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To manage the impact of Industry 4.0 on industrial engineering (IE) education curriculum requirements, realistic teaching and learning infrastructure such as a learning factory are required. This paper scans the literature to determine Industry 4.0’s principles and interactions with IE and a learning factory, surveys relevant universities by questionnaire to determine its current status and practices, and formulates didactic design parameters for an Industry 4.0 learning factory to support IE education in South Africa, making use of existing models of cyber-physical systems and learning factory morphology. In other results, the technical universities are discovered to be more positively disposed, in general terms, to developing an Industry 4.0 learning factory than are the traditional programmes which, with one exception, prefer computational facilities. Of ten universities that offer IE, only one — a traditional programme — has made significant progress towards creating an Industry 4.0 learning factory.

Purpose: The purpose of this work is to optimise the influence of 3D printing processing parameters on the ultimate compressive strength of 3D-printed polylactic acid (PLA) parts. The objective is to develop the predictive models to help predict and attain optimized compressive strength integrity of 3D printed parts. Design/Methodology/Approach: In the present study, 3D printed PLA samples were modelled and fabricated using carefully selected processing parameters-processing speed, processing temperature and nozzle diameter. Compressive tests were performed by ASTM D695-15 standard. Two characteristics response optimisation models based on the Taguchi Technique and multi-linear regression models were developed to optimize the process parameters and the ultimate compressive strength of the 3D printed samples. Findings: Results of this study reveal that ultimate compressive strength is significantly affected by the Nozzle diameter. The ultimate compressive strength of the 3D-printed PLA sample was found to be significantly higher than the strength of the original PLA filament printed. Research Implications/Limitations: In this study, only three critical 3D printing processing parameters including, processing speed; processing temperature and nozzle diameter were implemented concurrently. Practical implication: By optimising process parameters, such as layer thickness, infill density, printing speed, and processing temperature, manufacturers can produce 3D-printed PLA parts with higher compressive strength. This leads to higher product quality and reliability. Social implication: It can empower local communities and small businesses to manufacture parts and products that meet their specific needs. This can reduce dependence on centralized manufacturing and promote economic self-sufficiency. Originality / Value: In this work, Nozzle diameter, which is a not too much studied 3D printing processing parameter, is implemented simultaneously with processing speed, and processing temperature to 3D print PLA filament to achieve an ultimate compressive strength value significantly higher than the strength of the original filament. [ABSTRACT FROM AUTHOR]

As the industrial world inches ever closer to adopting the Industry 4.0 paradigm, it becomes necessary to evolve a model industrial engineering (IE) learning facility framework that is comprehensive enough to accommodate the full range of exposures required to give students a total practical learning experience. This paper formulates a description model (morphology) and classification scheme for an IE learning facility that considers various levels of automation, including Industry 4.0, to support holistic IE education and training in South Africa. The literature is searched to investigate the state of the art in IE practical learning infrastructure. A questionnaire survey then determines the current status and practices among universities offering industrial engineering. This is followed by the construction of a learning facility framework embodying a mix of facility types, along with a delineation of their relevant characteristics, niches, and strengths that can be customised and deployed to maximise the practical experiences of students. [ABSTRACT FROM AUTHOR]

Background: Medical records are kept in the interest of both the patient and clinician. Proper filing of patient's medical records ensures easy retrieval and contributes to decreased patient waiting time at the hospital and continuity of care. This paper reports on an intervention study to address the issue of misfiling and multiple patient folders in a health facility. Design: Intervention study. Setting: Municipal Hospital, Goaso, Asunafo North District, Brong Ahafo Region, Ghana. Methods: Methods employed for data collection were records review, direct observation and tracking of folders. Interventions instituted were staff durbars, advocacy and communication, consultations, in-service trainings, procurement and monitoring. Factors contributing to issuance of multiple folders and misfiling were determined. Proportion of multiple folders was estimated. Results: Results revealed direct and indirect factors contributing to issuance of multiple patient folders and misfiling. Interventions and monitoring reduce acquisition of numerous medical folders per patient and misfiling. After the intervention, there was significant reduction in the use of multiple folders (i.e., overall 97% reduction) and a high usage of single patient medical folders (i.e., 99%). Conclusion: In conclusion, a defined medical records filing system with adequate training, logistics and regular monitoring and supervision minimises issuance of multiple folders and misfiling. [ABSTRACT FROM AUTHOR]

