Machine Learning for Diabetes and Mortality Risk Prediction From Electronic Health Records

Data science can provide invaluable tools to better exploit healthcare data to improve patient outcomes and increase cost-effectiveness. Today, electronic health records (EHR) systems provide a fascinating array of data that data science applications can use to revolutionise the healthcare industry. Utilising EHR data to improve the early diagnosis of a variety of medical conditions/events is a rapidly developing area that, if successful, can help to improve healthcare services across the board. Specifically, as Type-2 Diabetes Mellitus (T2DM) represents one of the most serious threats to health across the globe, analysing the huge volumes of data provided by EHR systems to investigate approaches for early accurately predicting the onset of T2DM, and medical events such as in-hospital mortality, are two of the most important challenges data science currently faces. The present thesis addresses these challenges by examining the research gaps in the existing literature, pinpointing the un-investigated areas, and proposing a novel machine learning modelling given the difficulties inherent in EHR data. To achieve these aims, the present thesis firstly introduces a unique and large EHR dataset collected from Saudi Arabia. Then we investigate the use of a state-of-the-art machine learning predictive models that exploits this dataset for diabetes diagnosis and the early identification of patients with pre-diabetes by predicting the blood levels of one of the main indicators of diabetes and pre-diabetes: elevated Glycated Haemoglobin (HbA1c) levels. A novel collaborative denoising autoencoder (Col-DAE) framework is adopted to predict the diabetes (high) HbA1c levels. We also employ several machine learning approaches (random forest, logistic regression, support vector machine, and multilayer perceptron) for the identification of patients with pre-diabetes (elevated HbA1c levels). The models employed demonstrate that a patient's risk of diabetes/pre-diabetes can be reliably predicted from EHR records. We then extend this work to include pioneering adoption of recent technologies to investigate the outcomes of the predictive models employed by using recent explainable methods. This work also investigates the effect of using longitudinal data and more of the features available in the EHR systems on the performance and features ranking of the employed machine learning models for predicting elevated HbA1c levels in non-diabetic patients. This work demonstrates that longitudinal data and available EHR features can improve the performance of the machine learning models and can affect the relative order of importance of the features. Secondly, we develop a machine learning model for the early and accurate prediction all in-hospital mortality events for such patients utilising EHR data. This work investigates a novel application of the Stacked Denoising Autoencoder (SDA) to predict in-hospital patient mortality risk. In doing so, we demonstrate how our approach uniquely overcomes the issues associated with imbalanced datasets to which existing solutions are subject. The proposed model –– using clinical patient data on a variety of health conditions and without intensive feature engineering –– is demonstrated to achieve robust and promising results using EHR patient data recorded during the first 24 hours after admission

Frequency of Reporting and the Quality of Randomized Controlled Trials Published in the Nigerian Journal of Ophthalmology

Aim: To determine the frequency of reporting and the methodological quality of randomized controlled trials in the Nigerian Journal of Ophthalmology (NJO) from 1993 – 2001.Materials and methods: Back issues of NJO published from 1993 to 2001 were searched for reports of randomized controlled trials. The quality of identified trials was assessed using standard Cochrane methods.Results: One out of 104 articles published in the 9 volumes of NJO from 1993 – 2001 can be described as a randomized controlled trial. Complete information regarding the method of allocation concealment, masking of providers and recipients of care, and masking of outcome assessors was not provided. It was not clear whether all patients were followed-up for 6months or 1 year, or whether there was a differential loss to follow-up between the study groups.Conclusions: Only one randomized controlled trial was published in the Nigerian Journal of Ophthalmology between 1993-2001. Assessment of the methodological quality of the reported trial was hampered by lack of complete information on parameters used to assess trial quality in this study.Key words: clinical trials, reporting, methodological quality, Nigerian Journal of Ophthalmolog

Small Earth Dams in Nigeria: Prospects and Challenges

The study investigates the challenges and prospects of earth dams in Nigeria with emphasis on dams owned by the River Basin Development Authorities of the Federal Ministry of Agriculture and Water resources using Cham dam in Gombe State as case study. The general causes of earth dam failure were considered with emphasis on failures due to engineering factors. The dam water provides raw water for the supply of potable wholesome water to the community all year round and some for irrigated agriculture that not only boost the local economy and reduces poverty but also support a viable livestock management. Cham dam failed in September 1998 after commissioning in December 1992 as a result of poor planning, inadequate study, inconsistent design, un-engineered construction and lack of dam safety monitoring team at site. Based on the findings, suggestions were given on how some earth dam failures in Nigeria can be minimized in terms of adequate feasibility studies, good design, appropriate construction and an improved maintenance culture. Keywords: Small earth dams, un-engineered construction, environmental management, prospects SED, hydraulic failure. DOI: 10.7176/JETP/9-5-02 Publication date:June 30th 201

