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Patience Olayinka Akinwusi,1,2 Adetunji Oladeni Adeniji,3 Oluseyi Olaboyede Atanda,3 Adebayo Duyile Adekunle3 1Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, 3Department of Obstetrics and Gynecology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria Purpose: To determine the incidence of heart failure during pregnancy and incriminated cardiac lesions, as well as maternal and fetal outcomes in Ladoke Akintola University of Technology Teaching Hospital (LTH), Osogbo, Southwest Nigeria. Methods: This study was a retrospective, descriptive review of all cases of heart failure during pregnancy based on data retrieved from the medical records of LTH over a 7-year period from January 2004 to December 2010. Analysis of these data was carried out using SPSS 17. Ethical clearance was obtained from the Ethical Committee of LTH. Results: A total of 4523 patients delivered babies over the 7-year period, ten (2.2/1000) of which had cardiac decompensation. All patients were not registered at LTH for antenatal care (unbooked), with 70% of them aged 18–24 years. Fifty percent were primigravidae and the majority of them presented with symptoms in the second and third trimester. There were two cases of maternal deaths recorded and three cases of fetal/perinatal mortality. Only one case of congenital heart disease (pulmonary stenosis) and no cases of rheumatic heart disease were found. Conclusion: The data suggests that heart failure during pregnancy is uncommon in Southwest Nigeria. However, it occurs more often in young, unbooked primigravid women. Efforts should be aimed at encouraging early booking for antenatal care and a full cardiovascular evaluation to prevent associated maternal and fetal/perinatal morbidity and mortality. Keywords: heart failure, pregnancy, cardiac disease, fetal outcome, maternal outcome

Abstract Introduction Stroke is one of the most devastating complications of sickle cell disease (SCD). Transcranial Doppler Imaging (TCDI) is the least invasive screening method to predict patients at risk for developing stroke in the disease. After a 10-year follow-up, we longitudinally assessed the TCDI in children with SCD without neurological symptoms. Methods 25 out of 43 pediatric patients with SCD studied 10-year previously were recruited. The remaining 18 patient were not available for follow-up, but their initial data are presented for comparison. TCDI scanning was carried out using a phased-array transducer of 1–3 MHz through the trans-temporal window. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged mean of the maximum velocity (TAMMV), resistive index (RI), and pulsatility index (PI) were obtained in the anterior and posterior Circle of Willis vessels. Results The highest initial and follow-up TAMMV (mean ± SD) were: 77.3 ± 20.9 and 71.6 ± 9.9 in the t-ICA, 94.3 ± 25.8 and 82 ± 18.2 in the MCA, 76.6 ± 25.6 and 70.6 ± 10.7 in the ACA, and 59.1 ± 15.8 and 63.9 ± 8.5 in the PCA, respectively. There was no statistically significant difference between initial and follow-up SCD data for all vascular parameters in all vessels on each side (P > 0.05) except for RI and PI (P

Abstract Background The self-reported KIDSCREEN questionnaires are ideal for capturing children’s and adolescents’ health-related quality of life (HRQoL) and have gained worldwide popularity. Responding to demands for the concise nature of KIDSCREEN among Chinese Mainland researchers and practitioners, this study aimed to evaluate the psychometric properties of the Mandarin Chinese self-reported KIDSCREEN-27 (KS-27) and KIDSCREEN-10 index (KS-10), which are short versions of the self-reported KIDSCREEN-52 (KS-52). Methods This study reanalyzed the validation dataset of the Mandarin Chinese self-reported KS-52. The dataset originated from a cross-sectional survey conducted in Weifang City, the Chinese Mainland, from October to November 2016. Adolescents aged 11–17 years (N = 4385) were surveyed, and sub-samples (N = 841) were retested. Statistical analyses were conducted on the feasibility, item and dimension properties, reliability, and validity of the Mandarin Chinese self-reported KS-27 and KS-10. Results Indirect evidence from the Small Group Pilot Survey indicated that the Mandarin Chinese self-reported KS-27 and KS-10 can be completed on average in less than 12.33 mins. Their response rate exceeded 90% regardless of the unit- and item (dimension)-level. The psychometric properties of items and dimensions were likewise found to be satisfactory. Internal consistency was robust with inter-item and item-total correlations (0.173–0.873, 0.422–0.786), Cronbach’s alpha (0.786–0.881), Guttman’s lambda-2 and - 6 (0.807–0.889, 0.829–0.896), and McDonald’s omega (0.725–0.886). Test–retest reliability at both item- and dimension-level was excellent, with intraclass correlation coefficients (ICCs) of (0.590–0.696, 0.785–0.842); standard error of measurements (SEMs) of (0.352–0.635, 0.949–1.949). Confirmatory factor analysis (CFA) confirmed their five- and one-dimensional structures, albeit with slight modifications. Moreover, the multi-group confirmatory factor analysis (MG-CFA) substantiated their configural and metric invariance across gender and grade groups. Convergent validity was robust, with stronger correlations observed with comparable dimensions of the Mandarin Chinese self-reported PedsQL™ 4.0, while discriminant validity was evident with low correlations observed with less comparable dimensions. The known-group validity was mainly supported by medium to large effect sizes concerning differences in socioeconomic status (η2 = 0.07–0.17, Cohen’s d = 0.55–1.03) and mental health status (η2 = 0.09–0.40, Cohen’s d = 0.73–1.83). The Mandarin Chinese self-reported KS-52 served as the criterion; the ICCs between the Mandarin Chinese self-reported KS-27 and KS-10 and their comparable dimensions were stronger, indicating robust criterion validity. Conclusions The Mandarin Chinese self-reported KS-27 and KS-10 demonstrated excellent psychometric properties, indicating their good potential for measuring HRQoL for children and adolescents in the Chinese Mainland.

In contemporary Nigeria, the proliferation of prophetic claims has profoundly influenced popular religious practices across all societal strata. This phenomenon engages individuals from various backgrounds as they seek divine insights and prophecies from spiritual leaders. This study focuses on Ola Rotimi's play The Gods Are Not to Blame to critically examine the role of prophecy within African cultural beliefs. While existing scholarship on Rotimi's work often analyzes themes of fate, tragedy, and the allocation of blame within the play among others, scant attention has been paid to the fundamental role of prophecy itself as the root cause of the play’s tragic events. This research aims to conduct a deconstructive reading of the play, scrutinizing how the characters' pursuit of foreknowledge and attempts to alter their fates paradoxically precipitate their destinies. The method involves a detailed textual analysis of the play, focusing on key dialogues and actions that highlight the characters' motivations and the unfolding of events. The findings reveal two key instances: first, Baba Fakunle’s prophecy, which foretells disaster for Odewale’s family, leads his parents to attempt to kill him to prevent the predicted calamity. Ironically, this attempt to alter the future sets in motion the very disaster they sought to avoid. Secondly, an elder’s parable causes Odewale to discover the prophecy's truth. In trying to understand and avoid his destiny, Odewale discovers that his actions to prevent it end up fulfilling it. Both instances suggest that the desire to know and change the future is fraught with peril, often precipitating the very outcomes one seeks to avoid. The conclusion emphasizes the prudence of embracing the uncertainty of the future, as attempting to alter it can lead to unintended and often tragic consequences.

