IMPACT OF BANK CREDIT ON AGRICULTURAL PRODUCTIVITY:EMPIRICAL EVIDENCE FROM NIGERIA(1981-2015)

We examined the effect of bank credit on agricultural productivity in Nigeria so as to ascertain the existence of causal relationship between the dual. To achieve this objective, the time frame secondary data used in the study includes: written materials such as books and journals and also the use of time series data such as Agricultural Gross Domestic Product (AGDP), commercial bank credit to agricultural sectors (CBCA), Interest rate charges (INT), Government spending on agriculture (GSA), and Agricultural Credit Guarantee scheme (ACGSF).THE DATA collected were all sourced from the Central Bank of Nigeria (CBN) Statistical Bulletin. The statistical tool of analysis is the Toda and Yamamoto granger non causality techniques. Conversely the variables were exposed to the Unit Root Test to ensure stationarity both with and without structural break, the Johansen Co-Integration Test which showed that a long term relationship does not exist among variables and also the Vector Autoregression Estimates Decompositions Test was also computed to shows the contribution of each endogenous variable to the forecast of other variables before the application of the Toda and Yamamoto non granger causality test to determine if a causal relationship exist among variable of which the result attained was that there is a unidirectional causality running from ACGSF to AGDP thereby buttressing the estimate of the VAR model with respect to the role of ACGSF in explaining changes to AGDP. No other causality is found to run from AGDP to any other variable and vice versa

Predictors of in-hospital mortality among HIV-positive patients presenting with an acute illness to the emergency department

OBJECTIVES : Despite better access to antiretroviral therapy (ART) over recent years, HIV remains a major global cause of mortality. The present study aimed to identify predictors of in-hospital mortality among HIV-positive patients presenting to an emergency department (ED). METHODS : In this cross-sectional study, HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult ED between 07 July 2017 and 18 October 2018 were prospectively enrolled. Data were compared between participants who survived to hospital discharge and those who died. The data were further subjected to univariate and multivariate logistic regression analyses to determine variables that were associated with in-hospital mortality. RESULTS : Of a total of 1224 participants, the in-hospital mortality was 13.6% (n = 166). On multivariate analysis, respiratory rate > 20 breaths/min [odds ratio (OR) = 1.90, P = 0.012], creatinine > 120 μmol/L (OR = 1.97, P = 0.006), oxygen saturation 2 mmol/L (OR = 4.83, P = 0.000) and cryptococcal meningitis (OR = 6.78, P = 0.000) were significantly associated with in-hospital mortality. CONCLUSIONS : Routine clinical and laboratory parameters are useful predictors of in-hospital mortality in HIV-positive patients presenting to the ED with an acute illness. These parameters may be of value in guiding clinical decision-making, directing the appropriate use of resources and influencing patient disposition, and may also be useful in developing an outcome prediction tool.http://www.wileyonlinelibrary.com/journal/hivhj2022Critical Car

Development and internal validation of the HIV In-hospital mortality prediction (HIV-IMP) risk score

BACKGROUND : Despite advances in availability and access to antiretroviral therapy (ART), HIV still ranks as a major cause of global mortality. Hence, the aim of this study was to develop and internally validate a risk score capable of accurately predicting in-hospital mortality in HIV-positive patients requiring hospital admission. METHODS : Consecutive HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult emergency department between 7 July 2017 and 18 October 2018 were prospectively enrolled. Multivariate logistic regression was used to determine parameters for inclusion in the final risk score. Discrimination and calibration were assessed by means of the area under the receiver operating curve (AUROC) and the Hosmer–Lemeshow goodness-of-fit test, respectively. Internal validation was conducted using the regular bootstrap technique. RESULTS : The overall in-hospital mortality rate was 13.6% (n = 166). Eight predictors were included in the final risk score: ART non-adherence or not yet on ART, Glasgow Coma Scale 20 breaths/min, oxygen saturation 120 μmol/L, lactate > 2 mmol/L and albumin < 35 g/L. After internal validation, the risk score maintained good discrimination [AUROC 0.83, 95% confidence interval (CI): 0.78–0.88] and calibration (Hosmer–Lemeshow χ2 = 2.26, p = 0.895). CONCLUSION : The HIV In-hospital Mortality Prediction (HIV-IMP) risk score has overall good discrimination and calibration and is relatively easy to use. Further studies should be aimed at externally validating the score in varying clinical settings.http://www.wileyonlinelibrary.com/journal/hivhj2022Critical Car

