Pattern and determinants of blood transfusion in a Nigerian neonatal unit

Objective: To determine the pattern and determinants of blood transfusion in a Nigerian neonatal unit.Materials and Methods: Newborn babies who required blood transfusions between January and December, 2008, were studied. The sex, age, and weight at the first transfusion, clinical conditions, indications for transfusion, and the outcome were analyzed with bivariate and multivariate methods.Results: A total of 402 neonates were hospitalized and 112 (27.9%) had blood transfusion; 61.9% had exchange transfusion, 66.1% had red cell transfusion, and 8% had plasma transfusion. There were 251 transfusions with a rate of 4.8 transfusions per week. Blood transfusions were done for severe jaundice (55.4%), severe anemia (40.2%), and bleeding disorders (4.4%). Weight < 2.5 kg, outside delivery, and jaundice were independent determinants of neonatal transfusion.Conclusion: The blood transfusion rate in this facility was remarkably high. Improved standard of newborn care and infrastructural support are required to reduce the transfusion rate

The Influence of Method, Timing of Onset and Duration of Enteral Feeding on the Duration of Hospitalization of Newborn Infants in a Nigerian Special Care Baby Unit

Background: Feeding practices among high‑risk newborn babies have not been extensively studied in the resource‑constrained parts of the world. Aim: To describe the pattern of milk use among infants in a resource‑poor special care baby unit (SCBU) and relate these to the outcome of hospitalization. Subjects and Methods: Setting – SCBU of Olabisi Onabanjo University Teaching Hospital, Sagamu. Design – Prospective study of consecutively admitted inborn babies within the first 24 h of life. The data analyzed included the weight and estimated gestational age (EGA) of the babies, the age at the onset of and duration of feeds (breast milk and artificial milk [AM]). Results: Out of the 118 infants studied, (78.8%) 93/118 received breast milk and 16.1% (19/118) received AM. The mean age at the commencement of enteral feeding was 3.9 days. The age at the onset of suckling was negatively correlated with the EGA and body weight. The age at the onset and duration of enteral feeding were directly related to the duration of admission. Conclusion: More than three‑quarter of the infants hospitalized in the unit received breast milk, but commencement was mostly delayed beyond the 3rd day of life. The duration of admission may be related to the timing of onset and duration of milk use.Keywords: Artificial milk, Breastfeeding, Breast milk, Intravenous fluid therapy, Newborn feeding, Resource‑poor settin

Pattern and determinants of newborn apnea in an under-resourced Nigerian setting

Objective: To determine the prevalence, distribution and determinants of newborn apnea in a resource-constrained setting.Design: Retrospective study.Materials and Methods: Newborn babies who had apnea during hospitalization between January and December 2008 were studied. The sex, age and body weight, clinical conditions, etiologies of apnea and outcome were recorded. Babies with and without apnea were compared using bivariate and multivariable analysis.Results: Out of 402 babies seen during the review, 78 (19.4%) had apnea. They comprised 59 preterm and 19 term babies. Forty (51.3%) had apnea at the point of admission while the remaining 38 (48.7) developed apnea after a mean interval of 118.5 ± 101.1 hours. Thirty-seven percent of preterms had idiopathic apnea. Etiologies included respiratory distress (50.0%), hypothermia (42.3%), and asphyxia (28.2%). Multivariate analysis showed that weight <2.5kg, hypothermia, referred status and presence of respiratory distress were determinants of apnea. Case fatality rate was 82.2% among apneic babies.Conclusion: Apnea occurred commonly in this population of babies. Stringent efforts like ventilator supports for babies in respiratory distress, better perinatal care including thermoregulation are required to reduce the occurrence of the major risk factors for newborn apnea. The identified determinants can be used to draw up effective preventive measures in resource-poor settings

Reducing the incidence of by-catch through fishing gear modification

There have been considerable efforts in recent time to modify fishing gears and practices to target particular sizes and species of fish (fin and shell) and other marine organisms more efficiently. These efforts are coming on the heels of the negative- impact they tend to have on the population of organisms in the aquatic ecosystem. By-catch consideration and gear modification play an important role in the regulation of several consideration and gear modification play an important role in regulation of several major fisheries now by catch reduction devices and other innovative gear modification are continuously being proposed and tested to mitigate against these problems among which are the turtle excluder device (TEDS) in the shrimp trawls to reduce mortality of endangered sea turtle, sorting grids and scaring device in long fisheries. Recommendation are made on effective monitoring of fishing gear to ensure that devices aimed at reducing by-catch are included and fishermen use only the appropriate gears to limit by-catch and discards

