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Item Dataset From: Forgotten but not gone in rural South Africa: Urinary schistosomiasis and implications for chronic kidney disease screening in endemic countries(2022-12-11) Craik,Alison; Mayindi,Nokthula; Chipungu,Shingirai; Khoza,Bongekile; Gómez-Olivé, Xavier F; Tomlinson, Laurie AlexandraStudy information The African Research on Kidney Disease (ARK) Study aimed to determine chronic kidney disease (CKD) prevalence and identify associated risk factors in rural South Africa. The study took place from November 2017 to September 2018 and included a population-based sample (N=2759) of adults aged 20-79 years from the Agincourt Health and Socio-Demographic Surveillance System (HDSS) site in rural Bushbuckridge, Mpumalanga Province. Institutional review board approval was obtained from the University of Witwatersrand (clearance number M170583) Written informed consent was obtained from individual participants prior to enrolment. This is a secondary data analysis nested within the ARK study. In this population-based cohort study, we aimed to characterise the burden of urinary schistosomiasis in rural South Africa and evaluate its relationship with markers of kidney dysfunction with implications for CKD screening. We recruited 2021 adults aged 20-79 years in the Mpumalanga Province, South Africa. Sociodemographic and anthropometric data were recorded, urinalysis performed, and serum and urine samples collected. We measured serum creatinine and urine albumin/creatinine. Kidney dysfunction was defined as an estimated glomerular filtration rate (eGFR) <60ml/min/1.73m2 and/or urine albumin-creatinine ratio >3.0mg/mmol. S.haematobium infection was determined by urine microscopy. Multivariable analyses were performed to determine relationships between S.haematobium and kidney dysfunction. The methodology for this sub-study is dependent on the larger ARK study processes. Data quality and ethics processes have previously been validated by the ARK consortium . Institutional review board approval was obtained from the University of Witwatersrand (clearance number M170583) Written informed consent was obtained from individual participants prior to enrolment. Additional approval for this sub-study from the London School of Hygiene and Tropical Medicine (reference number 22152). Kalyesubula R, Fabian J, Nakanga W, Newton R, Ssebunnya B, Prynn J, et al. How to estimate glomerular filtration rate in sub-Saharan Africa: design and methods of the African Research into Kidney Diseases (ARK) study. BMC Nephrol. 2020 Jan 15;21(1):20.Item Dataset from: Chronic kidney disease (CKD) and associated risk in rural South Africa: a population-based cohort study(2022-07-13) Fabian, June; Gondwe, Mwawi; Mayindi, Nokthula; Khoza, Bongekile; Gaylard, Petra; Wade, Alisha N.; Gómez‑Olivé, F. Xavier; Tomlinson, Laurie A.; Ramsay, Michele; Tollman, Stephen Meir; Winkler, Cheryl; George, Jaya Anna; Naicker, Saraladevi; Study data were collected and managed using opensource REDCap electronic data capture tools hosted at the University of the WitwatersrandStudy Methods This longitudinal cohort study was conducted from November 2017 to September 2018 in the Medical Research Council (MRC)/Wits Rural Public Health and Health Transitions Research Unit (otherwise referred to as "Agincourt") in Bushbuckridge, a rural subdistrict of the Mpumalanga province in north-eastern South Africa. Agincourt is a Health and Socio-Demographic Surveillance System (HDSS) site that includes approximately 115,000 people. For this study, a minimum sample size of 1800 was required to provide at least 80% power to determine CKD prevalence of at least 5%, provided the true prevalence was equal to or more than 6.5%. Proportional allocation of Black African adults aged 20 to 79 years ensured a representative sample based on the most recent annual population census. Sample size was increased proportionately to 2759 individuals to accommodate a 25% non-participation rate. Dataset is 2022 cases Variables are: 1. age 2. Gender 3. Years of Education (refers to completed years of schooling) 4. Height (cm) (one decimal place) 5. weight (kg) (one decimal place) 6. BMI (body mass index) 7. POC random cholesterol (mmol/L) (2 decimal places) 8. POC random glucose (mmol/L) (1 decimal place) 9. HIV status is: Based on (i) prior HIV testing history OR (ii) HIV PCR testing for ARK 10. Using the urine pregnancy test, is this participant pregnant? ( 