bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons on Implementation and Sustainability of M-Health Solutions in South Africa
Authors: Sibuyi Idon-Nkhenso , Horner Vincent
Published: October 2020

The Momconnect project was launched in 2014 by its champion, the minister of health, Hon. Dr. Aaron Motsoaledi. The system is an m-health application targeted at maternal health patients in South Africa. Execution of the project was carried out by a consortium headed by the National Department of Health. Project execution began in 2012, and the launch was two years later in 2014. In this research, a health systems framework for evaluation of implementations of m-health systems in developing countries was used to review the system. The sources of data for the study were face-to-face interviews of the Momconnect Task Team, Ministerial Advisory Committee on e-Health, and a sample of health care providers and consumers from the health facility level in Johannesburg Metro City. These interviews were supplemented by a document review. The findings of the study are reported according to the four headings of the study framework.
A Stakeholder's Analysis of the Effect of Mobile Money in Developing Countries
Authors: Kante Mahamadou , Kante Macire
Published: October 2020

Understanding the stakeholders of mobile money services and systems in developing countries remain critical issues that need to be addressed. Using the Stakeholder Theory, along with the Diffusion of Innovation Theory and Unified Theory of Acceptance and Use of Technology, this study gathered data from 110 respondents to contribute to the understanding of the mobile money (Orange Money) stakeholders in Mali. The results characterized the stakeholders of the mobile money system and revealed that each stakeholder has its unique drivers and challenges towards the adoption of the mobile money system. These findings suggest that specific attention should be paid to each stakeholder by the mobile money operator in developing countries.
Access to Learning Through Mobiles
Authors: Nampijja Dianah , Øyhus Arne Olav , Webersik Christian , Muyinda Paul Birevu
Published: October 2020

The common myth that mobile learning cannot propel in a rural setting is null and void. The influx of modern ICTs like mobile technologies can revolutionize information access among the less privileged in many African communities. Using the Actor-Network Theory as a methodological tool, the chapter explores opportunities of increasing knowledge access through mobiles, by understanding the networks involved in farmer's mobile learning practice, with reference to Uganda. The chapter reveals that mobile technologies offer affordable individual and group learning opportunities to smallholder farmers. Learning is a socially constructed activity, where farmers with access to ICTs like mobile phones share knowledge among those with no access. Through a socio-technical discussion, technological initiatives ought to be pro-people where farmers' needs are key considerations in the mLearning actor-network. For sustainable impacts, all actors need to work collaboratively, negotiate different realities, and appreciate the local challenges within which mobile technologies can support learning.
The Potential Adoption of Second Life as a Platform for Learning
Authors: Ako-Nai Sonny Anyetei , Ajayi Nurudeen
Published: October 2020

Second Life (SL), an advanced virtual world technology used in education, creates an environment that facilitates engagement, collaboration, and conceptualization of knowledge to improve teaching and learning. The chapter investigates the potential of SL as a learning platform and students' perceptions on the ease of use of SL and usefulness as a learning platform, and challenges with SL implementation. The chapter adopts the qualitative research method, the Technology Acceptance Model, and a purposive sample drawn from fourth year Information Systems and Technology (IS&T) students at the University of KwaZulu-Natal in South Africa. The chapter reports that SL is perceived to be a useful learning platform by students and improves students' instinctive and creative learning ability. However, inadequate training and insufficient information technology (IT) infrastructure are the challenges that hamper SL implementation efforts. Thus, the chapter suggests adequate training, provision of infrastructure and creation of a support pathway for SL as a learning platform as the possible solutions.
Role of Data Science and Data Analytics in Forensic Accounting and Fraud Detection
Authors: Odia James Osabuohien , Akpata Osaheni Thaddeus
Published: October 2020

The chapter examines the roles of data science and big data analytics to forensic accountants and fraud detection. It also considers how data science techniques could be applied to the investigative processes in forensic accounting. Basically, the current increase in the volume, velocity, and variety of data offer a rich source of evidence for the forensic accountant who needs to be familiar with the techniques and procedures for extracting, analysing, and visualising such data. This is against backdrop of continuous global increase in economic crime and frauds, and financial criminals are getting more sophisticated, taking advantage of the opportunities provided by the unstructured data constantly being created with every email sent, every Facebook post, every picture on Instagram, or every thought share on Twitter. Consequently, it is important that forensic accountants are constantly abreast with developments in data science and data analytics in order to stay a step ahead of fraudsters as well as address evolving vulnerabilities created by big data.
Technology in Healthcare
Authors: Garg Niharika
Published: October 2020

Healthcare is one of the significant areas of development where the hospitals are turning to innovative models built around advanced medical technologies like electronic health, tele-medicine, and mobile health. Healthcare sector is revolving around big data sets and huge amount of unstructured information produced from these high-tech devices and tools. But the technologies like machine language, big data, and artificial intelligence are turning them to a data-intensive science. The data is used for analysis by medical researchers which in turn is becoming solution for many healthcare challenges like early diagnosis, quality care, portable healthcare, cost- and time-effective treatments, and many more. Therefore, the hospitals are turning to smart hospitals to strengthen their existence in tomorrow's challenging medical service market. This chapter discusses the technology contribution in healthcare, challenges in future, future healthcare and cost model, and challenges for insurance companies.
Gait Abnormality Detection Using Deep Convolution Network
Authors: Chakraborty Saikat , Suzuki Tomoya , Das Abhipsha , Nandy Anup , Venture Gentiane
Published: October 2020