Socio-clinical correlates of the perinatal outcome of severe perinatal asphyxia among referred newborn babies in Sagamu

Background: Most deliveries in the developing world take place outside the hospital with poor assistance for the newborn. This puts the babies at  risk of severe intrapartum events such as perinatal asphyxia. Most newborn babies admitted in tertiary centres with severe asphyxia are referred.Objectives: To determine the socio-demographic and clinical correlates of the perinatal outcome of neonates referred to a Nigerian tertiary facility on account of severe perinatal asphyxia.Methods: A prospective crosssectional study was conducted at the Children’s Emergency Room and Neonatal Ward among newborn babies referred with severe asphyxia. Socio-demographic and clinical parameters were recorded and statistically analysed.Results: A total of 72 mother infant pairs were studied. Half of the babies were admitted after 24 hours of birth and 75.0% of the families belonged to the lower socio-economic classes. Only 62.5% of mothers received antenatal care at orthodox health facilities. Most of the deliveries tookplace at private hospitals (29; 40.3%) and Traditional Birth Homes (18; 25.0%). Hypoxic- Ischaemic encephalopathy (HIE) was diagnosed among 57 (79.2%) babies with 46 (80.7%) and 11 (19.3%) classified as Stages II and III HIE respectively. There were 15 (20.8%) early neonatal deaths giving a perinatal mortality rate of 208.3/1000 admissions. The poor perinatal outcome was associated with age at admission within 24 hours, poor intrapartum careseeking behaviour and the commencement of feeding before admission .Conclusion: The quality of antenatal care, intrapartum care, and delivery services appear to influence perinatal outcomes among referred babies with severe asphyxia. Keywords: Asphyxia, Hypoxic-Ischaemic Encephalopathy, Intrapartum care, Perinatal mortality, Out-bor

A Transformer-based Framework For Multi-variate Time Series: A Remaining Useful Life Prediction Use Case

In recent times, Large Language Models (LLMs) have captured a global spotlight and revolutionized the field of Natural Language Processing. One of the factors attributed to the effectiveness of LLMs is the model architecture used for training, transformers. Transformer models excel at capturing contextual features in sequential data since time series data are sequential, transformer models can be leveraged for more efficient time series data prediction. The field of prognostics is vital to system health management and proper maintenance planning. A reliable estimation of the remaining useful life (RUL) of machines holds the potential for substantial cost savings. This includes avoiding abrupt machine failures, maximizing equipment usage, and serving as a decision support system (DSS). This work proposed an encoder-transformer architecture-based framework for multivariate time series prediction for a prognostics use case. We validated the effectiveness of the proposed framework on all four sets of the C-MAPPS benchmark dataset for the remaining useful life prediction task. To effectively transfer the knowledge and application of transformers from the natural language domain to time series, three model-specific experiments were conducted. Also, to enable the model awareness of the initial stages of the machine life and its degradation path, a novel expanding window method was proposed for the first time in this work, it was compared with the sliding window method, and it led to a large improvement in the performance of the encoder transformer model. Finally, the performance of the proposed encoder-transformer model was evaluated on the test dataset and compared with the results from 13 other state-of-the-art (SOTA) models in the literature and it outperformed them all with an average performance increase of 137.65% over the next best model across all the datasets

Challenges to effective fishing and preferred fishing gear in a hydrodynamic freshwater system

