Knowledge and Perception of Afenmai Residents on Lassa Fever Outbreak in Nigeria

The media as purveyors and carriers of information frequently examine issues of public health by publishing messages that could guide the audience to make informed decisions about their health. This study therefore, examined the knowledge and perception of Afenmai residents on lassa fever disease outbreak in Nigeria. Anchored on Agenda Setting and the Health Belief Model, the study relied on survey design with questionnaire as instruments of data collection. Multi-stage sampling technique was used to sample 400 respondents from a population of 1,317,655 persons selected from six local government areas: Akoko-Edo, Etsako-Central, Etsako-East, Etsako-West, Owan-West, Owan-East, in Afenmai region of Edo state. Findings indicate that the Afenmai people are exposed to campaigns on lassa fever prevention and control and that there is a significant level of adoption of the transmitted campaign messages. Based on the findings of the study, the researchers conclude that there is significant difference in the perception of Afenmai residents on lassa fever pandemic in Nigeria. The researchers further concluded that the media played useful role in sensitizing the residents of the region on the virus. It therefore, recommended that government and media organizations should enhance media campaign messages on lassa fever outbreak in the county amongst others. Keywords: Knowledge; Perception; Afenmai; Residents; Lassa Fever. DOI: 10.7176/NMMC/98-04 Publication date:September 30th 202

APPLICATION OF FUZZY-MLP MODEL TO ULTRASONIC LIVER IMAGE CLASSIFICATION

In this paper, we propose the application of fuzzy-MLP in theclassification of ultrasonic liver images. The four sets of ultrasonic liverimages used in the experiment are: normal, liver cysts, alcoholic cirrhosisand carcinoma.To deal with the sample images efficiently, we extract textural features fromthe Pathology Bearing Regions (PBRs) of the ultrasound liver images. Theselected features for the classification are entropy, energy and maximumprobability-based texture features extracted using gray level co-occurrencematrix second-order statistics. The fuzzy-MLP model is constructed for theselected features classify various categories of ultrasonic liver images.The efficacy of Fuzzy-MLP model and conventional artificial neural network(ANN) has been compared on the basis of the same feature vector. A testwith 82 training data and 110 test data for all the four classes shows 92.73%classification accuracy for the proposed fuzzy-MLP model. It is comparedwith the 81.82% counterpart provided by conventional ANN method

IMPLICATIONS OF HUMAN CAPITAL FORMATION ON OUTPUT AND EMPLOYMENT: EVIDENCE FROM NIGERIA

Many studies have documented that human capital formation is important to boost output both empirically and theoretically. However, studies on the implications of human capital on employment are still scanty, especially for developing countries. Against this background, the study investigates the shock and long-run implications of government financing on education and health on output and employment in Nigeria using a vector error correction model (VECM). The results show that the forecasting error shocks from government expenditure on health and education affect output more than employment along the 10-horizon period. Evidence from the long-run output model showed that government expenditure on education and human capital index is statistically significant, while government expenditure on health is not statistically significant. Government expenditure on education and the human capital index has a positive relationship with output. For the long-run employment model, government expenditure on health and education is statistically significant; while investment in human capital is not significant with employment. Government expenditure on education has a negative relationship with employment, while a positive relationship exists between government expenditure on health and employment. The result implies that human capital indicators in terms of quantity and quality do not contribute positively and significantly to employment growth in Nigeria. The study recommends the need to encourage self-reliance through entrepreneurship training to bolster employment opportunities in the long run

Dietary Antioxidants Impact DDT Resistance in \u3cem\u3eDrosophila melanogaster\u3c/em\u3e

Insects experience a diversity of subtoxic and/or toxic xenobiotics through exposure to pesticides and, in the case of herbivorous insects, through plant defensive compounds in their diets. Many insects are also concurrently exposed to antioxidants in their diets. The impact of dietary antioxidants on the toxicity of xenobiotics in insects is not well understood, in part due to the challenge of developing appropriate systems in which doses and exposure times (of both the antioxidants and the xenobiotics) can be controlled and outcomes can be easily measured. However, in Drosophila melanogaster, a well-established insect model system, both dietary factors and pesticide exposure can be easily controlled. Additionally, the mode of action and xenobiotic metabolism of dichlorodiphenyltrichloroethane (DDT), a highly persistent neurotoxic organochlorine insecticide that is detected widely in the environment, have been well studied in DDT-susceptible and -resistant strains. Using a glass-vial bioassay system with blue diet as the food source, seven compounds with known antioxidant effects (ascorbic acid, β-carotene, glutathione, α-lipoic acid, melatonin, minocycline, and serotonin) were orally tested for their impact on DDT toxicity across three strains of D. melanogaster: one highly susceptible to DDT (Canton-S), one mildly susceptible (91-C), and one highly resistant (91-R). Three of the antioxidants (serotonin, ascorbic acid, and β-carotene) significantly impacted the toxicity of DDT in one or more strains. Fly strain and gender, antioxidant type, and antioxidant dose all affected the relative toxicity of DDT. Our work demonstrates that dietary antioxidants can potentially alter the toxicity of a xenobiotic in an insect population

Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study.

