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Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

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Advances in Reproductive Sciences 2024年第2期12卷 116-124页

作者： Osita Celestine john Justina Omoikhefe Alegbeleye Department of Obstetrics and Gynaecology Faculty of Clinical Sciences University of Port Harcourt Port Harcourt Nigeria

Background: Health challenges that are difficult to manage at primary health centres should be referred to secondary health facilities, and if untreated, to the tertiary hospitals. A good referral should include the patient’s biography, such as age, gender, tribe, religion, occupation, medical history, the reason for the referral, treatments received, and clinical diagnosis. Objectives: To evaluate the referral patterns, indications for referrals, and feto-maternal outcomes for obstetric patients who were referred to the University of Port Harcourt Teaching Hospital. Materials and Methods: A prospective study of patients admitted to the Obstetric unit from January 1, 2021, to December 31, 2022. Data was collected from patients while on admission or clinic visits and recorded in an excel spread sheet. Data was analyzed with the Statistical Package for Social Sciences (SPSS) version 25. Results: Of the 3469 patients were admitted to the obstetric unit, 1476 and 1993 were admitted in 2021 and 2022, respectively. Most (70.35%) of the patients were in the 20-34 years age group, parity 1-4 was the most frequent (66.49%), while 85.39% of patients were booked. 10.46% of the booked patients were referred from other facilities, whereas 89.54% of patients were booked at our facility from the onset. Most common indications of referrals were previous caesarean section (CS) at term (40.09%) and hypertensive disorders of pregnancy (17.59%). The outcome for 2021 indicated 17 maternal deaths, 132 fetal deaths and 1010 live births, giving maternal mortality ratio (MMR) as 1810.44 per 100,000 live births and perinatal mortality ratio (PMR) of 130.7 per 1000 births respectively. In 2022, there were 17 maternal deaths, 130 fetal deaths and 1297 deliveries, giving a MMR of 1399 per 100,000 live births and a PMR of 100.2 per 1000 births. Conclusion: The pattern of referral among obstetric patients in this study shows that a lot of the patients do not get adequate care at the lower cadre o

关键词： Referral Pattern Obstetrics Southern Nigeria

Eclampsia: A Continuous Scourge in a Tertiary Hospital in Southern Nigeria

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 209-225页

作者： Celestine Osita john Justina Omoikhefe Alegbeleye Department of Obstetrics and Gynaecology Faculty of Clinical Sciences University of Port Harcourt Port Harcourt Nigeria

Background: Eclampsia is responsible for over 50,000 maternal deaths with incidence of 1 death in about 100 - 1500 deliveries in developing nations. In sub-Saharan Africa, Nigeria accounts for the highest maternal mortality ratio of 512 deaths per 100,000 live deliveries and the highest neonatal fatality of 67 per 1000 live births. Factors such young age, nulliparity, multifetal gestation, unbooked cases, preterm delivery (<32 weeks), lack of proper access to antenatal care, poor hospital care, financial constraints and inappropriate diagnosis, have all been identified as risk factors promoting eclampsia. Objectives: In this study, we investigated the prevalence of eclampsia in Rivers State, Nigeria and established the correlation between social demographic factors and the feto-maternal outcomes among the eclampsia patients. Methodology: A prospective observational study using a detailed data sheet was conducted on 1244 pregnant women admitted at the Obstetrics and Gynecology Department of University of Port Harcourt Teaching Hospital, for 1-year duration. Data analysis was conducted using statistical packages for social sciences (SPSS) version 22. Results: Demography showed that age range (20 - 24) occurred in 40.7%, nulliparous mothers were dominant with 40.7% while 70.1% of the study population had secondary level of education. 27 cases of eclampsia were diagnosed from the 1244 pregnant women, which signified 2.13% prevalence among the studied population. The feto-maternal outcome showed that out of the 27 mothers, 19 were alive (70.4%) while 8 died (29.6%), while fetal outcome showed that 16 were alive (59.3%) and 11 died (40.7%). Only parity and education showed significant correlation at 0.01 and 0.05 levels respectively with maternal outcome. Conclusion: The prevalence of eclampsia with associated poor feto-maternal outcome rates is high in this study. Its contribution to the maternal and perinatal morbidities and mortalities necessitates the narrative of ecl

