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Traumatic retroclival subdural hematoma is a rare entity that is more prevalent in the paediatric population. We managed a 3-year-old female with traumatic retroclival subdural hematoma. The mechanism of injury, treatment protocol, and outcome were highlighted. Prompt and accurate diagnosis of retroclival subdural hematoma with the aid of high-resolution computed tomography is key to a satisfactory outcome.

Protozoan parasites are microscopic, unicellular organisms, of a group of phyla of the kingdom Protista, that can be free-living or parasitic. These organisms can live, and reproduce their kind, in human tissues. This accounts, in part, for why just a single protozoan can survive and infect humans so profoundly. A lot of people suffer severe morbidity connected to parasites. Parasitic protozoan parasite infections are associated with a lack of sanitation and access to safe and potable water. These infections make it impossible for poor populations to enjoy the full potentials of a healthy body and vitality and this hampers their productivity and, consequently, their social life and economic progress. Protozoan parasites that adapt to and live in the oral environment are called, ‘oral protozoan parasites’. The appreciation of the fact that human oral protozoan parasites exist has long been documented by the empirical works of several researchers and scholars. Many of these works also indicated that Entamoeba gingivalis and Trichomonas tenax, which are parasitic oral protozoan parasites, are found only in the oral cavity. It is well known that the presence of these oral protozoan parasites may be established both in persons with pathological alterations in the oral cavity and those with no such symptoms. Human oral protozoan parasites cause gingival itch, palatal sore, halitosis, fatigue, fever, headaches, and periodontal tissue damage. Researchers have reported that the presence and impact of oral protozoan parasites may vary with age, gender, oral hygiene measures, general and oral health status, immune status, and alcohol and tobacco usage. Oral protozoan parasites constitute a growing concern to health authorities and researchers because they can either compromise oral integrity and health or complicate clinical intervention goals. The intentional control of oral parasites remains the only valid clinical option to improve the quality of life for sufferers and, by extension, all humans.

Polymers play a significant role in enhanced oil recovery (EOR) due to their viscoelastic properties and macromolecular structure. Herein, the mechanisms of the application of polymeric materials for enhanced oil recovery are elucidated. Subsequently, the polymer types used for EOR, namely synthetic polymers and natural polymers (biopolymers), and their properties are discussed. Moreover, the numerous applications for EOR such as polymer flooding, polymer foam flooding, alkali–polymer flooding, surfactant–polymer flooding, alkali–surfactant–polymer flooding, and polymeric nanofluid flooding are appraised and evaluated. Most of the polymers exhibit pseudoplastic behavior in the presence of shear forces. The biopolymers exhibit better salt tolerance and thermal stability but are susceptible to plugging and biodegradation. As for associative synthetic polyacrylamide, several complexities are involved in unlocking its full potential. Hence, hydrolyzed polyacrylamide remains the most coveted polymer for field application of polymer floods. Finally, alkali–surfactant–polymer flooding shows good efficiency at pilot and field scales, while a recently devised polymeric nanofluid shows good potential for field application of polymer flooding for EOR.

Ever since the Taiwanese government introduced the giant freshwater shrimp (GFS) (Macrobrachium rosenbergii) to Saint Lucia in the 1980s, its production has increased significantly. This production although has contributed significantly to the well-being of local farmers and the gross domestic product of Saint Lucia, its productivity is however threatened by challenges such as scarcity and high cost of live feed (nauplii from Anemia sp.), poor funding, insufficient and substandard hatcheries, poor infrastructures, high mortality rate of postlarvae due to adverse climate, diseases, and knowledge gap between researchers and local farmers (inadequate extension services). Among these challenges, the total reliance on scarce and expensive live feeds (nauplii from Anemia sp.) is the most crucial . Therefore increasing production costs is of the utmost importance and requires urgent attention. Although it would not be possible to completely substitute nauplii, combining it with other inexpensive, readily accessible, and locally sourced feed components is paramount. As evident in postlarvae-producing countries, alternative diets have been compounded and fed in place of nauplii to lower production costs without any negative impact on the general performance of GFS postlarvae being recorded. This could be adopted and replicated in the production of GFS postlarvae in Saint Lucia because most of the ingredients such as powdered fishmeal, duckweed, moringa leaf, freshwater daphnia and rotifers, and microalgae are readily available and accessible within the country. KEY WORDS: Aquaculture, Anemia, Macrobrachium rosenbergii, feed, production, shrimp, INTRODUCTION The growth of aquaculture in the Caribbean has been characterized as slow but steady since the introduction of tilapia culture in the early 1960s (Largo et al. 2020). More [...]

Coronavirus disease 2019 (COVID 19) has had serious social, economic, and health effects globally. The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2), which was first announced in December 2019 has resulted in more than 24 million infections. There is paucity of knowledge on the role of risk perception in the adoption of public health interventions needed to control the spread of COVID 19 infections within communities. This was a scoping review and documents how risk perception may be a major challenge for populations to adopt and implement different behavioral changes recommended to curtail the spread COVID- 19 pandemic in sub-Saharan Africa; and seeks to proffer solutions on how the identified challenges can be addressed drawing from lessons learnt from previous epidemics within the region. Database search of Google Scholar, PubMed, Research Gate among others were performed using related keywords to identify relevant journals and lists of primary articles. Culture, religious beliefs and poverty may influence how populations respond to infectious disease outbreaks. Risk strategies that focus only on biomedical approaches to control the COVID-19 pandemic may not mobilize the needed behavioral change. Lessons learnt from HIV and Ebola epidemics showed that involvement of communities could help transform weak adoption of public health measures when measures were framed in the relevant cultural context. An understanding of the factors influencing risk perception is needed to design appropriate risk communication strategies. Community engagement and reliance on local communication networks could promote mutual trust and increase the uptake of public-health interventions.

Introduction The interplay between human salivary potential hydrogen (pH), which measures the acidity and alkalinity level of saliva, and the prevalence of human oral protozoan parasites should be of immense interest to clinicians who are wary of the role salivary pH plays in the regulation of the oral microbiota. Salivary pH affects the growth of microorganisms and helps maintain the oral environment. Purpose This study was undertaken to assess the interplay between human salivary pH and infection with human oral protozoan parasites in the Ogbeke-Nike community of Enugu State, Nigeria, to enhance clinical decisions. Materials and methods The study design adopted for this research work was a cross-sectional survey. A total of 233 participants were selected, using the convenience non-probability sampling method, from 6 rural villages in the Ogbeke-Nike community, Enugu-East LGA of Enugu State, Nigeria, and were studied, using questionnaires, clinical assessments, and parasitological techniques. Results Analyses of data from the study revealed that the prevalence of human oral protozoan parasites, Entamoeba gingivalis, and the mixed infections (E.gingivalis & Tichomonas tenax) were higher in participants with salivary pH of 6.0 – 6.5 (36.51%, 17.99 & and 13.23%, respectively) and zero in participants with salivary pH of 5.0 – 5.5, 8 – 8.5 and 9.0 – 9.5 (0.00% all through). T. tenax infection was more common in participants with salivary pH of 7.0 – 7.5 (16.67%). 5.29% of participants with the 6.0 – 6.5 salivary pH also manifested T. tenax, whereas the infection was not found in all other pH values. Results also indicated that there was no significant relationship between salivary pH and infection with human oral protozoan parasites (p>0.05). Conclusions Even though there was no significant relationship between salivary pH and the occurrence of infection with human oral protozoan parasites, the peak incidence of these commensals may be positively associated with the pH value of 6.0 – 6.5. Maintaining the ideal salivary pH may be key to regulating oral microbiota.

Background: Anencephaly is a common but lethal form of neural tube defect which occurs as a result of failure of closure of the rostral neuropore. There is no data on this lethal congenital anomaly in our community. Objective: The aim of this review is to document the prevalence of anencephaly in our community. Methods: A retrospective review of the labour ward register over eleven-year period from 2007 to 2017 was carried out. The total number of deliveries was evaluated for congenital anomalies of the central nervous system. The case notes of the mothers who gave birth to children with anencephaly were further reviewed for their epidemiological profile, antenatal care and use of folic acid, fetal profile and placental weight. The data obtained was analyzed and using inferential statistics conclusions were derived. Results: There were 5 cases of anencephaly out of the 3, 789 deliveries over the eleven year period resulting in 1.3 per 1000 deliveries. There was a case of congenital hydrocephalus but there was no documented case of encephalocele and myelomeningocele. The Male: Female ratio was 2:3. The mothers’ age range was 18 years to 33 years and all affected mothers were not registered for the antenatal care and have no documentation of folic acid supplementation during the pregnancy. Conclusion: This retrospective review showed that the prevalence of anencephaly in our agrarian community agrees with the lower end of the incidence spectrum obtainable in the available literature. There is, therefore, need for a well-designed prospective study to corroborate these findings.

