Stem Cells and Extracellular Vesicles: Biological Regulators of Physiology and Disease

This is an extraordinary time in cell biology with evolving data pushing a reconsideration of the stability of cell systems and the regulatory mechanisms underlying cell phenotypes, especially the functional cell phenotypes. In this chapter, we will explore new insights into stem cell and extracellular vesicle biology with a focus on the role of extracellular vesicles in normal stem cell physiology as well as in various disease states. Extracellular vesicles (EVs) are being recognized as influential mediators of cellular function and potential experimental therapeutic strategies for a number of disorders outlined in this review. An evolving paradigm indicates a dynamic flux of EV populations within these disease states. We conclude our discussion of EV by extending our knowledge of robust EV biology toward disease detection and prognostication. Characterizing the biophysical and functional changes of vesicles amid disease progression or regression enables investigators to merge this information flux with existing deep learning computational and statistical techniques—allowing knowledge to be abstracted from large data sets profiling the biology of EVs within various disease states. Understanding how EV population shifts represent disease regression or progression creates paramount potential for EVs as salient and clinically relevant diagnostic and prognosticating tools

Age and gender-related fat mass index and fat- free mass index patterns among adolescents in Surulere LGA, Lagos

Background: Percent body fat, fat mass and fat mass index are measures of body fat while fat free mass and fat free mass index measure lean mass. These measures of body composition vary with age and sex.Aim: To show the age-related patterns of measures of fat and lean mass in adolescent Nigerians in Lagos.Methods: Percent body fat was measured in school pupils aged 10years to 18years (377 boys and 376 girls) using Tanita ® body fat monitor (BF 666). Fat mass (FM) was derived from percentage body fat and body mass and fat free mass (FFM) was obtained by subtracting fat mass from body mass. Fat mass index (FMI) and fat free mass index (FFMI) were derived by dividing FM and FFM, respectively by the square of the height.Results: Overall percent body fat and FM were significantly higher in girls (18.9±7.5% Vs 9.5±4.5%: p < 0.001 and 9.7±6.1kg Vs 4.5±3.2kg: p < 0.001 respectively). FMI for girls ranged from 3.2 to 4.5kg/m² peaking at 16 years. At all ages, girls had higher mean FMI than boys. The mean FMI for males fell from 2.6 kg/m² at 10 years to a trough of 1.5 kg/m² at 16 years before a slight rise to 1.9 kg/ m² at 18 years. FFM in boys increased consistently with age, overtaking that of girls at 12 years with the gap widening up to 18 years. Measures of body fat were much lower in study subjects than reported from western countries even where lean mass was comparable.Conclusion: Adolescent females have higher body fat indices while males have higher lean mass indices. Indices of body fat in the current study are much lower than reported for western counterparts.Keywords: Adolescents, Fat mass, Fat mass index, Fat free mass and Fat free mass inde

Perspectives of Librarians on Quality Assurance Measures for Admission of Students in Distance Education Programme in Nigeria

The quality assurance measures for admission of students into Distance Education (DE) programs in Nigeria were evaluated in this study. The study employed a descriptive survey design, with a total population of Librarians and learners in distance learning centers in Southeast in Nigeria, of which 206 librarians were used in the study. The librarians and learners were chosen using a multi-stage sampling technique. The data gathering instrument was a questionnaire. Three professionals independently validated the instrument. The questionnaire\u27s reliability index was 0.97. The data was analyzed using the mean, standard deviation, and analysis of variance. The findings revealed that quality is highly assured for students admitted to DE programs (X = 2.87, SD = 0.49). In South East Nigeria, significant variations in the mean assessments of students and librarians on how quality is ensured in the admission of students to DE programs were discovered. It was suggested that prospective students be provided greater opportunities to enroll in distant education programs in order to minimize illiteracy among the population

Natural Gas Flaring in Nigeria, its Effects and Potential Alternatives – A Review

Nigeria is a country blessed with vast oil and natural gas resources, due to inadequate management of resources most of the natural gas is flared. One of the most pressing challenges today is global warming. Gas flaring has been known to deliver carbon dioxide and other ozone depleting substances which cause unnatural weather change. This paper focuses on gas flaring; its definition, composition, types and classifications. It also highlights the policies that have been made in Nigeria concerning gas flaring and provides alternative solutions to gas flaring