关键词： Eclampsia Preeclampsia Prevalence Maternal Fetal Mortality Booked Un-booked

Efficiency of Botanical and Chemical Pesticides on the Control of Field Insect Pests under Cowpea Production

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American Journal of Plant Sciences 2024年第3期15卷 203-221页

作者： john Ssengo Brian Zebosi Jeninah Karungi Department of Plant Pathology Entomology and Microbiology Iowa State University Ames IA USA Department of Agricultural Production Makerere University Kampala Uganda Department of Genetics Development and Cell Biology Iowa State University Ames IA USA

The pulse cowpea [Vigna unguiculata (L.) Walp] holds a significant agricultural position in Uganda, ranking fourth among legume crops, following common beans, groundnuts, and soybeans. Known for its versatility, cowpeas are consumable at various developmental stages, from early seedling to maturity. However, the crop faces persistent pest challenges at each stage, leading to substantial yield losses. In Uganda, chemical insecticides are the primary pest control means, but their increased and excessive use raises environmental, health, and economic concerns. This has prompted a quest for alternative and sustainable solutions, prompting an exploration of botanical insecticides. This study, conducted at Makerere University Agricultural Research Institute (MUARIK), aimed to evaluate the effectiveness of three selected botanical insecticides versus four established chemical insecticides for managing cowpea insect pests under field conditions. The treatments included: Carbofuran, Cypermethrin 10% EC, Dimethoate, Pestwin, Pyrethrum ewc , Pyrethrum 5ew, Profenofos 40% Cypermethrin 4% EC mix, and Untreated, arranged in a randomized complete block design with three replications. The significant pests studied were aphids, thrips, pod-sucking bugs, and legume pod borer. Results indicated substantial impacts of the treatments on pest infestation, with Profenofos 40% Cypermethrin 4% EC being the most effective against most pests. The plant parameter, plant height, was significantly affected by treatments in 2016B, while the number of pods was impacted in 2017A. Pestwin, a botanical insecticide blend (containing Azadirachtin indica, Pongamia pinnata, and Ricinus communis extracts) demonstrated superior efficacy against cowpea aphids. Moreover, it positively influenced plant height, number of pods, and pod biomass, surpassing many chemical insecticides. Pestwin’s environmental friendliness positions it as a potential contributor to reducing environmental pollution, making it a prom

关键词： Cowpea Pest Management Botanical Solutions Profenofos Sustainability

The Use of Glycated Albumin in the Diagnosis of Gestational Diabetes Mellitus

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Journal of Biosciences and Medicines 2024年第1期12卷 19-28页

作者： Atochi Prince Woruka Celestine Osita john Obstetrics and Gynecology Department University of Port Harcourt Teaching Hospital Port Harcourt Nigeria Obstetrics and Gynecology Department University of Port Harcourt Port Harcourt Nigeria

Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.

关键词： Glycated Albumin Gestational Diabetes Mellitus Oral Glucose Tolerance Test University of Port Harcourt Teaching Hospital

Literature Review of the Prevalence of Hypertension at Gulu University, Gulu City, Acholi Subregion, Northern Uganda

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World Journal of Cardiovascular Diseases 2024年第9期14卷 588-602页

作者： Lamwaka Alice Veronica Mboowa john Bosco Department of Pharmacy Faculty of Medicine Gulu University Gulu City Uganda

Hypertension is a big problem worldwide. The purpose of this study is to examine the prevalence, knowledge, attitude, and practice about hypertension at Gulu University, Gulu city, Gulu district, Acholi subregion, Northern Uganda. A literature search on hypertension was done. It showed that, in Uganda, a representative number of 17,777 adult patients’ data were analyzed from January 2014 to February 2024. The epidemiological data on awareness of hypertension was found to be at 8%. Of this, 18.3% of the people with hypertension had it under control. The results of the findings were promising. Hypertension is an important public health challenge in Uganda particularly in Northern Uganda where Gulu University falls. In comparison with the two regions of Central Uganda and Northern Uganda, there was a significant number of populations that were not aware of their condition. Those diagnosed were on treatment but the treatment was not adhered to due to stock outs of medicines. Therefore, Measures are required to prevent hypertension, improve awareness, treatment and control within the community, especially at Gulu University where research has never been done.