Human gait analysis plays a significant role in clinical domain for diagnosis of musculoskeletal disorders. It is an extremely challenging task for detecting abnormalities (unsteady gait, stiff gait, etc.) in human walking if the prior information is unknown about the gait pattern. A low-cost Kinect sensor is used to obtain promising results on human skeletal tracking in a convenient manner. A model is created on human skeletal joint positions extracted using Kinect v2 sensor in place using Kinect-based color and depth images. Normal gait and abnormal gait are collected from different persons on treadmill. Each trial of gait is decomposed into cycles. A convolutional neural network (CNN) model was developed on this experimental data for detection of abnormality in walking pattern and compared with state-of-the-art techniques.
Exploration of Computational Intelligence Insights and Data Analytics to Combat COVID-19
Authors: Prakash J.  , Vinoth Kumar B.
Published: October 2020

COVID-19 is having a huge impact on the society around the world, causing a huge number of deaths, which is increasing day by day. All the countries are fighting against this global pandemic by working on vaccines, implementing complete and partial lockdowns to avoid the spread of virus. On the basis of the various literature surveys done by the authors, it is found that computational intelligence and data analytics can play a vital role in this pandemic and can be really helpful. This chapter explains how data analytics and computational intelligence can serve the world to combat COVID-19.
Influence of Some Sociodemographic Factors on Causes of Death Among South African Youth
Authors: Mogale Boipelo Vinolia , Tsoku Johannes Tshepiso , Munapo Elias , Olusegun Sunday Ewemooje
Published: October 2020

Youth mortality is a challenge in South Africa, where on a daily basis a number of deaths are reported and are related to youth. This study used the 2014 Statistics South Africa data to examine the influence of sociodemographic factors on causes of death among South African youth aged 15-34 years, using a logistic regression model. The results showed that there is a significant relationship between education and causes of death as well as other sociodemographic factors and that the youth mortality will likely reduce if more youth have higher levels of education. The results of this study could be used to improve national prevention campaigns to reduce death among young South Africans, especially adolescents.
Concussion Knowledge, Attitudes, and Self-Reporting Intentions in Youth Athletes
Authors: Chandran Avinash , Nedimyer Aliza K. , Kerr Zachary Y. , O'Neal Cathleen , Mensch James , Yeargin Susan W.
Published: October 2020

Context

Although it has been suggested that developmental and sociological factors play a role in concussion reporting, the empirical evidence related to this is limited.

Objective

To examine the influences of sex, school level, school location, concussion-reporting history, and socioeconomic status on concussion-related knowledge, attitudes, and reporting intentions among middle school and high school athletes.

Design

Cross-sectional study.

Setting

Middle School students and High School athletes attending pre-participation examinations (PPEs) were asked to complete paper-based surveys.

Patients or Other Participants

Overall, 541 athletes representing 18 sports returned fully completed surveys.

Main Outcome Measure(s)

Outcomes were concussion-related knowledge, perceived seriousness, positive feelings about reporting, and self-reporting intentions. We examined group differences in these outcomes across levels of the explanatory variables of sex, school level (middle school versus high school), school location (urban versus rural), concussion self-reporting history (yes or no), and socioeconomic status (free or reduced-price lunch versus no free or reduced-price lunch) using Wilcoxon rank sum tests. Then we used multivariable ordinal logistic regression models to identify predictors of higher score levels for each outcome. Odds ratio (OR) estimates with 95% confidence intervals (CIs) excluding 1.00 were deemed significant.

Results

Odds of higher levels of knowledge were higher in urban versus rural school student-athletes (ORAdjusted = 1.81; 95% CI = 1.03, 3.17), and lower in student-athletes on free or reduced-price lunch versus those not on free or reduced-price lunch (ORAdjusted = 0.52; 95% CI = 0.36, 0.77). Similarly, odds of higher levels of seriousness were lower in male versus female student-athletes (ORAdjusted = 0.48; 95% CI = 0.32, 0.72). Further, odds of higher levels of self-reporting intentions were lower among male versus female student-athletes (ORAdjusted = 0.53; 95% CI = 0.37, 0.75).

Conclusions

Developmental and sociological factors were differentially associated with concussion-related knowledge, attitudes, and self-reporting intentions. These results can inform medical providers, parents, and coaches with regard to context-specific clinical assessments of concussion symptoms.
Comparison of sensitivity of bacteria isolated in odontogenic infections to ceftriaxone and amoxicillin-clavulanate
Authors: Adamson Olawale Olatunbosun , Adeyemi Michael Olayinka , Gbotolorun Olalekan Micah , Oduyebo Omoniyi Omolola , Odeniyi Olalekan , Adeyemo Wasiu Lanre
Published: October 2020