11. ERY (erythrocytes, blood) 12. Hb (haemoglobin, blood) LEU (leucocytes) 13. NIT (nitrites) 14. PRO (protein) 15. hepatitis B surface antigen 16. Serum creatinine (umol/L) 17. Systolic BP(1) 18. Diastolic BP (1) 19. Systolic BP(2) 20. Diastolic BP (2) 21. Systolic BP(3) 22. Diastolic BP (3) 23. Serum creatinine (umol/L) 24. Urine microalbumin (mg/L) 25. Urine creatinine (mmol/L) 26. Urine microalbumin (mg/L) 27. Urine creatinine (mmol/L) 28. APOL1 haplotypeItem Sterkfontein Member 4 fabric data(2022) Stratford, DominicItem Portraits of Displacement – Memory and Narratives of South African Durban Communities through the photographic exhibition Proclamation 73(Taylor & Francis Group, 2022-04-14) Cloete, Nicola Marthe; Bentel, ClaudiaThis paper spans two temporal locations - on the one hand it holds the historical events of indentured labour in the then British Colony of Natal in the 19th century in mind, on the other is the contemporary photographic exhibition produced in 2019, which includes images that broadly relate to apartheid era law but also extends as far back as the 1800s. We suggest there are ways in which the visually constituted archive material starts to shift our expectations and understandings of what the narratives of forced migration may mean and where their resonances may reside, particularly in the South African context. In the analysis we undertake of the exhibition and the images they encompass; we zoom in on the ongoing racialised regimes of looking and knowing and simultaneously show how these regimes have consistently been disrupted in the space of the personal family album.Item Dataset from: Clinicopathological correlation of kidney disease in HIV infection pre- and post- ART rollout: VERSION 2(2022-04-14) Diana, Nina Elisabeth; Davies, Malcolm; Mosiane, Pulane; Vermeulen, Alda; Naicker, SaraladeviData note Methods Ethics approval for this study was granted in writing by the Human Research Ethics Committee (Medical) of the University of the Witwatersrand, Johannesburg, South Africa (clearance certificate numbers M1511104, M121184, M120874). This approval permitted a record review of all HIV-positive patients who underwent a kidney biopsy at two tertiary hospitals in Johannesburg within the defined study period. Informed consent for this retrospective record review was waived. Data from included patients was anonymised prior to statistical analysis. Renal biopsies performed at these two tertiary hospitals, on HIV-positive individuals, from January 1989 to December 2014 were retrospectively analysed. Demographic data (age, sex and race), clinical parameters (CD4 count, HIV viral load, serum creatinine and urine protein creatinine ratio), indication for biopsy and renal histological pattern was recorded at time of kidney biopsy. The estimated glomerular filtration rate (eGFR) was calculated according to the CKD-EPI creatinine equation without ethnicity correction. ART rollout began in April 2004 in South Africa. Patients were divided into 2 groups - those who were biopsied pre-ART rollout and those biopsied post-ART rollout. These two groups were compared with respect to the above parameters. In a subgroup of the patients biopsied between 2004 and 2014, additional data laboratory parameters (serum haemoglobin, serum albumin, serial serum creatinine and eGFR) and ART use (at time of biopsy) were recorded. All renal biopsies were processed according to standard techniques for light microscopy, immunofluorescence and electron microscopy. All biopsies were reviewed by the National Health Laboratory Service histopathology team who were aware of the HIV status of the patient at time of biopsy. Histological diagnoses were tabulated using the 2018 Kidney Disease Improving Global Outcomes (KDIGO) Controversies Conference guidelines. As per this guideline FSGS (NOS) in the setting of HIV describes all non-collapsing forms of FSGS. Those ICGN with no identifiable comparative etiology other than HIV were categorized as uncharacterized ICGN with no etiology other than HIV. The biopsies with multiple diagnoses were assigned its major clinical-pathological diagnosis for the purposes of analysis. All data was collected by Dr Nina Diana and Dr Alda Vermeulen from paper based patient hospital records and the electronic hospital laboratory system. All data was checked twice to ensure accuracy. Each patient was allocated a study number and data anonymised prior to entry into Microsoft Excel. Shapiro Wilk W testing