Adherence to antiretroviral therapy among HIV-infected prisoners : a systematic review and meta-analysis

Data on antiretroviral therapy (ART) adherence among prison inmates are limited and not previously synthesized in a systematic manner. The objective of this study was to provide accurate and up-to-date ART adherence estimates among prison inmates. We searched electronic databases for all studies reporting adherence as a primary or secondary outcome among prison inmates. A random-effects model was used to pool adherence rates; sensitivity, heterogeneity and publication bias were assessed. Eleven studies involving 2895 HIV-infected prison inmates were included. The studies were carried out between 1992 and 2011 and reported between 1998 and 2013. A pooled analysis of all studies indicated a pooled estimate of 54.6% (95% confidence interval 48.1–60.9%) of prison inmates had adequate (≥95%) ART adherence. The adherence estimates were significantly higher among cross-studies and studies that used self-reported measures. In summary, our findings indicate that optimal adherence remains a challenge among prison inmates. It is crucial to monitor ART adherence and develop appropriate interventions to improve adherence among these population

An Analysis of the Urban Canopy Heat Island (UCHI) of Kano Metropolis during the Warm/Wet Season

Urbanization has had a profound impact on our local, regional and even global climate, through the modification of the natural environment by replacing it with artificial surfaces, canyons and materials. This study seeks to assess the nature of Urban Canopy Heat Island (UCHI) intensities in Kano metropolis during the Wet/Warm season. The study involved the measurement of temperature within the period and determination of the UCHI within Kano metropolis. The study measured the temperature data using an automatic temperature data logger and determined the UCHI from the data collected. The different sample stations were determined using the canyon zoning system known as the Urban Climate Zone (UCZ). Temperature and UCHI variation for the study were also determined for two periods that showed its diurnal distribution. The study area was categorized into 13 stations and all the classes of the UCZ fit into the study area. The UCHI Characteristics shows a generally warm profile during the day time and night time periods, suggesting that most of the stations had high temperatures. This can be attributed to the high amount of clouds found in August, which provides a green house effect for the out going long wave radiation, there by conserving the heat within the UCZ

Malaria infection and socioeconomic status of some residents of Port Harcourt metropolis, Rivers State, Nigeria

The study investigated the prevalence of malaria and socioeconomic status of subjects in part of Port Harcourt metropolis. Following ethical clearance which was obtained from the University of Port Harcourt and the parents of the subjects who gave their written consents, blood samples were collected and analysed following standard parasitological method from 200 subjects within the age bracket of 0-17years. The demographic characteristics of 200 subjects showed that more males, 105 (52.5%), were examined compared with females, 94 (47.5%). The socioeconomic status of subjects were grouped into higher class with 144 (72.0%), middle class with 22 (11.0%) and lower class with 34 (17.0%). Overall prevalence of 71 (35.5%) was recorded. Sex related prevalence showed that more males were infected with 42 (40.0%) and parasite density of 91120 μl than females with 29 (30.5%) and parasite density of 62480 μl. The differences in prevalence between males and females was not significant (P>0.05).The prevalence of malaria infections based on socioeconomic status showed that greater percentage of infection of 55 (38.2%) was recorded among the higher class with parasite density of 112880 μl followed by infection of 12 (35.3%) and parasite density of 29120 μl in the lower class with the least percentage of 4 (18.2%) and parasite density of 11600 μl recorded in the middle class. There was no significant difference (P>0.05) in infection rate on the basis of socioeconomic status. In Conclusion, malaria infection does not respect individual’s socioeconomic status. There is need to sustain the current intervention measures and awareness campaign among Port Harcourt residents for prevalence rate to be reduced to the desired zero level.Keywords: Malaria infection, prevalence, Parasite intensity, Socio-economic status

Awareness, benefits and drawbacks of net zero energy building practices: construction industry professional’s perceptions

In a bid to overcome climate change and global warming, the adoption of net zero energy building (nZEB) practices in construction projects has become a viable measure of reducing energy consumption and CO2 emissions in buildings. nZEB is a facility with a significantly lowered energy needs such that the rest of the energy requirements can be supplied by on-site or off-site renewable technologies. The present study therefore investigated the awareness, benefits and challenges confronting the actualization of nZEB in Nigeria construction industry. A cross sectional survey design was adopted wherein a close ended questionnaire was purposively administered online to construction industry professionals who have understanding of nZEB initiatives. Descriptive statistical tests were conducted, with the results showing about 9% and 25% of the selected professionals been not aware of nZEB concepts and have not been involved in the concept in their professional career. Further details revealed that reduction in the land use effect, reduction in vulnerability of power infrastructures to vandalism and economic competitiveness were dominant benefits of nZEB practices. However, low return on investment, conflict with public policy regulation and policy clarity, lack of evaluation and valuation processes were perceived as the top hindering factors to nZEB practices. The implication for practice is for construction stakeholders to participate and develop effective implementation strategies towards nZEB for could be ecological and economical friendly

ASSESSMENT OF INTEGRATION OF BUILDING AUTOMATION SYSTEMS IN RESIDENTIAL BUILDINGS IN DEVELOPING COUNTRIES: PROFESSIONALS` PERSPECTIVES

