COMPARISON OF THE EFFICACY OF ARV MEDICATIONS ALONE AND IN COMBINATION WITH HERBAL MEDICATIONS IN THE TREATMENT OF HIV AMONG NIGERIAN HIV+ PATIENTS

ABSTRACT COMPARISON OF THE EFFICACY OF ARV MEDICATIONS ALONE AND IN COMBINATION WITH HERBAL MEDICATIONS IN THE TREATMENT OF HIV AMONG NIGERIAN HIV+ PATIENTS MAY 2017 ABDULFATTAH B. DUROJAIYE, BSN, UNIVERSITY OF MEDICINE & DENTISTRY OF NJ (NOW RUTGERS UNIVERSITY) BSc, UNIVESITY OF AGRICULTURE, ABEOKUTA, NIGERIA MSc, UNIVERSITY OF IBADAN, NIGERIA PhD, UNIVERSITY OF MASSACHUSETTS, AMHERST Directed by Prof. Donna Zucker Background/Purpose: There is disproportionate incidence of HIV in Sub-Saharan Africa in comparison to the rest of the world. Of the estimated 35.3 million people living with HIV, Sub-Saharan Africa has the highest level of HIV infections, accounting for 69% of global HIV infection in spite of having only 12% of the global population. Nigeria, with over 3.2 million people living with HIV, has the second highest HIV/AIDS burden in the world, next only to South Africa (5.6 million) whose population is approximately one third of Nigeria’s population. According to the World Health Organization (WHO) an estimated 80% of Africans reportedly use herbal therapies in the treatment of many diseases (WHO, 2002). The use of herbal remedies in the treatment of HIV has gained currency in Nigeria. The purpose of this study was to investigate the efficacy of ARV- only therapy and a combined therapy of ARV and herbal medications and to also investigate the effect of these treatment modalities on HIV symptoms and patients’ quality of life among HIV patients in Nigeria. Methods: This is a comparative analysis study designed to compare the efficacy of conventional antiretroviral (ART) medications with a combination therapy of ART and herbal therapies as they are already used by Nigerian HIV patients. The World Health Organization Quality of Life Instrument for HIV (WHOQOL-HIV BREF) and the Sign and Symptom Check-List for persons with HIV disease (SSC-HIV BREF) questionnaires were administered to 110 participants drawn from two groups of Nigerian HIV patients: those using conventional antiretroviral medications only and those using a combination of herbal remedies and conventional antiretroviral medications. Each group was composed of 55 participants. Physiological data (CD4 counts) was also collected for the two groups. Data generated from the study was analyzed using IBM SPSS Statistics 22 software. Both descriptive and inferential data analyses were used to analyze study results. Descriptive statistics was used to analyze the demographic data (age, gender, and ethnicity) while inferential statistics was used to draw conclusion from study data. Paired Sample test was used to determine the differences between baseline CD4 counts and post-treatment CD4 counts in both groups. Analysis of covariance (ANCOVA) was used to statistically adjust and control the differences noted in baseline CD4 counts between the two groups before comparative analyses of the two groups’ CD4 counts were done. Independent t-test was used to compare the differences between ARV group and combined group. Findings: There was a statistically significant difference between baseline CD4 counts and post- treatment CD4 counts after treatment with ARV only and combined therapies. However, no statistically significant difference was noted in the overall quality of life of patients receiving ARV only and those receiving combined therapies (p=.211). Statistically significant difference was noted in social relationship domain (p=.028) and health satisfaction domain (p=.049) of the WHOQOL BREF instruments. No statistically significant difference was noted in all the sign and symptom factors evaluated except in the fever factor (p=.003) and sore throat factor (p=.013). Conclusion: Findings from this study have shown that a vast majority of patients on combined therapy do so without disclosing the use of herbal remedies to their physicians and care providers. It is expected that physicians and care providers would incorporate this knowledge into their care model, build trusting and supportive relationships with patients and specifically solicit information about the use of herbal therapy in combination with ARV. This knowledge will enable physicians, nurses and other care providers to explore possible side effects and cross reactions between ARV and herbal remedies. Keywords: HIV, ARV, Herbal Medications, Nigeri

DEVELOPMENT OF A WEB BROWSER EXTENSION FOR PHISHING WEBSITE DETECTION USING MACHINE LEARNING

Online platforms play a critical role in daily life; however, they expose users to cybersecurity threats, including phishing attacks. This study focuses on developing a web browser extension that utilizes machine learning techniques to identify phishing websites with enhanced accuracy. Five machine learning algorithms - Decision Tree, Random Forest, Support Vector Machine (SVM), Logistic Regression, and Gaussian Naive Bayes - were evaluated for phishing detection using a dataset of 11,430 URLs consisting of 87 features such as URL length, domain age, and web traffic. The study also engaged Exploratory Data Analysis to extract key insights from the dataset. The evaluation reveals the effectiveness of different machine learning models. Metrics like accuracy, precision, recall, and F1 score are provided for each model, highlighting their strengths and limitations. Through cross-validation and careful hyperparameter tuning, the Random model emerges as the most accurate. Rule extraction is then applied to this model, yielding understandable rules that illuminate its decision-making process. Additionally, the study practically applies the developed model through a phishing detection Web Browser Extension. This extension offers real-time website validation and alerts users about potential phishing risks. By seamlessly integrating machine learning into a user-friendly interface, the browser extension empowers users to assess website legitimacy, thereby enhancing online security. This study offers valuable insights into cybersecurity by presenting an efficient machine learning method for the identification and classification of phishing websites. The findings underscore the potential of this model to safeguard sensitive information and counter the rising threat of phishing attacks

