Sefako Makgatho Health Sciences University

Background Sociodemographic characteristics can influence the burden of caring for patients with mental illnesses such as schizophrenia. Aim The aim of this study was to ascertain the sociodemographic characteristics implicated in severe caregiver burden among family caregivers of patients with schizophrenia. Methods Over 3 months, 300 caregivers of patients with schizophrenia were consecutively recruited at the psychiatry outpatient department in a tertiary hospital in Gauteng province, South Africa. The sociodemographic characteristics of the caregivers were ascertained. The 22-item Zarit Burden Interview (ZBI-22) was administered to the participants to measure the caregiver burden. Results The range of ZBI-22 was 0–75 with a median of 19.00 (interquartile range [IQR]: 13.0–30.5). Severe burden occurred in 2.33% (7/300) of the participants. The sociodemographic characteristics that had the highest percentage amongst those with the severe burden (and their median burden score plus IQR) were increasing duration of caregiving 132.0 (72.0–264.0), residing in Northern Gauteng 17.0 (13.0–30.0), age ≥50 years 28.0 (18.0–36.0), female 23.5 (15.0–34.0), married 23.5 (17.0–31.0), parent 27.0 (16.0–36.0), living with the patient 20.0 (14.0–31.0), medical comorbidity 18.5 (14.0–31.0), secondary education 19.0 (13.0–29.0) and having another family member that requires care 27.0 (17.0–42.0). Conclusion Caregivers with the implicated characteristics require periodic evaluation of their burden of care to offer them available support including referral to appropriate socioeconomic agencies. A future research agenda is to investigate how these characteristics contribute to the burden of care in the study setting. Contribution An array of sociodemographic characteristics is implicated in severe caregiver burden and their interactions in the study setting need further investigation.

Predicting cryptocurrency prices is challenging due to market volatility and external influences like social media sentiment. This study integrates Twitter sentiment analysis with deep learning models (LSTM, GRU, Bi-LSTM, and Temporal Attention Model) to enhance Bitcoin price forecasting. Sentiment features were extracted using VADER and RoBERTa, with findings showing that RoBERTa-based models significantly outperform VADER. Bi-LSTM (RoBERTa) achieved the lowest MAPE of 2.01%, demonstrating the effectiveness of deep contextual embeddings. SHAP analysis identified Sentiment Momentum, RoBERTa Compound Score, and VADER Negativity Score as key predictors of price movements. These results highlight the value of sentiment-driven forecasting and provide insights for traders, investors, and researchers.

This paper explores an optimal control problem of weakly coupled abstract hyperbolic systems with missing initial data. Hyperbolic systems, known for their wave‐like phenomena and complexity, become even more challenging with weak coupling between subsystems. The study introduces no‐regret and low‐regret control strategies to handle missing information and achieve optimal performance. By deriving the Euler–Lagrange optimality system, it characterizes these control approaches in the context of weak coupling. Additionally, the paper establishes the existence and uniqueness of a no‐regret and low‐regret control, emphasizing the influence of uncertain coupling parameters. These findings are optimal control strategies for abstract weakly coupled hyperbolic systems under uncertainty. Finally, as highlighted in our conclusion, future research could explore integrating memory effects through fractional derivatives to improve the modeling of viscoelasticity, diffusion with memory, and wave damping.

The main objective of the present paper is to establish the existence and uniqueness of solutions for the fractional Langevin equation involving the ϕ-Caputo fractional operator with nonlocal boundary conditions. The Langevin differential equation can accurately depict many physical phenomena and help researchers effectively represent anomalous diffusion. This paper considers a fractional Langevin differential equation, including the ϕ-Caputo fractional operator. Furthermore, some novel boundaries are selected to be considered as a problem. The existence of the solution is obtained by applying a fixed point theorem, and the uniqueness of the solution is obtained by using the Banach contraction mapping principle to the considered problem. Moreover, we discuss the Hyres-Ulam stability result. The manuscript is concluded with an illustrative example to corroborate the reported results. This study extends and generalizes various results in the literature and provides new insights into the qualitative behavior of fractional differential systems.

