Effect of Fermentation on Antinutritional Factors and in Vitro Protein Digestibility of Bambara Nut (Voandzeia subterranean L.)

Bambara nut (Voandzeia subterranean L.) has better nutritive values than most other legumes. However, it is being underutilized due to long cooking time, antinutritional constituents and dehulling constraints. Fermentation as a unit operation has been able to address most of the factors responsible for the underutilization of some legumes. In this study, a full factorial block design comprising of time (0, 12, 24, 36, 48, 60 and 72 h) and Rhizopus combinations (A, B, C, AB, AC, BC and ABC) were used. Three species of Rhizopus (R. oligosporus (A), R. oryzae (B) and R. nigricans (C)) and their combinations were used in the fermentation for 3 days. Fermented samples that were collected at 12 hourly intervals were blanched, dried and milled to Bambara Flour (BF).  The BF was evaluated for tannin, oxalate, phytate, trypsin inhibitors and in vitro protein digestibility (IVPD). The results show that fermentation significantly (p < 0.05) reduced the antinutritional factors and enhanced IVPD of bambara nut. Ranges of values for antinutritional factors were tannin (0.35 – 0.02), oxalate (1.54 – 0.39), phytate (35.20 – 10.70) and trypsin inhibitor (3.22 – 0.49mg/g) while in vitro protein digestibility were 21.70 – 66.14%. Therefore, fermented bambara nut flour could be useful to supplement starchy foods. Key words: Antinutritional factors, in vitro protein digestibility, Rhizopus, bambara flou

Suicide Risk Assessment and Prevention Tools in the UK: Current Landscape and Future Directions

Suicide is a major global public health problem, with profound implications for individuals, families, and communities. In the United Kingdom (UK), despite efforts to detect and manage suicidal ideas, suicide rates persist, especially among middle-aged men and women, particularly those aged 45 to 54 years. Recent global challenges, such as the COVID-19 pandemic, climate change, conflict, and the environmental crisis, have raised concerns about an increase in suicide rates, particularly among young people. As a result, a population-wide preventive approach based on evidence is imperative to mitigate the projected increase in suicides. To evaluate the effectiveness of suicide prevention strategies, there is a need for an objective and universally accepted risk assessment approach that does not currently exist. This review examines the current landscape of suicide prevention in the United Kingdom and evaluates the strengths and limitations of existing suicide risk assessments tools. The current suicide prevention tools used, including machine learning and mobile applications are discussed. Also, the epidemiological trends in the various regions of the UK, risk factors including age, sex, and socio-economic status are assessed to provide context. Through this discourse, we hope to provide valuable insight for clinicians, researchers, and policy makers about the current landscape of suicide, especially within the United Kingdom, while presenting recommendations regarding areas that require further research and improvement. Accordingly, suicide prevention is and will continue to be a major focus of both the national health service and research in the UK in the strive to reduce the rate of suicide across all regions. Indeed, headways have been made in the use of technology in preventing suicide both locally and globally. However, research should in the future investigate the value of personalized interventions tailored to the various risk factors of suicide and based on appropriate screening and assessment tools

Heart rate variability in patients with cirrhosis: a systematic review and meta-analysis.

BACKGROUND: Cirrhosis is associated with abnormal autonomic function and regulation of cardiac rhythm. Measurement of heart rate variability (HRV) provides an accurate and non-invasive measurement of autonomic function as well as liver disease severity currently calculated using the MELD, UKELD, or Child-Pugh scores. This review assesses the methods employed for the measurement of HRV, and evaluates the alteration of HRV indices in cirrhosis, as well as their value in prognosis. METHOD: We undertook a systematic review using Medline, Embase and Pubmed databases in July 2020. Data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias of included studies was assessed by a modified version of the Newcastle-Ottawa Scale. The studies descriptive were analysed and the standardized mean differences of HRV indices were pooled. RESULTS: Of the 247 studies generated from our search, 14 studies were included. One of the 14 studies was excluded from meta-analysis because it reported only median of HRV indices. The studies included have a low risk of bias, and include 583 patients with cirrhosis and 349 healthy controls. The HRV time and frequency domains were significantly lower in cirrhotic patients. Between-studies heterogeneity was high in most of the pooled studies (P<0.05). Further, HRV indices predict survival independent of the severity of liver disease as assessed by MELD. CONCLUSION: HRV is decreased in patients with cirrhosis compared with healthy matched controls. HRV correlated with severity of liver disease and independently predicted survival. There was considerable variation in the methods used for HRV analysis, and this impedes interpretation and clinical applicability. Based on the data analysed, SDNN (standard deviation of inter-beat intervals) and cSDNN (i.e. SDNN corrected for basal heart rate) are the most suitable indices for prognosis in patients with cirrhosis

ANALYSIS OF THE EFFECT OF CLASS ATTENDANCE ON STUDENTS'ACADEMIC PERFORMANCE USING ASSOCIATION RULE MINING TECHNIQUE

Many institutions of learning encourage students to have good lecture attendance records. The belief is that an above average attendance rate will enhance students’ academic performance. However, very few studies have attempted to answer questions that relate to: i) the actual impact of good attendance record on students' academic performance; ii) the extent, in quantitative terms, of the effect of good attendance record on students’ academic performance. This paper reports the findings from an experimental analysis of students’ attendance record and corresponding academic performance results using Association Rule Mining. Over the years, Association Rule Mining has proved to be effective in analysing relationship between variables in transactional databases. The result of the case study provides useful information for the managements of higher institutions of learning on appropriate perspective to adopt on class attendance policies

Reduction in hospitalised COPD exacerbations during COVID-19: A systematic review and meta-analysis

BACKGROUND: Reports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus disease 2019 (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies. METHODS: Electronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index. RESULTS: A total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Nine studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.44–0.57). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index (rho = 0.20, p = 0.53). CONCLUSION: There was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period compared to pre-pandemic times, likely associated with a reduction in respiratory viral infections that trigger exacerbations. Future guidelines should consider including recommendations on respiratory virus infection control measures to reduce the burden of COPD exacerbations beyond the pandemic period

Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis

Background: Reduced heart rate variability (HRV) is an independent predictor of mortality in patients with cirrhosis. However, conventional HRV indices can only be interpreted in individuals with normal sinus rhythm. In patients with recurrent premature ventricular complexes (PVCs), the predictive capacity of conventional HRV indices is compromised. Heart Rate Turbulence (HRT) represents the biphasic change of the heart rate after PVCs. This study was aimed to define whether HRT parameters could predict mortality in cirrhotic patients. Materials and Methods: 24 h electrocardiogram recordings were collected from 40 cirrhotic patients. Turbulence Onset was calculated as HRT indices. The enrolled patients were followed up for 12 months after the recruitment in relation to survival and/or transplantation. Results: During the follow-up period, 21 patients (52.5%) survived, 12 patients (30%) died and 7 patients (17.5%) had liver transplantation. Turbulence Onset was found to be strongly linked with mortality on Cox regression (Hazard ratio = 1.351, p < 0.05). Moreover, Turbulence Onset predicted mortality independently of MELD and Child-Pugh's Score. Conclusion: This study provides further evidence of autonomic dysfunction in cirrhosis and suggests that HRT is reliable alternative to HRV in patients with PVCs

EFFECT OF FERMENTATION ON THE VITAMIN AND MINERAL CONTENTS OF BAMBARA NUT USING SELECTED RHIZOPUS SPECIES

This study evaluates the effect of fermentation with selected Rhizopus species on the vitamin and mineral contents of bambara nut (Voandzeia subterranean L.thouars) which is a leguminous plant.&nbsp; Bambara nut was fermented with three species of Rhizopus (R. oligosporus, R. nigricans and R. oryzae) and their combinations for 3 days. The samples were collected at 12 hourly intervals and were blanched, dried and milled to produce bambara flour. Vitamin and mineral contents determination were carried out on the samples.&nbsp; The values of vitamin A, riboflavin, niacin and thiamine were (21.70 – 66.14%), (0.38 – 0.86 mg/g), (0.16 – 3.53 mg/g), (0.50 – 4.52 mg/g) and (0.24 – 0.02mg/g), respectively. Mineral contents (potassium, calcium, phosphorus, iron and magnessium) ranges were (1.228 – 1.633), (0.093 – 0.300), (0.297 – 0.465), (0.013 – 0.028) and (0.017 – 0.052mg/100g), respectively.&nbsp; Therefore, fermented bambara nut could find uses in combacting endemic malnutrition in the developing countries. &nbsp

