Diagnostic Value of Serum Glypican 3 in Hepatocellular Carcinoma: A Case Control Study of Patients Seen at the University College Hospital, Ibadan, Nigeria

Hepatocellular carcinoma (HCC) is a major health problem which has been increasing in Nigeria with a doubling in the incidence rate in the past 10 years. Current diagnosis of HCC relies on clinical information, liver imaging and measurement of serum alpha-fetoprotein (AFP). The reported sensitivity and specificity of AFP are not sufficient for early diagnosis, and so additional and more sensitive markers are needed. One of such tumor markers is serum Glypican 3 (GPC3). So, this study aimed to determine the frequency of GPC3 in apparently healthy controls and patients with HCC, comparing the diagnostic efficacy of GPC3 to AFP in HCC and to assess the diagnostic accuracy of combined AFP and GPC3 in the diagnosis of HCC.Fifty patients with clinical, radiological and/or histological features of HCC, and fifty apparently healthy controls who were HBsAg and anti-HCV negative and had normal abdominal ultrasonography scan were recruited for the study. Serum estimation of AFP and GPC-3 were done for all the subjects. The sensitivity and specificity of GPC3 was 54 % and 44% respectively based on a receiver operating characteristic(ROC) curve –derived optimum cut-off level >20 ng/ml. The sensitivity and specificity of AFP were 64% and 100% at an ROC derived optimum cut- off level of 20 ng/ml. The area under the receiver operating characteristic curve (AUROC) for AFP was 0.69 and was significantly larger than that of GPC3 which was 0.42(p <0.001). The diagnostic value of GPC3 in our patients with advanced hepatocellular carcinoma is poor in comparison with AFP. Keywords: Glypican 3, Diagnostic value, Hepatocellular carcinoma, Nigeria DOI: 10.7176/JHMN/59-0

Assessment of Maintenance Management Culture of Tertiary Institutions in Nigeria

Buildings are critical factors in achieving desirable outcomes for tertiary institutions. Any inadequacy in building facilities represents a loss in value of the institution, its users and stakeholders. Hence, institution buildings require maintenance in order to create a conducive environment that supports and stimulates learning, teaching, innovation and research as there seems to be a strong correlation between learning and the environment in which knowledge is imparted. In this research, maintenance management structure of tertiary institutions was assessed and the usual maintenance procedures as well as means of funding maintenance activities in the institutions were examined and evaluated. Data used for this research work were collected using structured questionnaires and interview which were administered to workers of the various departments in charge of maintenance work. Data received were analyzed using simple statistical tools such as mean item score, percentage and frequency. The research shows that institutions have a structure in place to carryout maintenance work but do not have a formal organogram showing the hierarchy flow of authority and that maintenance department is characterized by inexperienced staff. It also revealed that maintenance works are properly funded but characterized by frequent occurrences like underestimating and cost overrun. The research recommends that the institution should have a formal organogram to show the distribution of power and to carry out proper training of maintenance staff especially the quantity surveyors in preparing maintenance budgets. Keywords: Tertiary Institutions, Maintenance, Maintenance Department, Maintenance Practice, Nigeria

BIM for deconstruction: an interpretive structural model of factors influencing implementation.

Transitioning from demolition to deconstruction practices for end-of-life performances is gaining increasing attention following the need for the construction industry to minimise construction and demolition waste. Building information modelling (BIM) presents an opportunity for sustainable deconstruction. However, the notion of BIM for deconstruction (BIMfD) is still in its infancy in the United Kingdom. Although a few studies on BIMfD are evident, a focus on identifying the underlying factors necessary for successful implementation of BIMfD is lacking. The purpose of this study was to identify and analyse the underlying factors necessary for BIMfD implementation in the UK construction industry. It employed a four-stage research design. The reviewed literature explored extant views on BIM implementation factors to identify an initial list of possible factors influencing BIMfD implementation. Subsequently, a mix of questionnaire, focus group discussions and structured interviews were employed at various stages to refine and contextualise 15 factors necessary for BIMfD implementation in the UK construction industry. The contextual interrelationships among the factors were evaluated using interpretive structured modelling (ISM). This evaluation culminated in a BIMfD implementation factor model. The findings identified BIMfD experts, responsiveness of business models to innovative practices and industry’s acceptance to embrace change as the principal factors influencing BIMfD implementation in the UK. The implications of the findings attest that BIMfD experts and advisors must champion the adoption and implementation of BIMfD in the UK and business models need to become more responsive to accommodate BIMfD innovative practices. A BIMfD framework was conceptualised. Even though the BIMfD framework was designed from the UK perspective, the global construction industry can leverage the outcomes of this study. This paper, therefore, brings to the fore, a hierarchical BIMfD implementation factor model to support improved deconstruction practices in the construction industry

