Relationship between age and white matter integrity in children with phenylketonuria

Diffusion tensor imaging (DTI) has shown poorer microstructural white matter integrity in children with phenylketonuria (PKU), specifically decreases in mean diffusivity (MD), in comparison with healthy children. However, little research has been conducted to investigate the relationship between age and white matter integrity in this population. The present study examined group differences in the relationship between age and MD across a range of brain regions in 31 children with early- and continuously-treated PKU and 51 healthy control children. Relationships among MD, age, and group were explored using hierarchical linear regression and Pearson correlation. Results indicated a stronger age-related decrease in MD for children with PKU in comparison with healthy children in 4 of the 10 brain regions examined, suggesting that the trajectory of white matter development is abnormal in children with PKU. Further research using longitudinal methodology is needed to fully elucidate our understanding of white matter development in children with PKU

Post-operative complications of stapled versus Ferguson hemorrhoidectomy at Mulago Hospital. A randomized comparative study

Background: Hemorrhoids are a common anorectal condition. New surgical treatments have led to a reappraisal of hemorrhoid disease over the last few decades and despite a range of treatment modalities, the options are limited in their effectiveness and can lead to a number of complications. This study set out to compare post operative complications between stapled haemorrhoidopexy (SH) and Ferguson haemorrhoidectomy (FH) for patients with Grade III and IV in Mulago National Referral and teaching Hospital.Methods: Following ethical approval 48 consenting participants with Grade III/IV hemorrhoids were randomized to either FH or SH under regional anesthesia on 1:1 allocation. Early and short term post-operative complications were analyzed. .Results: We enrolled 24 participants in each arm with equal sex allocation and mean age of 39 years with 100% follow up. There was largely no difference in early and short term complications between FH and SH save for bleeding in the short term follow up which occurred more frequently in the FH group (p-value 0.045). The bleeding was mild and did not require transfusion.Conclusion: There was no major difference in short term complication rates between SH and FH. SH is a safe alternative to FH in Mulago Hospital.Keywords: Ferguson hemorrhoidectomy. Stapled hemorrhoidopexy. Hemorrhoids.PPH, Mulago Hospital, colorectal surger

Daytime Sleepiness Among Young Adult Omani Car Drivers

Objectives: Sleepiness and fatigue play significant roles in exacerbating the occurrence of car crashes. However, there is a dearth of studies examining the prevalence of sleepiness while driving among Omanis. This study aimed to determine the proportion of young Omani adults who confess to daytime sleepiness while driving and to investigate associations between gender, daytime sleepiness and risk of obstructive sleep apnoea syndrome (OSAS). Methods: This cross-sectional study took place at the Sultan Qaboos University Hospital, Muscat, Oman, between May and July 2014 and included 600 young adult Omani non-commercial drivers. The Berlin Questionnaire and Epworth Sleepiness Scale (ESS) were distributed among the participants, along with additional questions about their sleeping habits. Associations between daytime sleepiness while driving and nocturnal sleep duration, risk of OSAS and gender were determined. Results: A total of 492 private vehicle drivers took part in the study (response rate: 82%), of which 50.4% were male. Overall, 124 Omanis (25.2%) reported experiencing daytime sleepiness while driving at least once per month. There was a significant association between nocturnal sleep duration of 10 on the ESS, indicating a greater propensity for daytime sleepiness (P = 0.006). However, male drivers were significantly more likely to report sleepiness while driving (P = 0.001). Conclusion: Sleepiness while driving was common among young male drivers in Oman and might be due to nocturnal sleep deprivation. Further studies are needed so that preventative measures can be developed. Keywords: Motor Vehicles; Traffic Accidents; Sleep; Fatigue; Obstructive Sleep Apnea Syndrome; Oman

One Hundred Priority Questions for the Development of Sustainable Food Systems in Sub-Saharan Africa