This paper introduces an inertial spectral algorithm for solving monotone nonlinear equations, building upon prior developments in spectral methods for unconstrained optimization problems. Previous approaches introduced new spectral parameters and addressed such problems using a modified secant condition and quasi‐Newton directions. We modify the search direction and integrates an inertial technique to improve numerical efficiency. The proposed method consistently ensures that the search direction satisfies the sufficient descent property independent of the method's line‐search. We establish global convergence and a linear convergence rate under some standard assumptions. Extensive numerical experiments demonstrate the algorithm's strong performance, especially for large‐scale problems. We also showcase its practical applications in logistic regression, a key model in data analysis, and sparse signal recovery, a prominent area in signal processing. The results emphasize the method's superior efficiency and effectiveness in these fields.

This study examines traveling wave solutions of the SIS epidemic model with nonlocal dispersion and delay. The research shows that a key factor in determining whether traveling waves exist is the basic reproduction number $R_{0}$. In particular, the system permits nontrivial traveling wave solutions for $\sigma \geq \sigma ^{*}$ for $R_{0} > 1$, whereas there are no such solutions for $\sigma < \sigma ^{*}$. This is because there is a minimal wave speed $\sigma ^{*}> 0$. On the other hand, there are no traveling wave solutions when $R_{0} \leq 1$. In conclusion, we provide several numerical simulations that illustrate the existence of TWS.

The current work focuses on the dispersive concatenation model, which is a framework used to describe the interaction of multiple dispersive effects. In this study, polarization mode dispersion is analyzed in the presence of multiplicative white noise, which affects both polarization components of the system. Using the F F -expansion method, a comprehensive analysis is carried out, revealing a broad spectrum of optical solitons, including various forms such as bright, dark, and singular solitons, as well as complexiton solutions. The investigation shows that despite the presence of white noise, its influence remains restricted primarily to the phase components of the two polarized modes, without significantly altering the amplitude or the fundamental nature of the solitons. This indicates that the soliton structures are robust against the noise, preserving their shape and energy profiles while experiencing phase shifts.

Ovarian cancer presents a significant public health challenge, often being diagnosed at advanced stages due to the limitations of current detection methods. This systematic review addresses the urgent need for innovative approaches to enhance early detection and diagnosis of ovarian cancer. We systematically evaluate recent advancements in nanotechnology, focusing specifically on their novel applications and potential in comparison to traditional diagnostic modalities. Our analysis encompasses a wide range of studies investigating nanoparticles, biosensors, advanced imaging techniques, and biomarker detection platforms, with an emphasis on evaluating key performance indicators such as detection rates, turnaround times, and the accuracy of distinguishing cancerous from non-cancerous tissues. Our findings indicate that nanotechnology-based approaches have the potential to significantly improve early detection capabilities for ovarian cancer. Notably, studies on nanoparticle-based imaging techniques and biosensors consistently demonstrate high sensitivity and specificity for identifying ovarian cancer biomarkers, with detection rates exceeding 90% reported for early-stage cancers in several instances. This review underscores the promise of emerging nanotechnologies to transform the landscape of early detection and diagnosis, offering a pathway toward earlier diagnoses, enhanced therapeutic interventions, and improved patient outcomes. We advocate for future research dedicated to the translational efforts required to move these technologies from bench to bedside, ensuring their effectiveness is validated across diverse clinical populations.