Determinants of Fisher’s Choice of Fishing Activity along the Volta Lake in Yeji, Ghana

The study examined factors that influence people’s decision to engage in the fishery-related activities in Yeji, a major inland fishing town in Ghana. A total of 304 respondents were randomly selected and interviewed using semi-structured questionnaire. The analysis was done using the Ordered Probit Model and descriptive statistics. The study revealed that fishers in Yeji depend on the small-scale fisheries as their source of livelihood. The Ordered Probit regression analysis showed that the likelihood to engage in the fishery-related activities was significantly influenced by factors such as fishers’ level of education, average daily catch, gear ownership (boat), credit access, fishing experience, income and household size. The study revealed that lack of credit access as affirmed by majority (82%) of the respondents as the major challenge faced in the study areas. It is concluded that the fisheries sub-sector has the potential to boost economic growth, reduce poverty and ensure household food security in Yeji. It is therefore recommended that Ghana government through the Fisheries Commission should put in place sustainable measures and strategies that would ensure availability of fishing nets and boats for rural poor fishers.Key words: Volta Lake, Determinants, Fishing Experience, Likelihood, Ordered Probit Mode

Growth Performance of the Nile Tilapia, Oreochromis Niloticusf Cultured in Cages in Two Dams in the Bongo District of Ghana

This study was carried out to compare the growth performance and survival rate of Nile tilapia, Oreochromis niloticus cultured in cages in two different dams in the Bongo District of the Upper East Region of Ghana. Three cages with the same structural characteristics were constructed in each of the dams as replicates. Each cage was stocked with 9500 all male O. niloticus fingerlings and fed with 48 % nourish plus feed thrice daily for a period of eight weeks. Twenty-five samples of the fishes were randomly collected bi-weekly from each cage and measurements such as standard length and body weight recorded. Other growth characteristics such as specific growth rate (SGR), feed conversion ratio (FCR), protein efficiency ratio (PER), mean weight gain (MWG), condition factor (K) and survival rate (SR) were estimated. The results revealed that, O. niloticus cultured in the Soe-Yidongo community dam recorded the highest growth performance in terms of final body weight, standard length, weight gain, specific growth rate, condition factor and protein efficiency ratio, and they were significantly different (p < 0.05) from those recorded in the Bon-Gurigo community dam which was attributed to the variations recorded in the physicochemical parameters of the two dams. It was concluded that tilapia cultured in cages might be an important alternative livelihood strategy for poor people in rural communities in Ghana

Optimization of simultaneous production of waste cooking oil based-biodiesel using iron-manganese doped zirconia-supported molybdenum oxide nanopeprintss catalyst

Biodiesel derived from simultaneous esterification and transesterification of waste cooking oil has been attracting consideration as a replacement green fuel for diesel fuels, as it is economically feasible and circumvents the issue of energy versus food, which is estimated to take place with current biodiesel production techniques. In this optimization study, iron-manganese doped zirconia-supported molybdenum oxide catalyst has been prepared and used in the synthesis of waste cooking oil based biodiesel by a simultaneous esterification and transesterification method. The catalyst is prepared via an impregnation method and consequently characterized by XRD, TEM, TGA (thermogravimetric analysis), TPD-NH3, and Brunauer–Emmer–Teller (BET) techniques. The simultaneous process for biodiesel production has been assessed and improved statistically via response surface methodology in combination with the central composite design. It has been established that the process for synthesis of waste cooking oil based biodiesel achieved about 96.8% biodiesel yield at a best condition of 200 °C, waste cooking oil/ methanol molar ratio of 1:30 and 5.0 wt. % as loading of the catalyst. The highest ester yield of 96.8% has been obtained due to the improved physicochemical properties of zirconia-supported molybdenum oxide catalyst which accesses diffusion of the reactants to the active sites

Negotiating caring practices among internal migrant women in Accra-Ghana

175 leaves ; 29 cm.Includes abstract and appendices.Includes bibliographical references (leaves 162-175).This thesis focuses on the negotiation of care provision, changes in caring practices post-migration and the impact of women`s internal, North-South migration on gender and family relations and communities of origin in Ghana. Ten in-depth interviews with migrant women revealed that women have become frontrunners in the migration process, engaging in different modalities of care where they negotiate with spouses and other family members for the care of their left behind families. The story of negotiating caring practices shows that women’s migration changes gender and family roles to an extent, while, at the same time it reproduces them. There are financial, material and emotional consequences of migration on migrant women and their families as well as their communities of origin. Directions for future research should include the impacts of care-giving on left behind families from their own experiences, and the reconstruction of masculinities from men`s perspectives

ORIGINAL ARTICLES Limnological Evaluation of the Fisheries Potentials of a Ghanaian Reservoir

ABSTRACT Morpho-edaphic Index (MEI), and total nutrient input have been applied to the Dawhenya reservoir in Ghana from August 2006 to July 2007 to estimate existing fish yield and future potential productivity. The estimated existing fish yield from the reservoir was about 38.44 kg/ha. In the Dawhenya reservoir, 12 species belonging to 8 genera were encountered out of which 7 genera were fin fishes while the remaining genus was a shell fish. During the dry season, eight fish species were sampled and Barbus macrops contributed the highest (71.6 %) and Oreochromis niloticus the lowest (0.2 %) by weight while in the wet season five fish species were collected and Barbus macrops contributed the highest (85.3 %) and Macrobrachium vollenhovenii the lowest (2.1 %) of total weight of fish in drag net catches. Estimates of b-values ranged from 2.793 in Sarotherodon galilaeus to 3.267 in Macrobrachium vollenhovenii. Only Barbus macrops growth pattern in the reservoir was isometric meaning there was an equal increase in length and weight during growth, while Macrobrachium vollenhovenii, Macrobrachium macrobrachion and Sarotherodon galilaeus growth patterns were allometric, meaning increases in length and weight of the species were not equal during growth. The general physicochemical parameters monitored during the study period fell within the ranges suitable for fisheries and aquatic life in reservoirs, except for phosphates which were outside recommended ranges. Observations of pH showed that the reservoir was slightly alkaline. Agricultural activities within the catchment area of the reservoir should be monitored and controlled to prevent nutrient enrichment since the inhabitants were predominantly peasant farmers

Evaluation of adverse drug reaction reports in adult patients on antiretroviral therepy in Ahmadu Bello University Teaching hospital Zaria-Nigeria

Antiretroviral therapy (ART) has reduced morbidity and mortality in HIV patients. In Nigeria, there are over 400,000 patients on ART in over 200 secondary and tertiary hospitals. However, data on adverse drug reactions (ADRs) due to ARTs are limited. The aim of this study was to evaluate ADRs reports in adult patients on ART in Ahmadu Bello University Teaching Hospital Zaria (ABUTH). The study was a retrospective cross-sectional study on randomly selected adult patients on ART with ADR reports in Nasara Clinic of ABUTH, between January, 2012 and December, 2013. Medical records and ADR reports of the patients were reviewed and fitted into a structured questionnaire. Data were analyzed using SPSS Version 20.0. The study reviewed the records of 302 patients on ART as per the sample size out of a total of 1405 patients in the register within the study period. Of the 302 patients, 109 (36.1%) were reported to have at least one form of ADR, majority of whom were females 65 (59.6%). The most common ADRs were cough (34%), skin rash (44%), headache (20%) and diarrhea (10%), with few cases of anemia (5.5%), lipodostrophy (3.6%) and neuropathy (1.8%). 55% and 98% had concomitant disease and medications respectively. The actions taken to manage the ADR were; specific treatment of the ADR (69.7%), change of ARV regimen (22%) and few cases of hospitalization (6.4%). In conclusion, the study revealed the occurrence of ADRs in adult patients on ART in ABUTH. These reactions occurred within few months of medication, and were found to be related to age, social factor, ART regimen, gender, as well as other concomitant diseases and medications. Close monitoring is required to prevent severe ADR and improve adherence.Keywords: Antiretroviral therapy, adverse drug reaction, cough, retrospectiv