and visual inspection of the histogram plot indicated non-parametric distribution of baseline characteristics of the cohort; accordingly, central and dispersal measurements were described using the median and interquartile range (IQR), and the Kruskal Wallis ANOVA and Mann-Whitney U tests were used for comparative analyses. Kidney survival, defined by an eGFR above threshold for consideration for dialysis initiation in these institutions (15mL/min/1.73m²), censored for patient default with preserved function, was fitted for patients in the subgroup using the Kaplan Meyer method; histological diagnoses were compared using Log-rank testing.Item Debunking the Myth of the Fourth Industrial Revolution(2022-03-01) Moll, IanFourth Industrial Revolution (4IR) is all the rage these days. In ideological terms, it appears to be hegemonic in its construal of our contemporary socioeconomic context, from our day-to-day interpersonal exchanges to the machinations of the global economic order. We often hear appeals to the supposed “magic” of the technology that goes with it, to resolve the economic, political and educational crises and problems of the world (and latterly, its health crises – WEF, 2020). Appeals to a 4IR usually go with a listing of a whole lot of ‘new’, ‘unprecedented’ technologies that sound smart, make us feel outdated, and leave us in awe of the future. Technologies like cyber systems, artificial intelligence, delivery drones, the internet of things, and fully autonomous killer robots.3 But it is around this misleading sense of awe – which I shall later refer to as an ideology – that my argument turns in this paper. None of these technologies necessarily warrants the claim that we are in a technological revolution, let alone a “Fourth Industrial Revolution”. I shall examine these and similar technologies, to establish my claim. The argument also runs deeper than that. An industrial revolution, properly conceived, encompasses a complex range of economic, social and cultural transformations, and there is very little evidence to suggest that we are living through a fourth one of these. A careful, deep analysis of the First, Second and Third Industrial Revolutions will make this quite clear. What we discover in these three revolutions, by way of fundamental social transformation, is not taking place in the current context of the digital, networked, information society. This paper commences with an account of the dispute between Schwab (2016) and Rifkin (2011, 2016) about whether there is such a thing as a 4IR, to provide a context for subsequent arguments. It then moves to start to develop its main argument, that there is no such thing as a Fourth Industrial Revolution. First, an account of the First Industrial Revolution (1IR) is provided, based on an examination of historical literature. This establishes analytically that this period of history was one of fundamental, transcontinental change, characterized by complex, interconnected, mutually-dependent social and socioeconomic relations and practices, as well as economic and technical innovations. The significance of the 1IR, of course, is that it is the archetypal industrial revolution in historical and theoretical terms. From this history, a framework for the analysis of any industrial revolution can be derived; this is done here to establish the criteria that any social transformation must meet if it is to count as such. Having established this analytic framework, the argument then goes on to examine the Second Industrial Revolution (2IR) and the Third Industrial Revolution (3IR). Again through an analysis of historical literature, it is established that both of these meet the criteria to be considered as industrial revolutions. They did indeed take place, to the full extent of the social, economic and cultural relations that one might expect. The 3IR is also carefully examined in relation to the aggregate of technical innovations that characterize it, because this is crucial in determining whether or not we can meaningfully claim a revolution from the 3IR to a 4IR. The resolution reached here is that there is no evidence that we are living in a contemporary, society-wide, technological revolution of any sort. The final substantive section of the paper moves on to the much more important question of whether there is a contemporary industrial revolution that is fundamentally transforming society beyond the dominant everyday, economic, social, cultural and