关键词： Prevalence Hypertension Blood Pressure Knowledge Attitude Practices Cross Sectional Studies

Eye on the Sky: A UAP Research and Field Study off New York’s Long Island Coast

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Open Journal of Applied Sciences 2024年第8期14卷 2267-2295页

作者： john Joseph Tedesco Gerald Thomas Tedesco Harvard Universitys Galileo Project Independent Research Affiliate Cambridge USA Consortium for The Scientific Understanding of Natures Mysteries Holbrook USA Institute of Electrical and Electronic Engineers Washington USA American Academy of Environmental Engineers and Scientist Annapolis USA Independent Researcher Holbrook USA

A ten-month field research study was meticulously conducted at Robert Moses State Park (RMSP) on the south shore of Long Island, NY. The objective was to determine if aerial phenomena of an unknown nature exist over a coastal location and to characterize their properties and behaviors. Primary and secondary field observation methods were utilized in this data-centric study. Forensic engineering principles and methodologies guided the study. The challenges set forward were object detection, observation, and characterization, where multispectral electro-optical devices and radar were employed due to limited visual acuity and intermittent presentation of the phenomena. The primary means of detection utilized a 3 cm X-band radar operating in two scan geometries, the X- and Y-axis. Multispectral electro-optical devices were utilized as a secondary means of detection and identification. Data was emphasized using HF and LF detectors and spectrum analyzers incorporating EM, ultrasonic, magnetic, and RF field transducers to record spectral data in these domains. Data collection concentrated on characterizing VIS, NIR, SWIR, LWIR, UVA, UVB, UVC, and the higher energy spectral range of ionizing radiation (alpha, beta, gamma, and X-ray) recorded by Geiger-Müller counters as well as special purpose semiconductor diode sensors.

关键词： Unidentified Anomalous Phenomenon (UAP) Forensic Techno-Signatures Office of the Director of National Intelligence (ODNI) Multispectral Electro-Optical (MEO) Ultraviolet A Radiation (UVA) Ultraviolet B Radiation (UVB) Ultraviolet C Radiation (UVC) Visible (VIS) Near-Infrared (NIR) Short-Wave Infrared (SWIR) Long-Wave Infrared (LWIR) Low-Frequency (LF) High-Frequency (HF) Radio-Frequency (RF) Alpha Beta Gamma Ultrasonic X-Band Active Radar Kinematics Aerodynamics Luminous Spheroids Robert Moses State Park (RMSP)

Investigation and mitigation of Mott neuronal oscillation fluctuation in spiking neural network

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Science China(Information Sciences) 2024年第2期67卷 291-301页

作者： Lindong WU Zongwei WANG Lin BAO Linbo SHAN Zhizhen YU Yunfan YANG Shuangjie ZHANG Guandong BAI Cuimei WANG john ROBERTSON Yuan WANG Yimao CAI Ru HUANG School of Integrated Circuits Peking University Beijing Advanced Innovation Center for Integrated Circuits State Key Laboratory of Information Photonics and Optical Communications Beijing University of Posts and Telecommunications Department of Engineering University of Cambridge

Mott devices, featuring low hardware cost and high energy efficiency, have been demonstrated as a key oscillatory element in artificial neurons to enable spiking neural networks(SNNs) such as conversionbased SNNs(CSNNs). However, there will be inevitably non-ideal fluctuation in the oscillation behavior,causing the accuracy degradation of networks. In this paper, we investigate the Mott neuronal oscillation fluctuation(NOF) through experiments and modeling. The results show that the NOF phenomenon conforms to Gaussian distribution and originates from thermal fluctuation induced switching voltage variations. We construct a two-layer CSNN for image recognition tasks to study the NOF effect and propose the activation function boundary(AFB) method to strengthen the stability of the network. The results indicate that AFB can improve the accuracy of CSNN by up to 15.5% by tightening output distribution.