Abstract Background Non-communicable diseases are an increasing threat in sub-Saharan Africa (SSA), and overweight and obesity are affecting people across all socioeconomic groups. Some studies suggest that big body sizes may be perceived as desirable among women in SSA and that high prevalence of obesity and overweight are especially present in low socioeconomic societies. This study explores the role of socioeconomic factors in the perception of the ideal body among Kenyan women and whether perceptions and beliefs about the ideal body should be considered relevant when targeting the prevention of obesity and overweight. Method In-depth interviews were conducted with 8 Kenyan women with varying educational backgrounds, aged between 21 and 48, using a qualitative study design. The interviews were conducted in December 2022 and January 2023 in Nairobi, audio-recorded, transcribed and analysed through qualitative content analysis and a coding system using deductive and inductive codes. Results The participants reported that conclusions about a person’s health and wealth status are drawn based on different body sizes. Furthermore, traditional views about the ideal body size, societal pressure, as well as the women’s own experience with their body size play a role in the perception of an ideal body. Conclusion Small-sized women desire to gain weight as society may view them as weak and sick. Big-sized women aim to reduce weight primarily due to health complications. Nevertheless, traditionally, a big-sized woman is considered strong and wealthy, creating external pressure on women to fulfil this body image—these findings emphasise traditional aspects in designing culturally sensitive prevention and intervention methods to address overweight and obesity.

Objective To explore the gaps in the safe handling, administration, preparation and disposal of chemotherapy agents in low and middle-income countries.Design Two surveys comprising a needs assessment survey and an American Cancer Society (ACS) ChemoSafe Facility Assessment.Setting 2019 African Research Group for Oncology Symposium in South-West Nigeria (needs assessment) and the 2021 virtual engagement (ChemoSafe Assessment).Participants Health professionals (n=50 of 98) from multiple institutions across Nigeria (needs assessment survey) and a designated task force of health professionals (n=10) from one teaching hospital in Southwest Nigeria(ChemoSafe Facility Assessment).Results In 2019, 75% of survey respondents (n=50) reported a lack of training resources for safe handling of chemotherapy. Additionally, 61% felt dissatisfaction with assessment practices for preparing and administering chemotherapy. ChemoSafe is a programme developed by the ACS to assess the ability of a facility to handle hazardous drugs. The 2021 ACS ChemoSafe survey administered at one teaching hospital indicated several areas for improvement to promote concordance with international standards for safe handling. Thirty-three (19.5%) items received a ‘Yes’ response (ie, met compliance with international standards).Conclusion There is a need for the implementation of training resources for handling, administering and disposing of chemotherapy at sites across Nigeria. Strategies to identify and prioritise areas of need must be implemented in the context of available resources.

Abstract Background Eosinophilic fasciitis (EF) is a rare disease characterized by skin induration and musculoskeletal abnormalities. Diagnostic criteria for EF are based on adult populations. There is a need to expand the literature on EF in children due to limited reported cases and potential differences compared to adults. Methods We conducted a retrospective review of medical records for six pediatric patients diagnosed with EF at our institution between November 2011 and April 2023. Inclusion criteria required patients to be under 18 years of age at the time of diagnosis and to have confirmed diagnosis through clinical history, imaging, and histology. Results Most of our cohort were female (83%) and non-Hispanic white (50%). Age at diagnosis ranged from 4 to 16 years. Duration of symptoms before diagnosis varied from 1 to 12 months. Follow-up periods ranged from 14 to 123 months. Concurrent medical conditions included localized scleroderma, acquired thrombophilia, and juvenile idiopathic arthritis. Patients presented with progressive painful swelling, severe joint limitations, and positive prayer sign. Initial regimens involved corticosteroids and methotrexate. Hydroxychloroquine, immunoglobulin, mycophenolate mofetil, rituximab, and tocilizumab were also used depending on the patient’s disease severity and course. Conclusions Juvenile EF may manifest as swelling and progressive induration without apparent skin abnormalities. Unlike adult populations, no underlying malignancies or associations with trauma were observed in our cohort. Our cases did not exhibit systemic involvement observed in previous studies on juvenile EF. While non-specific, the prayer sign may aid in early recognition of juvenile EF and help prevent long-term disability.

Abstract Background Exploring and understanding indicators of better life outcomes have remained popular among social and health researchers. However, the subjective approach to measuring well-being has raised questions on the appropriateness of standard measures of well-being in multicultural settings. The current study examines generalised well-being and its dependence on the implicit understanding of individual culture and circumstances. Methods A mixed-method approach with a cross-sectional design and focus group discussions was adopted. Fifteen focus group discussions with 66 participants were conducted in four provinces of South Africa. Descriptive statistics, correlations, regression analysis and analysis of variance were computed for quantitative data. The focus group discussions were analysed using a content analysis approach. The recorded focus group discussions were transcribed using the intelligent verbatim technique. Data analysis was done stepwise using open, axial, and selective coding techniques. Results Quantitative analysis showed a strong and significant association between quality of life and income and a moderate association with educational attainment. The open coding technique for qualitative data confirmed 11 different subconstructs of well-being, mentioned 403 times during the 15 focus group discussions. Furthermore, well-being indicators varied based on participants’ racial identity. Conclusions The findings confirm personal circumstance and culture as significant for interpreting results from well-being research. Furthermore, it supports Maslow’s Hierarchy of Needs, highlighting the movement from deficiency needs to growth needs after deficiency needs are met. Research must adopt a more sociological approach to improve the accuracy and implementibility of findings when using standardised measures of well-being.

The planetary gear sets find application in the final stages of the helicopter transmission system. Unlike the single axis gear, the planetary gears have complex structural arrangement and unique operational characteristics which makes diagnosis of incipient fault much more challenging with planetary gears compared to the single axis gear. This study provides a background for effective planetary bearing fault analysis in an SA330 Super-Puma Helicopter Main gearbox by studying the characteristic of the planetary stage and investigating some prominent frequency components which are vital to fault feature extraction. Vibration data of healthy and faulty conditions at varying load regimes from a seeded fault experiment were captured. The analysis of the vibration transmission paths and the signal amplitude in the time and frequency domain provide the basis for the determination of the best signal quality. Eight transmission paths affecting the signal energy were established however, the shortest path to the radial direction of the faulty bearing assures better signal gain. The gear mesh frequencies and harmonics of the planetary stages are suppressed by the high amplitude frequencies of the forward, aft and bevel reduction gears. The impulsive carrier frequency at high speed has a strong correlation with gear-related frequencies. Though the fault frequencies can be traced in some instances, it is mostly dominated in the spectrum because of the gear-related frequencies and amplitude modulation of the planetary stages. This work enhances the planetary bearing fault extraction.

The restriction of blood flow due to narrowing of arteries that supply blood to different parts of the body leads to high blood pressure and cholesterol in humans. In this study, blood flow in a 3D model of arterial stenosis was examined using computational fluid dynamics (CFD) technique. The geometry of the stenosis was modeled using ANSYS software, and a structured tetrahedral mesh was generated for accurate representation. The CFD analysis was performed using the ANSYS (FLUENT) 19.2 commercial code to investigate three stenosis levels of 75%, 50%, and 25% over the Reynolds number range of 500-2000 with blood as the working fluid. The blood flowed steadily upstream of the stenosis as incompressible, homogeneous, and Newtonian, while the artery is considered to be inflexible. The Reynolds-averaged Navier-Stokes equations and the low Reynolds number SST k-ω turbulence model were employed to simulate the blood flow. The governing equations are solved, and the pressure-velocity coupling is handled using the SIMPLEC algorithm. The steady state velocity and pressure generated at the inlet and outlet of the artery enabled the hemodynamic properties and flow reversal through arteries with a progressive amount of atherosclerosis to be determined. The results are presented in terms of velocity distribution, streamlines, and turbulence intensity contours. The results showed that at the throat (Z = 0) of the 75% stenosis, the relative magnitude of the velocity is greater than or equal to four times the average velocity. Reversal of flow is visible at for Re = 500 and for Re = 750 and Re = 2000. Furthermore, the effects of 25% stenosis on the flow pattern are relatively blunt and weak at . The throat of the stenosis, or a site therein, exhibits the highest value of centerline velocity, while turbulence intensity becomes severe at the post-stenotic site and they both increase with increasing stenosis level. The study provides valuable insights into the velocity distribution, flow reversal phenomenon, and turbulence intensity in arterial stenosis. The findings highlight the significant impact of stenosis levels and Reynolds numbers on the hemodynamic behavior, offering important considerations for understanding and managing arterial health issues.

Abstract Understanding socioeconomic status (SES) and social capital as predictors of life outcomes has remained central to humanitarian, health and social research. This current study explores how socioeconomic status and social capital (community solidarity, locus of control and generalised trust) predict happiness among a sample of South African adults. Possible gender differences were also considered. Cross-sectional data from (n = 1049) South Africans on SES, social capital, happiness and sociodemographic characteristics were collected using an online questionnaire between January 2021 and September 2021. A correlation matrix was calculated to explore bivariate associations between the variables. Hierarchical regression analysis was conducted to examine the predictive influence of SES and social capital indices on happiness and the gender differential in these relationships. SES and all social capital variables were significantly correlated with happiness. The model, including SES and social capital, accounted for 25% of the variance in happiness. Gender differences were found regarding the relationship between SES and all social capital variables (except locus of control) and happiness. The results confirm that efforts to facilitate individual social capital correspond to greater happiness among South Africans. Furthermore, it highlights the need for further empirical exploration of social predictors of life outcomes. The current analysis provides a framework for developing and implementing policies that promote happiness and other life outcomes.

Abstract The war in Ukraine has generated an increase in the number of refugees. As one of the top recipients of refugees, Germany has introduced policies to ease the integration of Ukrainians. The current study explores mental health outcomes and their association with quality of life among a sample of Ukrainian refugees in Germany. Cross-sectional data were collected from a sample of Ukrainian refugees in Germany (n = 304) using standardised instruments. A t-test was used to check for possible significant differences based on gender. Multiple regression analysis was used to analyse potential associations between general health (GHQ-12) and depressive symptoms and anxiety (PHQ-4), and quality of life (EUROHIS-QOL 8 item). Female participants reported significantly higher psychological distress, depressive symptoms and anxiety. The significant model (p

Background/Introduction: Conflict-induced displacement continue to be a pressing public policy concern due to the adverse effects on the well-being of internally displaced persons (IDPs). Understanding the integration process of these individuals, particularly the role of solidarity and social integration in fostering a sense of belonging and improving their community experiences and psychological well-being, remains unclear. This study investigates the role of community satisfaction in the relationship among social integration, solidarity, and psychological health of IDPs in Cameroon. Methods: Cross-sectional data from 428 displaced individuals in the Ntui subdivision, Cameroon, were analyzed using structural equation modeling (SEM). This technique tested four latent variables: social integration, solidarity, community satisfaction, and psychological health. Results: The results show a direct association between solidarity and both community satisfaction (β = 0.282; p

While recurrence is frequent in ependymoma, the underlying molecular mechanisms remain to be explored. Here, the authors investigate epigenetic, genetic and tumorigenic changes in 30 patient-matched repeated relapses over 13 years and identify distinct patterns of DNA methylation.

The global energy crisis and ozone layer depletion as a result of carbon emissions have increased the awareness and acceptance of renewable energy sources as an alternative form of electric power, resulting in the sizing of renewable energy sources. However, in order to properly size an energy power system, the information being addressed, such as the load demand, is critical. The Load demand data of Nile University campus is obtained from one of its power stations (PS-1) for a period of eight month. The data was measured from the bus bar of the power station using smart meters on a weekly basis. To power the university campus, the diesel generators are synchronized using Genset controllers with suitable communications interfaces and a SMA hybrid controller, which continually checks the power output of the power sources as well as the working condition of all loads in the busbar. The diesel generators are synchronized using SMA hybrid controllers and combined with the other source of the energy at a common bus bar and used to power the university campus. Additionally, carbon emission data were obtained from the PV solar system reading.

Food production in Nigeria is almost entirely rain fed despite the great potential of irrigation in Nigeria to boost agricultural productivity. The study assessed the profitability and efficiency of dry season irrigated okra farming in Adamawa State using primary data collected from 180 farmers through a simple random sampling technique. Profit efficiency and stochastic frontier function were used in analyzing the data. The result revealed that labor costs accounted for 48% of average variable cost while a farmer’s total revenue from irrigated okra produce was ₦228,642.56K ($408.2), total fixed cost and variable input cost was ₦102,440.37K ($182.93), resulting in a net farm income (NFI) of ₦126,201.63K ($225.36). The coefficients of farm size, household size, and fertilizer were positive and significant at the 1%, 10%, and 5% levels of probability, respectively, as revealed by the OLS results. Empirical estimate shows that the mean technical efficiency value of vegetable farmers was about 0.73 while Technical inefficiency coefficient of farming experience (−0.420), adjusted household size (−0.193), and extension contacts (−0.162) are variables that increased technical efficiency. Lack of access to water, high cost of equipment, and inadequate finance were identified as lead constraints of the okra farmers. Therefore, recommendations by the study are that farmers be encouraged to establish cooperative organizations so that they can pool their resources to create an irrigation system that is affordable. Also, sustainability of small scale irrigation scheme should be promoted by the government through skill enhanced trainings.

Male gonopods are useful in taxonomic diagnoses and descriptions of millipedes, although they may vary intraspecifically in shape and size. To assess this intraspecific variation, we used geometric morphometric analysis to compare gonopod morphology among eight isolated populations of the colour-polymorphic southern African millipede Bicoxidens flavicollis. Our results showed that gonopod shapes vary significantly across the examined populations, and elucidated subtle variations. CVA cross-validation test indicates an average classification rate of 75% for the five populations for which we had more than one specimen. Although we had a small number of replicates for three populations, our results still illustrate the importance of applying quantitative approaches to what would otherwise be qualitative and subjective gonopod shape categories in millipedes. As such, the taxonomic assignment of the populations of B. flavicollis may require further investigation, and further revisions would be required with an integrative approach, including molecular data, in order to re-evaluate the taxonomic diversity and distribution data of this species. Finally, we highlight the conservation potential of divergent populations as evolutionary insurance against a dynamic and unpredictable climate, whether or not they undergo full speciation.

This work presents a three-dimensional computational study of nanoparticles (metallic and non-metallic) suspended in blood flowing through a diseased artery with both stenosis and aneurysm. From the perspective of pharmacodynamics and heat transfer, the influence of nanoparticles on hemodynamic indicators was investigated in a diseased artery. The blood was flowing fluid, steady-state, incompressible, homogeneous, and Newtonian, while the artery was a rigid wall. The three-dimensional continuity, Navier-Stokes, and energy equations were solved numerically by using a RAN-based standard k-ω model, which was performed on the ANSYS commercial software package. The influence of different selected nanoparticles (Al2O3, CuO, SiO2, and ZnO), nanoparticle concentration (1.0%-4.0%), and nanoparticle diameters (25 nm - 100 nm) on hemodynamic parameters such as velocity, temperature, turbulence intensity, more particularly skin friction coefficient and Nusselt number of the blood flow on the diseased artery, was also investigated. The streamlines, contours, and plots were adopted to better visualize the blood flow behavior in an artery with stenosis and aneurysm. The numerical results revealed that at a 4.0% nanoparticle concentration, CuO nanoparticles greatly reduced the blood velocity by 1.96% compared to other nanoparticles. About 0.66%-2.05% reduction in the blood velocity could be achieved by increasing the nanoparticle concentration from 1.0% to 4.0%. The SiO2 blood nanofluid showed the best result in augmentation of the Nusselt number by 53.0%. However, the nanoparticle diameter and concentration showed an insignificant effect on the skin friction factor

