University of Ghana

Minimal residual disease (MRD) is a central biomarker in multiple myeloma (MM), offering unprecedented sensitivity for evaluating treatment efficacy and serving as a potential surrogate endpoint. We conducted a comprehensive analysis of clinical trials registered on ClinicalTrials.gov between 2014 and 2025. Interventional trials or observational studies investigating therapeutic interventions were included. Data on therapy response, MRD outcomes, measurement, and their role as primary, secondary, or adaptive endpoints were extracted. A total of 1336 studies met inclusion criteria. Among interventional trials, 86.4% included therapy response and 30.9% MRD as an outcome. Trials assessing MRD increased steadily from 6.7% in 2014 to 56.8% in 2025. Almost 50% of trials with recruiting (46.0%) or not yet recruiting (46.8%) status had an MRD outcome. MRD served as a primary outcome in 28.4% of trials with MRD assessment and guided therapeutic decisions in 7.5%. Most studies used next-generation flow or sequencing at a 10-5 threshold, though reporting heterogeneity persisted. MRD integration in trials has expanded substantially, reflecting its clinical and regulatory importance. Still, there is a need for coordinated evidence generation, standardization, and alignment with evolving EMA and HTA requirements. Future research should integrate patient experience data and emerging non-invasive MRD technologies to enhance clinical relevance and policy acceptance.

Reliable dietary data for adolescents in low- and middle-income countries (LMICs) are limited due to high costs and estimation errors in traditional dietary assessment methods. Although technology-assisted dietary assessment tools are becoming popular, few have been validated in LMICs. This study validated the PlantVillage Food Recognition Assistance and Nudging Insights (FRANI), an artificial intelligence-assisted mobile application for dietary assessment, against weighed food records (WFR) and multipass 24-h recalls (24HR) among adolescent girls aged 14‒18 y (n = 60) in urban/semi-urban communities in Sri Lanka. Dietary intake was assessed over 2 non-consecutive days using 3 methods: FRANI, WFR, and 24HR. The equivalence of nutrient intake was evaluated using mixed-effect models accounting for repeated measures by comparing intake ratios (FRANI/WFR and 24HR/WFR) with 10%, 15%, and 20% equivalence bounds. The concordance correlation coefficient was utilized to assess the agreement between methods. FRANI demonstrated equivalence with WFR at the 10% bound for energy and vitamin A; 15% for protein, fiber, iron, and zinc; and 20% for fat, niacin, and folate intakes. Comparisons between 24HR and WFR found that no nutrients fell within the 10% bound. Energy, protein, fat, iron, niacin, and vitamin A intakes were equivalent at 15% bound, whereas fiber, calcium, folate, and vitamin C intakes were equivalent at 20% bound. Concordance correlation coefficient ranged from 0.49 to 0.89 for FRANI compared to WFR, and 0.44 to 0.84 for 24HR compared with WFR. Omission errors were 2% for FRANI and 12% for 24HR, and intrusion errors were 7% and 9%, respectively. PlantVillage FRANI application accurately estimated nutrient intakes of adolescent girls in Sri Lanka compared to the WFR. Its performance was at least comparable to the traditional 24HR method, supporting its potential as a scalable alternative for dietary assessment in similar LMIC populations.

To examine the association between women's empowerment, measured using the Survey-based Women's emPowERment (SWPER) Global Index, and receipt of quality antenatal care (ANC) in Ghana. Cross-sectional analysis of nationally representative survey data. Ghana. A total of 3837 women aged 15-49 years who had a live birth or stillbirth in the 3 years preceding the 2022 Ghana Demographic and Health Survey and reported at least one ANC visit for the most recent pregnancy. Quality ANC was defined as receipt of four essential ANC components: blood pressure measurement, urine testing, blood sample collection and iron supplementation. Women's empowerment was assessed across three SWPER domains: attitude toward violence, social independence and decision-making, categorised as low, medium or high. Multilevel mixed-effects logistic regression models were used to examine associations while accounting for individual, household, community and regional-level factors. Overall, 90.9% of women received all four ANC components. In bivariate and partially adjusted analyses, higher empowerment in the attitude toward violence and social independence domains was associated with higher odds of receiving quality ANC. However, these associations were attenuated and no longer statistically significant in the fully adjusted multilevel model. The strongest independent associations with quality ANC were health-service utilisation factors. Late ANC initiation at 4-6 months (adjusted OR (AOR)=0.75, 95% CI 0.59 to 0.97) and ≥7 months (AOR=0.28, 95% CI 0.16 to 0.49) reduced the likelihood of receiving quality ANC, whereas attending 4-8 visits (AOR=2.89, 95% CI 2.05 to 4.07) and ≥nine visits (AOR=4.25, 95% CI 2.69 to 6.71) increased the likelihood. Receiving ANC at private hospitals was associated with lower odds of quality ANC compared with public hospitals (AOR=0.43, 95% CI 0.26 to 0.74). Regular radio exposure was positively associated with quality ANC, and substantial regional disparities persisted, particularly in the Western North, Northern, Savannah, North East and Upper East regions. In Ghana, women's empowerment indirectly influences the quality of ANC through pathways of early initiation and adequate continuity of care, whereas health-system factors and regional inequities remain the dominant independent determinants. Policy efforts should prioritise timely ANC initiation, continuity of care and equitable service delivery, alongside integrated empowerment strategies within broader health-system strengthening initiatives.

Abstract Purpose With widening wage gaps between Ghana’s public and private sectors, many workers engage in secondary employment (moonlighting) to supplement income and sustain living standards. This paper examines the incidence and drivers of moonlighting, focusing on how sectoral wage differentials shape such decisions. While prior studies have explored general motives for multiple jobholding, few have empirically linked these behaviours to wage disparities. The study investigates whether public–private wage gaps influence moonlighting and identifies the main determinants of sectoral wage outcomes. Design/methodology/approach: Drawing on nationally representative data from the Ghana Living Standards Survey (GLSS 7), the study applies Ordinary Least Squares (OLS) to estimate determinants of wages, Oaxaca–Blinder decomposition to quantify wage gaps, and probit models to assess the probability of moonlighting. Explanatory variables include personal (education, gender, marital status), household (size, rural/urban location), and labour market characteristics (experience, hours worked, job security). Findings: Results show that education, location, and experience significantly affect wages in both sectors, while men consistently earn more than women. Oaxaca–Blinder decomposition reveals that most wage differences stem from variations in worker characteristics, though unexplained disparities point to structural inefficiencies. Moonlighting is more prevalent in the public sector, driven by lower wages and cost-of-living pressures. Lower earnings, larger households, and rural residence significantly increase the likelihood of secondary employment. Originality/value: This study provides the first empirical evidence linking public–private wage disparities to moonlighting in Ghana, offering insights to guide wage policy, labour market reforms, and human resource strategies.