A Hybrid Fuzzy Time Series Technique for Forecasting Univariate Data

In this paper a hybrid forecasting technique that integrates Cat Swarm optimization Clustering (CSO-C) and Particle Swarm Optimization (PSO) with Fuzzy Time Series (FTS) forecasting is presented. In the three stages of FTS, CSO-C found application at the fuzzification module where its efficient capability in terms of data classification was utilized to neutrally divide the universe of discourse into unequal parts. Then, disambiguated fuzzy relationships were obtained using Fuzzy Set Group (FSG). In the final stage, PSO was adopted for optimization; by tuning weights assigned to fuzzy sets in a rule. This rule is a fuzzy logical relationship induced from FSG. The forecasting results showed that the proposed method outperformed other existing methods; using RMSE and MAPE as performance metrics.            

Choice of antihypertensive medications among physicians and its impact on blood pressure control among Nigerians living with hypertension

Background: Hypertension, if untreated or uncontrolled, leads to damage of vital organs such as the brain, heart and the kidneys among others. These complications have been shown to be severer in black Africans. Benefit of treatment has been repeatedly demonstrated by many studies. Therefore, many guidelines have been produced by relevant bodies in different countries in order to assist physicians in making the right choices for blood pressure (BP) control. Most of these bodies produce the guidelines based on the peculiarities of hypertension in their respective population. Several reports have shown how different hypertension is, in black Africans, still there is no published unified guideline for its treatment in this population.Methods: This was a survey of known hypertensives who were on follow up visit. Their prescriptions were assessed for drug name, class and number. Their blood pressures at that visit were also recorded. Prevalence of single therapy and combination therapy were determined. Compliance with the AHA recommended 2 – drug combination was determined. The percentage of BP control as well as the prescribed drugs in each group were also obtained.Results: Those on single agents were 13% out of which 52% were controlled. 87% were on various combination of 2 or more drugs of whom 41.9% of those on 2 drugs and 21.1% of those on more than 2 drugs had controlled BP. BP control in those on 2 drugs was better than in those with > 2 drugs, (p=0.0027).ACEI were the commonest used drug either as single agent (55.9%) or as 2 – drug combination as seen in 54.8% of the subjects on 2 – drug combination. 13 different 2 – drug combinations were identified with the best control in ARB + Diuretic, ACEI + Diuretic and CCB + Diuretic. The least control was observed in the ACEI + CCB group. Compliance with AHA recommendation was good but still 7.7% were under unacceptable group while another 7.7% were unclassified.Conclusion: ACE-Is are becoming the drugs of choice both as monotherapy and as combination therapy. Despite good compliance to AHA recommendation on drug combination, overall control is still a problem which calls for a revisit of these recommendations in Africans.Keywords: Ahtihypertensives; Physicians; Impact; Blood Pressure; Nigerian

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

C ADOPTION OF IMPROVED MAIZE VARIETIES IN NORTHERN GUINEA SAVANNAH OF BORNO STATE, NIGERIA

ABSTRACT This study examined the adoption of improved maize varieties in northern Guinea Savanna of Borno State. Primary data were collected by use of structured questionnaire and using multi-stage random sampling procedure, 400 farmers were selected. Descriptive and inferential Statistics were used for data analyses. The study reveals that majority (81.1%) of the respondents were male. Only 17% of the respondents had access to credit. The study also revealed that (89.2%) of the respondents were married with the average household size of 7 persons. The findings show that 78.4% of respondents had an average age of 40 years, 37.4% had formal education. Overall adoption rate was 89.0%. Coefficient of socio-economic and institutional factors such as extension contact, farm size, education level, access to credit and age were found to be significant (P≤0.01) and positively influencing adoption of improved maize varieties.  Household size and income level were also significant (P≤0.05) and positively related to likelihood of adoption of improved maize varieties. Non-availability of technology (99%), high cost of technology (92%) and high cost of labour (88%) were the major constraining factors to adoption of improved maize varieties. The study recommended that: community seed production should be encouraged and promoted to facilitate easy access to improved seeds by farmers. The extension system should be strengthened, a policy, which provides adequately trained and equipped extension workers for disseminating extension messages to farmers, re-strengthening of Community Based Organizations and seed companies to introduce labour saving tools like planters and harvesters etc

C ADOPTION OF IMPROVED MAIZE VARIETIES IN NORTHERN GUINEA SAVANNAH OF BORNO STATE, NIGERIA

ABSTRACT This study examined the adoption of improved maize varieties in northern Guinea Savanna of Borno State. Primary data were collected by use of structured questionnaire and using multi-stage random sampling procedure, 400 farmers were selected. Descriptive and inferential Statistics were used for data analyses. The study reveals that majority (81.1%) of the respondents were male. Only 17% of the respondents had access to credit. The study also revealed that (89.2%) of the respondents were married with the average household size of 7 persons. The findings show that 78.4% of respondents had an average age of 40 years, 37.4% had formal education. Overall adoption rate was 89.0%. Coefficient of socio-economic and institutional factors such as extension contact, farm size, education level, access to credit and age were found to be significant (P≤0.01) and positively influencing adoption of improved maize varieties.  Household size and income level were also significant (P≤0.05) and positively related to likelihood of adoption of improved maize varieties. Non-availability of technology (99%), high cost of technology (92%) and high cost of labour (88%) were the major constraining factors to adoption of improved maize varieties. The study recommended that: community seed production should be encouraged and promoted to facilitate easy access to improved seeds by farmers. The extension system should be strengthened, a policy, which provides adequately trained and equipped extension workers for disseminating extension messages to farmers, re-strengthening of Community Based Organizations and seed companies to introduce labour saving tools like planters and harvesters etc

C ADOPTION OF IMPROVED MAIZE VARIETIES IN NORTHERN GUINEA SAVANNAH OF BORNO STATE, NIGERIA

ABSTRACT This study examined the adoption of improved maize varieties in northern Guinea Savanna of Borno State. Primary data were collected by use of structured questionnaire and using multi-stage random sampling procedure, 400 farmers were selected. Descriptive and inferential Statistics were used for data analyses. The study reveals that majority (81.1%) of the respondents were male. Only 17% of the respondents had access to credit. The study also revealed that (89.2%) of the respondents were married with the average household size of 7 persons. The findings show that 78.4% of respondents had an average age of 40 years, 37.4% had formal education. Overall adoption rate was 89.0%. Coefficient of socio-economic and institutional factors such as extension contact, farm size, education level, access to credit and age were found to be significant (P≤0.01) and positively influencing adoption of improved maize varieties.  Household size and income level were also significant (P≤0.05) and positively related to likelihood of adoption of improved maize varieties. Non-availability of technology (99%), high cost of technology (92%) and high cost of labour (88%) were the major constraining factors to adoption of improved maize varieties. The study recommended that: community seed production should be encouraged and promoted to facilitate easy access to improved seeds by farmers. The extension system should be strengthened, a policy, which provides adequately trained and equipped extension workers for disseminating extension messages to farmers, re-strengthening of Community Based Organizations and seed companies to introduce labour saving tools like planters and harvesters etc

Diagnosing linear immunoglobulin - A dermatosis of childhood in a resource-constrained area: Case report and review of literature

Linear immunoglobulin A (IgA) dermatosis (LAD) of childhood is a self-limiting blistering eruption. At histology, the blisters are subepidermal and may be reported as resembling dermatitis herpetiformis or bullous pemphigoid. Direct immunofluorescence (DIF) of normal or perilesional skin shows a linear band of IgA at the basement membrane. Many of the patients also have a circulating IgA antibody against the basement membrane. Diagnosis of this condition in a resource constrainedcenter, where immunofluorescence is unavailable, may pose diagnostic challenges, and may therefore require high index of suspicion. We describe a case of LAD of childhood in a 7-year-old boy in this report

