A pragmatic digital health informatics based approach for aiding clinical prioritisation and reducing backlog of care: A study in cohort of 4022 people with diabetes.

BACKGROUND AND AIMS: The backlog of care in resource stretched healthcare systems requires innovative approaches to aid clinical prioritisation. Our aim was to develop an informatics tool to identify and prioritise people with diabetes who are likely to deteriorate whilst awaiting an appointment to optimise clinical outcomes and resources. MATERIALS AND METHODS: Using data from electronic health care records we identified 6 risk-factors that could be addressed in 4022 people (52% male, 30% non-Caucasian) with diabetes attending a large university hospital in London. The risk-factors were new clinical events/data occurring since their last routine clinic visit. To validate and compare data-led prioritisation tool to a traditional 'clinical approach' a sample of 450 patients were evaluated. RESULTS: Of the 4022 people, 549 (13.6%) were identified as having one or more risk events/factors. People with risk were more likely to be non-Caucasian and had greater socio-economic deprivation. Taking clinical prioritisation as the gold standard, informatics tool identified high risk patients with a sensitivity of 83% and lower risk patients with a specificity of 81%. An operational pilot pathway over 3 months using this approach demonstrated in 101 high risk people that 40% received interventions/care optimisation to prevent deterioration in health. CONCLUSION: A pragmatic data-driven method identifies people with diabetes at highest need for clinical prioritisation within restricted resources. Health informatics systems such as our can enhance care and improve operational efficiency and better healthcare delivery for people with diabetes.

Mechanical and optimization studies of polypropylene hybrid biocomposites.

Towards developing a polymeric matrix characterized by high strength to cost ratio, polypropylene (PP) was hybridized with low-cost particulate snail shell (PSS) and kenaf fiber (KF) via compression moulding at 180 °C and 0.2 MPa. The developed composites were grouped into three and labeled as mix 2, 4, and 10. Each group entailed the blend of 5, 10, 20, and 30 wt% KF with 2, 4, 10 wt% PSS respectively. From the results, it is observed that the hardness value was enhanced by the blend of 5 to 30 wt% KF and 2, 4, and 10 wt% PSS. However, 2 wt% PSS mix with 5 to 30 wt% KF resulted in progressive improvement in impact, compressive, flexural, and tensile strengths values. The 4 wt% PSS yielded consecutive increase in impact, compressive and flexural strength when combined with 5 and 10 wt% KF. However, it was observed that subsequent addition of 20 and 30 wt% KF led to a marginal reduction in the strength values. The tensile strength attained optimum value when 4 wt% PSS was commixed with 30 wt% KF. Conversely, the combinations of 10 wt% PSS with 5, 10, 20, and 30 wt% KF had no significant improvement to the mechanical properties of PSS/KF-bio-PP composite (except for hardness) siring strength decrease. Taguchi optimization revealed that the collage of 4 wt% PSS and 10 wt% KF presented optimum mix for hybrid bio-PP composite.

Genetic loci regulating cadmium content in rice grains.

It has been estimated that up to 90% of human exposure to cadmium is through food, and that cadmium within rice grains can be a major contributor to that dietary source. In this study genome wide association mapping was conducted on the Bengal and Assam Aus Panel (BAAP) of rice to identify quantitative trait loci and candidate genes for lowering grain cadmium. Field experiments were conducted over two years under two different irrigation systems: continually flooded and alternate wetting and drying (AWD). There was significant effects of water treatment, genotype, and genotype by water treatment interaction. Importantly, AWD increased grain cadmium, on average, by 49.6% and 108.8% in year 1 and 2 respectively. There was between 4.6 and 28 fold variation in cadmium concentration. A total of 58 QTLs were detected but no loci are clearly specific to one water regime despite approximately 20% of variation attributable to genotype by water regime interaction. A number of QTLs were consistent across most water treatments and years. These included QTLs on chromosome 7 (7.23-7.61, 8.93-9.04, and 29.12-29.14 Mbp), chromosome 5 (8.66-8.72 Mbp), and chromosome 9 (11.46-11.64 Mbp). Further analysis of the loci on chromosome 7 (8.93-9.04 Mbp), identified the candidate gene OsNRAMP1, where cultivars with a deletion upstream of the gene had higher concentrations of cadmium compared to the cultivars that did not have the deletion. The distribution of alleles within the BAAP suggest this QTL is easily detected in this population because it is composed of aus cultivars. Local genome cluster analysis suggest high Cd alleles are uncommon, but should be avoided in breeding. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1007/s10681-020-02752-1).

Psychometric Properties and Validation of the 9-Item Social Media Scale Among Pre-University Students in Nigeria.

OBJECTIVE: To validate the Social Media Disorder scale in Nigerian adolescents by determining its unidimensional structure, reliability, sensitivity, specificity, and criterion validity. METHODS: A total of 516 and 1213 pre-university students in two universities were randomly recruited and assessed using the 9-item Social Media Scale and the 12-item General Health Questionnaire (in the second survey only). RESULTS: 46.3% and 56.3% of respondents in the first and second surveys met the criteria for social media disorder, respectively. Factor loading of items on the latent factor (addiction) was moderate. The model yielded a fairly acceptable fit in both samples. The averaged measure for intra-class correlation was acceptable (0.612). The internal consistency (Cronbach's alpha) was good (0.713 for sample 1 and 0.724 for sample 2). The test-retest reliability among the 113 respondents was good (r=0.696, p<0.001). The item-total correlations were all significant. Sensitivity of each item ranged from 67.7% (tolerance) to 91.3% (escape); specificity of each item ranged from 41.2% (escape) to 87.6% (displacement). For criterion validity, the total Social Media Disorder scale score correlated with General Health Questionnaire items that assess self-esteem, depression, and mood, as well as the total score. CONCLUSION: The 9-item Social Media Disorder scale is acceptable for screening social media disorder in pre-university students in Nigeria. The high prevalence of social media disorder should be of concern to counsellors, teachers, and mental health practitioners. Strategies for public health education on social media use are needed in Nigeria.

Microbial cell immobilization in biohydrogen production: a short overview.

The high dependence on fossil fuels has escalated the challenges of greenhouse gas emissions and energy security. Biohydrogen is projected as a future alternative energy as a result of its non-polluting characteristics, high energy content (122 kJ/g), and economic feasibility. However, its industrial production has been hampered by several constraints such as low process yields and the formation of biohydrogen-competing reactions. This necessitates the search for other novel strategies to overcome this problem. Cell immobilization technology has been in existence for many decades and is widely used in various processes such as wastewater treatment, food technology, and pharmaceutical industry. In recent years, this technology has caught the attention of many researchers within the biohydrogen production field owing to its merits such as enhanced process yields, reduced microbial contamination, and improved homogeneity. In addition, the use of immobilization in biohydrogen production prevents washout of microbes, stabilizes the pH of the medium, and extends microbial activity during continuous processes. In this short review, an insight into the potential of cell immobilization is presented. A few immobilization techniques such as entrapment, adsorption, encapsulation, and synthetic polymers are discussed. In addition, the effects of process conditions on the performance of immobilized microbial cells during biohydrogen production are discussed. Finally, the review concludes with suggestions on improvement of cell immobilization technologies in biohydrogen production.

Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.

Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations.

Doctors' attitude towards people with mental illness in Western Nigeria.

INTRODUCTION: It had been suggested that those more knowledgeable about mental illness are less likely to endorse negative or stigmatizing attitudes. This study aimed to evaluate the attitude of doctors in Nigeria towards the mentally ill. METHODS: Medical doctors (n = 312) from eight selected health institutions in Nigeria completed various questionnaires on knowledge and attitude towards people with mental illness. RESULTS: Beliefs in supernatural causes were prevalent. The mentally ill were perceived as dangerous and their prognosis perceived as poor. High social distance was found amongst 64.1% and the associated factors include not having a family member/friend with mental illness (OR 7.12, 95% CI 3.71-13.65), age less than 45 years (OR 2.33, 95% CI 1.23-4.40), less than 10 years of clinical experience (OR 6.75, 95% CI 3.86-11.82) and female sex (OR 4.98, 95% CI 2.70-9.18). CONCLUSION: Culturally enshrined beliefs about mental illness were prevalent among Nigerian doctors. A review of medical curriculum is needed and the present anti-stigma campaigns should start from the doctors.