Introduction: Clinical pharmacists are crucial for optimizing medication therapy and improving patient outcomes, yet their potential is underutilized in many low- to middle-income countries. Shifting from traditional dispensing to clinical roles requires professional development and identity transformation. In South Africa’s public healthcare system, this shift faces additional challenges, such as a lack of formal positions, limited resources, and role ambiguity. Understanding how clinical pharmacists navigate this transition and develop their clinical identity is essential for their integration into healthcare teams and for improving patient care. Methods: Using a constructivist approach, this qualitative study employed semi-structured interviews with clinical pharmacists (n = 12) across South Africa’s public healthcare sector. We analyzed data through the lens of boundary crossing. Through thematic analysis we explored how pharmacists navigate the complexities of transitioning from dispensing to broader clinical roles, and how these experiences shape their professional identity. Results: Clinical pharmacists navigated both intrapersonal and interpersonal boundaries in their evolving roles. Three key themes were identified: (a) Bridging the gap within: Pharmacists navigate intrapersonal boundaries for clinical identity formation, (b) Bridging the gap between: Pharmacists navigate interprofessional boundaries for collaboration and identity formation, and (c) Building bridges: Pharmacists employ strategies to promote collaboration and recognition. Discussion: This study uncovered the complex interplay between intrapersonal boundaries – such as role ambiguity, self-doubt, reconciling traditional dispensing roles with expanded clinical responsibilities, and the need for mentorship – and interpersonal boundaries, including hierarchical structures, unclear role expectations, limited recognition, and challenges in interprofessional collaboration, in shaping clinical pharmacists’ identities. Fostering boundary crossing competence and interprofessional collaboration can help overcome systemic barriers, enabling pharmacists to navigate their roles, advocate for their expertise, and gain recognition within healthcare teams, ultimately enhancing their integration and improving patient care in resource-constrained settings like South Africa.

Background This study aims to quantify the frequency of insomnia symptoms in older individuals in the Philippines as well as its associated factors and the mediating role of body pain and depressive symptoms on insomnia symptoms. Methods There were 5209 cross‐sectional nationally representative data from the 2018 Longitudinal Study on Ageing and Health in the Philippines (LSAHP) pertaining to older persons (≥60 years) analysed in total. The Jenkins Sleep Scale was used to measure insomnia symptoms (JSS‐4). Results The prevalence of overall insomnia symptoms was 33.3%, and the prevalence of late insomnia symptoms was the highest (25.0%), followed by initial insomnia symptoms (15.2%), intermediate insomnia symptoms (14.7%), and daytime sleepiness (3.6%). In the final adjusted regression model, experiencing hunger (adjusted odds ratio (AOR): 1.73, 95% CI: 1.21–2.47), unmet healthcare need (AOR: 1.69, 95% CI: 1.16–2.48), taking care of grandchildren (AOR: 1.53, 95% CI: 1.09–2.15), poor self‐rated health (AOR: 1.58, 95% CI: 1.15–2.19), loneliness (AOR: 1.56, 95% CI: 1.06–2.28), depressive symptoms (AOR: 1.64, 95% CI: 1.19 to 2.25), and multimorbidity (AOR: 1.63, 95% CI: 1.18–2.26), were positively associated and daily prayers (AOR: 0.67, 95% CI: 0.51–0.90), and was negative associated with insomnia symptoms. In addition, respiratory illness (AOR: 1.65, 95% CI: 1.12–2.43) and arthritis, neuralgia or rheumatism (AOR: 1.50, 95% CI: 1.05–2.14) increased the odds of insomnia symptoms. Furthermore, there was a significant indirect effect of hunger (explaining 43.0%) and body pain (explaining 32.3%) on insomnia symptoms via depressive symptoms. Conclusion One in three older adults reported insomnia symptoms. Older age, stress factors and health status factors increased the odds and support factors decreased the odds of insomnia symptoms. Healthcare providers should be aware of the high associations between insomnia symptoms with various stress‐ and health‐related factors.