Background: Odontogenic infections is a cause of mortality and morbidity in maxillofacial patients. This is largely due to resistance of organisms to antibiotics prescribed.Objectives: To isolate organisms involved in odontogenic infections and compare the sensitivity of the organisms to Ceftriaxone and Amoxicillin-Clavulanate.Methods: The causative organisms and antibiotic sensitivity were determined by the following steps: Aspiration of pus done with needle, sample of pus or exudate collected using sterile swab if aspiration was unsuccessful and specimen were placed in transport media (thioglycolatebroth) and sent immediately to microbiology laboratory for culture of organisms and antibiotic sensitivity.Results: Out of a total 55 samples taken for bacteriology, 42 (76.4%) yielded positive culture for bacteria. A total number of 21 bacteria species were identified from the positive cultures. Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics (Table 3). Ceftriaxone was statistically significantly more potent in inhibiting bacteria growth than amoxicillin-clavulanate (P =0.009).Keywords: Sensitivity of bacteria, odontogenic infections, ceftriaxone, amoxicillin-clavulanate.
ABCB1 variants C3435T and T129C are not associated with colorectal cancer risk
Authors: Al Qahtani Areej M , Al-Ghafari Ayat B , Al Doghaither Huda A , Alzahrani Anas H , Omar Ulfat M , Rahimulddin Sawsan A
Published: October 2020

Background: Colorectal cancer (CRC) is one of the most prevalent cancers in Saudi Arabia that is highly characterized with poor survival rate and advanced metastasis. Many studies contribute this poor outcome to the expression of ABC transporters on the surface of cancer cells.Objectives: In this study, two ABCB1 variants, C3435T and T129C, were examined to evaluate their contribution to CRC risk.Methods: 125 subjects (62 CRC patients and 63 healthy controls) were involved. The DNA was isolated and analyzed with PCR-RFLP to determine the different genotypes. The hardy-Weinberg equilibrium was performed to determine genotype distribution and allele frequencies. Fisher’s exact test (two-tailed) was used to compare allele frequencies between patients and control subjects. Results: The study showed that for SNP C3435T, the population of both CRC patients and controls were out of Hardy-Weinberg equilibrium. Genotype distribution for CRC patients was (Goodness of fit χ2 = 20, df= 1, P≤0.05), whereas, for the controls the genotype distribution was (Goodness of fit χ2 = 21, df =1, P ≤0.05). For SNP T129C, all subjects showed normal (TT) genotype.Conclusion: There was no significant association between ABCB1 3435C>T and 129T>C polymorphisms with CRC risk.Keywords: Colorectal cancer, ABCB1 gene, SNP C3435T, SNP T129C, PCR-RFLP, Saudi Arabia.
Anxiolytic and anti-depressant effects of hydroalcoholic extract from Erythrina variegata and its possible mechanism of action
Authors: Chu Hong-Biao , Tan Yue-De , Li Yun-Jing , Cheng Bin-Bin , Rao Bao-Qi , Zhou Ling-Shan
Published: October 2020

Background:Erythrina variegata has been widely used as a traditional medicine.Objective: The study was designed to evaluate the anxiolytic and anti-depressant effects of an extract from Erythrina variegata.Methods: The extract was evaluated for anxiolytic and anti-depressant action using the elevated plus maze, light/dark box, open field, forced swimming and tail suspension tests in mice. The mechanism of action was further elucidated using high-performance liquid chromatography with fluorescence detection methods to assay the levels of five neurotransmitters in brain.Results: The extract exhibited significant increase in the percentage of the open arms entries and the time spent in the open arms in the elevated plus maze test. The results of the light/dark box test revealed a significant increase in the amount of time spent in the light chamber. Extract- treated mice also produced significant increase in the number of crossings and rearings in the open field test.In the forced swimming and tail suspension tests, the extract was able to promote significant decrease in the immobility time. In addition, the extract significantly altered the levels of five neurotransmitters in the brain tissue.Conclusion: These findings suggest that Erythrina variegata presents potential anxiolytic and anti-depressant activity, and the mechanism may be related to the alteration of neurotransmitter levels.Keywords: Anxiolytic; anti-depressant; Erythrina variegata; elevated plus maze; forced swimming; neurotransmitters.
Approach to stress endocrine response: somatization in the context of gastroenterological symptoms: a systematic review
Authors: Keskin Gülseren
Published: October 2020

Background: Stress can be defined as an acute threat to the homeostasis of an organism, and in order to manage stress, and maintain stability, the allostatic systems activate an adaptive response. Stress has been shown to have both short - and long-term effects on the function of the gastrointestinal tract, but long-term exposure to stress is more likely to cause endocrine disorders.Objective: The aim of this study was to investigate the endocrine response to stress, and evaluate the relationship between somatization and gastrointestinal symptoms.Methods: A systematic literature search was conducted on several academic databases, which included, Pubmed, EBSCO and Science Direct. The search was performed using the keywords, “endocrine response to stress”, “somatization” and “gastrointestinal symptoms”. Results: The hypothalamic-pituitary-adrenal (HPA) axis is essential in controlling physiological stress responses. Dysfunction is related to several mental disorders, including anxiety and depression, or somatization. Symptoms associated with genetic, or other traumatic experiences of individuals under stress, can lead to a maladaptive response to stress. These stressful life events were found to be associated with digestive system-related chronic diseases. Gastrointestinal disorders significantly affect millions of people worldwide. Conclusion: This study examined how the endocrine system responds to stress, and the effect this has in causing stress-related gastrointestinal distresses. Our findings indicate that stress-related psychological disorders are strongly associated with the severity of gastrointestinal symptoms.Keywords: Stress, endocrine response, somatization, gastrointestinal symptoms.
Inorganic pollutants in edible grasshoppers (Ruspolia nitidula) of Uganda and their major public health implications
Authors: Kasozi Keneth Iceland , Namazi Catherine , Basemera Elizabeth , Atuheire Collins , Odwee Ambrose , Majalija Samuel , Kateregga John N
Published: October 2020