Sub-Saharan Africa is facing an expected doubling of human population and tripling of food demand over the next quarter century, posing a range of severe environmental, political, and socio-economic challenges. In some cases, key Sustainable Development Goals (SDGs) are in direct conflict, raising difficult policy and funding decisions, particularly in relation to trade-offs between food production, social inequality, and ecosystem health. In this study, we used a horizon-scanning approach to identify 100 practical or research-focused questions that, if answered, would have the greatest positive impact on addressing these trade-offs and ensuring future productivity and resilience of food-production systems across sub-Saharan Africa. Through direct canvassing of opinions, we obtained 1339 questions from 331 experts based in 55 countries. We then used online voting and participatory workshops to produce a final list of 100 questions divided into 12 thematic sections spanning topics from gender inequality to technological adoption and climate change. Using data on the background of respondents, we show that perspectives and priorities can vary, but they are largely consistent across different professional and geographical contexts. We hope these questions provide a template for establishing new research directions and prioritising funding decisions in sub-Saharan Africa

Applying Bayesian model averaging for uncertainty estimation of input data in energy modelling

Background Energy scenarios that are used for policy advice have ecological and social impact on society. Policy measures that are based on modelling exercises may lead to far reaching financial and ecological consequences. The purpose of this study is to raise awareness that energy modelling results are accompanied with uncertainties that should be addressed explicitly. Methods With view to existing approaches of uncertainty assessment in energy economics and climate science, relevant requirements for an uncertainty assessment are defined. An uncertainty assessment should be explicit, independent of the assessor’s expertise, applicable to different models, including subjective quantitative and statistical quantitative aspects, intuitively understandable and be reproducible. Bayesian model averaging for input variables of energy models is discussed as method that satisfies these requirements. A definition of uncertainty based on posterior model probabilities of input variables to energy models is presented. Results The main findings are that (1) expert elicitation as predominant assessment method does not satisfy all requirements, (2) Bayesian model averaging for input variable modelling meets the requirements and allows evaluating a vast amount of potentially relevant influences on input variables and (3) posterior model probabilities of input variable models can be translated in uncertainty associated with the input variable. Conclusions An uncertainty assessment of energy scenarios is relevant if policy measures are (partially) based on modelling exercises. Potential implications of these findings include that energy scenarios could be associated with uncertainty that is presently neither assessed explicitly nor communicated adequately

One hundred priority questions for the development of sustainable food systems in sub-Saharan Africa

Sub-Saharan Africa is facing an expected doubling of human population and tripling of food demand over the next quarter century, posing a range of severe environmental, political, and socio-economic challenges. In some cases, key Sustainable Development Goals (SDGs) are in direct conflict, raising difficult policy and funding decisions, particularly in relation to trade-offs between food production, social inequality, and ecosystem health. In this study, we used a horizon-scanning approach to identify 100 practical or research-focused questions that, if answered, would have the greatest positive impact on addressing these trade-offs and ensuring future productivity and resilience of food-production systems across sub-Saharan Africa. Through direct canvassing of opinions, we obtained 1339 questions from 331 experts based in 55 countries. We then used online voting and participatory workshops to produce a final list of 100 questions divided into 12 thematic sections spanning topics from gender inequality to technological adoption and climate change. Using data on the background of respondents, we show that perspectives and priorities can vary, but they are largely consistent across different professional and geographical contexts. We hope these questions provide a template for establishing new research directions and prioritising funding decisions in sub-Saharan Africa

Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial

Background Neutrophil serine proteases are involved in the pathogenesis of COVID-19 and increased serine protease activity has been reported in severe and fatal infection. We investigated whether brensocatib, an inhibitor of dipeptidyl peptidase-1 (DPP-1; an enzyme responsible for the activation of neutrophil serine proteases), would improve outcomes in patients hospitalised with COVID-19. Methods In a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial, across 14 hospitals in the UK, patients aged 16 years and older who were hospitalised with COVID-19 and had at least one risk factor for severe disease were randomly assigned 1:1, within 96 h of hospital admission, to once-daily brensocatib 25 mg or placebo orally for 28 days. Patients were randomly assigned via a central web-based randomisation system (TruST). Randomisation was stratified by site and age (65 years or ≥65 years), and within each stratum, blocks were of random sizes of two, four, or six patients. Participants in both groups continued to receive other therapies required to manage their condition. Participants, study staff, and investigators were masked to the study assignment. The primary outcome was the 7-point WHO ordinal scale for clinical status at day 29 after random assignment. The intention-to-treat population included all patients who were randomly assigned and met the enrolment criteria. The safety population included all participants who received at least one dose of study medication. This study was registered with the ISRCTN registry, ISRCTN30564012. Findings Between June 5, 2020, and Jan 25, 2021, 406 patients were randomly assigned to brensocatib or placebo; 192 (47·3%) to the brensocatib group and 214 (52·7%) to the placebo group. Two participants were excluded after being randomly assigned in the brensocatib group (214 patients included in the placebo group and 190 included in the brensocatib group in the intention-to-treat population). Primary outcome data was unavailable for six patients (three in the brensocatib group and three in the placebo group). Patients in the brensocatib group had worse clinical status at day 29 after being randomly assigned than those in the placebo group (adjusted odds ratio 0·72 [95% CI 0·57–0·92]). Prespecified subgroup analyses of the primary outcome supported the primary results. 185 participants reported at least one adverse event; 99 (46%) in the placebo group and 86 (45%) in the brensocatib group. The most common adverse events were gastrointestinal disorders and infections. One death in the placebo group was judged as possibly related to study drug. Interpretation Brensocatib treatment did not improve clinical status at day 29 in patients hospitalised with COVID-19. Funding Sponsored by the University of Dundee and supported through an Investigator Initiated Research award from Insmed, Bridgewater, NJ; STOP-COVID19 trial

