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Book
Zaja JO. 2012 Mwongozo wa Mstahiki Meya, Longhorn Publishing Ltd, Nairobi Kenya. Nairobi: Longhorn Publishers Kenya Ltd; 2012.
Philipsson J, Rege JEO, Zonabend E. Animal improvement for increased productivity and food availability.; 2011. AbstractWebsite

This module discusses important factors to consider when designing sustainable genetic improvement programmes, especially under tropical conditions. Previous attempts to launch breeding programmes in developing countries have too often failed for several reasons, although there are success stories to learn from as well. Long-term and simple strategies are necessary as is the need to efficiently exploit the potential of indigenous breeds. Increased productivity per animal or area of land used also need to be considered. However, that must be achieved while also considering the variable socio-economic and cultural values of livestock in different societies or regions. Within the module there are links [blue] to web resources and [green] to case studies and other related components of this resource that help illustrate the issues presented.

Book Chapter
Zalasiewicz J, Waters CN, Williams M, Summerhayes CP, Odada E, Wagreich M, Draganits E, Edgewor M. "7 The Stratigraphic Boundary of the Anthropocene.". In: The Anthropocene as a Geological Time Unit: A Guide to the Scientific Evidence and Current Debate. Cambridge University Press; 2019. Abstract

Here we outline the basis on which a formal proposal should be made for potential inclusion of the Anthropocene in the Geological Time Scale, examining the scale and rate of human change to the Earth System to help recognise the point at which anthropogenic impacts became of sufficient scale to allow discrimination of the Anthropocene as a geological unit. This examination covers such factors as impacts from early hominin species, the first human artefacts, early ecosystem modification through agriculture, deforestation, the domestication of animals, urbanisation, metal mining and smelting and early globalisation. The Industrial Revolution, starting in the UK in the 18th century, and the global Great Acceleration of the mid-20th century, are investigated, as both provide popular narratives that explain the Earth System changes indicative of the Anthropocene, with the latter producing the near-synchronous stratigraphic signals most consistent with an effective geological time boundary. We assess which hierarchical level–age, epoch, period, era or eon–seems most suitable for the Anthropocene, and suggest that epoch (= series) level is conservative and appropriate. The Anthropocene might be defined via a Global Standard Stratigraphic Age or a Global boundary Stratotype Section and Point, with the latter being most appropriate. Finally, we assess the kinds of geological environments, including anoxic marine basins, annually banded coral and bivalve skeletons, estuaries and deltas, lake floors, peat mires, anthropogenic deposits, polar ice, speleothems and tree rings, in which such a physical reference level might be placed.

Z Q, A M. "Development of Basic Obstetric Theater Facility in a Low-resource Setting.". In: Gynecologic and Obstetric Surgery Challenges and Management Options.; 2016.
Zarins CK, Xu C, Taylor CA, Glagov S. "Localization of {Atherosclerotic} {Lesions}." In: MD RWA, MD LHH, eds. Vascular {Surgery}. Blackwell Publishing; 2007:. Abstract

This chapter contains sections titled: * Arterial structure and function * Physiologic adaptation of the arterial wall * Human atherosclerotic plaque morphology * Mechanical determinants of plaque localization * Susceptible regions of the arterial vasculature * Conclusion

Baliraine FN, Bonizzoni M, Guglielmino CR, Osir EO, Lux SA, Mulaa FJ, Gomulski LM, Zheng L, Quilici S, Gasperi G, Malacrida AR. "Population genetics of the potentially invasive African fruit fly species, Ceratitis rosa and Ceratitis fasciventris (Diptera: T."; 2004.
McAvaney BJ, C. Covey, S. Joussaume, V. Kattsov, A. Kitoh, W. Ogana, A.J. Pitman, A.J. Weaver, R.A. Wood, Zhao Z-C. "Model evaluation.". In: Climate Change 2001: The Scientific Basis. Contribution of Working Group I to the Third Assessment Report of the Intergovernmental Panel on Climate Change. Houghton, J.T., Y. Ding, D.J. Griggs, M. Noguer, P.J. van der Linden, X. Dai, K. Maskell and C.A. J. England: Cambridge University Press; 2001.
Milatovic D, Montine TJ, Zaja-Milatovic S, Madison JL, Bowman AB, Aschner M. "Morphometric {Analysis} in {Neurodegenerative} {Disorders}.". In: Current {Protocols} in {Toxicology}. John Wiley & Sons, Inc.; 2001. Abstract

The study of dendritic length and spine density has become standard in the analysis of neuronal abnormalities, since a considerable number of neurological diseases have their foundation in alterations in these structures. One of the best ways to study possible alterations in neuronal morphometry is the use of Golgi impregnation. Introduced more than a century ago, it is still the standard and state-of-the-art technique for visualization of neuronal architecture. We successfully applied the Golgi method to mouse, rat, monkey, and human brain tissues for studying both the normal and abnormal morphology of neurons. We were able to discover subtle morphological alterations in neuronal dendrites and dendritic spines in different brain areas. Although Golgi preparations can be examined by electronic microscopy, we used light microscopy and reconstruction using Neurolucida software to quantitatively explore the relationship between total dendritic length and spine density in different types of neurons. This unit summarizes the methodology used to quantify neuronal abnormalities and discusses the utility of these techniques in different models of neurodegeneration. Curr. Protoc. Toxicol. 43:12.16.1-12.16.14. © 2010 by John Wiley & Sons, Inc.

Conference Paper
Yarmoshuk AN, Gauntai A, Mwangu M, Cole D, Zarowsky C. "Resilient and responsive Global Health partnerships of East African universities in a changing world.". In: Fourth Global Symposium on Health Systems Research.; 2016.resilient_and_responsive_global_health_partnerships_of_east_african.pdf
R.O.Onzago, S.G.Kiama, J.M. Mbaria, Z.M.Rukenya, D.W. Gakuya. "Efficacy and safety of Vernonia hymenolepis a medicinal plant used in Kenya for oral health.". In: 48th KVA Annual scientific conference. Boma Inn,Eldoret,Uasin Gishu county,Kenya; 2014.
Zander K;, Holm-Mueller K;, Mburu J. "Modelling the value of local cattle breeds – the case of the Borana cattle in East Africa."; 2013. Abstract

The Borana cattle, originated in the southern lowlands of Ethiopia, have been exported to various neighbouring countries as well as to Western countries such as USA and Australia due to the breed’s outstanding reputation of having unique traits that make it suitable for the harsh environment in the lowlands. In Ethiopia and Kenya, Borana cattle are the main source of the livestock-keepers’ income and the local people’s cultural identity is based on the husbandry of these animals. Nevertheless, the Borana breed is deteriorating in these countries and its cultural heritage is threatened due to genetic erosion and dwindling number of pure Borana animals as well as increasing crossbreeding among different breeds. This depletion has many driving factors such as population pressure, ecological changes, natural catastrophes and adverse economic conditions, and provides justification for conservation initiatives that preserve the irreversible loss of the Borana genes. The conservation of these animal genetic resources (AnGR) is crucial for future use and enhancement of global biodiversity, but financial aid for conservation purposes is scarce. Therefore, economic measures are needed to confirm the economic value of the Borana breed as an indicator for conservation justification. This study seeks to quantify the total value of the Borana cattle to the Ethiopian and Kenyan livestock-keepers and to show why it deserves priority in funding by applying a multinomial logit model (MNL) and as its extension a random parameter logit model (RPL). Both models are applied to a data set obtained from a stated preference choice experiment study on the value of different attributes of cattle. Such a data set is characterised by discrete choice data that can be sought as being generated via a random utility process revealing the livestock-keepers’ relative preferences for different attributes of the Borana cattle. Furthermore, the results of the RPL supports decision-makers in finding appropriate conservation strategies by shedding light on heterogeneity among livestock-keepers’ preferences or utilities for different cattle breeds, showing which group of livestock-keepers could be targeted in conservation initiatives of the Borana cattle.

Omucheni DL, Kaduki KA, Angeyo HK, Bulimo WD, Zoueu JT. "Application of Principal Component Analysis (PCA) to Multispectral Imaging Microscopy for Malaria Diagnosis.". In: African Spectral Imaging Network (AFSIN) International Workshop on Spectral Imaging in Remote Sensing. Nairobi, Kenya; 2012.
Omucheni DL, Kaduki KA, Angeyo HK, Bulimo WD, Zoueu JT. "A joint Kenya – Ivory Coast Malaria Measurement Campaign.". In: African Spectral Imaging Network (AFSIN) International Workshop on Spectral Imaging in Remote Sensing. Nairobi, Kenya; 2012.
Khasakhala A, Agwanda A, Odwe G, Z L, Imbwaga A. "Reassessing Mortality decline in Kenya.". In: The 6th African Population Conference . Ougadougou , Burkina Faso ; 2011.
Kaduki KA, Angeyo HK, Omucheni DL, Wabwile R, Abramczyk H, Zoueu JT. "Disease diagnostics by chemometrics-assisted spectroanalytical and imaging techniques.". In: LAM9 International Workshop on Optics and Lasers in Science and Technology. Dakar, Senegal; 2010.
Ambuko JL, Sekozawa Y, Sugaya S, Zanol G, Gemma H. "Effect of Postharvest Hot Air Treatments on Ripening and Soluble Sugars in Banana Fruits, Musa Spp.'Williams'.". In: XXVIII International Horticultural Congress on Science and Horticulture for People (IHC2010): International Symposium on 934.; 2010:. Abstract
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Boman J, GATARI MJ, Gaita SM, Zhang X, Xue B, Wagner A. "Seasonal variation in trace elemental concentrations in PM2.5 particles in Nairobi, Kenya."; 2009.
ZEKE MRWAWERU. "Jointly edited a book on"Africa communication and the future".". In: In Proceedings of the 45th Industrial Waste Conference May 8, 9, 10, 1990; Purdue University. World Conference of Phylosophy Proceedings; 2006.
ZEKE MRWAWERU. "Paper on"the issue of mass media and the Africa debt crisis (UNPUBLISHED).". In: In Proceedings of the 45th Industrial Waste Conference May 8, 9, 10, 1990; Purdue University. World Conference of Phylosophy Proceedings; 2006.
Njoroge EM;, Mbithi PMF;, Gathuma JM;, Wachira TM;, Magambo JK;, Zeyhle E. "Use of ultrasound in diagnosis of cystic echinococcosis in domestic intermediate hosts in Kenya."; 2001.
Maj M, Satz P, Janssen R, Zaudig M, Starace F, D'Elia L, Sughondhabirom B, Mussa M, Naber D, Ndetei MD, et al. "WHO Neuropsychiatric AIDS study, cross-sectional phase II."; 1994.
Zander K;, Mburu J. "Determining Right Priorities for Conserving Farm Animal Genetic Resources — The Case of Borana Cattle in East Africa."; 1985. Abstract

Borana cattle have their origin in Southern Ethiopia and Kenya where they are guarded by the Borana-Oromyfa clans in the harsh environment of the Borana plateau. Borana cattle are also the main source of the livestock-keepers’ income and the local people’s cultural identity is formed on the husbandry of these animals. Nowadays the existence of this breed and hence its cultural heritage is threatened due to intensifying crossbreeding among different breeds and eventually dwindling records of pure Borana animals. Conservation of the pure Borana genetic resources is important for future use and enhancement of biodiversity, but financial aid for conservation initiatives is scarce. This study addresses two crucial topics in conservation theory: the question of “which” Borana animals should be conserved and hence deserve priority in funding, and the question of “who” should conserve them. 370 livestock-keepers on the Borana plateau were selected for conducting semi-structured questionnaires and choice experiments. The models were then analysed using NLOGIT 3.0. The first question is driven by the fact that currently three different subtypes of the Borana breed are known and kept on the Borana plateau. Appropriate allocation of funds among them must take place according to their economic and genetic values. Economic values are determined by applying a discrete choice analysis estimating the livestock-keepers’ willingness to pay and relative preferences for different attributes of the Borana cattle. Genetic values depend on two factors, namely the level of extinction probability and the level of marginal genetic diversity. Both factors are incorporated into the model and together with economic values form the total value of Borana cattle and its subtypes. The question of “who” should participate in conservation initiatives requires the consideration of individual livestock-keepers’ characteristics into the model revealing heterogeneity in livestock-keepers’ preferences and willingness to pay for different cattle attributes. A random parameter logit model is used seeking to establish different groups of livestock-keepers that can be targeted for conserving Borana. Results suggest that Borana cattle are particularly important because of their adaptability and performance attributes and that their values vary significantly among livestock keepers with different production systems and in different areas.

McPherson CNL;, Zeyhle, E; Romig T,; Mwangi, M.; Rees P,; McPherson C;, Wachira T;, Cheruiyot H;, Gathura PB;, Gathuma JM;, Kinoti GK. "Echnicoccus – Research for appropriate control techniques for Turkana.".; 1985.
McPherson CNL;, Zeyhle E;, Mwangi M;, Rees P;, McPherson C;, Wachira T;, Cheruiyot H;, Gathura PB;, Gathuma JM;, Romig T;, Kinoti GK. "Echnicoccus – Research for appropriate control techniques for Turkana.".; 1985.
Conference Proceedings
Omucheni DL, Kaduki KA, Angeyo HK, Zoueu JT. A joint Kenya-Ivory coast malaria measurement campaign. ICIPE, Nairobi: AFSIN; 2012.
Z.M K, Narla RD, Waudo SW. Pyrethrum Wilt Caused by Fusarium Oxysporum in Kenya.; 1998.
Journal Article
J.O'Connell P, Brown M, Chan TM, Granado RC-D, J.Davies S, Eiam-Ong S, H.Hassan M, Kalantar-Zadeh K, Levin A, E.Martin D, Muller E, Ossareh S, Tchokhonelidze I, Trask M, Twahir A, J.O.Were A, Yang C-W, Zemchenkov A, N.Harden P. "The role of kidney transplantation as a component of integrated care for chronic kidney disease." Science Direct. 2020.Website
Masila VM, Ndakala AJ, Byamukama R, Midiwo JO, Kamau RW, Wang M, Kumarihamy M, Zhao J, Heydreich M, Muhammad I. "Synthesis, structural assignments and antiinfective activities of 3-O-benzyl-carvotacetone and 3-hydroxy-2-isopropyl-5-methyl-p-benzoquinone." Natural Product Research. 2020:1-9. AbstractJournal Abstract

Description
In an attempt to synthesize carvotacetone analogues, new 3-O-benzyl-carvotacetone (10) and previously reported 3-hydroxy-2-isopropyl-5-methyl-p-benzoquinone (11) were synthesized from piperitone (7). In this work, we describe the synthesis of 10 and other analogues from 7. Luche reduction of 7 to cis-piperitol (8), followed by benzylation yielded 3-O-benzyl-piperitol (9). Riley oxidation of 9 afforded corresponding ketone 10, 11 and 3-benzyloxy-4-isopropylcyclohex-1-enecarbaldehyde (12). Structures of these compounds were determined based on NMR, IR and LC-MS spectral data. Compound 11, exhibited antiplasmodial activities against chloroquine-sensitive (D6) and resistant (W2) strains of Plasmodium falciparum with IC50 values of 0.697 and 0.653 µg/mL, respectively. In addition, compound 11 was active against Cryptococcus neoformans with an IC50 value of 3.11 µg/mL, compared to reference …

Marangu D, Gray D, Vanker A, Zampoli M. "Exogenous lipoid pneumonia in children: A systematic review." Paediatr Respir Rev. 2019. Abstract

To describe the clinical-radiological-pathological characteristics and treatment outcomes of children with suspected exogenous lipoid pneumonia (ELP).