Background: Inorganic contamination of food products is associated with adverse health effects, however, information on grasshoppers in Africa is sparse. The objective of the study was to determine antioxidant, heavy metal and food safety status of edible grasshoppers of Uganda.Methods: A cross-sectional study was conducted in central and southwestern Uganda, in which a questionnaire was administered to grasshopper harvesters. Grasshopper samples were collected from each harvesting point and analyzed in the laboratory for antioxidant and heavy metal content i.e. Lead (Pb), Chromium (Cr), Zinc (Zn) and Cadmium (Cd) using atomic absorbance spectrometric (AAS) method on the heads and abdomen of the insects.Results: Major antioxidants were Catalase > Glutathione > Glutathione peroxidase. In addition concentrations of heavy metals were in the order of Pb > Cr > Zn > Cd in the heads and abdomens of the grasshoppers. Pb concentrations were found to be higher in the heads than the abdomens and the carcinogenic potential of the grasshoppers was over 10 times over the recommended levels. Grasshoppers were found not to be safe especially in children due to their small body weight in comparison to adults.Conclusion: Pb poisoning in the Ugandan children would be propagated through contaminated grasshoppers.Keywords: Ecotoxicology, Food Safety, Metals in Insects, Nutritional Toxicology, Pb poisoning, Uganda.
An assessment of the trainability of beggars and the destitute in Abakaliki Nigeria: implication for policy on their health, vocational rehabilitation and social reintegration
Authors: Nweze Tina , Yasin Asfa M , Okolie Ugochukwu C , Ogundele Alexander G , Uneke Chigozie J , Agwu Uzoma , Omoke Philip C , Ajayi Nnenna
Published: October 2020

Background: Begging and destitution constitute serious health and social problems in low and middle-income countries (LMICs).Objectives: The objective of this study was to assess the trainability of beggars and the destitute in Abakaliki Nigeria in order to provide scientific evidence required for the development of a policy on their health, vocational rehabilitation and social reintegration.Methods: The study was a cross-sectional descriptive survey of 50 purposively selected beggars and destitute persons identified from motor parks, church cathedrals, market places etc. Data was collected using a structured interviewer-administered questionnaire. Analysis was based on mean rating (MNR), median rating (MDR), and range. Interview of each respondent lasted approximately 20 minutes. Results: Of the 50 respondents who participated in this study, 17 (34%) were females. Most subjects were of age category 31-35 years (30%) and 36-40 years (34%). Fifteen (30%) admitted having sight impairment while 17 (34%) admitted that they were physically challenged. The outcome of the trainability assessment showed relatively high mean ratings (MNRs) ranging from 3.42-4.06 on a scale of 5 points.Conclusion: The findings of this study clearly suggest that there is a very high potential for the vocational rehabilitation and social reintegration of beggars and the destitute in the study area.Keywords: Beggars, destitute, policy, health, vocational, rehabilitation, reintegration, Nigeria.
Endoscopic endonasal resection of congenital trans-sphenoidal meningoencephalocele with extension to the epipharynx in early childhood: a case report
Authors: Dzhambazov Karen , Kehayov Ivo , Topalova Alexandrina , Kitov Borislav , Zhelyazkov Hristo , Davarski Atanas
Published: October 2020

Background: The clinical presentation of sphenoid sinus meningoencephaloceles (MEC) may have insidious onset and evolution. Contemporary treatment incorporates endoscopic resection via the endonasal route.Case description: We present a case of 3 year old girl who had been complaining of permanent nasal discharge, impeded nasal breathing and difficulty with feeding since she was 5 months old. There was no history of rhinoliquorrhea. Pre-operative magnetic resonance imaging demonstrated MEC that extended from the sellar region through the non-pneumatized sphenoid sinus to the nasopharynx. The lesion was resected via endoscopic endonasal approach. Follow-up rhinoscopy confirmed the absence of post-operative cerebrospinal fluid leak.Conclusion: Endoscopic endonasal approach can be an effective and a safe treatment option for resection of congenital transsphenoidal MEC in early childhood.Keywords: Sphenoid sinus; endoscopic endonasal approach; meningoencephalocele; CSF leak; congenital.
Editorial I Reproductive health issues, infections and non-communicable diseases
Authors: K Tumwine James
Published: October 2020

NIL
Malnutrition amongst HIV adult patients in selected hospitals of Bushenyi district in southwestern Uganda
Authors: Odwee Ambrose , Iceland Kasozi Keneth , Amongi Acup Christine , Kyamanywa Patrick , Ssebuufu Robinson , Obura Richard , B Agaba Jude , Makeri Danladi , Kirimuhuzya Claude , Sasirabo Olivia , H Bamaiyi Pwaveno
Published: October 2020

Background: Malnutrition is an important clinical outcome amongst HIV patients in developing countries and in Uganda, there is scarcity of information on its prevalence and risk factors amongst HIV adult patients.

