COMPARATIVE EFFECTIVENESS STUDY OF COMBINED ANTIHYPERTENSIVES FOR NIGERIAN PATIENTS

Objective: The objective of the study was to compare the clinical and economic effectiveness of four combination antihypertensives recommended for Nigerians. Methods: An open, randomized, controlled, and longitudinal double-blind trial of four groups of antihypertensives combinations: Telmisartan/ chlorthalidone/amlodipine (TCA), TC, CA, and TA was conducted among hypertensive patients. The participants were recruited from three hospitals in Enugu, and randomly assigned to the study groups. The primary outcome for this study was blood pressure (BP) control, based on Joint National Committee-8 and cost per BP control. The secondary outcomes were cost per quality adjusted life years (QALY) and patients’ self-reported health status. Descriptive and inferential statistics were used for statistical analysis. Results: Of the 110 patients enrolled in the study, more than half were women (55.5%). The mean age of patients was 54.93±12.38. The enrollees had hypertension for over 9 years (9.17±8.40). About 77% of the patients completed the study in all the groups except for TA (66.7%). There was no difference in BP in all the groups at baseline and at end-of-study (p>0.050). However, the probability of BP control was highest in TCA group (0.37±0.01), followed by TC group (0.23±0.02). The TA group showed the most favorable cost per QALY, then CA, TC, and TCA in that order. The group with the most favorable cost per BP control was TCA (70.92±0.04), then TA (94.16±0.05). Conclusion: The triple combination therapy of TCA had the best cost per BP control in the management of hypertensive patients. It demonstrated the highest probability of BP control

Optimization of 4D/3D printing via machine learning: a systematic review

This systematic review explores the integration of 4D/3D printing technologies with machine learning, shaping a new era of manufacturing innovation. The analysis covers a wide range of research papers, articles, and patents, presenting a multidimensional perspective on the advancements in additive manufacturing. The review underscores machine learning's pivotal role in optimizing 4D/3D printing, addressing aspects like design customization, material selection, process control, and quality assurance. The examination reveals novel techniques enabling the fabrication of intelligent, self-adaptive structures capable of transformation over time. Additionally, the review investigates the use of predictive algorithms to enhance efficiency, reliability, and sustainability in 4D/3D printing processes. Applications span aerospace, healthcare, architecture, and consumer goods, showcasing the potential to create intricate, personalized, and once-unattainable functional products. The synergy between machine learning and 4D/3D printing is poised to unlock new manufacturing horizons, enabling rapid responses to market demands and sustainability challenges. In summary, this review provides a comprehensive overview of the current state of 4D/3D printing optimization through machine learning, highlighting the transformative potential of this interdisciplinary fusion and offering a roadmap for future research and development. It aims to inspire innovators, researchers, and industries to harness this powerful combination for accelerated evolution in manufacturing processes into the 21st century and beyond

A cognitive forcing tool to mitigate cognitive bias:A randomised control trial

Abstract Background Cognitive bias is an important source of diagnostic error yet is a challenging area to understand and teach. Our aim was to determine whether a cognitive forcing tool can reduce the rates of error in clinical decision making. A secondary objective was to understand the process by which this effect might occur. Methods We hypothesised that using a cognitive forcing tool would reduce diagnostic error rates. To test this hypothesis, a novel online case-based approach was used to conduct a single blinded randomized clinical trial conducted from January 2017 to September 2018. In addition, a qualitative series of “think aloud” interviews were conducted with 20 doctors from a UK teaching hospital in 2018. The primary outcome was the diagnostic error rate when solving bias inducing clinical vignettes. A volunteer sample of medical professionals from across the UK, Republic of Ireland and North America. They ranged in seniority from medical student to Attending Physician. Results Seventy six participants were included in the study. The data showed doctors of all grades routinely made errors related to cognitive bias. There was no difference in error rates between groups (mean 2.8 cases correct in intervention vs 3.1 in control group, 95% CI -0.94 – 0.45 P = 0.49). The qualitative protocol revealed that the cognitive forcing strategy was well received and a produced a subjectively positive impact on doctors’ accuracy and thoughtfulness in clinical cases. Conclusions The quantitative data failed to show an improvement in accuracy despite a positive qualitative experience. There is insufficient evidence to recommend this tool in clinical practice, however the qualitative data suggests such an approach has some merit and face validity to users

A limited-size ensemble of homogeneous CNN/LSTMs for high-performance word classification

The strength of long short-term memory neural networks (LSTMs) that have been applied is more located in handling sequences of variable length than in handling geometric variability of the image patterns. In this paper, an end-to-end convolutional LSTM neural network is used to handle both geometric variation and sequence variability. The best results for LSTMs are often based on large-scale training of an ensemble of network instances. We show that high performances can be reached on a common benchmark set by using proper data augmentation for just five such networks using a proper coding scheme and a proper voting scheme. The networks have similar architectures (convolutional neural network (CNN): five layers, bidirectional LSTM (BiLSTM): three layers followed by a connectionist temporal classification (CTC) processing step). The approach assumes differently scaled input images and different feature map sizes. Three datasets are used: the standard benchmark RIMES dataset (French); a historical handwritten dataset KdK (Dutch); the standard benchmark George Washington (GW) dataset (English). Final performance obtained for the word-recognition test of RIMES was 96.6%, a clear improvement over other state-of-the-art approaches which did not use a pre-trained network. On the KdK and GW datasets, our approach also shows good results. The proposed approach is deployed in the Monk search engine for historical-handwriting collections

Improved pregnancy outcome in refugees and migrants despite low literacy on the Thai-Burmese border: results of three cross-sectional surveys

BACKGROUND: Maternal and infant health has been associated with maternal education level, which is highly associated with literacy. We aimed at estimating literacy rates among reproductive age women attending antenatal clinics in camps for refugees and in migrant clinics in Tak province, north-western Thailand, to determine whether illiteracy had an impact on birth outcomes. METHODS: Three reading assessments were conducted using an identical method each time, in 1995-97, 2003 and 2008. Midwives chose at random one of four pre-set sentences. Each woman was asked to read aloud and scoring was based on a "pass/fail" system. Pregnancy outcomes were compared with maternal literacy rate. RESULTS: Overall, 47% (1149/2424) of women were able to read. A significant improvement was observed among migrant (34% in 2003 vs. 46% in 2008, p = 0.01), but not refugee (47% in 1995-97, 49% in 2003, and 51% in 2008) women. Literate women were significantly more likely to be of non-Karen ethnicity, primigravidae, non-smokers, to remain free from malaria during pregnancy and to deliver in a health clinic. Significant improvements in pregnancy outcome (reductions in premature births, low birth weight newborns and neonatal death) between 1995-97 and 2003 were unrelated to literacy. CONCLUSIONS: Significant reductions in poor pregnancy outcome over time have not been driven by changes in literacy rates, which have remained low. Access to early diagnosis and treatment of malaria in this population, and delivery with skilled birth attendants, despite ongoing low literacy, appears to have played a significant role

Assessment of endogenous fibrinolysis in clinical using novel tests - Ready for clinical roll-out?

© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.The occurrence of thrombotic complications, which can result in excess mortality and morbidity, represent an imbalance between the pro-thrombotic and fibrinolytic equilibrium.The mainstay treatment of these complications involves the use of antithrombotic agents but despite advances in pharmacotherapy, there remains a significant proportion of patients who continue to remain at risk.Endogenous fibrinolysis is a physiological counter-measure against lasting thrombosis and may be measured using several techniques to identify higher risk patients who may benefit from more aggressive pharmacotherapy. However, the assessment of the fibrinolytic systemis not yet accepted into routine clinical practice.In this review, we will revisit the different methods of assessing endogenous fibrinolysis (factorial assays, turbidimetric lysis assays, viscoelastic and the global thrombosis tests), including the strengths, limitations, correlation to clinical outcomes of each method and howwe might integrate the assessment of endogenous fibrinolysis into clinical practice in the future.Peer reviewedFinal Published versio

Librarians as human resource managers: the challenges

No abstract. Lagos Journal of Library and Information Science Vol. 1(1) 2003: 77-8

Effect of momordica charantia extracts on blood glucose and lipid peroxidation levels in albino rats.

Hypoglycemic and antioxidant properties of Mormordica Charantia plant (Ejirin in Yoruba language) were investigated using albino rats.Bioassays were carried out using crude alkaloid and fractionated extracts of the plant material. Thirty-six albino rats weighing between 230-250gwere divided into six groups and respectively administrated orally, aqueous, Ethyl acetate, chloroform and crude alkaloid extracts of the plantleaf as well as the whole plant leaf at the concentration of 150mg/kg body weight. Results show that the whole plant leaf extract as well as theaqueous fraction significantly (