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In the evolving landscape of computer vision, the integration of machine learning algorithms with cutting-edge hardware platforms is increasingly pivotal, especially in the context of disruptive healthcare systems. This study introduces an optimized implementation of a Convolutional Neural Network (CNN) on the Basys3 FPGA, designed specifically for accelerating the classification of cytotoxicity in human kidney cells. Addressing the challenges posed by constrained dataset sizes, compute-intensive AI algorithms, and hardware limitations, the approach presented in this paper leverages efficient image augmentation and pre-processing techniques to enhance both prediction accuracy and the training efficiency. The CNN, quantized to 8-bit precision and tailored for the FPGA’s resource constraints, significantly accelerates training by a factor of three while consuming only 1.33% of the power compared to a traditional software-based CNN running on an NVIDIA K80 GPU. The network architecture, composed of seven layers with excessive hyperparameters, processes downscale grayscale images, achieving notable gains in speed and energy efficiency. A cornerstone of our methodology is the emphasis on parallel processing, data type optimization, and reduced logic space usage through 8-bit integer operations. We conducted extensive image pre-processing, including histogram equalization and artefact removal, to maximize feature extraction from the augmented dataset. Achieving an accuracy of approximately 91% on unseen images, this FPGA-implemented CNN demonstrates the potential for rapid, low-power medical diagnostics within a broader IoT ecosystem where data could be assessed online. This work underscores the feasibility of deploying resource-efficient AI models in environments where traditional high-performance computing resources are unavailable, typically in healthcare settings, paving the way for and contributing to advanced computer vision techniques in embedded systems.

Abstract Background The prognostic relevance of blood pressure in Africans with heart failure (HF) has not been well investigated despite the different trajectories of HF in Africans compared to other ethnicities. We investigated the shape and strength of associations of systolic blood pressure (SBP) and mean arterial pressure (MAP) with incident death in Nigerian Africans with hypertensive HF. Results Present analyses include 118 participants (mean age 57.6 years, 55% men) with ambulatory hypertensive HF. Over a median 2.2 years of follow-up, there were 74 incident deaths. There was an inverse log-linear association between each of SBP and MAP, and incident death throughout the distribution of blood pressure studied and no J-shape effect was seen. Individuals in the bottom distribution of SBP (mean 100 mmHg) and MAP (mean 77 mmHg) had the highest cumulative incident death. Each 10 mmHg higher SBP and MAP was associated with lower risk of incident death (aHR 0.80 [95% CI: 0.70–0.91, p

Aneurysmal bone cysts (ABCs) are rare benign osteolytic tumors which occur most frequently within the first two decades of life and can lead to pathological fractures. They have characteristic imaging and histologic features and have historically been classified into two types: primary ABCs, which are true neoplasms linked to specific oncogenes, and secondary ABCs, which are preceded by other bone lesions. The occurrence of multiple concurrent primary ABCs is exceedingly rare; with only a few cases reported in the published literature. Here, we present an unusual case of this condition, along with a review of the typical presentation, imaging and pathological findings, and available treatment options.

Abstract Background The World Health Organization prioritizes Mother’s Own Milk (MOM) or donor human milk (DHM) when MOM is unavailable or insufficient. It is also important for healthcare workers (HCWs) to provide adequate support, information, and education to mothers to help improve their milk production and breastfeeding experience. DHM is scarce in developing countries, prompting a need for understanding health workers’ perspectives. Methods This cross-sectional study, conducted in 2021 in Ekiti State, Nigeria, examined the knowledge and attitudes of HCWs regarding human milk banking. A sample of 321 participants from government-owned hospitals completed a self-administered questionnaire. Results Of the 321 participants (84.7% response rate), the majority were females (69.2%), aged 30–39 (32.1%), Christian (91.9%), and employed in tertiary hospitals (91.9%). About 65% of the HCWs believe that HMB is a safe practice and 42% believe that the DHM has the same quantity of immunological factors as fresh human milk. While 80.4% displayed good DHM knowledge, attitudes varied. The HCWs profession influenced their attitudes and a higher proportion of all female HCWs (71%), except for health assistants (65.4%), expressed willingness to donate their breast milk if needed. Among males HCWs, the majority of those who were doctors (82.8%) and pharmacists (62.5%) expressed willingness to support their spouses to donate breast milk, and they also had higher acceptance of DHM for their infants. In all, more than 80% of the HCWs will encourage mothers to donate their milk and feed babies under their care with DHM, but only 47% would accept DHM to feed their own children. Health assistants had less favourable views, and negative perceptions were linked to the internet and media sources. Conclusions The study highlights health workers’ awareness of DHM but indicates a reluctance to fully embrace it, especially among health assistants. The need for targeted education programs, to address knowledge gaps and negative perceptions, is crucial for the successful implementation of human milk banks in Nigeria. Overcoming challenges, such as safety concerns and sociocultural influences, requires focused efforts from policymakers and healthcare institutions.

Introduction: Psychological distress in heart failure has been relatively neglected by researchers and practitioners, and early detection and treatment may improve the prognosis and patient's quality of life. This study sought to assess psychological distress exemplified by depression and anxiety among acute heart failure (AHF) patients seen at a large teaching hospital in South West Nigeria. Method: The study was a cross-sectional study of 153 consecutively admitted AHF patients who completed the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder 7-item questionnaires. The report of this article adhere to the STROBE reporting guideline. Data was analysed using standard statistical methods. Results: A total of 153 participants with AHF completed the study. The mean age±SD of participants was 57.7±15.0years. The prevalence of depression of any severity was 26.8% while that of anxiety was 9.2%. History of alcohol intake, male gender, and higher score of anxiety were independently associated with depression while the presence of higher depressive scores was the sole independent factor associated with anxiety. Conclusion: Psychological distress is present in AHF patients, so clinicians must evaluate these problems early in all such patients, address their specific needs, and intervene through a team approach when necessary.

Abstract Background The COVID-19 pandemic had a profound impact on healthcare and ophthalmology services globally. Numerous studies amongst various medical and surgical specialties showed a reduction in patient attendance and surgical procedures performed. Prior published ophthalmic literature focused on specific types of procedures and were usually single centre. The current study attempts to quantify the impact on a larger scale, namely that of sub-Saharan Africa, and to include all ophthalmic subspecialties. Methods This is a retrospective analysis of the surgical records from 17 ophthalmology centres in seven countries located in East, Central, West and Southern Africa. The date of declaration of the first lockdown was used as the beginning of the pandemic and the pivot point to compare theatre records one year prior to the pandemic and the first year of the pandemic. We examined the total number of surgical procedures over the two year period and categorized them according to ophthalmic subspecialty and type of procedure performed. We then compared the pre-pandemic and pandemic surgical numbers over the two year period. Results There were 26,357 ophthalmic surgical procedures performed with a significant decrease in the first year of the pandemic (n = 8942) compared to the year prior to the pandemic (n = 17,415). The number of surgical procedures performed was lower in the first year of the pandemic compared to the year prior to the pandemic by 49% [Incidence rate ratio (IRR) 0.51, 95% CI 0.41–0.64), 27% (0.73, 0.55–0.99), 46% (0.54, 0.30–0.99), 40% (0.60, 0.39–0.92) and 59% (0.41, 0.29–0.57) in sub-Saharan Africa (4 regions combined), West, Central, East and Southern Africa, respectively]. The number of surgical procedures in the different sub-specialty categories in sub-Saharan Africa (4 regions combined) was significantly lower in the first year of the pandemic compared to the year prior to the pandemic, except for glaucoma (IRR 0.72, 95% CI 0.52–1.01), oncology (0.71, 0.48–1.05), trauma (0.90, 0.63–1.28) and vitreoretinal (0.67, 0.42–1.08) categories. Conclusion This study provides insight into the impact of the COVID-19 pandemic in multiple regions and countries on the African continent. The identification of which surgical subspecialty was most affected by the COVID-19 pandemic in each region allows for better planning and resource allocation to address these backlogs.

