Search

The forecasting of evapotranspiration (ET) in some water-stressed regions remains a major challenge due to the lack of reliable and sufficient historical datasets. For efficient water balance, ET remains the major component and its proper forecasting and quantifying is of the utmost importance. This study utilises the 18-year (2001 to 2018) MODIS ET obtained from a drought-affected irrigation scheme in the Eastern Cape Province of South Africa. This study conducts a teleconnection evaluation between the satellite-derived evapotranspiration (ET) time series and other related remotely sensed parameters such as the Normalised Difference Vegetation Index (NDVI), Normalised Difference Water Index (NDWI), Normalised Difference Drought Index (NDDI), and precipitation (P). This comparative analysis was performed by adopting the Mann–Kendall (MK) test, Sequential Mann–Kendall (SQ-MK) test, and Multiple Linear Regression methods. Additionally, the ET detailed time-series analysis with the Keiskamma River streamflow (SF) and monthly volumes of the Sandile Dam, which are water supply sources close to the study area, was performed using the Wavelet Analysis, Breaks for Additive Seasonal and Trend (BFAST), Theil–Sen statistic, and Correlation statistics. The MODIS-obtained ET was then forecasted using the Autoregressive Integrated Moving Average (ARIMA) and Artificial Neural Networks (ANNs) for a period of 5 years and four modelling performance evaluations such as the Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), Mean Absolute Error (MAE), and the Pearson Correlation Coefficient (R) were used to evaluate the model performances. The results of this study proved that ET could be forecasted using these two time-series modeling tools; however, the ARIMA modelling technique achieved lesser values according to the four statistical modelling techniques employed with the RMSE for the ARIMA = 37.58, over the ANN = 44.18; the MAE for the ARIMA = 32.37, over the ANN = 35.88; the MAPE for the ARIMA = 17.26, over the ANN = 24.26; and for the R ARIMA = 0.94 with the ANN = 0.86. These results are interesting as they give hope to water managers at the irrigation scheme and equally serve as a tool to effectively manage the irrigation scheme.

Over recent decades, water quality at the Mthatha River Catchment (MRC) within the Eastern Cape Province of South Africa has been threatened by various pollutants. The continuous effluent concentration discharges from the Mthatha Prison and the Efata School for the Blind and Deaf have caused ineffable damage to the Mthatha River's water quality. Thus, the time series-measured data between 2012 and 2020 were analysed to determine the trends and enable forecasting of selected water quality parameters using the Thomas–Fiering (T–F) stochastic model. The Kendall's τ test trends show an increase in the coefficient of variation of 0.498 and 0.394 at the Mthatha Prison and Efata School, respectively, for abrupt changes, whereas the mean monthly T–F forecasted model shows a good correlation value range from 0.79 to 0.87 for the various predicted variables. The simulated predicted models and trends could serve as a measure to forecast selected water quality parameters' occurrence and a likelihood period when the river pollutants could be controlled. Water managers and researchers would find usefulness in the employed tools for an effective control planning of the river pollutants. HIGHLIGHTS Innovative ways for analysing and forecasting water quality (WQ) parameters.; Prerequisite for prompt mitigation measures in maintaining a healthy river state.; Contribution to the statistical approach, visual modelling, and predictive algorithms.;

Background: Overnutrition has been documented at epidemic levels in children and adults. The associated risk factors may include poor dietary habits, sedentary behaviour, inadequate sleep and low parental education. Objective: To describe dietary habits, physical activity and sleep patterns among secondary school adolescents. Methods: A cross-sectional study of 1,120 adolescents recruited from public and private secondary schools in Lagos, Nigeria, was carried out to study the dietary habits, sleep patterns and physical activity in relation to nutritional status. Results: Ten per cent of the adolescents skipped breakfast, while 28% had fruits on up to five days of the week. Eleven per cent had a sweetened drink every day, while 20 % had a sweetened drink on most days of the week. One out of four (26%) adolescents had more than two hours of screen time daily, and only 5% engaged in sporting activities up to five times weekly. One-third of the students slept for less than six hours daily and experienced sleeping difficulties. Multivariate analysis showed that females were twice as likely not to participate in sports (OR = 2.38, CI = 1.3-4.37, p = 0.002 and to have a higher intake of confectionaries (OR = 1.47, CI = 1.07-2.04, p = 0.01. Conclusion: Poor dietary habits, inadequate physical activity and insufficient sleep were observed among secondary school adolescents. A multi-pronged approach to improve these behaviours is recommended.

Background: The global increase in paediatric endocrine disorders (PED) is thought to be a result of multiple factors including changing lifestyles, environmental pollution and increasing awareness and diagnostic capabilities. Studies on the prevalence of paediatric endocrine disorders in the developing world are few. A preliminary audit of PED at the Lagos State University Teaching Hospital two years ago revealed type 1 diabetes mellitus as the commonest diagnosis. Since then many more children with PED continue to be referred from various centres. Objective: The aim of the present study was to describe the burden and pattern paediatric endocrine disorders over a three-year period. Subjects and Methods: Records of patients who presented in the paediatric endocrine unit between March 2017 and March 2020 were reviewed and relevant data on age at presentation, sex and diagnosis were extracted. Results: A total of 172 patients representing 0.45% of the total paediatric patients seen within the period. There were more females 90(52.3%) than males 79(45.9%) and three patients (1.7%) presented with disorders of sexual differentiation. Age of presentation ranged between 11 days and 16 years with mean of 6.27 ± 4.5 years. The commonest groups of endocrine disorders were disorders of pancreas/lipids-diabetes (n=33, 19.2%), pubertal disorders (n=25, 14.5%) and thyroid disorders (n=24, 14.0%). Conclusion: Our unit witnessed a comparatively larger case-load of PEDs compared to earlier reports from other parts of Nigeria. Diabetes mellitus, pubertal and thyroid disorders constituted the commonest paediatric endocrine disorders encountered.

Cerebrovascular accident (CVA) is a rare neurological complication of diabetic ketoacidosis (DKA) in the paediatric population. The risk of developing CVA in DKA patients is often increased due to abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. Cerebral oedema, the most common neurological complication of DKA, may also predispose to CVA. We report the case of a -12-year-old adolescent with DKA complicated by CVA. She developed features of right hemispheric CVA while on admission and had radiological confirmation of an ischaemic CVA. This report highlights that cerebrovascular accidents in DKA can easily be missed or confused with cerebral oedema.

Cushing syndrome (CS) is an uncommon morbidity in children. As a result of this rarity, there may be a delay in making the diagnosis or it may be missed completely resulting in progression to life-threatening complications. COVID-19 is an infectious disease that is currently the cause of a global pandemic although it affects children less commonly than adults. Our patient developed CS in early infancy which was diagnosed by elevated serum cortisol and left adrenal adenoma on abdominal magnetic resonance imaging (MRI). Unfortunately, the diagnosis of CS was missed earlier thereby delaying treatment and she also contracted the COVID-19 infection. The presence of these two medical conditions in a very young child may have resulted in a more advanced diseased state and increased chances of a poor outcome. A high index of suspicion for CS is necessary to forestall delay in commencement of appropriate treatment. Parental consent was obtained to publish this report.

Obesity is a major public health problem in the world with increasing prevalence among children and adolescents. The current study was a descriptive crosssectional study involving 1100 students attending public and private secondary schools in Lagos. Calculations of body mass index (BMI) were performed, and 513 males and 587 females aged between 10 and 19 years were studied. Prevalence rates of overweight and obesity were 5.8% and 1.7% respectively; females had higher prevalence rates than males. Prevalence rates of overweight and obesity in private schools were higher than in public schools. [ABSTRACT FROM AUTHOR]

This paper presents the application of a new evolutionary algorithm technique called combined Pareto multi-objective differential evolution (CPMDE) to optimize irrigation water allocation and crop distribution under limited water availability with three different crops (maize, potatoes and groundnut) planted on a 100 ha farmland at Vaalharts irrigation scheme, South Africa. The algorithm combines methods of Pareto ranking and Pareto dominance selections to implement a novel selection scheme at each generation. The ability of CPMDE in solving unconstrained, constrained and real-world optimization problems was demonstrated. The two objectives of the model are to maximize total crop net benefit (NB) over a planting season while minimizing total irrigation water allocation. A set of non-dominated solutions with the high NBs at lower irrigation water allocation for three crop types was obtained, and compromise programming approach was used in evaluating the most favourable solution. The best solution shows that maize produced the highest crop yield under limited water allocation in the study area. Comparing this result with that of a previous study which adopted a multi-objective optimization algorithm called multi-objective differential evolution algorithm, CPMDE is a good and robust alternative algorithm suitable for resolving crop distribution under limited water availability.

The Center for International Blood and Marrow Transplant Research (CIBMTR) prepares an annual set of summary slides to summarize the trends in transplantation and cellular therapies. For the first time in the 2023 summary slides, the CIBMTR incorporated data for patients receiving chimeric antigen receptor T cell (CAR-T) infusions. In addition, data on patient-reported outcomes (PROs) are included. This report aims to update the annual trends in US hematopoietic cell transplantation (HCT) activity and incorporate data on the use of CAR-T therapies. A second aim is to present and describe the development, implementation, and current status of PRO data collection. In August 2020, the CIBMTR launched the Protocol for Collection of Patient-Reported Outcomes Data (CIBMTR PRO Protocol). The CIBMTR PRO Protocol operates under a centralized infrastructure to reduce the burden to centers. Specifically, PRO data are collected from a prospective convenience sample of adult HCT and CAR-T recipients who received treatment at contributing centers and consented for research. Data are merged and stored with the clinical data and used under the governance of the CIBMTR Research Database Protocol. Participants answer a series of surveys developed by the Patient Reported Outcomes Measurement Information System (PROMIS) focusing on physical, social and emotional, and other measures assessing financial well-being, occupational functioning, and social determinants of health. To complement traditionally measured clinical outcomes, the surveys are administered at the same time points at which clinical data are routinely collected. As of September 2023, PRO data have been collected from 993 patients across 25 different centers. With the goal of incorporating these important patient perspectives into standard clinical care, the CIBMTR has added the PRO data to Data Back to Centers (DBtC). Through expanding the data types represented in the registry, the CIBMTR aims to support holistic research accounting for the patients' perspective in improving patient outcomes. CIBMTR PRO data aim to provide a foundation for future large-scale, population-level evaluations to identify areas for improvement, emerging disparities in access and health outcomes (eg, by age, race, and ethnicity), and new therapies that may impact current treatment guidelines. Continuing to collect and grow the PRO data is critical for understanding these changes and identifying methods for improving patients' quality of life., (Copyright © 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)

Objective: To evaluate the psychometric properties of the AL-PROfile, a patient-reported outcome measure combining the Patient-Reported Outcomes Measurement Information System (PROMIS)-29, two items from PROMIS Cognitive Function, and select Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) items., Methods: Content validity was assessed through cognitive debriefing interviews of 20 patients who completed the AL-PROfile (Study 1). Study 2 involved 297 participants who completed the AL-PROfile and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Reliability (internal consistency and test-retest reliability) and validity (convergent and discriminant validity, known groups validity by stage/organ involvement) were calculated., Results: Study 1 participants found the AL-PROfile straightforward confirming the relevance of the included content. Some felt that certain questions were not related to their amyloidosis experience. Study 2 demonstrated acceptable internal consistency for all domains/items except PROMIS Cognitive Function and acceptable test-retest reliability for all except PROMIS Cognitive Function and PRO-CTCAE nausea. Large correlations were seen for the same domain across measures while correlations for divergent domains within a measure and different domains across different measures were small. The PRO-CTCAE items showed small to medium correlations with each other and with PROMIS and SF-36 domains. Stage was associated with physical function, fatigue, social roles, swelling, and shortness of breath scores., Conclusion: The AL-PROfile has acceptable reliability and validity for use in systemic light chain amyloidosis patients., (© 2024 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.)

