Determinants of maternal mortality in south-western Nigeria: Midwives’ perceptions

Background Maternal mortality remains one of Nigeria's most significant public health challenges. In order to address this issue sustainably, it is necessary to consider the perceptions of all stakeholders involved, including midwives. Objectives To examine the determinants of maternal mortality in south-western Nigeria from the midwife's perspective. Design A cross-sectional study was employed using mixed methods with a semi-structured questionnaire and an in-depth interview guide. Participants Quantitative data were obtained from 215 midwives using a convenience sampling technique. Qualitative data were obtained from 25 midwives from five government health centres, selected using a stratified sampling technique. Methods Quantitative data were analysed using SPSS Version 20 using descriptive and inferential statistics with 95 % confidence intervals, while qualitative data were analysed using thematic analyses. Findings The mean age and work experience of the participants were 35.2 ± 9.3 years and 8.4 ± 7.0 years, respectively. The midwives perceived that the main determinants of maternal mortality were postpartum haemorrhage (86.5 %), hypertensive disorder in pregnancy (80.9 %), mismanagement at mission homes/traditional birth attendant centres (MH/TBAs) (79.1 %) and sepsis (70.1 %). Some of the priority target areas to improve the well-being of pregnant women as identified by the midwives, were increased awareness of pregnancy danger signs (97 %), destigmatising caesarean section (CS) (96 %), regulation of MH/TBAs (92 %), and increased accessibility of hospitals (84 %). Findings from the qualitative data also affirmed that regulating MH/TBAs, destigmatising CS and subsidising healthcare expenses were prerequisites to curbing maternal mortality. Inferential analysis revealed that determinants such as unsafe abortion (p < 0.001), ectopic pregnancy (p = 0.001), domestic violence (p = 0.023), malaria (p = 0.029), short interbirth interval (p = 0.03), and patients’ negative perceptions of CS delivery (p = 0.036) were more commonly perceived to be associated with maternal mortality by younger midwives (age 17–34 years) compared with older midwives

EVALUATION OF THE AGRONOMIC PERFORMANCE AND NUTRITIVE VALUES OF TEPHROSIA BRACTEOLATA GUILL. & PERR. AND GMELINA ARBOREA ROXB PRUNNINGS AT DIFFERENT STAGES OF GROWTH

This study was carried out to investigate the growth, dry matter yield and chemical composition of Tephrosia bracteolata and Gmelina arborea at Teaching and Research Farm, Federal University of Agriculture, Abeokuta, Nigeria. The objective of this study was to evaluate the effect of different stages of growth of T. bracteolata and G. arborea on their agronomic performance, herbage yield and nutritive value in the humid zone of Nigeria. Data were collected at 8, 12, 16 and 20 weeks after planting (WAP). Results showed that T. bracteolata attained the height of 161 cm at 20 WAP, though not significantly different from the height at 16 WAP. The leaf number (24), branch number (7) and dry matter yield of T. bracteolata were recorded highest at 16 WAP. The height of G. arborea was on constant increase throughout the experimental period. The crude protein (CP) and ether extract (EE) contents of the two browse plants were highest at 8 WAP and thereafter, declined throughout the experimental period. Fibre fractions, the neutral detergent fibre (NDF), acid detergent fibre (ADF) and acid detergent lignin (ADL) had a least value for both browse species at 8 WAP and highest values at 20 WAP. From the study, considering the dry matter yield and nutritive value, T. bracteolata being an annual species, can be harvested at 16 WAP when the quality and quantity will support livestock productivity and can be conserved to be fed to ruminant animals during dry season when feed availability and quality are extremely low. However, planting of G. arborea should be encouraged being a perennial browse plant that will support livestock productivity during the dry season in the tropics. In conclusion, T. bracteolata and G. arborea grow rapidly and are recommended as forage of high nutritive values that meet ruminant animal protein requirements especially during the dry season

Scientific complications and controversies noted in the field of CdS/CdTe thin film solar cells and the way forward for further development