Abstract Background There has been an increase in the reporting of cases of left ventricular noncompaction (LVNC) cardiomyopathy in medical literature due to advances in medical imaging. Patients with LVNC may be asymptomatic or may present with arrhythmias, heart failure, thromboembolism or sudden death. LVNC is typically diagnosed by echocardiography, although there are higher-resolution cardiac imaging techniques such as cardiac magnetic resonance imaging (MRI) to make the diagnosis. The objective of the study is to report on a series of 9 cases of LVNC cardiomyopathy seen at the University College Hospital, Ibadan. Cases of LVNC seen between September 1, 2015 and July 31, 2022 in our echocardiography service is being reported. Results There were a total of 6 men and 3 women. Mean age at presentation was 52.89 ± 15.02 years. The most common mode of presentation was heart failure (6 patients). Hypertension was the most common comorbidity (6 patients). Three patients had an ejection fraction of less than 40% and the mean ratio of noncompacted to compacted segment at end-systole was 2.80 ± 0.48. The most common areas of trabecular localization were the LV lateral wall and the apex. Beta blockers were highly useful in the management of the patients. Conclusions LVNC cardiomyopathy is not uncommon in our environment and a high index of suspicion is often required.

Background: The implementation of task sharing and shifting (TSTS) policy as a way of addressing the shortage of physicians and reducing the burden of hypertension in Africa birthed the idea of the African School of Hypertension (ASH). The ASH is saddled with the responsibility of training non-physician health workers across Africa continent in the management of uncomplicated hypertension. Aim: To get feedback from some faculty members and students who participated in the first ASH programme. Methods: This was a cross-sectional exploratory qualitative study conducted among eight students and eight faculty members. Feedback from the program was obtained by conducting in-depth interviews centred on description of course content; expectations and knowledge acquired from ASH; level of interaction between students and faculty members; challenges faced during the ASH; level of implementation of acquired training; and suggestions to improve subsequent ASH programs Results: The course content of the ASH was described as simple, appropriate and adequate while interaction between students and faculty members were highly cordial and engaging. New knowledge about hypertension management was acquired by the students with different levels of implementation post-graduation. Some identified challenges with the ASH program were poor internet connectivity during lectures, non-uniformity of TSTS policies and hypertension management guidelines across Africa, technical problems with hypertension management app and low participation from other African countries apart from Nigeria. Some recommendations to improve ASH program were development of a uniform hypertension management guideline for Africans, wider publicity of the ASH, interpretation of lectures into French and Portuguese languages and improvement of internet connectivity. Conclusion: The ASH programme has largely achieved its objectives with the very encouraging feedback received from both faculty members and the students. Steps should be taken to address the identified challenges and implement the suggested recommendations in subsequent ASH program to sustain this success.

Spermatic cord abscess is a rare condition usually associated with other genitourinary infections. We present a case of a 49-year-old male with past medical history of uncontrolled diabetes mellitus. He presented with right groin swelling and pain for a week. Ultrasound showed a tubular hyperemic structure extending into the scrotal sac. Computed tomography showed concurrent perinephric abscess and right spermatic cord abscess. The spermatic cord abscess was managed surgically by incision and drainage. To our knowledge, this is the first case report of a patient with spermatic cord abscess and concurrent perinephric abscess. We highlight the clinical importance of familiarity with such a rare condition and the role of imaging in establishing the correct diagnosis while excluding close differentials.

Abstract Crimean Congo Hemorrhagic Fever virus (CCHFV) is a deadly human pathogen that causes an emerging zoonotic disease with a broad geographic spread, especially in Africa, Asia, and Europe, and the second most common viral hemorrhagic fever and widely transmitted tick-borne viral disease. Following infection, the patients are presented with a variety of clinical manifestations and a fatality rate of 40%. Despite the high fatality rate, there are unmet clinical interventions, as no antiviral drugs or vaccines for CCHF have been approved. Immunoinformatics pipeline and reverse vaccinology were used in this study to design a multi-epitope vaccine that may elicit a protective humoral and cellular immune response against Crimean-Congo hemorrhagic fever virus infection. Three essential virulent and antigenic proteins (S, M, and L) were used to predict seven CTL and 18 HTL epitopes that were non-allergenic, antigenic, IFN-γ inducing, and non-toxic. The epitopes were connected using linkers and 50S ribosomal protein L7/L12 was used as an adjuvant and raised a multi-epitope vaccine (MEV) that is 567 amino acids long. Molecular docking and simulation of the predicted 3D structure of the MEV with the toll-like (TLR2, TLR3, and TLR4) receptors and major histocompatibility complex (MCH-I and MCH-II) indicate high interactions and stability of the complexes, MM-GBSA free binding energy calculation revealed a favourable protein–protein complex. Maximum MEV expression was achieved with a CAI value of 0.98 through in silico cloning in the Drosophila melanogaster host. According to the immune simulation, IgG1, T-helper cells, T-cytotoxic cells, INF-γ, and IL-2 were predicted to be significantly elevated. These robust computational analyses demonstrated that the proposed MEV is effective in preventing CCHFV infections. However, it is still necessary to conduct both in vitro and in vivo experiments to validate the potential of the vaccine.