Methods: A cross-sectional study amongst 253 HIV patients in Bushenyi district assessed their nutritional status using the body mass index (BMI) and mid-upper arm circumference (MUAC), and a questionnaire was used to identify major risk factors.

Results: The mean age of the study participants was 38.74 ± 0.80 yrs, while females and males were 52.2% and 47.8% respectively. Prevalence of malnutrition was 10.28% (95% CI: 6.82 – 14.69) in the study. Major socio-economic factors associated with malnutrition were being female, unemployed, dependent and with many family members. Patients with op- portunistic infections, low adherence to HAART, and stage of HIV/AIDS had a higher risk of malnutrition.

Discussion: In rural communities, a majority of malnourished patients are elderly and these were identified as priority groups for HIV outreach campaigns. The current policy of prioritizing children and women is outdated due to changing disease dynamics, thus showing a need to revise extension service provision in rural communities.

Conclusion: Malnutrition is a threat in HIV adult patients in rural communities of Uganda.

Keywords: Malnutrition; HIV adult patients; Bushenyi district; Uganda.
Acceptance and utilization of HIV testing among the youth: a cross-sectional study in Techiman, Ghana
Authors: YA Asare Bernard , Y Yeboaa Henrietta , Dwumfour-Asare Bismark
Published: October 2020

Background: In Ghana, efforts including ‘Know Your Status’ campaign have been made to increase awareness and improve the uptake of HIV screening.

Objective: This study examined the acceptance and utilization of the HIV/AIDS ‘Know Your Status’ campaign and determine dthe differences in HIV testing by demographic characteristics among the youth in Techiman, Ghana.

Method: This study was a cross-sectional study conducted among the youth aged 15-24 years. A structured questionnaire was used to collect data from 200 purposively selected respondents.

Results: The mean age of the respondents was 19.6±2.72 years. There was a universal awareness (100%) of HIV/AIDs, and were knowledgeable about the mode of transmission, symptoms and the prevention of HIV. A high proportion of the respon- dents (n=161, 80.5%) had heard about the ‘Know Your Status’ (KYS) campaign. Less than half of respondents (n=91, 45.5%) had tested for HIV, and only 16.5% (n=15/91) of respondents tested through the KYS campaign. Testing for HIV was associ- ated with age (p<0.001) and marital status (p<0.001).

Conclusion: The youth should therefore be targeted in the awareness and the ‘Know Your Status campaigns’, and in an effort- sto promote screening for HIV.

Keywords: Awareness; campaign; knowledge; HIV/AIDS; know your status; screening.
Antimicrobial susceptibility pattern of Stenotrophomonas species isolated from Mexico
Authors: O Elufisan Temidayo , Cristina Rodriguez-Luna Isabel , O Oyedara Omotayo , Sanchez-Varela Alejandro , Bocanegra García Virgilio , O Oluyide Busayo , Flores-Treviño Samantha , Angel Villalobos López Miguel , Guo Xianwu
Published: October 2020

Background: Stenotrophomonas species are multi-resistant bacteria with ability to cause opportunistic infections.

Objective: We isolated 45 Stenotrophomonas species from soil, sewage and the clinic with the aim of investigating their susceptibility to commonly used antimicrobial agents.

Methodology: The identities of isolates were confirmed with 16S rRNA gene sequence and MALDI-TOF analysis. Anti-mi- crobial resistance, biofilm production and clonal diversity were also evaluated. The minimum inhibitory concentration technique as described by Clinical & Laboratory Standards Institute: CLSI Guidelines (CLSI) was employed for the evaluation of isolate susceptibility to antibiotics.

Result: Forty-five Stenotrophomonas species which include 36 environmental strains and 9 clinical strains of S. maltophilia were considered in this study. 32 (88.9 %) environmental strains were identified to be S. maltophilia, 2 (5.6 %) were Stenotrophomonas nitritireducens, and 2 (5.6 %) cluster as Stenotrophomonas spp. Stenotrophomonas isolates were resistant to at least six of the antibiotics tested, including Trimethoprim/Sulfamethoxazole (SXT).

Conclusion: Environmental isolates from this study were resistant to SXT which is commonly used for the treatment of S. maltophilia infections. This informs the need for good public hygiene as the environment could be a reservoir of multi-resistant bacteria. It also buttresses the importance of surveillance study in the management of bacterial resistance.

Keywords: Stenotrophomonas; environmental; biochemical characterization; clonal diversity; anti-microbial susceptibility.
Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis
Authors: Mařincová Lenka , Šafaříková Simona , Cahlíková Radka
Published: October 2020

Background: Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence.

Objectives: The aim of this study was to analyse the predictors of obesity in the region of East Africa.

Methods: Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated.

Results: Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level.

Conclusion: Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region.

