Patterns of Antenatal Care Seeking Behavior in South East Nigeria: Exploring Relationship with Age, Education, and Socioeconomic Status

Background: Maternal and infant morbidity and mortality are major public health problems in Nigeria. Although it is well-known that appropriate antenatal care (ANC) is important in reducing maternal morbidity and mortality, there is limited information on inequities on ANC seeking pattern among the pregnant women in Nigeria. Aim: The study was designed to explore inequities due to age, education, and socioeconomic status (SES) of women of childbearing age in seeking ANC services in Nigeria. Subjects and Methods: A household survey was conducted in 10 randomly selected villages in Nnewi, Anambra State, South-East Nigeria. An interviewer-administered questionnaire was used to collect relevant data from 420 women of childbearing age from the villages. The effects of age, education, SES, and ANC seeking behavior were analyzed. Results: It was found that 61.4% (254/420) of the respondents attended ANC clinic at least 6times. Although most of the respondents sought ANC in formal health, a greater percentage utilized private hospitals/clinics more than public health facilities. Age (P < 0.01), educational level (P < 0.001), and SES (P < 0.01) had statistically significant effects on respondents’ antenatal clinic attendance and choice of facilities. The highest SES group was more likely to utilize teaching hospitals and private clinics than other SES groups. Conclusions: There were inequities due to SES, educational level, and age of respondents in the pattern of ANC seeking behavior. These inequities could negate the achievement of millennium development goals (MDGs). Interventions that would address the inequities should be developed and implemented if the health-related MDGs are to be achieved.KEY WORDS: Antenatal care, health seeking behavior, inequities, Nigeria, women of childbearing ag

Acidosis Activation of the Proton-Sensing GPR4 Receptor Stimulates Vascular Endothelial Cell Inflammatory Responses Revealed by Transcriptome Analysis

Acidic tissue microenvironment commonly exists in inflammatory diseases, tumors, ischemic organs, sickle cell disease, and many other pathological conditions due to hypoxia, glycolytic cell metabolism and deficient blood perfusion. However, the molecular mechanisms by which cells sense and respond to the acidic microenvironment are not well understood. GPR4 is a proton-sensing receptor expressed in endothelial cells and other cell types. The receptor is fully activated by acidic extracellular pH but exhibits lesser activity at the physiological pH 7.4 and minimal activity at more alkaline pH. To delineate the function and signaling pathways of GPR4 activation by acidosis in endothelial cells, we compared the global gene expression of the acidosis response in primary human umbilical vein endothelial cells (HUVEC) with varying level of GPR4. The results demonstrated that acidosis activation of GPR4 in HUVEC substantially increased the expression of a number of inflammatory genes such as chemokines, cytokines, adhesion molecules, NF-κB pathway genes, and prostaglandin-endoperoxidase synthase 2 (PTGS2 or COX-2) and stress response genes such as ATF3 and DDIT3 (CHOP). Similar GPR4-mediated acidosis induction of the inflammatory genes was also noted in other types of endothelial cells including human lung microvascular endothelial cells and pulmonary artery endothelial cells. Further analyses indicated that the NF-κB pathway was important for the acidosis/GPR4-induced inflammatory gene expression. Moreover, acidosis activation of GPR4 increased the adhesion of HUVEC to U937 monocytic cells under a flow condition. Importantly, treatment with a recently identified GPR4 antagonist significantly reduced the acidosis/GPR4-mediated endothelial cell inflammatory response. Taken together, these results show that activation of GPR4 by acidosis stimulates the expression of a wide range of inflammatory genes in endothelial cells. Such inflammatory response can be suppressed by GPR4 small molecule inhibitors and hold potential therapeutic value

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17 : analysis for the Global Burden of Disease Study 2017

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health

Optimization of Process Conditions (Blanching Time and Temperature) on the Beta Carotene Content of Diced Orange Flesh Sweet Potato

Optimization of process condition (blanching and drying) on the beta-carotene content of orange fleshed sweet potato (mother delight) using response surface methodology was studied. Sweet potatoes were washed, peeled, diced, blanched, and dried at various temperature ranges. Nutritional composition of the fresh and dried samples was determined using standard methods. A three-factor central composite rotatable design (CCRD) was used to study the effects of blanching time (X1), blanching temperature (X2), and drying temperature (X3) on the beta-carotene content of the orange fresh sweet potato. Fourteen experimental combinations were produced with six replicates at the center point to generate twenty (20) runs. The sweet potato was blanched at a temperature range of 60-900C for 3-5 minutes and dried at a temperature ranging between 70-800C. the result showed that the beta-carotene content of fresh sweet potatoes was 8403µg and dried ones ranged from 4401µg to 2826µg. Sweetpotato processed for 3mins (blanching time), at 900C (blanching temperature) and 700C (drying temperature) produced the maximum beta carotene. The experimental data was fitted to a second-order polynomial equation using multiple regression analysis and the quadratic model was highly significant (p<0.05)

Occurrence of two rare species from order lampriformes: Crestfish lophotus lacepede (Giorna, 1809) and scalloped ribbonfish zu cristatus (Bonelli, 1819) in the northern coast of sicily, Italy

The bony fish Lophotus lacepede (Giorna, 1809) and Zu cristatus (Bonelli, 1819) are the two species rarely recorded within the Mediterranean basin, usually reported as accidentally captured in depth (mesopelagic) fishing operations. In the current work, we present the first record of L. lacepede and Z. cristatus in fishing catches from southwestern Tyrrhenian Sea. Moreover, in order to improve existent biological/ecological knowledge, some bio-related aspects such as feeding aspect, sexual maturity and age estimate have been discussed

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease