The association between a detectable HIV viral load and non-communicable diseases comorbidity in HIV positive adults on antiretroviral therapy in Western Cape, South Africa.

BACKGROUND: Past studies have found a relationship between detectable HIV viral load and non-communicable diseases (NCDs) in HIV-infected individuals on antiretroviral therapy in high-income settings, however there is little research in South Africa. Our objective was to investigate the association between detectable HIV viral load and prevalent NCDs in a primary health centre in peri-urban South Africa. METHODS: HIV-infected adults (aged ≥25) who had been on antiretroviral therapy for ≥ six months and attended the HIV clinic within a primary health centre in Khayelitsha, Cape Town, were recruited. We recorded participants' demographics, HIV characteristics, the presence of NCDs via self-report, from clinic folders and from measurement of their blood pressure on the day of interview. We used logistic regression to estimate the association between a detectable HIV viral load and NCD comorbidity. RESULTS: We recruited 330 adults. We found no association between a detectable HIV viral load and NCD comorbidity. Within our multivariable model, female gender (OR3·26; p = 0·02) age > 35 (OR 0·40; p = 0·02) low CD4 count (compared to CD4 < 300 (reference category): CD4:300-449 OR 0·28; CD4:450-599 OR 0·12, CD4:≥600 OR 0·12; p = < 0·001), and ever smoking (OR 3·95; p = < 0·001) were associated with a detectable HIV viral load. We found a lower prevalence of non-communicable disease in clinic folders than was self-reported. Furthermore the prevalence of hypertension measured on the day of interview was greater than that reported on self-report or in the clinic folders. CONCLUSIONS: The lack of association between detectable viral load and NCDs in this setting is consistent with previous investigation in South Africa but differs from studies in high-income countries. Lower NCD prevalence in clinic records than self-report and a higher level of hypertension on the day than self-reported or recorded in clinic folders suggest under-diagnosis of NCDs in this population. This potential under-detection of NCDs may differ from a high-income setting and have contributed to our finding of a null association. Our findings also highlight the importance of the integration of HIV and primary care systems to facilitate routine monitoring for non-communicable diseases in HIV-infected patients

Effect of Celluclast 1.5L on the Physicochemical Characterization of Gold Kiwifruit Pectin

The effects of Celluclast 1.5L concentration on the physicochemical characterization of gold kiwifruit pectin was evaluated. Varying the enzyme concentration affected the pectin yield and pectin physicochemical properties. The viscosity of extracted pectin was largely dependent on the enzyme concentration. Celluclast 1.5L with medium concentration exhibited the highest viscosity. Varying the enzyme concentration also influenced the molecular weight distribution. High molecular weight (Mw) pectin (1.65 × 106 g/mol) was obtained when the medium concentration was used. Overall, the study clearly reflects the importance of taking into consideration the amount of cellulytic enzyme added in order to determine the final quality of pectin

EFFECTS OF FEED RESTRICTION AND REALIMENTATION ON PERFORMANCE AND NITROGEN UTILISATION IN GROWING WEST AFRICAN DWARF RAMS

The effects of feed restriction on the performance of growing West African Dwarf sheep were determined in twenty four (24) growing West African dwarf (WAD) rams with average weight of 8.9 ± 0.59kg. The twenty-four WAD rams were allotted to three treatments of eight rams per treatment and balanced for weight in a Completely Randomized Design. Animals in group C which represents the control were fed with dried Panicum maximum ad libitum and concentrate supplement while group two (R1) and group three (R2) were fed with P. maximum without concentrate supplementation for one and two months, respectively. Thereafter, two months of realimentation followed the restriction. Data were taken on the feed intake, weight gain and digestibility. Results obtained on average daily gain showed significant difference (P &lt; 0.05) whereby sheep on R2 group recorded the lowest value (50.7g/day) during restriction. Digestible organic matter intake (g/Kg 0.75 d-1) for sheep on the C group was significantly (P &lt; 0.05) higher than R1 group, but not significantly (P &gt; 0.05) different from R2 group. The Crude protein intake was highest in the control (49.9g/day). Rumen amino acid of the control animals (4.1) was significantly (P &lt; 0.05) higher than R1 (2.1) and R2 (3.5) groups. Nitrogen intake (g/day) was significant and higher in the C group (8.0) compared to the two restricted groups R1 and R2. During realimentation period, average daily weight gain (g/day) was highest (P &lt; 0.05) for animals in the control (57.5) and least in R2 (34.5). The feed conversion ratio ranged from 8.3 (C) to 14.3 (R2) while the total weight gain (kg) ranged from 2.1 (R2) to 3.5 (C). Similarly, the CP intake (g/day) was higher in the control group compared to those in R1 and R2 groups. However, the dietary amino acid recorded in R2 differ significantly (P &lt; 0.05) from R1 and C groups. During the realimentation period, nitrogen intake for rams in R1 (8.8g/day) and R2 (10.1g/day) groups doubled the values obtained during the restriction period. It was concluded that rams should be restricted for one month because they gained more weight than those restricted for two months.Â

