehensive review.

The study used scattered literature to summarize the effects of excess Cd, As, and Pb from contaminated soils on plant secondary metabolites/bioactive compounds (non-nutrient organic substances). Hence, we provided a systematic overview involving the sources and forms of Cd, As, and Pb in soils, plant uptake, mechanisms governing the interaction of these risk elements during the formation of secondary metabolites, and subsequent effects. The biogeochemical characteristics of soils are directly responsible for the mobility and bioavailability of risk elements, which include pH, redox potential, dissolved organic carbon, clay content, Fe/Mn/Al oxides, and microbial transformations. The radial risk element flow in plant systems is restricted by the apoplastic barrier (e.g., Casparian strip) and chelation (phytochelatins and vacuole sequestration) in roots. However, bioaccumulation is primarily a function of risk element concentration and plant genotype. The translocation of risk elements to the shoot via the xylem and phloem is well-mediated by transporter proteins. Besides the dysfunction of growth, photosynthesis, and respiration, excess Cd, As, and Pb in plants trigger the production of secondary metabolites with antioxidant properties to counteract the toxic effects. Eventually, this affects the quantity and quality of secondary metabolites (including phenolics, flavonoids, and terpenes) and adversely influences their antioxidant, antiinflammatory, antidiabetic, anticoagulant, and lipid-lowering properties. The mechanisms governing the translocation of Cd, As, and Pb are vital for regulating risk element accumulation in plants and subsequent effects on secondary metabolites.

What alternative and innovative domestic methods of healthcare financing can be explored to fix the current claims reimbursement challenges by the National Health Insurance Scheme of Ghana? Perspectives of health managers.

BACKGROUND: Low-and-middle -income countries (LMICs), to achieve sustainable universal health coverage (UHC) governments are implementing local and sustainable methods of healthcare financing. However, in Ghana, there is limited evidence on these local methods for healthcare financing to inform policy. This study aimed at exploring health managers views on alternative domestic and sustainable methods of healthcare financing for UHC under the National Health Insurance Scheme (NHIS). METHODS: A qualitative study using in-depth interviews with 16 health facility managers were held. The health facilities and participants were selected using convenience and purposive sampling methods. A written consent was obtained from participants prior to participation in the interview. Data was transcribed verbatim and analyzed using thematic framework approach. RESULTS: Health managers across all the health facilities mentioned delayed and erratic claims reimbursement to health facilities as the main challenge. Participants attributed the main reason to lack of funds by the National Health Insurance Authority (NHIA). They said the delayed and irregular payments has been a challenge to efficient delivery of quality healthcare to clients. That in some instances they have been compelled to demand cash or out-of-pocket payment from insured clients or insurance card bearers to be able to render needed healthcare services to them. Participants think that to ensure regular reimbursement of claims to the health facilities by the NHIA, the managers think alternative local sources of funding need to be explored to fill the funding gap. To put in place this, they suggested the need to start levying special taxes on natural resources such as crude oil and gas, gold, bauxite, cocoa, mobile money transfers, airtime and increasing the proportion of levies on the existing Value Added Tax (VAT). CONCLUSION: The study provides important insights into potential innovative alternative domestic sources for raising additional funds to finance healthcare services in Ghana. Despite the potential of these sources, it is important for governments and health policy makers in Ghana and other LMICs who are working towards implementing innovative local methods using special levies on mobile communication services and natural resources to finance their UHC, to implement those that best suit their economies to ensure equity for better health.

Association between pulmonary function and cardiac enzymes in sickle cell disease.