Abstract Objectives Transcranial Doppler imaging (TCDI) of the cerebral arteries is the method of choice to predict patients with sickle cell disease (SCD) at risk for stroke. This study reports TCDI follow‐up of cerebral blood flow in a cohort of Kuwaiti children with SCD after a 10‐year interval. Methods Twenty‐one pediatric patients with SCD, aged 16.0 ± 1.6 years were initially studied when they were aged 6.5 ± 1.2 years. TCDI scanning was carried out using a phased‐array transducer of 1–3 MHz through the trans‐temporal window. Peak systolic velocity (PSV), end‐diastolic velocity (EDV), time‐averaged mean of the maximum velocity (TAMMV), resistive index (RI), and pulsatility index (PI) were obtained in the anterior and posterior Circle of Willis vessels. Results The follow‐up indices were mostly lower than in the initial study although they remained within the normal range in all the arteries. TAMMV was less than 170 cm/s, and PSV did not exceed 200 cm/s in all vessels. The initial and follow‐up TAMMV (mean ± SD) were: 77.3 ± 20.9 and 71.6 ± 9.9 in the terminal internal carotid artery, 94.3 ± 25.8 and 82 ± 18.2 in the middle cerebral artery, 76.6 ± 25.6 and 70.6 ± 10.7 in the anterior cerebral artery, and 59.1 ± 15.8 and 63.9 ± 8.5 in the posterior cerebral artery, respectively. The mean differences between the old and follow‐up data for RI, and PI were statistically significant (p

Abstract Background The introduction of energy devices has significantly expanded the scope of surgical expedition. The LigaSure™ vessel sealing system is a bipolar electrosurgical device, recently introduced to our practice. Its impact on peri-operative outcomes in a variety of major operations was evaluated in this study. Methods A retrospective review of operations performed following the adoption of the LigaSure™ vessel sealing device was carried out. Five categories of operations were evaluated (Thyroidectomies, Gastrectomies, Colectomies, Pancreaticoduodenectomies, and Anterior/Abdomino-perineal resection [A/APR of the rectum). Peri-operative outcomes (duration of operation, intra-operative blood loss, blood transfusion rates) were compared with a cohort of similar operations performed using conventional techniques. Data analysis and comparisons were done on a subgroup basis. Results A total of 117 operations were performed using the LigaSure™ device with thyroidectomies being the most common (66/117-56.4%). Compared to cases done using conventional techniques of suture and knot with electrocautery (120 cases), the use of LigaSure™ was associated with a significant reduction in operation time in all categories of operations. Intraoperative blood loss was also lower in all categories of cases, but this was only statistically significant following A/APR and Thyroidectomies. Generally, there was a trend towards a reduction in blood transfusion rates. Conclusions The use of energy devices for surgical operations is feasible in a resource-limited setting. It has the potential of improving outcomes.

Background: Breast cancer is a global burden and has become a major public health concern. Early diagnosis through screening is the best way to achieve cure, reduce morbidity and mortality from breast cancer. Many of the women in this environment have little or no knowledge about breast cancer and the attitude and orientation of health-care professional are important determinants of the use of breast screening program. Aim: The aim of the study was to evaluate the knowledge and practice of breast cancer screening among female nurses in the Bida, Niger state. Materials and Methods: This study was a cross-sectional conducted among female nurses in Federal Medical Centre, Bida, between May and August 2021. The questionnaire contained 20 questions on the knowledge of breast cancer. Each correct answer had a score of 1 and 0 for an incorrect answer or “don't know.” The overall score was calculated for each respondent by summing up the symptom and risk score. It was graded as 0–9 = Poor and 10–20 = Good. Data collected were analyzed by computer analysis using the SPSS version 25. Results: A total of 150 female nurses participated in the study with mean age of 41.7 ± 8.1 years. Overall assessment of the respondent's knowledge of breast cancer revealed that 112 (74.7%) of them had good knowledge and 38 (25.3%) had poor knowledge. Only 59 (38.3%) practice breast self-examination monthly. Concerning clinical breast examination, 22 (14.7%) of them have had their breast examined before by a health professional while 12 (8%) of the participants had done mammography before. Conclusion: Our findings highlight that the knowledge of breast cancer among female nurses was good but it has not really translated into practices of the preventive measures for early detection of breast cancer.

Alcohol consumption is known to cause an array of alcohol-induced biochemical changes in a biological system. This study investigated the durations effects of different alcohol concentrations (30%, 40%, and 50%) on malondialdehyde levels, testes histology, and sperm characteristics in matured male Wistar rats. The rats were divided into four groups namely thus; control, 30%, 40% and 50%. Control group was orally administered 0% alcohol while, group 30%, 40% and 50% received orally 30%, 40% and 50% of alcohol concentrations (3.20 g/ Kg body weight) respectively for maximum durations of 28 days. On the day 1, 7, 14, 21, and 28, five rats from each group (control, 30%, 40% and 50% alcohol) were sacrificed, and malondialdehyde levels, testes histology, and sperm characteristics were examined.Graded alcohol concentrations caused different detrimental effects on sperm characteristics and induced pathological lesions in the testes. Significant increases in serum, liver and testes malondialdehyde levels were durations independent but almost entirely concentrations dependent.Ultimately, administration of alcohol graded concentration led to loss of sperm motility and testicular degeneration in concentration and durations dependent manner without a concomitant increase in the malondialdehyde levels.

Tax compliance is a major contemporary debate surrounding corporate taxation in the business world. The tax avoidance issue, which remains an ethical problem for companies, has been a general concern in developed and developing countries alike. The main problem of this study is a non-tax compliance behavior of the corporate organization taxpayers in Nigeria. This study examined the influence of tax fairness on the tax compliance behavior of listed manufacturing companies in Nigeria. The paper adopted a survey research method, and four hundred (400) copies of the questionnaire were administered to the selected manufacturing companies of both consumer and industrial goods sectors. The Laffer Curve Theory underpinned this study and Correlation Analysis, Analysis of Variance (ANOVA), and Multiple Regression Analysis were also employed. The study found that there is a significant level of tax compliance among the listed manufacturing companies in Nigeria. The study also shows that the corporate taxpayer’s perception of fairness of –2.765 (0.006) has a significant impact on corporate taxpayers’ willingness to pay taxes and tax knowledge of 4.601 (0.000) significantly influenced tax compliance. Based on tax knowledge, the study recommends that tax authorities must improve the knowledge of taxpayers and tax collection agents through programs, initiatives, and training on tax awareness.

Geopolymer concrete and mortar have evolved over the years as potential alternatives for reducing the greenhouse gases associated with cement production. This current research was aimed at investigating the optimum dosage and concentration of sodium hydroxide required to leach out silica and alumina oxides in the fly ash for geopolymerization to take place. Blackish grey fly ash from Morupule, Botswana, was synthesized by varying sodium hydroxide (NaOH) of 98% purity between 8 M and 14 M, respectively. The ratio influence of sodium hydroxide to fly ash in dissolving the oxides was carried out at the values of 0.55, 0.62, and 0.75. The results showed that the workability of the geopolymer mortar and paste decreased with the increase in the ratio of fly ash to alkaline activator. The highest workability was achieved at a ratio of 0.75 : 1. The compressive strength, setting time, and workability of geopolymer mortar and paste can be controlled by adjusting the ratio of fly ash to alkaline activator. A ratio of 1.5 : 1 was found to be the most suitable for achieving high compressive strength, while a ratio of 0.75 : 1 was found to be the most suitable for achieving high workability. Furthermore, the workability values were in the range of 105 to 143 mm, while the ranges of initial and final setting times were found to be between 280–350 and 950–1170 minutes, respectively. This study is significant because no previous study has carried out geopolmerization of the Morupule fly ash as a result of its unique characteristics. These findings have important implications for the development of sustainable construction materials. The main finding was that for optimum reaction to take place, and NaOH/fly ash ratio should be kept at 0.55 and molarity of 12 to avoid leaching of other oxides that might weaken the strength.

The loss of splenic function is associated with an increased risk of infection in sickle cell disease (SCD); however, spleen function is rarely documented among SCD patients in Africa, due partly to the non-availability of sophisticated techniques such as scintigraphy. Methods of assessing splenic function which may be achievable in resource-poor settings include counting red blood cells (RBC) containing Howell Jolly Bodies (HJB) and RBC containing silver-staining (argyrophilic) inclusions (AI) using a light microscope. We evaluated the presence of HJB-and AI-containing RBC as markers of splenic dysfunction among SCD patients in Nigeria. We prospectively enrolled children and adults with SCD in steady state attending outpatient clinics at a tertiary hospital in North-East Nigeria. The percentages of HJB-and AI-containing red cells were estimated from peripheral blood smears and compared to normal controls. There were 182 SCD patients and 102 healthy controls. Both AI- and HJB-containing red cells could be easily identified in the participants blood smears. SCD patients had a significantly higher proportion of red cells containing HJB (1.5%; IQR 0.7%-3.1%) compared to controls (0.3%; IQR 0.1%-0.5%) (P

Introduction COVID-19 pandemic public health emergency is one of the worse disease outbreaks in the history of infectious disease. The consequence has resulted in over 4 million deaths globally. Therefore, a more in-depth understanding of the dynamics of the disease, vaccine development, and safety has become crucial for the disease eradication. Objective The study adopted bibliometric analysis to identify the global contribution in COVID-19 and Vaccine Safety and analyzed the current status, development, and research hotspots to reference for future research directions. Methods Studies published between January 1, 2019 and July 11, 2021 were retrieved from the Scopus database. Data analysis and visualization were conducted using VOSviewer ver 1.6.6, Bibliometrix app. (Using R). Results A total of 1827 publications with 12.14 average citations per document were identified. These publications were published in 796 journals by 10,243 authors (with 5.61 authors per document) from 80 countries/regions. About 33.75% of the researches were from the developed countries. The USA, China, and India were top contributors for scientific research on COVID-19 and vaccine safety. The “Vaccine” is the most productive journal with 58 articles. Li Y, NA NA, and Liu X were the top three prolific authors. Furthermore, “Human,” “Coronavirus disease 2019,” and “Drug safety,” were the most common frontier topics. Conclusions Our analysis highlights the characteristics of the most influential articles on COVID-19 related to vaccine safety. The findings provided valuable insight into the scientific research progress in this domain and suggest scaling-up research and information dissemination on COVID-19 and vaccine safety.

This paper discusses the application of Eye Tracking (ET) technologies for researchers to understand a driver’s perception of signage at the highway work zone. Combining ET within a screen-based motion pictures and a driving simulator, the team developed an analytical method that allowed designers to evaluate signage design. Two experiments were set up to investigate how signage design might affect a driver’s visual attention and interaction under various environmental complexities and glare conditions. The study explores the visual perception related to several spatial features, including signage modality, scene complexity, and color schemes. The ET method utilizes total fixation time and time to first fixation data to evaluate the effectiveness of signage presented through screen-based video and a driving simulator.

Abstract Atypical teratoid rhabdoid tumor (ATRT) is an aggressive embryonal brain tumor among infants and young children. Two challenges exist for preclinical testing in ATRT. First, genetically quiet, ATRT is a difficult tumor to target molecularly. Tumor cells need to divide to propagate tumor growth—intercepting the common crossroads in cell cycle progression is a feasible strategy. KIF11 is needed for bipolar spindle formation in metaphase. We identified KIF11 as a universal target of all ATRT-molecular-subtypes. Ispinesib, a KIF11-inhibitor, effectively inhibited tumor proliferation in all seven cell lines. A second challenge—a major challenge in preclinical drug testing in-vivo among aggressive tumor models, is the narrow therapeutic window to administer drugs within the limited murine lifespan. Our most aggressive ATRT tumor model was lethal in all mice within ~ 1 month of tumor implantation. Such short-surviving mouse models are difficult to employ for preclinical drug testing due to the narrow time window to administer drugs. To overcome this time restriction, we developed a clinical staging system which allowed physically-fit mice to continue treatment, in contrast to the conventional method of fixed drug-dose-duration regimen in preclinical testing which will not be feasible in such short-surviving mouse models. We validated this approach in a second embryonal brain tumor, medulloblastoma. This is a clinically relevant, cost-efficient approach in preclinical testing for cancer and non-cancer disease phenotypes. Widely used preclinical mouse models are not the most accurate and lack the aggressive tumor spectrum found within a single tumor type. Mice bearing the most aggressive tumor spectrum progress rapidly in the limited murine life-span, resulting in a narrow therapeutic window to administer drugs, and are thus difficult to employ in preclinical testing. Our approach overcomes this challenge. We discovered ispinesib is efficacious against two embryonal brain tumor types.

Research in social and humanitarian science has identified socioeconomic status (SES) as one of the essential determinants of quality of life (QoL). Similarly, racial identity is assumed to predict SES outcomes in multiracial settings. Therefore, understanding how racial identity moderates the association between SES and QoL may provide essential insights into the mechanisms generating socioeconomic inequalities and their implication on life outcomes. The current study employs a cross-sectional study designed to investigate the moderating effect of racial identity on the association between SES and QoL in a sample of 1,049 South Africans. A correlation matrix was computed to explore the bivariate associations between QoL, socioeconomic, and sociodemographic features. ANOVA was used to evaluate racial differences in QoL and SES. A moderator analysis was adopted to determine a possible moderating effect of racial identity on the connection between SES and QoL. Findings show a significant difference in QoL and SES based on race. While racial identity was a significant moderator of the association between QoL and SES for Black Africans, no significant moderating effect was reported for other racial groups. These results highlight the importance of racial identity for life outcomes and emphasis the unique experience associated with Black racial identity and its implications for SES, QoL, and their association in South Africa. This study explains the necessity to improve the QoL of minority groups, such as Black South Africans, and offers detailed explanations of their perceived disadvantage.

Objectives: Thyroglossal duct cyst (TDC) is the most common congenital anterior neck mass in clinical practice. Due to its congenital origin, presentation in adulthood is uncommon with only 7% of cases presenting in this age group. Data are therefore limited on the management of TDC in adults, particularly in Sub-Saharan Africa. This study describes the pattern of the presentation and treatment outcomes, following the management of TDC in a series of adults in a Nigerian tertiary hospital. Subjects and Methods: A retrospective review of all adult patients with TDCs over a 5-year period was carried out. Sociodemographic data, operative details, and postoperative outcomes were obtained and presented as descriptive statistics. Results: Seven adult patients, including five males and two females, were managed during the period. Their ages ranged from 19 to 60 years, with a mean of 37 ± 16.4 years. All the patients presented with anterior neck swellings which had been present for a median duration of 3 years. Cysts were located in the infrahyoid position in all instances, and all had Sistrunk operation over a mean operative time of 78 ± 16 min. There were no intraoperative complications. The mean duration of the postoperative stay was 2 days. There was no recurrence after a median follow-up period of 15 months. Conclusion: This study highlights the rarity of TDC in adults and describes a single institution's experience with the management of adult cases of TDC using the classical Sistrunk operation.