Frontotemporal dementia (FTD) is one of the leading causes of young-onset dementia before age 65, typically manifesting as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). Although FTD affects all populations across the globe, knowledge regarding the pathophysiology and genetics derives primarily from studies conducted in North America and Western Europe. Globally, biomedical research for FTD is hindered by variable access to diagnosis, discussed in this group's earlier article, and by reduced access to expertise, funding, and infrastructure. This perspective paper was produced by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART) and discusses the field's current status on the cross-cultural aspects of basic and translational research in FTD (including that focused on epidemiology, genetics, biomarkers, and treatment). It subsequently provides a summary of gaps and needs to address the disparities and advance global FTD biomedical research.

Identifying factors that affect treatment response is a central objective of clinical research, yet the role of common genetic variation remains largely unknown. Here, we develop a framework to study the genetic architecture of response to commonly prescribed drugs in large biobanks. We quantify treatment response heritability for statins, metformin, warfarin, and methotrexate in the UK Biobank. We find that genetic variation modifies the primary effect of statins on LDL cholesterol (9% heritable) as well as their side effects on hemoglobin A1c and blood glucose (10% and 11% heritable, respectively). We identify dozens of genes that modify drug response, which we replicate in a retrospective pharmacogenomic study. Finally, we find that polygenic score (PGS) accuracy varies up to 2-fold depending on treatment status, showing that standard PGSs are likely to underperform in clinical contexts.

Sickle cell anaemia (SCA) is associated with macrovascular complications at relatively normal blood pressures. This has led to the development of the term ‘relative systemic hypertension’ (RSH). The electrocardiography (ECG) and echocardiography (ECHO) findings in these people has not been well highlighted.Patients with SCA in steady state were consecutively recruited. History, physical examination, ECG and ECHO information were obtained from all participants after informed consent was obtained. Eighty-three people were recruited in all- 15 of which had RSH, giving a prevalence of 18.1%. Those with RSH had higher packed cell volumes (PCV), smaller right atria area, lower tricuspid regurgitant velocities, lower incidence of early satiety, longer QTc and higher frequency of a history of vaso-occlusive crises. The indices of right and left ventricular function were normal in both groups. Right atrial area was the only significant determinant of RSH in this study.RSH is associated with higher PCV, longer QTc and smaller right atrial area in SCA patients. More studies to evaluate sympathetic output in SCA with RSH is required.

Background Coronary artery disease was hitherto a rarity in Africa. Acute coronary syndrome (ACS) accounts for coronary artery disease–related morbidity and mortality. Reports on ACS in Africa are few. Methods and Results We enrolled 1072 indigenous Nigerian people 59.2±12.4 years old (men, 66.8%) with ACS in an observational multicentered national registry (2013–2018). Outcome measures included incidence, intervention times, reperfusion rates, and 1‐year mortality. The incidence of ACS was 59.1 people per 100 000 hospitalized adults per year, and comprised ST‐segment–elevation myocardial infarction (48.7%), non–ST‐segment–elevation myocardial infarction (24.5%), and unstable angina (26.8%). ACS frequency peaked 10 years earlier in men than women. Patients were predominantly from urban settings (87.3%). Median time from onset of symptoms to first medical contact (patients with ST‐segment–elevation myocardial infarction) was 6 hours (interquartile range, 20.1 hours), and only 11.9% presented within a 12‐hour time window. Traditional risk factors of coronary artery disease were observed. The coronary angiography rate was 42.4%. Reperfusion therapies included thrombolysis (17.1%), percutaneous coronary intervention (28.6%), and coronary artery bypass graft (11.2%). Guideline‐based pharmacotherapy was adequate. Major adverse cardiac events were 30.8%, and in‐hospital mortality was 8.1%. Mortality rates at 30 days, 3 months, 6 months, and 1 year were 8.7%, 9.9%, 10.9%, and 13.3%, respectively. Predictors of mortality included resuscitated cardiac arrest (odds ratio [OR], 50.0; 95% CI, 0.010–0.081), nonreperfusion (OR, 34.5; 95% CI, 0.004–0.221), pulmonary edema (OR, 11.1; 95% CI, 0.020–0.363), left ventricular diastolic dysfunction (OR, 4.1; 95% CI, 0.091–0.570), and left ventricular systolic dysfunction (OR, 2.1; 95% CI, 1.302–3.367). Conclusions ACS burden is rising in Nigeria, and patients are relatively young and from an urban setting. The system of care is evolving and is characterized by lack of capacity and low patient eligibility for reperfusion. We recommend preventive strategies and health care infrastructure‐appropriate management guidelines.

Purpose: Previous studies that evaluated the prevalence of hypertension in Nigeria were either clinic based, non-standardized or did not include out-of-clinic blood pressure (BP) measurement. Materials and Methods: We selected a rural and an urban community in one state in each of the 6 geopolitical zones of Nigeria. Five consecutive BP of adults older than 18 years were measured in the clinic following which, each participant was provided with a home BP device to obtain duplicate morning and evening BP for 3 days. Result: Out of 556 invited from Anambra State, South-East Nigeria, 490 (88%) consented. Overall, more women participated in both rural (115 vs 61, p

Dementia prevention in Africa is critically underexplored, despite the continents high prevalence of modifiable risk factors. With a predominantly young and middle-aged population, Africa presents a prime opportunity to implement evidence-based strategies that could significantly reduce future dementia cases and mitigate its economic impact. The multinational Africa-FINGERS program offers an innovative solution, pioneering culturally sensitive, multidomain interventions tailored to the unique challenges of the region.  Leveraging insights from landmark global studies such as Worldwide-FINGERS and Alzheimers Disease Neuroimaging Initiative, the program employs a multideterminant precision prevention framework, grounded in community based systems dynamics. Africa-FINGERS further integrates cutting-edge state-of-the-art multimodal biomarker evaluations tailored to regional contexts, with the goal of advancing brain health and establishing a global standard for dementia prevention. This groundbreaking initiative highlights the potential for scalableand sustainable interventions, thus is poised to transform dementia risk reduction efforts across the continent. HIGHLIGHTS: Dementia rates are escalating in Africa, largely due to longer life spans and increased prevalence of modifiable risk factors. Yet, few regional interventions have directly targeted lifestyle factors to reduce dementia risk. The multinational Africa-FINGERS study will address this gap by adapting the successful FINGERS lifestyle intervention to African populations. Africa-FINGERS will pioneer a culturally informed, multidomain dementia risk reduction intervention in the African region through feasibility dementia prevention trials in rural and urban sites across Kenya and Nigeria in the first instance, enrolling 600 at-risk adults (≥ 50 years). The program adopts participatory research methods to develop culturally appropriate interventions and build infrastructure to evaluate dementia biomarkers from ante and post mortem samples. A cost-effectiveness analysis will be conducted to guide the strategic implementation of Africa-FINGERS into regional health systems. The Africa-FINGERS strategy aligns with the Worldwide-FINGERS framework and integrates the global Alzheimers Disease Neuroimaging Initiative approach, emphasizing multimodal analysis.

Background Death registration provides an opportunity for the legal documentation of death of persons. Documentation of deaths has several implications including its use in the recovery of inheritance and insurance benefits. It is also an important input for construction of life tables which are crucial for national planning. However, the registration of deaths is poor in several countries including Nigeria. Objective This paper describes the performance of death registration in Nigeria and factors that may affect its performance. Methods We conducted a systematic literature review of death registration completeness in Nigeria to identify, characterize issues as well as challenges associated with realizing completeness in death registration. Results Only 13.5% of deaths in Nigeria were registered in 2007 which regressed to 10% in 2017. There was no data reported for Nigeria in the World Health Organization database between 2008 and 2017. The country scored less than 0.1 (out of a maximum of 1) on the Vital Statistics Performance Index. There are multiple institutions with parallel constitutional and legal responsibilities for death registration in Nigeria including the National Population Commission, National Identity Management Commission and Local Government Authorities, which may be contributing to its overall poor performance. Conclusions We offer proposals to substantially improve death registration completeness in Nigeria including the streamlining and merger of the National Population Commission and the National Identity Management Commission into one commission, the revision of the legal mandate of the new agency to mainly coordination and establishment of standards. We recommend that Local Government authorities maintain the local registries given their proximity to households. This arrangement will be enhanced by increased utilization of information and communications technology in Civil Registration and Vital Statistics processes that ensure records are properly archived.