关键词： Mott neuron oscillation fluctuation variation-aware Mott neuronal model conversion-based spiking neural network activation function boundary

Smart contract applications in the built environment: How prepared are Nigerian construction stakeholders?

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Frontiers of Engineering Management 2024年第1期11卷 50-61页

作者： Andrew EBEKOZIEN Clinton AIGBAVBOA Samuel Adeniyi ADEKUNLE Mohamad Shaharudin SAMSURIJAN john ALIU Bernard Martins ARTHUR-AIDOO Godpower Chinyeru AMADI Department of Construction Management and Quantity Surveying University of JohannesburgJohannesburg 2006South Africa School of Social Sciences Universiti Sains MalaysiaGelugor11800 USM PenangMalaysia Department of Quantity Surveying Auchi PolytechnicAuchiNigeria Institute for Resilient Infrastructure Systems College of EngineeringUniversity of GeorgiaAthensGA 30602USA Department of Building Technology Faculty of Built EnvironmentAccra Technical UniversityAccraGhana Nigerian Institute of Management Port HarcourtNigeria

Studies have demonstrated that advanced technology,such as smart contract applications,can enhance both pre-and post-contract administration within the built environment *** contract technology,exemplifying blockchain technologies,has the potential to improve transparency,trust,and the security of data transactions within this ***,there is a dearth of academic literature concerning smart contract applications within the construction industries of developing countries,with a specific focus on ***,this study seeks to explore the relevance of smart contract technology and address the challenges impeding its adoption,offering strategies to mitigate the obstacles faced by smart contract *** investigate the stakeholders,this research conducted 14 virtual interview sessions to achieve data *** interviewees encompassed project management practitioners,senior management personnel from construction companies,experts in construction dispute resolution,professionals in construction software,and representatives from government construction *** data obtained from these interviews underwent thorough analysis employing a thematic *** study duly recognizes the significance of smart contract applications within the *** the 12 identified barriers,issues such as identity theft and data leakage,communication and synchronization challenges,high computational expenses,lack of driving impetus,excessive electricity consumption,intricate implementation processes,absence of a universally applicable legal framework,and the lack of a localized legal framework were recurrent impediments affecting the adoption of smart contract applications within the *** study also delves into comprehensive measures to mitigate these *** conclusion,this study critically evaluates the relevance of smart contract applications within the built environment,with a specific focus on promoting their *** may serve

关键词： built environment industry digitalization Nigeria smart contract technological revolution

Supramolecular Bonding Competition Enabled Nanostructure Evolution and Mechanical Reinforcement

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CCS Chemistry 2024年第1期6卷 157-164页

作者： Yuting Wang Peng Meng Aidan Brock Yanan Xu Hang Meng Zixuan Liu Kan Zhang john McMurtrie Jingsan Xu School of Chemistry and Physics and Centre for Materials Science Queensland University of TechnologyBrisbaneQueensland 4000 Central Analytical Research Facility Institute for Future EnvironmentsQueensland University of TechnologyBrisbaneQueensland 4000 State Key Laboratory of Superhard Materials Department of Materials Science and Key Laboratory of Automobile MaterialsMOEJilin UniversityChangchun 130012

In this work,competition between different supramolecular interactions is investigated based on a fibrous crystal composed of hydrogen-bonded cyanuric acid(CA)and amidinothiourea(ADT).Melamine(M)is found to prevail over ADT and bond to CA due to its stronger triple H-bonding affiliation,forming hollow microtubes assembled by oriented CAM crystalline arrays,as guided by the directionality of peripheral hydrogen ***,competitive interaction between hydrogen bonding and ionic/covalent bonding is demonstrated by mixing Ag+ions with the CA-ADT fibers,where sulfur atoms are abstracted from ADT molecules to produce Ag_(2)S *** in situ-formed Ag_(2)S serves as a binding glue to generate CA-ADT/Ag_(2)S composites with significantly enhanced mechanical strength compared to the pristine CA-ADT fiber pellet.

关键词： supramolecular interaction hydrogen bonds chemical bond competition hollow crystal array organic-inorganic composite