Challenges to fishing and preferred gear of multiple used Lake, whose water depth is controlled by opening of its dam gate were investigated. Geographic survey, interview and focused group discussion of fishermen were used to assess factors influencing effectiveness of fishing and the preferred gear of Asejire Lake. Water usage (s) such as frequency of Complete and Partial Opening of Dams Gate (CODG and PODG) were investigated as indices for hydrodynamic condition. Response during focused group discussion with about 33% of fishermen of the Lake were obtained on sources of disturbance to effective fishing (SDEF), most effective gear (MEG)- least environmentally perturbed gear, comparability of catch structure of preferred gear to conventional gear and sustainability of superiority of preferred gears in situations outside hydrodynamic condition (SSPPG). The PODG occurred 1-7times/Month-dry season, 15-18times/Month-wet season; CODG occurred 1-2times/Month in both season; Interval of CODG was 3-17 and 5-12days (dry and wet season). It affected set-net and catch. The SDEF were gear availability, weather condition, dam’s gate opening, religion activities and Health of fisher-folks. 50% respondents accepted opening of dams gate as most important disturbance while religion was least (5% respondents accepted). 60% respondents accepted traps as MEG being the least affected while 75% respondents accepted Gura cage trap as the MEG among traps.90% respondents accepted that among traps, its catch structure was closest (comparable) to conventional gear. However, 75% respondents rejected SSPPG. Opening of dams’ gate creates hydrodynamic condition and it affects fishing. Gura trap was preferred for fishing hydrodynamic condition

Levels of selected heavy metals in garden soil in Walmer Township and Wells Estate, Port Elizabeth

Heavy metals are naturally occurring elements that have high densities. Heavy metals have been found to have applications in various sectors such as the industrial, domestic, agricultural and medical sectors, thus resulting in environmental pollution which may pose a hazard to human health. Heavy metals such as arsenic, cadmium, manganese, lead and mercury rank among the priority metals that are of public health significance, and they are commonly found in garden soils. In this study, residential garden soils were sampled in dwelling sites in Wells Estate and Walmer Township, and analysed for mercury, cadmium, arsenic, manganese and lead. A cross sectional design was employed in this study. The research was carried out in two phases; the first phase involved soil sample collection, preparation and laboratory work for the determination of heavy metal concentrations. The second phase focused on the social aspect of the study population which included the use of a pre-approved questionnaire and face-to-face interviews for the collection of human health related information at each dwelling site where soil samples were collected. The research protocol was approved by the Health Sciences Faculty Postgraduate Studies Committees (FPGSC) of Nelson Mandela University. Garden soil from residential yards of Wells Estate (near an industrial site, ̴ 2 km) and Walmer Township (further away from the industrial site (̴ 22 km), but relatively close to Port Elizabeth airport, ̴ 2 km) were sampled over a total of six sampling sessions resulting in 100 soil samples. Fifty soil samples were collected in Wells Estate and fifty soil samples in Walmer Township during the month of May 2017. Surface soil samples were collected from the top 2 cm of the soil using a sterile stainless-steel spoon. In addition to the collection of soil samples, a visual inspection of the house was undertaken to collect information about the house characteristics, geographic location (GPS coordinates) and characteristics of the surrounding area. Soil samples were prepared for analysis by grinding and drying followed by heavy metal determination using an X-ray fluorescence (XRF) analyser (Bruker s1 TITAN Analyser, USA). A face-to-face questionnaire was administered to a suitable respondent at each dwelling site to obtain information related to health symptoms such as coughing, fever, chest pains, earache, sore throat, headaches, rapid breathing, sneezing, running/blocked nose, teary watery eyes, cancer, hypertension, heart diseases and mental illness. The mean concentrations of heavy metals were in the order manganese>lead>arsenic for both study sites. In Walmer Township soil samples, the mean concentrations of heavy metals determined were 154.8 mg/kg, 84.4 mg/kg and 5.4 mg/kg for manganese, lead, and arsenic, respectively. Mean concentrations of heavy metals as determined in Wells Estate were 322.2 mg/kg, 11.5 mg/kg, and 3.4 mg/kg for manganese, lead and arsenic, respectively. Manganese concentration across the study sites are below the guideline levels for USA (630 mg/kg) and South African (1500 mg/kg). About 2.0% of the sample exceeded the South African lead guideline level of 230 mg/kg, while 4.1% exceeded European lead level of 400 mg/kg in Walmer Township. Lead levels in Wells Estate were all below the South African, European and United States guideline levels. By contrast, 2.0% of the sample exceeded the South African arsenic guideline level of 48 mg/kg, 2.0% exceeded European arsenic guideline level of 50 mg/kg and 2.0% exceeded USA arsenic guideline level of 11 mg/kg in Walmer Township, while 2.0% exceeded USA arsenic guideline level of 11 mg/kg in Wells Estate. Mann Whitney U test showed statistically significant differences between lead levels (U=1527, p < 0.001) and manganese levels (U=2632, p < 0.001) across study sites. Soil manganese level showed significant association with age of house (crude OR: 0.34, 95% CI: 0.14-0.83, p =0.016). Using data obtained from the questionnaire, a multivariate logistic regression analysis was performed to examine the relationship between soil heavy metals and the various health outcomes. In Walmer Township, manganese showed association with dry cough (OR: 11.35, 95% CI: 1.08-119.20) and sneezing (OR: 11.30, 95% CI: 1.09-116.67). Manganese was also associated with wet cough (OR: 0.19 95% CI: 0.05-0.70), dry cough (OR: 0.22, 95% CI: 0.06-0.83) and watery eye (OR: 4.55, 95% CI: 1.01-20.58) in Wells Estate. Dry cough (OR: 0.31, 95% CI: 0.16-0.64), sneezing (OR: 2.18, 95% CI: 1.06-4.48) and watery eye adjusted (OR: 3.71, 95% CI: 1.63-8.48) were also associated with manganese in the total sample. Confounding factors such as overcrowding (adjusted OR = 2.23; 95% CI: 1.11-4.48) and air pollution (adjusted OR = 2.76; 95% CI:1.39-5.50), predicted wet cough and sneezing, respectively, across the total sample. Heavy metal concentration in most of the study dwellings of Walmer Township and Wells Estate were below the safe limit recommended by United States, European and South Africa soil reference levels. Nevertheless, we found a strong association between manganese and respiratory symptoms such as dry cough and sneezing in Walmer Township, as well as a strong association between manganese and watery eyes in Wells Estate. There was no evidence of associations between heavy metal exposure and gastrointestinal symptoms, chronic diseases and mental illness