Lassa virus, an arenavirus, represents the most prevalent human pathogen causing viral hemorrhagic fever. It is endemic in Nigeria and other West African countries. Despite the high burden of the disease, limited treatments are available and no approved vaccine for the prevention of this disease is available. In this study, an Immunoinformatics and reverse vaccinology pipeline was employed to predict a multi-epitope vaccine. Four fundamental virulent and proteogenic proteins (glycoprotein precursor, Viral matrix protein, viral RNA polymerase, and Nucleoprotein) were identified. Using various immunoinformatics tools, 12 CTL, 14 HTL, and six B-cell epitopes were predicted and connected via suitable linkers, together with an adjuvant to develop a 602 amino acids long vaccine construct (VC). The VC was assessed to be non-allergenic, non-toxic, stable, soluble, and highly antigenic. Molecular docking of VC with RIG-I, major histocompatibility complex class I and class II were carried out to validate the interactions with the receptors. The complex of VC-RIG-I was subjected to a dynamic stability test and the RMDS and RMSF results suggest that the complex is stable. Validation of the final vaccine construct was done through in silico cloning using E. coli as a host. A CAI value of 0.99 suggests that the vaccine construct expressed properly in the host. The immune simulation predicted significantly high levels of IgG1, T-helper, T-cytotoxic cells, INF-γ, and IL-2. This rigorous computational study suggests infection control by creating an effective immunological memory against Lassa virus infections. However, both in vitro and in vivo experiments are needed to validate the potential of the proposed vaccine.

Background: Previous studies that evaluated the prevalence, awareness and treatment of hypertension in Nigeria were either localized to some specific regions of the country or non-standardized thereby making evaluation of trend in hypertension care difficult. Methods: We used the World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance to evaluate in a nationally representative sample of 4192 adult Nigerians selected from a rural and an urban community in one state in each of the six geo-political zones of the country. Results: The overall age-standardized prevalence of hypertension was 38.1% and this varied across the geo-political zones as follows: North-Central, 20.9%; North-East, 27.5%; North-West, 26.8%; South-East, 52.8%; South-South, 44.6%; and South-West, 42.1%. Prevalence rate did not differ significantly (p > 0.05) according to place of residence; 39.2% versus 37.5 %; urban vs rural. Prevalence of hypertension increased from 6.8% among subjects less than 30 years to 63.0% among those aged 70 years and above. Awareness was better (62.2% vs. 56.6%; P = 0.0272); treatment rate significantly higher (40.9 % vs. 30.8%; P < 0.0001) and control similar (14 vs. 10.8%) among urban compared to rural residents. Women were more aware of (63.3% vs. 52.8%; P < 0.0001); had similar (P > 0.05) treatment (36.7 vs. 34.3%) and control (33.9% vs. 35.5%) rates of hypertension compared to men. Conclusion: Our results suggest a large burden of hypertension in Nigeria and a closing up of the rural-urban gap previously reported. This calls for a change in public health policies anchored on a primary health care system to address the emerging disease burden occasioned by hypertension.