Background Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study. Methods and Results Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine‐based eGFR was 1.67 (1.49, 1.89), 1 SD lower cystatin C‐based‐eGFR was 2.43 (2.10, 2.80), and 1 SD higher log‐albuminuria was 1.65 (1.53, 1.78), all P\u3c0.001. When all 3 kidney function measures were simultaneously included in the model, lower cystatin C‐based eGFR and higher log‐albuminuria remained significantly and directly associated with incidence of heart failure. After adjusting for eGFR, albuminuria, and other traditional cardiovascular risk factors, anemia (1.37, 95% CI 1.09, 1.72, P=0.006), insulin resistance (1.16, 95% CI 1.04, 1.28, P=0.006), hemoglobin A1c (1.27, 95% CI 1.14, 1.41, P\u3c0.001), interleukin‐6 (1.15, 95% CI 1.05, 1.25, P=0.002), and tumor necrosis factor‐α (1.10, 95% CI 1.00, 1.21, P=0.05) were all significantly and directly associated with incidence of heart failure. Conclusions Our study indicates that cystatin C‐based eGFR and albuminuria are better predictors for risk of heart failure compared to creatinine‐based eGFR. Furthermore, anemia, insulin resistance, inflammation, and poor glycemic control are independent risk factors for the development of heart failure among patients with chronic kidney disease

Payer leverage and hospital compliance with a benchmark: a population-based observational study

<p>Abstract</p> <p>Background</p> <p>Since 1976, Medicare has linked reimbursement for hospitals performing organ transplants to the attainment of certain benchmarks, including transplant volume. While Medicare is a stakeholder in all transplant services, its role in renal transplantation is likely greater, given its coverage of end-stage renal disease. Thus, Medicare's transplant experience allows us to examine the role of payer leverage in motivating hospital benchmark compliance.</p> <p>Methods</p> <p>Nationally representative discharge data for kidney (<it>n </it>= 29,272), liver (<it>n </it>= 7,988), heart (<it>n </it>= 3,530), and lung (<it>n </it>= 1,880) transplants from the Nationwide Inpatient Sample (1993 – 2003) were employed. Logistic regression techniques with robust variance estimators were used to examine the relationship between hospital volume compliance and Medicare market share; generalized estimating equations were used to explore the association between patient-level operative mortality and hospital volume compliance.</p> <p>Results</p> <p>Medicare's transplant market share varied by organ [57%, 28%, 27%, and 18% for kidney, lung, heart, and liver transplants, respectively (<it>P </it>< 0.001)]. Volume-based benchmark compliance varied by transplant type [85%, 75%, 44%, and 39% for kidney, liver, heart, and lung transplants, respectively (<it>P </it>< 0.001)], despite a lower odds of operative mortality at compliant hospitals. Adjusting for organ supply, high market leverage was independently associated with compliance at hospitals transplanting kidneys (OR, 143.00; 95% CI, 18.53 – 1103.49), hearts (OR, 2.84; 95% CI, 1.51 – 5.34), and lungs (OR, 3.24; 95% CI, 1.57 – 6.67).</p> <p>Conclusion</p> <p>These data highlight the influence of payer leverage–an important contextual factor in value-based purchasing initiatives. For uncommon diagnoses, these data suggest that at least 30% of a provider's patients might need to be "at risk" for an incentive to motivate compliance.</p

Effects of control interventions on Clostridium difficile infection in England: an observational study

Background: The control of Clostridium difficile infections is an international clinical challenge. The incidence of C difficile in England declined by roughly 80% after 2006, following the implementation of national control policies; we tested two hypotheses to investigate their role in this decline. First, if C difficile infection declines in England were driven by reductions in use of particular antibiotics, then incidence of C difficile infections caused by resistant isolates should decline faster than that caused by susceptible isolates across multiple genotypes. Second, if C difficile infection declines were driven by improvements in hospital infection control, then transmitted (secondary) cases should decline regardless of susceptibility. Methods: Regional (Oxfordshire and Leeds, UK) and national data for the incidence of C difficile infections and antimicrobial prescribing data (1998–2014) were combined with whole genome sequences from 4045 national and international C difficile isolates. Genotype (multilocus sequence type) and fluoroquinolone susceptibility were determined from whole genome sequences. The incidence of C difficile infections caused by fluoroquinolone-resistant and fluoroquinolone-susceptible isolates was estimated with negative-binomial regression, overall and per genotype. Selection and transmission were investigated with phylogenetic analyses. Findings: National fluoroquinolone and cephalosporin prescribing correlated highly with incidence of C difficile infections (cross-correlations >0·88), by contrast with total antibiotic prescribing (cross-correlations 0·2). Interpretation: Restricting fluoroquinolone prescribing appears to explain the decline in incidence of C difficile infections, above other measures, in Oxfordshire and Leeds, England. Antimicrobial stewardship should be a central component of C difficile infection control programmes