Characterizing the metabolic phenotype of intestinal villus blunting in Zambian children with severe acute malnutrition and persistent diarrhea

Background: Environmental enteric dysfunction (EED) is widespread throughout the tropics and in children is associated with stunting and other adverse health outcomes. One of the hallmarks of EED is villus damage. In children with severe acute malnutrition (SAM) the severity of enteropathy is greater and short term mortality is high, but the metabolic consequences of enteropathy are unknown. Here, we characterize the urinary metabolic alterations associated with villus health, classic enteropathy biomarkers and anthropometric measurements in severely malnourished children in Zambia. Methods/Principal findings: We analysed 20 hospitalised children with acute malnutrition aged 6 to 23 months in Zambia. Small intestinal biopsies were assessed histologically (n = 15), anthropometric and gut function measurements were collected and the metabolic phenotypes were characterized by 1H nuclear magnetic resonance (NMR) spectroscopy. Endoscopy could not be performed on community controls children. Growth parameters were inversely correlated with enteropathy biomarkers (p = 0.011) and parameters of villus health were inversely correlated with translocation and permeability biomarkers (p = 0.000 and p = 0.015). Shorter villus height was associated with reduced abundance of metabolites related to gut microbial metabolism, energy and muscle metabolism (p = 0.034). Villus blunting was also related to increased sucrose excretion (p = 0.013). Conclusions/Significance: Intestinal villus blunting is associated with several metabolic perturbations in hospitalized children with severe undernutrition. Such alterations include altered muscle metabolism, reinforcing the link between EED and growth faltering, and a disruption in the biochemical exchange between the gut microbiota and host. These findings extend our understanding on the downstream consequences of villus blunting and provide novel non-invasive biomarkers of enteropathy dysfunction. The major limitations of this study are the lack of comparative control group and gut microbiota characterization

Reducing Early Neonatal Mortality in Nigeria—The Solution

The West African nation of Nigeria seems to have run out of ideas on how their neonatal mortality rate may be lowered. This situation has become dare as the country could not make any significant progress even with the great supports of the last 10 years of Millennium Development Goal. Presently, one in every two deceased child under 5 years of age in Nigeria is a neonate. Literature reveals that most of these deceased neonates are classified preterm or low birthweight, of which nearly four in five must die within first 7 days. This clearly identified the categories and stages of highest mortality; however, it is disappointing that the authorities of the Nigerian health care system have for too long been unable to devise a solution for the neonates. Probably, inadequacy of climatic and cultural compatibilities might partly be responsible for the failure of their current conventional ideas and technologies—these being predominantly imported. Yet, there seems to be lack of interest in some home-grown unconventional ideas that have achieved the needed reduction at few centers. In this chapter, we present the unconventional approaches and encourage across-the-nation translation of the applications to achieve accelerated end to this situation

Data driven optimal filtering for phase and frequency of noisy oscillations: application to vortex flowmetering

A new method for extracting the phase of oscillations from noisy time series is proposed. To obtain the phase, the signal is filtered in such a way that the filter output has minimal relative variation in the amplitude (MIRVA) over all filters with complex-valued impulse response. The argument of the filter output yields the phase. Implementation of the algorithm and interpretation of the result are discussed. We argue that the phase obtained by the proposed method has a low susceptibility to measurement noise and a low rate of artificial phase slips. The method is applied for the detection and classification of mode locking in vortex flowmeters. A novel measure for the strength of mode locking is proposed.Comment: 12 pages, 10 figure

Obesity in adult Nigerians: a study of its prevalence and common primary co-morbidities in a semi-urban Mission General Hospital in South-Eastern Nigeria.

Background: Obesity is socially and culturally acceptable in Nigeria and therefore not usually recognized as a medical problem. This study is aimedat determining the prevalence of obesity using body mass index(BMI) criterion and its common primary comorbiditiesamong adult Nigerians attending a semiurban Mission General Hospital in Imo state, South- Eastern, Nigeria. Methods: A descriptive study using primary data collection technique was carried out from October 2007 to December 2008. A total of 9296 consecutive new adult patients aged 18-88 years were screened for obesity using BMI criterion and 684 patients who had BMI=30 kg/m2 met the inclusion criteria. The data collected included age, sex, marital status, education, occupation, weight(kilogram), height(meters), andblood pressure; fasting blood sugar and fasting lipid profile. Obese patients' perception of their obese condition and knowledge of lifestyle modification werealso assessed. Results: Six hundred and eighty-four(7.4%) out of a total of 9296 patients screened for obesity were obese.Hypertension(18.4%) was the commonest primary comorbidity, others include high triglyceridaemia(9.2%), high total cholesterol(8.2%), high LDLcholesterol( 6.0%) and diabetes mellitus(3.4%). One hundred and one(14.8%) obese patients were aware of their obese condition and majority, 72(71.3%) of them were informed of their obese condition by healthcare professionals. Forty seven(46.5%) of those who were aware of their obese condition had knowledge of lifestyle modification. However, majority(72.3%) of those who had knowledge of lifestyle modification demonstrated low knowledge level of lifestyle modification. Conclusion: This study has shown the existence of obesity and its common primary co-morbidities among the study population. Anthropometric determination of obesity and screening for its common primary comorbidities should be integrated as part of clinic baseline assessment of adult Nigerians attending semiurban hospitals. Those who had obesity-related primary co morbidities should become secondary target for risk reduction therapy and appropriate management. Key words: Adult, Obesity, Prevalence, Comorbidities, Semi-urban, Hospital, Nigeria