In this work, we propose some new Douglas-Rashford splitting algorithms for solving a class of generalized DC (difference of convex functions) in real Hilbert spaces. The proposed methods leverage the proximal properties of the nonsmooth component and a fasten control parameter which improves the convergence rate of the algorithms. We prove the convergence of these methods to the critical points of nonconvex optimization under reasonable conditions. We evaluate the performance and effectiveness of our methods through experimentation with three practical examples in machine learning. Our findings demonstrated that our methods offer efficiency in problem-solving and outperform state-of-the-art techniques like the DCA (DC Algorithm) and ADMM.

Objectives This study aimed to review health education and promotion interventions that will assist in mitigating the practise of geophagy to reduce the potential health risks, mortalities and morbidities that are linked to geophagic practise. Methods A scoping review was carried out guided by Arksey and O’Malley’s (2005) methodological framework and PRISMA reporting flowchart. Results This scoping review found that health education and promotion interventions focusing on geophagy, nutrition, the uptake of iron and folic acid supplements, the potential health risks of geophagy, anaemia risk during pregnancy, oral and intravenous iron therapy and randomised trials are some of the methods that are currently used to prevent and control the practise of geophagy amongst women of reproductive age at antenatal care units, school and community level. Conclusion It is concluded that the existing health education and promotion interventions that can assist women of reproductive age to cease the practise of geophagia are not effective. More emphasis should be given to the establishment of health education awareness programmes on the practise of geophagy, nutrition, and iron and folic acids uptake at community level.

Background: Medical litigations are rising and becoming a global challenge. The multilayered demands of midwifery-related conditions and the multiple responsibilities of the midwifery team contribute to possible litigations. Midwife specialists in South Africa are trained to provide specialised midwifery care to improve outcomes for patients with midwifery-related complications. While midwife specialists are equipped with specialised knowledge and skills, no specific practice regulations exist to protect them against possible medical litigations.Aim: The study aimed to explore and describe medico-legal experts’ experiences of midwife specialists optimally utilising their knowledge and skills.Setting: The context of the study is the public and private sectors of South Africa.Methods: A qualitative, descriptive and contextual research design was employed. Six medico-legal experts identified through a snowball sampling technique participated in virtual, semi-structured interviews. Data were analysed using Collaizi’s descriptive method.Results: Three themes with subthemes emerged. Results confirmed that medico-legal experts recognised the midwife specialists’ expanded knowledge and skill set. The medico-legal experts experienced a disconnect between training regulations and the current practice regulations. Midwife specialists’ practice was experienced as being guided by a moral obligation rather than prescribed regulations.Conclusion: Midwife specialists are yet to receive full legal recognition in South Africa, challenging midwife specialists’ assumption of autonomous and independent roles.Contribution: Midwife specialists face potential risk of involvement in medical litigations under the current legislative framework. The findings of this study may guide the formulation of a scope of practice (SOP) that legally guides midwife specialists’ practice in South Africa.

Objective Despite growing evidence linking 24-h movement behaviors to health outcomes, there is limited research examining these relationships among university students in Southeast Asia. Therefore, the purpose of this study was to examine the prevalence and associations of adherence to 24-h movement guidelines (HMG) with dietary behaviour and mental health among university students in ASEAN. Methods A multi-center cross-sectional survey was conducted in 2015 included 3223 university students from five ASEAN nations—Indonesia, Malaysia, Myanmar, Thailand, and Vietnam—aged 18 to 30 years, selected by stratified random sampling. Established measures included demographics, social support, perceived stress, self-rated health status, body mass index, six dietary behaviours, eight mental health outcomes, and adherence to 24-h movement guidelines (24-HMG) was assessed based on self-reported physical activity (≥ 150 min/week), sedentary time (≤ 480 min/day), screen time (≤ 180 min/day), and sleep duration (7–9 h). The relationship between dietary behaviours, mental health indicators and meeting the 24-HMG number was investigated using logistic regression models, adjusted for relevant confounders. Results Among 3,223 participants, 11.7% met all three 24-h movement guidelines, while 13.1% met none, and 37.6% met either one or two guidelines. Adherence to all guidelines was higher among males, participants aged 22–30 years, and those from lower-income countries (Indonesia, Myanmar, and Vietnam). Multiple logistic regression analyses, adjusted for relevant confounders, revealed that meeting more movement guidelines was associated with: Increased odds of healthy dietary behaviors (fruit and vegetable intake: Adjusted Odds Ratio-AOR: 1.96, 95% Confidence intervals-CI: 1.35–2.83; breakfast intake: AOR: 2.48, 95% CI: 1.84–3.34; meal frequency: AOR: 1.83, 95% CI: 1.36–2.45; low soft drink intake: AOR: 2.20, 95% CI: 1.54–3.14; high sugared coffee or tea intake: AOR: 0.39, 95% CI: 0.24–0.61; low fast food intake: AOR: 1.46, 95% CI: 1.08–1.96; and low snacking: AOR: 2.71, 95% CI: 2.00–3.66), and Decreased odds of mental health issues (depressive symptoms: AOR: 0.43, 95% CI: 0.26–0.70; suicidal behaviour: AOR: 0.66, 95% CI: 0.47–0.93; pathological internet use: AOR: 0.60, 95% CI: 0.45–0.81; hazardous or harmful alcohol use: AOR: 0.44, 95% CI: 0.29–0.66; illicit drug use: AOR: 0.38, 95% CI: 0.20–0.73; and had poorer sleep quality: AOR: 0.33, 95% CI: 0.16–0.68). No significant associations were found between guideline adherence and PTSD symptoms or tobacco use (p > 0.05). Conclusions This is the first study to look at the prevalence, correlates, and relationships between 24-HMG adherence and dietary behaviour and mental health outcomes among university students in ASEAN. This pioneering study among ASEAN university students demonstrates that adherence to 24-h movement guidelines is associated with better dietary behaviours and mental health outcomes in a dose–response manner. Future university health policies should incorporate 24-h movement guidelines into existing health promotion strategies, particularly in resource-limited settings.

Background and Aims Sub‐Saharan African (SSA) women face significant reproductive health challenges, including unwanted pregnancies and unsafe abortions. Despite the high prevalence of pregnancy termination in the continent, multilevel determinants and recent data trends remain understudied. This study addresses these gaps by leveraging recent Demographic and Health Survey (DHS) data and advanced statistical techniques. Methods This study involves secondary analysis using DHS data collected between 2010 and 2021 from 33 countries in Sub‐Saharan Africa. The analysis focused on pregnancy termination among women aged 15–49, comprising a weighted sample of 470,330 individuals. The data underwent a weighting process, considering sampling weight, primary sampling units, and strata. We utilized a multilevel binary logistic regression model to evaluate the correlation between individual and community‐level variables and the probability of pregnancy termination. Given the nested structure of the models, comparisons were made using the deviance statistic (−2 log‐likelihood ratio). All analyses were performed using STATA version 17. Variables with a p‐value ≤ 0.2 in the bivariable multilevel analysis were included in the multivariable model. The final results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to indicate the strength and statistical significance of associations. Results The overall prevalence of pregnancy termination among reproductive‐age women in SSA was 6.96% (95% CI: 6.89%, 7.03%), with the highest (13.59%) and lowest (3.83%) prevalence reported in Ghana and Ethiopia, respectively. The odds of pregnancy termination among rural resident women were 8% lower (AOR = 0.92, 95% CI: 0.89, 0.95) compared to urban residents. Women in Southern Africa had 9% decreased odds of pregnancy termination than women in Eastern Africa. Compared to women from East Africa, women in Western and Central Africa were 1.21 (AOR = 1.21, 95% CI: 1.18, 1.25) and 1.40 (AOR = 1.40, 95% CI: 1.35, 1.44) times higher odds of pregnancy termination, respectively. Conclusion The study reveals a notably high rate of pregnancy termination in SSA, which is particularly worrisome due to the legal limitations on abortion services in many SSA countries. Expanding access to contraception and comprehensive sexual health education is crucial to reducing unintended pregnancies across the region. Additionally, a reassessment of the strictness of abortion service restrictions is critical to encourage women to obtain these services from qualified professionals.