Experiences of discrimination such as everyday racism can negatively affect the mental and physical health of children and adolescents with an immigrant background and impair their integration process in the host societies. Although experiences of racism are part of the everyday life of many minors affected by the process of “Othering” (e.g., those with an immigrant background), an overview of empirical findings is missing for this age group worldwide. A systematic review was conducted to identify and analyze international research on the impact of discrimination on the developmental outcomes and integration of immigrant children and adolescents. Three scientific databases were systematically searched up to June 11, 2021. A total of k = 4,769 identified publications were reviewed based on inclusion and exclusion criteria in terms of the PICOS format by independent reviewers. Thirty-four primary studies published between 1998 and 2021 met all inclusion criteria. The samples examined were mainly migrant youth (k = 30), with only k = 2 studies assessing refugee youth and k = 1 study assessing both migrant and refugee youth. The majority of included studies assessed perceived discrimination, with only k = 1 study directly assessing experiences of racism. The association between discrimination or racism and developmental outcomes was assessed by the included studies within the three main topics of (a) mental and physical health-related outcomes (k = 30, e.g., self-esteem, depressive symptoms), (b) school-related outcomes (k = 6, e.g., academic achievement), and (c) other developmental outcomes (k = 13, e.g., misconduct or delinquency). Data collection procedures were implemented, and findings on minors’ developmental outcomes and integration process who experience discrimination and racism were summarized and discussed. The current review suggests experienced (racial) discrimination as a negative predictor of children and adolescents’ (mental) health-related outcomes, while no clear results could be found for the association between discrimination and school-related outcomes. A need for more empirical research focusing on the path and (possibly) indirect link between discrimination and children and adolescents’ school-related outcomes as well as resulting school recommendations and the chosen career path was derived.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260291], identifier [CRD42021260291].

Clinical outcomes in patients with WHO grade II/III astrocytoma, oligodendroglioma or secondary glioblastoma remain poor. Isocitrate dehydrogenase 1 (IDH1) is mutated in > 70% of these tumors, making it an attractive therapeutic target. To determine the efficacy of our newly developed mutant IDH1 inhibitor, SYC-435 (1-hydroxypyridin-2-one), we treated orthotopic glioma xenograft model (IC-BT142AOA) carrying R132H mutation and our newly established orthotopic patient-derived xenograft (PDX) model of recurrent anaplastic oligoastrocytoma (IC-V0914AOA) bearing R132C mutation. In addition to suppressing IDH1 mutant cell proliferation in vitro, SYC-435 (15 mg/kg, daily x 28 days) synergistically prolonged animal survival times with standard therapies (Temozolomide + fractionated radiation) mediated by reduction of H3K4/H3K9 methylation and expression of mitochondrial DNA (mtDNA)-encoded molecules. Furthermore, RNA-seq of the remnant tumors identified genes (MYO1F, CTC1 and BCL9) and pathways (base excision repair, TCA cycle II, sirtuin signaling, protein kinase A, eukaryotic initiation factor 2 and α-adrenergic signaling) as mediators of therapy resistance. Our data demonstrated the efficacy SYC-435 in targeting IDH1 mutant gliomas when combined with standard therapy and identified a novel set of genes that should be prioritized for future studies to overcome SYC-435 resistance.

Abstract Moyamoya is a progressive cerebrovascular disease associated with stenosis or occlusion of the arteries of the Circle of Willis. It is uncommon in thalassemia. We present a 9‐year‐old girl with HbEβ‐thalassemia who presented with headache, vomiting, and episodes of transient hemiparesis with complete occlusion internal carotid arteries.

Abstract Background The frequency of the alpha thalassemia trait is approximately 40% in the Kuwaiti population, but there has been no comprehensive study of the prevalent alleles. This is a report of patients who were referred for molecular diagnosis over a 20-year period. Methods This is a retrospective study of the α-globin genotypes obtained in the Hemoglobin Research Laboratory of the Department of Pediatrics, Kuwait University from 1994 to 2015. Genotyping was performed by a combination of PCR, allele-specific oligonucleotide hybridization and reverse dot blot hybridization (Vienna Lab Strip Assay). Results Four hundred samples were characterized and analyzed from individuals aged

Abstract Demand Response (DR) provides both operational and financial benefits to a variety of stakeholders in the power system. For example, in the deregulated market operated by the Electric Reliability Council of Texas (ERCOT), load serving entities (LSEs) usually purchase electricity from the wholesale market (either in day-ahead or real-time market) and sign fixed retail price contracts with their end-consumers. Therefore, incentivizing end-consumers’ load shift from peak to off-peak hours could benefit the LSE in terms of reducing its purchase of electricity under high prices from the real-time market. As the first-of-its-kind implementation of Coupon Incentive-based Demand Response (CIDR), the EnergyCoupon project provides end-consumers with dynamic time-of-use DR event announcements, individualized load reduction targets with EnergyCoupons as the incentive for meeting these targets, as well as periodic lotteries using these coupons as lottery tickets for winning dollar-value gifts. A number of methodologies are developed for this special type of DR program including price/baseline prediction, individualized target setting and a lottery mechanism. This paper summarizes the methodologies, design, critical findings, as well as the potential generalization of such an experiment. Comparison of the EnergyCoupon with a conventional Time-of-Use (TOU) price-based DR program is also conducted. Experimental results in the year 2017 show that by combining dynamic coupon offers with periodic lotteries, the effective cost for demand response providers in EnergyCoupon can be substantially reduced, while achieving a similar level of demand reduction as conventional DR programs.

Background: Haemorrhoids are common anorectal conditions seen in surgical practice, with various treatment modalities. This study compared the short-term outcome of injection sclerotherapy with 50% dextrose in water and rubber band ligation in the management of second-and third-degree haemorrhoids, in terms of symptoms improvement, complications, recurrence rate, retreatment rate and acceptability. Methodology: This was a prospective comparative study that was carried out in the endoscopic unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, in southwestern Nigeria. Sixty consecutive patients with second- and third-degree haemorrhoids, who consented, were recruited into the study and were randomised into two groups. Group A had endoscopic injection sclerotherapy and Group B had endoscopic rubber band ligation. Results: With regard to anal protrusion, more patients consistently reported either complete (16 [64.4%]) or partial (9 [40.9%]) resolution of symptoms in Group B, compared to Group A which had 7 (28.0%) and 5 (22.7%) cases, respectively (P = 0.03). Resolution of anal bleeding was initially more in Group B than A (22 [95.7%] vs. 17 [77.3%] patients, respectively), in the first 24-h post-treatment; however, within the 1st week, this ratio was reversed (P = 0.07). The retreatment rate for Group A and B was 23.3% and 13.3%, respectively,P = 0.34. More patients in Group B experienced severe pain post-treatment compared to Group A (P = 0.01). Three-month post-treatment, two (11.8%) patients in Group A and one (4.5%) in Group B had recurrence of anal bleeding (P = 0.42). There was no recurrence in anal protrusion in both treatment groups. Conclusion: Endoscopic rubber band ligation had a significantly higher success rate than endoscopic injection sclerotherapy, in terms of resolution of anal protrusion, but with higher pain score.

Background: Poor mental health affects adolescent development and is associated with health and social outcomes in later life. The current study uses cross-sectional data to explore the understudied aspects of peer relationships as a predictor of depressive symptom severity of adolescents in Germany.Method: Data from the German BELLA study were analyzed. We focused on the most recent measurement point of the BELLA study and analyzed data of 446 adolescents (aged 14–17 years). Peer relationship was measured using four items from the internationally established Patient-Reported Outcome Measurement Information System (PROMIS). Depressive symptoms were assessed via seven items of the German version of the Centre for Epidemiological Studies Short Depression Scale (CES-D). Hierarchical linear regression models were computed to explore the association between depressive symptoms and peer relationships. Hierarchical linear regression models served to determine the added predictive effects of each aspect of peer relationships.Result: The regression model showed that 22% of the variance of the severity of depressive symptoms could be explained by the quality of adolescents’ peer relationships (F(1,444) = 125.65, p < 0.001). Peer acceptance has the most substantial unique contribution to peer relationship as a predictor of depressive symptom severity (Change in R2 = 0.05; Change in F = 27.01, p < 0.001). The gender-specific analysis shows different trends for boys and girls.Conclusion: The quality of peer relationships is a significant predictor of adolescents’ depressive symptoms severity. Improved peer acceptance, dependability, and ease of making new friends are significantly associated with reduced depression symptoms for Germany’s adolescent population.