Home-based hand hygiene practices of mothers in relation to infections in their infants

Background: Infections are the leading causes of death in children. Most of these infections are transmitted through the hands of mothers, carers and health workers.Objective: To determine the pattern of home-based hand hygiene practices among mothers of young infants attending a tertiary facility clinic in relation to infections in their infants.Methods: A cross-sectional study of mothers of infants attending an immunization clinic was conducted using a self-designed, pretested questionnaire.Results: The mean age of the 203 mothers was 30.3 ±3.8 years. The majority of the mothers received counselling about hand washing as part of antenatal care (79.8%), had access to water at home (94.0%) and always washed hands with water and soap (48.3%). Although 149 (73.4%) knew&nbsp; hand sanitizers, only 28 (13.8%) used it. Close to half of their infants (46.3%) had various infections (diarrhoea, acute respiratory infections, and boils) within a month of the interview. Only counselling was associated with good quality hand washing practices (p&lt;0.0001) while the age of child less than 6 months and good quality of hand washing were associated with the absence of infections in the infants (p = 0.029 and p&lt;0.0001 respectively).Conclusion: Half of the cohort of mothers practiced good quality hand washing but with poor use of hand sanitizers. With various infections recorded in close to half of their infants, it is important to emphasise better hand washing techniques and improve access to alcohol-based hand sanitizers. Key words: Alcohol-based Hand sanitizers, Hand hygiene, Hand washing, Infants, Infections, Sagamu

Reducing by-catch through fishing gear modification

There have been considerable efforts in recent years to modify fishing gears and practices to target particular sizes and species of fish (fin and shell) and other marine organisms more efficiently. By catch consideration and gear modification play an important role in regulation of several major fisheries and new by-catch reduction devices and other innovative gear modification are continuously being proposed and tested to mitigate against these problems, among which are the turtle excluder device (T.E.DS) in the shrimp trawls to reduce mortality of endangered sea turtle; sorting grids and scaring device in long line fisheries. This paper assesses the incidence of by catch in fisheries, provides a review of successful developments and application of selective fishing techniques that have been used to achieve by-catch reduction. Recommendations were also made on effective monitoring of fishing gears to ensure that devices aimed at reducing by-catch are included and fishermen use only the appropriate gears to limit by-catch and discards