Kawakyu N, Nduati R, Obimbo E, Munguambe K, Coutinho J, Mburu N, DeCastro G, Inguane C, Zunt A, Abburi N, Sherr K, S. G. "Development and Implementation of a Mobile Phone-Based Prevention of Mother-To-Child Transmission of HIV Cascade Analysis Tool: Usability and Feasibility Testing in Kenya and Mozambique." JMIR Mhealth Uhealth. 2019;13;7(5):( doi: 10.2196/13963.):e13963.
Ogeng’o JA, Obimbo MM, Zhou Y, McMaster MT, Cohen CR, QURESHI ZAHIDA, Ong’ech J, Fisher SJ. "Placental Structure in Preterm Birth Among HIV-Positive Versus HIV-Negative Women in Kenya." J Acquir Immune Defic Syndr . 2019;80(1):94-102. Abstractplacental_structure_in_preterm_birth_among_hiv-positive.pdfWolters Kluwer Health, Inc

Background: Preterm birth (PTB) is a major cause of infant
morbidity and mortality in developing countries. Recent data suggest
that in addition to Human Immunodeficiency Virus (HIV) infection,
use of antiretroviral therapy (ART) increases the risk of PTB. As the
mechanisms remain unexplored, we conducted this study to
determine whether HIV and ART were associated with placental
changes that could contribute to PTB.
Setting: We collected and evaluated placentas from 38 HIVpositive
women on ART and 43 HIV-negative women who had
preterm deliveries in Nairobi, Kenya.
Methods: Anatomical features of the placentas were examined at
gross and microscopic levels. Cases were matched for gestational
age and compared by the investigators who were blinded to maternal
HIV serostatus.
Results: Among preterm placentas, HIV infection was significantly
associated with thrombosis (P = 0.001), infarction (P = 0.032),
anomalies in cord insertion (P = 0.02), gross evidence of membrane
infection (P = 0.043), and reduced placental thickness (P = 0.010).
Overall, preterm placentas in both groups were associated with
immature villi, syncytial knotting, villitis, and deciduitis. Features of
HIV-positive versus HIV-negative placentas included significant
fibrinoid deposition with villus degeneration, syncytiotrophoblast
delamination, red blood cell adhesion, hypervascularity, and reduction
in both surface area and perimeter of the terminal villi.
Conclusions: These results imply that HIV infection and/or ART
are associated with morphological changes in preterm placentas that
contribute to delivery before 37 weeks. Hypervascularity suggests
that the observed pathologies may be attributable, in part, to hypoxia.
Further research to explore potential mechanisms will help elucidate
the pathways that are involved perhaps pointing to interventions for
decreasing the risk of prematurity among HIV-positive women.
Key Words: preterm birth, term birth, placenta, HIV, ART

Marangu D, Pillay K, Banderker E, Gray D, Vanker A, Zampoli M. "Exogenous lipoid pneumonia: an important cause of interstitial lung disease in infants." Respirol Case Rep. 2018;6(7):e00356. Abstract

Exogenous lipoid pneumonia (ELP), an important cause of interstitial lung disease, often goes unrecognized. We conducted a retrospective study of children with histologically confirmed ELP at Red Cross Children's Hospital, South Africa. Twelve children of Zimbabwean heritage aged 2.1-10.8 months were identified between 2012 and 2017. Repeated oral administration of plant-based oil for cultural reasons was reported by 10 of 11 caregivers. Cough (12/12), tachypnoea (11/12), hypoxia (9/12), and diffuse alveolar infiltrates on chest radiography (12/12) were common at presentation. Chest computed tomography revealed ground-glass opacification with lower zone predominance (9/9) and interlobular septal thickening (8/9). Bronchoalveolar lavage specimens appeared cloudy/milky, with abundant lipid-laden macrophages and extracellular lipid on Oil-Red-O staining (12/12), with polymicrobial (6/12) and Mycobacterium abscessus (2/12) co-infection. Antibiotics, systemic corticosteroids, and therapeutic lavage were interventions in all eight and five patients, respectively. Clinicians should consider ELP in children with non-resolving pneumonia in settings with similar practices.

Mwangi N, Gachago M, Gichangi M, Gichuhi S, Githeko K, Jalango A, Karimurio J, Kibachio J, Muthami L, Ngugi N, Nduri C, Nyaga P, Nyamori J, Zindamoyen ANM, Bascaran C, Foster A. "Adapting clinical practice guidelines for diabetic retinopathy in Kenya: process and outputs." Implement Sci. 2018;13(1):81. Abstract

The use of clinical practice guidelines envisages augmenting quality and best practice in clinical outcomes. Generic guidelines that are not adapted for local use often fail to produce these outcomes. Adaptation is a systematic and rigorous process that should maintain the quality and validity of the guideline, while making it more usable by the targeted users. Diverse skills are required for the task of adaptation. Although adapting a guideline is not a guarantee that it will be implemented, adaptation may improve acceptance and adherence to its recommendations.

Mwangi N, Gachago M, Gichangi M, Gichuhi S, Githeko K, Jalango A, Karimurio J, Kibachio J, Ngugi N, Nyaga P, Nyamori J, Zindamoyen ANM, Bascaran C, Foster A. "Adapting clinical practice guidelines for diabetic retinopathy in Kenya: process and outputs." Implement Sci . 2018;13(81):https://doi.org/10.1186/s13012-018-0773-2.
and Zubeda Mucheke DNBS. "Challenges to electronic conveyancing in Kenya." Open University of Tanzania Law Journal. 2018.
AJ O’o, Z Q, M O. "Infection in pregnancy; understanding impact on placental microenvironment and preterm birth: a review." JOGECA . 2018;29(1). Abstract

Background: Pregnancy increases susceptibility to and severity of infections caused by certain microbes and
parasites. The presence of these infectious agents at the maternofetal interface may lead to adverse pregnancy
outcomes including preterm birth either via direct action of the microbes or indirectly via alteration of the placental
microenvironment.
Objective: To summarize the literature regarding the role of various infectious agents in alteration of placental
microenvironment and predisposition to preterm birth.
Method: A review search using Google scholar, PubMed, Cochrane Library and Trip database was conducted at the
University of California San Francisco. A total of 880 abstracts were reviewed and a total of 95 studies were included.
Studies were included if they reported any information on infection during pregnancy, effect on placenta or fetal
membranes or risk of preterm birth.
Results: The current evidence indicates that various infectious agents affect pregnancy and alter placental
microenvironment at the maternofetal interface. Severity of these infections increases with gestation. Additionally,
these infections are associated with the risk of adverse obstetric outcomes including preterm birth.
Conclusion: Prevention, early detection and treatment of these infections including those that are asymptomatic is
important in maintaining integrity of the placenta and in reducing the burden of preterm births.

Kitonyo OM, Sadras VO, Zhou Y, Denton MD. "Nitrogen supply and sink demand modulate the patterns of leaf senescence in maize." Field Crops Research. 2018;225:92-103.
Odongo DO, Tiampati CM, Mulinge E, Mbae CK, Bishop RP, Zeyhle E, Magambo J, Wasserman M, Kern P, Romig T. "Prevalence and genotyping of Echinococcus granulosus in sheep in Narok County, Kenya." Parasitology research. 2018;117(7):2065-2073.
Ouko C, Mulwa R, Kibugi R, Owuor M, Zaehringer J, Oguge N. "Community Perceptions of Ecosystem Services and the Management of Mt. Marsabit Forest in Northern Kenya." Environments. 2018;5(11):121. Abstract
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Zipporah M, Robinson M, Julius M, Arti K. "Perpendicular magnetic anisotropy in Mn2VIn (001) films: An ab initio study." AIP Advances. 2018;8:055701. Abstract
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Zipporah M, Robinson M, Julius M, Arti K. "Perpendicular magnetic anisotropy in Mn2VIn (001) films: An ab initio study." AIP Advances. 2018;8:055701. Abstract
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Zipporah M, Robinson M, Julius M, Arti K. "Perpendicular magnetic anisotropy in Mn2VIn (001) films: An ab initio study." AIP Advances. 2018;8:055701. Abstract
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Zipporah M, Robinson M, Julius M, Arti K. "Perpendicular magnetic anisotropy in Mn2VIn (001) films: An ab initio study." AIP Advances. 2018;8:055701. Abstract
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Gichuhi S, Kabiru J, Zindamoyen AM'bongo, Rono H, Ollando E, Wachira J, Munene R, Onyuma T, Sagoo MS, Macleod D, Weiss HA, Burton MJ. "Delay along the care-seeking journey of patients with ocular surface squamous neoplasia in Kenya." BMC Health Serv Res. 2017;17(1):485. AbstractWebsite

BACKGROUND:

In Africa, accessing eye health services is a major challenge. Ocular surface squamous neoplasia (OSSN) is a substantial ocular health problem in Africa related to solar UV light exposure and HIV infection among other risk factors. The disease causes visual loss and even death in advanced cases. This study was conducted to assess referral pathway and treatment delay for patients with OSSN in Kenya.
METHODS:

Adults with conjunctival lesions presenting to four eye centres were asked about their occupations, when they noticed the growth, health facilities visited in seeking care, cost of consultation, surgery, medicines and histopathology and dates at each step. The time-to-presentation was divided into quartiles and correlates analysed using ordinal logistic regression.
RESULTS:

We evaluated 158 first-time presenters with OSSN. Most were women (102 [65%]), living with HIV (78/110 tested [71%]), with low to medium income (127 [80%]). Most of the HIV patients (49/78 [63%]) were in antiretroviral care programs. About half (88/158, [56%]) presented directly to the study centres while the rest were referred. Indirect presenters sought care earlier than direct presenters (median 2.0 months vs 5.5 months) and travelled a shorter distance to the first health facility (median 20 km vs 30 km) but had surgery later (median 12.5 months vs 5.5 months). Visits beyond the first health facility for indirect presenters markedly increased delay (median 7.3, 29.0, 37.9, and 32.0 months for 1-4 facilities, respectively). Delay was associated with number of health facilities visited (adjusted ordered OR = 9.12; 95%CI 2.83-29.4, p < 0.001) and being female (adjusted ordered OR = 2.42; 95%CI 1.32-4.44, p = 0.004). At the time of presentation at the study centres for surgery the median tumour diameter in both directly and indirectly presenting patients was 6 mm (p = 0.52) and the histological spectrum of OSSN was similar between the groups (p = 0.87).
CONCLUSIONS:

Referral delays definitive treatment for OSSN. Women were more likely to experience delay. Despite regular contact with the health system for those with known HIV infection, delays occurred. Early detection and referral of OSSN in the HIV service might reduce delays, but reassuringly delay did not give rise to a larger proportion with more advanced grade of OSSN.

Dziuban EJ, DeVos J, Ngeno B, Ngugi E, Zhang G, Sabatier J, Wagar N, Diallo K, Nganga L, Katana A, Yang C, Rivadeneira ED, Mukui I, Odhiambo F, Redfield R, Raizes E. "High Prevalence of Abacavir-associated L74V/I Mutations in Kenyan Children Failing Antiretroviral Therapy." Pediatr. Infect. Dis. J.. 2017;36(8):758-760. Abstract

A survey of 461 HIV-infected Kenyan children receiving antiretroviral therapy found 143 (31%) failing virologically. Drug resistance mutations were found in 121; 37 had L74V/I mutations, with 95% receiving abacavir (ABC)-containing regimens. L74V/I was associated with current ABC usage (P = 0.0001). L74V/I may be more prevalent than previously realized in children failing ABC-containing regimens, even when time on treatment has been short. Ongoing rigorous pediatric drug resistance surveillance is needed.

Odada E, Zalasiewicz J, Williams M, Waters CN, Barnosky AD, et al. " Scale and diversity of the physical technosphere: A geological perspective." The Anthropocene Review. 2017;4(1):9-22. AbstractFull Text

We assess the scale and extent of the physical technosphere, defined here as the summed material output of the contemporary human enterprise. It includes active urban, agricultural and marine components, used to sustain energy and material flow for current human life, and a growing residue layer, currently only in small part recycled back into the active component. Preliminary estimates suggest a technosphere mass of approximately 30 trillion tonnes (Tt), which helps support a human biomass that, despite recent growth, is ~5 orders of magnitude smaller. The physical technosphere includes a large, rapidly growing diversity of complex objects that are potential trace fossils or ‘technofossils’. If assessed on palaeontological criteria, technofossil diversity already exceeds known estimates of biological diversity as measured by richness, far exceeds recognized fossil diversity, and may exceed total biological diversity through Earth’s history. The rapid transformation of much of Earth’s surface mass into the technosphere and its myriad components underscores the novelty of the current planetary transformation.

Nyawira M, Muchai G, Gichangi M, Gichuhi S, Githeko K, Atieno J, Karimurio J, Kibachio J, Ngugi N, Nyaga PT, Nyamori J, Zindamoyen ANM, Bascaran C, Foster A. "Clinical guidelines for diabetic retinopathy in Kenya: an executive summary of the recommendations." J Ophthalmol East Cent & S Afr. . 2017;21(2):33-39. Abstract

All persons living with Diabetes Mellitus (DM) have a lifetime risk of developing Diabetic Retinopathy (DR), a
potentially blinding microvascular complication of DM. The risk increases with the duration of diabetes. The
onset and progression of DR can be delayed through optimization of control of blood glucose, blood pressure and lipids. The risk of blindness from DR can be reduced through cost-effective interventions such as screening for DR and treatment of sight-threatening DR with laser photocoagulation and anti-VEGF medications.
Several factors make it important to provide guidance to clinicians who provide services for diabetes and
diabetic retinopathy in Kenya. First, the magnitude of both DM and DR is expected to increase over the next
decade. Secondly, as the retina is easily accessible for examination, the early signs of retinopathy may provide clinicians with the best evidence of microvascular damage from diabetes. This information can be used to guide subsequent management of both DM and DR. Thirdly, there are notable gaps in service delivery for the detection,treatment and follow-up of patients with DR, and the services are inequitable. Strengthening of service delivery will require close collaboration between diabetes services and eye care services.
Following a systematic and collaborative process of guideline development, the first published national
guidelines for the management of diabetic retinopathy have been developed. The purpose of this paper is to
highlight the recommendations in the guidelines, and to facilitate their adoption and implementation.