Background: In October 2010 an outbreak of cholera began among a group of small-scale gold miners in the East-Akim Municipality (EAM), Eastern Region. We investigated to verify the diagnosis, identify risk factors and recommend control measures. Methods: We conducted a descriptive investigation, active case-search and an unmatched case-control study. A cholera case-patient was a person with acute watery diarrhoea, with or without vomiting in EAM from 1st October to 20th November, 2010. Stool from case-patients and water samples were taken for laboratory diagnosis. We performed univariate and bivariate analysis using epi-info version 3.3. Results: Of 136 case-patients, 77 (56.6%) were males, of which 40% were miners or from miners households. Index case, a 20 yr-old male miner from Apapam village reported on October 13th, and case-patients peaked (18.4%) 20 days later. Attack rate was 2/1000 population with no fatality. Ages ranged from 1-84 years; mean of 34±18 yrs. Age-group 20-29 yrs was mostly affected (30.1%) with Apapam village having most case-patients (19.9%). Vibrio cholera serotype ogawa was isolated from stool samples. The main water source, Birim river was polluted by small-scale miners through defecation, post-defecation baths and sand-washings. Compared to controls, case-patients were more likely to have drunk from Birim-River [OR= 6.99, 95% CI: 2.75-18]. Conclusion: Vibrio cholera serotype ogawa caused the EAM cholera-outbreak affecting many young adult-males. Drinking water from contaminated community-wide -River was the major risk factors. Boiling or chlorination of water was initiated based on our recommendations and this controlled the outbreak. [ABSTRACT FROM AUTHOR]

Oligonucleotides derived from the flanking regions of the putative coat protein gene of the cacao swollen shoot badnavirus isolate 1 A (CSSV- 1 A) were able to prime the synthesis of specific products directly from extracts from CSSV-1 A-infected leaves by immunocapture polymerase chain reaction (IC-PCR), following trapping of virions with polyclonal antibodies to CSSV-1 A. CSSV isolates serologically distinct from CSSV-1 A were not detected by IC-PCR when the CSSV-1A-derived primers were used following trapping with homologous antisera. IC-PCR was at least 100-fold more sensitive than double antibody sandwich (DAS)-ELISA in comparative tests on samples from greenhouse-grown cacao plants. The superior sensitivity of IC-PCR over DAS-ELISA was confirmed in attempts to detect and identify CSSV-1 A isolates in field samples and permitted detection of CSSV-1 A isolates even in symptomless leaves from plants showing stem swelling only. The IC-PCR products obtained from four randomly selected field samples were sequenced and shown to contain a region of the CSSV- 1 A genome where ORF X overlaps ORF 3. Analysis of the partial amino acid sequences deduced from ORF 3 and ORF X of the four field isolates revealed a considerable variation in these CSSV-1 A gene products. [ABSTRACT FROM AUTHOR]