Highly functionalized isocyanides, particularly those with a stereogenic center, are more difficult to access compared to simple isocyanides, which are commercially available. Several research groups have reported the synthesis of novel isocyanides, which constitute necessary reagents for the synthesis of pharmacologically active drugs. Likewise, natural compounds with isocyano functionality are well‐known in many kingdoms of living organisms. Of course, the origin of such a functional group, as well as the mechanisms that have evolved in biosynthetic pathways to allow isocyanide synthesis, are critical biochemical questions. Many natural isonitriles have been demonstrated to have significant antibacterial, fungicidal, or anticancer effects. Hence, synthetic techniques are of great interest. In this manuscript, we have reviewed the synthesis of both simple and functionalized isocyanides, with particular emphasis on naturally occurring isocyanides derived from terrestrial and marine sources, including isonitrile (R‐N≡C‐) natural products (NPs).

Background: Non-specific low back pain (NSLBP) is prevalent among athletes engaged in repetitive overhead movements, often linked to sport-specific biomechanical demands. However, research on its prevalence and risk factors in South African amateur athletes is limited, despite the high participation in sports. Objectives: This study aimed to determine the prevalence of NSLBP and identify sport-specific risk factors among amateur overhead athletes in Gauteng Province, addressing a critical gap in the literature. Methods: This cross-sectional study involved 52 amateur overhead athletes aged 18 and above who participated in volleyball, basketball, netball, soccer goalkeeping, tennis, and swimming. Data collection included self-reported NSLBP prevalence, clinical tests for scapular dyskinesia (SD) and latissimus dorsi flexibility, and the Keele STarT Back Screening Tool. Statistical analysis examined the associations between NSLBP, SD, and sport-specific factors. Results: NSLBP prevalence was 25%, with volleyball (33%) and basketball (30%) athletes most affected. Scapular dyskinesia was observed in 48% of participants, particularly grades 1 and 2. Reduced latissimus dorsi flexibility was present in 40% of athletes and was significantly correlated with scapular dyskinesia (p<0.05). Conclusion: The study successfully met its objectives by identifying the prevalence of NSLBP and sport-specific risk factors among amateur overhead athletes. Findings emphasise the importance of targeted interventions focusing on scapular function and muscle flexibility to reduce NSLBP incidence. These insights provide valuable guidance for clinical practice and preventive strategies.

Antibiotic resistance (AR) has emerged as a significant global health issue. Wastewater treatment plants (WWTPs) contain diverse bacterial communities, including pathogens, and have been identified as crucial reservoirs for the emergence and dissemination of AR. The present study aimed to identify antibiotic resistance genes (ARGs) and screen for the presence of mutations associated with AR in Legionella pneumophila and Aeromonas spp. from municipal wastewater. Metagenome-assembled genomes (MAGs) of L. pneumophila and Aeromonas spp. were reconstructed to investigate the molecular mechanisms of AR in these organisms. A total of 138 nonsynonymous single nucleotide variants (SNVs) in seven genes associated with AR and one deletion mutation in the lpeB gene were identified in L. pneumophila. In Aeromonas spp., two (aph(6)-Id and aph(3’’)-Ib) and five (blaMOX−4, blaOXA−1143, blaOXA−724, cepH, and imiH) ARGs conferring resistance to aminoglycosides and β-lactams were identified, respectively. Moreover, this study presents β-lactam resistance genes, blaOXA−1143 and blaOXA−724, for the first time in Aeromonas spp. from a municipal WWTP. In conclusion, these findings shed light on the molecular mechanisms through which clinically relevant pathogenic bacteria such as L. pneumophila and Aeromonas spp. found in natural environments like municipal wastewater acquire AR. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-025-03957-x.