Keywords: Obesity; meta-analysis; East Africa.
Relationship between plasma homocysteine and blood pressure in hypertensive Northern-Nigerians
Authors: Uzoamaka Onyemelukwe Obiageli , Bello Maiha Bilkisu
Published: October 2020

Aim: The study sought to determine whether there is any relationship between plasma homocysteine and blood pressure levels in Nigerians with essential hypertension.

Method: It was a cross-sectional analytical study done on 120 randomly selected hypertensive patients and 120 normal healthy controls seen at the large Conference hall of the Ahmadu Bello University (ABU) Medical Centre, Zaria as well as the ABU Teaching Hospital, Zaria, Northern-Nigeria. Pearson’s Correlation and Binary Logistic Regression analysis determined the rela- tionship between homocysteine and hypertension.

Results: Hyperhomocysteinaemia found in the hypertensive patients (22.8 ± 6.6 µmol/L) differed significantly (p<0.001) from controls (10.9 ± 2.8 µmol/L) with significant (p<0.001), blood pressure difference between both groups. Homocysteine signifi- cantly positively correlated with systolic (r = 0.51, p<0.001) and diastolic (r = 0.47, p<0.001) blood pressures in hypertensive subjects. The relation of plasma hcy to hypertension was statistically significant for SBP; OR: 1.08 (95% CI, 1.05-1.11) and DBP; OR: 1.08 (95% CI, 1.03-1.13) in the unadjusted model. When adjusted for confounding variables, hcy was significantly related to SBP; OR: 1.1 (95% CI, 1.04-1.18) but not DBP (p=0.25; OR: 1.06 (95 % CI, 0.96-1.18). The mean plasma folate level was high (115.2 ± 48.0 ng/mL) in the hypertensive subjects. The hyperhomocysteinaemic subjects showed a 2.8 times Odds of developing hypertension.

Conclusion: This study showed higher mean plasma homocysteine levels in hypertensives than controls not accounted for by sub-optimal folate levels. Hyperhomocysteinaemia showed a positive relationship to systolic hypertension after adjusting for confounders.

Keywords: Plasma homocysteine; hypertension; healthy controls; folic acid; blood pressure; Northern-Nigerians.
Prevalence, factors associated and treatment outcome of hyperbilirubinaemia in neonates admitted to St Francis hospital, Nsambya, Uganda: a descriptive study
Authors: Nyangabyaki-Twesigye Catherine , Mworozi Edison , Namisi Charles , Nakibuuka Victoria , Kayiwa Joshua , Ssebunya Robert , Aggrey Mukose David
Published: October 2020

Background: With targeted management of neonatal hyperbilirubinaemia in high-income countries, there has been a dras- tic drop in both the prevalence and mortality. On the contrary, over two-thirds of the global burden of neonatal hyperbiliru- binaemia is in Sub-saharan Africa and South East Asia with a high mortality risk of 16-35%. Neonatal hyperbilirubinaemia is not a leading global cause of neonatal mortality, however leads to irreversible neurological damage and death when managed poorly. Three-quarters of the babies admitted to the national referral hospital in Uganda had significant hyperbilirubin- aremia; 16.6% of these babies died. We aimed at determining the prevalence, treatment outcome and describing factors associated with hyperbilirubinaemia in neonates admitted to St Francis hospital, Nsambya.

Methods: A cross sectional study was carried out. A total of 242 files of babies with a preliminary diagnosis of hyperbiliru- binaemia were retrieved retrospectively. Relevant data was extracted from the files and analysed using STATA version 14.0.

Results: The prevalence of significant hyperbillirubinaemia was 22.7% (55/242). Seventy-seven percent of the babies ad- mitted did not require treatment for hyperbilirubinaemia. No factors were found to be significantly associated with sig- nificant hyperbilirubinaemia. The case fatality for severe hyperbilirubinaemia was 20% (6/30); half of these babies had haemolytic disease of the newborn.

Conclusion: Establishment of local guidelines will prevent unnecessary admissions and ensure timely treatment is admin- istered. Longitudinal studies are required to discover factors associated with neonatal hyperbilirubinaemia in this region.

Keywords: Neonatal jaundice; hyperbilirubinaemia; phototherapy; exchange transfusion.
Prevalence, short term outcome and factors associated with survival in patients suffering from upper gastrointestinal bleeding in a resource limited-setting, the case of Mulago hospital in Kampala, Uganda
Authors: Kahatwa Kiringa Serge , Quinlan Jacklyn , Ocama Ponciano , Mutyaba Innocent , Kagimu Magid
Published: October 2020

Background: Upper gastrointestinal bleeding (UGIB) is a common cause of admission and death in the gastroenterology service. The prevalence, risk factors and the case fatality rate of UGIB may differ by settings.

Objectives: Our objective was to determine the prevalence of symptoms and the case fatality rate of UGIB among patients at the gastroenterology service of Mulago Hospital in Kampala, Uganda and to describe the clinical and laboratory risk fac- tors associated with the survival of these patients.

Methods: In a cross-sectional study performed between September 2013 and April 2014, patients were screened for UGIB symptoms. Data was collected on socio-demographic characteristics, clinical presentation and patient’s outcome within one week of admission. Bivariate, multivariate, and survival analysis were performed to identify variables that were significantly associated with mortality.