The release of sulfur-containing compounds during direct combustion of diesel fuel has caused environment issues which require urgent attention. Recently, stringent environmental regulations by the Environmental Protection Agency (EPA) to minimise the total sulfur-containing compounds released into the atmosphere have intensified the research in this area. In this present study, adsorption experiments in batch mode were conducted using an activated green adsorbent (Neem leaves powder) to reduce the amount of dibenzothiophene (DBT) in a synthetic oil. The synthetic oil was prepared by dissolving 0.1 g of dibenzothiophene (DBT) in 100 mL of hexane. Various analytical techniques were used such as; Scanning electron microscopy (SEM) to check the morphological structure of the adsorbent. Nitrogen adsorption and desorption experiments (Brunauer-Emmett-Teller, BET) at 77 K were used to check the surface area, pore size and pore volume of the adsorbent. N2 physio-sorption at 77 K before and after adsorption showed adsorption of DBT molecules onto the surface of the adsorbent after adsorption experiment. The results showed about 65.78 % removal of DBT at temperature of 30oC and adsorbent amount of 0.8 g. Therefore, neem leave powder could be an alternative cheap adsorbent to reduce the concentration of organo-sulfur compound in petroleum distillates. This may offer new perception into the development and application of green materials in sustainable, innovative and effective waste management and abatement of environmental pollution.

Background: A walk through the Agbogbloshie e-waste recycling site shows a marked heterogeneity in the spatial distribution of the different e-waste processing activities, which are likely to drive clustering of health conditions associated with the different activity type in each space. Objective of study: To conduct a spatial assessment and analysis of health conditions associated with different e-waste activities at different activity spaces at Agbogbloshie. Methods: A choropleth showing the various activity spaces at the Agbogbloshie e-waste site was produced by mapping boundaries of these spaces using Etrex GPS device and individuals working in each activity spaces were recruited and studied. Upon obtaining consent and agreeing to participate in the study, each subject was physically examined and assessed various health outcomes of interest via direct physical examination while characterizing and enumerating the scars, lacerations, abrasions, skin condition and cuts after which both systolic and diastolic blood pressure values were recorded alongside the administration of open and close ended questionnaires. All individuals working within each activity space and consented to participate were recruited; giving a total of one hundred and twelve (112) subjects in all. Results: A study of the choropleth showed that health conditions associated e-waste processing activities were clustered in a fashion similar to the corresponding distribution of each activity. While a total of 96.2% of all the study subjects had cuts, the dismantlers had higher mix of scars, lacerations and abrasions. Abrasions were observed in 16.3% of the dismantlers. Scars were the most common skin condition and were observed on the skins of 93.6% of the subjects. Prevalence of burns among the study subjects was 23.1%. Developing hypertension was not associated with activity type and while a total of 90.2% of subjects had normal blood pressure and 9.8% of them were hypertensives. Finally, 98.2% of respondents felt the need to have a first aid clinic at the site with 96.4% and 97.3% willing to visit the clinic and pay for services respectively. Conclusion: We conclude that while the observed injuries were random and were due purely to accidents without any role of spatial determinants such as the configuration, slope, topography and other subterranean features of the activity spaces, a strong association between the injuries and activity type was observed.

This study examined the influence of economic and , psychological factors, as well as the moderating role of perceived service orientation on the tax compliance of Nigerian SMEs owners / managers. Three hundred and twenty one SME owners /managers participated in the survey. The Partial Least Squares (PLS) path modeling was employed to analyze the data. The results showed that the probability of detection, incentives, and the public governance quality had significant positive effects on tax compliance, while tax complexity had a significant negative effect on tax compliance. On the contrary, the results showed that tax rates and tax knowledge had no significant effect on tax compliance. Furthermore, the findings of the moderating effect revealed that perceived service orientation only moderated tax rates and incentives, while in moderating effect was discovered on the relationship between the probability of detection, tax complexity, tax knowledge and public governance quality. The implications for tax revenue authorities and other policy-makers were also discussed.

BACKGROUND:High global neonatal deaths have triggered efforts to improve facility-based care. However, the outcomes achievable at different levels of care are unclear. This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality. OBJECTIVE:This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality. METHODS:A cross-sectional study involving a records-review over one year at the Upper West Regional Hospital, and three years at St Joseph's District Hospital, Jirapa was carried out. Age, sex, gestational age, weight, duration of admission, diagnosis, among others were examined. The data were analysed and statistical inference made. RESULTS:Altogether, 2004 newborns were examined, comprising 1,241(62%) from St Joseph's District Hospital and 763(38%) from Upper West Regional Hospital. The proportion of neonatal deaths was similar, 8.94% (St Joseph's District Hospital) and 8.91% (Upper West Regional Hospital). Prematurity, neonatal sepsis, birth asphyxia, low birth weight, neonatal jaundice and pneumonia contributed the most to mortality and suspected infections including malaria accounted for almost half (45.5%). Mortality was significantly associated with duration of stay of 48 hours, being premature, and being younger than 3 days. CONCLUSION:Majority of the mortality among the neonates admitted was due to preventable causes. Better stabilization and further studies on the epidemiology of sepsis, prematurity, low birth weight, including the contribution of malaria to these and outcome of transferred neonates are needed.

