Effects of cassava mill effluent on some chemical and micro-biological properties of soils in Cross River State, Nigeria

The paper examines the effects of cassava mill effluent on the Physicochemical and biological properties of soils of Obubra and Odukpani Local Areas in Cross River State after long time of pollution by the effluent. The soil samples were collected with an auger at the depths of 0-15cm and 15-30cm in each of the polluted and non-polluted soils. The results showed that the texture of the soil ranged from sandy to loamy sand in polluted soils and sandy loam in non-polluted soils. The pH ranged from 5.1 to 6.6 and organic carbon from 0.86 to 1.69% in polluted soils. Thetotal nitrogen content ranged from 0.08 to 0.53% while the CEC was low in polluted soils and ranged from 2.50 to 5.50 cmol kg-1. Calcium and Sodium ranged from 1.80 to 3.00 cmolkg-1 and 0.05 to 0.12 cmolkg-1 respectively. The bacteria and fungi isolated in the polluted soils of Obubra and Odukpani were Lactococcus lactic, Bacillus subtilis, Lactobacillus lactis, Aspergillius Niger and rhizopus spp,.Pseudomonas aeruginosa and Penicullum spp. were only isolated in non-polluted and polluted soils of Odukpani. The cassava effluent increased pH, N, organic carbon,exchangeable acidity, microorganisms and decreased CEC, available P, Mg and K

Morbidity And Quality Of Life Among Head And Neck Cancer Patients Treated With Radical Radiotherapy

Objectives: To determine the relative frequency of acute radiation morbidity and their perceived effect on quality of life among head and neck cancer patients treated with radical radiotherapy.Design: A cross-sectional study.Setting: Kenyatta National Hospital, Nairobi.Subjects: Thirty eight patients comprising 28 males and 10 females with ages ranging between 21 and 69 years were evaluated.Results: Most of the tumours occurred in the nasopharynx (38.6%). The rest of the tumours were equally divided between the oral cavity and larynx (31.6%). All tumours except two were carcinomas. The two exceptions were a glomus tumour and a malignant melanoma. The patients had received doses of radiotherapy ranging between 58.5 Grey and 75.5 Grey. Of the 38 patients, 22 (53%) completed their treatment in the prescribedtime while 16 (47%) had treatment interruption on account of radiation morbidity. The cumulative radiation done at the time of interruption ranged between 20 and 46 Grey. The most frequent symptom was dryness of the mouth while the most troublesome symptom was difficulty in tasting foods. The quality of life (QOL) did not vary by age, gender or tumour site. Patients who had treatment interruption had a better QOLthan those who did not.Conclusion: This study provides information that should aid in communicating with the head and neck cancer patients scheduled for radiotherapy and in the design of preventive and interventional strategies aimed at enhancing patient support and rehabilitation

An Optimization Approach to the Ordering Phase of an Attended Home Delivery Service

Attended Home Delivery (AHD) systems are used whenever a supplying company offers online shopping services that require that customers must be present when their deliveries arrive. Therefore, the supplying company and the customer must both agree on a time window, which ideally is rather short, during which delivery is guaranteed. Typically, a capacitated Vehicle Routing Problem with Time Windows forms the underlying optimization problem of the AHD system. In this work, we consider an AHD system that runs the online grocery shopping service of an international grocery retailer. The ordering phase, during which customers place their orders through the web service, is the computationally most challenging part of the AHD system. The delivery schedule must be built dynamically as new orders are placed. We propose a solution approach that allows to (non-stochastically) determine which delivery time windows can be offered to potential customers. We split the computations of the ordering phase into four key steps. For performing these basic steps we suggest both a heuristic approach and a hybrid approach employing mixed-integer linear programs. In an experimental evaluation we demonstrate the efficiency of our approaches

The role of brand loyalty and social media in e-commerce interfaces: survey results and implications for user interfaces

This paper explores the role of brand loyalty and social media in e-commerce interfaces. A survey consisting of 118 respondents was contacted to address the questions relating to online shopping and brand loyalty. Link between the frequency of access and time spent on an e-commerce user interface, and brand loyalty, gender and age profile differences, and the role of social media to branding and on-line shopping was analyzed. It was found that online loyalty differs from offline loyalty and loyalty also differed across genders, showing men were more loyal than women when shopping online. Information shared about products on social media by friends and family played an important role in purchase decision making. Website interface and ease of navigation were also key aspects for online shopping. The research concluded with recommendations to create multimodal websites which are more interactive and targeted so customer experience is enhanced and loyalty is achieved through the use of interactivity and social media

Freight distribution performance indicators for service quality planning in large transportation networks

This paper studies the use of performance indicators in routing problems to estimate how transportation cost is affected by the quality of service offered. The quality of service is assumed to be directly dependent on the size of the time windows. Smaller time windows mean better service. Three performance indicators are introduced. These indicators are calculated directly from the data without the need of a solution method. The introduced indicators are based mainly on a "request compatibility", which describes whether two visits can be scheduled consecutively in a route. Other two indicators are introduced, which get their values from a greedy constructive heuristic. After introducing the indicators, the correlation between indicators and transportation cost is examined. It is concluded that the indicators give a good first estimation on the transportation cost incurred when providing a certain quality of service. These indicators can be calculated easily in one of the first planning steps without the need of a sophisticated solution tool. The contribution of the paper is the introduction of a simple set of performance indicators that can be used to estimate the transportation cost of a routing problem with time window