Analysis of squat shear wall with different dimensions and position of opening under different type of static loads

Shear walls are usually used in high-rise building or building on high frequency of wind area as the structural element to restrain lateral forces. Openings are created on the shear wall for the architecture, ventilation or mechanical and electrical purposes. With the existence of the opening, the strength of the wall is reduced by the reduction in concrete area and the discontinuity of the reinforcement due to opening which may lead to structural failure. The main objective is to study the effect of size and position of the opening towards the structural behavior of the shear wall under different type of static loads. The analysis is done using the software ANSYS12.0. The samples are SW1, SW2, SW3, SW4, SW5, SW6, SW7 and SW8 where SW1 is solid shear wall while SW2, SW3, SW4, SW5, SW6, SW7 and SW8 are shear walls with different size and position of opening. They are analyzed by using 2 different types of loads which are uniformly distributed axial load and uniformly lateral load. From the same magnitude of loads applied towards the shear walls, they are compared by the cracking pattern and the stress distribution. Under both axial and lateral loads, it shows a significance results that the shear wall with greater opening size shows less efficiency. The position of opening further from the support shows a more significance effect towards the strength of the wall from axial load but opposite from the lateral load. Besides, the closer the position of the shear wall to the load, the less efficient it is. As a conclusion from the results, the most suitable position of the opening on the shear wall is further from the support and the loads and it shows that there is a significance effect even from a smallest opening

Preexisting morbidity profile of women newly diagnosed with breast cancer in sub-Saharan Africa: African Breast Cancer-Disparities in Outcomes study.

The presence of preexisting morbidities poses a challenge to cancer patient care. There is little information on the profile and prevalence of multi-morbidities in breast cancer patients across middle income countries (MIC) to lower income countries (LIC) in sub-Saharan Africa (SSA). The African Breast Cancer-Disparities in Outcomes (ABC-DO) breast cancer cohort spans upper MICs South Africa and Namibia, lower MICs Zambia and Nigeria and LIC Uganda. At cancer diagnosis, seven morbidities were assessed: obesity, hypertension, diabetes, asthma/chronic obstructive pulmonary disease, heart disease, tuberculosis and HIV. Logistic regression models were used to assess determinants of morbidities and the influence of morbidities on advanced stage (stage III/IV) breast cancer diagnosis. Among 2189 women, morbidity prevalence was the highest for obesity (35%, country-specific range 15-57%), hypertension (32%, 15-51%) and HIV (16%, 2-26%) then for diabetes (7%, 4%-10%), asthma (4%, 2%-10%), tuberculosis (4%, 0%-8%) and heart disease (3%, 1%-7%). Obesity and hypertension were more common in upper MICs and in higher socioeconomic groups. Overall, 27% of women had at least two preexisting morbidities. Older women were more likely to have obesity (odds ratio: 1.09 per 10 years, 95% CI 1.01-1.18), hypertension (1.98, 1.81-2.17), diabetes (1.51, 1.32-1.74) and heart disease (1.69, 1.37-2.09) and were less likely to be HIV positive (0.64, 0.58-0.71). Multi-morbidity was not associated with stage at diagnosis, with the exception of earlier stage in obese and hypertensive women. Breast cancer patients in higher income countries and higher social groups in SSA face the additional burden of preexisting non-communicable diseases, particularly obesity and hypertension, exacerbated by HIV in Southern/Eastern Africa

Mortality in children aged <5 years with severe acute respiratory illness in a high HIV-prevalence urban and rural areas of South Africa, 2009–2013

BACKGROUND: Severe acute respiratory illness (SARI) is an important cause of mortality in young children, especially in children living with HIV infection. Disparities in SARI death in children aged <5 years exist in urban and rural areas. OBJECTIVE: To compare the factors associated with in-hospital death among children aged <5 years hospitalized with SARI in an urban vs. a rural setting in South Africa from 2009–2013. METHODS: Data were collected from hospitalized children with SARI in one urban and two rural sentinel surveillance hospitals. Nasopharyngeal aspirates were tested for ten respiratory viruses and blood for pneumococcal DNA using polymerase chain reaction. We used multivariable logistic regression to identify patient and clinical characteristics associated with in-hospital death. RESULTS: From 2009 through 2013, 5,297 children aged <5 years with SARI-associated hospital admission were enrolled; 3,811 (72%) in the urban and 1,486 (28%) in the rural hospitals. In-hospital case-fatality proportion (CFP) was higher in the rural hospitals (6.9%) than the urban hospital (1.3%, p<0.001), and among HIV-infected than the HIV-uninfected children (9.6% vs. 1.6%, p<0.001). In the urban hospital, HIV infection (odds ratio (OR):11.4, 95% confidence interval (CI):5.4–24.1) and presence of any other underlying illness (OR: 3.0, 95% CI: 1.0–9.2) were the only factors independently associated with death. In the rural hospitals, HIV infection (OR: 4.1, 95% CI: 2.3–7.1) and age <1 year (OR: 3.7, 95% CI: 1.9– 7.2) were independently associated with death, whereas duration of hospitalization ≥ 5 days (OR: 0.5, 95% CI: 0.3–0.8) and any respiratory virus detection (OR: 0.4, 95% CI: 0.3–0.8) were negatively associated with death. CONCLUSION: We found that the case-fatality proportion was substantially higher among children admitted to rural hospitals and HIV infected children with SARI in South Africa. While efforts to prevent and treat HIV infections in children may reduce SARI deaths, further efforts to address health care inequality in rural populations are needed.http://www.plosone.orgpm2022Medical Virolog

High-Throughput Sequence Analyses of Bacterial Communities and Multi-Mycotoxin Profiling During Processing of Different Formulations of Kunu, a Traditional Fermented Beverage

Kunu is a traditional fermented single or mixed cereals-based beverage popularly consumed in many parts of West Africa. Presently, the bacterial community and mycotoxin contamination profiles during processing of various kunu formulations have never been comprehensively studied. This study, therefore, investigated the bacterial community and multi-mycotoxin dynamics during the processing of three kunu formulations using high-throughput sequence analysis of partial 16S rRNA gene (hypervariable V3-V4 region) and liquid chromatography tandem mass spectrometry (LC-MS/MS), respectively. A total of 2,303 operational taxonomic units (OTUs) were obtained across six processing stages in all three kunu formulations. Principal coordinate analysis biplots of the Bray-Curtis dissimilarity between bacterial communities revealed the combined influences of formulations and processing steps. Taxonomically, OTUs spanned 13 phyla and 486 genera. Firmicutes (phylum) dominated (relative abundance) most of the processing stages, while Proteobacteria dominated the rest of the stages. Lactobacillus (genus taxa level) dominated most processing stages and the final product (kunu) of two formulations, whereas Clostridium sensu stricto (cluster 1) dominated kunu of one formulation, constituting a novel observation. We further identified Acetobacter, Propionibacterium, Gluconacetobacter, and Gluconobacter previously not associated with kunu processing. Shared phylotypes between all communities were dominated by lactic acid bacteria including species of Lactobacillus, Lactococcus, Leuconostoc, Pediococcus, and Weissella. Other shared phylotypes included notable acetic acid bacteria and potential human enteric pathogens. Ten mycotoxins [3-Nitropropionic acid, aflatoxicol, aflatoxin B1 (AFB1), AFB2, AFM1, alternariol (AOH), alternariolmethylether (AME), beauvericin (BEAU), citrinin, and moniliformin] were quantified at varying concentrations in ingredients for kunu processing. Except for AOH, AME, and BEAU that were retained at minimal levels of &lt; 2 μg/kg in the final product, most mycotoxins in the ingredients were not detectable after processing. In particular, mycotoxin levels were substantially reduced by fermentation, although simple dilution and sieving also contributed to mycotoxin reduction. This study reinforces the perception of kunu as a rich source of bacteria with beneficial attributes to consumer health, and provides in-depth understanding of the microbiology of kunu processing, as well as information on mycotoxin contamination and reduction during this process. These findings may aid the development of starter culture technology for safe and quality kunu production

Lung perfusion findings on perfusion SPECT/CT imaging in non-hospitalized de-isolated patients diagnosed with mild COVID-19 infection

Abstract Background The aim of this retrospective study is to assess the incidence and type of lung perfusion abnormalities in non-hospitalized patients diagnosed with mild COVID-19 infection after de-isolation. Data from 56 non-hospitalized patients diagnosed with COVID-19 infection referred to our nuclear medicine department from July–December 2020 for a perfusion only SPECT/CT study or a ventilation perfusion SPECT/CT study were collected. Images were assessed for the presence and type of perfusion defects. The CT component of the study was also assessed for the presence of mosaic attenuation and COVID pneumonia changes. Results Thirty-two (57.1%) cases had perfusion defects. There were 20 (35.7%) cases with defects in keeping with pulmonary embolism, 17 (30.4%) cases with defects associated with mosaic attenuation but not due to pulmonary embolism, and 6 (10.7%) of cases with defects due to pulmonary infiltrates from COVID pneumonia. A total of 24 (42.9%) cases had mosaic attenuation on CT, with 10 (17.9%) of them showing a pattern likely consistent with shunting on the perfusion images. Conclusion Lung perfusion abnormalities are a common finding in non-hospitalized COVID-19 patients with mild disease. They are usually either due to pulmonary embolism, parenchymal infiltrates, or other causes of mosaic attenuation related to, but not specific to the pathophysiology of COVID-19 infection. The value of VQ SPECT/CT imaging is also shown in this study, in detecting and differentiating the various types of perfusion abnormalities

Perspectives on common chronic diseases in adult cancer patients in South Africa

There is a rising noncommunicable disease (NCD) burden in low- and middle-income countries. Sub-Saharan Africa (SSA) bears a higher burden than the global average with South Africa (SA) enduring the highest regional burden. SA among other southern African countries also bears a high prevalence of HIV and other chronic communicable diseases. Having a perspective on common chronic diseases in the ever-increasing numbers of adult cancer patients in SA will inform our understanding of approaches to better manage them. This commentary reviews regional and national studies and data of low- and middle-income countries and particularly SA on the chronic infectious and NCD multimorbidity burden among adult cancer patients. It also reflects on the considerable health system challenges of managing discordant multimorbidity among adult cancer patients within the SA Public Health System. Despite the critical need to better manage the growing MM burden in general and particularly the high prevalence of discordant multimorbidity among cancer patients, there is a dearth of research into MM management generally and in LMICs particularly

Seasonal Trends in Hospitalization of Attempted Suicide and Self-Inflicted Injury in United States Adults.

Introduction Suicide is the 10th leading cause of death in the United States (US) and the prevalence continues to increase. It is estimated that there is an average of 25 attempted suicides for every suicide death in the US, and the economic burden of suicide and attempted suicide is high. Identification of those at risk for suicide and attempted suicide can help with early and prompt intervention. Studies in Europe and Asia have shown that there is a relationship between seasonal patterns and suicidal risk. However, little is known about seasonal patterns of suicidal attempts in the US. Therefore, our study aimed to assess seasonal patterns by days of the week and months of the year in the US. Methods Hospitalized adult patients with suicide attempts and self-inflicted injury were identified using the discharge data from the National Inpatient Sample (NIS) from January 1, 2010 to December 31, 2014. We looked at the seasonal trends of patients with attempted suicide and self-inflicted injury by weekday vs weekend and month of the year over the five-year study period. We also assessed two groups, male and female with attempted suicide and compared trends and contributing risk factors over the study period using Student\u27s t-test and chi-square test. Results A total of 249,845 patients with attempted suicide and self-inflicted injury were reported during the study period with a prevalence rate increase of 15%, among which 70% were males, 65.5% white and 38.8% were age 40-64 years. An overall prevalence rate of about 168-200 per 100,000 hospitalizations was reported. There was a higher admission rate on weekends as compared to weekdays (190-300 vs 150-178 per 100,000 hospitalizations). Attempted suicide and self-inflicted injury admissions peaked during the months of July and August with a peak period range of 200-230 per 100,000 hospitalizations in a year. Conclusion The prevalence of attempted suicide is steadily rising. Awareness of the seasonal and epidemiological trends of attempted suicide and self-inflicted injury is a very important step towards developing effective strategies to prevent suicide and attempted suicide