Conceptual modelling of explanation experiences through the iSeeonto ontology.

Explainable Artificial Intelligence is a big research field required in many situations where we need to understand Artificial Intelligence behaviour. However, each explanation need is unique which makes it difficult to apply explanation techniques and solutions that are already implemented when faced with a new problem. Therefore, the task to implement an explanation system can be very challenging because we need to take the AI model into account, user's needs and goals, available data, suitable explainers, etc. In this work, we propose a formal model to define and orchestrate all the elements involved in an explanation system, and make a novel contribution regarding the formalisation of this model as the iSeeOnto ontology. This ontology not only enables the conceptualisation of a wide range of explanation systems, but also supports the application of Case-Based Reasoning as a knowledge transfer approach that reuses previous explanation experiences from unrelated domains. To demonstrate the suitability of the proposed model, we present an exhaustive validation by classifying reference explanation systems found in the literature into the iSeeOnto ontology

iSee: intelligent sharing of explanation experiences.

The right to an explanation of the decision reached by a machine learning (ML) model is now an EU regulation. However, different system stakeholders may have different background knowledge, competencies and goals, thus requiring different kinds of explanations. There is a growing armoury of XAI methods, interpreting ML models and explaining their predictions, recommendations and diagnoses. We refer to these collectively as "explanation strategies". As these explanation strategies mature, practitioners gain experience in understanding which strategies to deploy in different circumstances. What is lacking, and what the iSee project will address, is the science and technology for capturing, sharing and re-using explanation strategies based on similar user experiences, along with a much-needed route to explainable AI (XAI) compliance. Our vision is to improve every user's experience of AI, by harnessing experiences of best practice in XAI by providing an interactive environment where personalised explanation experiences are accessible to everyone. Video Link: https://youtu.be/81O6-q_yx0

Clinical characteristics and treatment patterns of pregnant women with hypertension in primary care in the Federal Capital Territory of Nigeria: Cross-sectional results from the Hypertension Treatment in Nigeria Program

BACKGROUND: Hypertensive disorders of pregnancy, including hypertension, are a leading cause of maternal mortality in Nigeria. However, there is a paucity of data on pregnant women with hypertension who receive care in primary health care facilities. This study presents the results from a cross-sectional analysis of pregnant women enrolled in the Hypertension Treatment in Nigeria Program which is aimed at integrating and strengthening hypertension care in primary health care centres. METHODS: A descriptive analysis of the baseline results from the Hypertension Treatment in Nigeria Program was performed. Baseline blood pressures, treatment and control rates of pregnant women were analysed and compared to other adult women of reproductive age. A complete case analysis was performed, and a two-sided p value \u3c 0.05 was considered statistically significant. RESULTS: Between January 2020 to October 2022, 5972 women of reproductive age were enrolled in the 60 primary healthcare centres participating in the Hypertension Treatment in Nigeria Program and 112 (2%) were pregnant. Overall mean age (SD) was 39.6 years (6.3). Co-morbidities were rare in both groups, and blood pressures were similar amongst pregnant and non-pregnant women (overall mean (SD) first systolic and diastolic blood pressures were 157.4 (20.6)/100.7 (13.6) mm Hg and overall mean (SD) second systolic and diastolic blood pressures were 151.7 (20.1)/98.4 (13.5) mm Hg). However, compared to non-pregnant women, pregnant women had a higher rate of newly diagnosed hypertension (65.2% versus 54.4% p = 0.02) and lower baseline walk-in treatment (32.1% versus 42.1%, p = 0.03). The control rate was numerically lower among pregnant patients (6.3% versus 10.2%, p = 0.17), but was not statistically significant. Some pregnant patients (8.3%) were on medications contraindicated in pregnancy, and none of the pregnant women were on aspirin for primary prevention of preeclampsia. CONCLUSIONS: These findings indicate significant gaps in care and important areas for future studies to improve the quality of care and outcomes for pregnant women with hypertension in Nigeria, a country with the highest burden of maternal mortality globally

Formative evaluation and adaptation of a hypertension Extension for Community Health Outcomes program for healthcare workers within the Federal Capital Territory, Nigeria

BACKGROUND: The Extension for Community Health Outcomes (ECHO) model has been used extensively to link care providers in rural communities with experts with the aim of improving local patient care. OBJECTIVE: The aim of this qualitative research study was to assess the feasibility, acceptability, perceived needs, and contextual factors to guide implementation of a hypertension focused ECHO program for Community Health Extension Workers (CHEWs) in the Federal Capital Territory, Nigeria. METHODS: From September 2020 to December 2020, key informant interviews were performed with seven global organizations (hubs) providing ECHO training focused on cardiovascular disease or nephrology to identify contextual factors and implementation strategies used by each hub. In February 2022, seven focus group discussions were performed with 42 frontline healthcare workers in the Federal Capital Territory to inform local adaptation of a hypertension ECHO program. Directed content analysis identified major themes which were mapped to the Consolidated Framework for Implementation Research. Qualitative analyses were performed using Dedoose, and results were synthesized using the Implementation Research Logic Model. RESULTS: We found both barriers and facilitators across the Consolidated Framework for Implementation Research domains that mapped to a number of constructs in each one. The results of these analyses confirmed that the core components of the ECHO model are a feasible and appropriate intervention for hypertension education of healthcare workers. However, implementing the ECHO program within the Federal Capital Territory may require strategies such as utilizing communications resources effectively, developing incentives to motivate initial participation, and providing rewards or recognition for ongoing engagement. CONCLUSIONS: These results provide valuable formative insights to guide implementation of our proposed hypertension ECHO program for CHEWs in the Federal Capital Territory, Nigeria. This information was used for key decisions around: 1) scope and content of training, 2) format and frequency, 3) selection of implementation strategies, and 4) building a community of practice

Towards an improved service quality: transportation modelling of product distribution

The study aims to assess customer satisfaction with the activities of the case study company. It established, through a survey, a level of dissatisfaction by the company’s customers, attributable to inefficient product distribution. The solution to the transportation model of the company’s product distribution pattern, using the Vogel’s Approximation Method shows that the company can reduce its transportation cost from N60,095,397.20 to N58,385,972.20. This saving made from product distribution cost becomes a motivation for management of the company to ensure adherence to the accompanying shipping list, thus improving the reliability rating of the company due to a more efficient product distribution. This study would help enlighten companies, especially the case study company, on the need to continually assess their performance on service delivery (from the customers’ perspective), and analyse their activities with a view to improving customer satisfaction, service delivery and their operational efficiency and effectiveness.Keywords: transportation modelling, service quality, logistics, product distribution, customer satisfactio

Stakeholder perspectives on Nigeria's national sodium reduction program: Lessons for implementation and scale-up.

BackgroundTo reduce excess dietary sodium consumption, Nigeria's 2019 National Multi-sectoral Action Plan (NMSAP) for the Prevention and Control of Non-communicable Diseases includes policies based on the World Health Organization SHAKE package. Priority actions and strategies include mandatory sodium limits in processed foods, advertising restrictions, mass-media campaigns, school-based interventions, and improved front-of-package labeling. We conducted a formative qualitative evaluation of stakeholders' knowledge, and potential barriers as well as effective strategies to implement these NMSAP priority actions.MethodsFrom January 2021 to February 2021, key informant interviews (n = 23) and focus group discussions (n = 5) were conducted with regulators, food producers, consumers, food retailers and restaurant managers, academia, and healthcare workers in Nigeria. Building on RE-AIM and the Consolidated Framework for Implementation Research, we conducted directed content qualitative analysis to identify anticipated implementation outcomes, barriers, and facilitators to implementation of the NMSAP sodium reduction priority actions.ResultsMost stakeholders reported high appropriateness of the NMSAP because excess dietary sodium consumption is common in Nigeria and associated with high hypertension prevalence. Participants identified multiple barriers to adoption and acceptability of implementing the priority actions (e.g., poor population knowledge on the impact of excess salt intake on health, potential profit loss, resistance to change in taste) as well as facilitators to implementation (e.g., learning from favorable existing smoking reduction and advertising strategies). Key strategies to strengthen NMSAP implementation included consumer education, mandatory and improved front-of-package labeling, legislative initiatives to establish maximum sodium content limits in foods and ingredients, strengthening regulation and enforcement of food advertising restrictions, and integrating nutrition education into school curriculum.ConclusionWe found that implementation and scale-up of the Nigeria NMSAP priority actions are feasible and will require several implementation strategies ranging from community-focused education to strengthening current and planned regulation and enforcement, and improvement of front-of-package labeling quality, consistency, and use