geopolitical realities of the 3IR. It argues that it is quite clear, on the basis of all the evidence adduced, that there is no such phenomenon. The last part of the paper is more illustrative. By way of a selection of quotations from a range of sectors, it shows how the ideological frame of the 4IR as a massively converged set of global, technological marvels has spread around the world, despite the fact that it is nonsense.Item Dataset From: Evaluation of potential kidney donors and outcomes post-donation at Charlotte Maxeke Johannesburg Academic Hospital (1983-2015)(Division of Nephrology, Charlotte Maxeke Johannesburg Academic Hospital, 2022-03-23) Dayal, Chandni; Davies, Malcolm; Diana, Nina Elisabeth; Meyers, Anthony M.Data was collected from existing clinical records of the Living Donor Clinic held by the Division of Nephrology at Charlotte Maxeke Johannesburg Academic Hospital. This was performed by the primary investigator / first author in a pseudo-anonymized fashion and stored securely in an Excel database to which only the primary investigator had access along with the data key. Procedures pertaining to original data capturing to clinical records by the data manager (Sister Nancy Makoe), were in accordance with the standard operating procedure set out by the Transplant Unit at Charlotte Maxeke Johannesburg Academic Hospital. Objectives of research Primary Objective • To determine donor morbidity and mortality after donation. • Analysis of morbidity will focus on the development of - New onset hypertension following donation (BP ≥140/90) - Chronic kidney disease following donation, defined as the development of either of the following - New onset proteinuria (AER >300mg/day) - An eGFR <60 ml/min/1.73 m² (using the CKD-EPI formula) Secondary Objectives • To determine the reasons for exclusion of potential donors from living kidney donation • To determine the prevalence of ESKD following donation (eGFR <15 ml/min/1.73 m² using the CKD-EPI formula) • To determine potential risk factors associated with proteinuria and/or a reduced eGFR post kidney donation, by evaluating a. donor demographics b. the presence of isolated medical abnormalities prior to donation, defined by: - a borderline pre-donation 51Cr-EDTA GFR (<80 ml/min/1.73 m²) - pre-existing hypertension (well controlled on a single agent with no end-organ damage) - class I obesity (BMI 30-35 kg/m²) • To determine the proportion of patients lost to follow-up post donation 5.2 Study design A single centre retrospective observational study was conducted of all patients attending the Living Donor Clinic in the Renal Unit at CMJAH over a 32-year period between 01 January 1983 and 31 July 2015. The closing date for sampling reflects the period of protocol submission for this study. The cohort comprised of 1208 potential living donors, of which: • 910 are failed living donors, assessed between 01 January 1990 and 31 July 2015 • 298 are accepted living donors, assessed between 01 January 1983 and 31 July 2015 5.3 Data collection 5.2.1 Data collection for failed living donors Data collection for failed living donors comprised the following parameters: • Demographic data – age at assessment, gender and ethnicity • Family history of the donor • Relation to the intended recipient – whether related, unrelated or altruistic • The outcome of eligibility evaluation • If excluded from living donation, reasons for non-donation will be documented, which were categorised as: - donor-recipient related, - donor-related, - recipient-related, or - miscellaneous. • The indications and findings of any renal biopsy undertaken on a donor was recorded 5.2.2 Data collection for accepted living donors Data collection for accepted living donors comprised the following parameters: • Demographic information – gender, ethnicity, age at donation (as well as age at each follow-up point) • Family history of the accepted donor • Details pertaining to the donation, specifically: - relation to the recipient, as well as cause of renal failure in the recipient - the date of donation - the graft outcome (if known) • The last follow-up date at the Living Donor Clinic and the approximate number of post-donation follow-up visits • Domicile in relation to the Living Donor Clinic (in kilometres from transplant centre) • The reason for lost to follow-up (if known) • Baseline characteristics at donation, including: - Body mass index - Urine albumin: creatinine ratio - Systolic blood pressure - Diastolic