Functional, physical and sensory properties of cookies prepared from okara, red teff and wheat flours

The present study was carried out to determine the effect of different proportions of red teff, wheat and okara on the physical, functional and sensory properties. The experiment was conducted in a D-optimal mixture design using Design Expert® and generated 16 runs with different proportions of three flours. The minimum and maximum values of red teff, wheat and okara were considered as 40-50%, 20-40% and 10-20% respectively. The functional, physical and sensory properties were determined for all the cookies as well as for the control sample (100% wheat) according to the standard methods. Statistically significant (p≤0.05) difference in bulk density was observed between red teff with okara. The water absorption capacity showed a highly significant difference (p≤0.01) in red teff with okara interaction. The highest hardness value (71 N) was recorded for cookies prepared from 40%, 10%, 50% of red teff, wheat and okara flour blends respectively, whereas the lowest value (23 N) was recorded for the control. The spread ratio of the cookies varied between 1.652 and 2.067. Okara concentrations affected the aroma and taste due to the beany flavour. The overall acceptability of cookies prepared from red teff, wheat and okara showed no significant difference (p≤0.05) in both linear and quadratic models and overall acceptability of the cookies from 100% wheat and blends was almost the same. In conclusion, the functional and physical properties of the cookies that are prepared with the different concentrations of okara, and teff blended cookies correspond to the levels shown by the control samples. In sensory analysis, overall acceptability of the cookies prepared with okara was similar to the control (only wheat). So, okara can be successfully used in the preparation of cookies

EFFECT OF CERTAIN PROCESSING METHODS ON PHOSPHOLIPID COMPONENTS IN RABBIT MEAT

Fore limb, loin and hind limb cuts of California and New Zealand white rabbits (both sexes) of a marketable age (2 and 3 months) were used to study the effect of certain processing methods (pressure cooking, roasting and smoking) on phospholipid components in rabbit meat. Phospholipids were fractionated applying thin-layer chromatographic (TLC) tech- nique to eight fractions (phosphatidylserine (PS), lysophosphatidylcholine (LPC), phos- phatidyl inositol (PI), sphingomyelin (SL), phosphatidylcholine (PC), phosphatidyl ethanolamine (PE), phosphatidic acid (PA) and phosphatidyl glycerol (PG)). Rather slight differences were observed between sexes, ages and three studied cuts in the quantities of phospholipid components. Phospholipid fractions showed qualitatively the same pattern as that of fresh meat in the three studied processing methods of rabbit meat. However, all studied processing methods resulted in a decrease in all phospholipid fraction contents, except that of Iysophosphatidyl choline and (phosphatidic acid + phosphatidyl glycerol) which slightly increased

Establishing the extent of malaria transmission and challenges facing pre-elimination in the Republic of Djibouti.

BACKGROUND: Countries aiming for malaria elimination require a detailed understanding of the current intensity of malaria transmission within their national borders. National household sample surveys are now being used to define infection prevalence but these are less efficient in areas of exceptionally low endemicity. Here we present the results of a national malaria indicator survey in the Republic of Djibouti, the first in sub-Saharan Africa to combine parasitological and serological markers of malaria, to evaluate the extent of transmission in the country and explore the potential for elimination. METHODS: A national cross-sectional household survey was undertaken from December 2008 to January 2009. A finger prick blood sample was taken from randomly selected participants of all ages to examine for parasitaemia using rapid diagnostic tests (RDTs) and confirmed using Polymerase Chain Reaction (PCR). Blood spots were also collected on filter paper and subsequently used to evaluate the presence of serological markers (combined AMA-1 and MSP-119) of Plasmodium falciparum exposure. Multivariate regression analysis was used to determine the risk factors for P. falciparum infection and/or exposure. The Getis-Ord G-statistic was used to assess spatial heterogeneity of combined infections and serological markers. RESULTS: A total of 7151 individuals were tested using RDTs of which only 42 (0.5%) were positive for P. falciparum infections and confirmed by PCR. Filter paper blood spots were collected for 5605 individuals. Of these 4769 showed concordant optical density results and were retained in subsequent analysis. Overall P. falciparum sero-prevalence was 9.9% (517/4769) for all ages; 6.9% (46/649) in children under the age of five years; and 14.2% (76/510) in the oldest age group (≥50 years). The combined infection and/or antibody prevalence was 10.5% (550/4769) and varied from 8.1% to 14.1% but overall regional differences were not statistically significant (χ2=33.98, p=0.3144). Increasing age (p<0.001) and decreasing household wealth status (p<0.001) were significantly associated with increasing combined P. falciparum infection and/or antibody prevalence. Significant P. falciparum hot spots were observed in Dikhil region. CONCLUSION: Malaria transmission in the Republic of Djibouti is very low across all regions with evidence of micro-epidemiological heterogeneity and limited recent transmission. It would seem that the Republic of Djibouti has a biologically feasible set of pre-conditions for elimination, however, the operational feasibility and the potential risks to elimination posed by P. vivax and human population movement across the sub-region remain to be properly established

Female and low- and middle-income authorship trends in high-impact ENT journals (2011-2020)

INTRODUCTION: Despite a recent drive to increase diversity, the global academic workforce is skewed in favor of authors from high-income countries, and women are under-represented in the published medical literature. OBJECTIVES: To explore the trends in authorship of three high-impact otolaryngology journals over a ten-year period (2011-2020). METHODS: Journals selected: JAMA Otolaryngology-Head and Neck Surgery, The Laryngoscope and Rhinology. Articles were reviewed from four issues per journal per year, and data was collected on: time of publication; subspeciality; number of authors; sex of first and last authors; country of practice of first author and country where each study was conducted. Trends were examined though univariate and multivariate logistic regression models. RESULTS: 2998 articles were included. 93.9% of first authors and 94.2% of studies were from high-income countries.Women were first authors in 31.5% (n = 912) and senior authors in 18.4% (n = 524) of articles. Female first authorship significantly increased between 2011 and 2020 however female senior authorship remained the same. There have been no significant changes in the proportion of published articles from low-and middle-income countries (LMIC) over time (p = .65). Amongst the LMIC articles, 72% came from Brazil, Turkey or China and there were no published papers from countries with a low-income economy (gross national income per capita of $1085 or less). CONCLUSIONS: Although female first authorship has increased in the last decade, there has been minimal other demographic change in authorship over this time. High-impact otolaryngology journals poorly represent academia in low-and-middle income countries. There is a need for increased advocacy promoting gender and geographical research equity in academic medicine. LEVEL OF EVIDENCE: III

Nuclear energy development in Bangladesh: A study of opportunities and challenges

It is a challenging task for Bangladesh to meet its increasing demand of energy while its economy is rapidly growing. Though prices of oil, coal, and fossil fuels around the world have been volatile, the price trend in Bangladesh demonstrates a persistent rise in the immediate past. This is further exacerbated by depleting reserves of natural gas. Cumulatively, these two effects heighten Bangladesh's energy needs. Bangladesh presently mitigates her energy requirements predominantly through natural gas, supplemented by a handful of coal and furnace oil plants. Consequently, due to scarcity of natural gas, oil and coal resources, nuclear power surfaces as a palatable strategic option for Bangladesh's future development agenda. However, a successful nuclear power program entails an extensive infrastructure. Just like the other nuclear energy-producing countries, Bangladesh also face challenges to safeguard the health and security of nuclear reactors, the proper management for nuclear waste treatment and the security concerns over the safe usage of nuclear materials. Additionally, the development of nuclear energy is also bewildered because of the complex nature of fission technology, lack of efficient human resources, and non-existence of proper legal instruments to guide safe nuclear power production. Moreover, the further challenges include the questions, for example: whether the nuclear power plant project is supported by the mass people or not? What are the strategies for nuclear waste disposal? Whether the recent initiatives for nuclear energy production is necessary or the country should more concern with renewable sources? This paper evaluates the nuclear energy development in Bangladesh. It operates under qualitative methodological framework and utilises secondary sources for analysis. We advance several recommendations in this paper to remedy the highlighted issues: (1) creating a comprehensive legal and regulatory system; (2) fortifying home-based technology of nuclear development and simultaneously localising of foreign-based technology; (3) reducing the cost of nuclear energy production; (4) fast-tracking the procedure of efficient development of nuclear technology; (5) accelerating the procedure of switching to more efficient reactor and nuclear fuel cycle, and (6) conducting effective profile-raising activities to generate greater awareness and spur common acceptance

