AbstractBis-(morpholinodithiato-s,s′)-Cu-Cd was synthesized from appropriate reagents as a single solid
source precursor and characterized using particle induced x-ray emission (PIXE), Fourier transform
infrared (FTIR)spectroscopy and differential thermal analysis(DTA). Cu-Cd-S thin films were
deposited on sodalime glass substrate using MOCVD technique at temperatures in the range 360 °C–
450 °C. The films were further characterized using Rutherford backscattering spectroscopy (RBS),
x-ray diffraction (XRD), scanning electron microscopy (SEM), UV-visible spectroscopy and four-
point probe technique. PIXE revealed that the synthesized precursor contained the expected elements
which led to the successful deposition of the Cu-Cd-S thin films. FTIR ascertained that the organic
ligand actually attached to the metals. DTA analysis showed that the synthesized precursor was
thermally stable and could pyrolyzed around 300 and 500 °C. RBS of the deposited films showed that
the stoichiometry and the thickness depended on deposition temperature. XRD analysis revealed that
the films deposited at 360 and 380 °C are amorphous while those deposited at 400 °C to 450 °C showed
peaks, which supported the possible co-existence of CuS and CdS as Cu-Cd-S, with an improvement
in the crystallinity as substrate temperature increased. SEM showed that the films are uniform and
crack-free, in which the morphology strongly depended on substrate temperature. Optical analysis
revealed that the films have high absorbance in the UV region and high transmittance in the visible
and near infrared region, in which direct band gap energy of 2.36 to 2.14 eV was obtained as deposition
temperature increased. Other optical parameters such as Urbach energy, refractive index, extinction
coefficient, dielectric constant also increased as the deposition temperature increased. Electrical
analysis showed that resistivity is temperature dependent as it reduced as deposition temperature
increased.

Bis-(morpholinodithiato-s,s′)-Cu-Zn was synthesized as a single solid source precursor and characterized using particle-induced x-ray emission (PIXE), Fourier transform infrared (FTIR) spectroscopy and differential scanning calorimetry (DSC). Cu-Zn-S thin film was deposited on sodalime glass substrate using metal organic chemical vapor deposition (MOCVD) technique at temperatures ranging from 360°C to 450°C. The thin films were characterized using Rutherford backscattering spectroscopy (RBS), x-ray diffraction (XRD), scanning electron microscopy (SEM), UV–visible spectroscopy and four-point probe technique. PIXE of the precursor confirmed the presence of the expected elements that can lead to deposition of Cu-Zn-S thin film while FTIR confirmed that the organic ligands were attached to the metals. DSC showed that the precursor is thermally stable and can pyrolyze at temperature between 340°C and 460°C. RBS analysis of the films showed that there was no substantial deposition at 360°C while other films showed various stoichiometry and thickness. XRD analysis of the films showed that films deposited at 360°C and 380°C are amorphous, while those deposited between 400°C and 450°C showed peaks, in which the crystal size decreased as the deposition temperature increased. The SEM micrographs showed that the morphology of the films is temperature dependent and as deposition temperature increased larger secondary grains dissociated into smaller grains that are closely packed, without cracks and holes. Optical characterization showed that the films exhibited high transmittance, which fairly increased as the deposition temperature increased. A direct band gap value between 2.49 eV and 2.92 eV was obtained as deposition temperature increased. Urbach energy also increased from 0.87 eV to 1.51 eV, while the steepness parameter decreased as the deposition temperature increased. The electrical characterization showed that the resistivity of the films decreased as the deposition temperature increased while the I–V plot showed a rectifying character.