Impacts of heavy duty truck emissions on the vertical distributions of soil polycyclic aromatic hydrocarbons at a big haulage vehicle park

Nigeria relies heavily on heavy duty haulage vehicles to convey commodities from one end of the nation to the other, owing to the decades-long collapse of the rail transportation infrastructure. This is resulting in settings with very high concentrations of the trucks on the country’s key roads. Diesel engine exhausts have long been recognized to be detrimental to human health. The concentrations of polycyclic aromatic hydrocarbons (PAHs) in the top and bottom soil samples from an extensive haulage vehicle stop located at Ogere, a roadside town along the ever busy Lagos-Ibadan highway were investigated. Soil samples taken at depths of 0–15 cm and 15–30 cm were subjected gas-chromatographic/mass spectrometer analysis. The Ʃ priority PAHs in the top and bottom soils at four sampling locations ranged between 16.4 and 32.0 mg/kg and 18.6–26.6 mg/kg respectively. The corresponding Ʃ carcinogenic PAHs for top and bottom soils ranged between 9.2 and 17.4 mg/kg and 8.7–12.0 mg/kg respectively. The concentrations of PAHs obtained in this study clearly exceeded the permissible limits set for soil PAHs in most developed nations of the world. The diagnostic ratio attributed the observed PAHs to diesel emissions. The study concluded that the emissions from the trucks at the haulage vehicle stop have tremendous impact on the soil PAH concentrations

Closing the Revolving Door: Enhanced Orientation and Mentoring of New Nurses to Decrease Turnover in Long Term Care

Background: New nurse turnover is a global issue and in the United States the cost to onboard a bedside registered nurse averages $40,038.This money is lost if the nurse decides to leave the job. Losses attributed to nurse turnover can cost a hospital$3.6 million to $6.5 million annually, and the problem is getting worse. Many studies have found that mentorship is effective in new nurse retention. Objectives: To implement mentorship and preceptorship at a long-term care facility to see if it will improve the high turnover of new nurses there. Methods: The project is a quality improvement (QI) project, pre- and post-survey design, that followed the “Plan-Do-Study-Act” (PDSA) framework. The Intention to stay or leave survey measured the intention to stay or leave their position at the beginning and end of the mentorship program. The intervention was a 3-month designed preceptorship/mentorship program. Result: Positive results were noted, showing that close mentoring, support, and guidance helped retain new nurses. For the question on intent to stay for 12 months there were 2 agree or strongly agree pre-intervention and 4 agree or strongly agree post-intervention showing improvement in the primary concern, similar positive results were found in the other 6 questions as well. Conclusion: Structured preceptorship/mentorship for at least three months is beneficial to retaining new nurses. It is imperative for healthcare facilities to push the idea of providing the support and guidance needed for new nurses to feel valued, appreciated, and confident in their skills

The potential cost and benefits of raltegravir in simplified second-line therapy among HIV Infected Patients in Nigeria and South Africa

BACKGROUND: There is an urgent need to improve the evidence base for provision of second-line antiretroviral therapy (ART) following first-line virological failure. This is particularly the case in Sub-Saharan Africa where 70% of all people living with HIV/AIDS (PHA) reside. The aim of this study was to simulate the potential risks and benefits of treatment simplification in second-line therapy compared to the current standard of care (SOC) in a lower-middle income and an upper-middle income country in Sub-Saharan Africa. METHODS: We developed a microsimulation model to compare outcomes associated with reducing treatment discontinuations between current SOC for second-line therapy in South Africa and Nigeria and an alternative regimen: ritonavir-boosted lopinavir (LPV/r) combined with raltegravir (RAL). We used published studies and collaborating sites to estimate efficacy, adverse effect and cost. Model outcomes were reported as incremental cost effectiveness ratios (ICERs) in 2011 USD per quality adjusted life year ($/QALY) gained. RESULTS: Reducing treatment discontinuations with LPV/r+RAL resulted in an additional 0.4 discounted QALYs and increased the undiscounted life expectancy by 0.8 years per person compared to the current SOC. The average incremental cost was$6,525 per treated patient in Nigeria and $4,409 per treated patient in South Africa. The cost-effectiveness ratios were$16,302/QALY gained and $11,085/QALY gained for Nigeria and South Africa, respectively. Our results were sensitive to the probability of ART discontinuation and the unit cost for RAL. CONCLUSIONS: The combination of raltegravir and ritonavir-boosted lopinavir was projected to be cost-effective in South Africa. However, at its current price, it is unlikely to be cost-effective in Nigeria.Karen Schneider, Chidi Nwizu, Richard Kaplan, Jonathan Anderson, David P. Wilson, Sean Emery, David A. Cooper, Mark A. Boy