Mwangi N, Gachago M, Gichangi M, Gichuhi S, Githeko K, Jalango A, Karimurio J, Kibachio J, Ngugi N, Nyaga P, Nyamori J, Zindamoyen ANM, Bascaran C, Foster A. "Clinical guidelines for diabetic retinopathy in Kenya: an executive summary of the recommendations." J Ophthalmol East Cent & S Afr.. 2017;21(2):33-9.
Zipporah M, Rohit P, Robinson M, Ralph S. "First-principle investigation of structural, electronic and magnetic properties of Co2VIn and CoVIn Heusler compounds." AIP Advances. 2017;7. Abstract

Investigation of the structural, electronic and magnetic properties of full-Heusler Co2VIn as well as half-Heusler CoVIn Cobalt based Heusler compounds using density functional theory (DFT) leads to the general conclusion that Co2VIn and CoVIn are half-metallic materials with a gap at the Fermi level in the minority states and majority states respectively. A Hubbard-like Coulomb correlation term U has been included in the DFT (DFT+U) for the computation of the electronic and magnetic properties of the compounds. The structural properties have been calculated for the paramagnetic and ferromagnetic phases, and both Co2VIn and CoVIn are found to be stable in the ferromagnetic phase. The calculated magnetic moments are 2 μB2 μB and 0.9 μB0.9 μB per formula unit for Co2VIn and CoVIn respectively.

Scott AA, Misiani H, Okoth J, Jordan A, Gohlke J, Ouma G, Arrighi J, Zaitchik BF, Jjemba E, Verjee S, Waugh DW. "Temperature and Heat in Informal Settlements in Nairobi." PloS one. 2017;12(11). AbstractPLOS One

Nairobi, Kenya exhibits a wide variety of micro-climates and heterogeneous surfaces. Paved roads and high-rise buildings interspersed with low vegetation typify the central business district, while large neighborhoods of informal settlements or “slums” are characterized by dense, tin housing, little vegetation, and limited access to public utilities and services. To investigate how heat varies within Nairobi, we deployed a high density observation network in 2015/2016 to examine summertime temperature and humidity. We show how temperature, humidity and heat index differ in several informal settlements, including in Kibera, the largest slum neighborhood in Africa, and find that temperature and a thermal comfort index known colloquially as the heat index regularly exceed measurements at the Dagoretti observation station by several degrees Celsius. These temperatures are within the range of temperatures previously associated with mortality increases of several percent in youth and elderly populations in informal settlements. We relate these changes to surface properties
such as satellite-derived albedo, vegetation indices, and elevation.

Odada E, Zalasiewicz J, Waters CN, Summerhayes CP, Wolfe AP, et al. "The Working Group on the Anthropocene: Summary of evidence and interim recommendations." Anthropocene. 2017;19:55-60. AbstractFull Text

Since 2009, the Working Group on the ‘Anthropocene’ (or, commonly, AWG for Anthropocene Working Group), has been critically analysing the case for formalization of this proposed but still informal geological time unit. The study to date has mainly involved establishing the overall nature of the Anthropocene as a potential chronostratigraphic/geochronologic unit, and exploring the stratigraphic proxies, including several that are novel in geology, that might be applied to its characterization and definition. A preliminary summary of evidence and interim recommendations was presented by the Working Group at the 35th International Geological Congress in Cape Town, South Africa, in August 2016, together with results of voting by members of the AWG indicating the current balance of opinion on major questions surrounding the Anthropocene. The majority opinion within the AWG holds the Anthropocene to be stratigraphically real, and recommends formalization at epoch/series rank based on a mid-20th century boundary. Work is proceeding towards a formal proposal based upon selection of an appropriate Global boundary Stratotype Section and Point (GSSP), as well as auxiliary stratotypes. Among the array of proxies that might be used as a primary marker, anthropogenic radionuclides associated with nuclear arms testing are the most promising; potential secondary markers include plastic, carbon isotope patterns and industrial fly ash. All these proxies have excellent global or near-global correlation potential in a wide variety of sedimentary bodies, both marine and non-marine.

Awuor OB, Zipporah O, Ooko J. "The Effect of Managerial Ownership on Stock Performance of Firms Listed at the Nairobi Securities Exchange." Scholars Journal of Economics, Business and Management. 2017;4:279-290. Abstract
n/a
Fu P, Hughes J, Zeng G, Hanook S, Orem J, Mwanda OW, Remick SC. "A comparative investigation of methods for longitudinal data with limits of detection through a case study." Stat Methods Med Res. 2016;25(1):153-66. Abstract

The statistical analysis of continuous longitudinal data may be complicated since quantitative levels of bioassay cannot always be determined. Values beyond the limits of detection (LOD) in the assays may not be observed and thus censored, rendering complexity to the analysis of such data. This article examines how both left-censoring and right censoring of HIV-1 plasma RNA measurements, collected for the study on AIDS-related Non-Hodgkin's lymphoma (AR-NHL) in East Africa, affects the quantification of viral load and explores the natural history of viral load measurements over time in AR-NHL patients receiving anticancer chemotherapy. Data analyses using Monte Carlo EM algorithm (MCEM) are compared to analyses where the LOD or LOD/2 (left censoring) value is substituted for the censored observations, and also to other methods such as multiple imputation, and maximum likelihood estimation for censored data (generalized Tobit regression). Simulations are used to explore the sensitivity of the results to changes in the model parameters. In conclusion, the antiretroviral treatment was associated with a significant decrease in viral load after controlling the effects of other covariates. A simulation study with finite sample size shows MCEM is the least biased method and the estimates are least sensitive to the censoring mechanism.

Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM'bongo, Rono H, Ollando E, Wachira J, Munene R, Onyuma T, Jaoko WG, Sagoo MS, Weiss HA, Burton MJ. "Risk factors for ocular surface squamous neoplasia in Kenya: a case-control study." Trop. Med. Int. Health. 2016;21(12):1522-1530. AbstractWebsite

OBJECTIVE:
To determine modifiable risk factors of ocular surface squamous neoplasia (OSSN) in Kenya using disease-free controls.

METHODS:
Adults with conjunctival lesions were recruited at four eye care centres in Kenya and underwent excision biopsy. An equal number of controls having surgery for conditions not affecting the conjunctiva and unrelated to ultraviolet light were group-matched to cases by age group, sex and eye care centre. Associations of risk factors with OSSN were evaluated using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Continuous variables were compared using the t-test or the Wilcoxon-Mann-Whitney U-test depending on their distribution.

RESULTS:
A total of 131 cases and 131 controls were recruited. About two-thirds of participants were female, and the mean age of cases and controls was 42.1 years and 43.3 years, respectively. Risk factors for OSSN were HIV infection without antiretroviral therapy (ART) use (OR = 48.42; 95% CI: 7.73-303.31) and with ART use (OR = 19.16; 95% CI: 6.60-55.57), longer duration of exposure to the sun in the main occupation (6.9 h/day vs. 4.6 h/day, OR = 1.24; 95% CI: 1.10-1.40) and a history of allergic conjunctivitis (OR = 74.61; 95% CI: 8.08-688.91). Wearing hats was protective (OR = 0.22; 95% CI: 0.07-0.63).

CONCLUSION:
Measures to prevent and control HIV, reduce sun exposure such as wearing hats and control allergic conjunctivitis are recommended.

Odada E, Waters CN, Zalasiewicz J, Summerhayes C, Barnosky AD, et al. "The Anthropocene is functionally and stratigraphically distinct from the Holocene." Science. 2016;351(6269):aad2622. AbstractFull Text

BACKGROUND

Humans are altering the planet, including long-term global geologic processes, at an increasing rate. Any formal recognition of an Anthropocene epoch in the geological time scale hinges on whether humans have changed the Earth system sufficiently to produce a stratigraphic signature in sediments and ice that is distinct from that of the Holocene epoch. Proposals for marking the start of the Anthropocene include an “early Anthropocene” beginning with the spread of agriculture and deforestation; the Columbian Exchange of Old World and New World species; the Industrial Revolution at ~1800 CE; and the mid-20th century “Great Acceleration” of population growth and industrialization.
ADVANCES

Recent anthropogenic deposits contain new minerals and rock types, reflecting rapid global dissemination of novel materials including elemental aluminum, concrete, and plastics that form abundant, rapidly evolving “technofossils.” Fossil fuel combustion has disseminated black carbon, inorganic ash spheres, and spherical carbonaceous particles worldwide, with a near-synchronous global increase around 1950. Anthropogenic sedimentary fluxes have intensified, including enhanced erosion caused by deforestation and road construction. Widespread sediment retention behind dams has amplified delta subsidence.

Geochemical signatures include elevated levels of polyaromatic hydrocarbons, polychlorinated biphenyls, and pesticide residues, as well as increased 207/206Pb ratios from leaded gasoline, starting between ~1945 and 1950. Soil nitrogen and phosphorus inventories have doubled in the past century because of increased fertilizer use, generating widespread signatures in lake strata and nitrate levels in Greenland ice that are higher than at any time during the previous 100,000 years.

Detonation of the Trinity atomic device at Alamogordo, New Mexico, on 16 July 1945 initiated local nuclear fallout from 1945 to 1951, whereas thermonuclear weapons tests generated a clear global signal from 1952 to 1980, the so-called “bomb spike” of excess 14C, 239Pu, and other artificial radionuclides that peaks in 1964.

Atmospheric CO2 and CH4 concentrations depart from Holocene and even Quaternary patterns starting at ~1850, and more markedly at ~1950, with an associated steep fall in δ13C that is captured by tree rings and calcareous fossils. An average global temperature increase of 0.6o to 0.9oC from 1900 to the present, occurring predominantly in the past 50 years, is now rising beyond the Holocene variation of the past 1400 years, accompanied by a modest enrichment of δ18O in Greenland ice starting at ~1900. Global sea levels increased at 3.2 ± 0.4 mm/year from 1993 to 2010 and are now rising above Late Holocene rates. Depending on the trajectory of future anthropogenic forcing, these trends may reach or exceed the envelope of Quaternary interglacial conditions.

Biologic changes also have been pronounced. Extinction rates have been far above background rates since 1500 and increased further in the 19th century and later; in addition, species assemblages have been altered worldwide by geologically unprecedented transglobal species invasions and changes associated with farming and fishing, permanently reconfiguring Earth’s biological trajectory.
OUTLOOK

These novel stratigraphic signatures support the formalization of the Anthropocene at the epoch level, with a lower boundary (still to be formally identified) suitably placed in the mid-20th century. Formalization is a complex question because, unlike with prior subdivisions of geological time, the potential utility of a formal Anthropocene reaches well beyond the geological community. It also expresses the extent to which humanity is driving rapid and widespread changes to the Earth system that will variously persist and potentially intensify into the future.

Anne Fischer, Ivette Santana-Cruz, Wambua L, Cassandra Olds, Charles Midega, Matthew Dickinson, Praphat Kawicha, Zeyaur Khan, Masiga D, Joerg Jores, Bernd Schneider. "Draft genome sequence of “Candidatus Phytoplasma oryzae” strain Mbita1, the causative agent of Napier grass stunt disease in Kenya." Genome announcements. 2016;4(2):e00297-16.
Zhang J, Pazoki M, Simiyu J, Johansson MB, Cheung O, Häggman L, Johansson EMJ, Vlachopoulos N, Hagfeldt A, Boschloo G. "The effect of mesoporous TiO2 pore size on the performance of solid-state dye sensitized solar cells based on photoelectrochemically polymerized Poly (3, 4-ethylenedioxythiophene) hole conductor." Electrochimica Acta. 2016;210:23-31.
Takken W, Loon JJAV, Zwiebel LJ, Pask GM, Wolfgang Richard Mukabana. "Insect repellent compositions and methods of use.". 2016.
Scott A, Misiani HO, Zaitchik BF, Ouma GO, Anyah RO, Jordan A. "Inter-annual Variability of Temperature and Extreme Heat Events during the Nairobi Warm Season." AGU Fall Meeting Abstracts. 2016. AbstractSAO/NASA ADS Physics Abstract Service

Extreme heat events significantly stress all organisms in the ecosystem, and are likely to be amplified in peri-urban and urban areas. Understanding the variability and drivers behind these events is key to generating early warnings, yet in Equatorial East Africa, this information is currently unavailable. This study uses daily maximum and minimum temperature records from weather stations within Nairobi and its surroundings to characterize variability in daily minimum temperatures and the number of extreme heat events. ERA-Interim reanalysis is applied to assess the drivers of these events at event and seasonal time scales. At seasonal time scales, high temperatures in Nairobi are a function of large scale climate variability associated with the Atlantic Multi-decadal Oscillation (AMO) and Global Mean Sea Surface Temperature (GMSST). Extreme heat events, however, are more strongly associated with the El Nino Southern Oscillation (ENSO). For instance, the persistence of AMO and ENSO, in particular, provide a basis for seasonal prediction of extreme heat events/days in Nairobi. It is also apparent that the temporal signal from extreme heat events in tropics differs from classic heat wave definitions developed in the mid-latitudes, which suggests that a new approach for defining these events is necessary for tropical regions.

Yarmoshuk AN, Guantai AN, Mwangu M, Cole DC, Zarowsky C. "Mapping International University Partnerships Identi fi ed by East African Universities as Strengthening Their Medicine, Nursing, and Public Health Programs." Annals of Global Health. 2016;82(5):665-677. Abstract2016_-_mapping_international_university_partnerships.pdf

Background: International university partnerships are recommended for increasing the capacity of sub-Saharan African universities. Many publications describe individual partnerships and projects, and tools are available for guiding collaborations, but systematic mappings of the basic, common characteristics of partnerships are scarce.

Objective: To document and categorize the international interuniversity partnerships deemed significant to building the capacity of medicine, nursing, and public health programs of 4 East African universities.

Methods: Two universities in Kenya and 2 in Tanzania were purposefully selected. Key informant interviews, conducted with 42 senior representatives of the 4 universities, identified partnerships they considered significant for increasing the capacity of their institutions' medicine, nursing, and public health programs in education, research, or service. Interviews were transcribed and analyzed. Partners were classified by country of origin and corresponding international groupings, duration, programs, and academic health science components.