Background: Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria., Methods: A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee., Results: Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510]., Conclusion: Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care., (© 2024. The Author(s).)

Objective: To assess the impact of organ involvement on patient-reported outcomes (PROs) in light chain (AL) amyloidosis., Methods: PROs were evaluated using the KCCQ-12, PROMIS-29 + 2, and SF-36 in individuals with AL amyloidosis. The 2004 Mayo system was used to stage disease and cardiac, neurologic, and renal involvement was considered. Global physical and mental health (MH) scores, physical function (PF), fatigue, social function (SF), pain, sleep, and MH domains were evaluated. Effect sizes between scores were measured using Cohen's d., Results: Of 297 respondents, the median age at diagnosis was 60 years with 58% cardiac, 58% renal, and 30% neurologic involvement. Fatigue, PF, SF, and global physical health with PROMIS and SF-36 discriminated the most by stage. Significant discrimination in PROMIS and/or SF-36 was seen in PF, fatigue, and global physical health with cardiac involvement. For neurologic involvement, PF, fatigue, SF, pain, sleep, global physical, and MH with PROMIS and role physical, vitality, pain, general health, and physical component summary with SF-36 were discriminatory. For renal amyloid, pain by SF-36 and PROMIS, and SF-36 MH and role emotional subscales were significant., Conclusions: Fatigue, PF, SF, and global physical health can discriminate stage, cardiac and neurologic, but not renal, AL amyloidosis involvement., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: We conducted a cross-sectional study to characterize health-related quality of life and symptom burden in individuals living with light chain (AL) amyloidosis., Methods: Members of the Amyloidosis Support Groups, Inc. with AL amyloidosis who consented to this IRB-approved survey provided information on their amyloidosis diagnosis, treatment, symptoms, and functioning. HRQL was measured using PROMIS and PRO-CTCAE questionnaires., Results: Among 297 participants who responded, the median age at diagnosis was 60 years (23-82) with 52% female and 90% white race. There were 69% AL (lambda) and 39% reported 3 or more organs involved with amyloidosis (58% cardiac, 58% renal, 30% neurological AL). Time from diagnosis was less than 2 years in 64 (22%), 2-5 years in 105 (36%), > 5 years in 126 (43%), and unknown in 2 (< 1%) individuals. Therapy included prior chemotherapy in 88% and stem cell transplant in 52%. Fifty percent of the cohort was on active treatment. Multiple domains were impaired in AL amyloidosis compared to the general population, including physical function, fatigue, and social roles. While highest among those within 2 years of diagnosis, high symptom burden was also seen in long-term survivors. A trend to decreased severity and number of impaired symptoms was seen with longer treatment-free interval but many symptoms remained persistent., Conclusions: Significant and persistent symptom burden is seen in AL amyloidosis. Patient-reported outcomes should be routinely measured and used to provide best supportive care to all AL amyloidosis patients, including long-term survivors and those not on active therapy., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Growth hormone deficiency (GHD) is an important differential diagnosis for short stature, defined as a height percentile below the mean population height. In the developed world well- child visits are commonplace; in a limited resource setting such as Sub-Saharan Africa (SSA) this is not the case. As such, the use of anthropometric data for evaluating growth may be compromised. Despite this, clinicians should be aware that sick visits offer an opportunity to gather such data and in spite of the resource constraints which may preclude a complete work up, GHD could be managed effectively when there is a high clinical index of suspicion. This article uses highlights of three cases diagnosed in SSA to address challenges encountered in the course of management to make recommendations in the approach to medical care of a child with suspected GHD., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Background: Current guidelines recommend genetic testing for all patients with pancreatic cancer (PC)., Methods: Patients with localized PC who received neoadjuvant therapy between 2009 and 2018 were identified. Genetic consultation (including personal and family history of cancer), genetic testing, and variant data were abstracted., Results: Of 510 patients identified, 163 (32%) underwent genetic counseling and genetic testing was performed in 127 (25%). Patients who underwent genetic testing were younger (median age: 63 vs. 67, p = 0.01). Multi-gene testing was performed in 114 (90%) of 127 patients, targeted gene testing was performed in 8 (6%), and not specified in 5 (4%). Of 127 patients who underwent genetic testing, 20 (16%) had pathogenic (P)/likely pathogenic (LP) variants, observed in ATM (n = 7/105,7%), CHEK2 (n = 3/98, 3%), BRCA1 (n = 2/117, 2%), BRCA2 (n = 2/122, 2%), PALB2 (n = 1/115, 1%), MUTYH (n = 1/98, 1%), CDKN2A (n = 1/94, 1%), STK11 (n = 1/97, 1%), NBN (n = 1/98, 1%), and MSH6 (n = 1/97, 1%). Of 20 patients with either a P/LP variant, nine (45%) had a prior cancer, three (15%) had a first-degree relative with PC, and six (30%) had an any-degree relative with PC., Conclusion: Pathogenic/likely pathogenic variants were identified in 16% of patients who underwent genetic testing, 60% of which occurred in the homologous recombination pathway., (Copyright © 2020. Published by Elsevier Ltd.)