Background:Pain is a public health problem requiring serious attention. One major barrier to the provision of quality pain treatment in many countries is lack of training for healthcare workers. The aim of this study was to evaluate the impact of pain education on the knowledge and attitude of healthcare workers, and opioid utilization in a university teaching hospital.
Methods:
Pain management workshops were conducted for healthcare workers over a 12-month period. The modified "Knowledge and Attitudes Survey Regarding Pain" questionnaire was administered to participants pre- and post- training for each of the workshops. The total mark by each participant was entered into the Statistical Package for Social Sciences (SPSS) software version 16 software for windows (SPSS Inc., Chicago, Illinois, USA) for comparison of means for pre- and post-test. Changes in opioid utilization were evaluated.
Results:
The pre-test and post-test questionnaires were filled by 715 and 700 participants respectively. The mean post-test score was significantly higher than the pre-test score (68% versus 49% respectively, p = 0.00001). The doctors scored significantly higher than the other groups (p < 0.0001) in the pre-test. The mean post-test scores were significantly higher than the corresponding mean pre-test scores for the various groups (p < 0.0001). Sustained increase (up to 60.4%) in total morphine utilization was observed during the training.
Conclusion:
There is a wide knowledge gap requiring regular training and re-training to achieve improved pain management and opioid utilization among healthcare workers. Inclusion of robust pain curricula in medical training programs will significantly improve pain management.

BackgroundIt is challenging to find an iron compound that combines good bioavailability with minimal sensory changes when added to seasonings or condiments. Ferric pyrophosphate (FePP) is currently used to fortify bouillon cubes, but its bioavailability is generally low. Previously, the addition of a stabilizer, sodium pyrophosphate (NaPP), improved iron bioavailability from a bouillon drink.
Objective
We assessed whether there is a dose-response effect of added NaPP on iron bioavailability from local meals prepared with intrinsically labeled FePP-fortified bouillon cubes in young Nigerian women using iron stable isotope techniques.
Methods
In a double-blind, randomized, cross-over trial, women (n = 24; aged 18–40 y; mean BMI 20.5 kg/m²) consumed a Nigerian breakfast and lunch for 5 d prepared with bouillon cubes containing 2.5 mg ⁵⁷Fe (as FePP) and 3 different molar ratios of NaPP: ⁵⁷Fe (0:1, 3:1, and 6:1). Iron bioavailability was assessed by measuring ⁵⁷Fe incorporation into erythrocytes 16 d after each 5 d NaPP: ⁵⁷Fe feeding period. Data were analyzed using a linear regression model of log iron absorption on NaPP ratio, with body weight and baseline body iron stores as covariates and subject as a random intercept.
Results
Of the women included, 46% were anemic and 26% were iron deficient. Iron bioavailability was 10.8, 9.8, and 11.0% for the 0:1, 3:1, and 6:1 NaPP:⁵⁷Fe treatments, respectively. There was no dose-response effect of an increasing NaPP:⁵⁷Fe ratio (β ± SE: 0.003 ± 0.028, P = 0.45).
Conclusions
In this study, the addition of NaPP did not increase iron bioavailability from FePP-fortified bouillon cubes. However, iron bioavailability from the Nigerian meals prepared with FePP-fortified bouillon cubes was higher than expected. These results are encouraging for the potential of bouillon cubes as a fortification vehicle. Further studies are needed to assess the effect of FePP-fortified bouillon cubes on improving iron status in low-income populations. This trial was registered at clinicaltrials.gov as NCT02815449.

Background: Family caregivers of people living with mental illness use religious coping strategies to cope with the burden of caring for their relatives.Objectives: To compare caregiver burden and religious coping and their interactions in caregivers of patients living with schizophrenia and bipolar affective disorder.
Methods: Caregivers of psychiatric patients, Schizophrenia (N=100) and Bipolar Affective Disorder (BAD) (N=100) were assessed for caregiver burden with the Burden Interview Schedule and religious coping with the Ways of Religious Coping Scale.
Results: The total burden level was higher in caregivers of schizophrenia patients than caregivers of BAD patients (t=3.53; p=0.001). The caregivers were found to use more of the internal ways of religious coping than the external ways of religious coping, while religious coping was significantly higher among the caregivers of schizophrenia patients (t=2.56; p=0.001). Predictors of the burden for both groups of caregivers were the number of previous admissions of the patient and depression in the caregivers while the duration of illness was a significant predictor of caregiver burden for bipolar affective disorder patients only. Age of onset of the illness and anxiety level were significant predictors of religious coping in both groups of caregivers, while the age of caregiver was an independent predictor of religious coping for only caregivers of BAD patients.
Conclusion: In spite of the potentials of religious coping as a coping strategy in stress, its application needs to be properly defined to determine who will benefit from what.

AMPA receptors (AMPARs) are tetrameric ligand-gated channels made up of combinations of GluA1-4 subunits encoded by GRIA1-4 genes. GluA2 has an especially important role because, following post-transcriptional editing at the Q607 site, it renders heteromultimeric AMPARs Ca2+-impermeable, with a linear relationship between current and trans-membrane voltage. Here, we report heterozygous de novo GRIA2 mutations in 28 unrelated patients with intellectual disability (ID) and neurodevelopmental abnormalities including autism spectrum disorder (ASD), Rett syndrome-like features, and seizures or developmental epileptic encephalopathy (DEE). In functional expression studies, mutations lead to a decrease in agonist-evoked current mediated by mutant subunits compared to wild-type channels. When GluA2 subunits are co-expressed with GluA1, most GRIA2 mutations cause a decreased current amplitude and some also affect voltage rectification. Our results show that de-novo variants in GRIA2 can cause neurodevelopmental disorders, complementing evidence that other genetic causes of ID, ASD and DEE also disrupt glutamatergic synaptic transmission.

Background: It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa. Objective: To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies. Methods: A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed. Results: Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability was associated with having at least post-secondary education (OR 1.51, 1.25–1.81) and a family history of stroke (OR 1.20, 1.03–1.39) while Islamic religion (OR=0.82, CI: 0.72–0.94), being currently unmarried (OR = 0.81, CI: 0.70–0.92), and alcohol use (OR = 0.78, CI: 0.67–0.91) were associated with lower odds of awareness of stroke as a heritable disorder. Willingness to undergo genetic testing for stroke was associated with having a family history of stroke (OR 1.34, 1.03–1.74) but inversely associated with a medical history of high blood pressure (OR = 0.79, 0.65–0.96). Conclusion: To further improve knowledge of stroke heritability and willingness to embrace genetic testing for stroke, individuals with less formal education, history of high blood pressure and no family history of stroke require targeted interventions.

Objective: To identify disease-causing variants in autosomal recessive axonal polyneuropathy with optic atrophy and provide targeted replacement therapy. Methods: We performed genome-wide sequencing, homozygosity mapping, and segregation analysis for novel disease-causing gene discovery. We used circular dichroism to show secondary structure changes and isothermal titration calorimetry to investigate the impact of variants on adenosine triphosphate (ATP) binding. Pathogenicity was further supported by enzymatic assays and mass spectroscopy on recombinant protein, patient-derived fibroblasts, plasma, and erythrocytes. Response to supplementation was measured with clinical validated rating scales, electrophysiology, and biochemical quantification. Results: We identified biallelic mutations in PDXK in 5 individuals from 2 unrelated families with primary axonal polyneuropathy and optic atrophy. The natural history of this disorder suggests that untreated, affected individuals become wheelchair-bound and blind. We identified conformational rearrangement in the mutant enzyme around the ATP-binding pocket. Low PDXK ATP binding resulted in decreased erythrocyte PDXK activity and low pyridoxal 5′-phosphate (PLP) concentrations. We rescued the clinical and biochemical profile with PLP supplementation in 1 family, improvement in power, pain, and fatigue contributing to patients regaining their ability to walk independently during the first year of PLP normalization. Interpretation: We show that mutations in PDXK cause autosomal recessive axonal peripheral polyneuropathy leading to disease via reduced PDXK enzymatic activity and low PLP. We show that the biochemical profile can be rescued with PLP supplementation associated with clinical improvement. As B6 is a cofactor in diverse essential biological pathways, our findings may have direct implications for neuropathies of unknown etiology characterized by reduced PLP levels. ANN NEUROL 2019;86:225–240.