Cadmium telluride-based solar cell is the most successfully commercialised thin film solar cell today. The laboratory-scale small devices have achieved ~ 22%, and commercial solar panels have reached ~ 18% conversion efficiencies. However, there are various technical complications and some notable scientific contradictions that appear in the scientific literature published since the early 1970s. This review paper discusses some of these major complications and controversies in order to focus future research on issues of material growth and characterisation, post-growth processing, device architectures and interpretation of the results. Although CdTe can be grown using more than 14 different growth techniques, successful commercialisation has been taken place using close-space sublimation and electrodeposition techniques only. The experimental results presented in this review are mainly based on electrodeposition. Historical trends of research and commercial successes have also been discussed compared to the timeline of novel breakthroughs in this field. Deeper understanding of these issues may lead to further increase in conversion efficiencies of this solar cell. Some novel ideas for further development of thin film solar cells are also discussed towards the end of this paper

APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

Quantum dynamics of molecules in 4He nano-droplets: Microscopic Superfluidity

High resolution spectroscopy of doped molecules in 4He nano-droplets and clusters gives a signature of superfluidity in microscopic system, termed as microscopic superfluidity. Ro-vibrational spectrum of 4HeN-M clusters is studied with the help of some important observations, revealed from experiments (viz., localised and orderly arrangement of 4He atoms, although, being free to move in the order of their locations; individual 4He atoms can not be tagged as normal/ superfluid, etc.) and other factors (e.g., consideration that the 4He atoms which happen to fall in the plane of rotation of a molecule, render a equipotential ring and thus, do not take part in rotation; etc.) which effect the rotational and vibrational spectrum of the system. This helps us in successfully explaining the experimental findings which state that the rotational spectrum of clusters have sharp peaks (indicating that the molecule rotates like a free rotor) and moment of inertia and vibrational frequency shift have a non-trivial dependence on N

PDXK mutations cause polyneuropathy responsive to pyridoxal 5'-phosphate supplementation.

OBJECTIVE: To identify disease-causing variants in autosomal recessive axonal polyneuropathy with optic atrophy and provide targeted replacement therapy. METHODS: We performed genome-wide sequencing, homozygosity mapping, and segregation analysis for novel disease-causing gene discovery. We used circular dichroism to show secondary structure changes and isothermal titration calorimetry to investigate the impact of variants on adenosine triphosphate (ATP) binding. Pathogenicity was further supported by enzymatic assays and mass spectroscopy on recombinant protein, patient-derived fibroblasts, plasma, and erythrocytes. Response to supplementation was measured with clinical validated rating scales, electrophysiology, and biochemical quantification. RESULTS: We identified biallelic mutations in PDXK in 5 individuals from 2 unrelated families with primary axonal polyneuropathy and optic atrophy. The natural history of this disorder suggests that untreated, affected individuals become wheelchair-bound and blind. We identified conformational rearrangement in the mutant enzyme around the ATP-binding pocket. Low PDXK ATP binding resulted in decreased erythrocyte PDXK activity and low pyridoxal 5'-phosphate (PLP) concentrations. We rescued the clinical and biochemical profile with PLP supplementation in 1 family, improvement in power, pain, and fatigue contributing to patients regaining their ability to walk independently during the first year of PLP normalization. INTERPRETATION: We show that mutations in PDXK cause autosomal recessive axonal peripheral polyneuropathy leading to disease via reduced PDXK enzymatic activity and low PLP. We show that the biochemical profile can be rescued with PLP supplementation associated with clinical improvement. As B6 is a cofactor in diverse essential biological pathways, our findings may have direct implications for neuropathies of unknown etiology characterized by reduced PLP levels. ANN NEUROL 2019;86:225-240

Surface science of soft scorpionates

The chemisorption of the soft scorpionate Li[PhTmMe] onto silver and gold surfaces is reported. Surface enhanced Raman spectroscopy in combination with the Raman analysis of suitable structural models, namely, [Cu(κ3-S,S,S-PhTmMe)(PCy3)], [Ag(κ3-S,S,S-PhTmMe)(PCy3)], [Ag(κ2-S,S-PhTmMe)(PEt3)], and [Au(κ1-S-PhTmMe)(PCy3)], are employed to identify the manner in which this potentially tridentate ligand binds to these surfaces. On colloidal silver surface-enhanced Raman spectroscopy (SERS) spectra are consistent with PhTmMe binding in a didentate fashion to the surface, holding the aryl group in close proximity to the surface. In contrast, on gold colloid, we observe that the species prefers a monodentate coordination in which the aryl group is not in close proximity to the surface