Findings: One hundred twenty-nine university-to-university partnerships from 23 countries were identified. Each university reported between 25 and 36 international university partners. Seventy-four percent of partnerships were with universities in high-income countries, 15% in low- and middle-income countries, and 11% with consortia. Seventy percent included medicine, 37% nursing, and 45% public health; 15% included all 3 programs. Ninety-two percent included an education component, 47% research, and 24% service; 12% included all 3 components.

Conclusions: This study confirms the rapid growth of inter-university cross-border health partnerships this century. It also finds, however, that there is a pool of established international partnerships from numerous countries at each university. Most partnerships that seek to strengthen universities in East Africa should likely ensure they have a significant education component. Universities should make more systematic information about past and existing partnerships available publicly.

Hyunwoo, L., James, D. M., Tobias, P. F., Cynthia, J.E., A.K S, Zachary, D.S., Kianji, G. "Massive and prolonged deep carbon emissions associated with continental rifting." Natural Geosciece. 2016.lee2016_ng_co2degassingear-_recent_publication-january_2016.pdf
J H, Z Q. "Preventing deaths due to haemorrhage. ." Best Practice & Research Clinical Obstetrics & Gynaecology Elsevier. 2016;36:68-32.Website
Recorla LA, Achenbach TM, Ivanova MY, Turner LV, Althoff RR, Arnadottir HA, Au A, Belina M, Caldas J, Chen Y-C, Csemy L, da Rocha MM, Decoster J, Fontaine JR, Funabiki Y, Guomundsson HS, Harder VS, Sebre S, Silvares E, Simulioniene R, Sokoli E, Vazquez N, Kim YA, Leung P, Ndetei DM, Maras JS, Marcovic J, Oh KJ, Samaniego VC, Zasepa E. "Problems and adaptive functioning reported by adults in 17 societies ." International perspectives in physiology research practice. 2016;5(2):91-109.
M W, H A-A, G C, YS C, A C, B F, S G, GJ H, P L, K M, TM N, Z Q, JP S, AM G. "Room temperature stable carbetocin for the prevention of postpartum haemorrhage during the third stage of labour in women delivering vaginally." Study protocol for a randomized controlled trial. 2016;17(1). Abstract

Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries and contributes to nearly a quarter of maternal deaths globally. The current available interventions for prevention of postpartum haemorrhage, oxytocin and carbetocin, are limited by their need for refrigeration to maintain potency, as the ability to maintain a cold chain across the drug distribution and storage network is inconsistent, thus restricting their use in countries with the highest burden of maternal mortality. We describe a randomized, double-blind noninferiority trial comparing a newly developed room temperature stable formulation of carbetocin to the standard intervention (oxytocin) for the prevention of PPH after vaginal birth.
METHODS/DESIGN:
Approximately 30,000 women delivering vaginally will be recruited across 22 centres in 10 countries. The primary objectives are to evaluate the non-inferiority of room temperature stable carbetocin (100 μg intramuscular) versus oxytocin (10 IU intramuscular) in the prevention of PPH and severe PPH after vaginal birth. The primary endpoints are blood loss ≥500 mL or the use of additional uterotonics (composite endpoint required by drug regulatory authorities) and blood loss ≥1,000 mL (WHO requirement). Non-inferiority will be assessed using a two-sided 95 % confidence interval for the relative risk of the above endpoints for room temperature stable carbetocin versus oxytocin. The upper limit of the two-sided 95 % confidence interval for the relative risk for the composite endpoint of blood loss ≥500 mL or the use of additional uterotonics, and for the endpoint of blood loss ≥1,000 mL, will be compared to a non-inferiority margin of 1.16 and 1.23, respectively. If the upper limit is below the corresponding mar in, non-inferiority will have been demonstrated. The safety analysis will include all wom n receiving treatment. Safety and tolerability will be assessed by a review of adverse events, by conducting inferential testing with significance levels for between-group comparisons.
DISCUSSION:
If the results of the study show that room temperature stable carbetocin is a safe and effective alternative to oxytocin, this could have a substantial impact on the prevention of postpartum haemorrhage and maternal survival worldwide.
TRIAL REGISTRATION:
ACTRN12614000870651 (14 August 2014).

Odada E, Steffen W, Leinfelder R, Zalasiewicz J, Waters CN, Williams M, et al. "Stratigraphic and Earth System approaches to defining the Anthropocene." Earth's Future. 2016;4(8):324-345. AbstractFull Text

Stratigraphy provides insights into the evolution and dynamics of the Earth System over its long history. With recent developments in Earth System science, changes in Earth System dynamics can now be observed directly and projected into the near future. An integration of the two approaches provides powerful insights into the nature and significance of contemporary changes to Earth. From both perspectives, the Earth has been pushed out of the Holocene Epoch by human activities, with the mid‐20th century a strong candidate for the start date of the Anthropocene, the proposed new epoch in Earth history. Here we explore two contrasting scenarios for the future of the Anthropocene, recognizing that the Earth System has already undergone a substantial transition away from the Holocene state. A rapid shift of societies toward the UN Sustainable Development Goals could stabilize the Earth System in a state with more intense interglacial conditions than in the late Quaternary climate regime and with little further biospheric change. In contrast, a continuation of the present Anthropocene trajectory of growing human pressures will likely lead to biotic impoverishment and a much warmer climate with a significant loss of polar ice.

Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wachira J, Munene R, Maina J, Onyuma T, Sagoo MS, Weiss HA, Burton MJ. "Topical fluorouracil after surgery for ocular surface squamous neoplasia in Kenya: a randomised, double-blind, placebo-controlled trial." Lancet Glob Health. . 2016;4(6):e378-85. AbstractWebsite

BACKGROUND:

Ocular surface squamous neoplasia (OSSN) is an aggressive eye tumour particularly affecting people with HIV in Africa. Primary treatment is surgical excision; however, tumour recurrence is common. We assessed the effect of fluorouracil 1% eye drops after surgery on recurrence.
METHODS:

We did this multicentre, randomised, placebo-controlled trial in four centres in Kenya. We enrolled patients with histologically proven OSSN aged at least 18 years. After standard surgical excision, participants were randomly allocated to receive either topical fluorouracil 1% or placebo four times a day for 4 weeks. Randomisation was stratified by surgeon, and participants and trial personnel were masked to assignment. Patients were followed up at 1 month, 3 months, 6 months, and 12 months. The primary outcome was clinical recurrence (supported by histological assessment where available) by 1 year, and analysed by intention to treat. The sample size was recalculated because events were more common than anticipated, and trial enrolment was stopped early. The trial was registered with Pan-African Clinical Trials Registry (PACTR201207000396219).
FINDINGS:

Between August, 2012, and July, 2014, we assigned 49 participants to fluorouracil and 49 to placebo. Four participants were lost to follow-up. Recurrences occurred in five (11%) of 47 patients in the fluorouracil group and 17 (36%) of 47 in the placebo group (odds ratio 0·21, 95% CI 0·07-0·63; p=0·01). Adjusting for passive smoking and antiretroviral therapy had little effect (odds ratio 0·23; 95% CI 0·07-0·75; p=0·02). Adverse effects occurred more commonly in the fluorouracil group, although they were transient and mild. Ocular discomfort occurred in 43 of 49 patients in the fluorouracil group versus 36 of 49 in the placebo group, epiphora occurred in 24 versus five, and eyelid skin inflammation occurred in seven versus none.
INTERPRETATION:

Topical fluorouracil after surgery substantially reduced recurrence of OSSN, was well-tolerated, and its use recommended.
FUNDING:

British Council for Prevention of Blindness and the Wellcome Trust.

Bagui OK, Kaduki KA, Berrocal E, Zoueu JT. "Structured Laser Illumination Planar Imaging Based Classification of Ground Coffee Using Multivariate Chemometric Analysis." Applied Physics Research. 2016;8(3):32. Abstract
n/a
Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM'bongo, Rono H, Ollando E, Wanyonyi L, Wachira J, Munene R, Onyuma T, Jaoko WG, Sagoo MS, Weiss HA, Burton MJ. "Toluidine Blue 0.05% Vital Staining for the Diagnosis of Ocular Surface Squamous Neoplasia in Kenya." JAMA Ophthalmol. 2015;133(11):1314-21. Abstract

Clinical features are unreliable for distinguishing ocular surface squamous neoplasia (OSSN) from benign conjunctival lesions.

Zhang X, Wallace OL, Domi A, Wright KJ, Driscoll J, Anzala O, Sanders EJ, Kamali A, Karita E, Allen S, Fast P, Gilmour J, Price MA, Parks CL. "Canine distemper virus neutralization activity is low in human serum and it is sensitive to an amino acid substitution in the hemagglutinin protein." Virology. 2015;482:218-24. Abstract

Serum was analyzed from 146 healthy adult volunteers in eastern Africa to evaluate measles virus (MV) and canine distemper virus (CDV) neutralizing antibody (nAb) prevalence and potency. MV plaque reduction neutralization test (PRNT) results indicated that all sera were positive for MV nAbs. Furthermore, the 50% neutralizing dose (ND50) for the majority of sera corresponded to antibody titers induced by MV vaccination. CDV nAbs titers were low and generally were detected in sera with high MV nAb titers. A mutant CDV was generated that was less sensitive to neutralization by human serum. The mutant virus genome had 10 nucleotide substitutions, which coded for single amino acid substitutions in the fusion (F) and hemagglutinin (H) glycoproteins and two substitutions in the large polymerase (L) protein. The H substitution occurred in a conserved region involved in receptor interactions among morbilliviruses, implying that this region is a target for cross-reactive neutralizing antibodies.

Omosa-Manyonyi G, Mpendo J, Ruzagira E, Kilembe W, Chomba E, Roman F, Bourguignon P, Koutsoukos M, Collard A, Voss G, Laufer D, Stevens G, Hayes P, Clark L, Cormier E, Dally L, Barin B, Ackland J, Syvertsen K, Zachariah D, Anas K, Sayeed E, Lombardo A, Gilmour J, Cox J, Fast P, Priddy F. "A Phase I Double Blind, Placebo-Controlled, Randomized Study of the Safety and Immunogenicity of an Adjuvanted HIV-1 Gag-Pol-Nef Fusion Protein and Adenovirus 35 Gag-RT-Int-Nef Vaccine in Healthy HIV-Uninfected African Adults." PLoS ONE. 2015;10(5):e0125954. Abstract

Sequential prime-boost or co-administration of HIV vaccine candidates based on an adjuvanted clade B p24, RT, Nef, p17 fusion protein (F4/AS01) plus a non-replicating adenovirus 35 expressing clade A Gag, RT, Int and Nef (Ad35-GRIN) may lead to a unique immune profile, inducing both strong T-cell and antibody responses.

Odada E, Williams M, Zalasiewicz JA, Waters CN, Edgeworth M, Bennett CE, Barnosky AD, et al. "The Anthropocene: a conspicuous stratigraphical signal of anthropogenic changes in production and consumption across the biosphere.". 2015. AbstractFull Text

Biospheric relationships between production and consumption of biomass have been
resilient to changes in the Earth system over billions of years. This relationship has increased in its com-
plexity, from localized ecosystems predicated on anaerobic microbial production and consumption
to a global biosphere founded on primary production from oxygenic photoautotrophs, through the
evolution of Eukarya, metazoans, and the complexly networked ecosystems of microbes, animals, fungi,
and plants that characterize the Phanerozoic Eon (the last∼541 million years of Earth history). At present,
one species,
Homo sapiens, is refashioning this relationship between consumption and production in the
biosphere with unknown consequences. This has left a distinctive stratigraphy of the production and
consumption of biomass, of natural resources, and of produced goods. This can be traced through stone
tool technologies and geochemical signals, later unfolding into a diachronous signal of technofossils and
human bioturbation across the planet, leading to stratigraphically almost isochronous signals developing
by the mid-20th century. These latter signals may provide an invaluable resource for informing and
constraining a formal Anthropocene chronostratigraphy, but are perhaps yet more important as tracers
of a biosphere state that is characterized by a geologically unprecedented pattern of global energy flow
that is now pervasively influenced and mediated by humans, and which is necessary for maintaining the
complexity of modern human societies.

Z.B A. "Business Strategy, Internal Resources, National Culture And Competitive Advantage: A Critical Review ." 1st DBA Africa Management Review International conference ( 2015). 2015;1(1).
Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wanyonyi L, Wachira J, Munene R, Onyuma T, Sagoo MS, Weiss HA, Burton MJ. "Clinical Presentation of Ocular Surface Squamous Neoplasia in Kenya." JAMA Ophthalmology. 2015;133(11):1305-1313. AbstractWebsite

IMPORTANCE:
There is a trend toward treating conjunctival lesions suspected to be ocular surface squamous neoplasia (OSSN) based on the clinical impression.

OBJECTIVE:
To describe the presentation of OSSN and identify clinical features that distinguish it from benign lesions and subsequently evaluate their recognizability.

DESIGN, SETTING, AND PARTICIPANTS:
Prospective multicenter study in Kenya from July 2012 through July 2014 of 496 adults presenting with conjunctival lesions. One histopathologist examined all specimens. Six additional masked ophthalmologists independently examined photographs from 100 participants and assessed clinical features.

EXPOSURES:

Comprehensive history, slit lamp examination, and photography before excision biopsy.

MAIN OUTCOMES AND MEASURES:
Frequency of clinical features in OSSN and benign lesions were recorded. Proportions and means were compared using χ2, Fisher exact test, or t test as appropriate. Interobserver agreement was estimated using the κ statistic. Examiners' assessments were compared with a reference.

RESULTS:
Among 496 participants, OSSN was the most common (38%) histological diagnosis, followed by pterygium (36%) and actinic keratosis (19%). Patients with OSSN were slightly older (mean [SD] age, 41 [11.6] vs 38 [10.9] years; P = .002) and tended to have lower levels of education than patients with benign lesions (P = .001). Females predominated (67% of OSSN vs 64% of benign lesions; P = .65). Human immunodeficiency virus infection was common among patients with OSSN (74%). The most common location was the nasal limbus (61% OSSN vs 78% benign lesions; P < .001). Signs more frequent in OSSN included feeder vessels (odds ratio [OR], 5.8 [95% CI, 3.2-10.5]), moderate inflammation (OR, 3.5 [95% CI, 1.8-6.8]), corneal involvement (OR, 2.7 [95% CI, 1.8-4.0]), leukoplakia (OR, 2.6 [95% CI, 1.7-3.9]), papilliform surface (OR, 2.1 [95% CI, 1.3-3.5]), pigmentation (OR, 1.5 [95% CI, 1.0-2.2]), temporal location (OR, 2.0 [95% CI, 1.2-3.2]), circumlimbal location (6.7% vs 0.3%; P < .001), severe inflammation (6.7% vs 0.3%; P < .001), and larger mean (SD) diameter (6.8 [3.2] vs 4.8 [2.8] mm; P < .001). All OSSN signs were also observed in benign lesions. There was slight to fair inter-observer agreement in assessment of most signs and diagnosis (κ, 0.1-0.4). The positive predictive value of clinical appearance in identifying OSSN was 54% (interquartile range, 51%-56%) from photographs in which prevalence was 32%.

