Acute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria

Decadal Assessment and Distribution of Rainfall Anomaly Index (1991 – 2020) for Benin City, Edo State, Nigeria

This study was designed to provide valuable insight into the temporal patterns of rainfall in Benin City, Edo State, Nigeria using rainfall data from 1991 – 2020 (30 years) collected from Nigerian Meteorological Agency (NIMET), airport station, Benin City. The data were assessed based on 10 years interval (decade) identified as decadal A (1991-2000), decadal B (2001-2010) and decadal C (2011-2020). The data was analysed descriptively using charts and graphs. Also, Rainfall Anomaly Index (RAI) was determined for each decadal. Findings from the study reveal that rainfall pattern changes significantly based on statistics for each decadal. In decadal A, rainfall usually began in the month of July to October, June to September in decadal B while May to September in decadal C with rainfall going above the annual precipitation (2679 mm) for the City. The rainfall anomaly over the city revealed that there was a composite nature in which some dry years were mixed with wet years and vice versa and this occurred in all decades. RAI revealed that decadal C recorded the highest number of years (7) of intense rainfall compared to decadal A and B. The trend for the average annual rainfall showed a significant trend based on the decade. The average annual rainfall increased with time (decade) as the trend rose from 1886.9 mm in decade A to 1890.0mm in decade B and 2078.8 mm in decade C. The year of greatest positive value was 2016 (decadal C), with an average RAI of 6.53 classified as extremely humid. Based on these findings, the study concludes that the climate in Benin City has significantly changed

Chapter 11 - Near-term climate change: Projections and predictability

This chapter assesses the scientific literature describing expectations for near-term climate (present through mid-century). Unless otherwise stated, "near-term" change and the projected changes below are for the period 2016-2035 relative to the reference period 1986-2005. Atmospheric composition (apart from CO2; see Chapter 12) and air quality projections through to 2100 are also assessed

Potentials of 3D extrusion‐based printing in resolving food processing challenges: A perspective review

Three-dimensional (3D) printing has promising application potentials in improving food product manufacturing, increasingly helping in simplifying the supply chain, as well as expanding the utilization of food materials. To further understand the current situation of 3D food printing in providing food engineering solutions with customized design, the authors checked recently conducted reviews and considered the extrusion-based type to deserve additional literature synthesis. In this perspective review, therefore, we scoped the potentials of 3D extrusion-based printing in resolving food processing challenges. The evolving trends of 3D food printing technologies, fundamentals of extrusion processes, food printer, and printing enhancement, (extrusion) food systems, algorithm development, and associated food rheological properties were discussed. The (extrusion) mechanism in 3D food printing involving some essentials for material flow and configuration, its uniqueness, suitability, and printability to food materials, (food material) types in the extrusion-based (3D food printing), together with essential food properties and their dynamics were also discussed. Additionally, some bottlenecks/concerns still applicable to extrusion-based 3D food printing were brainstormed. Developing enhanced calibrating techniques for 3D printing materials, and designing better methods of integrating data will help improve the algorithmic representations of printed foods. Rheological complexities associated with the extrusion-based 3D food printing require both industry and researchers to work together so as to tackle the (rheological) shifts that make (food) materials unsuitable.info:eu-repo/semantics/publishedVersio

An Assessment of the UK’s Trade with Developing Countries under the Generalised System of Preferences

The European Union (EU) Generalised System of Preferences (GSP Scheme) grants preferential treatment to 88 eligible countries. There are, however, concerns that the restrictive features (such as Rules of Origin, Low Preference Margin and Low Coverage) of the existing scheme indicate gravitation towards commercial trade agenda to which efficiency imperatives appear subordinated. Whether these concerns are genuine is an empirical question whose answer largely determines whether, after Brexit, the UK continues with the existing specifics of the EU scheme or develops a more inclusive UK-specific GSP framework. This study quantitatively examines the efficiency of the EU GSP as it relates to UK beneficiaries from 2014 to 2017. We draw on the descriptive efficiency estimation (The utilisation Rate, Potential Coverage Rate, and the Utility Rate) using import data across 88 beneficiary countries and agricultural products of the Harmonised System Code Chapter 1 to 24. Asides the Rules of Origin that, generally, harm the uptake of GSP, low preference margin is found to cause low utilisation rates in a non-linear manner. Essentially, a more robust option (such that allows “global Cumulation” or broader product coverage) could, substantially, lower the existing barriers to trade and upsurge the efficiency of the GSP scheme

Prevalence and pattern of work-related musculoskeletal disorders among Nigerian bricklayers