Introduction: Tumor profiling can improve the selection of oncologic therapies in patients with pancreatic cancer (PC). The impact of neoadjuvant therapy on tumor testing is unknown., Methods: Molecular profiling using commercially available 53-, 315-, or 472-gene next generation sequencing (NGS) panels was performed on surgical specimens following neoadjuvant therapy. All specimens with 472-gene sequencing also had immunohistochemical (IHC) testing. Treatment recommendations were based on somatic variants and IHC staining., Results: NGS was performed on 74 patient specimens: 42 (57%) with a 472-gene panel, 28 (38%) with a 315-gene panel, 3 (4%) had 472- and 315-gene panels, and 1 (1%) patient had 53- and 472-gene panels (78 total tests). Likely pathogenic/pathogenic variants were identified in 73 (94%) of the 78 tests. Of the 73 samples with variants identified, 13 (18%) variants were associated with an actionable treatment: ATM (n = 10), BRCA1 (n = 1), PIK3CA (n = 1), and BRCA2 (n = 1). No patient had more than one actionable variant. Based on NGS results, the most commonly recommended therapy was a platinum agent (n = 12/78, 15%). Of the 46 specimens that underwent IHC analysis, overlapping chemotherapeutic treatment recommendations were identified in 40 (87%) specimens., Conclusion: Using current multigene NGS panels, actionable variants were identified in 13 (18%) of 74 surgical specimens and primarily involved genes of the DNA repair pathway. Anecdotal reproducibility of test concordance was low.

Background: In 2008, several Nigerian children developed acute kidney injury (AKI) after ingesting teething syrup contaminated with diethylene glycol (DEG). Because there are limited diagnostic facilities in resource-constrained countries, this study investigated whether AKI associated with DEG could be identified by other means., Methods: This was a multicenter study. Information was obtained from hospital records. Clinicopathological features of all children with AKI over a 6-month period were reviewed., Results: Sixty (50.4%) of 119 children ingested "My pikin" teething syrup. Compared to children who had not ingested it, they were significantly (p < 0.05) younger (11.95 vs. 31 months), more were anuric (98.3 vs. 74.6%), hypertensive (84 vs. 52%), had severe metabolic acidosis (46.7 vs. 20.5%), and died (96.6 vs. 71.2%). They developed increasing metabolic acidosis and multiorgan dysfunction despite peritoneal dialysis. Late presentation, financial difficulties, inadequate facilities for toxicology, and hemodialysis complicated management., Conclusions: Identifying AKI associated with DEG is difficult. Detailed drug history, increasing metabolic acidosis, and multiorgan deterioration despite peritoneal dialysis should arouse suspicion. Simple diagnostic tests need to be developed and facilities for hemodialysis of infants and financial support provided. Recurrences can be prevented by creating awareness, improving manufacturing practices, field-testing of drugs, and international monitoring of pharmaceuticals imported for manufacture.