Abstract Background Modern contraceptive use remains an important public health intervention and a cost-effective strategy to reduce maternal mortality, avert unintended pregnancies and to control population explosion, especially in developing countries. Despite these benefits, there are reports of low usage among reproductive-aged women in most developing countries. This study examined the prevalence and predictors of use of modern contraceptive among reproductive-aged women in an urban center with a high density population in Ghana. Methods A cross-sectional, interviewer-administered survey was conducted with 217 randomly selected reproductive-aged women. Data was analyzed with STATA. Logistic regression was performed to identify factors influencing modern contraceptive use. Results Although we found high levels of knowledge and awareness (98%; n = 213) of modern contraception use, only 21% of participants were using modern contraceptives. Marital status, partner consent and support, and religious beliefs strongly predicted usage. Conclusion Usage of modern contraceptives among reproductive-aged women in the Ledzokuku Krowor Municipality is lower than the national target. A multilevel family planning intervention program that primarily focuses on promoting inclusive participation of husbands, targets the unmarried and non-literates reproductive-aged women, and dispels misconceptions, misinformation and religious myths about modern contraceptives has been discussed.

Abstract Background Many low and middle income countries are implementing reforms to support Universal Health Coverage (UHC). Perhaps one of the most ambitious examples of this is Indonesia’s national health scheme known as the JKN which is designed to make health care available to its entire population of 255 million by end of 2019. If successful, the JKN will be the biggest single payer system in the world. While Indonesia has made steady progress, around a third of its population remains without cover and out of pocket payments for health are widespread even among JKN members. To help close these gaps, especially among the poor, the Indonesian government is currently implementing a set of UHC policy reforms that include the integration of remaining government insurance schemes into the JKN, expansion of provider networks, restructuring of provider payments systems, accreditation of all contracted health facilities and a range of demand side initiatives to increase insurance uptake, especially in the informal sector. This study evaluates the equity impact of this latest set of UHC reforms. Methods Using a before and after design, we will evaluate the combined effects of the national UHC reforms at baseline (early 2018) and target of JKN full implementation (end 2019) on: progressivity of the health care financing system; pro-poorness of the health care delivery system; levels of catastrophic and impoverishing health expenditure; and self-reported health outcomes. In-depth interviews with stakeholders to document the context and the process of implementing these reforms, will also be undertaken. Discussion As countries like Indonesia focus on increasing coverage, it is critically important to ensure that the poor and vulnerable - who are often the most difficult to reach – are not excluded. The results of this study will not only help track Indonesia’s progress to universalism but also reveal what the UHC-reforms mean to the poor.

Formation damage is an unwanted operational problem-taking place through several phases of oil reservoir life. The permeability reduction is a key indicator for the formation damage. Suitable assessment of permeability reduction is critical for hydrocarbon recovery. As oil production reach tertiary recovery stage in many fields, formation damage critical evaluation is needed to avoid additional operational cost and technical feasibility concern. The interaction between reservoir minerals and chemical injection practices is not fully understood. Also, clay mineral presence is highly sensitive to the chemicals, while adsorption phenomena can also occur. The degree of permeability reduction cannot be generalized for core/field scales; therefore investigating the permeability reduction in core scale is important before field-scale assessment. Therefore, this study investigates the permeability reduction after chemicals injection under low flow rate in sand-quartz cores and in the presence of kaolinite. Artificial sandpacks were used to control the sand-kaolinite mixture percentage. The permeability was measured before and after each flood by pressure drop calculation. The study showed that the seawater flood has the highest reduction in permeability followed by polymer and surfactants. Also, the results showed a strong effect of surfactant nature and molecular weight on the adsorption process and consequently the permeability reduction. The study provides an insight for the effect of chemicals on cores physical properties.