Vegetative buds of three cocoa varieties, 'Amelonado' (P30), 'Trinitarto' (K5) and 'Upper Amazon' (T85/799) were irradiated with 15, 20 and 25 Gy of γ-rays, respectively, and budded on to rootstocks to generate MV1 shoots. The terminal buds of the shoots were removed to induce the formation of MV2 shoots, from which MV3 shoots were similarly derived. The MV3 plants were screened for resistance to the Cocoa Swollen Shoot Virus (CSSV) by patch-graft inoculation of the root-stocks. Only a few plants from each of the three cocoa varieties were found to be symptomless after indexing. These plants were multiplied by budding to the MV4 and MV5 stages and screened at each stage for CSSV resistance by inoculation using virus-carrying mealybugs. At the MV5 stage, some plants still remained symptomless and this was confirmed with enzyme-linked immunosorbent assay (ELISA), The study reveals that γ-rays can be used to induce genetic variability for resistance to CSSV in cocoa, as well as for other traits such as chlorophyll deficiency. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated the malaria surveillance system in Adaklu District of the Volta Region of Ghana to determine if the system was meeting its objectives and assessed its usefulness and attributes., Study Design: Descriptive cross-sectional design was used in evaluating the surveillance system., Methods: We interviewed stakeholders using a semi-structured questionnaire on case detection and reporting. We assessed the system attributes using the Centers for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems. We extracted and reviewed malaria surveillance data from the District Health Management Information System 2. Summary statistics and direct content analysis were performed on quantitative and qualitative data respectively., Results: Of the 80,441 suspected malaria cases recorded in Adaklu District from 2014 to 2018, 47,917 (59.6%) cases were confirmed. The system was meeting its objective of detecting malaria cases and monitoring trends in the population however, the system missed an epidemic in August 2016. Data generated from the surveillance system is used by the NMCP to aid in the distribution of logistics such as LLINs, RDT test kits, and track malaria control progress in the district. Staff at all levels were able to detect, confirm, treat and report malaria. All sub-districts/health facilities reported to the district and reports were all accurate and timely. The predictive value positive was 62.9%., Conclusions: The malaria surveillance system in Adaklu District was useful and meeting its set objective of monitoring trends of malaria in the population. It was simple, flexible, acceptable and representative; however, the system was not detecting epidemics. The District Health Management Team should set alert and epidemic thresholds to help detect promptly epidemics of malaria in the district., Competing Interests: Authors declare that there is no competing interest as far as this work is concerned. All views expressed in the piece of work are views of the authors and does not represent the views of position of any organization., (© 2023 The Authors.)

X-linked chronic granulomatous disease (X-CGD) is a primary immunodeficiency caused by mutations in the CYBB gene, resulting in the inability of phagocytic cells to eliminate infections. To design a lentiviral vector (LV) capable of recapitulating the endogenous regulation and expression of CYBB, a bioinformatics-guided approach was used to elucidate the cognate enhancer elements regulating the native CYBB gene. Using this approach, we analyzed a 600-kilobase topologically associated domain of the CYBB gene and identified endogenous enhancer elements to supplement the CYBB promoter to develop MyeloVec, a physiologically regulated LV for the treatment of X-CGD. When compared with an LV currently in clinical trials for X-CGD, MyeloVec showed improved expression, superior gene transfer to hematopoietic stem and progenitor cells (HSPCs), corrected an X-CGD mouse model leading to complete protection against Burkholderia cepacia infection, and restored healthy donor levels of antimicrobial oxidase activity in neutrophils derived from HSPCs from patients with X-CGD. Our findings validate the bioinformatics-guided design approach and have yielded a novel LV with clinical promise for the treatment of X-CGD.

Introduction: the increasing use of motorcycles in northern Ghana is associated with a high incidence of motorcycle crashes and resultant head injuries. This study sought to determine factors associated with head injuries among survivors of motorcycle crashes in northern Ghana., Methods: a prospective unmatched case-control study was conducted at the Tamale Teaching Hospital (TTH). A total of 326 cases (victims who suffered a head injury with or without other injuries) and 294 controls (persons who suffered various injuries except for head injury) from motorcycle crashes were consecutively sampled at TTH from December 15, 2019, to May 15, 2020. A semi-structured questionnaire was used to interview patients in addition to medical records review. Factors associated with head injury were examined using multivariable logistic regression at p<0.05 and a 95% confidence interval., Results: the prevalence of head injury was 53.03% among of 660 survivors of motorcycle crashes. The majority of the patients were young males aged 15-44 years. The rate of helmet use was lower in cases (12.88%) than in controls (57.82%) (p<0.001). Factors associated with head injury were not wearing helmet (AOR= 9.80, 95% CI: 6.22, 15.43), male (AOR=1.75, 95% CI: 1.07, 2.85), student (AOR=0.38, 95% CI: 0.16, 0.91), and alcohol use within 24 hours (AOR=0.17, 95% CI: 0.04, 0.70)., Conclusion: non-use of helmet and male gender significantly increased the risk of head injury risk in this study. Alcohol use and being a student were associated with lower odds of head injuries. Motorcycle safety efforts in the study area should emphasize helmet promotion., Competing Interests: The authors declare no competing interests., (Copyright: Anthony Baffour Appiah et al.)