Sodium Content and Labelling of Packaged Foods and Beverages in Nigeria: A Cross-Sectional Study

Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. The nutrition information on packaged foods can help guide consumers toward products with less sodium and support government actions to improve the healthiness of the food supply. The aims of this study were to estimate the proportion of packaged foods displaying nutrition information for sodium and other nutrients specified by Nigerian nutrition labelling regulations and to determine the amount of sodium in packaged foods sold in Nigeria using data from the nutritional information panel. Data were collected from November 2020 to March 2021 from in-store surveys conducted in supermarkets in three states. A total of 7039 products were collected. Overall, 91.5% (n = 6439) provided only partial nutrition information, 7.0% (n = 495) provided no nutritional information, and only 1.5% (n = 105) displayed a nutrient declaration that included all nutrients specified by 2019 Nigerian regulations. Some form of sodium content information was displayed for 86% of all products (n = 6032), of which around 45% (n = 2689) expressed this as ‘salt’ and 59% (n = 3559) expressed this as ‘sodium’, while a small number of food products had both ‘salt’ and ‘sodium’ content (3.6%). Provision of sodium or salt information on the label varied between food categories, ranging from 50% (vitamins and supplements, n = 2/4) to 96% (convenience foods, n = 44/46). Food categories with the highest median sodium content were ‘meat and meat alternatives’ (904 mg/100 g), ‘sauces, dressings, spreads, and dips’ (560 mg/100 g), and ‘snack foods’ (536 mg/100 g), although wide variation was often observed within categories. These findings highlight considerable potential to improve the availability and consistency of nutrition information on packaged products in Nigeria and to introduce further policies to reduce the amount of sodium in the Nigerian food supply

Fixed‐dose combination therapy‐based protocol compared with free pill combination protocol: Results of a cluster randomized trial

Abstract Fixed‐dose combination (FDC) therapy is recommended for hypertension management in Nigeria based on randomized trials at the individual level. This cluster‐randomized trial evaluates effectiveness and safety of a treatment protocol that used two‐drug FDC therapy as the second and third steps for hypertension control compared with a protocol that used free pill combinations. From January 2021 to June 2021, 60 primary healthcare centers in the Federal Capital Territory of Nigeria were randomized to a protocol using FDC therapy as second and third steps compared with a protocol that used the same medications in free pill combination therapy for these steps. Eligible patients were adults (≥18 years) with hypertension. The primary outcome was the odds of a patient being controlled at their last visit between baseline to 6‐month follow‐up in the FDC group compared to the free pill group. 4427 patients (mean [SD] age: 49.0 [12.4] years, 70.5% female) were registered with mean (SD) baseline systolic/diastolic blood pressure 155 (20.6)/96 (13.1) mm Hg. Baseline characteristics of groups were similar. After 6‐months, hypertension control rate improved in the two treatment protocols, but there were no differences between the groups after adjustment (FDC = 53.9% versus free pill combination = 47.9%, cluster‐adjusted p = .29). Adverse events were similarly low (<1%) in both groups. Both protocols improved hypertension control rates at 6‐months in comparison to baseline, though no differences were observed between groups. Further work is needed to determine if upfront FDC therapy is more effective and efficient to improve hypertension control rates

IgG levels of participants who were seropositive at baseline and corresponding month 3 and month 6 follow up levels.

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IgG levels of participants who were seronegative to SARS-CoV-2 at baseline and corresponding month 3 and month 6 follow up levels.

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