BackgroundAdherence with medication regimens for human immunodeficiency virus (HIV) is a life-saving behavior for people with HIV infection, yet adherence is challenging for many individuals with co-occurring substance use and/or mood disorders. Medication-taking self-efficacy, which is the confidence that one can take one’s medication as prescribed, is associated with better adherence with HIV medication. However, little is known about the influence that other kinds of self-efficacy have on adherence with HIV medication, especially among HIV-infected individuals with co-occurring substance use and/or mood disorders. We sought to examine the relationship between adherence with HIV medication among substance users and three specific kinds of self-efficacy, ie, one’s confidence that one can communicate with medical providers, get support, and manage one’s mood. We further sought to examine whether symptoms of depression and anxiety moderate these relationships.MethodsPatients were recruited from three HIV clinics in the southeastern United States as part of an integrated study of treatment for HIV and substance use.ResultsWe interviewed 154 patients with HIV and substance use who reported taking HIV medications. Based on symptoms of depression and anxiety using the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale-Anxiety, 63% had probable depression and/or anxiety. Higher levels of self-efficacy in provider communication (β = 3.86, P < 0.01), getting needed support (β = 2.82, P < 0.01), and mood management (β = 2.29, P < 0.05) were related to better self-reported adherence with HIV medication among study participants with probable depression and/or anxiety. The three kinds of self-efficacy were not associated with medication adherence among participants with HIV and substance use only.ConclusionIn the search for mutable factors to improve medication adherence among individuals triply diagnosed with HIV, substance use, and mood disorders, these findings support previous research indicating the benefit of enhancing self-efficacy, and further point to three specific kinds of self-efficacy that may benefit medication adherence, ie, provider communication, getting support, and mood management.

Ras-dependent signaling is an important regulator of cell cycle progression, proliferation, senescence, and apoptosis. Several of the downstream effectors of Ras play dual roles in each of these processes. Under one set of conditions, they promote cell cycle progression and proliferation; yet, in a different paradigm, they drive cell cycle arrest and apoptosis. Furthermore, there is cross talk between certain downstream effectors of Ras including the PI3K-AKT and Raf-MEK-ERK pathways. Here we describe a series of experiments used to dissect the effect of different Ras-dependent signaling pathways on cell cycle progression, proliferation, senescence, and apoptosis. Furthermore, we highlight the importance of consistent growth conditions of cells in culture when studying Ras-dependent signaling as we show that the activation of downstream effectors of Ras changes with the confluency at which the cells are grown.

A 68-year-old male with a history of end-stage renal disease and latent tuberculosis on isoniazid (INH), and no psychiatric history presented with a five-day history of anorexia, fatigue, and nausea. Physical exam in the emergency department was notable for somnolence, right upper extremity tremor, and diffuse abdominal pain. Initial workup revealed an anion gap metabolic acidosis with elevated lactate, prompting admission to the general ward for empiric IV antibiotics for suspected bacteremia from his permacath. Within a few hours of admission, he became increasingly encephalopathic and had two episodes of copious hematemesis. Repeat studies revealed a cholestatic pattern of liver injury and new-onset coagulopathy. With an overall clinical picture consistent with fulminant hepatic failure, our pharmacy team initiated a comprehensive pill count of all his medications, which established that he had been inadvertently taking up to six times the recommended dose of INH. With INH discontinuation and supportive therapy, he improved and was discharged on hospital day eight. Our experience provides lessons in the timely recognition and management of this rarely reported toxidrome in the United States.

Background: Intensive (ICU) care in many African countries, such as Uganda is comparatively underdeveloped and underprioritized, largely because of other pressing healthcare system needs. However, experiences like the COVID-19 pandemic, declines in infectious disease-associated mortality, and the ongoing epidemiologic transition make the current state of critical-care in the region important. But most countries in the region, including Uganda, do not collect ICU data, leaving published studies as one of few potential sources of robust data. Existing systematic reviews utilize this fact; however, these studies report their findings in aggregate, making country-specific conclusions impossible. As a result, aspects of critical care in several individual African countries remain unknown. Objective: To assess intensive care utilization in Uganda over time; specifically, we ascertain patient demographics and the most common reasons for ICU admission. Methods: We performed a systematic search of the following indexing databases: PuBMed, EMBASE, Google scholars, and African Journals Online prior to March 2020. To assess the gray literature, we searched the dissertation databases of the largest public universities in the country (Makerere & Mbarara University) for relevant papers. Inclusion criteria for studies were: (i) study conducted in Uganda at a facility with intensive care capacity, (ii) adult population; (iii) N>100 patients. Findings: A total of 10 papers, collectively reporting on 3519 adult patients and published between 2005 and 2018 met our study’s inclusion criteria. The median of the average age on admission was 35.50 [IQR: 26.11-43.4], with post-operative management as the most common reason for ICU admission. Median mortality was 37.50% [IQR: 28.5-40.5]. Conclusions: Our study provides evidence supporting previous anecdotal reports of a comparatively low median age of patients in Uganda’s ICUs. However, we also find that most ICU research is conducted at the national referral hospital, Mulago, in the country’s capital, Kampala. This second finding highlights a significant knowledge gap, as private ICUs (whose catchment population includes Uganda’s rapidly growing middle class), and other districts in the country are not represented. As a result, these results should be interpreted cautiously. Future research studies should attempt to include private hospitals and those outside Kampala. Systematic review registration: PROSPERO. Registration ID: CRD42020168940

Learning from anywhere anytime is a contemporary phenomenon in the field of education that is thought to be flexible, time and cost saving. The phenomenon is evident in the way computer technology mediates knowledge processes among learners. Computer technology is however, in some instances, faulted. There are studies that highlight drawbacks of computer technology use in learning. In this study we aimed at conducting a SWOT analysis on ubiquitous computing and computer-mediated social interaction and their affect on education. Students and teachers were interviewed on the mentioned concepts using focus group interviews. Our contribution in this study is, identifying what teachers and students perceive to be the strength, weaknesses, opportunities and threats of ubiquitous computing and computer-mediated social interaction in education. We also relate the findings with literature and present a common understanding on the SWOT of these concepts.Results show positive perceptions. Respondents revealed that ubiquitous computing and computer-mediated social interaction are important in their education due to advantages such as flexibility, efficiency in terms of cost and time, ability to acquire computer skills. Nevertheless disadvantages where also mentioned for example health effects, privacy and security issues, noise in the learning environment, to mention but a few. This paper gives suggestions on how to overcome threats mentioned. Keywords: Ubiquitous Computing, Education, SWOT, Computer-mediated social interaction INTRODUCTIONThe term "ubiquitous computing" was first coined by Mark Weiser of Xerox PARC in 1988 who wrote, "The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it" (Wesier, 1991). Weiser's visionary reflections of such technologies and those of others were later believed to have transformed the way we interact and go about our daily lives. Practically, today we live surrounded by "ubiquitous" technology which is "invisible" to us. Like Weiser, a similar dream was envisioned by Turing, the father of Artificial Intelligence (AI) when he noted that: "What I would very much like to do is to educate a computer, partly by direct training, partly by letting it find out things for itself. We don't know how to do this yet, but I believe that it will be achieved in the very near future" (Feigenbaum, 1996 p.102). What is evident today is that we do not find out "things" by ourselves but the computers do that for us. Our intellect is influenced by technology which makes our operations ubiquitous.