Community-acquired pneumonia in Ugandan adults: short-term parenteral ampicillin therapy for bacterial pneumonia

A hospital-based prospective study of 99 patients with community-acquired pneumonia (CAP) was carried out in Kampala, Uganda. We evaluated microbiological etiologies, clinical features and effectiveness of short-term parenteral ampicillin followed by oral amoxicillin for these patients in relation to HIV-status. We demonstrated a very high prevalence (75%) of HIV-1 infection. No significant difference was observed with respect to age, gender, prior antibiotic usage, symptoms, laboratory data or bacterial etiology between HIV-1-infected and HIV-uninfected CAP patients. Most strains of Streptococcus pneumoniae (n = 19) and Haemophilus influenzae (n = 8) isolated from HIV-1-infected patients were penicillin-resistant (95%) and beta-lactamase producing (75%) strains, respectively. A high percentage of good clinical response was found in both HIV-1-infected (81%) and HIV-uninfected (86%) among 39 patients with CAP due to a defined bacterial pathogen. These data support the use of short-term parenteral ampicillin for patients with bacterial CAP irrespective of HIV-status

Reduced Bacterial Counts from a Sewage Treatment Plant but Increased Counts and Antibiotic Resistance in the Recipient Stream in Accra, Ghana-A Cross-Sectional Study.

Wastewater treatment plants receive sewage containing high concentrations of bacteria and antibiotics. We assessed bacterial counts and their antibiotic resistance patterns in water from (a) influents and effluents of the Legon sewage treatment plant (STP) in Accra, Ghana and (b) upstream, outfall, and downstream in the recipient Onyasia stream. We conducted a cross-sectional study of quality-controlled water testing (January-June 2018). In STP effluents, mean bacterial counts (colony-forming units/100 mL) had reduced E. coli (99.9% reduction; 102,266,667 to 710), A. hydrophila (98.8%; 376,333 to 9603), and P. aeruginosa (99.5%; 5,666,667 to 1550). Antibiotic resistance was significantly reduced for tetracycline, ciprofloxacin, cefuroxime, and ceftazidime and increased for gentamicin, amoxicillin/clavulanate, and imipenem. The highest levels were for amoxicillin/clavulanate (50-97%) and aztreonam (33%). Bacterial counts increased by 98.8% downstream compared to the sewage outfall and were predominated by E. coli, implying intense fecal contamination from other sources. There was a progressive increase in antibiotic resistance from upstream, to outfall, to downstream. The highest resistance was for amoxicillin/clavulanate (80-83%), cefuroxime (47-73%), aztreonam (53%), and ciprofloxacin (40%). The STP is efficient in reducing bacterial counts and thus reducing environmental contamination. The recipient stream is contaminated with antibiotic-resistant bacteria listed as critically important for human use, which needs addressing

Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis

ObjectivesThis study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa.MethodsThis systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger’s regression test were used to assess the publication bias.ResultsA total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46–26.97) and 36.02% (CI: 26.68–45.36), respectively. The meta-analyses revealed that Apgar score &lt; 7 (OR: 2.4, 95% CI: 1.6–3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8–4.5), prolonged rupture of membranes &gt;12 h (OR: 2.8, 95% CI: 1.9–4.1), male sex (OR: 1.2, 95% CI: 1.1–1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5–3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4–5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01–10.9), parity (OR: 0.5, 95% CI: 0.3–0.7), prolonged labor (OR: 3.4, 95% CI: 1.6–6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3–14.3) were significantly associated with maternal sepsis.ConclusionThe prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.Systematic review registration: PROSPERO (ID: CRD42022382050)

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely