Publications by authors named "Manda S"

Background: The majority of phase 3 clinical trials are implemented in multiple sites or centres, which inevitably leads to a correlation between observations from the same site or centre. This correlation must be carefully considered in both the design and the statistical analysis to ensure an accurate interpretation of the results and reduce the risk of biased results. This scoping review aims to provide a detailed statistical method used to analyze data collected from multicentre HIV randomized controlled trials in the African region.

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Multivariate spatial data are commonly modelled using the shared spatial component and multivariate intrinsic conditional autoregressive (MICAR) models where the spatial random variables are assumed to be normally distributed. However, the normality assumption may not be always right as the spatially structured component may show non-normal distributions. We present, multivariate skew-normal spatial distribution in the modelling of multivariate conditional autoregressive models.

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Article Synopsis
  • The study investigates the spatial trends of cattle bovine tuberculosis (BTB) and human extrapulmonary tuberculosis (EPTB) and drug-resistant tuberculosis (DRTB) in Malawi to enhance disease control strategies.
  • Data from 2018 to 2022 was analyzed using multivariate disease mapping methods, which found that while specific disease patterns were more common in southern Malawi, shared effects were also significant in both southern and western regions.
  • The results suggest a correlation between cattle and human disease densities and highlight the potential for integrated interventions targeting high-density areas to improve outcomes for both cattle BTB and human EPTB/DRTB.
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Significance: People with peripheral field loss report colliding with other pedestrians on their blind side(s). We show that, in dyadic collision scenarios between persons, one with field loss, such as homonymous hemianopia, and the other normally sighted pedestrian, collisions occur only if the persons with homonymous hemianopia are overtaking the pedestrians, and the collision risk is concentrated at farther bearing angles than previously suggested.

Purpose: Prior work computed the risk of collision while simulating both pedestrians as points and did not consider the ability of the other pedestrian's normal vision to avoid the collision.

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Article Synopsis
  • The study examines the low implementation of the WHO's recommended Advanced HIV Disease screening in resource-limited settings, noting that over 50% of newly diagnosed HIV clients are not screened due to various barriers.
  • Researchers conducted focus group discussions with healthcare providers at a hospital in Malawi to identify strategies that could improve the uptake of this screening.
  • They identified 6 primary strategies with high expert endorsement and 4 secondary strategies, focusing on improving resource availability, simplifying the intervention, enhancing access to information, and fostering better communication among healthcare stakeholders.
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Background: Childhood stunting is a major indicator of child malnutrition and a focus area of Global Nutrition Targets for 2025 and Sustainable Development Goals. Risk factors for childhood stunting are well studied and well known and could be used in a risk prediction model for assessing whether a child is stunted or not. However, the selection of child stunting predictor variables is a critical step in the development and performance of any such prediction model.

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Background: Computer-aided detection (CAD) can help identify people with active tuberculosis left undetected. However, few studies have compared the performance of commercially available CAD products for screening in high tuberculosis and high HIV settings, and there is poor understanding of threshold selection across products in different populations. We aimed to compare CAD products' performance, with further analyses on subgroup performance and threshold selection.

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Significance: Performance-based outcome measures are crucial for clinical trials of field expansion devices. We implemented a test simulating a real-world mobility situation, focusing on detection of a colliding pedestrian among multiple noncolliding pedestrians, suitable for measuring the effects of homonymous hemianopia and assistive devices in clinical trials.

Purpose: In preparation for deploying the test in a multisite clinical trial, we conducted a pilot study to gather preliminary data on blind-side collision detection performance with multiperiscopic peripheral prisms compared with Fresnel peripheral prisms.

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Due to ongoing ocean warming, subtropical environments are becoming accessible to tropical species. Among these environments are the vermetid reefs of the Southeastern Mediterranean (SEM). In the last decades, these valuable coastal habitats witnessed the proliferation of numerous alien species of tropical origin.

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Venetoclax, a highly selective BCL-2 inhibitor, combined with hypomethylating agents (HMAs) azacitidine or decitabine, is approved for the treatment of newly diagnosed acute myeloid leukemia (ND AML) in patients who are ineligible to receive intensive chemotherapy. Previous clinical studies initiated venetoclax plus HMA in an inpatient setting owing to concerns of tumor lysis syndrome (TLS). This study (NCT03941964) evaluated the efficacy and safety of venetoclax plus HMA in a United States community-based outpatient setting in patients with ND AML (N = 60) who were treatment naïve for AML, ineligible to receive intensive chemotherapy, had no evidence of spontaneous TLS at screening, and were deemed as appropriate candidates for outpatient initiation of venetoclax plus HMA by the investigator.

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Modern analytical tools, from microfocus X-ray diffraction (XRD) to electron microscopy-based microtexture measurements, offer exciting possibilities of diffraction-based multiscale residual strain measurements. The different techniques differ in scale and resolution, but may also yield significantly different strain values. This study, for example, clearly established that high-resolution electron backscattered diffraction (HR-EBSD) and high-resolution transmission Kikuchi diffraction (HR-TKD) [sensitive to changes in interplanar angle (Δθθ)], provide quantitatively higher residual strains than micro-Laue XRD and transmission electron microscope (TEM) based precession electron diffraction (PED) [sensitive to changes in interplanar spacing (Δdd)].

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Glioblastoma multiforme (GBM) is the most aggressive type of glioma and is often resistant to traditional therapies. Evidence suggests that glioma stem cells (GSCs) contribute to this resistance. Mithramycin (Mit-A) targets GSCs and exhibits antitumor activity in GBM by affecting transcriptional targets such as SRY-related HMG-box transcription factor 2 (SOX2), oligodendrocyte lineage transcription factor 2 (OLIG2), and zinc finger E-box binding homeobox 1 (ZEB1).

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Objectives: The aim of this pilot study is to identify the genetic factors that contribute to the response of metronomic chemotherapy in head and neck squamous cell carcinoma (HNSCC) patients using whole-exome sequencing (WES). This study would facilitate the identification of predictive biomarkers, which would enable personalized treatment strategies and improve treatment outcomes for patients with HNSCC.

Materials And Methods: We have selected patients with recurrent head and neck cancer who underwent metronomic chemotherapy.

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Introduction: The identification of classes of nutritionally similar food items is important for creating food exchange lists to meet health requirements and for informing nutrition guidelines and campaigns. Cluster analysis methods can assign food items into classes based on the similarity in their nutrient contents. Finite mixture models use probabilistic classification with the advantage of taking into account the uncertainty of class thresholds.

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Population-based serological testing is important to understand the epidemiology and estimate the true cumulative incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to inform public health interventions. This study reports findings of a national household population SARS-CoV-2 serosurvey in people 12 years and older in South Africa. This cross-sectional multi-stage random stratified cluster survey undertaken from November 2020 to June 2021 collected sociodemographic data, medical history, behavioural data, and blood samples from consenting participants.

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Long-term proteasome inhibitor (PI) treatment can improve multiple myeloma (MM) outcomes, but this can be difficult to achieve in clinical practice due to toxicity, comorbidities, and the burden of repeated parenteral administration. US MM-6 (NCT03173092) enrolled transplant-ineligible patients with newly diagnosed MM to receive all-oral ixazomib-lenalidomide-dexamethasone (IRd; ≤39 cycles or until progression or toxicity) following three cycles of bortezomib-based induction. Primary endpoint: 2-year progression-free survival (PFS).

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Biological membrane channels mediate information exchange between cells and facilitate molecular recognition. While tuning the shape and function of membrane channels for precision molecular sensing via de-novo routes is complex, an even more significant challenge is interfacing membrane channels with electronic devices for signal readout, which results in low efficiency of information transfer - one of the major barriers to the continued development of high-performance bioelectronic devices. To this end, we integrate membrane spanning DNA nanopores with bioprotonic contacts to create programmable, modular, and efficient artificial ion-channel interfaces.

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The gut microbiota has emerged as a key human health and disease determinant. However, there is a significant knowledge gap regarding the composition, diversity, and function of the gut microbiota, specifically in the African population. This scoping review aims to examine the existing literature on gut microbiota research conducted in Africa, providing an overview of the current knowledge and identifying research gaps.

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Background And Aims: Reduction of alcohol consumption is important for people undergoing treatment for HIV. We tested the efficacy of a brief intervention for reducing the average volume of alcohol consumed among patients on HIV antiretroviral therapy (ART).

Design, Setting And Participants: This study used a two-arm multi-centre randomized controlled trial with follow-up to 6 months.

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Background: In sub-Saharan Africa (SSA), adolescent girls and young women (AGYW) have the highest risk of acquiring HIV. This has led to several studies aimed at identifying risk factors for HIV in AGYM. However, a combination of the purported risk variables in a multivariate risk model could be more useful in determining HIV risk in AGYW than one at a time.

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Article Synopsis
  • Rapid on-site evaluation (ROSE) is key in diagnosing thyroid diseases, especially for identifying thyroid lymphoma and ensuring unnecessary surgeries are avoided.* -
  • A case study involved a 45-year-old male with neck swelling, where ROSE indicated a malignant thyroid neoplasm, later confirmed as B-cell Non-Hodgkin lymphoma through further testing.* -
  • Primary thyroid lymphomas are rare, making up less than 5% of thyroid cancers; ROSE not only aids in quick diagnosis but also helps minimize invasive procedures like biopsies.*
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Unlabelled: An adequate supply of energy, micronutrients and macronutrients is essential to achieve food and nutrition security to prevent malnutrition. Socio-economic, political, and climatic events, however, can affect the supply of food and nutrients. We assessed country-level supply trends of food and nutrients and their sources within the context of policy changes and political, socio-economic and climatic events from 1961 to 2013 in Zambia.

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We describe coverage of maternal syphilis screening, syphilis positivity, coverage of treatment and their association with maternal HIV infection and antiretroviral treatment (ART) status among pregnant women attending South African antenatal clinics. The 2019 antenatal care sentinel survey was a cross-sectional survey conducted from 1 October to 15 November 2019 at 1589 sentinel sites in all nine provinces of the country and aimed to enrol 36,000 pregnant women ages 15-49 years regardless of HIV, ART or syphilis status. Data collection procedures included obtaining written informed consent, a brief interview, medical record review and blood specimen collection.

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