Background: The use of institutional delivery services is essential for improving maternal and child health. However, studies in Liberia reveal over 20% of women still deliver at home. We assessed the prevalence and associated factors of home delivery among women of reproductive age in Margibi County, Liberia., Methods: We conducted a cross-sectional study among 438 women of reproductive age in Margibi County. Data were obtained using a semi-structured questionnaire. A simple random sampling approach was used to select the participants for the study. We performed binary logistic regression to identify factors influencing home delivery. Findings were summarized into tables displaying the frequencies, percentages, crude, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs)., Results: Prevalence of home delivery in the County was 90.6% (95% CI = 87.5 - 93.0). Women who were ≥ 31 years (aOR = 6.74, 95%CI = 2.86-15.90), women who had two or more children (aOR = 9.68, 95%CI = 4.07-22.99) and those who had rapid onset of labor (aOR = 6.35, 95%CI = 1.59 - 25.27) were associated with increased odds of home delivery. Good attitude of health workers (aOR = 0.01, 95%CI = 0.001 - 0.08) and the availability of transport to the nearest health facility (aOR = 0.01, 95%CI = 0.003 - 0.03) were factors associated with a decreased odds of home delivery among the study participants., Conclusion: The high prevalence of home delivery in the county is a call for urgent interventions by the government of Liberia and various non-governmental organizations. The government may need to supply the county with ambulances and ensure in-service training of health workers on good attitudes., (© 2022. The Author(s).)

Background: Low birth weight (LBW) contributes significantly to infant and child mortality. Each year, about 20 1million deliveries are LBW with 96.5% occurring in developing countries. Whiles the incidence of LBW is reducing in other districts of Sierra Leone, it has been reported to be increasing in the Western Area Urban district. Determining the risk factors in a specific geographic area is important for identifying mothers at risk and thereby for planning and taking appropriate action. The current study sought to identify factors associated with LBW deliveries in the Western Area Urban district of Sierra Leone., Methods: A hospital-based unmatched 1:2 case-control study was conducted among mothers who delivered live singleton babies from November, 2019 to February, 2020 in five referral health facilities. Mothers were conveniently sampled and sequentially enrolled into the study after delivery. Their antenatal care cards were reviewed and a pre-tested questionnaire administered to the mothers. Data analysis was done using Stata 15.0 and association between maternal socio-demographic, socio-economic, obstetric and lifestyle factors and LBW assessed using bivariable and multivariable logistic regression analyses., Results: A total of 438 mothers (146 cases and 292 controls), mean age: 24.2 (±5.8) and 26.1 (±5.5) years for cases and controls respectively participated in the study. Multivariable analysis revealed that being unemployed (AoR = 2.52, 95% CI 1.16-5.49, p = 0.020), having anaemia during pregnancy (AoR = 3.88, 95% CI 1.90-7.90, p <  0.001), having less than 2 years inter-pregnancy interval (AoR = 2.53, 95% CI 1.11-5.73, p = 0.026), and smoking cigarettes during pregnancy (AoR = 4.36, 95% CI 1.94-9.80, p <  0.001) were significantly associated with having LBW babies., Conclusion: Factors associated with LBW identified were unemployment, anaemia during pregnancy, < 2 years inter-pregnancy interval and cigarette smoking during pregnancy. Health care providers should screen and sensitize mothers on the risk factors of LBW during antenatal sessions., (© 2021. The Author(s).)

