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Cost of hospitalization associated with inpatient goals-of-care program implementation at a comprehensive cancer center: a propensity score analysis
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Hui, David; Nortje, Nico; Huang, Yu-Ting
The impact of goals-of-care programs on acute hospitalization costs is unclear. We compared the hospitalization cost in an 8-month period before implementation of a multimodal interdisciplinary goals-of-care program (1 May 2019 to 31 December 2019) to an 8-month period after program implementation (1 May 2020 to 31 December 2020). Propensity score weighting was used to adjust for differences in potential covariates. The primary outcome was total direct cost during the hospital stay for each index hospitalization. This analysis included 6977 patients in 2019 and 5964 patients in 2020. The total direct cost decreased by 3% in 2020 but was not statistically significant (ratio 0.97, 95% CI 0.92, 1.03). Under individual categories, there was a significant decrease in medical oncology (ratio 0.58, 95% CI 0.50, 0.68) and pharmacy costs (ratio 0.86, 95% CI 0.79, 0.96), and an increase in room and board (ratio 1.06, 95% CI 1.01, 1.10). In subgroup analysis, ICU patients had a significant reduction in total direct cost after program implementation (ratio 0.83, 95% CI 0.72, 0.94).
Unveiling novel contrasting photosynthetic responses in medicago truncatula under combined drought stress and phoma medicaginis infection
(Taylor & Francis, 2024) Maiza, Nourhene; Ludidi, Ndiko; Mnafgui, Wiem
Forage legumes face simultaneous abiotic and biotic stresses, causing substantial yield losses. This study explores the combined impacts of drought and Phoma medicaginis infection on the growth and photosynthetic activity of Medicago truncatula contrasting lines TN6.18 and F83005.5. The tolerant TN6.18 line exhibits superior tolerance to combined drought and P. medicaginis infection, manifesting in minimal leaf area reduction, the highest number of healthy leaves, increased carotenoids content, a consistently high and stable photosynthesis rate, and enhanced performance of photosystems PSI and PSII. On the contrary, the sensitive F83005.5 line shows pronounced leaf chlorosis, particularly under drought stress, and decreased pigment levels under the combination of drought and P. medicaginis infection stresses (combined stress). Moreover, the drought-stressed F83005.5, experiences reduced hydration and photosynthetic performance, linked to diminished gas exchange and chlorophyll fluorescence parameters. Chlorophyll fluorescence revealed more severe PSI impairment than PSII under combined stress. In conclusion, understanding the Pm8 infection-drought interaction enhances insights into M. truncatula resistance mechanisms to the combination of these stresses.
Afriplex GRTTM extract attenuates hepatic steatosis in an in vitro model of NAFLD
(Public Library of Science, 2024) Gabuza, Kwazi; Mabuda, Thendo Innocent; Patel, Oelfah
Currently, it is acknowledged that vitamin E, insulin sensitizers and anti-diabetic drugs are used to manage non-alcoholic fatty liver disease (NAFLD), however, these therapeutic interventions harbour adverse side effects. Pioglitazone, an anti-diabetic drug, is currently the most effective therapy to manage NAFLD. The use of natural medicines is widely embraced due to the lack of evidence of their negative side effects. Rooibos has been previously shown to decrease inflammation and oxidative stress in experimental models of diabetes, however, this is yet to be explored in a setting of NAFLD. This study was aimed at investigating the effects of an aspalathin-rich green rooibos extract (Afriplex GRTTM) against markers of hepatic oxidative stress, inflammation and apoptosis in an in vitro model of NAFLD. Oleic acid [1 mM] was used to induce hepatic steatosis in C3A liver cells. Thereafter, the therapeutic effect of Afriplex GRTTM, with or without pioglitazone, was determined by assessing its impact on cell viability, changes in mitochondrial membrane potential, intracellular lipid accumulation and the expression of genes and proteins (ChREBP, SREBF1, FASN, IRS1, SOD2, Caspase-3, GSTZ1, IRS1 and TNF-α) that are associated with the development of NAFLD.
Feasibility of introducing digital music skills into South African primary school curriculum
(OpenJournals Publishing AOSIS (Pty) Ltd, 2024) Yende, Sakhiseni Joseph
BACKGROUND: As the global landscape of education evolves with digital advancements, the feasibility of integrating digital music skills into primary school curricula has become a subject of exploration, South Africa is no exception
AIM: This study aims to conduct a content analysis of the existing scholarly writings to assess the feasibility of infusing digital music skills into the curriculum of South African primary schools
SETTING: The research is conducted using content analysis, the inclusion of different South African public-school contexts allows for a comprehensive examination of the feasibility of digital music skills integration across varied environments
METHODS: The study uses a rigorous qualitative content analysis methodology, drawing on historical documents, archival materials and scholarly discourse
RESULTS: The study reveals nuanced insights into the cultural emphasis on music, historical disparities influencing resource distribution, the role of positive social interactions, challenges in curriculum alignment and the imperative for teacher professional development in the context of digital music skills integration
CONCLUSION: Findings underscore the importance of a balanced and culturally sensitive approach to curriculum development, highlighting the need for tailored strategies that address historical inequalities and promote collaborative efforts
CONTRIBUTION: This article enhances music education by integrating digital technologies, offering virtual practice spaces, collaborative platforms and interactive opportunities. The incorporation of real-time feedback, specialised courses and immersive experiences through virtual and augmented reality not only boosts skill development but also readies students for contemporary music careers
Covid-19 demography in France and South Africa: a comparative study of morbidity and mortality in 2020–2022
(Public Library of Science, 2024) Garenne, Michel; Stiegler, Nancy
Background Covid-19 epidemics raged around the world in years 2020–2022. The dynamics of the epidemics and their mortality varied by country depending on prevention, treatments, vaccination and health status of the population. Objective The study compares Covid-19 morbidity and mortality in South-Africa and in France, two countries with similar population size and with reliable reporting systems, in order to better understand the dynamics and impacts of the epidemics and the effects of health policies and programs. Data and methods Data on cases, deaths, hospitalizations, vaccinations were drawn from national statistics. Published data on cases and deaths were corrected for undercount. Results Results show a different epidemiology in the two countries in the first three years of the epidemic (2020–2022). Incidence was higher in South Africa, and some 44% more people were infected by December 2022 than in France. Mortality and case-fatality were also higher in South Africa despite a favourable age structure. The age pattern of mortality showed higher values in South Africa among the young adults. Young women appeared somewhat disadvantaged in South Africa. Lastly, vaccination appeared to have had no effect on incidence, but a large effect on case-fatality in France. Conclusions Despite about the same population size and the same crude death rate at baseline, South Africa exhibited more cases and more deaths from Covid-19 over the 2020–2022 period. Prevention strategies (lockdown and vaccination) appear to have had large impacts on morbidity and mortality.