Technical Efficiency and Constraints among Medium Scale Maize Production in Oyo State, Nigeria

This study presents the empirical analysis of the constraints and determinants of technical efficiency in medium – scale maize production in Oyo state, Nigeria. Primary data were collected on 76 medium scale maize farmers selected from some major maize producing agricultural area Afijio L. G. A. in Oyo state Nigeria. The selection of respondents was multi – staged and involved random sampling as well as purposive sampling methods. Mean and standard deviation were used to analyze the constraints on maize production while translog stochastic frontier model was used to estimate the determinants of technical efficiency of the farmers. The major constraints on maize production as perceived by medium – scale farmers among others was inadequate processing facilities (39.5%) and lack of mechanical services (25.0%). The average technical efficiency about 75%. The determinants of technical efficiency which were statistically significant were sex, age and experience, sex and age had an inverse relationship with technical inefficiencies of farmers while experience had a direct relationship. Hence, Nigeria, public and private policies that would improve the farmers’ experience in maize production especially in handing the available technologies would lead to significant increase in the level of technical efficiency in medium – scale maize production. Keywords: Technical Efficiency, Constraints, Stochastic Frontier, Maize production, Nigeri

IMPLEMENTATION OF A HARDWARE TROJAN CHIP DETECTOR MODEL USING ARDUINO MICROCONTROLLER

These days, hardware devices and its associated activities are greatly impacted by threats amidst of various technologies. Hardware trojans are malicious modifications made to the circuitry of an integrated circuit, Exploiting such alterations and accessing the level of damage to devices is considered in this work. These trojans, when present in sensitive hardware system deployment, tends to have potential damage and infection to the system. This research builds a hardware trojan detector using machine learning techniques. The work uses a combination of logic testing and power side-channel analysis (SCA) coupled with machine learning for power traces. The model was trained, validated and tested using the acquired data, for 5 epochs. Preliminary logic tests were conducted on target hardware device as well as power SCA. The designed machine learning model was implemented using Arduino microcontroller and result showed that the hardware trojan detector identifies trojan chips with a reliable accuracy. The power consumption readings of the hardware characteristically start at 1035-1040mW and the power time-series data were simulated using DC power measurements mixed with additive white Gaussian noise (AWGN) with different standard deviations. The model achieves accuracy, precision and accurate recall values. Setting the threshold proba¬bility for the trojan class less than 0.5 however increases the recall, which is the most important metric for overall accuracy acheivement of over 95 percent after several epochs of training

The Prevalence of Human Immunodeficiency Virus Infection among Pregnant Women in Labour with Unknown Status and those with Negative status early in the Index Pregnancy in a Tertiary Hospital in Nigeria.

Rapid HIV test in labour provide an opportunity for the identification of HIV positive pregnant women who should benefit from interventions to reduce the risk of mother-to-child transmission (MTCT) of HIV. Between November 2013 and June 2014 we conducted rapid HIV testing of pregnant women in labour at the National Hospital Abuja to determine the HIV seroconversion rate in pregnancy and the prevalence of HIV in pregnant women in labour with previously unknown status. HIV testing and counseling (HTC) was acceptable to 224 (99.6%) of the pregnant women who met the study criteria. The mean 'turnaround' time for test result was 288 minutes and 16.2 minutes for tests performed in the hospital laboratory and those performed at the point‐of‐care (labour ward) respectively. HIV seroconversion was detected in 2(1.2%) of the 165 parturients with initial HIV negative result early in the index pregnancy. HIV infection was detected in four (2.7%) of the 59 parturients with unknown HIV status. Secondary school level education was significantly associated with HIV seroconversion in pregnancy P<0.001. HTC in labour using rapid testing strategy is feasible and acceptable in our setting. The introduction of HCT will lead to the diagnosis of HIV positive women in labour, appropriate interventions and prevention of MTCT of HIV. (Afr J Reprod Health 2015; 19[3]: 137-143). Keywords: Human Immunodeficiency Virus, mother‐to‐child transmission, rapid HIV testing, prevention of mother-to-child transmission of HIV, seroconversion, HIV prevalence Les analyses rapides pour détecter le VIH pendant le travail fournit une opportunité pour l'identification des femmes enceintes séropositives qui devraient bénéficier des interventions visant à réduire le risque de transmission du VIH de la mère à l'enfant (TME). Entre novembre 2013 et juin 2014, nous avons mené un dépistage rapide du VIH auprès des femmes enceintes en travail à l'Hôpital National d'Abuja pour déterminer le taux de séroconversion du VIH pendant la grossesse et la prévalence du VIH chez les femmes enceintes dans le travail avec l’état de santé jusque-là inconnue. Le Dépistage et les Conseils à propos du VIH (DCV) étaient acceptables à 224 femmes enceintes (99,6%) qui répondaient aux critères de l'étude. Le temps moyen de «redressement» pour le résultat de l’analyse était de 288 minutes et 16,2 minutes pour les analyses effectuées dans le laboratoire de l'hôpital et celles effectuées au point des soins (salle d’accouchement) respectivement. La séroconversion du VIH a été détectée chez 2 (1,2%) des 165 parturientes initiales qui avaient des résultats négatifs du VIH au début de la grossesse index. Infection par le VIH a été détectée dans quatre (2,7%) des 59 parturientes dont l’état d santé par rapport au VIH était inconnu. La scolarité de niveau secondaire était significativement associée à la séroconversion du VIH pendant la grossesse P <0,001. Le DCV pendant le travail en utilisant la stratégie de dépistage rapide est possible et acceptable dans notre milieu. L'introduction du DCV mènera au diagnostic des femmes séropositives dans le travail, aux interventions appropriées et à la prévention de la TME du VIH. ((Afr J Reprod Health 2015; 19[3]: 137-143). Mots-clés: Virus de l'immunodéficience humaine, transmission de la mère à l’enfant, dépistage rapide du VIH, prévention de la transmission de la mère à l'enfant, séroconversion, prévalence du VIH