An Assessment of the Roles of Leadership and Followership in Nation Building: The Nigerian Experience

This paper examined leadership and followership in nation building in Nigeria. In an ethno-centred and highly heterogeneous society life Nigeria, a well-articulated leadership and followership structure could have served for the good of all and promote the spirit of “live and let liveâ€. But on the contrary, leadership and followership tussles have been the bane of unity and collective existence of the people. The study employed both primary and secondary sources of data collection such as oral interviews, archival materials, journals and articles, published text books etc. Since knowledge cut across disciplines, the study also adopted the interdisciplinary approach, using knowledge from related disciplines in the Humanities and Social Sciences to add to the available historical sources. The paper established that leadership and followership is the major challenge to nation building in Nigeria because it has over the years walked through the part of ethnicity and favouritism. Leadership and followership in Nigeria is without a clear vision and focus due to deliberate neglect of history, experiences of predecessors and consequences of visionless leadership and followership across the globe. The paper argued that the failure of leadership in Nigeria is as a result of the failure of followership. The followership is the watch dog of every society and as such must ensure the policing and accountability of leadership in the country. Ironically, the Nigerian followership are divided along ethnic lines with a biased approach to actions and inactions of leaders from their ethnic divides. It is against this background that the paper submits that nationhood can only be attained in Nigeria if leadership and followership is redefined with the consciousness of building a nation devoid of ethnic and religious sentiments, favouritism, nepotism and dictatorial leadership. The paper concludes that Nigeria can only be respected as the giant of Africa if her leadership and followership are restructured with national integration, unity, sustainable peace and development as the watch words. Keywords: Leadership, Followership, Nigeria, Nation Building, Development

Stochastic analysis of stock price changes as markov chain in finite states

In this work, stochastic analysis of Markov chain model used to examine stock price formation in finite states. The data was subjected to 5-step transition matrix for independent stocks where transition matrix replicated the use of 3-states transition probability matrix. This enables us proffer precise condition of obtaining expected mean rate of return of each stock. Out of the four stocks studied, stock (1), stock (2), stock (3) and stock (4), it  was also discovered that stock (1) has the highest mean rate of return:4.0548 and Stock (4) has the best probability of price increasing in the near future:21%. This informs the investor about the behavior of the stocks for the purpose of decision making. From the stochastic analysis, it is revealed that stock price changes are memory-less satisfying the properties of Markov chain. i.e., it converges to a point or becomes stationary at n=5 ie S1:0.1967-0.2354,S2:0.2053-0.1913,S3:0.1972-0.2051 and S4:0.2023-0.1835. Also all states of the transition communicate and are all time dependent.&nbsp

Impact of implementing constructed wetlands on supporting the sustainable development goals

The United Nations Sustainable Development Goals’ (UN SDGs) action call promotes worldwide social, environmental, and economic prosperity. Each country developed a local plan to achieve the SDGs’ objectives and targets. The UN presents an annual global SDG progress report, based on an international indicator framework and regional available data. Wetland ecosystems contribute to the SDGs; however, more research is required to evaluate wetlands’ impact on sustainable development. This study investigates how implementing constructed wetlands (CW) at a local scale can contribute to achieving and promoting the SDGs with application in Kuwait. A preliminary design of a constructed wetlands wastewater treatment system is proposed alongside a local scoring framework based on regional information to assess the future projection of the SDGs in Kuwait. Overall, CW implementation plans contributed positively to improving the level of achievement of SDG 2: Zero Hunger, SDG 3: Good Health, SDG 6: Clean Water, SDG 7: Affordable and Clean Energy, and SDG 15: Life on Land. The analysis also highlights synergies that need to be considered for integrated environmental governance and enhanced policy coherence for Kuwait’s sustainable development management

Consequences of long-term consumption of water from Nworie River (Owerri, Nigeria) on haematological, hepatic, and renal functions using rat model

