Screening for Atrial Fibrillation in Sub-Saharan Africa:A Health Economic Evaluation to Assess the Feasibility in Nigeria

Background: Cardiovascular disease reflects a major burden of non-communicable disease in Sub-Saharan Africa (SSA). Early detection and treatment of atrial fibrillation (AF), as a preventive measure against stroke, is currently not in the scope of the World Health Organization recommendation to reduce cardiovascular disease. Objective: We hypothesized that screening for AF would be an important approach to determine the true AF prevalence in the general population in African countries and to identify asymptomatic AF patients at risk for stroke to optimize prevention. Methods: A decision analytic model was developed to study the health-economic impact of AF screening in Nigeria over a life-time horizon. The patient population explored in the model was a population of newly detected AF cases that would be diagnosed with a one-time systematic screening for AF with a single lead ECG device in community health centres across Nigeria. Conclusions: The health gain per newly detected AF patient (N = 31,687) was 0.41 QALY at a cost of $5,205 per patient with 100$12,587 per QALY gained. The intervention was cost-effective with a 99.9% warfarin use with an ICER of $1,363 per QALY gained. The total cost of a single screening session was$7.3 million for the total screened population in Nigeria or $1.60 per patient screened. Screening for AF to detect AF patients in need for stroke prevention can be a cost-effective intervention in the Sub-Saharan region, depending on type of anticoagulant used and drug costs

ISOLATION AND CHARACTERIZATION OF MICROCRYSTALLINE CELLULOSE FROM OIL PALM FRONDS USING CHEMO-MECHANICAL PROCESS

This study investigates the characteristic of the microcrystalline cellulose (MCC) isolated from oil palm (Elaies guineensis) fronds using acid hydrolysis method. The morphology and size of the MCC were characterized using both Sherrer equations for X-ray diffraction (XRD) result and transmission electron microscopy (TEM). The thermal stability of MCC was determined from thermogravimetry analysis (TGA) profiles whilst, Fourier transform infrared spectroscopy (FTIR) was used to analyse the chemical modifications that occurred under these conditions. The XRD results showed that the MCC isolated from oil palm fronds (OPF-MCC) fibres had an average diameter and crystallinity index of 12.15 nm and 60.1 % respectively. Both the FTIR and the XRD indicated that lignin and hemicellulose contents decreased while the cellulose-I polymorph remained constant. Thermogravimetric analysis (TGA) revealed that OPF-MCC had higher thermal stability compared to the OPF fibres. The study revealed the potential applications of the MCC isolated from the oil palm biomass as green reinforcement or/and fillers in the production of biodegradable biocomposite

Biological sample donation and informed consent for neurobiobanking: Evidence from a community survey in Ghana and Nigeria

Copyright: \ua9 2022 Singh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Genomic research and neurobiobanking are expanding globally. Empirical evidence on the level of awareness and willingness to donate/share biological samples towards the expansion of neurobiobanking in sub-Saharan Africa is lacking. Aims To ascertain the awareness, perspectives and predictors regarding biological sample donation, sharing and informed consent preferences among community members in Ghana and Nigeria. Methods A questionnaire cross-sectional survey was conducted among randomly selected community members from seven communities in Ghana and Nigeria. Results Of the 1015 respondents with mean age 39.3 years (SD 19.5), about a third had heard of blood donation (37.2%, M: 42.4%, F: 32.0%, p = 0.001) and a quarter were aware of blood sample storage for research (24.5%; M: 29.7%, F: 19.4%, p = 0.151). Two out of ten were willing to donate brain after death (18.8%, M: 22.6%, F: 15.0%, p<0.001). Main reasons for unwillingness to donate brain were; to go back to God complete (46.6%) and lack of knowledge related to brain donation (32.7%). Only a third of the participants were aware of informed consent (31.7%; M: 35.9%, F: 27.5%, p<0.001). Predictors of positive attitude towards biobanking and informed consent were being married, tertiary level education, student status, and belonging to select ethnic groups. Conclusion There is a greater need for research attention in the area of brain banking and informed consent. Improved context-sensitive public education on neurobiobanking and informed consent, in line with the sociocultural diversities, is recommended within the African sub region

Age, sex, and setting in the etiology of stroke study (ASSESS): Study design and protocol