CONCLUSIONS AND RELEVANCE:
With overlapping phenotypes and modest inter-observer agreement, OSSN and benign conjunctival lesions are not reliably distinguished clinically. Point-of-care diagnostic tools may help.

M O'onge, Z.B A. "The effect of autonomy on financial performance of the Kenyan owned commercial state corporations ." Prime Journal of Business Administration and Management (BAM). 2015;5(6):1868-1880.
J.W N, V.N M, J.K M, Z.B A, X.N I. "Knowledge Sharing, Organizational Learning and Performance of Top 100 Medium Enterprises in Kenya ." Kenya 1st DBA Africa Management Review International conference ( 2015). 2015;1(1).
B.E O, V.N M, Z.B A, G W. "Organizational Resources, Innovation and Performance of Insurance Companies in Kenya." 1st DBA Africa Management Review International conference ( 2015). 2015;1(1).
Massele A, Burger J, Katende-Kyenda NL, Kalemeera F, Kenaope T, Kibuule D, Mbachu O, Mubita M, Oluka M, Olusanya A, Paramadhas BAD, van Zyl P, Godman B. "Outcome of the first Medicines Utilization Research in Africa group meeting to promote sustainable and rational medicine use in Africa." Expert Rev. Pharmacoecon. Outcomes Res.. 2015;15(6):885-888. Abstractoluka_massele_et_al_2015.pdf

The first Medicines Utilization Research in Africa group workshop and symposium brought researchers together from across Africa to improve their knowledge on drug utilization methodologies as well as exchange ideas. As a result, progress was made on drug utilization research and formulating future strategies to enhance the rational use of medicines in Africa. Anti-infectives were the principal theme for the 1-day symposium following the workshops. This included presentations on the inappropriate use of antibiotics as well as ways to address this. Concerns with adverse drug reactions and adherence to anti-retroviral medicines were also discussed, with poor adherence remaining a challenge. There were also concerns with the underutilization of generics. These discussions resulted in a number of agreed activities before the next conference in 2016

Odada E, Fekete BM, Robarts RD, Kumagai M, Nachtnebel H-P, Zhulidov AV. "Time for in situ renaissance." Science. 2015;349(6249):685-686. AbstractFull Text

of satellite observations is that measurements are readily collected and shared across
political boundaries. In contrast, many countries refuse to share ground-based hydrologic
measurements for socioeconomic and political reasons, whereas others simply lack the
capacity to centralize and digitize what data are collected. This impedes investigations on a
continental-to-global scale, as well as efforts to avert food and water crises. Because
satellites can monitor water resources at scales relevant to effective transboundary water
management and because data are often provided through freely accessible digital
archives, policies of international data denial may ultimately become obsolete (17).
Governments around the world are now instructing their water management agencies to
plan for the uncertain hydrologic future that satellite observations have helped reveal.

Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wanyonyi L, Wachira J, Munene R, Onyuma T, Jaoko WG, Sagoo MS, Weiss HA, Burton MJ. "Toluidine Blue 0.05% Vital Staining for the Diagnosis of Ocular Surface Squamous Neoplasia in Kenya." JAMA Ophthalmology. 2015;133(11):1314-1321. AbstractWebsite

IMPORTANCE:
Clinical features are unreliable for distinguishing ocular surface squamous neoplasia (OSSN) from benign conjunctival lesions.

OBJECTIVE:
To evaluate the adverse effects, accuracy, and interobserver variation of toluidine blue 0.05% vital staining in distinguishing OSSN, confirmed by histopathology, from other conjunctival lesions.

DESIGN, SETTING, AND PARTICIPANTS:
Cross-sectional study in Kenya from July 2012 through July 2014 of 419 adults with suspicious conjunctival lesions. Pregnant and breastfeeding women were excluded.

EXPOSURES:
Comprehensive ophthalmic slitlamp examination was conducted. Vital staining with toluidine blue 0.05% aqueous solution was performed before surgery. Initial safety testing was conducted on large tumors scheduled for exenteration looking for corneal toxicity on histology before testing smaller tumors. We asked about pain or discomfort after staining and evaluated the cornea at the slitlamp for epithelial defects. Lesions were photographed before and after staining.

MAIN OUTCOMES AND MEASURES:
Diagnosis was confirmed by histopathology. Six examiners assessed photographs from a subset of 100 consecutive participants for staining and made a diagnosis of OSSN vs non-OSSN. Staining was compared with histopathology to estimate sensitivity, specificity, and predictive values. Adverse effects were enumerated. Interobserver agreement was estimated using the κ statistic.

RESULTS:
A total of 143 of 419 participants (34%) had OSSN by histopathology. The median age of all participants was 37 years (interquartile range, 32-45 years) and 278 (66%) were female. A total of 322 of the 419 participants had positive staining while 2 of 419 were equivocal. There was no histological evidence of corneal toxicity. Mild discomfort was reported by 88 (21%) and mild superficial punctate keratopathy seen in 7 (1.7%). For detecting OSSN, toluidine blue had a sensitivity of 92% (95% CI, 87%-96%), specificity of 31% (95% CI, 25%-36%), positive predictive value of 41% (95% CI, 35%-46%), and negative predictive value of 88% (95% CI, 80%-94%). Interobserver agreement was substantial for staining (κ = 0.76) and moderate for diagnosis (κ = 0.40).

CONCLUSIONS AND RELEVANCE:
With the high sensitivity and low specificity for OSSN compared with histopathology among patients with conjunctival lesions, toluidine blue 0.05% vital staining is a good screening tool. However, it is not a good diagnostic tool owing to a high frequency of false-positives. The high negative predictive value suggests that a negative staining result indicates that OSSN is relatively unlikely.

Odada E, Zalasiewicz J, Waters CN, Williams M, Barnosky AD, et al. "When did the Anthropocene begin? A mid-twentieth century boundary level is stratigraphically optimal." Quaternary International. 2015;383:196-203. AbstractFull Text

We evaluate the boundary of the Anthropocene geological time interval as an epoch, since it is useful to have a consistent temporal definition for this increasingly used unit, whether the presently informal term is eventually formalized or not. Of the three main levels suggested – an ‘early Anthropocene’ level some thousands of years ago; the beginning of the Industrial Revolution at ∼1800 CE (Common Era); and the ‘Great Acceleration’ of the mid-twentieth century – current evidence suggests that the last of these has the most pronounced and globally synchronous signal. A boundary at this time need not have a Global Boundary Stratotype Section and Point (GSSP or ‘golden spike’) but can be defined by a Global Standard Stratigraphic Age (GSSA), i.e. a point in time of the human calendar. We propose an appropriate boundary level here to be the time of the world's first nuclear bomb explosion, on July 16th 1945 at Alamogordo, New Mexico; additional bombs were detonated at the average rate of one every 9.6 days until 1988 with attendant worldwide fallout easily identifiable in the chemostratigraphic record. Hence, Anthropocene deposits would be those that may include the globally distributed primary artificial radionuclide signal, while also being recognized using a wide range of other stratigraphic criteria. This suggestion for the Holocene–Anthropocene boundary may ultimately be superseded, as the Anthropocene is only in its early phases, but it should remain practical and effective for use by at least the current generation of scientists.

Vogel JP, Souza JP, Gülmezoglu MA, Mori R, Lumbiganon P, QURESHI ZAHIDA, Carroli G, Laopaiboon M, Fawole B, Ganchimeg T, Zhang J, Torloni MR, Bohren M, Temmerman M. "Use of antenatal corticosteroids and tocolytic drugs in preterm births in 29 countries: an analysis of the WHO Multicountry Survey on Maternal and Newborn Health." Lancet. 2014;384(9957):1869-77. Abstract

Despite the global burden of morbidity and mortality associated with preterm birth, little evidence is available for use of antenatal corticosteroids and tocolytic drugs in preterm births in low-income and middle-income countries. We analysed data from the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS) to assess coverage for these interventions in preterm deliveries.

Mbugua JK, Kemboi A, Michira IN, Madadi VO, Zaranyika MF, Kamau GN. "Adsorption of Atrazine pesticide by sediment and soil samples: Effect of Equilibration Time on the Freundlich Parameter (n)." International Journal of BioChemiPhysics. 2014;22:31-41.
D.D. K, Z.I. O, P.K. N. "Application of GIS to Water Quality Management for the City of Nairobi Water Supply." ICASTOR Journal of Engineering. 2014;7(1):5-23.oonge.docx
D.D. K, Z.I. O, P.K. N. "Application of GIS to Water Quality Management for the City of Nairobi Water Supply." ICASTOR Journal of Engineering. 2014;7(1):5-23.oonge.docx
Loiselle S, zar A´s C´, Adgo E, Ballatore T, Chavula G, Descy JP, Harper DM, Kansiime F, Kimirei I, Langenberg V, Ma R, Sarmento12 H, Odada E. "Decadal Trends and Common Dynamics of the Bio- Optical and Thermal Characteristics of the African Great Lakes." PLOS ONE. 2014;9(4):1-6. Abstract

The Great Lakes of East Africa are among the world’s most important freshwater ecosystems. Despite their importance in providing vital resources and ecosystem services, the impact of regional and global environmental drivers on this lacustrine system remains only partially understood. We make a systematic comparison of the dynamics of the bio-optical and thermal properties of thirteen of the largest African lakes between 2002 and 2011. Lake surface temperatures had a positive trend in all Great Lakes outside the latitude of 0u to 8u south, while the dynamics of those lakes within this latitude range were highly sensitive to global inter-annual climate drivers (i.e. El Nin˜o Southern Oscillation). Lake surface temperature dynamics in nearly all lakes were found to be sensitive to the latitudinal position of the Inter Tropical Convergence Zone. Phytoplankton dynamics varied considerably between lakes, with increasing and decreasing trends. Intra-lake differences in both surface temperature and phytoplankton dynamics occurred for many of the larger lakes. This inter-comparison of bio-optical and thermal dynamics provides new insights into the response of these ecosystems to global and regional drivers.

D.D.Keruyu, Z.I.Oonge, P.K.Ndiba. "The Effect of Surface Treatment on Corrosion Behavior of 316L Stainless Steel." ICASTOR Journal of Engineering. 2014;7(1).
Zaccara S, Crosa G, Vanetti I, Binelli G, Harper DM, Mavuti KM, Balarin JD, Britton RJ. "Genetic and morphological analyses indicate high population mixing in the endangered cichlid Alcolapia flock of East Africa." Conservation genetics. 2014;15(2):429-440.
Gichuhi S, Onyuma T, Macharia E, Kabiru J, Zindamoyen AM, Sagoo MS, Burton MJ. "Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in Kenya - a case report." BMC Ophthalmology. 2014;45(14). Abstract

BACKGROUND:

Ocular rhinosporidiosis is a chronic granulomatous infection caused by a newly classified organism that is neither a fungus nor bacterium. It often presents as a benign conjunctival tumour but may mimic other ocular conditions. It is most often described in India. In Africa cases have been reported from South Africa, Kenya, Tanzania, Malawi, Uganda, Congo and Ivory Coast.

CASE PRESENTATION:

A 54 year old man was seen in Kenya with a lesion that resembled a conjunctival papilloma. We report resemblance to conjunctival papilloma and the result of vital staining with 0.05% Toluidine Blue.

CONCLUSION:

Ocular rhinosporidiosis occurs in East Africa. It may resemble conjunctival squamous papilloma. Vital staining with 0.05% Toluidine blue dye did not distinguish the two lesions well.

Zachariah R, Kumar AMV, Reid AJ, den Bergh VR, Isaakidis P, Draguez B, Delaunois P, Nagaraja SB, Ramsay A, Reeder JC, Denisiuk O, Ali E, Khogali M, Hinderaker SG, Kosgei RJ, van Griensven J, Quaglio GL, Maher D, Billo NE, Terry RF, Harries AD. "Open access for operational research publications from low and middle-income countries: who pays?" Public Health Action . 2014;4(3):141-144.open_acess_for_operations_research_who_pays.pdf
Edwards JK, Thiongó A, den Bergh VR, Kizito W, Kosgei RJ, Sobry A, Vandenbulcke A, Zuniga I, Reid AJ. "Preventable but neglected: rickets in an informal settlement, Nairobi, Kenya." Public Health Action. 2014;4(2):122-127.preventable_but_neglected-_rickets_in_an_informal_settlement__nairobi_kenya.pdf
C M, Z.B A, J N. "Top Management Team, Diversity Management Strategies And Performance Of Commercial Banks In Kenya ." DBA Africa Management Review. 2014;4(2):23-31.
Zhao S, Tian H, Ma L, Yuan Y, Yu RC, Ma M. "Activity-{Dependent} {Modulation} of {Odorant} {Receptor} {Gene} {Expression} in the {Mouse} {Olfactory} {Epithelium}." PLoS ONE. 2013;8:e69862. AbstractWebsite

Activity plays critical roles in development and maintenance of the olfactory system, which undergoes considerable neurogenesis throughout life. In the mouse olfactory epithelium, each olfactory sensory neuron (OSN) stably expresses a single odorant receptor (OR) type out of a repertoire of ∼1200 and the OSNs with the same OR identity are distributed within one of the few broadly-defined zones. However, it remains elusive whether and how activity modulates such OR expression patterns. Here we addressed this question by investigating OR gene expression via in situ hybridization when sensory experience or neuronal excitability is manipulated. We first examined the expression patterns of fifteen OR genes in mice which underwent neonatal, unilateral naris closure. After four-week occlusion, the cell density in the closed (sensory-deprived) side was significantly lower (for four ORs), similar (for three ORs), or significantly higher (for eight ORs) as compared to that in the open (over-stimulated) side, suggesting that sensory inputs have differential effects on OSNs expressing different OR genes. We next examined the expression patterns of seven OR genes in transgenic mice in which mature OSNs had reduced neuronal excitability. Neuronal silencing led to a significant reduction in the cell density for most OR genes tested and thinner olfactory epithelium with an increased density of apoptotic cells. These results suggest that sensory experience plays important roles in shaping OR gene expression patterns and the neuronal activity is critical for survival of OSNs.

Tian J, Hu S, Sun Y, Yu H, Han X, Cheng W, Ban X, Zhang S, Yu B, Jang I-K. "Vasa vasorum and plaque progression, and responses to atorvastatin in a rabbit model of atherosclerosis: contrast-enhanced ultrasound imaging and intravascular ultrasound study." Heart (British Cardiac Society). 2013;99:48-54. Abstract

{OBJECTIVES: To serially investigate the relationship between vasa vasorum (VV) proliferation and plaque progression in vivo, and the effects of atorvastatin on VV and atherosclerosis as assessed by contrast-enhanced ultrasound (CEUS) and intravascular ultrasound (IVUS) imaging. METHODS: Carotid atherosclerosis was induced in rabbits with a high-cholesterol diet for 20 weeks and balloon injury. At week 16, following the imaging of the right common carotid arteries by CEUS and IVUS, 20 rabbits were randomised into a control or atorvastatin group (2 mg/kg/day). At week 20, CEUS and IVUS were repeated. Normalised maximal video-intensity enhancement (MVE) was calculated to quantify the density of VV. Plaque volume was determined by IVUS. RESULTS: When compared with the control group, lipid levels were not significantly lower following 4 weeks of atorvastatin administration. The increases in the normalised MVE over time were greater in the control group than in the atorvastatin group (p=0.001). The increase in plaque volume from 16 to 20 weeks was significantly greater in the control group than in the atorvastatin group (p=0.001). There was a positive relationship between changes in normalised MVE and plaque volume (r=0.72

Tian J, Hu S, Sun Y, Yu H, Han X, Cheng W, Ban X, Zhang S, Yu B, Jang I-K. "Vasa vasorum and plaque progression, and responses to atorvastatin in a rabbit model of atherosclerosis: contrast-enhanced ultrasound imaging and intravascular ultrasound study." Heart (British Cardiac Society). 2013;99:48-54. Abstract

{OBJECTIVES: To serially investigate the relationship between vasa vasorum (VV) proliferation and plaque progression in vivo, and the effects of atorvastatin on VV and atherosclerosis as assessed by contrast-enhanced ultrasound (CEUS) and intravascular ultrasound (IVUS) imaging. METHODS: Carotid atherosclerosis was induced in rabbits with a high-cholesterol diet for 20 weeks and balloon injury. At week 16, following the imaging of the right common carotid arteries by CEUS and IVUS, 20 rabbits were randomised into a control or atorvastatin group (2 mg/kg/day). At week 20, CEUS and IVUS were repeated. Normalised maximal video-intensity enhancement (MVE) was calculated to quantify the density of VV. Plaque volume was determined by IVUS. RESULTS: When compared with the control group, lipid levels were not significantly lower following 4 weeks of atorvastatin administration. The increases in the normalised MVE over time were greater in the control group than in the atorvastatin group (p=0.001). The increase in plaque volume from 16 to 20 weeks was significantly greater in the control group than in the atorvastatin group (p=0.001). There was a positive relationship between changes in normalised MVE and plaque volume (r=0.72

Zhao Z, Jiang C. "Effect of myopia on ganglion cell complex and peripapillary retinal nerve fibre layer measurements: a {Fourier}-domain optical coherence tomography study of young {Chinese} persons." Clinical & Experimental Ophthalmology. 2013;41:561-566. AbstractWebsite

Background To investigate the change of the ganglion cell complex and peripapillary retinal nerve fibre layer under different refractive conditions, as measured by optical coherence tomography. Design Cross-sectional observational study. Participants A total of 107 eyes from 107 subjects were studied. Methods Ganglion cell complex and retinal nerve fibre layer were studied by a spectral-domain system. Their relationship against spherical equivalents and axial length was studied. Main Outcome Measures The thickness of ganglion cell complex and retinal nerve fibre layer at different area and under different refractive conditions as measurements by optical coherence tomography. Results The average, superior and inferior macular ganglion cell complex thickness was significantly associated with both spherical equivalents (all P {\textless} 0.05) and axial length (all P {\textless} 0.05). Peripapillary retinal nerve fibre layer thicknesses from the superior, inferior and temporal quadrants were associated with both spherical equivalents (all P {\textless} 0.01), axial length (all P {\textless} 0.05) and ganglion cell complex thickness (all P {\textless} 0.001), except for the nasal part. However, if the retinal nerve fibre layer thickness was studied in sections, then some parts of the upper and lower temporal part showed no correlation with either spherical equivalents or axial length (all P {\textless} 0.05). Conclusions The thicknesses of the ganglion cell complex and most of the peripapillary retinal nerve fibre layer were correlated with refraction and axial length. Therefore, when using these for clinical purposes, attention must be paid to the refractive state of the patient.

Souza JP, Gülmezoglu AM, Vogel J, Carroli G, Lumbiganon P, QURESHI ZAHIDA, Costa MJ, Fawole B, Mugerwa Y, Nafiou I, Neves I, Wolomby-Molondo J-J, Bang HT, Cheang K, Chuyun K, Jayaratne K, Jayathilaka CA, Mazhar SB, Mori R, Mustafa ML, Pathak LR, Perera D, Rathavy T, Recidoro Z, Roy M, Ruyan P, Shrestha N, Taneepanichsku S, Tien NV, Ganchimeg T, Wehbe M, Yadamsuren B, Yan W, Yunis K, Bataglia V, Cecatti JG, Hernandez-Prado B, Nardin JM, Narváez A, Ortiz-Panozo E, Pérez-Cuevas R, Valladares E, Zavaleta N, Armson A, Crowther C, Hogue C, Lindmark G, Mittal S, Pattinson R, Stanton ME, Campodonico L, Cuesta C, Giordano D, Intarut N, Laopaiboon M, Bahl R, Martines J, Mathai M, Merialdi M, Say L. "Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study." Lancet. 2013;381(9879):1747-55. Abstract

We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities.

Zachariah R, Reid T, Van den Bergh R, Dahmane A, Kosgei RJ, Hinderaker SG, Tayler-Smith K, Manzi M, Kizito W, Khogali M, Kumar AMV, Baruani B, Bishinga A, Kilale AM, Nqobili M, Patten G, Sobry A, Cheti E, Nakanwagi A, Enarson DA, Edginton ME, Upshur R, Harries AD. "Applying the ICMJE authorship criteria to operational research in low-income countries: the need to engage programme managers and policy makers." Trop. Med. Int. Health. 2013;18(8):1025-8.applying_the_icmje_authorship_criteria_to_operational_research_in_low-income_countries_the_need_to_engage_programme_managers_and_policy_makers.pdf
Mbugua JK, Kemboi A, Michira I, Madadi V, Zaranyika M, Kamau G. "Adsorption of Atrazine Pesticide by sediments and soil samples: Apparent thermodynamic properties." International Journal of Biochemiphysics. 2013;07(10).
G G, ZN Q, W K, F W. "Antenatal corticosteroid use in preterm birth at Kenyatta National Hospital." Journal of Obstetrics and Gynaecology of Eastern and Central Africa. 2013;1(25):15-21. Abstractantenatal_corticosteroid_use_in_preterm_birth_at_kenyatta_national_hospital.pdf

Background:Preterm birth causes about 75% of neonatal deaths that are not attributable to congenital malfor-mations. Antenatal corticosteroids (ACS) given to mothers at risk of preterm birth reduce the incidence/severity of RDS, intraventricular haemmorhage, necrotizing enterocolitis and neonatal deaths. The WHO recommends use of antenatal steroids for all pregnant women 26-34 weeks gestation at risk of preterm delivery and after 34 weeks gestation only if there is evidence of fetal pulmonary immaturity. Despite this, ACS are widely used locally across all gestational periods.Objective: To determine the frequency of administration and impact of ACS in reducing the morbidity and mor-tality in preterm neonates born 28- 37 weeks gestation at Kenyatta National Hospital.Design: This was a hospital-based retrospective cohort study.Setting: Kenyattah National Hospital labour ward, antenatal wards, NBU, NICU.Methods: The study compared the neonatal outcomes of mothers with preterm birth who received antenatal steroids and those who did not receive. The study populations were mothers with preterm birth due to preterm labor, PPROM and severe pre eclampsia and their neonates. Mothers who met the inclusion criteria were recruit-ed immediately after delivery, interviewed, medical records scrutinized and information obtained entered into a questionnaire. Neonates were followed until discharge/death/ 7th day whichever came earlier. The outcome measures considered were the occurrence and severity of RDS, NBU admissions and neonatal deaths.Results: Two hundred and six mother/neonate pairs were recruited. Overall 35% of mothers/neonates were exposed to ACS. Forty six percent of those who delivered <34 weeks received ACS compared to 26% of those who delivered >34 weeks. Only 3% of mothers received a complete course of ACS. ACS significantly reduced the occurrence and severity of RDS in preterm neonates up to 34 weeks gestation. Sixty eight percent of neonates delivered before 34 weeks and not exposed to ACS developed RDS compared to 38% of those exposed (RR 0.6, 95% CI 0.4-0.9, P= 0.005). Exposure to ACS >34 weeks gestation did not reduce occurrence and severity of RDS. Forty percent of those exposed to ACS developed RDS compared to 37% of those not exposed (RR 1.2 95% CI 0.7-1.8, P =0.755). ACS reduced neonatal mortality across all gestational ages. The neonatal mortality within 7 days of life was 26% among those exposed to ACS <34 weeks compared to 38% among those not exposed (RR1.2, 95% CI 0.9-1.6, p=0.224). for those delivered after 34 weeks mortality was 3.3% in the exposed group compared to 9.2% in the non exposed group (RR 1.1 95%CI 1.0-1.2 p=0.443). ACS did not reduce NBU/NICU admissions across all gestational ages. Eighty five percent of neonates exposed to ACS before 34 weeks were admitted to NBU compared to 71% of those not exposed (RR1.2, 95% CI 1-2.1, p=0.113). Fifty percent of neonates exposed to ACS after 34 weeks were admitted to NBU compared to 32.2% of those not exposed (RR 1.3 95% CI 0.9-2.1, p=0.225). Conclusions: ACS are underutilized. ACS significantly reduce the incidence/severity of neonatal RDS and mortality <34 weeks gestation.Recommendations: There is need to upscale the utilization of ACS. The study provides local evidence to discourage routine use of ACS >34 weeks.

G G, ZN Q, W K, F W. "Antenatal corticosteroid use in preterm birth at Kenyatta National Hospital." Journal of Obstetrics and Gynaecology of Eastern and Central Africa. 2013;25(1):15-21. Abstractfull_article.pdf

AbstractBackground: Preterm birth causes about 75% of neonatal deaths that are not attributable to congenital malfor-mations. Antenatal corticosteroids (ACS) given to mothers at risk of preterm birth reduce the incidence/severity of RDS, intraventricular haemmorhage, necrotizing enterocolitis and neonatal deaths. The WHO recommends use of antenatal steroids for all pregnant women 26-34 weeks gestation at risk of preterm delivery and after 34 weeks gestation only if there is evidence of fetal pulmonary immaturity. Despite this, ACS are widely used locally across all gestational periods.Objective: To determine the frequency of administration and impact of ACS in reducing the morbidity and mor-tality in preterm neonates born 28- 37 weeks gestation at Kenyatta National Hospital.Design: This was a hospital-based retrospective cohort study.Setting: Kenyattah National Hospital labour ward, antenatal wards, NBU, NICU.Methods: The study compared the neonatal outcomes of mothers with preterm birth who received antenatal steroids and those who did not receive. The study populations were mothers with preterm birth due to preterm labor, PPROM and severe pre eclampsia and their neonates. Mothers who met the inclusion criteria were recruit-ed immediately after delivery, interviewed, medical records scrutinized and information obtained entered into a questionnaire. Neonates were followed until discharge/death/ 7th day whichever came earlier. The outcome measures considered were the occurrence and severity of RDS, NBU admissions and neonatal deaths.Results: Two hundred and six mother/neonate pairs were recruited. Overall 35% of mothers/neonates were exposed to ACS. Forty six percent of those who delivered <34 weeks received ACS compared to 26% of those who delivered >34 weeks. Only 3% of mothers received a complete course of ACS. ACS significantly reduced the occurrence and severity of RDS in preterm neonates up to 34 weeks gestation. Sixty eight percent of neonates delivered before 34 weeks and not exposed to ACS developed RDS compared to 38% of those exposed (RR 0.6, 95% CI 0.4-0.9, P= 0.005). Exposure to ACS >34 weeks gestation did not reduce occurrence and severity of RDS. Forty percent of those exposed to ACS developed RDS compared to 37% of those not exposed (RR 1.2 95% CI 0.7-1.8, P =0.755). ACS reduced neonatal mortality across all gestational ages. The neonatal mortality within 7 days of life was 26% among those exposed to ACS <34 weeks compared to 38% among those not exposed (RR1.2, 95% CI 0.9-1.6, p=0.224). for those delivered after 34 weeks mortality was 3.3% in the exposed group compared to 9.2% in the non exposed group (RR 1.1 95%CI 1.0-1.2 p=0.443). ACS did not reduce NBU/NICU admissions across all gestational ages. Eighty five percent of neonates exposed to ACS before 34 weeks were admitted to NBU compared to 71% of those not exposed (RR1.2, 95% CI 1-2.1, p=0.113). Fifty percent of neonates exposed to ACS after 34 weeks were admitted to NBU compared to 32.2% of those not exposed (RR 1.3 95% CI 0.9-2.1, p=0.225). Conclusions: ACS are underutilized. ACS significantly reduce the incidence/severity of neonatal RDS and mortality <34 weeks gestation.Recommendations: There is need to upscale the utilization of ACS. The study provides local evidence to discourage routine use of ACS >34 weeks.