Objective: We mapped and generated hot spots for potential meningitis outbreak from existing data in Upper East region, Ghana., Design: This was a cross-sectional study conducted in 2017., Data Source: Meningitis data in the Upper East Region from January 2007, to December 2016., Main Outcome Measure: We used spatial tools in Quantum Geographic Information System (QGIS) and Geoda to draw choropleth map of meningitis incidence, case fatality and hotspot for potential meningitis outbreak., Results: A total of 2312 meningitis cases (suspected and confirmed) were recorded from 2016-2017 with median incidence of 15.0cases/100,000 population (min 6.3, max 47.8). Median age of cases was 15 years (IQR: 6-31 years). Most (44.2%) of those affected were 10 years and below. Females (51.2%) constituted the highest proportion. Median incidence from 2007-2011 was 20cases/100,000 population (Min 11.3, Max 39.9) whilst from 2012-2016 was 11.1cases/100,000 populations (Min 6.3, Max 47.8). A total of 28 significant hotspot sub-districts clusters (p=0.024) were identified with 7 High-high risk areas as potential meningitis outbreak spots., Conclusion: The occurrence of meningitis is not random, spatial cluster with high -high-risk exist in some sub-districts. Overall meningitis incidence and fatality rate have declined in the region with district variations. Districts with high meningitis incidence and fatality rates should be targeted for intervention., Funding: Author EA was supported by the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN°57212014/mcrt)., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)

Background: Evaluate the Tuberculosis (TB) surveillance system in the Ga West Municipality to determine if it is achieving its objectives, and to assess its attributes and usefulness., Design: Descriptive analysis of primary and secondary data., Data Source: Stakeholder interviews and record reviews on the objectives and operation of the surveillance system at all levels of the system., Intervention: We evaluated the system's operation from 2011-2015 using the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems and the World Health Organisation (WHO) TB surveillance checklist for assessing the performance of national surveillance systems., Results: The TB surveillance system in the municipality was functional and operated at all levels for timely detection of cases, accurate diagnosis, and case management. The system improved management of TB/HIV co-infections. The average time taken to confirm a suspected TB case was one day. The registration of a confirmed case and subsequent treatment happen immediately after confirmation. The municipality detected 109 of 727 TB cases in 2015 (case detection rate=15%). The positive predictive value (PPV) was 6.4%. There was one diagnostic centre in the municipality. Private facilities involvement in TB surveillance activities was low (1/15)., Conclusion: The Tuberculosis surveillance system in the Ga West Municipality is well structured but partially meeting its objectives. The system is timely, stable and acceptable by most stakeholders and useful at all levels. It has no major data quality issues. Private health facilities in the municipality should be well incorporated into TB surveillance., Funding: This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana through the support of the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN° 57212014/mcrt) to B-YA., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)

Background: Agriculture represents the mainstay of African economies and livestock products are essential to the human population's nutritional needs. However, in many developing countries, including Ghana, livestock production fails to meet demand due to population growth and negative effects of climate change. One of the challenges to production is livestock loss affecting farmers. However, despite stressful events experienced, livestock farmers' mental health is poorly documented. This study aims to identify the root causes of livestock losses and their influence on pastoralists' mental health., Methods: We conducted a mixed methods study in two districts in the Northern and Southern Belts of Ghana. Using the Depression Anxiety and Stress Scale-21 and guided interviews, we collected quantitative and qualitative data from 287 livestock farmers and 24 key-informants respectively. Mental health scores were categorized using standard guidelines. We evaluated the factors that explained variations in mental wellbeing using general linear models (α = 0.05)., Results: About 85% (240/287) of the livestock farmers lost cattle within 1 year. Of these, 91% lost cattle to animal diseases, 50% to theft and 27% to pasture shortages. Qualitative findings reveal that due to poor access to veterinary services, farmers treat livestock diseases themselves with drugs from unregulated sources and often sell diseased cows for meat to recover losses. Findings showed that 60% of livestock farmers had poor mental health. Of those, 72% were depressed, 66% anxious and 59% stressed. Mental wellbeing was negatively associated with the number of adverse events experienced, proportion of livestock lost to most of the major loss factors, emotional attachment to livestock and self-reported physical illnesses in farmers, but positively associated with increasing herd size [F (8,278) = 14.18, p < 0.001, R 2  = 0.29]., Conclusions: Livestock diseases are the leading cause of losses to livestock farmers, whose mental wellbeing is negatively affected by these losses. Although an adaptive strategy by farmers to compensate for poor veterinary services, the arbitrary use of veterinary drugs and sale of diseased cattle pose health risks to the public. Further research to evaluate the performance of veterinary services in Ghana, mental health problems and risk to human health due to potential high-risk meat entering the food chain, is needed.