RATIONALE: Stroke etiology and risk factors vary by age, sex, setting (hospital or community-based) and by region. Identifying these differences would improve our understanding of stroke etiology, diagnosis, and treatment. AIM: The Age, Sex and Setting in the Etiology of Stroke Study (ASSESS) is a multicenter cohort study to assess differences in stroke etiology. METHODS AND DESIGN: Data from all centers will be categorized according to age, sex, setting, stroke subtypes. Centers with extensive hospital- or community-based data regarding stroke from Argentina, Australia, Canada, India, Iran, Italy, Ghana, Nigeria, Thailand, the United Kingdom and the United States have agreed to participate so far. STUDY OUTCOMES: The primary outcome includes differences in stroke etiology in study centers. The secondary outcomes include stroke incidence, risk factors, preventive strategies, and short- and long-term outcomes. CONCLUSION: ASSESS will enable comparisons of data from different regions to determine the age and sex distribution of the most common causes of stroke in each setting. This will help clinicians to tailor the assessment and treatment of stroke patients on the basis of their specific local characteristics. It will also empower stroke epidemiologists to design preventive measures by targeting the specific characteristics of each population

Insolvency of Small Civil Engineering Firms: An Examination of Critical Strategic Factors

Construction industry insolvency studies have failed to stem the industry’s high insolvency tide because many focus on big civil engineering firms (CEF) when over 90% firms in the industry are small or micro (S&M). This study thus set out to uncover insolvency criteria of S&M CEFs and the underlying factors using mixed methods. Using convenience sampling, storytelling method was used to execute interviews of 16 respondents from insolvent firms. Narrative and thematic analysis were used to extract 17 criteria under 2 groups. Criteria were used to formulate questionnaire of which 81 completed copies were received and analysed using Cronbach’s alpha coefficient and relevance index score for reliability and ranking respectively. The five most relevant criteria are: economic recession, immigration, too many new firms springing up, collecting receivables and burden of sustainable construction. The 4 underlying factors established through factor analysis are: market forces, competence-based management, operations efficiency and other management issues and information management. The factors were in line with Mintzberg’s and Porters’ strategy theories. Results demonstrate that insolvency factors affecting big and small CEF can be quite different and sometimes, even opposite. This research will provide a unique resource on the ‘beware’ factors for potential owners of S&M CEF. The criteria are potential variables for insolvency prediction models for S&M CEFs

Novel functional insights into ischemic stroke biology provided by the first genome-wide association study of stroke in indigenous Africans

\ua9 The Author(s) 2024. Background: African ancestry populations have the highest burden of stroke worldwide, yet the genetic basis of stroke in these populations is obscure. The Stroke Investigative Research and Educational Network (SIREN) is a multicenter study involving 16 sites in West Africa. We conducted the first-ever genome-wide association study (GWAS) of stroke in indigenous Africans. Methods: Cases were consecutively recruited consenting adults (aged > 18 years) with neuroimaging-confirmed ischemic stroke. Stroke-free controls were ascertained using a locally validated Questionnaire for Verifying Stroke-Free Status. DNA genotyping with the H3Africa array was performed, and following initial quality control, GWAS datasets were imputed into the NIH Trans-Omics for Precision Medicine (TOPMed) release2 from BioData Catalyst. Furthermore, we performed fine-mapping, trans-ethnic meta-analysis, and in silico functional characterization to identify likely causal variants with a functional interpretation. Results: We observed genome-wide significant (P-value < 5.0E−8) SNPs associations near AADACL2 and miRNA (MIR5186) genes in chromosome 3 after adjusting for hypertension, diabetes, dyslipidemia, and cardiac status in the base model as covariates. SNPs near the miRNA (MIR4458) gene in chromosome 5 were also associated with stroke (P-value < 1.0E−6). The putative genes near AADACL2, MIR5186, and MIR4458 genes were protective and novel. SNPs associations with stroke in chromosome 2 were more than 77 kb from the closest gene LINC01854 and SNPs in chromosome 7 were more than 116 kb to the closest gene LINC01446 (P-value < 1.0E−6). In addition, we observed SNPs in genes STXBP5-AS1 (chromosome 6), GALTN9 (chromosome 12), FANCA (chromosome 16), and DLGAP1 (chromosome 18) (P-value < 1.0E−6). Both genomic regions near genes AADACL2 and MIR4458 remained significant following fine mapping. Conclusions: Our findings identify potential roles of regulatory miRNA, intergenic non-coding DNA, and intronic non-coding RNA in the biology of ischemic stroke. These findings reveal new molecular targets that promise to help close the current gaps in accurate African ancestry-based genetic stroke’s risk prediction and development of new targeted interventions to prevent or treat stroke

