Review of Method Study Approach to Productivity Gain: A Multi-case Study of Portable Water Producing Factory

This study evaluated level of work-study approach (wsa) to productivity advancement in Southwest-Nigeria Portable Water Producing Factories (PWPF). Objectives were to, measure productivity trend (PT) and, evaluate managers’ recognition and contribution(s) of wsa to productivity growth. PT was measured from 4 years records provided by 50 employers in 50 PWPF. Questionnaires were used on the employers and 120 employees to measure adopted wsa and impacts with responses reported on the scale of 1 to 5. Data was analyzed using t-test statistical analysis. The best performed PWPF was rated 43.75%. Disloyalty, low remuneration, lack of trainings and unsafe workplace were the major factors reported to have influenced the PT. Machinery Utilization (MeU) maximization was the commonly adopted approach. The employers’ ratings of MeU statistically significantly lower (mean=3.6364, SEM= 0.06913) to that of employees (mean=3.7333 SEM=0.6645) t(169) =0.641, p=0.522. Human resources management (p=0.235) and workers’ performance evaluation (p=0.906) were also significant and rated above average. However, work-method, safe work-practices and work-demands reviews, which were key attributes of ergonomic techniques and workers-related factors (wrf), were not significant, rated below average. The author concluded that neglects of wrf in wsa, must have greatly contributed to the weak PT of the industry and should be properly addressed to enhance productivity growth. Keywords— ergonomic, industry, productivity, water, work-stud

Controlled synthesis and structure characterization of a new fluconazole polymorph using analytical techniques and multivariate method

In the crystallization and search for higher multicomponent forms of fluconazole (FLZ), a metastable FLZ polymorph (concomitant) that manifests in the same crystallization system and transforms into the stable FLZ form (II) after the lyophilization process was observed. In this report, we demonstrated and showed how this FLZ polymorph 10 (Mw = 306.79 g/mol) of the monoclinic C2 space group was detected and reproduced through a controlled lyophilized experiment, and modeled differentiation between vibrational and absorption modes of FLZ functionalities like C=O, OH, –CH2 and –NH. The FLZ polymorph shows strong O–H···N and weak C−H···X (X = N, and F) hydrogen bond and the presence of pi-pi bond interactions in the overlapping triazole rings. The combination of vibrational spectroscopic techniques (Raman/FT-IR) and principal component analysis (PCA) aid the development of important models for polymorph screening and identification. In addition, X-ray diffraction (powder and single crystal) techniques support the polymorph characterization and structure depiction. The PCA models and X-ray diffraction analyses confirmed the newness of FLZ polymorph 10, and further solid-state characterization using thermal techniques (DSC and TGA) affirmed its uniqueness and novelty. Finally, the thermal stability and solubility studies on the new FLZ polymorph were determined to understand its structure properties and compare these with previously reported polymorphs of FLZ

Primary stroke prevention worldwide: translating evidence into action

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course

The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

Background A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. Methods In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. Findings Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I 2 of > 75%) between estimates for almost half of the outcomes. Interpretation To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. Funding Public Health Wales. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licens

Child’s risk attributes at birth and infant mortality disparities in Nigeria

Births in avoidable high-risk contexts defined by the interplay of sub-optimal childbearing age, short spacing, and first and high birth order incur elevated risks of childhood death. However, the extent of disparities in risks of dying in infancy vis-à-vis the continuum of non-high-risk and (un)avoidable high-risk attributes at birth as determined by mother‘s age at childbirth, child spacing, and birth order characteristics is yet to be adequately explored in Nigeria as elsewhere. To fill this gap, chi-square association test and Cox‘s proportional hazards regression were used to analyze data of 31,260 nationally representative children aged 0-59 months drawn from 2013 Nigeria Demographic and Health Survey. Disparities in infant mortality risks were mainly examined across the spectrum of birth-related risk attributes at birth broadly categorized as no extra high-risk, unavoidable firstorder risk and combined avoidable high-risk. The risks of dying in infancy differed significantly by risk attributes to the extent dictated by other confounders. Also, infant mortality risks varied significantly by all moderating factors excluding religion, water source, toilet type and place of delivery. Interventions targeted at reducing avoidable high-risk fertility rate and strengthening health system to provide life-saving care to most-at-risk children would engender rapid improvement in infant survival.Les naissances dans des contextes à risque élevé évitables, définies par l'interaction d'un âge de procréation sous-optimal, d'un espacement réduit, et du premier rang de naissance élevé, entraînaient des risques élevés de mortalité infantile. Toutefois, l'ampleur des disparités en matière de risque de décès dans la petite enfance par rapport au continuum d'attributs à haut risque non haut risque et (in) évitables haut risques à la naissance, déterminée par l'âge de la mère à la naissance, l'espacement des naissances et le rang de naissance les caractéristiques n‘a pas encore été explorée de manière adéquate au Nigeria comme ailleurs. Pour combler cette lacune, le test d‘association du khi-deux et la régression des hasards proportionnels de Cox ont été utilisés pour analyser les données de 31 260 enfants représentatifs au niveau national, âgés de 0 à 59 mois tirés de l‘enquête démographique et de santé réalisée en 2013 au Nigéria. Les disparités dans les risques de mortalité infantile ont été principalement examinées à travers le spectre d'attributs de risque liés à la naissance, généralement classées dans la catégorie comme pas de haut risque supplémentaire, à très haut risque, risque inévitable de premier ordre et le haut évitable combiné. Les risques de mourir dans la petite enfance différaient considérablement par les attributs de risque dans la mesure dictée par d'autres facteurs de confusion. En outre, les risques de mortalité infantile variaient de manière significative en fonction de tous les facteurs modérateurs, à l'exclusion de la religion, de la source d'eau, du type de toilette et du lieu de livraison. Les interventions visant à réduire le taux de fécondité évitable à haut risque et à renforcer le système de santé afin de fournir des soins vitaux aux enfants les plus exposés, engendreraient une amélioration rapide de la survie des nourrissons.Keywords: Infant Mortality, High-Risk Birth, Fertility Behaviour, Disparities, NigeriaAfr J Reprod Health 2019; 23[3]:120-13

Identification of a NACC1-Regulated Gene Signature Implicated in the Features of Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC), characterized by a deficiency in estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor2 (HER2), is among the most lethal subtypes of breast cancer (BC). Nevertheless, the molecular determinants that contribute to its malignant phenotypes such as tumor heterogeneity and therapy resistance, remain elusive. In this study, we sought to identify the stemness-associated genes involved in TNBC progression. Using bioinformatics approaches, we found 55 up- and 9 downregulated genes in TNBC. Out of the 55 upregulated genes, a 5 gene-signature (CDK1, EZH2, CCNB1, CCNA2, and AURKA) involved in cell regeneration was positively correlated with the status of tumor hypoxia and clustered with stemness-associated genes, as recognized by Parametric Gene Set Enrichment Analysis (PGSEA). Enhanced infiltration of immunosuppressive cells was also positively correlated with the expression of these five genes. Moreover, our experiments showed that depletion of the transcriptional co-factor nucleus accumbens-associated protein 1 (NAC1), which is highly expressed in TNBC, reduced the expression of these genes. Thus, the five genes signature identified by this study warrants further exploration as a potential new biomarker of TNBC heterogeneity/stemness characterized by high hypoxia, stemness enrichment, and immune-suppressive tumor microenvironment

Primary stroke prevention worldwide: translating evidence into action

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population