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P2Y12 is a G-protein-coupled receptor that is activated upon ADP binding. Considering its well-established role in platelet activation, blocking P2Y12 has been used as a therapeutic strategy for antiplatelet aggregation in cardiovascular disease patients. However, receptor studies have shown that P2Y12 is functionally expressed not only in platelets and the microglia but also in other cells of the immune system, such as in monocytes, dendritic cells, and T lymphocytes. As a result, studies were carried out investigating whether therapies targeting P2Y12 could also ameliorate inflammatory conditions, such as sepsis, rheumatoid arthritis, neuroinflammation, cancer, COVID-19, atherosclerosis, and diabetes-associated inflammation in animal models and human subjects. This review reports what is known about the expression of P2Y12 in the cells of the immune system and the effect of P2Y12 activation and/or inhibition in inflammatory conditions. Lastly, we will discuss the major problems and challenges in studying this receptor and provide insights on how they can be overcome.

The neuropeptides vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating polypeptide (PACAP) have emerged as potent modulators of immune responses during sepsis, yet their roles remain complex, alternating between protective and permissive depending on timing, tissue compartment, and inflammatory context. This review presents a historical assessment of VIP and PACAP in sepsis research, highlighting the evolution of conceptual advances across five decades. Starting in the 1980s, early studies revealed that VIP levels rise during endotoxemia and correlated with hypotension and mortality, suggesting a deleterious role. By the 1990s, research pivoted toward understanding gut-derived VIP and its interaction with nitric oxide, culminating in the classification of VIP and PACAP as \"macrophage deactivating factors\" that downregulate TNFα and IL-6. The 2000s further clarified their cell-specific actions through VPAC1/2 and PAC1 receptors, showing anti-inflammatory effects on both innate and adaptive immune cells, while illuminating delivery challenges overcome by liposomal encapsulation. The 2010s expanded this narrative by dissecting receptor dynamics, gut barrier regulation, and VIP's role in neuroimmune crosstalk and thrombo-inflammation. Most recently, studies in the 2020s provide a nuanced view of how VIP suppresses inflammatory damage but also enables pathogen persistence during live bacterial infection, implicating VIP signaling in trade-offs between tolerance and clearance. Across this chronological framework, VIP and PACAP have oscillated between friend, foe, and frenemy, underscoring the importance of context in leveraging their therapeutic potential in sepsis.

Although ART has transformed HIV into a manageable chronic condition, significant cost and logistical challenges persist, threatening progress toward the UNAIDS 95-95-95 targets. Budget allocation to the health sector declined by over 30% in the last decade in Zimbabwe, attributed to donor fatigue and emergence of pandemics. The time-driven activity-based costing (TDABC) method was used to estimate the provider costs of ART and inform resource allocation for sustained ART programming. A descriptive cross-sectional study in 11 facilities across Zimbabwe’s four levels of care collected data using standardized instruments, capturing over 2,500 provider-recipient observations. Process maps of HIV care pathways were developed with subject matter experts to document resource use and standard of care. Time taken to deliver ART services, cost of space and cost of equipment were used to calculate costs and validated by national level stakeholders. In 2022, annual provider costs for ART in totalled$168.66 million for 1.2 million patients. National costs are projected to $ 192.44 million by 2026, attributed to declining HIV-related mortality and incidence. Primary care facilities bore 75% of costs due to higher patient volume. Provider costs averaged$57.05 for adult ART initiation and $ 62.70 for paediatric initiation. First-year ART costs per client were$252.78 (adult) and $ 450.56 (paediatric). Annual maintenance costs were$138.93 for first-line and $ 174.93 for second-line ART. Laboratory services ( $30.72) contributed more to adult ART costs than medicines ($ 27.98). ART costs exceeded prior estimates, driven by facility-level differences, laboratory expenses, and paediatric formulations. Task-shifting proved cost-efficient, but sustainability is threatened by funding gaps and low health worker compensation. Optimizing laboratory systems and decentralizing services remain critical. External funding withdrawal created an annual gap of more than $50 million. Sustaining ART to 2030, requires improving domestic resource mobilization, strengthening ART decentralization, and designing cost-efficient laboratory models that preserve treatment quality.

Sepsis, a complex clinical syndrome resulting from a serious infection, is a major healthcare problem associated with high mortality. Sex-related differences in the immune response to sepsis have been proposed but the mechanism is still unknown. Purinergic signaling is a sex-specific regulatory mechanism in immune cell physiology. Our studies have shown that blocking the ADP-receptor P2Y 12 but not P2Y 1 receptor was protective in male mice during sepsis, but not female. We now hypothesize that there are sex-related differences in modulating P2Y 12 or P2Y 1 signaling pathways during sepsis. Male and female wild-type (WT), P2Y 12 knock-out (KO), and P2Y 1 KO mice underwent sham surgery or cecal ligation and puncture (CLP) to induce sepsis. The P2Y 12 antagonist ticagrelor or the P2Y 1 antagonist MRS2279 were administered intra-peritoneally after surgery to septic male and female mice. Blood, lungs and kidneys were collected 24 hours post-surgery. Sepsis-induced changes in platelet activation, secretion and platelet interaction with immune cells were measured by flow cytometry. Neutrophil infiltration in the lung and kidney was determined by a myeloperoxidase (MPO) colorimetric assay kit. Sepsis-induced platelet activation, secretion and aggregate formation were reduced in male CLP P2Y 12 KO and in female CLP P2Y 1 KO mice compared with their CLP WT counterpart. Sepsis-induced MPO activity was reduced in male CLP P2Y 12 KO and CLP P2Y 1 KO female mice. CLP males treated with ticagrelor or MRS2279 showed a decrease in sepsis-induced MPO levels in lung and kidneys, aggregate formation, and platelet activation as compared to untreated male CLP mice. There were no differences in platelet activation, aggregate formation, and neutrophil infiltration in lung and kidney between female CLP mice and female CLP mice treated with ticagrelor or MRS2279. In human T lymphocytes, blocking P2Y 1 or P2Y 12 alters cell growth and secretion in vitro in a sex-dependent manner, supporting the data obtained in mice. In conclusion, targeting purinergic signaling represents a promising therapy for sepsis but drug targeting purinergic signaling is sex-specific and needs to be investigated to determine sex-related targeted therapies in sepsis.

Due to rapid development and population growth in Ghana’s urban and peri-urban areas, most freshwater resources are degrading, directly affecting residents in these vicinities. This study, therefore, evaluates how human activities such as urbanization, farming and industrialization affect the Bonsa River and the health-related quality of life of residents living downstream. The study adopted statistical package for the social sciences (SPSS) and partial least square structural equation modeling (PLS-SEM) to assess the data retrieved from the residents living in and around the Bonsa River in Tarkwa Nsuaem, Ghana. The study’s outcome reveals a positive and significant impact of land use change on freshwater resource degradation and poor health-related quality of life of the inhabitants in the catchment area. The study has numerous practical and policy implications for the government, environmental and healthcare industry, and policymakers.

Outside plant (OSP) is essential for telecommunications, internet, and other communication services that require connectivity beyond indoor spaces. These networks often involve the installation of cables, conduits, cabinets, poles, and other infrastructure elements to connect various locations. However, different service channels such as water pipelines, network cables, and electric cables make the implementation of these installations very challenging. This research presents an investigation into the route design and analysis of fiber architectures, taking into account aerial and underground installations. In this research, a novel safe route that will enable safe, undeterred, and cost‐effective OSP fiber optic installation was implemented. A high‐level design was produced to realize the optimum structural design and implementation of the backend framework of the fiber system. This method helped to tidy the utility corridors and tackle the problem associated with improper planning and design of passive OSP routes. The area to be worked on was demarcated and specification of the boundaries under consideration was noted. A key position for setting up the fiber distribution terminals (FDTs) was determined after which the area being considered is divided into sections, with each distribution line from the FDT serving one section. This was followed by a low‐level design which was more detailed. In this stage, the area under consideration was divided into sections with which different distribution lines to serve each section. This was achieved through the identification of residential clusters. To demonstrate our methodology, we provided fiber to the home (FTTP) to an apartment located in the capital city of Ghana. Estimation of parameters, gathering of information, implementation, testing, and analyses were made, followed by adjustments where necessary. Losses from distances of 0.15–5 km were observed. Individual components in the OSP architecture contributed to fixed losses of 0.7, 10.5, and 10.6 in the optical line terminal (OLT), FDT, and fiber access terminal (FAT), respectively. Actual losses from cable length and the nature of the route ranged from 1.04 to 2.24 dB. A slope of 0.24 dB/km was obtained and this is within the required route loss of less than 1 dB/km in fiber optic transmissions. From the research, it was observed that there was a loss in signal power as distance increased. Also, signal loss at a wavelength of 1550 nm was better than signal loss at 1310 nm. Our research revealed a balanced loss of 0.35 dB/km for 1310 nm wavelengths and 0.25 dB/km for 1550 nm. The total distribution length loss for core cables 1, 2, 3, and 4 at wavelengths of 1310 nm were 1.0307, 0.76556, 1.1719 dB, and 1.1322 dB, respectively. The total distribution length loss for core cables 1, 2, 3, and 4 at wavelengths of 1550 nm were 0.7362, 0.5468, 0.837, and 0.8087 dB, respectively. FAT Power (dBm) for feeder lines 1, 2, 3, and 4 and distribution lines 1, 2, 3, and 4, respectively, were all within the acceptable range. The design will help to reduce the cost of repairing damaged cables drastically. Also, the design methodology helped us to develop a backbone network to get closer to the various homes and premises. The architecture was also designed to prioritize the bandwidth demand by clients at the premises. The significance and impact of the research are essential in enhancing efficiency, reducing costs, improving reliability, and ensuring scalability in network design and route analysis. The integration of novel technologies and innovative methodologies makes them relevant in today’s fast‐evolving technologies.

Over the past decade, mobile money services have rapidly expanded in developing economies, yet research on their adoption by petty traders remains limited. This study investigates the factors influencing the intention to use MTN Mobile Money (MTN MoMo) among Makola traders in Ghana. Using a two-stage PLS-SEM artificial neural network (ANN) predictive analytic approach, the study first applied PLS-SEM to test hypotheses, followed by ANN to detect nonlinear effects. A total of 945 questionnaires were collected, revealing that performance expectancy, effort expectancy, social influence, price value, and trust significantly influence traders’ intentions to use MTN MoMo. Additionally, both intention to use and facilitating conditions significantly predict the actual usage of MTN MoMo. Model B indicates differences in the ranking of price value, trust, and intention to use between the PLS-SEM and ANN models, suggesting hidden attributes may influence these relationships. These findings benefit policymakers and service providers committed to advancing digital financial inclusion and economic development. Theoretically, the study extends UTAUT2 in the context of MoMo, a neglected research area. Methodologically, it is the first to apply the UTAUT2 model using the hybrid PLS-SEM-ANN approach in Ghana.

The main force behind the development of new access technologies is the rise in demand for high‐speed internet. Also, the rapid expansion of digital services in Ghana has necessitated the deployment of high‐speed broadband networks. Various technologies that use optical fiber as a transmission medium make up the fiber‐to‐the‐premises (FTTP) family of technologies. In our research, we designed and implemented a gigabit passive optical network (GPON). This research provided a detailed design and field implementation of a secure FTTP access network supporting up to 128 clients. It focused on the design and implementation of FTTP using GPON architecture, which offers a cost‐effective solution for delivering triple‐play services (voice, data, and video) over fiber optic cables, providing high bandwidth and reliability. The GPON system consists of an optical line terminal (OLT) at the central office and optical network terminals (ONTs) at user premises, connected via passive optical splitters that distribute signals to multiple users. The fundamental elements of the network are discussed, along with how each element contributes to the FTTP network architecture. We designed a splitter configuration that divides an incident light beam from a single input fiber cable into eight different output cables, which is our first‐level splitting. The architecture includes security features in the feeder network to provide redundancy. Each of the eight output fiber cables is divided into 16 separate output cables to provide network access to all 128‐end clients. In doing so, we identify the optimal splitting ratio combination that will allow for quick data transmission and better performance to improve broadband services, support future‐proof bandwidth demands, and contribute to the country’s technological advancement.

The effects of large-scale land acquisitions for development projects such as mining, urbanization and dams are widely contested in the literature. Prior research has focused on the difficulties that resettlement poses for the affected families in terms of their capacity to meet the demands of the new community. This study suggests that resettlement (built environment) quality may act as a predictor and influence the residential satisfaction and quality of life of project-affected families. This study investigates how residential satisfaction influences the relationship between the quality of the dwelling, the context of resettlement homes, and the quality of life of mining-affected families in Ghana. A sample of 256 household heads displaced by a large-scale mining project in Ellembelle was used to evaluate the suggested model. The findings indicate that resettlement quality greatly enhances the quality of life of the mining-affected families. The findings also revealed that residential satisfaction was a significant mediator of the quality of dwellings and the context of the resettlement, in addition to being a strong predictor of quality of life. Indirectly, resident characteristics, such as socioeconomic and demographic conditions, influenced how people felt about their homes and quality of life. These results indicate that residential satisfaction and resettlement quality are accurate indicators of the mining-affected families’ quality of life. Integrating these features make it possible to quantify the mining-affected families’ quality of life for future research and public policy.

Background. Iodine deficiency is a public health problem. The universal salt iodization (USI) program is the main, simple, and cost-effective intervention strategy to control iodine deficiency. The study examined the iodine status in school-aged children in Ashanti region, Ghana, using thyroid volumes along with urinary iodine concentrations, the methods recommended by the WHO/ICCIDD for monitoring the sustained impact of USI programs. Methods. This cross-sectional study was conducted among school-aged children (6–12 years) from randomly selected schools in the central and northern part of the Ashanti region, Kumasi Metropolis, and Ejura-Sekyedumase Municipality, respectively. A total of 852 children were enrolled in the study. Thyroid volume and urinary iodine concentrations of the children were determined using the standardized methods recommended by WHO/ICCIDD. Anthropometric measurements were also evaluated. Results. The mean values of thyroid volume in female and male school-aged children were 3.53 ± 0.09 and 3.32 ± 0.07, respectively. The thyroid size was significantly associated with age (P<0.0001), weight (P<0.0001), height (P<0.0001), BMI (P<0.05), and BSA (P<0.0001) by Pearson’s correlation in both males and females. The P50 (median) thyroid volumes of school children investigated in this study were generally larger compared to the WHO/ICCIDD reference data by age and body surface area. The median value of urinary iodine concentration was 201.85 μg/L, which showed significant sex difference (P value <0.0001). Excessive iodine nutrition (≥300 μg/L) was observed among 34.4% of male children and 27.6% of female children. Also, 12.8% of the male and 19.5% of the female children had UIC below requirement (<100 μg/L). The criteria of thyroid volume per age yielded a goitre prevalence of 2.2%. In contrast, the criteria of thyroid volume by body surface area yielded a goitre prevalence of 0.9%. Conclusion. The study clearly indicated that adequate iodine nutrition exists generally among the school children. However, insufficient and excessive iodine intakes still persist among some of the children. The establishment of local reference values for thyroid volume that might be applicable to precisely define goitre prevalence in the Ghanaian context is highly recommended.