The pollution and toxicity problems posed by arsenic in the environment have long been established. Hence, the removal and recovery remedies have been sought, bearing in mind the effi- ciency, cost effectiveness and environmental friendliness of the methods employed. The sorption kinet- ics and intraparticulate diffusivity of As (III) bioremediation from aqueous solution using modified and unmodified coconut fiber was investigated. The amount adsorbed increased as time increased, reach- ing equilibrium at about 60 minutes. The kinetic studies showed that the sorption rates could be described by both pseudo-first order and pseudo-second order process with the later showing a better fit with a value of rate constant of 1.16 x 10 -4 min -1 for the three adsorbent types. The mechanism of sorption was found to be particle diffusion controlled. The diffusion and boundary layer effects were also investigation. Therefore, the results show that coconut fiber, both modified and unmodified is an efficient sorbent for the removal of As (III) from industrial effluents with particle diffusion as the pre- dominant mechanism.

Palm oil is one of the two most important vegetable oils in the world’s oil and fats market. The extraction and purification processes generate different kinds of waste generally known as palm oil mill effluent (POME). Earlier studies had indicated the possibility of using boiler fly ash to adsorb impurities and colour in POME treatment. The adsorption treatment of POME using boiler fly ash was further investigated in detail in this work with regards to the reduction of BOD, colour and TSS from palm oil mill effluent. The amount of BOD, colour and TSS adsorbed increased as the weight of the boiler fly ash used was increased. Also, the smaller particle size of 425μm adsorbed more than the 850μm size. Attempts were made to fit the experimental data with the Freundlich, Langmuir and Dubinin-Radushkevich isotherms. The R2 values, which ranged from 0.8974–0.9898, 0.8848–0.9824 and 0.6235–0.9101 for Freundlich, Langmuir and Dubinin-Radushkevich isotherms respectively, showed that Freundlich isotherm gave a better fit followed by Langmuir and then Dubinin-Radushkevich isotherm. The sorption trend could be put as BOD > Colour > TSS. The apparent energy of adsorption was found to be 1.25, 0.58 and 0.97 (KJ/mol) for BOD, colour and TSS respectively, showing that sorption process occurs by physiosorption. Therefore, boiler fly ash is capable of reducing BOD, Colour and TSS from POME and hence could be used to develop a good adsorbent for POME treatment.

Abstract Background Urinary Schistosomiasis and malaria are endemic in Sub-Saharan Africa. There are public health concerns and implications of these parasites. This study sought to assess the prevalence of malaria, urinary schistosomiasis, and anaemia in children of school going age in two municipalities in Ghana. Methods A cross-sectional study design was used to investigate the prevalence of S. haematobium, P. falciparum infection and the haemoglobin concentration of respondents. A total of 404 (231 males and 173 females) school children between ages 9 - 14 years (mean age 11.8 ± 1.4 years) were recruited for the survey. Urine and blood samples were collected using standard operating procedures for urinary schistosomiasis and malaria diagnosis. Haemoglobin concentration was measured using a Hemocue® Hb 201 m. Results The prevalence of mono-infection was 4.7 and 12.9% for S. haematobium and P. falciparum respectively with a small proportion (0.9%) of the respondents infected with both parasites. The prevalence of anaemia in the study population was 59.9%. The risk of developing anaemia was not associated with being infected with any of the parasites. All co-infected children had anaemia. Conclusion High prevalence of anaemia was observed within the study population. Prevalence of malaria was higher compared to schistosomiasis. Interventions to address the high levels of anaemia is required within the community.

Biosynthesis of metal nanoparticles using plant extract has received much attention due to its eco-friendly nature. The present study elucidates the green synthesize of Silver nanoparticles (AgNPs) from methanolic extract of Coleus Vettiveroids –an endemic species. The synthesis of AgNPs was confirmed by UV-visible spectrometry at 416 nm. Further, biosynthesized nanoparticles were characterized by FTIR for the confirmation of biomolecules acting as reducing agent. Average size and presence of elemental silver were characterized by scanning electron microscopy (SEM) and Transmission electron microscopy (TEM).Average size of nanoparticles was found to be 5 nm. The antioxidant ability of AgNPs was analyzed using DPPH. In vitro antibacterial effect of various concentrations of AgNPs was investigated against both Gram positive (S.Aureus) and Gram negative (E.Coli) bacterial strains. The result shows that biosynthesized AgNPs have significant antibacterial activity. Synthesized silver nanoparticles were also used effectively as photo catalyst in degradation of Organic Dyes and can be concluded that synthesized silver nanoparticles are also promising photo catalyst.