A Novel Approach for the Investigation of Multidisciplinary Collaboration using Social Network Analysis on Electronic Health Record Data

Social network analysis (SNA) is widely used to study multidisciplinary collaboration among healthcare professionals. Most of the earlier works have however relied on survey and observational data, which do not scale, and have been limited to only descriptive studies without providing insight on how to improve patient outcomes. However, since the widespread adoption of electronic health records (EHR) for care delivery, there has been progressively increasing interest in exploiting the rich collection of activity data that are captured in EHR systems. Ability to exploit EHR data has the potential to offer unprecedented capacity to study and improve multidisciplinary teams. Unfortunately, the methodologic approaches used so far have had significant limitations, which have hampered the realization of this promise. In this dissertation, I describe a novel, process-mining based methodologic approach for applying SNA to study multidisciplinary collaboration using metadata of clinical activities captured in EHR. First, I described the process of linking the EHR activity metadata to trauma registry data, which is rich in quality clinical and encounter data to produce a linked dataset that was used for the dissertation. Second, I described and applied the methodology to identify collaborative EHR usage patterns and correlated them to patient outcomes. I demonstrated that a more collaborative EHR usage pattern were associated with shorter emergency department length of stay, in the process, identifying meaningful insight that can be the focus of further research or intervention. And finally, I described and applied a modification of the methodology to identify and compare diurnal variations in collaborative care teams at various locations in the hospital. I demonstrated the presence of multi-team systems and described how the composition and collaborative patterns of the multi-team systems varied with the time of day. This dissertation provides a promising new direction for harnessing EHR data, and in doing so, sets the stage for future studies

Down With the Sickness: The Impact of Residential Living on the Spread of Illness

The health and wellbeing of students are extremely important, and with close quarters and prolonged contact in residential schools, we must consider the risk of contagious and infectious illnesses spreading faster and causing absences from classes. Residential living contributes to the learning environment at IMSA in multiple positive and impactful ways. However, it is important to discuss the potential health impacts that the increased exposure to other students can have on students and the absences these can cause. In this project, we will analyze the effects of residential living on the spread of illness and absences due to illness, especially during the flu outbreak of January 2018. In this project, we will use health records from the nurse and analyze them so we can see if there is a strong correlation between the spread of infectious diseases and residential living on campus. The data will help us answer questions about the number of students that have reported sick to the nurse\u27s office and if they went home due to their sickness or carried on with the school day

Discourse acts and clause process options : an investigation into the spoken English used by teachers and pupils during selected lessons in some secondary school classrooms in urban areas of Nigeria

The research reported in this thesis has as its setting the secondary school classroom in Nigeria, where English is used as further tongue medium of instruction. In order to investigate the use of English as medium across the curriculum, the spoken language of teachers and pupils during forty lessons, ten from each of four subject areas, was analysed. The method of analysis used focuses on the discourse acts and the grammatical rank clause. The occurrences of discourse acts and choices from process options within the clause are identified and analysed, as are interactions between the two ranks, Features within lessons which appear to influence these occurrences and interactions are also identified and discussed. The findings of the investigation indicate that the teachers in the present sample, on the whole, tend to use a wide range of both discourse acts and clause process options. The pupils, on the other hand, tend to use a more limited range on 80th measures. With regard to the interaction between discourse acts and the clause process options expressed within them, the findings suggest that patterns of choice from the clause process options within certain discourse acts reflect the acts' discourse function. Some apparently subject-linked features are identified in the patterns of choice from the clause process options. The predominance of minor clauses in pupils' spoken English is seen as a cause for concern in the further tongue English setting. Teaching devices which apparently affect the amount of practice pupils are given in using a wider range of discourse acts and clause process options are identified. The implications of the findings for the training of teachers in the use of spoken English across the curriculum are discussed, as are the limitations of this study and its implications for future research