This study investigated the pore characterization of polyurethane (PU) foam as a necessary step in water filtration membrane fabrication. Porous material characterization is essential for predicting membrane performance, strength, durability, surface feel, and to understand the transport mechanisms using modeling and simulations. Most existing pore characterization techniques are relatively costly, time-consuming, subjective, and have cumbersome sample preparations. This study focused on using three relatively inexpensive imaging systems: a black box, Canon camera (EOS760D), and LaserJet scanner (M1132 MFP). Two standard, state-of-the-art imaging systems were used for comparison: a stereomicroscope and a scanning electron microscope. Digital images produced by the imaging systems were used with a MATLAB algorithm to determine the surface porosity, pore area, and shape factor of the polyurethane foam in an efficient manner. The results obtained established the compatibility of the image analysis algorithm with the imaging systems. The black box results were found to be more comparable to both the stereomicroscope and SEM systems than those of the Canon camera and scanner imaging systems. Indeed, the current research effort demonstrates the possibility of substrate characterization with inexpensive imaging systems.

Background: Influenza-like Illness (ILI) is a medical diagnosis of possible influenza or another respiratory illness with a common set of symptoms. The deaths of four schoolchildren, during a pandemic influenza outbreak in December 2017 in Ghana, raised doubts about the ILI surveillance system's performance. We evaluated the ILI surveillance system in the Greater Accra region, Ghana, to assess the system's attributes and its performance on set objectives., Methods: CDC guidelines were used to evaluate the data of the ILI surveillance system between 2013 and 2017. We interviewed the surveillance personnel on the system's description and operation. Additionally, routinely entered ILI data from the National Influenza Center provided by the six sentinel sites in Accra was extracted. We sampled and reviewed 120 ILI case-investigation forms from these sites. Surveillance activities were examined on system's performance indicators, each being scored on a scale of 1 to 3 (poorest to best performance)., Results: All population and age groups were under ILI surveillance over the period evaluated. Overall, 2948 suspected case-patients, including 392 (13.3%) children under-five were reported, with 219 being positive for influenza virus (Predictive value positive = 7.4%). The predominant influenza subtype was H3N2, recorded in 90 (41.1%) of positive case-patients. The system only met two out of its four objectives. None of the six sentinel sites consistently met their annual 260 suspected case-detection quota. Samples reached the laboratory on average 48 hours after collection and results were disseminated within 7 days. Of 120 case-investigation forms sampled, 91 (76.3%) were completely filled in., Conclusions: The ILI surveillance system in the Greater Accra region is only partially meeting its objectives. While it is found to be sensitive, representative and timely, the data quality was sub-optimal. We recommend the determination of thresholds for alert and outbreak detection and ensuring that sentinel sites meet their weekly case-detection targets., Competing Interests: The authors have declared that no competing interests exist.

Background: A One-Health approach is advocated to ensure effective rabies surveillance in sub-Saharan Africa. Information is needed to assess the current state of dog bites and rabies in Ghana. We analyzed data on reported events in the Eastern Region of Ghana from 2013 to 2015 to generate information that can be used for rabies elimination in Ghana through the One-Health approach., Method: We extracted data on dog bites and rabies from the database of the regional health service and performed descriptive analysis using Epi Info version 7™. We followed up with interviews with three key informants from the health and veterinary services on issues related to surveillance and data quality., Results: Overall, 4821 dog bites were reported over the three-year period. This translated into an annual incidence of 172 cases per a population of 100,000. Most of cases were in children aged less than 10 yrs. Fifteen (53.3% males) cases of rabies were recorded in seven out of the 26 municipalities and districts, translating into a rabies to dog bite ratio of 3: 1000. The median age of victims was 9 years (range: 3-72 years). A parallel and uncoordinated system of rabies surveillance is maintained by the health and veterinary services, with gross disparities in the number of reported events and overall impression of underreporting., Conclusion: Rabies remains an important cause of preventable deaths in this region. An integrated approach to surveillance based on the One-Health concept needs to be adopted.

Maintaining stability under dynamic conditions is an inherent challenge to bipedal running. This challenge may impose an energetic cost (Ec) thus hampering endurance running performance, yet the underlying mechanisms are not clear. Wireless triaxial trunk accelerometry is a simple tool that could be used to unobtrusively evaluate these mechanisms. Here, we test a cost of instability hypothesis by examining the contribution of trunk accelerometry-based measures (triaxial root mean square, step and stride regularity, and sample entropy) to interindividual variance in Ec (J/m) during treadmill running. Accelerometry and indirect calorimetry data were collected concurrently from 30 recreational runners (16 men; 14 women) running at their highest steady-state running speed (80.65 ± 5.99% V̇o 2max ). After reducing dimensionality with factor analysis, the effect of dynamic stability features on Ec was evaluated using hierarchical multiple regression analysis. Three accelerometry-based measures could explain an additional 10.4% of interindividual variance in Ec after controlling for body mass, attributed to anteroposterior stride regularity (5.2%), anteroposterior root mean square ratio (3.2%), and mediolateral sample entropy (2.0%). Our results lend support to a cost of instability hypothesis, with trunk acceleration waveform signals that are 1) more consistent between strides anteroposterioly, 2) larger in amplitude variability anteroposterioly, and 3) more complex mediolaterally and are energetically advantageous to endurance running performance. This study shows that wearable trunk accelerometry is a useful tool for understanding the Ec of running and that running stability is important for economy in recreational runners. NEW & NOTEWORTHY This study evaluates and more directly lends support to a cost of instability hypothesis between runners. Moreover, this hypothesis was tested using a minimalist setup including a single triaxial trunk mounted accelerometer, with potential transferability to biomechanical and performance analyses in typical outdoor settings.

Background: Globally, 4 million neonates die annually, with one-third of such deaths occurring as a result of infections. In 2011, there were 7.2million deaths in children below 5 years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multidrug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health. The change in these organisms has been reported to vary across regions, between health facilities and even within the same facility. Continuous surveillance is required to inform antibiotic choice for neonatal sepsis management. We identified the common causative organisms of neonatal sepsis and their antibiotic susceptibility pattern in the Ho municipality., Method: A cross sectional study was conducted in the Ho municipality from January to May, 2016. A semi-structured questionnaire was used to collect socio-demographic data from mothers of neonates with clinically suspected of sepsis. Clinical data of both mothers and neonates were extracted from case notes. A 2 ml volume of blood was also taken from neonates and dispensed into a 20 ml mixture of thioglycollate fluid broth and tryptone soy broth for culture and antibiotic susceptibility pattern determined., Results: Out of the 150 clinically suspected neonatal sepsis cases, 91 (60.7%) were males. The Median gestational week was 38 (IQR: 36-39) and Median birthweight was 3.0 kg (IQR 2.5-3.4). The prevalence of culture positive sepsis was 17.3% of the 150 suspected cases. A total of 26 different pathogens were isolated, of which gram positive organisms had a preponderance of 18 (69%) over gram negative organisms 8 (31%). Staphylococcus epidermidis was the most common 14 (53.8%) isolate identified. There was a single isolate (4%) each of Proteus mirabilis and Escherichia coli identified. All the isolates identified showed 100% resistance to ampicillin., Conclusion: The prevalence of culture proven sepsis was 17.3% and Staphylococcus epidermidis was the most common isolate identified. Pathogens isolated were resistant to the first line drugs for management of neonatal sepsis. Hence, the need for a review of first line drug for empirical treatment in neonatal sepsis., Competing Interests: The authors declare that they have no competing interests.Approval for this study was obtained from the Ghana Health Service Ethical Review Committee. Permission was also sort from the Municipal Health Directorate and the hospital administration of the respective hospitals. An informed consent was administered to mothers of neonates before participation in the study, and each respondent was given a unique identifier such that data gathered could not be traced back to respondents.Not applicable.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.