Epidemiological and diagnostic aspects of spontaneous miscarriage in the department of gynecology-obstetric of the university hospital of Treichville in Abidjan

Background: Describe the epidemiological and diagnostic of spontaneous aspects of early miscarriage in the department of the Gynecology Obsteric of Treichville University Teaching Hospital of   Treichville in Abidjan.Methods: A cross-sectional study was performed from January 2016 to March 2017 on patients received for an early miscarriage (gestational age less than 14 weeks of amenorrhea).Results: We recorded 337 cases of miscarriage and it shows that miscarriage was frequently estimated at 58 percent. Our patients had a average age of 32.9 years, 60.4 percent of them with primary education and 48 percent are housewives. The patients were paucigestes in 46 percent and the majority of them were nulliparous (62 percent). 6 percent with history of high blood pressure; diabetes (3 percent) and 31 percent of patients were HIV positive. Patients had pelvic pain at the admission in (55 percent). A miscarriage appears before 10 weeks of amenorrhea (76.1 percent) of cases. Ultrasound showed ovular debris (47 percent) of patients and (55.4 percent) were chromosomal abnormalities on anatomy-pathological examination.Conclusions: Spontaneous abortions are common and pathological examination is essential for diagnosis

Inhaled Nitric Oxide for Clinical Management of COVID-19: A Systematic Review and Meta-Analysis

Background: Severe COVID-19 is associated with hypoxemia and acute respiratory distress syndrome (ARDS), which may predispose multiorgan failure and death. Inhaled nitric oxide (iNO) is a clinical vasodilator used in the management of acute respiratory distress syndrome (ARDS). This study evaluated the response rate to iNO in patients with COVID-19-ARDS. Method: We searched Medline and Embase databases in May 2022, and data on the use of iNO in the treatment of ARDS in COVID-19 patients were synthesized from studies that satisfied predefined inclusion criteria. A systematic synthesis of data was performed followed by meta-analysis. We performed the funnel plot and leave-one-out sensitivity test on the included studies to assess publication bias and possible exaggerated effect size. We compared the effect size of the studies from the Unites States with those from other countries and performed meta-regression to assess the effect of age, year of publication, and concomitant vasodilator use on the effect size. Results: A total of 17 studies (including 712 COVID-19 patients) were included in this systematic review of which 8 studies (involving 265 COVID-19 patients) were subjected to meta-analysis. The overall response rate was 66% (95% CI, 47–84%) with significantly high between-studies heterogeneity (I2 = 94%, p < 0.001). The funnel plot showed publication bias, although the sensitivity test using leave-one-out analysis showed that removing any of the study does not remove the significance of the result. The response rate was higher in the Unites States, and meta-regression showed that age, year of publication, and use of concomitant vasodilators did not influence the response rate to iNO. Conclusion: iNO therapy is valuable in the treatment of hypoxemia in COVID-19 patients and may improve systemic oxygenation in patients with COVID-19-ARDS. Future studies should investigate the mechanism of the activity of iNO in COVID-19 patients to provide insight into the unexplored potential of iNO in general ARDS

Improving Rural Healthcare Delivery in Nigeria using Distributed Expert System Technology

Provision of adequate healthcare for the citizens is the responsibility of governments. This involves recruiting qualified medical personnel, and providing quality medical services nationwide. Theratio of medical doctorsto patients in Nigeria is 1:6,800, which means the citizens are grossly underserved in terms of medical services. Hence, there is need for new strategies that will ensure that more citizens access healthcare services, particularly people in the rural areas. In this paper, a framework for an SMS based expert system for rural healthcare delivery is proposed, which takes advantage of the wide coverage of telephony services in the rural areas in Nigeria. A preliminary evaluation of the expert system for pulmonary heart disease that was developed reveals that it emulates human expert capability at a reasonable level. This makes it suitable for deployment on a national scale to cater for the shortage of medical practitioners particularly in the rural area