Evaluation of a cocopeat-based substrate system for rose production in Naivasha, Kenya

The current production system of roses in Kenya involves mostly the use of soil and open drip irrigation, which is inefficient as water and nutrients are lost through drainage. A recycling system can improve efficiency, as drainage water containing nutrients is re-used. A study was carried out from January to June 2013, at van den Berg Roses (a commercial rose farm) in Naivasha, Kenya, to evaluate a cocopeat-based system for rose production in comparison with a conventional soil-based production system. Net water use, stem production, stem length and economic benefits were assessed. Net water use in the cocopeat system and soil systems were 411 and 1098 L m-2, respectively. The difference of 687 L m-2 equals 65% water saving as a result of using the cocopeat system. The cumulative number of harvested stems m-2 in the cocopeat system was 24% higher than in the soil system. Rose stems harvested from the cocopeat system were on average longer, with 64% of the stems falling in the 60 and 70 cm categories, while this was 46% for the stems harvested from the soil system. Average stem weights were 39.2 and 33.6 g in the cocopeat and soil system, respectively. The results show that a cocopeat system with re-use of drain water in a soil system results in water saving, higher yield and better rose flower quality. A total of 764 L m-2 containing 1482 g m-2 fertilizer was collected from cocopeat and used in soil system over the period. The fertilizer in the drain solution was valued at € 0.93 m-2. Overall turnover from cocopeat was greater than soil system by € 3.15 m-2. The higher amount of marketable weight can be attributed to the greater number of stems that were obtained from the cocopeat compared to the soil

Vegetative growth of rose flower in cocopeat and soil in Naivasha, Kenya

Roses in Kenya are mostly grown in soil with an open drip irrigation system which is inefficient as water and nutrients are lost through drainage. A study was carried out from January to December 2013 at a commercial rose farm in Naivasha, Kenya, to evaluate the potential of a cocopeat-based system, which additionally enables re-use of the drain water in a soil-based system. Vegetative growth in both systems was assessed in terms of leaf expansion, number of leaves, stem length, chlorophyll content (represented by the measured SPAD value) and flower head expansion. The water used throughout the year was also measured. Leaf expansion was characterized by an initial slow expansion rate followed by a fast expansion rate before levelling off. Maximum leaf length reached was 63 mm in the cocopeat system, while it was 60 mm in soil system; however, the difference was not significant. The number of leaves did not differ between the soil and cocopeat system. The maximum number of leaves per stem was 20 for both systems. There was no significant difference in stem length of plants in cocopeat system (650 mm) and in soil system (630 mm). Measured SPAD value on plants grown in the cocopeat system were significantly higher than for plants grown in soil (P0.01). Net water use for the cocopeat system was lower than for the soil system, with a difference of 1197 L m-2 or 58%, due to the re-use of water in a soil system. There was a significant substrate effect on the number of stems m-2 and measured SPAD value, which are associated with differences in leaf chlorophyll and nitrogen content. It is likely that the optimized fertigation regime in cocopeat system led to higher growth rates and enabled a higher stem production. Other parameters were not significantly affected by the substrate type under the same greenhouse climatic conditions.</p