BACKGROUND: There is scarcity of data on association between lung function and cardiac markers in patients with sickle cell disease (SCD). Meanwhile, SCD affects multi-organs in any one population. There seem to be an association between reduced pulmonary function with cardiac dysfunction. The current study examined the association between pulomanry function with cardiac markers in patients with SCD. METHODOLOGY: This was a cross-sectional study with cases and controls. The cases (n=117) were made up of patients with SCD. The control subjects (n=58) were voluntary blood donors without SCD. The cellulose acetate electrophoresis was used to determine the genotypes of the study subjects. Blood samples were collected from all the study subjects for full blood count and measurement of cardiac enzymes. The cardiac enzymes measured were lactate dehydrogenase (LDH) and creatine kinase-myocardial band (CK-MB). Lung function test, using the vitalograph was done on all the study subjects. The Global Lung Initiative criteria were used to categorize lung disease as obstruction, restriction, mixed obstruction/restriction and normal. RESULTS: The prevalence of elevated CK-MB and LDH among the SCD patients was 76.92% and 9.40% respectively, higher than the non-SCD controls (51.72% and 0% for elevated CK-MB and LDH respectively). Of all the impaired lung function, lung restriction was prevalent in all the study groups (30.77% and 15.52% for SCD patients and non-SCD controls respectively). In the fully adjusted model, reduced FEV1 was associated with nearly 3.5-fold higher odds of elevated CK-MB (odds ratio 3.35, 95% CI 1.26-8.90, p-value 0.015) in individuals with SCD. CONCLUSION: Reduced FEV1 which reflects airflow impairments are associated with CK-MB elevations in patients with SCD, suggesting a possible damage to the cardiomyocytes.

Exercise-induced haemoglobin oxygen desaturation in patients with SCD.

BACKGROUND: Patients with sickle cell disease (SCD) may experience severe clinical complications when there is low tissue oxygenation due to the increased risk of the polymerization of haemoglobin S in deoxygenated environment. The predictors of oxygen desaturation after exercise is not clear in patients with SCD. The current study compared lung function and six-minute walk test (6MWT) between SCD patients with oxygen desaturation after exercise and those without oxygen desaturation. METHODOLOGY: A cross-sectional study was conducted among adults with SCD (with HbSS and HbSC genotypes) at a large tertiary hospital in Accra, Ghana. Lung function and exercise tolerance (using the 6MWT) were performed for all the study subjects (n=119). Venous blood was collected from all the study subjects for determination of some haemolytic markers. Oxygen saturation was assessed before and after the 6MWT for all the study subjects, and individuals who had oxygen desaturation of ≥3% after the 6MWT were considered as having exercise-induced haemoglobin oxygen desaturation (EIHOD). The lung function and 6MWT were compared between these two groups. Predictors of EIHOD were determined in both HbSC and HbSS patients. RESULTS: The prevalence of EIHOD in the HbSS and HbSC adults were 41% and 36.1% respectively. Haemoglobin, aspartate amino transaminase, indirect bilirubin, lactate dehydrogenase and six-minute walk distance did not differ in both HbSS and HbSC patients. Decreasing haemoglobin is a predictor of EIHOD in HbSC adults but not HbSS patients. Lung function abnormalities did not predict EIHOD in both HbSS and HbSC patients. CONCLUSION: The study demonstrates that SCD patients with EIHOD have similar degree of haemolysis and lung function when compared to those without EIHOD.

Effects of physicochemical properties of Au cyanidation tailings on cyanide microbial degradation.

The initial cyanide (CN-) concentration and amount of co-contaminants in GCTs can inhibit bacterial growth and reduce the CN--degrading ability of bacteria. Several microorganisms can biotransform a wide range of organic and inorganic industrial contaminants into nontoxic compounds. However, active enzymatic CN- metabolism processes are mostly constrained by the physical and chemical characteristics of GCTs. High concentrations of toxic metal co-contaminants, such as, Pb, and Cr, and factors, such as pH, temperature, and oxygen concentration create oxidative stress and limit the CN--degrading potential of cyanotrophic strains. The effects of such external and internal factors on the CN--degrading ability of bacteria hinder the selection of suitable microorganisms for CN- biodegradation. Therefore, understanding the effects of the physicochemical properties of GCTs on cyanobacteria strains can help identify suitable microbes and favorable environmental conditions to promote microbial growth and can also help design efficient CN- biodegradation processes. In this review, we present a detailed analysis of the physicochemical properties of GCTs and their effects on microbial CN- degradation.

Post-Vaccination Streptococcus pneumoniae Carriage and Virulence Gene Distribution among Children Less Than Five Years of Age, Cape Coast, Ghana.

In 2012, Ghana introduced PCV13 into its childhood immunization program. To monitor the pneumococcus after PCV13 vaccination, we analyzed serotypes, antibiotic resistance, and virulence genes of pneumococcal carriage isolates among children under five years of age. We obtained nasopharyngeal swabs from 513 children from kindergartens and immunization centers in Cape Coast, Ghana. Pneumococcal serotypes were determined by multiplex-PCR and Quellung reaction. Antibiotic resistance and virulence genes prevalence were determined by disc diffusion and PCR respectively. Overall, carriage prevalence was 29.4% and PCV13 coverage was 38.4%. Over 60% of the isolates were non-PCV13 serotypes and serotype 23B was the most prevalent. One isolate showed full resistance to penicillin, while 35% showed intermediate resistance. Resistance to erythromycin and clindamycin remained low, while susceptibility to ceftriaxone, levofloxacin and vancomycin remained high. Penicillin resistance was associated with PCV13 serotypes. Forty-three (28.5%) strains were multidrug-resistant. Virulence genes pavB, pcpA, psrP, pilus-1, and pilus-2 were detected in 100%, 87%, 62.9%, 11.9%, and 6.6% of the strains, respectively. The pilus islets were associated with PCV13 and multidrug-resistant serotypes. PCV13 vaccination had impacted on pneumococcal carriage with a significant increase in non-PCV13 serotypes and lower penicillin resistance. Including PcpA and PsrP in pneumococcal protein-based vaccines could be beneficial to Ghanaian children.

Use of Local Ecological Knowledge to Detect Declines in Mammal Abundance in Kogyae Strict Nature Reserve, Ghana.

The scarcity of environmental data means that other sources of information are needed to complement empirical evidence for conservation decisions. We, therefore, aimed to explore Local Ecological Knowledge (LEK) on mammal abundance and qualitative population trends through interviews from 331 local people in and around Kogyae Strict Nature Reserve, Ghana. The results show that 62% of the respondents perceived that mammal abundances had decreased, 31% perceived stability, and 8% perceived that mammals had increased between 2006 and 2017. The respondents attributed the decline to habitat degradation and illegal hunting. The knowledge of local people about mammal population trends is consistent with reported mammal encounters by law enforcement rangers. However, the length of residence, location of communities, and cardinal direction of communities influenced local peoples' knowledge of mammal abundance and population trends. Our results highlight the ability of LEK to provide reliable ecological information on animal abundance and qualitative population trends. Integrating LEK into monitoring and management is appealing because it can be cost-effective, enhance community participation, and provide novel insights into sustainable resource use.

Epidemiology of Pneumococcal Carriage among HIV-Infected Individuals in the Conjugate Vaccine Era: A Study in Southern Ghana.

Carriage of pneumococcus is considered as the precursor for development of pneumococcal disease. In sub-Saharan Africa, very little research has been done on the pneumococcus in relation to people with HIV infection in the era of pneumococcal conjugate vaccines. This study investigated pneumococcal carriage among HIV/AIDS patients in southern Ghana to determine the prevalence, risk factors, serotypes and antibiotic resistance of the organism. This was a cross sectional study involving 245 HIV/AIDS patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from November 2016 to March 2017. Epidemiological data on demographic, household and clinical features of the study participants were collected. Nasopharyngeal (NP) swabs were also collected from the study participants and cultured for Streptococcus pneumoniae; the isolates were serotyped by latex agglutination and Quellung reaction. Antimicrobial disc susceptibility was performed on the isolates, and antibiotics tested included tetracycline, erythromycin, cotrimoxazole, levofloxacin, oxacillin and ceftriaxone. Prevalence of pneumococcal carriage among the study participants was 11% (95% CI: 7.4 to 15.6); carriage among children and adults was 25% (95% CI: 14% to 38.9%) and 7.3% (95% CI: 4% to 11.9%) respectively. School attendance (p=0.001) and history of pneumococcal disease in the past year (p=0.001) were significantly associated with pneumococcal carriage. The most prevalent pneumococcal serotypes carried by the study participants were 19A (15.4%) and 23F (15.4%). Serotype coverage of the various pneumococcal vaccines were PCV10 (23.1%), PCV13 (42.3%) and PPV23 (50%). The prevalence of pneumococcal multidrug resistance was 18.5%. In conclusion, pneumococcal carriage among HIV-infected children was three-fold higher compared to carriage among HIV-infected adults. Pneumococcal carriage among both HIV-infected children and adults in the study area tends to be characterized by a predominance of non-vaccine serotypes and a considerable level of multidrug resistance.