Mercy BJ, Zakayo T. "Assessment of Nutritional Status and Biomarkers among Chronic Haemodialysis Patients." International Journal of Professional Practice. 2013;4(2):132-138.
Zaccara S, Mavuti KM, Crosa G, Vanetti I, Binelli G, Harper DM, Balarin JD, Britton RJ. "Genetic and morphological analyses indicate high population mixing in the endangered cichlid Alcolapia flock of East Africa." Conservation Genetics. 2013. Abstract

Alcolapia is a minor genus of small-bodied, polymorphic cichlids inhabiting the lagoons and hot
springs surrounding the soda lakes Natron (largely in Tanzania) and Magadi (Kenya). Three
Alcolapia species are present at Natron (Alcolapia alcalicus, Alcolapia ndalalani and Alcolapia
latilabris) and one at Magadi (Alcolapia grahami). All are IUCN Red Listed as either vulnerable
or endangered. We performed analyses of morphometric and genetic structure on 13 populations
of the Natron Alcolapia flock, and one A. grahami population of Lake Magadi as an out-group.
Morphometric analyses revealed significant differentiation in the head and mouth shape of the
species at Natron. From a genetic perspective, among 70 mtDNA control region sequences 17
haplotypes were found, showing in the minimum spanning network a star-like pattern around the
widespread haplotype 2lat. At Natron, there was limited genetic differentiation between the
different populations of A. alcalicus and A. latilabris, despite apparent ecological barriers of
extreme alkalinity that suggested their populations were isolated. Instead, there appeared to be
some population connectivity, with a rate of 0.5–2.3 migrants per generation suggesting that
natural factors, such as intense rains or transmission by large piscivorous birds, facilitate
population connectivity and maintain genetic similarity. The outputs of high population
connectivity and one genetic unit at the basin level (despite morphological divergence) suggest
that any human activities that disrupt the connectivity of the freshwater resources of the Natron
catchment could further threaten the integrity and current status of these already threatened fish
populations.

Yangyuoru PM, Zhang AYQ, Shi Z, Koirala D, Balasubramanian S, Mao H. "Mechanochemical Properties of Individual Human Telomeric RNA (TERRA) G‐Quadruplexes." ChemBioChem. 2013;14(15):1931-1935.
Popescu MR, Zugun FE, Cojocaru E, Tocan L, Folescu R, Zamfir CL. "Morphometric study of aortic wall parameters evolution in newborn and child." Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie. 2013;54:399-404. Abstract

The largest artery in the human body, intimately connected to the heart, aorta is usually regarded as the major source of oxygenated blood for the circulatory system. The three concentric layers, which surround the aortic lumen-the tunics intima, media and adventitia, transform the aorta in a large elastic duct, which is irregular calibrated according to its segments. The special aortic distensibility is facilitated by its elastic circumferential lamellar complex. Any disturbance of its structural components is able to interfere with its normal and vital activity. Our study intends to reveal that the development of elastic lamellae should be regarded not only as an indispensable step for the aortic wall configuration, but also like a process in a firm connection with the rest of aortic wall components. The transition from intrauterine life to a new stage of life, childhood, has to determine an adequate adaptation of almost all the components of aortic wall, in order to sustain a consistent pulsatile blood flow. Stereological quantitative analysis of thoracic aortic fragments prelevated from newborns and children was performed in order to estimate the dynamic of vascular wall increase. We first estimated the general configuration of the thoracic aortic wall, quantifying the principal constituents; the connective tissue profile, investigated through its main elements, collagen and elastic fibers, supports the idea that each type of fiber has a distinct evolution in different groups of ages and has to be correlated with their involvement in maintaining of the aortic wall mechanical properties. Elastic fibers percentage volume was increased in both examined groups, with a small difference reported in children aorta, while collagen fibers exhibit a slow increase in children aorta. Our morphometric quantitative assessment suggests that further studies have to draw of in a precisely manner the outline of the secretory well defined function of vascular smooth muscle cells; the elucidation of the manner in which the secretory pathway for each type of fiber becomes fully adapted to every stage of aortic development will allow a new perspective in aortic pathology.

Ambuko J, Zanol GC, Sekozawa Y, Sugaya S, Gemma H. "Reactive oxygen species (ROS) scavenging in hot air preconditioning mediated alleviation of chilling injury in banana fruits." Journal of Agricultural Science. 2013;5:319. Abstract
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Tian J, Hou J, Xing L, Jia H, Zhang S, Yu B, Jang I-K. "{SIGNIFICANCE} {OF} {INTRAPLAQUE} {NEOVASCULARIZATION} {FOR} {VULNERABILITY}: {OPTICAL} {COHERENCE} {TOMOGRAPHY} {STUDY}." Journal of the American College of Cardiology. 2012;59:E1439. AbstractWebsite
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Irimu GW, Gathara D, Zurovac D, Kihara H, Maina C, Mwangi J, Mbori-Ngacha D, Todd J, Greene A, English M. "Performance of health workers in the management of seriously sick children at a Kenyan tertiary hospital: before and after a training intervention." PLoS ONE. 2012;7(7):e39964. Abstract

Implementation of WHO case management guidelines for serious common childhood illnesses remains a challenge in hospitals in low-income countries. The impact of locally adapted clinical practice guidelines (CPGs) on the quality-of-care of patients in tertiary hospitals has rarely been evaluated.

A.M G, P. L, S. L, M. W, H. A-A, M. F, G. C, Z. Q, JP. S. "Active management of the third stage of labour with and without controlled cord traction: a randomised, controlled, non-inferiority trial." Lancet. 2012;379(9827):1721-7. Abstract

BACKGROUND:

Active management of the third stage of labour reduces the risk of post-partum haemorrhage. We aimed to assess whether controlled cord traction can be omitted from active management of this stage without increasing the risk of severe haemorrhage.

METHODS:

We did a multicentre, non-inferiority, randomised controlled trial in 16 hospitals and two primary health-care centres in Argentina, Egypt, India, Kenya, the Philippines, South Africa, Thailand, and Uganda. Women expecting to deliver singleton babies vaginally (ie, not planned caesarean section) were randomly assigned (in a 1:1 ratio) with a centrally generated allocation sequence, stratified by country, to placental delivery with gravity and maternal effort (simplified package) or controlled cord traction applied immediately after uterine contraction and cord clamping (full package). After randomisation, allocation could not be concealed from investigators, participants, or assessors. Oxytocin 10 IU was administered immediately after birth with cord clamping after 1-3 min. Uterine massage was done after placental delivery according to local policy. The primary (non-inferiority) outcome was blood loss of 1000 mL or more (severe haemorrhage). The non-inferiority margin for the risk ratio was 1·3. Analysis was by modified intention-to-treat, excluding women who had emergency caesarean sections. This trial is registered with the Australian and New Zealand Clinical Trials Registry, ACTRN 12608000434392.

FINDINGS:

Between June 1, 2009, and Oct 30, 2010, 12,227 women were randomly assigned to the simplified package group and 12,163 to the full package group. After exclusion of women who had emergency caesarean sections, 11,861 were in the simplified package group and 11,820 were in the full package group. The primary outcome of blood loss of 1000 mL or more had a risk ratio of 1·09 (95% CI 0·91-1·31) and the upper 95% CI limit crossed the pre-stated non-inferiority margin. One case of uterine inversion occurred in the full package group. Other adverse events were haemorrhage-related.

INTERPRETATION:

Although the hypothesis of non-inferiority was not met, omission of controlled cord traction has very little effect on the risk of severe haemorrhage. Scaling up of haemorrhage prevention programmes for non-hospital settings can safely focus on use of oxytocin.

FUNDING:
United States Agency for International Development and UN Development Programme/UN Population Fund/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research

Mbugua JK, Michira IN, Kagwanja SM, Madadi VO, Zeranyika M, Kamau GN. "Adsorption of 2,4,4,5,6-Tetrachloroisophthalonitrile (Chlorothalonil) by Nairobi River Sediments: Adsorption characteristics and Related Thermodynamic Data." International Journal of BioChemiPhysics. 2012;20:25-37.
Mbugua JK, Michira IN, Kagwanja SM, Madandi VO, Zaranyika MF, Kamau GN. "Adsorption of 2,4,5,6-tetra chloroisophthalonitrile by Nairobi river sediments: Adsorption characteristics and related thermodynamic data." International Journal of Biochemiphysics. 2012;20:25-37.
Zuriel D, Fink-Puches R, Cerroni L. "A case of primary cutaneous extranodal natural killer/t-cell lymphoma, nasal type, with a 22-year indolent clinical course.". 2012. AbstractWebsite

Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare type of cytotoxic lymphoma involving mainly the upper aerodigestive tract and associated with Epstein-Barr virus. The disease has usually a poor prognosis related to several factors. The skin is the second most common affected organ, and cases may be localized to the skin only without any other extracutaneous manifestations. Although primary cutaneous cases may have a better prognosis, survival usually is still poor. We report a case of primary cutaneous extranodal NK/T-cell lymphoma, nasal type, in a 77-year-old woman with an indolent course for more than 22 years and still limited to the skin.

Macharia-Mutie CW, Moretti D, den Briel VN, Omusundi AM, Mwangi AM, Kok FJ, Zimmerman MB, Brouwer ID. "Maize porridge enriched with a micronutrient powder containing low-dose iron as NaFeEDTA but not amaranth grain flour reduces anemia and iron deficiency in Kenyan pre-school children." Journal of Nutrition . 2012;142:1756-1763.
Purushotham K, Kamamia EK, Maitho T, Zakaullah S, Arshlya SA, Ashok KC, Anand C. "Medicated Lollipops of Paracetamol for Pediatric Patients." World Journal of Pharmacy and Pharmaceutical Sciences. 2012;1(3)(ISSN):2278-4357.
Zin AAM, Shakir KAR, Aminuddin AR, Mahedzan MR, Irnawati WAR, Andee DZ, Hassan SA, Ezane MA, Hasnan MN. "Solid-pseudopapillary carcinoma: a case study and literature review." BMJ case reports. 2012;2012:bcr2012006495. AbstractWebsite
n/a
Dao CN, Peters PJ, Kiarie JN, Zulu I, Muiruri P, Ong'ech J, Mutsotso W, Potter D, Njobvu L, Stringer JSA, Borkowf CB, Bolu O, Weidle PJ. "Hyponatremia, hypochloremia, and hypoalbuminemia predict an increased risk of mortality during the first year of antiretroviral therapy among HIV-infected Zambian and Kenyan women." AIDS Res. Hum. Retroviruses. 2011;27(11):1149-55. Abstract

Early mortality rates after initiating antiretroviral therapy (ART) are high in sub-Saharan Africa. We examined whether serum chemistries at ART initiation predicted mortality among HIV-infected women. From May 2005 to January 2007, we enrolled women initiating ART in a prospective cohort study in Zambia and Kenya. We used Cox proportional hazards models to identify risk factors associated with mortality. Among 661 HIV-infected women, 53 (8%) died during the first year of ART, and tuberculosis was the most common cause of death (32%). Women were more likely to die if they were both hyponatremic (sodium <135 mmol/liter) and hypochloremic (chloride <95 mmol/liter) (37% vs. 6%) or hypoalbuminemic (albumin <34 g/liter, 13% vs. 4%) when initiating ART. A body mass index <18 kg/m(2) [adjusted hazard ratio (aHR) 5.3, 95% confidence interval (CI) 2.6-10.6] and hyponatremia with hypochloremia (aHR 4.5, 95% CI 2.2-9.4) were associated with 1-year mortality after adjusting for country, CD4 cell count, WHO clinical stage, hemoglobin, and albumin. Among women with a CD4 cell count >50 cells/μl, hypoalbuminemia was also a significant predictor of mortality (aHR=3.7, 95% CI 1.4-9.8). Baseline hyponatremia with hypochloremia and hypoalbuminemia predicted mortality in the first year of initiating ART, and these abnormalities might reflect opportunistic infections (e.g., tuberculosis) or advanced HIV disease. Assessment of serum sodium, chloride, and albumin can identify HIV-infected patients at highest risk for mortality who may benefit from more intensive medical management during the first year of ART.

Campbell MS, Mullins JI, Hughes JP, Celum C, Wong KG, Raugi DN, Sorensen S, Stoddard JN, Zhao H, Deng W, Kahle E, Panteleeff D, Baeten JM, McCutchan FE, Albert J, Leitner T, Wald A, Corey L, Lingappa JR. "Viral linkage in HIV-1 seroconverters and their partners in an HIV-1 prevention clinical trial." PLoS ONE. 2011;6(3):e16986. Abstract

Characterization of viruses in HIV-1 transmission pairs will help identify biological determinants of infectiousness and evaluate candidate interventions to reduce transmission. Although HIV-1 sequencing is frequently used to substantiate linkage between newly HIV-1 infected individuals and their sexual partners in epidemiologic and forensic studies, viral sequencing is seldom applied in HIV-1 prevention trials. The Partners in Prevention HSV/HIV Transmission Study (ClinicalTrials.gov #NCT00194519) was a prospective randomized placebo-controlled trial that enrolled serodiscordant heterosexual couples to determine the efficacy of genital herpes suppression in reducing HIV-1 transmission; as part of the study analysis, HIV-1 sequences were examined for genetic linkage between seroconverters and their enrolled partners.

K. W, S. M, J.W. M, Z. Q, J. B, P. V. "Depression among women with obstetric fistula in Kenya." Int J Gynaecol Obstet. 2011;115(1):31-3. Abstract

OBJECTIVE:
To establish the prevalence of depression and describe associated factors among fistula patients attending an obstetric fistula surgical camp in Kenya.

METHODS:
A cross-sectional study was conducted focusing on obstetric fistula patients attending a national fistula camp held in August 2008 at Kenyatta National Hospital, Nairobi, Kenya. A structured questionnaire was used to obtain sociodemographic data and medical histories for all consenting patients before surgery. Depression measures were obtained using the Patient Health Questionnaire-9.

RESULTS:
Of the 70 women interviewed, 2 (2.9%) and 12 (17.1%) reported a history of psychiatric illness and suicidal ideations, respectively. Depression was present in 51 (72.9%) patients, with 18 (25.7%) meeting criteria for severe depression. Depression was significantly associated with women older than 20 years of age (P=0.01), unemployment (P=0.03), lack of social support following fistula (P=0.04), and living with fistula for over 3 months (P=0.01).

CONCLUSION:
Women with obstetric fistula are predisposed to high levels of depression. A holistic management approach, including mental health care and family support, is recommended

P.K. T, Z. Q, G. N. "Estimation of blood loss after vaginal delivery." J. Obst. Gynae. East Central. Afr.. 2011;23(2):55-60. Abstract

Background: Thirty to thirty nine percent of maternal mortality is attributed to excess bleeding after childbirth. Amount of blood loss after childbirth is generally estimated visually though it is known that such estimates are grossly inaccurate. Locally, no studies had been done to assess the performance of visual estimation and direct measurement methods of estimating blood loss after delivery. This study aimed at estimating the amount of blood loss after childbirth using three different quantitative methods (visual estimation, direct measurement and laboratory determination). The study also aimed at establishing the incidence of Postpartum Hemorrhage (PPH) in a setting where Active Management of Third Stage of Labor (AMSTL) is practiced.

Objectives: To determine the amount of blood loss and the prevalence of PPH after vaginal delivery.

Design: Analytic cross-sectional study.

Setting: Pumwani Maternity Hospital (PMH) in Nairobi, Kenya.