The introduction of solar photovoltaic (PV) systems would provide electricity accessibility to rural areas that are far from or have no access to the grid system. Various countries are planning to reduce their emissions from fossil fuel, due to its negative effects, by substituting with renewable energy resources. The use of solar PV systems is expanding globally because of growing energy demands and depleting fossil fuel reserves. Grid integration of the solar system is expected to increase further in the near future. However, the power output of solar PV systems is inherently intermittent, and depends on the irradiance and the temperature operation of the solar cell, resulting in a wide range of defects. Hence, it is vital to extract peak power from the solar panel in all conditions to provide constant power to the load. This paper presents a tracking control method of the peak output power of a solar PV system connected to a DC-DC boost converter using an improved incremental conductance and integral regulator (IC + IR). The research was carried out because the solar PV output is dependent on environmental parameters, such as solar insolation and temperature. Therefore, it is pertinent to forecast the peak power point in outdoor conditions and to operate at that point, so that solar PV can produce the highest output each time it is used. A peak power point strategy that maximizes the output of a solar PV array is proposed. This method establishes the maximum output operation point under the effects of the solar insolation and the module temperature. An automatic converter restoration scheme with block/de-block signal control is proposed to protect the converters from the higher phase current, total capacitor voltage deviation, grid disturbance, and fault current. The proposed scheme also tracks the peak power point (PPP) of the solar array with stable output voltage under varying operating conditions. It reduces the error signal and ripples at the PPP during instantaneous and incremental conductance to zero. In addition, it controls the solar PV system under constantly changing climatic conditions, and thus improves the system efficiency.

Statin drugs lower blood cholesterol levels for cardiovascular disease prevention. Women are more likely than men to experience adverse statin effects, particularly new-onset diabetes (NOD) and muscle weakness. Here we find that impaired glucose homeostasis and muscle weakness in statin-treated female mice are associated with reduced levels of the omega-3 fatty acid, docosahexaenoic acid (DHA), impaired redox tone, and reduced mitochondrial respiration. Statin adverse effects are prevented in females by administering fish oil as a source of DHA, by reducing dosage of the X chromosome or the Kdm5c gene, which escapes X chromosome inactivation and is normally expressed at higher levels in females than males. As seen in female mice, we find that women experience more severe reductions than men in DHA levels after statin administration, and that DHA levels are inversely correlated with glucose levels. Furthermore, induced pluripotent stem cells from women who developed NOD exhibit impaired mitochondrial function when treated with statin, whereas cells from men do not. These studies identify X chromosome dosage as a genetic risk factor for statin adverse effects and suggest DHA supplementation as a preventive co-therapy.

This systematic review examines the impact of parental preconception adversity on offspring mental health among African Americans (AAs) and Native Americans (NAs), two populations that have experienced historical trauma and currently experience ethnic/racial mental health disparities in the United States. PsycINFO, PubMed, CINAHL, Scopus, and Web of Science were searched for studies that included at least two generations of AAs or NAs from the same family, measured parental preconception adversity and their offsprings mental health, and examined the association between these variables. Over 3,200 articles were screened, and 18 articles representing 13 unique studies were included in this review. Among the studies with samples that included AAs (n = 12, 92%), 10 (83%) reported a significant association between parental preconception adversity and adverse offspring mental health. The only study with a sample of NAs (n = 1, 8%) also reported a significant association between these variables. Although the literature suggests that parental preconception adversity is associated with offspring mental health among AAs and NAs, it must be interpreted in the context of the small number of studies on this topic and the less-than-ideal samples utilized-just one study included a sample of NAs and several studies (n = 6, 46%) used multi-ethnic/racial samples without testing for ethnic/racial disparities in their results. A more rigorous body of literature on this topic is needed as it may help explain an important factor underlying ethnic/racial mental health disparities, with important implications for interventions and policy.

Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.

Background Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1‐month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1‐month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2±14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P=0.018) and septal (16.8 versus 19.1, P

Renewable Distributed Generation (RDG), when connected to a Distribution Network (DN), suffers from power quality issues because of the distorted currents drawn from the loads connected to the network over generation of active power injection at the Point of Common Coupling (PCC). This research paper presents the voltage rise regulation strategy at the PCC to enhance power quality and continuous operation of RDG, such as Photovoltaic Arrays (PVAs) connected to a DN. If the PCC voltage is not regulated, the penetration levels of the renewable energy integration to a DN will be limited or may be ultimately disconnected in the case of a voltage rise issue. The network is maintained in both unity power factor and voltage regulation mode, depending on the condition of the voltage fluctuation occurrences at the PCC. The research investigation shows that variation in the consumer’s loads (reduction) causes an increase in the power generated from the PVA, resulting in an increase in the grid current amplitude, reduction in the voltage of the feeder impedance and an increase in the phase voltage amplitude at the PCC. When the system is undergoing unity power factor mode, PCC voltage amplitude tends to rises with the loads. Its phase voltage amplitude rises above an acceptable range with no-loads which are not in agreement, as specified in the IEEE-1547 and Southern Africa grid code prerequisite. Incremental Conduction with Integral Regulator bases (IC + PI) are employed to access and regulate PVA generation, while the unwanted grid current distortions are attenuated from the network using an in-loop second order integral filtering circuit algorithm. Hence, the voltage rise at the PCC is mitigated through the generation of positive reactive power to the grid from the Distribution Static Compensator (DSTATCOM), thereby regulating the phase voltage. The simulation study is carried out in a MATLAB/Simulink environment for PVA performance.