Utilization of agrowaste-derived nanoparticles as reinforcement in microfilled epoxy composites

The substantial release of oil palm ash into ground water has been a serious concern to the environmentalist due to the enormous generation of oil palm ash waste from oil palm incineration. The effective utilization of this agrowaste is yet to be fully exploited. In this context, herein we, investigated the potential of oil palm ash nanofiller as an effective reinforcement in epoxy-based composites. Transmission electron microscopy (TEM) revealed that the prepared oil palm ash nanoparticles had circular morphology with particle size in the range of 20to 25 nm. X-ray diffraction patterns of the prepared oil palm ash nanoparticles revealed the crystalline nature of the oil palm ash nanoparticles. Tensile strength and tensile modulus of the epoxy composites were substantially improved to 64, 67, 70,and 75 MPa and 1.01,1.05,1.16,and 1.18 MP a at oil palm ash nanofiller loading of 1%,2%,3%,and %,respectively.The impact strength of nanocomposite was enhanced from 2.7015 ± 0.13 kJ/m2to 3.98 ± 0.17kJ/m2 at 3% of oil palm ash nanofiller loading. The optimum values of mechanical properties were attained at 4% filler loading,after which further loading resulted in the decrement of mechanical properties of epoxy nanocomposite. Thermal stability of the epoxy nanocomposite was enhanced substantially to 435 °C by the incorporation of oil palm ash nanofillers. This study proved that nano-sized oil palm ash could be an efficient reinforcement in polymer composite

A potent betulinic acid analogue ascertains an antagonistic mechanism between autophagy and proteasomal degradation pathway in HT-29 cells

Betulinic acid (BA), a member of pentacyclic triterpenes has shown important biological activities like anti-bacterial, anti-malarial, anti-inflammatory and most interestingly anticancer property. To overcome its poor aqueous solubility and low bioavailability, structural modifications of its functional groups are made to generate novel lead(s) having better efficacy and less toxicity than the parent compound. BA analogue, 2c was found most potent inhibitor of colon cancer cell line, HT-29 cells with IC50 value 14.9 μM which is significantly lower than standard drug 5-fluorouracil as well as parent compound, Betulinic acid. We have studied another mode of PCD, autophagy which is one of the important constituent of cellular catabolic system as well as we also studied proteasomal degradation pathway to investigate whole catabolic pathway after exploration of 2c on HT-29 cells. Mechanism of autophagic cell death was studied using fluorescent dye like acridine orange (AO) and monodansylcadaverin (MDC) staining by using fluorescence microscopy. Various autophagic protein expression levels were determined by Western Blotting, qRT-PCR and Immunostaining. Confocal Laser Scanning Microscopy (CLSM) was used to study the colocalization of various autophagic proteins. These were accompanied by formation of autophagic vacuoles as revealed by FACS and transmission electron microscopy (TEM). Proteasomal degradation pathway was studied by proteasome-Glo™ assay systems using luminometer.The formation of autophagic vacuoles in HT-29 cells after 2c treatment was determined by fluorescence staining – confirming the occurrence of autophagy. In addition, 2c was found to alter expression levels of different autophagic proteins like Beclin-1, Atg 5, Atg 7, Atg 5-Atg 12, LC3B and autophagic adapter protein, p62. Furthermore we found the formation of autophagolysosome by colocalization of LAMP-1 with LC3B, LC3B with Lysosome, p62 with lysosome. Finally, as proteasomal degradation pathway downregulated after 2c treatment colocalization of ubiquitin with lysosome and LC3B with p62 was studied to confirm that protein degradation in autophagy induced HT-29 cells follows autolysosomal pathway. In summary, betulinic acid analogue, 2c was able to induce autophagy in HT-29 cells and as proteasomal degradation pathway downregulated after 2c treatment so protein degradation in autophagy induced HT-29 cell