Antiretroviral resistance after first-line antiretroviral therapy failure in diverse HIV-1 subtypes in the SECOND-LINE study

We investigate mutations and correlates according to HIV-1 subtype after virological failure (VF) of standard first-line antiretroviral therapy (ART) (non-nucleoside/nucleotide reverse transcriptase inhibitor [NNRTI] +2 nucleoside/nucleotide reverse transcriptase inhibitor [N(t)RTI]). SECOND-LINE study participants were assessed at baseline for HIV-1 subtype, demographics, HIV-1 history, ART exposure, viral load (VL), CD4(+) count, and genotypic ART resistance. We used backward stepwise multivariate regression (MVR) to assess associations between baseline variables and presence of ≥3 N(t)RTI mutations, ≥1 NNRTI mutation, ≥3 thymidine analog-N(t)RTI [ta-N(t)RTI] mutations (TAMs), the K65/K70 mutation, and predicted etravirine (ETV)/rilpivirine (RPV) activity. The inclusion p-value for MVR was p  .05. Of 541 participants, 491 (91%) had successfully characterized baseline viral isolates. Subtype distribution: B (n = 123, 25%), C (n = 202, 41%), CRF01_AE (n = 109, 22%), G (n = 25, 5%), and CRF02_AG (n = 27, 5%). Baseline CD4(+) 200-394 cells/mm(3) were associated with <3 N(t)RTI mutations (OR = 0.47; 95% CI 0.29-0.77; p = .003), absence of the K65/K70 mutation (OR = 0.43; 95% CI 0.26-0.73; p = .002), and higher ETV sensitivity (OR = 0.52; 95% CI 0.35-0.78; p = .002). Recent tenofovir (TDF) use was associated with K65/K70 mutations (OR = 8.91; 95% CI 5.00-15.85; p < .001). Subtype CRF01_AE was associated with ≥3 N(t)RTI mutations (OR = 2.34; 95% CI 1.31-4.17; p = .004) and higher RPV resistance (OR = 2.13; 95% CI 1.30-3.49; p = .003), and subtype C was associated with <3 TAMs (OR = 0.45; 95% CI 0.21-0.99; p = .015). Subtypes CRF01_AE (OR = 2.46; 95% CI 1.26-4.78; p = .008) and G (OR = 4.77; 95% CI 1.44-15.76; p = .01) were associated with K65/K70 mutations. Higher VL at confirmed first-line VF was associated with ≥3 N(t)RTI mutations (OR = 1.39; 95% CI 1.07-1.78; p = .013) and ≥3 TAMs (OR = 1.62; 95% CI 1.15-2.29; p = .006). The associations of first-line resistance mutations across the HIV-1 subtypes in this study are consistent with knowledge derived from subtype B, with some exceptions. Patterns of resistance after failure of a first-line ta-N(t)RTI regimen support using TDF in N(t)RTI-containing second-line regimens, or using N(t)RTI-sparing regimens.Edward P. Lam, Cecilia L. Moore, Eduardo Gotuzzo, Chidi Nwizu, Adeeba Kamarulzaman, Ploenchan Chetchotisakd, Jean van Wyk, Hedy Teppler, Nagalingeswaran Kumarasamy, Jean-Michel Molina, Sean Emery, David A. Cooper, and Mark A. Boyd, for the SECOND-LINE study grou