blood pressure - Baseline serum creatinine - eGFR as defined by an isotope study, the chromium-51-ethylene-diamine-tetra-aceticacid scan (51Cr EDTA scan) as well as the CKD-EPI formula - Habits, including smoking status and history of alcohol consumption - History of pre-existing medical condition(s) • Characteristics at follow-up (correlated with time after donation), including: - Body mass index - Urine albumin: creatinine ratio - Systolic blood pressure - Diastolic blood pressure - Serum creatinine - eGFR as defined by the CKD-EPI formula - Habits, including smoking status and alcohol consumption - Development of co-morbid disease - History of nephrotoxic drug intake The above variables were retrospectively collected from data recorded at the patients’ first follow-up visit post-donation, one-year post-donation visit, and at the most recent follow-up visit. • Mortality data was collected in accepted living donors that demised during the study period, and will include: - age at death - the time from donation to mortality - cause of death, whether related to renal disease, a cardiovascular event or other cause 5.3 Definition of variables 5.3.1 Classification of donors • Potential living donors (PLDs) – refer to all donors assessed at the CMJAH Living Donor Clinic • Failed living donors (FLDs) – refer to the sub-group of PLDs excluded from living kidney donation • Accepted living donors (ALDs) – refer to the subgroup of PLDs that ultimately donated a kidney 5.3.2 Hypertension Defined as per the Eighth Joint National Committee (JNC8) guidelines for blood pressure targets: • For donors with a current age of more than sixty years: - a systolic blood pressure of more than 150mmHg, with - a diastolic blood pressure of more than 90mmHg • For donors with a current age of less than sixty years: - a systolic blood pressure of more than 140mmHg, with - a diastolic blood pressure of more than 90mmHg 5.3.2 Albuminuria Quantified as per the revised Kidney Disease Improving Global Outcomes (KDIGO) chronic kidney disease classification into three stages of albuminuria based on the albumin excretion rate (AER) in milligrams per day (mg/day): • A1: Normal or mildly increased (AER <30 mg/day) • A2: Moderately increased (AER between 30 - 300 mg/day) • A3: Severely increased (AER >300 mg/day, with nephrotic range proteinuria defined as >3500 mg/day) 5.3.3 Glomerular filtration rate • Pre-donation GFR will be defined: - as per isotope study: 51Cr EDTA scan - as calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, expressed as: GFR = 141 × min (Scr /κ, 1) α × max (Scr /κ, 1)-1.209 × 0.993Age × 1.018 [if female] × 1.159 [if black] where: GFR = glomerular filtration rate in ml/min/1,73m2 Scr = serum creatinine in mg/dL κ = 0.7 for females and 0.9 for males α = -0.329 for females and -0.411 for males min indicates the minimum of Scr /κ or 1, and max indicates the maximum of Scr /κ or 1. • Post-donation GFR will be calculated by the CKD-EPI formula, as expressed above. 5.3.4 Chronic kidney disease Defined as per the revised Kidney Disease Outcomes Quality Initiative (KDOQI) as either kidney damage or GFR<60 ml/min/1.73 m² for ≥ 3 months. Kidney damage encompasses pathological abnormalities or markers of damage, including biochemical or radiological abnormalities. GFR is further classified into stages (table 1.1). Table 1.1 | Revised KDOQI classification for chronic kidney disease GFR Stages GFR (ml/min/1.73 m2) Classification 1 >90 Normal 2 60 – 89 Mildly decreased 3a 45 – 59 Mildly to moderately decreased 3b 30 – 44 Moderately to severely decreased 4 15 – 29 Severely decreased 5 <15 ESKD 5.3.5 Body mass index • BMI will be calculated as weight (in kilograms) divided by height (in meters) squared. • It will then be sub-classified as per the World Health Organisation (WHO) international BMI classification (table 1.2). Table 1.2 | WHO international classification of BMI Classification BMI (kg/m2) Underweight < 18.5 Normal Range 18.5 to 24.99 Overweight Pre-obese Obese - Obese Class I - Obese Class II - Obese Class III ≥ 25 25 to 29.99 ≥ 30 30 to 34.99 35 to 39.99 ≥ 40 5.3.6 Isolated medical abnormalities Refers to donors with any of the following characteristics prior to donation: • A borderline 51Cr-EDTA GFR <80 ml/min/1.73 m2 • Pre-existing hypertension well-controlled on a single agent with no end- organ damage • Class I obesity (BMI 30 - 35 kg/m2 )Item Data Series : Teacher Choices in Action(2022-02-28) Rusznyak, LeeThe data is in its raw state and is subject to ethics restrictions. The data will be made accessible to via an application to the Teacher Choices in Action Project data access committee ( see https://forms.gle/QYhmfpMdcJct9dRN8) . Data access is granted to researchers who are employed by participating institutions and the post-graduate students they supervise. Applications to use the dataset must be accompanied by a full research proposal that shows how the proposed study aligns with the Project aims and comply with the ethical protocols. and will be subject to peer review by a committee appointed by the Project Governance Steering Committee. A data sharing agreement needs to be completed, signed and lodged with the Research Office.Item Dataset from: The effect of TNF-α inhibitor treatment on microRNAs and endothelial function in collagen induced arthritis(2022-01-13) Gunter, Sulè; Michel, Frederic S.; Fourie, Serena; Singh, Mikayra; Le Roux, Regina; Manilall, Ashmeetha; Mokotedi, Lebogang.Palesa; Millen, Aletta M.E.; Millen, Aletta M.E.The dataset consists of 129 datapoints. The data is taken across two-time points. The dataset comprises two components. A subset from a previous study (Le Roux R, Mokotedi L, Fourie S, Manilall A, Gunter S, Millen AME. TNF-α inhibitors reduce inflammation-induced concentric remodelling but not diastolic dysfunction in collagen-induced arthritis. Clin Exp Rheumatol. 2021. Epub Jan 2021.) and additional data were collected for this study. The codebook details 58 variables, with ranges, definitions and protocols. However, only complete data is available for only 7 variables: number, group, sex, time in weeks, bodyweight in grams, Systolic and diastolic blood pressure. Rats were randomly divided into the control (n=24, 9 females and 15 males), CIA (n=24, 12 females and 12 males) and CIA+etanercept (n=16, 8 females and 8 males) groups. Systemic inflammation was induced in the CIA and CIA+etanercept groups using bovine type II collagen dissolved in incomplete Freund’s adjuvant, as previously reported (Le Roux et al., 2021). Upon the first signs of inflammation, approximately 3-4 weeks after CIA was first induced. Rats in the CIA+etanercept group received intraperitoneal injections of etanercept (Enbrel) and a 10 mg/kg dose of TNF-α inhibitor (Roche, Basel, Switzerland) every three days for six weeks. The data reports on the experiment and its resulting markers of inflammation and responses in mesenteric arteries.Item An argument for a paid and regulated living-unrelated kidney donation system in South Africa(2021) Ewing (Naude), Susan LesleyOne of the biggest challenges that global healthcare is experiencing is the shortage of kidney organ donors. Globally, the demand for organs is far greater than the supply and as a result, people who are on waiting lists will not get a chance to receive a kidney. Those who are waiting for transplants will require ongoing dialysis to survive (Nath & Fervenza, 2018). Dialysis is extremely costly and burdens the healthcare systems. Given the enormous gaps between supply and demand, this report seeks to answer the question: “Should South Africa follow the model of a paid and regulated living unrelated kidney donation system?” I begin with an analysis of South Africa’s current structure, the effects of this system and ultimately seeing the need for a different solution. I analyzed the various models globally in kidney donation, including the only country that allows for a paid system and the objections thereto. Currently, the sale of organs is prohibited in South Africa. My view is that our current South African model is lacking in solutions to the shortage of organ donors, particularly kidneys. There is a need for a better solution as the current system is failing to meet the needs of patients. In this paper, I use the principlism framework consisting of the four bioethical principles namely, autonomy, beneficence, non-maleficence and justice, to highlight the constitutional conflicts and the ethical dilemmas when considering a paid donation system. As I am arguing for a paid system in South Africa, I have included the ubuntu theory to show why objections to a paid and regulated system would fail. In conclusion, a paid and regulated living-unrelated kidney donation system is argued to be the most ethically and practically appropriate system in South Africa, to improve kidney donation rates and the livelihoods of the people
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