Soil Seed Bank Dynamics in Tithonia diversifolia Dominated Fallowland Vegetation in Ile-Ife Area of Southwestern Nigeria

The soil seedbank of Tithonia diversifolia, an invasive species which dominates open waste fallowland vegetation was studied. Two different roadside sites which vary in extent of open waste land were selected.The species composition of the established vegetation was assessed in the two diferent sites. Twenty top soil samples were collected at five different distances (15 cm, 30 cm, 45 cm, 60 cm, and 75 cm) inwards away from each main road in dry and rainy seasons and the seed bank composition was determined by greenhouse germination over a 6 month period. The similarity between the composition of the seed bank flora and that of the established vegetation was low. The least and the highest emerged seedlings density was recorded in the 15 metres and 75 metres respectively inwards away from the main road in both seasons. The results of the seedlings emergence is a reflection of the extent of open waste land dominated by the invasive species due to human disturbance (road construction) on both sites. Overall results suggest that the emergence of the species from the soil seed bank may be due to the impact of the invasive species Tithonia diversifolia on other plant species in the study environment

Evaluation and storage studies of sausage roll produced from wheat-tigernut flour blends

This study was carried out to investigate the effects of wheat flour substitution with tigernut flour. Brown variety of tigernut was sorted and dried in a cabinet dryer at 60°C for 72hrs and was processed into flour and blended with wheat flour at different ratios of 100:0; 90:10; 80:20; 70:30; 60:40; 50:50, 40:60, 30:70, 20:80, 10:90 respectively. The flour blends were analyzed for proximate composition, functional properties, pasting properties and rheological properties (viscosity). Data obtained were subjected to analysis of variance and significant means were separated using Duncan multiple range test. Moisture, crude protein, crude fibre, total ash, crude fat and carbohydrate ranged from 4.11 to 10.35%, 4.72 to 12.28%, 2.82 to 9.81%, 0,51 to 0.78%, 0.84 to 15.61% and 50.26 to 73.25% respectively. Significant differences exist in the functional, pasting properties and viscosity of wheat and tigernut flour blends. As the substitution of tigernut flour increases, the hardness, crust and crumb moisture of the sausage increases during storage. The result of this study shows that tigernut has the advantage of improving the crude fat, total ash and crude fibre of the blends. Substitution of tigernut flour to wheat flour had a significant effect on all the functional properties of the flour blends. The pasting properties of wheat and tigernut flour blends were affected thereby leading to decreases in the peak, trough, breakdown, final viscosity, setback and peak time. The viscosity of wheat and tigernut flour blends is relatively too high and this suggests that the flour blends will be useful in production of baked products

The system dynamics analysis of cost overrun causations in UK rail projects in a COVID-19 epidemic era.

Cost overrun is a global issue plaguing transportation infrastructure projects and the rail industry in the United Kingdom is no exception. This industry plays a significant role in stimulating the country's economic development and growth. Understanding the factors contributing to cost overruns in rail projects is vital for ensuring the viability and sustainability of such projects, especially in the COVID-19 epidemic era. This study analyzed and predicted the impact of cost overruns on rail projects in the UK in a COVID-19 pandemic era through a sparse network and system dynamics approach. It leverages a review of existing literature and perceptions of 80 construction professionals purposively, to establish the factors affecting cost overruns in the UK rail construction sector. Findings reveal a web of causations, which highlights labor productivity, delay in the supply of construction materials and equipment, and access to the site as fundamental predictors of cost overruns during a COVID-19 pandemic era. The resulting findings have the potential to assist project managers in strategically planning for and mitigating the potential rise in cost overruns of rail projects in the UK during the pandemic

Spectrum and pattern of distribution of findings in patients with dyspepsia undergoing oesophago-gastro-duodenoscopy at a Tertiary Hospital in Ibadan, south west, Nigeria

