Rainfall trend detection in Northern Nigeria over the period of 1970-2012

This study examined the trends in variability and spatial distribution of annual rainfall over northern Nigeria during the period 1970-2012 with a view to understand the pattern of rainfall trend (significance and magnitude), by applying various statistical tools on the data obtained from 11 weather stations. The non-parametric Mann– Kendall test was used to determine the statistical significance of trends while the magnitude of trends was derived from the Sen slope estimator of the linear trends using Kendall robust line fitting. Map of rainfall trends was generated by applying a geo-statistical interpolation technique to visualize the detected tendencies. The findings revealed that a significant positive increase of 2.16mm in rainfall was recorded in the entire northern Nigeria within the period of 1970 to 2012. It further indicated that majority of the stations revealed an upward trend, with Bauchi, Borno, Kebbi and Sokoto stations showing significant positive trends of 8.13mm, 4.30mm, 4.76mm and 4.42mm respectively. It is concluded that there is high variability in rainfall in the northern Nigeria which signifies a clear evidence of climate change in the region

Influence of monsoon regime and microclimate on soil respiration in the tropical forests

The consequence of precipitation and how environmental factors influence soil respiration remain poorly understood in the tropical forest ecosystems under a monsoon climate in Malaysia. This study was conducted in a recovering tropical lowland Dipterocarpus forest in Peninsular Malaysia, and its monthly variations were examined in association with changing precipitation. Soil respiration was measured using a continuous open flow chamber system connected to a multi gas-handling unit and an infrared gas analyser. The aim of this study was to determine the effects of the monsoon period and microclimate of the tropical region on soil respiration. The average monthly soil respiration rates were 152.79 to 528.67, 120.97 to 500.73, 106.77 to 472.89, 122.89 to 453.89 and 120.33 to 434.89 mg m⁻² h⁻¹ in the respective months from September to January. The emission rate varied across the days and months, with the highest value recorded between September and October, and then gradually decreasing from November to January. Soil temperature explained more than 90% of the soil respiration rate whereas precipitation had a major effect during the monsoon regime. Soil organic carbon (SOC), total organic carbon (TOC), soil organic carbon stock (SOCstock), forest biomass, carbon to nitrogen ratio (C/N) and soil pH were found to vary in considerable amounts, provide nutrients and the environment favourable for microorganism activities, leading to emission of soil CO₂. The low values of soil respiration rate between November and January were due not only on the amount of soil moisture and water potential but also on the intensity and frequency of precipitation. Therefore, these results indicate that the monsoon regime can significantly alter the emission of soil CO₂ and influence the microclimatic conditions and other environmental factors

Forest recovering and soil respiration rate

This study was conducted to investigate the rate of soil respiration from a recovering forest of the tropics and its relationship with changes in environmental factorsafter years of deforestation. Soil respiration measurement was conducted using the continuous open flow chamber technique connected to a multi gas-handling unit and infrared gas analyser, while the forest biomass and soil properties were quantified using the Kjeldahl method and Walkley-black wet oxidation technique. The average means soil respiration rate were 341.23, 383.07, 340.30, 308.12, 286.07, 256.05 mg m-2 h-1 between June and December. Soil respiration in the month of July was significantly (p<0.01) higher compare to other months, with lower emission rate in December. Soil respiration exhibited a variation pattern that was similar to soil temperature pattern, the pattern varied monthly

Monthly analysis of PM10 in ambient air of Klang Valley, Malaysia

The urbanization in Klang Valley, Peninsular Malaysia over the last decades has induce the atmospheric pollution’s risk resulted to negative impact on the environment. The aims of this paper are to identify the spatial-temporal relationship of particulate matter (PM10), to determine the characteristic of each location and to classify hierarchical of the location in relation to their impact on PM10 concentration in Klang Valley. The Spearman correlation test indicate that there was strong significant relationship between all the locations (> 0.7; p < 0.001) and moderate relationship between Petaling Jaya-Kajang and Kajang-Shah Alam (< 0.7; p < 0.001). The principal component analysis (PCA) identifies all four locations have been affected by PM10 which were determined as one of the pollutant that deteriorated the air quality. Cluster analysis (CA) has classified the PM10 pattern into three (3) different classes; Class 1 (Klang), Class 2 (Petaling Jaya and Kajang) and Class 3 (Shah Alam) based on location. Further analysis of CA would be able to classify the PM10 classes into groups depending on their dissimilarities characteristic. Thus, possible period of extreme air quality degradation could be identified. Therefore, statistical and envirometric techniques have proved the impact of the various location on increasing concentration of PM10

Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study.

BACKGROUND: More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia. METHODS: From 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan. Babies were visited at home by community health workers up to ten times from age 0 to 59 days. Illness meeting the WHO definition of pSBI and randomly selected healthy babies were referred to study physicians. The primary objective was to estimate proportions of specific infectious causes by blood culture and Custom TaqMan Array Cards molecular assay (Thermo Fisher, Bartlesville, OK, USA) of blood and respiratory samples. FINDINGS: 6022 pSBI episodes were identified among 63 114 babies (95·4 per 1000 livebirths). Causes were attributed in 28% of episodes (16% bacterial and 12% viral). Mean incidence of bacterial infections was 13·2 (95% credible interval [CrI] 11·2-15·6) per 1000 livebirths and of viral infections was 10·1 (9·4-11·6) per 1000 livebirths. The leading pathogen was respiratory syncytial virus (5·4, 95% CrI 4·8-6·3 episodes per 1000 livebirths), followed by Ureaplasma spp (2·4, 1·6-3·2 episodes per 1000 livebirths). Among babies who died, causes were attributed to 46% of pSBI episodes, among which 92% were bacterial. 85 (83%) of 102 blood culture isolates were susceptible to penicillin, ampicillin, gentamicin, or a combination of these drugs. INTERPRETATION: Non-attribution of a cause in a high proportion of patients suggests that a substantial proportion of pSBI episodes might not have been due to infection. The predominance of bacterial causes among babies who died, however, indicates that appropriate prevention measures and management could substantially affect neonatal mortality. Susceptibility of bacterial isolates to first-line antibiotics emphasises the need for prudent and limited use of newer-generation antibiotics. Furthermore, the predominance of atypical bacteria we found and high incidence of respiratory syncytial virus indicated that changes in management strategies for treatment and prevention are needed. Given the burden of disease, prevention of respiratory syncytial virus would have a notable effect on the overall health system and achievement of Sustainable Development Goal. FUNDING: Bill & Melinda Gates Foundation

A fuzzy analytic hierarchy approach for ranking and prioritizing sustainability criteria and indicators of ecotourism management

Ecotourism is an approach that should be environmentally, socially and economically sustainable. For this reason, monitoring and evaluating the ecotourism destination is very important. A good practice is using an indicator system for planning and applying ecotourism models that emphasis on the sustainability approach. Ranking and prioritising of sustainability criteria and indicators facilitates evaluating the situation of the destination by managers. The purpose of this study was to prioritizing and ranking the sustainability criteria and indicators for monitoring and assessment of ecotourism management in Penang National Park, Malaysia. A Fuzzy Analytic hierarchical process (FAHP) was used for prioritizing 9 criteria and 21 indicators from four dimensions of 'ecological', 'social', 'economic' and 'institutional' which obtained from a modified Delphi survey

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used