Results: Out of 1085 patients screened, we identified the prevalence of UGIB symptoms in 220 patients (20.3%). Among these, 150 met the inclusion criteria for our study. The majority were males (70.7%) and 40 years of age or less (60%). The most prevalent clinical diagnosis were gastritis (39.3%), esophageal varices (17.3%) and peptic ulcer disease (PUD) (16%). Among patients who underwent endoscopy, esophageal varices (42.2%), PUD (26.3%) and gastritis (15.8%) were the lead- ing causes of bleeding. The overall case fatality rate was 16.7% (25/150). Uremia remained associated with mortality after controlling for confounders. Survival was significantly reduced for males as well as for patients with uremia and malignancy.

Conclusion: the prevalence of symptoms and the case fatality rate of UGIB among patients admitted to the gastroenter- ology ward in Mulago hospital were higher than in developed countries and similar to other resource-limited setting. The majority of patients were young men and presented with both hematemesis and melena. The most common causes of UGIB were esophageal varices, gastritis and PUD. Survival analysis indicate that male gender, uremia, and malignancy are associated with reduced survival.

Keyword: Upper gastrointestinal bleeding; gastroenterology; survival; Uganda; Africa.
Vitamin D deficiency and its effect on respiratory distress syndrome in premature infants: results from a prospective study in a tertiary care centre
Authors: Dogan Pelin , Ozkan Hilal , Koksal Nilgun , Bagci Onur , Guney Varal Ipek
Published: October 2020

Background: The positive effects of steroids on lung development are well known, and 1,25-dihydroxy vitamin D3 has been shown to exert positive effects on fetal lung development.

Objective: We aimed to investigate the relationship between 25-hydroxyvitamin D [25(OH)D] levels and respiratory distress syn- drome (RDS) in premature infants.

Methods: Infants aged ≤32 gestational weeks who were admitted to the neonatal intensive care unit (NICU) during 1 year were enrolled in this prospective study. 25(OH)D levels were obtained at the time of admission to NICU. Patients were divided into three groups according to their 25(OH)D levels: severe (group 1), moderate (group 2), and mild (group 3) 25(OH)D deficiencies.

Results: The study comprised 72 patients; of them, RDS was observed in 49 and not observed in 23 patients. The mean 25(OH)D levels were significantly lower in RDS patients (p=0.04). Multivariate analysis showed that patients with higher 25(OH)D levels can be preventive for the development of RDS (odds ratio 0.89; 95% confidence interval 0.8–0.99; p=0.04).

Conclusion: Our study revealed that 25(OH)D deficiency is an independent risk factor for RDS in premature infants. However, further studies are necessary to explore the association between 25(OH)D deficiency and RDS.

Keywords: 25-hydroxyvitamin D; prematurity; respiratory distress syndrome.
Sexual knowledge and practice of adolescent learners in a rural South African school
Authors: Mostert Karien , M Sethole Khethiwe , Khumisi Oumiki , Peu Dorrica , Thambura Julius , N Ngunyulu Roinah , F Mulaudzi Mavis
Published: October 2020

Background: Premature sexual activity has become a norm in South African society, often resulting in teenage pregnancy and sexually transmitted diseases (STD). Occurrence of premature sexual activity is related to insufficient education, gender inequal- ities, household poverty and place of residence. The Stepping Stones project uses a 10-session programme to educate learners about relationships, HIV-prevention and teenage pregnancy. The purpose was to measure and describe learners’ sexual knowl- edge and activities in a rural technical secondary school in North-west Province, South Africa.

Methods: A cross-sectional survey. Questionnaires were distributed to learners in grade 8 to 12. Descriptive statistics was used in analysis.

Results: Seventy-nine questionnaires were analysed. Despite a young sample, 26.6% were sexually active and 24.1% engaged in sexual activity. The mean age for first-time sexual intercourse was 15.2±2.3 years. The use of contraceptives was low (41.2%) and participants reported difficulty in talking to partners about condom use (54.8%). Almost half (45.5%) of the participants had never heard of STDs. Participants expressed a need to use social media as a sex education tool (12.3%). The primary source of information was from school-based programmes (58.0%).

Conclusion: Findings point to unsafe sexual practice of learners at a school in rural South Africa, even from an early age. This concern is accompanied by the occurrence of low levels of sexually-related knowledge. The learners would benefit from contin- ued implementation of the Stepping Stones programme. Implementation could be improved by incorporating social media and emphasising gender equality and negotiation skills in sexually vulnerable situations.

Keywords: Sexual knowledge; adolescent learners; South Africa.
Supplying the New York Market with High-Quality Puerto Rican Mangos
Authors: Mattern Frank , Pennock William , Valles Lamboy Santos
Published: October 2020

Improved varieties of mangos have been introduced to Puerto Rico for evaluation in several micro-climates and for market testing. During 1970, 20 consecutive weekly shipments of these mangos consisting of 1,926 flats were made to New York to acquire experience with export procedures, and to determine the extent of sales and fluctuation of prices as affected by season and size preferences. The fruit was shipped by ocean or air freight in ventilated cardboard flats containing approximately 12 pounds of mangos each. Marketing costs to New York City were estimated at $1.48 per flat. Wholesale prices varied from a high of $6.08 per flat in May to $2.67 during the flush of the season when heavy shipments of Florida mangos arrive on the market. Price differences between flats of large and medium fruit were minimal, but a sharp break in price occurred with small mangos. The average wholesale price received for the 20 shipments was $4.14 per flat. The results suggest that it would be advantageous to ship fruit to the New York market when prevailing wholesale prices are above $3.48 per flat. No deterioration of quality or spoilage were reported during the trial. Based on criteria of size, bearing season and productivity, Springfels may be rated first choice as a commercial variety, followed by Irwin, Haden, and Kent.
Gamma Radiation Effects on Biochemical Compojients of Puerto Rican Mangos
Authors: Cuevas-Ruiz José , Graham H. D. , Luse R. A.
Published: October 2020

The effects of gamma radiation were investigated on the content of ascorbic acid, total carotenoids, total carbohydrates and titratablc acidity in five varieties of mangos grown in Puerto Rico. Irradiation with 75-Krad doses did not significantly influence biochemical components. Subsequent changes were related closely to delay in fruit ripening, and reduction of fungal spoilage, effected by the radiation pasteurization. Radiation at the 75-Krad level extended shelf life to 7 days.
ABSENCE OF A PROTEINACEOUS INVERTASE-REGULATORY SYSTEM IN SUGARCANE STEM TISSUE
Authors: Acín Díaz Nilsa M. , Alexander Alex G.
Published: October 2020

ABSENCE OF A PROTEINACEOUS INVERTASE-REGULATORY SYSTEM IN SUGARCANE STEM TISSUE
Effect of Four Levels of Concentrate Feeding on Milk Production by Holstein Cows Grazing Intensively Managed Tropical Grass Pastures
Authors: Caro-Costas Rubén , Vicente-Chandler José , Abruña Fernando
Published: October 2020

Holstein cows grazing with free access to intensively managed, heavily fertilized Star and Pangola grass pastures produced similar yields of milk throughout a lactation when fed 20-percent protein concentrate at the rate of 1 pound per 1, 2, and 3 liters of milk produced daily. These cows produced an average of 10,465 pounds of milk during an average lactation period of 279 days, or an average of 17.1 liters daily. However, cows fed at the rate of 1 pound of concentrate per 4 liters of milk produced much less (7,447 pounds of milk per lactation).
Comparison of Heavily Fertilized Pangola and Star Grass Pastures in Terms of Beef Production and Carrying Capacity in the Humid Mountain Region of Puerto Rico
Authors: Caro-Costas Rubén , Abruña Fernando , Vicente-Chandler José
Published: October 2020

Intensively managed Star and Pangola grass pastures fertilized with one ton of 14-4-10 per acre yearly were compared in terms of beef production and carrying capacity during a 2-year period in the humid mountain region of Puerto Rico. Star grass produced an average of 1,350 pounds of beef per acre yearly with average daily gains of 1.33 pounds per head, compared to 947 pounds of beef per acre and average daily gains of 1.09 per head for Pangola. Star grass pastures had a carrying capacity equivalent to three 600-pound steers per acre compared to 2.5 for Pangola. Star grass had higher protein and dry matter contents than Pangola throughout the year. Protein content of the forage ranged from 11.3 to 19.6 percent, with highest values occurring during the slow growth of winter months. Both grasses produced lowest yields during the winter months in spite of rainfall in excess of 5 inches monthly during this period. Shorter days and cooler temperatures seem to be primary factors responsible for lower beef production during this season, although these variations are small in this tropical area. Excessive rainfall tended to depress weight gains.
Effect of Temperature and Moisture on Various Aspects of Development, Growth, and Pathogenicity of Thielaviopsis paradoxa from Sugarcane in Puerto Rico
Authors: Liu Lii-Jang , Cortés-Monllor Amelia
Published: October 2020

It was found that the optimum temperature range for mycelial growth and spore germination of Thielaviopsis paradoxa lies between 28° and 32° C, with the maximum above 36° C. and the minimum below 12° C. Neither mycelial growth nor spore germination was obtained at 8° or at 40° C. Pathogenicity of T. paradoxa to sugarcane variety P.R. 1059 was favored by temperatures between 28° and 32° C. No infection of sugarcane by this fungus occurred at 8° or at 40° C. The highest rate of infection of sugarcane by T. paradoxa was obtained at the lowest soil moisture with a maximum temperature up to 32° C. It thus appears that low soil moisture has a profound effect on rate of infection during summer months in Puerto Rico.
Yams (Dioscorea spp.) for Production of Chips and French Fries
Authors: Martin Franklin W. , Ruberté Ruth
Published: October 2020

Tubers of 25 varieties of yam (Dioscorea spp.) were peeled, sliced, and cooked in corn oil at 375° F. Chips were evaluated freshly cooked and after 1 week of storage. They were rated for crispness, hardness, flavor, and appearance. Species of yam other than D. alata usually did not yield good chips. The Puerto Rican vaiiety Forastero (D. alata) yielded one of the best chips. The quality of hot French fries was related closely to chip quality. Among cooking fats, corn oil and a mixture of lard and hydrogenated vegetable oil gave best results. These results can be commercialized with little modification.