Investigating Knowledge of Antibiotics, Antimicrobial Resistance and Antimicrobial Stewardship Concepts Among Final Year Undergraduate Pharmacy Students in Northern Nigeria

Samirah N Abdu-Aguye,1,&ast; Kromdi G Barde,1,&ast; Hadiza Yusuf,2,&ast; Basira Kankia Lawal,3,&ast; Aishatu Shehu,4,&ast; Elijah Mohammed5,&ast; 1Department of Clinical Pharmacy & Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria; 2Department of Clinical Pharmacy & Pharmacy Administration, University of Maiduguri, Maiduguri, Nigeria; 3Department of Clinical Pharmacy & Pharmacy Management, Kaduna State University, Kaduna, Nigeria; 4Department of Pharmacology & Therapeutics, Ahmadu Bello University, Zaria, Nigeria; 5Pharmacists Council of Nigeria, Abuja, Nigeria&ast;These authors contributed equally to this workCorrespondence: Samirah N Abdu-Aguye, Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria, Tel +234 803 201 9135, Email [email protected]: Well trained, knowledgeable and competent pharmacists are indispensable in the fight against antimicrobial resistance (AMR), which is a current global public health problem. The aim of this work was to assess knowledge of antibiotics, antimicrobial resistance and antimicrobial stewardship of fifth year pharmacy students at three universities in Northern Nigeria.Methods: A descriptive cross-sectional study that used a paper-based questionnaire to collect data from July to September 2021 was conducted. The questionnaire was self-administered and divided into four sections. The first section collected information about the demographic data of respondents, while section B explored their knowledge of antibiotics and AMR. Section C contained six questions assessing knowledge of various aspects of antimicrobial stewardship (AMS), while the final part assessed respondents’ preparedness to work with antibiotics and perceptions of their current knowledge of these concepts. Descriptive statistics were used to report the results obtained.Results: A total of 164 questionnaires were retrieved. Majority of respondents were male (58.3%) and aged between 21 and 25 years (53.4%). Most of them had some knowledge of antibiotics and AMR, however several misconceptions with respect to these concepts were identified. Only 80 (48.8%) of respondents indicated that they knew what AMS was, although most of these students were correctly knowledgeable about the goals and scope of AMS and composition of the AMS team. Generally, less than half of respondents agreed that their current knowledge of antibiotics, AMR or AMS was adequate for their future careers, and over 90% of them agreed that they would like more education about these topics.Conclusion: Many of the study’s’ respondents were somewhat knowledgeable about these concepts, although several knowledge gaps were also observed. Improving undergraduate pharmacy education with respect to these concepts is recommended.Keywords: antibacterial agents, antibiotic resistance, antimicrobial stewardship, Nigeria, pharmacy student

Potential Roles of Endoplasmic Reticulum Stress and Cellular Proteins Implicated in Diabesity

The role of the endoplasmic reticulum (ER) has evolved from protein synthesis, processing, and other secretory pathways to forming a foundation for lipid biosynthesis and other metabolic functions. Maintaining ER homeostasis is essential for normal cellular function and survival. An imbalance in the ER implied stressful conditions such as metabolic distress, which activates a protective process called unfolded protein response (UPR). This response is activated through some canonical branches of ER stress, i.e., the protein kinase RNA-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme 1α (IRE1α), and activating transcription factor 6 (ATF6). Therefore, chronic hyperglycemia, hyperinsulinemia, increased proinflammatory cytokines, and free fatty acids (FFAs) found in diabesity (a pathophysiological link between obesity and diabetes) could lead to ER stress. However, limited data exist regarding ER stress and its association with diabesity, particularly the implicated proteins and molecular mechanisms. Thus, this review highlights the role of ER stress in relation to some proteins involved in diabesity pathogenesis and provides insight into possible pathways that could serve as novel targets for therapeutic intervention