The challenges faced in the design, conduct and analysis of surgical randomised controlled trials

Randomised evaluations of surgical interventions are rare; some interventions have been widely adopted without rigorous evaluation. Unlike other medical areas, the randomised controlled trial (RCT) design has not become the default study design for the evaluation of surgical interventions. Surgical trials are difficult to successfully undertake and pose particular practical and methodological challenges. However, RCTs have played a role in the assessment of surgical innovations and there is scope and need for greater use. This article will consider the design, conduct and analysis of an RCT of a surgical intervention. The issues will be reviewed under three headings: the timing of the evaluation, defining the research question and trial design issues. Recommendations on the conduct of future surgical RCTs are made. Collaboration between research and surgical communities is needed to address the distinct issues raised by the assessmentof surgical interventions and enable the conduct of appropriate and well-designed trials.The Health Services Research Unit is funded by the Scottish Government Health DirectoratesPeer reviewedPublisher PD

Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment

Introduction: Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women. Methods: Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA), and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through$800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs); and incremental cost-effectiveness ratios (ICERs) in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed. Results: Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days). When assuming alendronate costs of$400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from$714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of$50,000/QALY at all alendronate costs evaluated. Conclusions: Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost-saving at annual alendronate costs of $200 or less. © 2012 Nayak et al

The Burden of Trachoma in Ayod County of Southern Sudan

Trachoma, a neglected tropical disease, is the leading cause of infectious blindness and is targeted for global elimination by the year 2020. We conducted a survey in Ayod County of Jonglei State, Southern Sudan, to determine whether blinding trachoma was a public health problem and to plan interventions to control this disease. We found the burden of trachoma in Ayod to be one of the most severe ever documented. Not only were adults affected by the advanced manifestations of the disease as is typical for older age groups, but young children were also affected. At least one person with clinical signs of trachoma was found in nearly every household, and 1 in 3 households had a person with severe blinding trachoma. Characteristics previously identified as risk factors were ubiquitous among surveyed households, but we were unable to identify why trachoma is so severe in this location. Surgical interventions are needed urgently to improve vision and prevent irreversible blindness in children and adults. Mass antibiotic distribution may alleviate current infections and transmission of trachoma may be reduced if communities adopt the behavior of face washing and safe disposal of human waste. Increasing access to improved water sources may not only improve hygiene but also reduce the spread of guinea worm and other water-borne diseases

Variable strength of forest stand attributes and weather conditions on the questing activity of Ixodes ricinus ticks over years in managed forests

Given the ever-increasing human impact through land use and climate change on the environment, we crucially need to achieve a better understanding of those factors that influence the questing activity of ixodid ticks, a major disease-transmitting vector in temperate forests. We investigated variation in the relative questing nymph densities of Ixodes ricinus in differently managed forest types for three years (2008–2010) in SW Germany by drag sampling. We used a hierarchical Bayesian modeling approach to examine the relative effects of habitat and weather and to consider possible nested structures of habitat and climate forces. The questing activity of nymphs was considerably larger in young forest successional stages of thicket compared with pole wood and timber stages. Questing nymph density increased markedly with milder winter temperatures. Generally, the relative strength of the various environmental forces on questing nymph density differed across years. In particular, winter temperature had a negative effect on tick activity across sites in 2008 in contrast to the overall effect of temperature across years. Our results suggest that forest management practices have important impacts on questing nymph density. Variable weather conditions, however, might override the effects of forest management practices on the fluctuations and dynamics of tick populations and activity over years, in particular, the preceding winter temperatures. Therefore, robust predictions and the detection of possible interactions and nested structures of habitat and climate forces can only be quantified through the collection of long-term data. Such data are particularly important with regard to future scenarios of forest management and climate warming

Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification.

There is evidence that the prevalence of migraine in children and adolescents may be increasing. Current theories of migraine pathophysiology in adults suggest activation of central cortical and brainstem pathways in conjunction with the peripheral trigeminovascular system, which ultimately results in release of neuropeptides, facilitation of central pain pathways, neurogenic inflammation surrounding peripheral vessels, and vasodilatation. Although several risk factors for frequent episodic, chronic, and refractory migraine have been identified, the causes of migraine progression are not known. Migraine pathophysiology has not been fully evaluated in children. In this review, we will first discuss the evidence that early therapeutic interventions in the child or adolescent new onset migraineur, may halt or limit progression and disability. We will then review the evidence suggesting that many adults with chronic or refractory migraine developed their migraine as children or adolescents and may not have been treated adequately with migraine-specific therapy. Finally, we will show that early, appropriate and optimal treatment of migraine during childhood and adolescence may result in disease modification and prevent progression of this disease