Hypertension has become an important public health problem in Africa. Currently an epidemiologic transition from infectious diseases is going on in the continent and the prevalence of chronic diseases like hypertension is increasing. The response of the heart to the stress/afterload imposed on the left ventricle by the progressively increasing arterial blood pressure is described as hypertensive heart disease. Hypertensive heart disease and failure are the commonest cardiovascular diseases of Africans. Since hypertension is a treatable cardiovascular risk factor, there is need to create more awareness about the disease and educate our patients concerning drug compliance. There is also a need for longitudinal multicentre study in Africa, in order to assess the severity and burden of the disease.

BackgroundThe burden of HIV/AIDS epidemic is huge, but this varies widely by population in Nigeria. Data that could be used to guide the scale up of HIV prevention and control strategies has significant gaps. The study sought to estimate the prevalence of HIV and its associated determinants in Akwa Ibom state.MethodsAkwa Ibom AIDS Indicator Survey (AKAIS) is a population based cross-sectional survey, with a two-stage probability sampling. The survey had both behavioural and biological components. Tablet-based questionnaire was used to collect data on participant's household information, demographics, socio-economic, and behavioral risk factors associated with HIV; while the biological component involved collection of venous blood samples for participants who were over 19months. For children aged 18months on less, capillary blood from finger prick sample was used. Participants were tested for HIV. Other biomarker tests for HIV positive participants included CD4, HIV-1 RNA viral load and incidence assays.ResultsIn all 15,609 people (8,963 adults aged 15 years and older (55% females), 6,646 individuals less than 15 years (51% males), from 4,313 households, participated in AKAIS. Overall, 2.8% (423 persons; 422 HIV-1 and 1 HIV-2) were found to be HIV positive. HIV prevalence was 4.8% in adults (15 years and above) and 0.4% in pediatric (< = 14 years) participants. HIV prevalence was significantly higher in females (5.6%) than males (3.7%) aged 15 years and older (p ConclusionsHIV prevalence among adults was 4.8% with an overall incidence of 0.41%. These estimates are essential to inform strategic control and prevention of HIV epidemic in Akwa Ibom state targeting the affected populations.

INTRODUCTION: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of child bearing age. Bacterial vaginosis has emerged as a global health issue due to the adverse outcome in pregnancy and in the puerperium. The study determined the prevalence of BV and outcome of delivery among pregnant women. METHODS: Socio-demographic data and vaginal swab samples were obtained from 362 consecutive pregnant women with abnormal vaginal discharge attending antenatal clinic in Ekiti State University Teaching Hospital, Ado-Ekiti. Data were analysed using SPSS statistical software 21 and association between variables was compared using Chi square. RESULTS: The prevalence of BV among pregnant women with abnormal vaginal discharge in this study was 16.6%. Age group 25-34yrs, multiparity and higher education were significantly associated with BV, p = 0.05. Symptoms such as vulvar itching, dyspareunia, lower abdominal pains and characteristic of vaginal discharge such as colour and consistency were significantly associated with BV, p = 0.05. Women with bacterial vaginosis significantly had prelabour rupture of fetal membrane and their babies were born prematurely with low birth weight and Apgar score of less than 5 at one minute, p = 0.05. However, there was no difference statistically in rate of admission into special care baby unit among the women, p = 0.05. CONCLUSION: The findings of this study suggest that there should be screening for BV in pregnant women presenting with abnormal vaginal discharge so that they could be treated accordingly. This will mitigate the complications arising from bacterial vaginosis.