The consequences of long term consumption of water from Nworie River (Owerri, Nigeria) on haematological, hepatic, and renal functions using rat model (Wistar albino strain). Twenty-four rats separated into two groups of twelve rats each were kept as test and control for sixty-four days. The test rats were placed on water from Nworie River while those of the control were placed on Eva water (purified Coca-cola bottled water). The rats were sacrificed in two sets: first set was on thirty-second day while the second set was on the sixty-fourth day. Six rats each from each group were sacrificed at each set. The Results obtained revealed that Hb, PCV, WBC, L, N, and ESR were significantly affected (p<0.05) in test rats against the control rats. The functional parameters of liver adequacy; AST, ALT, and ALP were significantly (p<0.05) affected in test rats against those of the control. Also, urea and electrolyte ions (Potassium ion, chloride and bicarbonate) indicating renal sufficiency were significantly (p<0.05) affected in test rats against those of the control. Creatinine, sodium ion, total bilirubin and conjugated bilirubin were not significantly affected (p>0.05) in test rats when compared to those of the control. The induced changes in the parameters investigated in this study have shown that long-term consumption of water from Nworie River has effect on haematological, hepatic, and renal function.KEYWORDS: Nworie River, haematology, liver function, kidney functio

Usefulness of Chlamydia serology in prediction of tubal factor infertility among infertile patients at Federal Medical Centre, Bida, North Central Nigeria

Background: Infertility is a major public health problem in developing countries where pelvic inflammatory disease due mainly to Chlamydia trachomatis and Neisseria gonorrhea infection have been implicated. The role of Chlamydia serology in predicting tubal factor infertility (TFI) has been demonstrated by many researchers elsewhere. However, there are limited data in our environment. This prospective cross-sectional study aims to determine the usefulness of Chlamydia Serology as a screening tool for TFI at Federal Medical Centre, Bida, North Central Nigeria.Methods: 125 women with infertility who met the inclusion criteria were enrolled into the study. Relevant information on their socio-demographic characteristics, gynaecological symptoms and risks factors for infertility were obtained. Participants had Hysterosalpingography (HSG) as part of their fertility work-up while 5ml of venous blood was withdrawn to check for Immunoglobulin G antibody to Chlamydia trachomatis using rapid test kits. The HSG findings were correlated with the result of Chlamydia serology. Data was analyzed using the computer software, Statistical Package for Social Science (SPSS) version 20. The level of significance (p value) was set at 0.05.Results: A total of 120 infertile women completed the study, 5 had incomplete investigations and were excluded from the analysis. The prevalence of TFI was 47.5%, while that of positive chlamydia serology was 36.5%. The prevalence of chlamydial seropositivity was 59.6% for patients with TFI but 15.9% for non-TFI. There was a significant association between positive chlamydia serology and TFI p< 0.05. The study revealed moderate sensitivity 59.6%, and negative predictive value 69.7% but high specificity 84.1% and positive predictive value of 77.2%. In this study the odds for diagnosing tubal infertility was 7.8.Conclusions: Chlamydia serology is useful in predicting TFI and should be incorporated in the routine work up for infertility

Endomicroscopic and transcriptomic analysis of impaired barrier function and malabsorption in environmental enteropathy

Introduction: Environmental enteropathy (EE) is associated with growth failure, micronutrient malabsorption and impaired responses to oral vaccines. We set out to define cellular mechanisms of impaired barrier function in EE and explore protective mechanisms. Methods: We studied 49 adults with environmental enteropathy in Lusaka, Zambia using confocal laser endomicroscopy (CLE); histology, immunohistochemistry and mRNA sequencing of small intestinal biopsies; and correlated these with plasma lipopolysaccharide (LPS) and a zinc uptake test. Results: CLE images (median 134 for each study) showed virtually ubiquitous small intestinal damage. Epithelial defects, imaged by histology and claudin 4 immunostaining, were predominantly seen at the tips of villi and corresponded with leakage imaged in vivo by CLE. In multivariate analysis, circulating log-transformed LPS was correlated with cell shedding events (β = 0.83; P = 0.035) and with serum glucagon-like peptide-2 (β = -0.13; P = 0.007). Zinc uptake from a test dose of 25mg was attenuated in 30/47 (64%) individuals and in multivariate analysis was reduced by HIV, but positively correlated with GLP-2 (β = 2.72; P = 0.03). There was a U-shaped relationship between circulating LPS and villus surface area. Transcriptomic analysis identified 23 differentially expressed genes in severe enteropathy, including protective peptides and proteins. Conclusions: Confocal endomicroscopy, claudin 4 immunostaining and histology identify epithelial defects which are probably sites of bacterial translocation, in the presence of which increased epithelial surface area increases the burden of translocation. GLP 2 and other protective peptides may play an important role in mucosal protection in EE