Ekiti State University

<h3>Importance</h3> Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. <h3>Objective</h3> To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. <h3>Evidence Review</h3> We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. <h3>Findings</h3> In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). <h3>Conclusions and Relevance</h3> The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

IMPORTANCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

On the Internet, where the number of choices is overwhelming, there is need to filter, prioritize and efficiently deliver relevant information in order to alleviate the problem of information overload, which has created a potential problem to many Internet users. Recommender systems solve this problem by searching through large volume of dynamically generated information to provide users with personalized content and services. This paper explores the different characteristics and potentials of different prediction techniques in recommendation systems in order to serve as a compass for research and practice in the field of recommendation systems.

Starch is, after cellulose, the most abundant organic compound in nature. Modification of starch is carried out to enhance the positive attributes and to eliminate the shortcomings of the native starches. Various methods have been developed to produce a range of modified starches with a variety of characteristics and applications. Physically modified starches are simple and inexpensive because they can be produced without chemicals or even biological agents. In contrast, chemical modification is possible due to ubiquitous hydroxyl groups in starches that have been exploited for over a century, principally in the preparation of starch esters and ethers, but also in more subtle alterations, e.g., in order to tune the structure of starches for specific applications. All these techniques tend to alter the highly flexible starch polymer with changed physicochemical properties and modified structural attributes of high technological value for the food and non‐food industries. Modification of starch is an ever evolving industry with numerous possibilities to generate novel starches which includes new functional and value added properties as demanded by the industry. This review aims to summarize the latest developments and recent knowledge regarding physically and chemically modified starches. This paper covers physical modification methods (pre‐gelatinization, hydrothermal, and non‐thermal processes), some chemical modifications and a combination of both.

Due to complex and erratic nature of groundwater occurrences in crystalline basement terrains, groundwater development in form of boreholes/wells without the necessary pre-drilling hydrogeological investigations usually results in failure. Therefore, there is the need for adequate characterization of aquifers and delineation of groundwater potential zones in such crystalline basement setting. This study employed the integration of multi-criteria decision analysis (MCDA), remote sensing (RS) and geographical information system (GIS) techniques to delineate groundwater potential zones in crystalline basement terrain of SW-Nigeria and validation of the result with existing borehole/well yield data. The study approach involved integration of nine different thematic layers (geology, rainfall geomorphology, soil, drainage density, lineament density, landuse, slope and drainage proximity) based on weights assignment and normalization with respect to the relative contribution of the different themes to groundwater occurrence using Saaty’s analytic hierarchy approach. Following weigh normalization and ranking, the thematic maps were integrated using ArcGIS 10.0 software to generate the overall groundwater potential map for the study area. The result revealed that the study area can be categorized into three different groundwater potential zones: high, medium and low. Greater portion of the study area (84,121.8 km2) representing about 78 % of the total area, fall within the medium groundwater potential zone which are generally underlain by medium-porphyritic granite, biotite-hornblende granite and granite gneiss bedrock settings. About 18,239.7 km2 (17 %) fall under high groundwater potential zone which are characterized by weathered/fractured quartzite, quartz-schist, amphibolite schist and phyllite bedrock settings. However, areas of low groundwater potentials constitute only 3 % (3,416.54 km2) of the total study area and are mostly underlain by migmatite, banded and augen gneiss bedrock settings. Subsequent validation with boreholes/well yield data revealed a good correlation with respect to the observed groundwater potential zonation. Wells/boreholes with yields greater than >150 m3/day are generally characteristic of areas with high groundwater potential while those with yields of 75–150 and <75 m3/day are typical of areas with medium and low groundwater potentials, respectively. The validation clearly highlights the efficacy of the integrated MCDA, RS and GIS methods employed in this study as useful modern approach for proper groundwater resources evaluation; providing quick prospective guides for groundwater exploration and exploitation in such crystalline basement settings.

BACKGROUND: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. METHODS: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. FINDINGS: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6-47·0) in 1990 to 63·4 years (63·1-63·7) in 2023. For males, mean age increased from 45·4 years (45·1-45·7) to 61·2 years (60·7-61·6), and for females it increased from 48·5 years (48·1-48·8) to 65·9 years (65·5-66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9-81·0) and for males 74·8 years (74·8-74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5-38·4) for females and 35·6 years (35·2-35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. INTERPRETATION: We examined global mortality patterns over the past three decades, highlighting-with enhanced estimation methods-the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. FUNDING: Gates Foundation.