The need to clean-up heavy metal contaminated environment can not be over emphasized. This paper describes the adsorption isotherm studies of Cd (II), Pb (II) and Zn (II) ions from aqueous solution using unmodified and EDTA-modified maize cob. Maize cob was found to be an excellent adsorbent for the removal of these metal ions. The amount of metal ions adsorbed increased as the ini- tial concentration increased. Also, EDTA - modification enhanced the adsorption capacity of maize cob probably due to the chelating ability of EDTA. Among the three adsorption isotherm tested, Dubinin- Radushkevich gave the best fit with R 2 value ranging from 0.9539 to 0.9973 and an average value of 0.9819. This is followed by Freundlich isotherm (Ave. 0.9783) and then the Langmuir isotherm (Ave. 0.7637). The sorption process was found to be a physiosorption process as seen from the apparent ener- gy of adsorption which ranged from 2.05KJ\mol to 4.56KJ\mol. Therefore, this study demonstrates that maize cob which is an environmental pollutant could be used to adsorb heavy metals and achieve cleanliness thereby abating environmental nuisance caused by the maize cob.

Abstract Recurring forage and water scarcity in the Sahelian zone of West Africa, especially in the dry season, has led to increased livestock movement into Sudano-Sahelian and Sudano-Guinean zones in the region. This increased movement by transhumant herders has resulted in growing competition over natural resources. Despite the strong presence of transhumant herds in the Sudano-Sahelian/Sudano-Guinean zones of Mali in the past 30 years, there has been limited research on the practice of transhumance in these zones, compared to several studies in the Sahelian zone. In this paper, we present how various actors in two districts in the Sudano-Sahelian/Sudano-Guinea zones of Mali perceived the effect of transhumant practices on natural resource management. Results from the study showed that more than 75% of all categories of respondents in both study sites perceived a decline in availability of forage resources and water as a result of the increased number of transhumant herders in their communities. Furthermore, a greater proportion of farmers and settled pastoralists in both study sites responded that there has been a decline in species richness of the vegetation. In contrast, more than 50% of transhumant herders did not see any change in species richness of natural vegetation due to their presence. They argued that the observed decline in species richness of the vegetation is due to climate change. Education level, location and socio-professional categories tended to be the key factors influencing respondent’s perception on the impact of transhumant practices on natural resource management. As the perceived impact of transhumant practices depends on socio-professional groups, it is necessary to engage all the actors on how to effectively manage the presence of transhumant herders, in order to promote sustainable use of natural resources in southern Mali. Besides, more research is needed to assess the validity of the reported perceptions in this study.

Abstract The malaria rapid diagnosis testing (RDT) landscape is rapidly evolving in health care delivery in Nigeria with many stakeholders playing or having potential for critical roles. A recent UNITAID grant supported a pilot project on the deployment of quality-assured RDTs among formal and informal private service outlets in three states in Nigeria. This paper describes findings from a series of stakeholder engagement meetings held at the conclusion of the project. The agreed meeting structure was a combination of plenary presentations, structured facilitated discussions, and nominal group techniques to achieve consensus. Rapporteurs recorded the meeting proceeding and summaries of the major areas of discussion and consensus points through a retrospective thematic analysis of the submitted meeting reports. Key findings indicate that private providers were confident in the use of RDTs for malaria diagnosis and believed it has improved the quality of their services. However, concerns were raised about continued access to quality-assured RDT kits. Going forward, stakeholders recommended increasing client-driven demand, and continuous training and supervision of providers through integration with existing monitoring and supervision mechanisms.

Abstract Background Evidence from the global burden of diseases show that psychiatric disorders are a growing public health concern. Maintaining adherence to medication is the most essential, but challenging course in the pharmacological treatment modality for major psychiatric disorders. Nevertheless, there is a paucity of abridged evidence on the level of psychotropic medication non-adherence and associated factors. Therefore, we aim to systematically summarize existing primary studies finding to estimate the level and identify associated factors of psychotropic medication non-adherence among adult patients with major psychiatric disorders. Methods We will search studies using computerized search engines, main electronic databases and other relevant sources. PubMed (Medline), EMBASE, CINAHL, PsycINFO, Web of Science, WHO Global Health Library, and direct Google search will be searched to retrieve studies written in English language before December 2017. Observational studies (cross-sectional, case-control, cohort or longitudinal, survey and surveillance reports) on major psychiatric disorders (schizophrenia, major depressive and bipolar disorders) among adult patients will be eligible. Data will be extracted independently by two authors. Data synthesis and statistical analysis will be carried out. Pooled estimate will be done to quantify the level of psychotropic medication non-adherence using Comprehensive Meta-Analysis software. Discussion Psychiatric disorders remain a public health, social and economic concern worldwide. Management of major psychiatric disorders is highly affected by medication non-adherence. Thus, undertaking an integrated and multifaceted approach is necessary to reduce the burden of medication non-adherence, and enhance the quality of patients’ life. Evidence is required to design appropriate intervention to prevent psychotropic medication non-adherence. Protocol registration PROSPERO: 2017: CRD42017067436 .

Fitnox is a newly developed dietary ingredient for physical endurance composed of the extracts of Moinga oleifera leaf (45–50%), Kaempferia parviflora (black ginger) root (15–20%) and Punica granatum peel (25–30%). The aim of this study was to assess the subchronic oral toxicity of Fitnox (test substance) - in Wistar albino rats. Forty rats equally divided into 4 groups (control male, control female, treatment male and treatment female) administrated the test substance at 1000 mg/kg per rat daily for 90 days. All the animals were observed for body weight, mortality and clinical observations during the entire study. Results revealed no significant changes between the control and Fitnox treated groups. Based on the results, it was concluded that orally administered Fitnox to rats (dose of 1000 mg/kg per rat, orally-90 days) is safe with no drug-related toxicity was observed during the study period. Thus, the no-observed adverse effect level (NOAEL) for the present study is evaluated to be 1000 mg/kg body weight in both the sexes. Keywords: Fitnox, Sports nutritional powder, Oral toxicity, Moringa leaf, Black ginger, Pomegranate peel

Abstract When a reservoir is flooded with polymer, the mobility ratio between the displaced fluid and the displacing fluid become favourable compared to the conventional water flooding. In the oil and gas industry, the synthetic polymer polyacrylamide in hydrolysed form and the biopolymer xanthan are being used for this purpose. However, the polyacrylamide is susceptible to high temperature and salinity. Also, its synthetic nature makes it harmful to the environment. The biopolymer xanthan has the problem of degradation and both are very expensive. With the shortfall in crude oil price and the high cost of exploitation and drilling new wells, there is need to look inward and think out of the box in formulating new improved polymers that can combat these problems. Natural polymers from agricultural and forest produce are abundant in nature, cheap and environmentally friendly. These agricultural and forest produce contain starch and cellulose which are known to have rigid and long polysaccharide chains that can withstand the harsh reservoir conditions. But the design of a polymer flood or a permeability-modified process involving polymer requires knowledge about the polymer flow mechanism and the rheological behaviour of the porous media. This paper, therefore, reviews the available natural polymers that can be used for enhanced oil recovery applications and the mechanism affecting their flow behaviour in porous media. The emphasis is on the physical aspect of the flow, the microscopic rheological behaviour of the natural polymers. The dominant mechanism of the flow process was adsorption, mechanical entrapment and hydrodynamic retention. It was observed that the polymer exhibited non-Newtonian, pseudoplastic and shear-thinning behaviours. The literature review on oil displacement test indicates that natural polymers can recover additional oil from an oil field. Environmental application issues associated with the application of natural polymers have opened new frontier for research and are also highlighted herein.

INTRODUCTION: The incidence of periprosthetic distal femur fractures (PDFF) is increasing as the number of total knee replacements becomes more common. This study compared the demographics, fracture characteristics, treatment, and outcomes of periprosthetic versus native distal femur fractures (NDFF). MATERIALS AND METHODS: This was a retrospective cohort study of patients ≥ 18 who underwent surgical fixation of NDFF or PDFF from 2012 to 2020 at a level-1 trauma center. The main variables collected included demographics, AO/OTA fracture classification, fixation construct, concomitant fractures, polytrauma rates, bone density, and reduction quality. Primary outcomes were unexpected return to the operating room (UROR), hospital length of stay, and quality of reduction. T-tests, Fishers exact tests, and multivariate analyses were used for statistical analysis. RESULTS: 209 patients were identified, including 70 PDFF and 139 NDFF. PDFF patients were elderly females (81%) with isolated (80%) and comminuted (85%) 33 A.3 (71%) fractures. NDFF patients included 53% females, were commonly middle-aged, and displayed comminuted (92%) 33 C.2 fractures. 48% of NDFF patients had concomitant fractures. Intramedullary nailing was the primary fixation for both groups, followed by nail-plate combination (37%) for PDFF and lateral locking plates (21%) for NDFF. NDFF patients experienced significantly longer hospital stays, higher UROR rates, and worse quality of reduction (p

Surveillance for genetic variation of microbial pathogens, both within and among species, plays an important role in informing research, diagnostic, prevention, and treatment activities for disease control. However, large-scale systematic screening for novel genotypes remains challenging in part due to technological limitations. Towards addressing this challenge, we present an advancement in universal microbial high resolution melting (HRM) analysis that is capable of accomplishing both known genotype identification and novel genotype detection. Specifically, this novel surveillance functionality is achieved through time-series modeling of sequence-defined HRM curves, which is uniquely enabled by the large-scale melt curve datasets generated using our high-throughput digital HRM platform. Taking the detection of bacterial genotypes as a model application, we demonstrate that our algorithms accomplish an overall classification accuracy over 99.7% and perform novelty detection with a sensitivity of 0.96, specificity of 0.96 and Youden index of 0.92. Since HRM-based DNA profiling is an inexpensive and rapid technique, our results add support for the feasibility of its use in surveillance applications.