The study assessed the integration of various Building Automation Systems (BAS) to enhance efficiency and productivity in residential buildings in developing countries: Professionals` perspectives. A survey technique was used for this research. Both Qualitative data and Quantitative data were obtained. 100 structured questionnaires were distributed to the professionals involved in construction of the systems. The data were analyzed and ranked based on Relative Importance Index (RII) calculation. The result showed that high energy management, improved security, improved safety in buildings were the most important benefits while High cost of purchasing devices and high maintenance cost., lack of adequate power supply, lack of technical-know where the challenges encountered in the use of BAS. There is lack of awareness of BAS by professionals. It recommended that there should more enlightenment and training of the construction professionals on the importance of building automation for better efficiency and productivity

Influence of bamboo fiber and limestone powder on the properties of self-compacting concrete

This paper examines the effect of combined bamboo fibers and limestone powder used as filler material on the fresh, hardened and microstructural properties of self-compacting concrete (SCC). The bamboo fibers of aspect ratio (l/d) of 50 and a maximum length of 50 mm was varied in steps of 0.25%, 0.5%, 0.75% and 1% in the SCC mix. While 10% of limestone powder was added as a filler in each of the SCC mix. The workability of the mix was assessed by slump flow test and V-funnel test, while the mechanical properties were assessed by considering the compressive and split tensile strength test after 7, 14 and 28 curing age. All concrete mixes were carried out by following the European Federation for Specialist Construction Chemicals and Concrete (EFNARC) standard, while the microstructure of selected samples was assessed using the Scanning Electron Microscopy (SEM). Test results indicate that fiber addition influences the fresh properties of SCC. Moreover, it was observed that SCC mix containing with fiber content of 0.75% and 0.5% with the inclusion of 10% limestone powder achieved the highest compressive and split tensile strength values of 28.04 MPa and 3.26 MPa, respectively. The result showe

Smile outcomes when using masseteric nerve-based nerve transfers versus direct muscle neurotization in facial palsy patients

Background: When dealing with a weak smile, nerve transfer is a viable strategy. We evaluated outcomes of masseteric nerve to facial nerve transfers and compared them with direct muscle neurotization (DMN). Methods: In a retrospective cohort study of 20 patients (n = 20), we compared nerve transfer versus DMN over a 6-year period (2016–2021). Outcomes were measured using the validated Sunnybrook score, Ackerman Smile Index, and Terzis scores. Statistical analysis was performed using the Wilcoxon sign rank and Mann-Whitney U tests. Results: Comparing pre- versus postoperative scores after nerve transfers, there was a significant improvement in median overall Sunnybrook score (24 versus 47, P = 0.043), lip elevation (1 versus 2, P = 0.046), open mouth smile (1 versus 3, P = 0.003), and Terzis scores (1 versus 3, P = 0.005), with no difference in resting symmetry (−15 versus −5; P = 0.496). Compared with DMN, there was no difference in median Terzis score improvement from preoperative to postoperative state (2 versus 1, P = 0.838), median smile improvement (2 versus 2, P = 0.838), resting symmetry (10 versus 5, P = 0.144) or overall Sunnybrook score (23 versus 21, P = 1.000). Lip elevation improvement was in favor of nerve transfers (1 versus 0, P = 0.047). Conclusions: This is the first study evaluating nerve transfer neurotization of smile-mimetic muscles and comparing the outcomes with DMN, with masseteric nerve as donor. Nerve transfer leads to improved facial mimetic function, smile excursion and open mouth smiles, as does DMN, with improvement in lip elevation in favor of nerve transfer. Nerve transfer was preferred for more severe smile weakness

Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (\u3c65 \u3eyears) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P \u3c 0.00001), overweight/obese (46.4% vs 26.3%, P \u3c 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income countries

A comparison of outcomes between finger and pulp replantation/revascularization in a single centre

Background: Supermicrosurgery has allowed the replantation/revascularization of the pulp, but how does this currently compare with more proximal digit replantation/revascularization? Methods: In a retrospective case study over a 5-year period at our institute, a total of 21 patients (n = 21) had either finger or pulp replantation-revascularization posttrauma. All pulp replants had a single-vessel anastomosis viz., “artery-to-artery” or “artery-to-vein” only, with venous outflow dependent on the skin-shave technique, while more proximal replants had both arterial and venous anastomoses. Age, sex, ischemic time, handedness, smoker status, and injury-replant interval were compared between the two groups, with all procedures performed by a single surgeon. The outcome parameters studied were length of hospital stay, timeline for wound healing, viability, and functional outcomes. Results: Our patients consisted of 18 men and three women, of which 14.3% were smokers and 85.7% were right-handed. There were 11 finger replantation/revascularizations (n = 11) versus 10 pulp replantation/revascularizations (n = 10). The average age of digit replantation/revascularization patients was 44.8 years compared with 26.4 years in pulp replantation/revascularization patients (Student t test, P = 0.04). Mean ischemia time in digital replants was 67 minutes versus 32.3 minutes in pulp replantation/revascularization (Student t test, P = 0.056). Digital replantation/revascularization was viable in 72% of cases versus a 90% viability in the pulp subcohort. Conclusions: In our patient cohort, pulp replantation/revascularizations produced better postoperative viability. Where supermicrosurgery expertise is available, pulp replantation/revascularization should be considered a worthwhile option when compared with digital replantation/revascularization