ELECTRONIC GOVERNANCE AND PUBLIC SERVICE DELIVERY IN NIGERIA: A REVIEW OF LITERATURE AND SUGGESTIONS FOR FURTHER STUDIES

The paper provided a detailed review of the literature and theoretical framework on egovernance and Public Service Delivery. The paper relied solely on secondary sources for its data from google scholar search engine. The study adopted thematic analysis from various relevant literatures. The findings from the data collected show the indispensable role of egovernance adoption in ensuring appreciable public service delivery. Based on the findings, recommendations were made. The paper concluded that e-governance creates an enabling environment for the effective delivery of public services

Geochemical Appraisal of Termite-Reworked Clay Soils from Basement Complex Terrain: Implications as Landfill Liners

The geochemical and mineralogical assessment was prompted by the considerable presence of Termitaria overburden on the Basement Complex outcrops in southwest Nigeria with the goal of determining their suitability as landfill liners. The X-Ray Fluorescene (XRF) and X-Ray Diffraction techniques were used to examine ten soil samples. Major oxides and mineralogical values were analysed to determine the effectiveness of soil engineering. Weathering indices and silica/sesquioxide ratios were also measured. The results of the mineralogical investigation showed that kaolinite clay mineral predominated, which is indicative of non-swelling qualities. The outcomes demonstrated that the soil is a true laterite as well as a lateritic soil. Fair carrying capacity was shown by the stability and shear resistance values of 47.15% and 48.11%, respectively. The weathering indices show severe weathering, high clay fraction, strong plasticity, and low hydraulic conductivity with an average of 95% and 0.59 weight percent, respectively. Additionally, the repackaging of the clay soils by termite activity produced greater interlocking and water film resistance. These characteristics make soils an excellent material for landfill liners due to their improved density and bearing capacity, resilience to chemical attack, and reconstructed structure. Keywords: Landfill liners. Termitaria, Kaolinite, Mineralogy and Geochemical Properties DOI: 10.7176/JEES/13-8-03 Publication date:October 31st 202

The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis

Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) and CVD mortality. However, the relationship between ED and subclinical CVD is less clear. We synthesized the available data on the association of ED and measures of subclinical CVD. We searched multiple databases for published literature on studies examining the association of ED and measures of subclinical CVD across four domains: endothelial dysfunction measured by flow-mediated dilation (FMD), carotid intima–media thickness (cIMT), coronary artery calcification (CAC), and other measures of vascular function such as the ankle–brachial index, toe–brachial index, and pulse wave velocity. We conducted random effects meta-analysis and meta-regression on studies that examined an ED relationship with FMD (15 studies; 2025 participants) and cIMT (12 studies; 1264 participants). ED was associated with a 2.64 percentage-point reduction in FMD compared to those without ED (95% CI: –3.12, −2.15). Persons with ED also had a 0.09-mm (95% CI: 0.06, 0.12) higher cIMT than those without ED. In subgroup meta-analyses, the mean age of the study population, study quality, ED assessment questionnaire (IIEF-5 or IIEF-15), or the publication date did not significantly affect the relationship between ED and cIMT or between ED and FMD. The results for the association of ED and CAC were inconclusive. In conclusion, this study confirms an association between ED and subclinical CVD and may shed additional light on the shared mechanisms between ED and CVD, underscoring the importance of aggressive CVD risk assessment and management in persons with ED

Implications of abnormal abdominal wall computed tomographic angiography findings on postmastectomy free flap breast reconstruction.

BACKGROUND: Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan. METHODS: We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected. RESULTS: Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were "miscellaneous." In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, and significant bone metastases. Another patient had no suitable vessels for a free flap and the surgical plan converted to a pedicled transverse rectus abdominis musculocutaneous flap. The remaining incidental findings had no impact on the surgical plan or appropriateness of FFBR. More than one in 10 of those with abnormal findings went on to have further imaging before their operation. CONCLUSIONS: CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed-to-fail and unsafe surgery. It is therefore important that these scans are reported by an experienced radiologist

Elevated gamma-glutamyl transferase is associated with subclinical inflammation independent of cardiometabolic risk factors in an asymptomatic population: a cross-sectional study

BACKGROUND: Serum Gamma-Glutamyl Transferase (GGT), a marker of oxidative stress, has been suggested to be independently associated with cardiovascular disease (CVD) events. We examined the association of serum GGT levels with the burden of subclinical inflammation across a spectrum of metabolic conditions. METHODS: We evaluated 5,446 asymptomatic subjects (43 ± 10 years, 78 % males) who had an employer-sponsored physical between 2008 and 2010. Highly sensitivity C-reactive protein (hsCRP) was measured as a marker of underlying systemic inflammation. A linear regression of GGT quartiles with log transformed hsCRP and a multivariate logistic regression of GGT quartiles with elevated hsCRP (≥3 mg/L) were performed. RESULTS: Median GGT was 31 IU/l (IQR: 22–45 IU/l), 1025 (19 %) had hsCRP ≥ 3 mg/L. The median hsCRP increased with GGT quartiles (Q1: 0.9 mg/L, Q2: 1.1 mg/L, Q3: 1.4 mg/L, Q4: 1.6 mg/L, p < 0.001). Linear regression models showed GGT in the fourth quartile was associated with 0.45 mg/L (95 % CI 0.35, 0.54, p < 0.001) increase in log transformed hsCRP adjusting for risk factors. The Odds Ratio (OR) for an elevated hsCRP (≥3 mg/L) also increased with higher GGT quartiles; GGT Q2 1.44 (95 % CI 1.12, 1.85), GGT Q3 1.89 (95 % CI 1.45, 2.46), GGT Q4 2.22 (95 % CI 1.67, 2.95), compared to GGT Q1. The strength of association increased in the presence of and combination of metabolic conditions. CONCLUSION: In our cohort of asymptomatic individuals a higher serum GGT level was independently associated with increased burden of subclinical inflammation across metabolic states. These findings may explain GGT association with increased CVD risk

The Pan-University Network for Global Health: framework for collaboration and review of global health needs

In the current United Nations efforts to plan for post 2015-Millennium Development Goals, global partnership to address non-communicable diseases (NCDs) has become a critical goal to effectively respond to the complex global challenges of which inequity in health remains a persistent challenge. Building capacity in terms of wellequipped local researchers and service providers is a key to bridging the inequity in global health. Launched by Penn State University in 2014, the Pan University Network for Global Health responds to this need by bridging researchers at more than 10 universities across the globe. In this paper we outline our framework for international and interdisciplinary collaboration, as well the rationale for our research areas, including a review of these two themes. After its initial meeting, the network has established two central thematic priorities: 1) urbanization and health and 2) the intersection of infectious diseases and NCDs. The urban population in the global south will nearly double in 25 years (approx. 2 billion today to over 3.5 billion by 2040). Urban population growth will have a direct impact on global health, and this growth will be burdened with uneven development and the persistence of urban spatial inequality, including health disparities. The NCD burden, which includes conditions such as hypertension, stroke, and diabetes, is outstripping infectious disease in countries in the global south that are considered to be disproportionately burdened by infectious diseases. Addressing these two priorities demands an interdisciplinary and multi-institutional model to stimulate innovation and synergy that will influence the overall framing of research questions as well as the integration and coordination of research