This paper discussed validity and reliability issues in educational research. It was suggested that validity and reliabilitycan be applied to both quantitative and qualitative educational research and that threats to educational research can beattenuated by paying attention to validity and reliability throughout the research.

E-learning presents an entirely new learning environment for students, thus requiring a different skill set to be successful. Critical thinking, research, and evaluation skills are growing in importance as students have increasing volumes of information from a variety of sources to sort through (New Media Consortium, 2007). In addition, particularly in courses that are electronic, students are much more independent than in the traditional setting. This requires that they be highly motivated and committed to learning, with less social interaction with peers or an instructor. Students in online courses tend to do as well as those in classrooms, but there is higher incidence of withdrawal or incomplete grades. E-learning can be viewed as computer assisted learning, and as pedagogy for student-centered and collaborative learning. Early developments in e-learning focused on computer assisted learning, where part or all of the learning content is delivered digitally. More recently, the pedagogical dimension of e-learning has become prominent. E-learning comprises all forms of electronically supported learning and teaching. The information and communication systems, whether networked learning or not, serve as specific media to implement the learning process.

BACKGROUND: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. OBJECTIVE: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. OUR APPROACH: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. ONGOING ACTIVITIES: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. CONCLUSION: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.

Sign language is an essential tool to bridge the communication gap between normal and hearing-impaired people. However, the diversity of over 7000 present-day sign languages with variability in motion position, hand shape, and position of body parts making automatic sign language recognition (ASLR) a complex system. In order to overcome such complexity, researchers are investigating better ways of developing ASLR systems to seek intelligent solutions and have demonstrated remarkable success. This paper aims to analyse the research published on intelligent systems in sign language recognition over the past two decades. A total of 649 publications related to decision support and intelligent systems on sign language recognition (SLR) are extracted from the Scopus database and analysed. The extracted publications are analysed using bibliometric VOSViewer software to (1) obtain the publications temporal and regional distributions, (2) create the cooperation networks between affiliations and authors and identify productive institutions in this context. Moreover, reviews of techniques for vision-based sign language recognition are presented. Various features extraction and classification techniques used in SLR to achieve good results are discussed. The literature review presented in this paper shows the importance of incorporating intelligent solutions into the sign language recognition systems and reveals that perfect intelligent systems for sign language recognition are still an open problem. Overall, it is expected that this study will facilitate knowledge accumulation and creation of intelligent-based SLR and provide readers, researchers, and practitioners a roadmap to guide future direction.

This study demonstrates the use of 3D Ni₃N/carbon cloth nanosheets as electrode materials for lithium ion batteries and supercapacitors.

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000-2018 geospatial estimates of anemia prevalence in women of reproductive age (15-49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization's Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.

Five biomasses spruce (Picea abies L.), beech (Fagus sylvatica L.), iroko (Chlophora excelsa L.), albizia (Albizia adianthifolia L.), and corncob (Zea mays ssp.) have been subjected to analytical pyrolysis (Py-GC/MS) and bench-scale pyrolysis with a fluidized bed reactor at 470 °C. The comparison of Py-GC/MS and bench scale results revealed only small differences in the relative concentration of single products mainly acetic acid, hydroxyacetaldehyde, hydroxypropanone, and lignin-derived guaiacyl and syringyl components. For European woods, organic oil yields were approximately 57%, whereas African biomasses yielded between 41 and 48% because of their higher mineral contents. The analysis of bio-oil composition revealed no significant differences between African and European biomasses. Acetic acid, hydroxyacetaldehyde, hydroxypropanone, and levoglucosan were found to be the largest individual components in the volatiles. Bio-oil from corncob, having the lowest lignin content contained high concentration of 4-vinyl-phenol, a lignin derived product. This implied that the degradation products largely depend on the constituents' structure of the biomass. The higher heating value of all bio-oils ranged 16−17 MJ/kg.

Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use.Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known.Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals.Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored.

Determination of the proximate, nutritionally valuable minerals and anti-nutrient compositions in larvae of Cirina forda (W) showed that they contained high levels of protein, (55.50%+/-1.20%) with ash, moisture, fat, and carbohydrate levels being (10.26%+/-0.01%), (10.85%+/-0.38%), (4.68%+/-0.01%) and (18.70%+/-0.84%) respectively. Fibre was not detected. Protein solubility was higher in alkaline media than in acidic media while the isoelectric points were pH 4, 6 and 9 indicating that C. forda may be useful in food formulations involving foods like meat products. Phosphorus had the highest value of (215.54+/-0.21) mg/100 g while manganese had the lowest value of (1.14+/-0.10) mg/100 g. Copper, Co, Pb, Cr and Ni were not available. Water absorption capacity was (300%+/-0.15%), oil absorption capacity was (358.44%+/-0.21%) and foaming stability was (3%+/-0.00%). The results of anti-nutritional analysis revealed that oxalate and phytic acid contents were (4.11+/-0.05) mg/100 g and (1.02+/-0.00) mg/100 g respectively and that these values fell within nutritionally accepted values. Tannin was not detected in C. forda. C. forda, a rich source of animal nutrients, usable in human diets and animal feeds formulations.

Background . Self-medication is the use of drugs to treat self-diagnosed disorders or symptoms or the intermittent or continued use of prescribed drug for chronic or recurrent disease or symptoms, and it is mostly common in developing countries. This study therefore assessed the practice of self-medication among undergraduate students of a private university in Nigeria. Methods . The study employed a descriptive cross-sectional design. A pretested questionnaire was self-administered to 384 undergraduate students of the university. Data were analysed and summarised using descriptive and inferential statistics such as chi-squared and Fisher’s exact tests. Results . Overall, 297 (81.8%) undergraduate students practiced self-medication. About 71% of the students had used analgesic, antibiotics (10.5%), and antimalarial drugs (33%) without prescription within one month prior to the survey. The most commonly used drug for self-medication was paracetamol (75.1%). Furthermore, self-medication was found to be significantly associated with age (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.021</mml:mn></mml:mrow></mml:math>), gender (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>), college (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.025</mml:mn></mml:mrow></mml:math>), and year of study (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.004</mml:mn></mml:mrow></mml:math>). Some of the reasons why undergraduate students practiced self-medication were because of the unfriendly attitude of health care workers (27.7%), lack of time to go to school clinic (26.7%), school clinic is too far from hostel (15.3%), and drugs prescribed in the school clinic do not improve health condition (15.3%). Conclusion . Majority of the students attributed the practice of self-medication to unfriendly attitude of health care workers in the university clinic.

This study showcases the predictive and optimization capabilities of response surface methodology with respect to the fresh and hardened properties of waste tyre steel fibre reinforced concrete containing limestone powder. Response surface methodology has the advantage of simultaneously varying chosen independent variables to provide a useful model for overall response variation. The study identifies aspect ratio (50–140), water cement ratio (0.2–0.4) and cement content (25%–40%) as independent variables while limestone powder was kept constant at 5% by weight of concrete. Predictive equations for the water intake/absorption, compressive strength, flexural strength, split tensile strength and slump of fibre reinforced concrete were obtained using the independent variables. The analysis of variance (ANOVA) for all properties indicates that the modified quadratic model was able to effectively predict the fresh and hardened properties of fibre reinforced concrete with coefficient of determination ranging between 0.86 and 0.98. In addition, RSM model predictive efficiency was classified as very good for compressive strength, splitting tensile strength, slump and water absorption and acceptable for FS in terms of Nash & Sutcliffe coefficient of model efficiency. An optimum condition of 140 for the aspect ratio, 0.26 for water cement ratio and 40% for cement content corresponding to 0.94%, 42.69 N/mm2, 7.97 N/mm2 5.23 N/mm2 7.65 cm for water intake/absorption, compressive strength, flexural strength, split tensile strength and slump respectively was achieved. These predictions were validated and a good correlation was observed between the experimental and predicted values judging by the absolute relative percent error of 0.842, 11.35, 3.6, 18.22 and 2.04 for water intake/absorption, compressive strength, flexural strength, split tensile strength and slump respectively. The proposed mathematical models are capable of predicting the required fresh and hardened properties of fibre-reinforced concrete as to inform early decision making when utilized in construction. Keywords: Compressive strength, Concrete, Fibre reinforcement, Response surface methodology, Waste management

The proximate analysis, evaluation of nutritionally valuable minerals, sugars, chemical properties of the oil and functional properties of the seed flour of quinoa (Chenopodium quinoa) were studied. The results showed that the quinoa flour contained 11.2% moisture, 13.5% crude protein, 6.3% ether extract, 9.5% crude fibre, 1.2% total ash and 58.3% carbohydrate. The quinoa has a high proportion of D-xylose (120.0 mg in 100 g sample) and maltose (101.0 mg in 100 g sample), and a low content of glucose (19.0 mg in 100 g sample) and fructose (19.6 mg in 100 g sample), suggesting that it would be useful in malted drink formulations. The values for the chemical properties of the oil extracted were: acid value, 0.50%; iodine value, 54.0%; peroxide value, 2.44%; and saponification value, 192.0%. Quinoa has a high water absorption capacity (147.0%) and low foaming capacity and stability (9.0%, 2.0%). The flour has a least gelation concentration of 16% w/v. Protein solubility of the flour was also evaluated and found to be pH dependent, with minimum solubility at about pH 6.0.

Introduction: There is continued unmet medical need for new medicines across countries especially for cancer, immunological diseases and orphan diseases. However, there are growing challenges with funding new medicines at ever increasing prices along with funding increased medicine volumes with the growing prevalence of both infectious diseases and non-communicable diseases across countries. This has resulted in the development of new models to better manage the entry of new medicines, new financial models being postulated as well as strategies to improve prescribing efficiency. However, more needs to be done. Consequently, the primary aim of this paper is to consider potential ways to optimise the use of new medicines balancing rising costs with increasing budgetary pressures to stimulate debate especially from a payer perspective. Methods: A narrative review of pharmaceutical policies and implications, as well as possible developments, based on key publications and initiatives known to the co-authors principally from a health authority perspective. Results: A number of initiatives and approaches have been identified including new models to better manage the entry of new medicines based on three pillars (pre-, peri-, and post-launch activities). Within this, we see the growing role of horizon scanning activities starting up to 36 months before launch, managed entry agreements and post launch follow-up. It is also likely there will be greater scrutiny over the effectiveness and value of new cancer medicines given ever increasing prices. This could include establishing minimum effectiveness targets for premium pricing along with re-evaluating prices as more medicines for cancer lose their patent. There will also be a greater involvement of patients especially with orphan diseases. New initiatives could include a greater role of multicriteria decision analysis, as well as looking at the potential for de-linking research and development from commercial activities to enhance affordability. Conclusion: There are a number of ongoing activities across countries to try and fund new valued medicines whilst attaining or maintaining universal healthcare. Such activities will grow with increasing resource pressures and continued unmet need.

Background: Triglyceride-glucose (TyG) index, a product of triglyceride and fasting plasma glucose, is a novel tool that can identify people with metabolic syndrome (MS). It is unknown if TyG index can identify MS among Nigerians. Methods: Cross-sectional health screening conducted between August and December 2018, among staff and students of Ekiti State University/Ekiti State University Teaching Hospital, Nigeria, Ado-Ekiti. The analysis included 473 participants, aged ≥18 years. Anthropometric indices and blood pressure were measured by standard protocol. Fasting lipid profile and blood glucose were determined. TyG index and product of TyG and anthropometric indices were calculated, and MS defined according to the harmonized criteria. The diagnostic ability of TyG index and related parameters to identify people with MS was determined with the area under curve (AUC) of receiver operating characteristic curves. Stepwise logistic regression analyses were used to generate odd ratios (ORs) for prediction of MS. Results: The mean age of the participants was 39.2 (11.4) years and there were 173 (36.6%) men. In all participants, TyG-waist to height ratio (TyG-WHtR) shows the largest AUC for MS detection (0.863, 95% confidence interval, CI: 0.828–0.892) followed by TyG-waist circumference (TyG-WC) (0.858, 95% CI: 0.823–0.888), TyG-body mass index (TyG-BMI) (0.838, 95% CI: 0.802–0.870), TyG index (0.796, 95% CI: 0.757–0.831), WHtR (0.791, 95% CI: 0.752–0.827), and TyG-waist-to-hip ratio (TyG-WHpR) (0.771, 95% CI: 0.730–0.808) in that order. Gender analysis revealed that TyG-WC and TyG-WHtR have largest AUC in both genders. Before and after adjustment, TyG-WHtR (OR: 6.86, 95% CI: 3.94–11.93) and TyG index (OR: 5.91, 95% CI: 3.01–11.59) presented the highest OR in all participants, respectively. Conclusions: TyG index is effective in identifying MS in this cross-sectional study, and the product of TyG index and anthropometric indices improved identification and prediction of MS.