Abstract Diffuse invasion is the primary cause of treatment failure of glioblastoma (GBM). Previous studies on GBM invasion have long been forced to use the resected tumor mass cells. Here, a strategy to reliably isolate matching pairs of invasive (GBMINV) and tumor core (GBMTC) cells from the brains of 6 highly invasive patient‐derived orthotopic models is described. Direct comparison of these GBMINV and GBMTC cells reveals a significantly elevated invasion capacity in GBMINV cells, detects 23/768 miRNAs over‐expressed in the GBMINV cells (miRNAINV) and 22/768 in the GBMTC cells (miRNATC), respectively. Silencing the top 3 miRNAsINV (miR‐126, miR‐369‐5p, miR‐487b) successfully blocks invasion of GBMINV cells in vitro and in mouse brains. Integrated analysis with mRNA expression identifies miRNAINV target genes and discovers KCNA1 as the sole common computational target gene of which 3 inhibitors significantly suppress invasion in vitro. Furthermore, in vivo treatment with 4‐aminopyridine (4‐AP) effectively eliminates GBM invasion and significantly prolongs animal survival times (P = 0.035). The results highlight the power of spatial dissection of functionally accurate GBMINV and GBMTC cells in identifying novel drivers of GBM invasion and provide strong rationale to support the use of biologically accurate starting materials in understanding cancer invasion and metastasis.

Poor social integration is associated with poor quality of life among minority groups. The current study hypothesized that trust and sociability may significantly explain the quality of life performance among Sub-Saharan African migrants in Germany. Data from 518 migrants were analyzed. Hierarchical multiple linear regression models were calculated to assess the predictive effect of trust and sociability on aggregate quality of life. Results show that general trust and sociability explained about 21% of the variance in quality of life score (adjusted R2 = .206; p < .001) for the total sample. Socioeconomic and demographic features suggested an added predictive effect of about 8% for total sample (adjusted R2 = .279; p < .001), 10% for male (adjusted R2 = .322; p < .001) and 4% for female (adjusted R2 = .211; p < .001). The results support trust and sociability as essential in connecting to a new environment and enhancing the quality of life.

The corrosion behavior of metal matrix composites (MMCs) is accelerated by the inclusion of reinforcements. Hence, this study investigates the corrosion behavior of MMCs produced from Al 6063 matrix alloy with reinforcement particulates of silicon carbide (SiC) and palm kernel shell ash (PKSA) inclusion at different mix ratios. The MMCs were synthesized using the double stir casting technique. The corrosion behaviors of the composites in NaCl solutions were studied via gravimetric analysis and electrochemical measurements. The gravimetric analysis showed fluctuating dissolution rate of the samples in NaCl solution to indicate flawed film as well as corrosion product formation over the surface of the specimens. The observed corrosion mechanism of the samples was general and pitting corrosion. The presence of reinforcements within the Al6063 matrix acted as active sites for corrosion initiation. The range of values for Ecorr and Icorr obtained in 3.5% NaCl at 24 h was between −220.62 and −899.46 mV and between 5.45 and 40.87 µA/cm2, respectively, while at 72 h, the Ecorr values ranged from 255.88 to −887.28 mV, and the Icorr ranged from 7.19 to 16.85 µA/cm2. The Nyquist and Bode plots revealed the electrochemical corrosion behavior of the samples under investigation, with predominant reactions on the surface of the samples linked to charge transfer processes. The relative resistance to corrosion of the samples depends on the thin oxide film formed on the surface of the samples.

Abstract Background (TA) n repeat sequence (rs8175347) of UGT1A1 gene promoter polymorphism is associated with serum bilirubin levels and gallstones among different sickle cell anaemia (SCA) populations. There are no data on UGT1A1 polymorphisms and their impact on Nigerian SCA patients. In this study, we determined the distribution of the UGT1A1 (TA) n genotypes among a group of young Nigerian SCA patients and healthy controls. In addition, the influence of UGT1A1 (TA) n genotypes on the laboratory and clinical events among the patients was determined. Methods The distribution of the UGT1A1 (TA) n genotypes among 101 young Nigerian SCA patients and 64 normal appropriate controls were determined and studied. The UGT1A1 (TA) n genotypes were further classified into subgroups and used to differentiate the clinical events and laboratory parameters of the patients. Results Four (TA) n alleles:(TA)5, 6, 7, and 8 were found. These were associated with 10 genotypes: TA5/5, 5/6, 5/7, 5/8, 6/6, 6/7, 6/8, 7/7, 7/8, 8/8. The normal (wild-type)-(TA) 6/6), low- (TA) 7/7, 7/8, 8/8), intermediate- (TA) 5/7, 5/8, 6/7, 6/8), and high-activity (TA) 5/5, 5/6,) genotypes were found in 24.8, 24.8, 41.5, and 8.9% patients and 20.3, 15.6, 61, and 3.1% controls respectively. The general genotype distribution of the patients and control group were not significantly different. There were significant differences in serum bilirubin and lactate dehydrogenase (LDH) of the patients when differentiated by the UGT1A1 (TA) n genotypes (p

Abstract The aim of this paper is to presents the validation of the 5-wave approach as a method capable of easing access and approximating a representative sample of a hard-to-reach population group (Sub-Saharan African migrants in Germany) for health, and social intervention projects and research. The 5-wave-approach addresses the non-representativeness in the Sudman and Kalton snowballing sampling technique by breaking down the discriminative referral system (snowball system) into five separate components. Data on socio-demographic characteristics collected in a cross-sectional from 532 Sub Saharan African migrants in Germany were compared with data from Germany Foreign Population registry 2016 (AuslaendBevoelkerung 2016) to check for the validity and representativeness of the method. Data comparison shows that sample socio-demographics characteristics reflect population characteristics, as presented in the 2016 German foreign population report. This finding supports the 5-wave-approach as a method capable of capturing a sample of Sub-Saharan African migrants (SSA migrants) that reflects and represents population demographics characteristics. The practicability of this approach offers health and social worker, policymakers and researchers with a communication channel that open up access to the larger group and facilitates the delivery of more efficient intervention projects.

Background: The outcome of studies on the effect of patients’ factors, dental factors and operative factors on postoperative sequelae following surgical extraction of lower third molar have been unequivocal. Objective: To determine the effect of surgical difficulty (using Pederson’s scale), Body Mass Index (BMI) and operative time on the extent of post-operative pain, swelling and trismus following third molar surgery. Methods: The study was a prospective analytical study of the effect of surgical difficulty, BMI, age and operative time – Total Intervention Time (TIT) - on the extent of post-operative pain, swelling and trismus. Eighty-four subjects with surgical extraction of impacted lower third molar were studied. All the subjects had a standard Peri-apical radiograph through which the difficulty index was calculated for all third molars using the Pederson scale. Anthropometric vertical and horizontal facial measurements and pain measurement were taken pre-operatively and post-operatively on days 1, 3, 5 and 7. Results: Of the 84 subjects, 16 (19%) were males, while 68 (81%) were females in the ratio of 1:4.2. BMI showed a positive correlation with all the three variables and was significant for swelling on the post-operative days assessed while TIT showed a negative correlation with most of the variables and was significant for trismus. Conclusion: This study showed that age and operative time might have an inverse relationship with the common post-operative complications after lower third molar surgery and BMI might influence the extent of these complications.

Background: The principles of safe and efficient thyroid surgery had been established and the technique has remained the same for over the century without any major significant changes. The introductions of electrosurgical devices constitute a major shift in the technique of thyroid surgery. Objective: We present our early experience with the use of LIGASURE vessel sealing system for the procedure of thyroidectomy. Materials and Methods: This was a quasi-experimental study comparing outcome of LigaSure thyroidectomy in a prospective nonrandomized cohort with another retrospective cohort of preintervention clamp-and-tie thyroidectomy. Results: A total of 30 patients with a clinical diagnosis of goiter were recruited into the study. There were two males and 28 females with a mean age of 42.6 years. Diagnosis was simple multinodular goiter 24 (80%), controlled toxic nodular goiter 3 (10%), grave disease 1 (3.3%), and multinodular goiter with retrosternal extension 2 (6.7%). The mean thyroid weight was 121.0 g. The mean duration of surgery was 59 min compared to 128 min for traditional technique (P < 0.01). The mean blood loss of 116 ml was significantly less than 328 ml following the traditional technique (P < 0.01). Mean duration of hospital stay was 1.9 days, compared to 3.55 days in the traditional technique group (P = 0.02). Troubling postoperative complications of change in voice quality occurred in only one patient (3.3%). Conclusion: LigaSure thyroidectomy was found to be easier and faster to carry out with no learning curve and easy to learn and adapt.

Background: Nigeria reportedly has one of the highest incidences of congenital hearing loss and the Universal Neonatal Hearing Screening (UNHS) offers a potential for early detection and intervention. Objectives: To determine the awareness and acceptability of newborn hearing screening among the antenatal clinic attendees of a Nigerian Teaching Hospital. Methods: This study was a cross-sectional survey among the pregnant women attending the antenatal clinic. Data were obtained using semi-structured interviewer-administered questionnaire Results: A total of 114 women aged 18 and 45 years participated in the survey; 51/114 (44.7%) were aware of hearing screening with most of them 39/51 (76.5%) having health workers as their first source of knowledge. A high acceptance rate was obtained among 97/114 (85.1%), and this was notably independent (p = 0.399) of awareness; 14/114 (12.2%) rejected UNHS and the commonest reason for rejection was lack of enough information among 10/14 (71.4%) on the existence and use of UNHS. Health care workers were the commonest source of information [39/51(76.5%)]. A majority [51/58 (87.9%)] thought that the best time to initiate treatment is early in life, before speech development, only 4/114 (3.5%) had relatives who had ever undergone UNHS and all were done abroad. Conclusions: Less than half of the participants attending ANC were aware of hearing screening and acceptance was high despite this low awareness rate. Parental awareness appeared to depend on contact with healthcare workers. Community education may increase awareness and demand for UNHS.

This study aimed to determine the performance of a rapid, point-of-care testing device (HemotypeSC)™ for diagnosing sickle cell disease (SCD) relative to 2 commonly-used methods compared to DNA polymerase chain reaction (PCR) as the reference standard. The diagnostic performance of (HemotypeSC)™ in diagnosing SCD and determining various other Hb genotypes relative to high performance liquid chromatography (HPLC) and cellulose acetate Hb electrophoresis in alkaline buffer (CAE) was investigated among 156 participants aged 4 to 23 years in Ekiti, Southwest Nigeria. PCR was considered as the reference method/gold standard. The sensitivity and specificity for SS, SC, AS, AC, and AA genotypes by HemotypeSC and HPLC when compared with PCR, were each 100%. Similarly, their positive and negative predictive values were each 100%. However, sensitivity and specificity for identifying these Hb genotypes by CAE were 100, 100, 96.5, 0, 99.2%, and 99, 100, 92.9, 0, 91.7%. Also, CAE did not identify any of the 2 HbAC individuals that were correctly identified by PCR and both HemotypeSC, and HPLC, thus representing 100% HbAC misdiagnosis. In conclusion, this study shows that HemotypeSC has perfect concordance with PCR and 100% accuracy in diagnosing SCD in the population tested. Its ease of use, accuracy and other attributes make it suitable for use in sub-Saharan Africa for rapid determination of Hb genotypes.

Objective: Sickle cell disease (SCD) is a haemoglobinopathy that causes several clinical complications. Unripe Carica papaya has been shown to possess antisickling activity that could reduce these complications. This study aimed to examine the presence of antisickling and sickling-reversal activities of aqueous extracts and ethyl acetate fractions of C. papaya fruit at different stages of ripening. Methods: Unripe, partly ripe, and fully ripe fruits were quantitatively screened for some phytochemicals using standard methods. Blood samples from sickle cell patients were used to investigate antisickling and sickling reversal activities of aqueous extracts and ethyl acetate fractions of the fruits. Data were analysed using one-way ANOVA. The p-value was set at 0.05. Results: Phytochemicals such as alkaloids, saponins, tannins, flavonoids and polyphenols were found in varying concentrations in C. papaya fruit at the different stages of ripening. All extracts and fractions showed antisickling and sickling-reversal activities with the ethyl acetate fraction of partly ripe C. papaya being most effective. Conclusion: The study showed that C. papaya fruit at different stages of ripening contains antisickling and sickling-reversal activities which may help reduce the associated complications of SCD when consumed by affected individuals.

Abstract Background This study was undertaken to assess the correlations between subjective symptom score in patients with chronic rhinosinusitis and endoscopic turbinoseptal relationship (TSR). Aim To assess the pattern of TSR and their correlations with symptom score in patients with chronic rhinosinusitis. Settings and design This was an observational study in a tertiary/teaching hospital setting Patients and Methods Consecutive pretreatment adults with chronic rhinosinusitis completed the sinonasal outcome test 22 (SNOT22) and had nasal endoscopy. At endoscopy, the TSR was determined, as well as the presence of nasal polyps. Statistical analysis Mean SNOT22 score was calculated and TSR types were grouped and their distribution documented with types 3 and 4 taken as unfavorable types. χ2-Tests were used to determine the correlations between turbinoseptal types, presence of nasal polys, and SNOT22 scores with the level of significance set at P value up to 0.05. Results A total of 53 [23 (43.4%) men and 30 (56.6%) women] patients with a mean age of 42.5±18.6, completed the study. Median symptom duration was 36 weeks (13–112 weeks). Mean SNOT22 score was 29.7±2.8. Unfavorable TSR types were found in 42.5% of nostrils, more on the right (χ2=13.2; P≤0.01). There is no significant correlation between the presence of unfavorable TSR and worsening total SNOT22 scores [R (K-S=0.13 P=0.95) L (K-S=0.34, P=0.07)]. Conclusion Unfavorable TSR is common in patients with chronic rhinosinusitis. However, there is no correlation between the presence of abnormal TSR and symptom scores.

Objective: Bladder tumor antigen (BTA) is a common biomarker for urothelial carcinoma while bladder wall thickening (BWT) is a sign of urinary bladder irritation which suggests cystitis or early-stage bladder cancer pathology, most especially in the absence of bladder outlet obstruction. The aim of this study was to find the incidence of urinary bladder thickness and evaluate the relationship between BTA and BWT in a low schistosomiasis-endemic Nigerian village. Materials and Methods: The study was descriptive and cross-sectional. Freshly passed mid-day urine samples of 56 individuals were screened using chemical reagent strips and then diagnosed microscopically for Schistosoma haematobium. Subsequent follow-up involving ultrasound examination was carried out on distended bladder. The lower urinary tract symptoms (LUTS) were also recorded. Urinary BTA analysis was carried out on the urine samples using enzyme-linked immunosorbent assay. Results: The prevalence of urogenital schistosomiasis in the area was 3.6%. The overall prevalence of human BTA and BWT in the individuals was 44.6 and 35.7%, respectively. The LUTS were associated with BWT (P = 0.004; odds ratio = 6.0; 95% confidence interval = 1.8–20.3). BTA, BWT, and LUTS were not sex and age dependent (P > 0.05). In addition, there was no association between urinary BTA, BWT, and LUTS (P > 0.05). The sensitivity of BWT and LUTS (60.0%) was improved than when either was used to diagnose BTA. Conclusion: The high occurrence of BTA and BWT in the individuals suggests that they may be prone to urothelial carcinoma and urinary bladder irritation, respectively. The role of urogenital schistosomiasis in urinary BTA levels needs to be further explored.