This study aimed to compare revision ratesand associated complications in femoral shaftfractures, with and without reduction of thesebutterfly fragments.

Intramedullary nailing is considered the gold-standard treatment for tibial shaft fractures. The goals of treatment for these fractures are correction of axial and rotational alignment and adequate mechanical stability, allowing for optimal healing. The nail is secured in place using screws or other fasteners that are placed through the bone and into the nail itself.2  Another benefit is the ability to preserve the soft tissue around the fracture to safeguard the extraosseous blood supply and minimize soft tissue damage.3 In reference to tibial intramedullary nailing, a start point is the location where a hole is drilled in the tibia to insert the intramedullary nail. The ideal starting point for guide wire placement for the average tibia is described as 2 mm medial to the lateral tibial eminence on AP imaging and just anterior to articular surface and parallel to the anterior tibia cortex on lateral imaging.6,7 It is a critical part of the procedure because it determines the trajectory and positioning of the nail within the medullary canal.7 Having a good, ideal starting point can prevent valgus angulation and translation at the fracture site. If the start point is too far off center or at the wrong angle, the nail may be inserted incorrectly and not provide the necessary support for the bone to heal, leading to malalignment or nonunion.  It is believed that different approaches to tibial intramedullary nailing may have differing abilities to achieve an optimal start point due to associated anatomical visualization and access. These approaches include suprapatellar, parapatellar, and infrapatellar nailing. The suprapatellar approach involves making an incision above the patella and placing instruments across the patellofemoral joint, potentially damaging the joint surface. However, the nail can be inserted at the start point with the knee extended, which leads to better alignment and stability of the fractured bone. Most importantly, the main advantage of the suprapatellar approach is that it reduces anterior angulation by eliminating the extension force of the quadriceps and aids fracture reduction by preventing proximal fragment migration.4,5 The parapatellar approach, proven to be effective and reliable, involves making a smaller incision below the patella with the knee in hyperflexion. This approach is less invasive than the suprapatellar approach regarding the patellofemoral joint, but the patellar tendon needs to be circumnavigated leading to potential for higher incidence of anterior knee pain.6 Also, it can be more difficult to achieve proper alignment and increases the risk of apex anterior deformities.4 The infrapatellar approach is split into transtendinous approach and paratendinous approach where the starting point is established by splitting the patellar tendon or making an incision on either side of the knee, respectively.6 This approach provides good visualization, but it can increase the risk of damage to the patellar tendon and other soft tissue structures around the knee.

Orthopaedic trauma remains a leading cause of patient morbidity, mortality, and global health care burden. Although significant advances have been made in the diagnosis, treatment, and rehabilitation of these injuries, complications such as malunion, nonunion, infection, disuse muscle atrophy and osteopenia, and incomplete return to baseline function still occur. The significant inherent clinical variability in fracture care such as differing patient demographics, injury patterns, and treatment protocols make standardized and replicable study, especially of cellular and molecular based mechanisms, nearly impossible. Hence, the scientists dedicated to improving therapy and treatments for patients with orthopaedic trauma rely on preclinical models. Preclinical models have proven to be invaluable in understanding the timing between implant insertion and bacterial inoculation on the bioburden of infection. Posttraumatic arthritis (PTOA) can take years to develop clinically, but with a porcine pilon fracture model, posttraumatic arthritis can be reliably induced, so different surgical and therapeutic strategies can be tested in prevention. Conversely, the racehorse presents a well-accepted model of naturally occurring PTOA. With preclinical polytrauma models focusing on chest injury, abdominal injury, multiple fractures, and/or head injury, one can study how various injury patterns affect fracture healing can be systemically studied. Finally, these preclinical models serve as a translational bridge to for clinical application in human patients. With selection of the right preclinical model, studies can build a platform to decrease the risk of emerging technologies and provide foundational support for therapeutic clinical trials. In summary, orthopaedic trauma preclinical models allow scientists to simplify a complex clinical challenge, to understand the basic pathways starting with lower vertebrate models. Then, R&D efforts progress to higher vertebrate models to build in more complexity for translation of findings to the clinical practice.