BACKGROUND: Typically, bricklayers in developing countries’ contexts manually lay bricks, concrete blocks and other similar materials to construct walls and buildings which make them susceptible to work-related musculoskeletal disorders (WRMSDs). The burden of WRMSDs among this high-risk group seems has not been well documented. OBJECTIVES: This study examined the prevalence of WRMSDs among bricklayers in Nigeria. METHODS: A cross-sectional survey of 118 consenting bricklayers from a Nigerian setting was carried out. The standardized Nordic musculoskeletal disorder questionnaire and a proforma were used to profile the prevalence of WRMSDs and socio-demographic information of the respondents. Data was analyzed using descriptive and inferential statistics. Alpha level was set at p <  0.05. RESULTS: The 12-months and 7-days prevalence of WRMSDs were 87.3% and 67.4% . Shoulder (61.0%) and the low-back (59.3%) were the two most affected anatomical sites based on 12-month prevalence. WRMSDs affecting the knees (6.8%) was the most disabling in carrying normal work routines. Working for less than 10 years was significantly associated with high prevalence of WRMSDs in the shoulder (odd ratio (OR) = 0.27, 95% confidence interval (CI) = 0.09 to 0.87) and wrist region (OR = 0.24, 95% CI 0.08 to 0.73). Having neck pain led to higher odds (OR = 0.29, 95% CI 0.13 to 0.68) of taking a break from work among the bricklayers. CONCLUSIONS: WRMSDs were high among Nigerian bricklayers. Years of work experience was associated with high prevalence of WRMSDs in the shoulder and wrist. In addition, taking work breaks was associated with neck pain

In Vitro Evolution of Allergy Vaccine Candidates, with Maintained Structure, but Reduced B Cell and T Cell Activation Capacity

Allergy and asthma to cat (Felis domesticus) affects about 10% of the population in affluent countries. Immediate allergic symptoms are primarily mediated via IgE antibodies binding to B cell epitopes, whereas late phase inflammatory reactions are mediated via activated T cell recognition of allergen-specific T cell epitopes. Allergen-specific immunotherapy relieves symptoms and is the only treatment inducing a long-lasting protection by induction of protective immune responses. The aim of this study was to produce an allergy vaccine designed with the combined features of attenuated T cell activation, reduced anaphylactic properties, retained molecular integrity and induction of efficient IgE blocking IgG antibodies for safer and efficacious treatment of patients with allergy and asthma to cat. The template gene coding for rFel d 1 was used to introduce random mutations, which was subsequently expressed in large phage libraries. Despite accumulated mutations by up to 7 rounds of iterative error-prone PCR and biopanning, surface topology and structure was essentially maintained using IgE-antibodies from cat allergic patients for phage enrichment. Four candidates were isolated, displaying similar or lower IgE binding, reduced anaphylactic activity as measured by their capacity to induce basophil degranulation and, importantly, a significantly lower T cell reactivity in lymphoproliferative assays compared to the original rFel d 1. In addition, all mutants showed ability to induce blocking antibodies in immunized mice.The approach presented here provides a straightforward procedure to generate a novel type of allergy vaccines for safer and efficacious treatment of allergic patients

Cardiac remodeling and dysfunction in nephrotic syndrome

There is an increased incidence of heart disease in patients with chronic nephrotic syndrome (NS), which may be attributable to the malnutrition and activated inflammatory state accompanying the sustained proteinuria. In this study, we evaluated renal function, cardiac morphometry, contractile function, and myocardial gene expression in the established puromycin aminonucleoside nephrosis rat model of NS. Two weeks after aminonucleoside injection, there was massive proteinuria, decreased creatinine clearance, and a negative sodium balance. Skeletal and cardiac muscle atrophy was present and was accompanied by impaired left ventricular (LV) hemodynamic function along with decreased contractile properties of isolated LV muscle strips. The expression of selected cytokines and proteins involved in calcium handling in myocardial tissue was evaluated by real time polymerase chain reaction. This revealed that the expression of interleukin-1beta, tumor necrosis factor-alpha, and phospholamban were elevated, whereas that of cardiac sarco(endo)plasmic reticulum calcium pump protein was decreased. We suggest that protein wasting and systemic inflammatory activation during NS contribute to cardiac remodeling and dysfunction

Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systetns, sample registration systetns, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings Globally, 18.7% (95% uncertainty interval 18.4-19.0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58.8% (58.2-59.3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48.1 years (46.5-49.6) to 70.5 years (70.1-70.8) for men and from 52.9 years (51.7-54.0) to 75.6 years (75.3-75.9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49.1 years (46.5-51.7) for men in the Central African Republic to 87.6 years (86.9-88.1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216.0 deaths (196.3-238.1) per 1000 livebirths in 1950 to 38.9 deaths (35.6-42.83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5.4 million (5.2-5.6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult tnales, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, wotnen, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. Copyright C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe