‘THEY CALL US KILLERS’: AN EXPLORATION OF HERBAL, SPIRITUAL AND WESTERN MEDICAL PRACTICES IN MOMBASA, KENYA

Background: This paper attempts to describe the multi-dimensional perceptions of mganga/waganga (Kiswahili: traditional healers) by members of their constituencies, patients, government health officials and religious leaders in Mombasa, Kenya. It also seeks to investigate how these conceptions and perceptions influence the relationships between traditional healers and other stakeholders in the delivery of public healthcare services in Mombasa. Materials and Methods: A qualitative approach consisting of in-depth interviews and focus group discussions was employed and 43 research participants were interviewed during the period of two months in the summer of 2010. Data were recorded (video and audio), transcribed, and analyzed using the constant comparison method. Results: Findings indicate that varied opinions and interpretations of mganga influence both the decision-making process of the patient and the provision of healthcare by the healer. High tensions exist between mganga and other actors, and furthermore, such perceptions seem to evidence themselves in the government’s support for waganga, as well as the delineation of healthcare services—whereby certain stakeholders and participants are relegated to specific tasks. Conclusions: This research builds upon the growing body of knowledge on how African patients—in general and Kenya in particular—and healers inhabit a multifaceted arena of healing in order to effectively negotiate their positions and needs to make complex decisions involving care, contingent upon local economic, social, cultural, and religious factors

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Magneto Jeffrey Nanofluid Bioconvection over a Rotating Vertical Cone due to Gyrotactic Microorganism

The particular inquiry is made to envision the behavioral characteristics of gyrotactic microorganism effects on the MHD flow of Jeffrey nanofluid. Together the nanoparticles and motile microorganism are inducted into the modeled nonlinear differential equations. The optimal solutions for the governing equations are tackled by optimal homotopy analysis method. The physical characteristics of the relatable parameters are explored and deliberated in terms of graphs and numerical charts. Also, the precision of the present findings is certified by equating them with the previously published work. It is explored that rescaled density of the motile microorganisms contracts with bioconvection Peclet number Pe. It is seen that bioconvection Rayleigh number Rb shrinks the magnitude of tangential velocity. Also, bioconvection Schmidt number Sb augments the reduced density number of the motile microorganisms