Introduction: Dyspepsia is a symptom complex with varied underlying etiologies. The underlying etiology determines the precise treatment and prognosis though Helicobacter pylori infection plays a central role. The aim of this study was to describe the spectrum and pattern of distribution of findings in patients with dyspepsia undergoing oesophago-gastroduodenoscopy at the University College Hospital, Ibadan.Methods: A retrospective analysis of computerized database patients with dyspepsia who underwent oesophago-gastro–duodenoscopy from 2015 to 2019.Results: A total of 1,373 procedures were done and dyspepsia was the indication in 736 (53.2%) comprising 317 (43.1%) male and 405 (55%) female (P< .001). The age ranged from 18 to 100 with a mean of 50 ± 15 years. The age group 40–59 years had the highest representation (P = .00). The esophageal mucosa was normal in 592 (80.4%) while 45 (6.1%) and 36 (4.9%) patients had esophagitis and esophageal candidiasis, respectively. In the stomach, 230 (31%) patients had normal mucosa while 433 (57.5%) and 40 (5.4%) patients had gastritis and gastric ulcers, respectively. Antrum was the most commonly involved site by the gastritis and ulcers in 236 (55.8%) and 24 (60%) patients, respectively. The mean age of those with non-ulcer dyspepsia was 49.8 ± 15 while that of those with organic dyspepsia was 55.7 ± 13.7 years (P= .01). Furthermore, there was a significant correlation between the age group and organic dyspepsia (P = .00). The first part of the duodenum was normal in 594 (80.7%) while bulbar duodenitis was seen in 106 (14.4%).Conclusion: In our practice, OGD in patients with dyspepsia is either normal or yielded few abnormalities. The most common abnormalities were gastritis, duodenitis, esophagitis and gastric ulcers. Gastritis and ulcers were antral predominant and gastric ulcers were more common than duodenal ulcers. There was a significant relationship between increasing age and organic dyspepsia

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Performance Evaluation of Surface Roughness in the Boring Operation of IS 2062 E250 Plate on CNC Machine Using Combined Entropy-Decision Tree-VIKOR Approach

In boring E250 B0 steel material, the selection of process parameters is one of the most challenging tasks to achieve. The boring literature lacks understanding and fails to reveal how to select the important boring parameters for utmost resource distribution to the most important parameters. This article proposes a novel method to analyse the importance of parameters in boring to produce utmost surface roughness using the entropy-decision tree-VIKOR approach as a multi-criteria decision-making solution to the choice of process materials for superior surface roughness. The choice parameters include speed, depth of cut, feed and nose radius. The entropy approach was instituted to attain the weight of the diverse parameters. The decision tree approach is deployed through the classification of the parameters as beneficial and non-beneficial and the expected values at each mode evaluated. The desirable weightage is then established and serves as the input to the VIKOR approach. This converts the desirable weightage into unit measures through the best/worst value and weightage evaluation. The individual regrets are then analyzed and the final ranking obtained. Results revealed that the depth of cut is the most important parameter, then nose radius (0.98), feed (0.307) and speed (0), respectively. Therefore, a plan to assign more measures to the depth of cut may be developed and the least resources may be assigned to speed. This detail may be helpful to prepare the annual budgets for the boring operation on the factory floor

Cause-and-Effect Relationship Analysis of Cocoa Pod Husk Composites in Water Absorption Process Parametric Evaluation: A DEMATEL Approach

Polymer composites are expanding in scope and applications to water-based structures such as the ship's hull in ship vessels due to their resistance to water and satisfactory mechanical properties. Unforunately, few studies have tackled their water absorption properties. In this paper, a novel method, DEMATEL, is used to analyse the conflicting water absorption process parameters of cocoa pod husk composite using the cause and effect associations of the parameters. The parameters considered are particulate loading, initial weight, particulate weight, the weight of the matrix, and weight after 150 days and rate of water absorption. A comparison scale explains the extent of influence of a criterion on the other. The direct relationship matrix is normalized and the total relation matrix generated to procedure a causal diagram. The most fascinating findings of the study are the differences between the sum of row and columns, which places particulate weights as the most appealing, 1.0798, while the rate of water absorption as the least appealing criterion. Besides, the sum of the row and column that yields the most attractive results is the particulate weight (5.4982) while the least attractive result is the rate of water absorption (3.5436). The novelty of this work lies in the application of DEMATEL structure to examine contextual associations between the essential pointers of water absorption process parameters, for cocoa pod husk composites in the water environment. To our knowledge, it is the first type of work in this area on the selected agro-filler-based composite