Subjects and methods: One hundred thirty four pregnant women delivering vaginally at PMH were recruited and studied. Sampled pregnant women were interviewed using a structured data collection form, pre- and post delivery venous blood samples were taken for determination of hematocrit and blood loss after delivery estimated visually by the primary clinician conducting the delivery and directly measured by the researchers.

Main outcome measures: Visually estimated blood loss, directly measured blood loss and pre-and post-delivery hematocrit values.

Results: The mean age of the study population was 24.7 ± 4.8 years. The mean visually estimated, directly measured and laboratory determined blood loss was 121.1 ml, 300.2 ml and 257.0 ml respectively. Prevalence of PPH (blood loss ≥ 500 ml) by visual estimation was zero percent and 13.4% (95% Cl 5.3 - 21.5) and 11.2% (95% Cl 4.0 - 18.8) by direct measurement and laboratory determination respectively. Visual estimation consistently underreported the most significant risk factor for PPH was performance of an episiotomy.

Conclusion: Visual estimation is not sensitive and grossly underestimates the amount of blood loss after delivery, magnitude of underestimation increases with increasing amount of blood loss. Direct measurement of blood loss is both highly sensitive and specific in the detection of PPH.

mugerwa S, Nyangito M, Nderitu J, and Chris Bkuneta DME, Mpaire D, Zziwa E. "Farmers ethno- ecological knowledge of the termite problem in semi-arid Nakasongola." African Journal of Agricultural Research . 2011;6(13):3183-3191.farmers-_ethno-ecological_knowledge_of_the_termite.pdf
Mugerwa S, Nyangito M, Nderitu J, Bakuneta C, Mpairwe D, Zziwa E. "Farmers’ ethno-ecological knowledge of the termite problem in semi-arid Nakasongola." African Journal of Agricultural Research . 2011;6 (13):3183-3191. Abstract

nfestation and destruction of rangeland vegetation by subterranean termites is a major constraint to livestock production in the rangelands of Uganda, particularly, in semi-arid Nakasongola. Ethno-ecological studies on termite dynamics are central to formulation of sustainable termite management strategies in such ecosystems. This study was thus conducted to investigate farmers’ traditional ecological knowledge of the termite problem with the intent to build more coherent principles required in the development of appropriate termite management strategies. Focus group discussions and individual interviews were conducted to capture information on farmers’ ethno-ecological knowledge of the factors enhancing termite damage on vegetation, temporal and spatial variability of damage and diversity of termite species in the Nakasongola ecosystem. Kruskal–Wallis test showed that there was a significant difference (X2=451.5, P>0.0001) among farmers’ ranking of factors responsible for the destructive behavior of termites on rangeland vegetation. Overgrazing and deforestation ware ranked significantly higher (X2=156, P>0.0001) than other factors. Eight species were identified and the species belonged to one family (Termitidae) and two sub-families (Macrotermitinae and Termitinae). The study provided basic information about farmers’ knowledge of the biology and ecology that could aid the development of sustainable and socially acceptable termite control strategies.

Key words: Grazing-lands, diversity, termite-damage.

Thomas TK, Masaba R, Borkowf CB, Ndivo R, Zeh C, Misore A, Otieno J, Jamieson D, Thigpen MC, Bulterys M, Slutsker L, De Cock KM, Amornkul PN, Greenberg AE, Fowler MG, Team KBSS, Mbori-Ngacha DA, et al. "http://erepository.uonbi.ac.ke/handle/123456789/30836.". 2011. Abstract

Effective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention. METHODS AND FINDINGS: HIV-infected pregnant women took zidovudine, lamivudine, and either nevirapine or nelfinavir from 34-36 weeks' gestation to 6 mo post partum. Infants received single-dose nevirapine at birth. Women were advised to breastfeed exclusively and wean rapidly just before 6 mo. Using Kaplan-Meier methods we estimated HIV-transmission and death rates from delivery to 24 mo. We compared HIV-transmission rates among subgroups defined by maternal risk factors, including baseline CD4 cell count and viral load. Among 487 live-born, singleton, or first-born infants, cumulative HIV-transmission rates at birth, 6 weeks, and 6, 12, and 24 mo were 2.5%, 4.2%, 5.0%, 5.7%, and 7.0%, respectively. The 24-mo HIV-transmission rates stratified by baseline maternal CD4 cell count <500 and ≥500 cells/mm(3) were 8.4% (95% confidence interval [CI] 5.8%-12.0%) and 4.1% (1.8%-8.8%), respectively (p = 0.06); the corresponding rates stratified by baseline maternal viral load <10,000 and ≥10,000 copies/ml were 3.0% (1.1%-7.8%) and 8.7% (6.1%-12.3%), respectively (p = 0.01). None of the 12 maternal and 51 infant deaths (including two second-born infants) were attributed to antiretrovirals. The cumulative HIV-transmission or death rate at 24 mo was 15.7% (95% CI 12.7%-19.4%). CONCLUSIONS: This trial shows that a maternal triple-antiretroviral regimen from late pregnancy through 6 months of breastfeeding for PMTCT is safe and feasible in a resource-limited setting. These findings are consistent with those from other trials using maternal triple-antiretroviral regimens during breastfeeding in comparable settings.

Dambolenaa JS;, Zuninoa MP;, Lópezb AG;, Rubinsteinc HR;, Zygadloa JA;, Mwangi JW;, Thoithi GN;, Kibwage IO;, Mwalukumbi JM;, Kariuki ST. "Innovative Food Science & Emerging Technologies.". 2011. Abstract

This work investigated the constituents and the efficacy against Fusarium verticillioides infection and fumonisin production of essential oils of Ocimum basilicum L. and Ocimum gratissimum L. from different locations in Kenya.The oil of leaves and flowering tops of O. basilicum from Sagana contained mainly linalool (95%). The flowering tops and leaves from Yatta contained mainly camphor (32.6 and 31.0%, respectively) and linalool (28.2 and 29.3, respectively). Eugenol was the main constituent in the oil of O. gratissimum leaves from both Sagana (95.5%) and Yatta (70.1%). The oil of the flowering tops had significantly less eugenol. The main component of the oil of flowering tops from Yatta was Z-β-ocimene (34.1%). Oil from both species had some antifungal activity. The oils of O. basilicum and O. gratissimum from different locations showed chemical variation, antifungal activity, free radical scavenging capacity and antimycotoxicogenic property. These properties are attributed to the phenolic compound eugenol.Industrial relevanceThis manuscript gives the chemical composition and some biological effects of essential oil of two Ocimum species in Kenya namely Ocimum basilicum L. and Ocimum gratissimum L. The work reveals that there are chemovarieties of these plants in different locations in the country. Of significance is the presence of very high amounts of linalool in one chemovariety of O. basilicum while geranial and neral are major in another. The third variety contains almost equal amounts of camphor and linalool. The first two containing high quantities of linalool, geranial and neral could be cultivated after agronomic studies to provide essential oils useful in perfumery, soap or food industry while that containing camphor and linalool may find use in medicine.Proper seed selection and good agricultural practice for O. gratissimum containing high amount of eugenol could serve as good substitute for cloves which grows best only in a few islands in East Africa. Clove oil due to its high eugenol content has many biological activities including those demonstrated in the present work, and many applications in medicine and commercial world.There is need for more research on these plants especially on cultivation and commercial exploitation of the herbs.

Nyongesa FW, Aduda BO, Soboyejo WO, Obwoya SK, Rahbar N, Zimba J. "An Investigation of Thermal Shock in Porous Clay Ceramics." ISRN Mechanical Engineering. 2011;DOI 10.5402/2011/816853(816853).thermal_shock_in_porous_clay_ceramics_2011.pdf
F.W. Nyongesa, Rahbar N, Obwoya SK, Zimba J, Aduda BO, Soboyejo WO. "An Investigation of Thermal Shock in Porous Clay Ceramics." International Scholarly Research Network. 2011:9. Abstract

The thermal shock resistance of porous ceramic materials is often characterized by the Hasselman parameters. However, in other
scenarios, the room-temperature residual strengths after thermal shock are also used to quantify the damage due to thermal shock.
This paper attempts to link the measured residual strengths to the dominant crack features that are introduced due to thermalshock in porous clay ceramics produced by the sintering of clay powders with well-controlled size ranges. Residual strength estimates from bend tests are compared with fracture mechanics predictions. The implications of the residual strength results are then discussed for the characterization of damage due to thermal shock.

Zeh C, Oyaro B, Vandenhoudt H, Amornkul P, Kasembeli A, Bondo P, Mwaengo D, Thomas TK, Hart C, Laserson KF, Ondoa P, Nkengasong JN. "Performance of six commercial enzyme immunoassays and two alternative HIV-testing algorithms for the diagnosis of HIV-1 infection in Kisumu, Western Kenya.". 2011. Abstract

Performances of serological parallel and serial testing algorithms were analyzed using a combination of three ELISA and three rapid tests for the confirmation of HIV infection. Each was assessed individually for their sensitivity and specificity on a blinded panel of 769 retrospective sera of known HIV status. Western blot was used as a confirmatory assay for discordant results. Subsequently, one parallel and one serial testing algorithm were assessed on a new panel of 912 HIV-positive and negative samples. Individual evaluation of the ELISAs and rapid tests indicated a sensitivity of 100% for all assays except Uni-Gold with 99.7%. The specificities ranged from 99.1% to 99.4% for rapid assays and from 97.5% to 99.1% for ELISAs. A parallel and serial testing algorithms using Enzygnost and Vironostika, and Determine followed by Uni-Gold respectively, showed 100% sensitivity and specificity. The cost for testing 912 samples was US$4.74 and US$ 1.9 per sample in parallel and serial testing respectively. Parallel or serial testing algorithm yielded a sensitivity and specificity of 100%. This alternative algorithm is reliable and reduces the occurrence of both false negatives and positives. The serial testing algorithm was more cost effective for diagnosing HIV infections in this population.

Zeh C, Amornkul PN, Inzaule S, Ondoa P, Oyaro B, Mwaengo DM, Vandenhoudt H, Gichangi A, Williamson J, Thomas T, De Cock KM, Hart C, Nkengasong J, Laserson. K. "Population-based biochemistry, immunologic and hematological reference values for adolescents and young adults in a rural population in Western Kenya.". 2011. Abstract

There is need for locally-derived age-specific clinical laboratory reference ranges of healthy Africans in sub-Saharan Africa. Reference values from North American and European populations are being used for African subjects despite previous studies showing significant differences. Our aim was to establish clinical laboratory reference values for African adolescents and young adults that can be used in clinical trials and for patient management. A panel of 298, HIV-seronegative individuals aged 13-34 years was randomly selected from participants in two population-based cross-sectional surveys assessing HIV prevalence and other sexually transmitted infections in western Kenya. The adolescent (<18 years)-to-adults (≥ 18 years) ratio and the male-to-female ratio was 1∶1. Median and 95% reference ranges were calculated for immunohematological and biochemistry values. Compared with U.S-derived reference ranges, we detected lower hemoglobin (HB), hematocrit (HCT), red blood cells (RBC), mean corpuscular volume (MCV), neutrophil, glucose, and blood urea nitrogen values but elevated eosinophil and total bilirubin values. Significant gender variation was observed in hematological parameters in addition to T-bilirubin and creatinine indices in all age groups, AST in the younger and neutrophil, platelet and CD4 indices among the older age group. Age variation was also observed, mainly in hematological parameters among males. Applying U.S. NIH Division of AIDS (DAIDS) toxicity grading to our results, 40% of otherwise healthy study participants were classified as having an abnormal laboratory parameter (grade 1-4) which would exclude them from participating in clinical trials. Hematological and biochemistry reference values from African population differ from those derived from a North American population, showing the need to develop region-specific reference values. Our data also show variations in hematological indices between adolescent and adult males which should be considered when developing reference ranges. This study provides the first locally-derived clinical laboratory reference ranges for adolescents and young adults in western Kenya.

N. W, H. T, Z. Q. "Prevalence of cervical cytology abnormalities among women attending antenatal clinic at Kenyatta National Hospital." J. Obst. Gynae. East Central. Afr.. 2011;23(2):37-41. Abstract

Background: Cancer of the cervix is among the leading causes of cancer related deaths among women in Kenya. Cervical cytology screening programs have been shown to significantly reduce mortality and morbidity associated with cancer of the cervix. Since 90% of pregnant women attend antenatal clinic at least once, the antenatal period offers an opportunity for cervical cytology screening. The local prevalence of abnormal cervical cytology has not been documented.

Objective: To determine the prevalence of cervical cytology abnormalities among women attending antenatal clinic at Kenyatta National Hospital.

Methods: This was a cross-sectional descriptive study, carried out among pregnant women on their first antenatal visit between February and August 2008. A papanicolaou smear was taken for each consenting participant. Obstetric and gynaecology profiles of the participants were obtained with a structured questionnaire.

Results: A total of 171 participants were recruited. Only 10.5% had had previous screening for abnormal cervical cytology. One hundred and sixty pap smears were satisfactory for evaluation while five (2.9%) were unsatisfactory. The prevalence of squamous intra-epithelial lesions was 5.8% (3.5% LSIL, 2.3% HSIL). Thirty one percent were inflammatory, 1.2% had trichomonas vaginalis, 7% had bacterial vaginosis (diagnosed by the presence of clue cells) and 10.5% had Candid spp. Forty nine percent of the pap smears were reported normal. HIV positive status and abnormal vaginal discharge were significantly associated with the presence of any pap smear abnormality (p value <0.05).

Conclusion and recommendations: The rate of previous screening for abnormal cervical cytology was low at 10.5%, while the prevalence of abnormal cervical cytology was high at 5.8%. Positive HIV sero-status and presence of abnormal vaginal discharge were noted to increase the risk of cervical smear abnormalities. This emphasizes the need for antenatal cervical cytology screening programs especially among HIV seropositive women and women with abnormal vaginal discharge.

Lewis BA, Walia RR, Terribilini M, Ferguson J, Zheng C, Honavar V, Dobbs D. "PRIDB: a protein–RNA interface database.". 2011. AbstractPRIDB: a protein–RNA interface database

The Protein–RNA Interface Database (PRIDB) is a comprehensive database of protein–RNA interfaces extracted from complexes in the Protein Data Bank (PDB). It is designed to facilitate detailed analyses of individual protein–RNA complexes and their interfaces, in addition to automated generation of user-defined data sets of protein–RNA interfaces for statistical analyses and machine learning applications. For any chosen PDB complex or list of complexes, PRIDB rapidly displays interfacial amino acids and ribonucleotides within the primary sequences of the interacting protein and RNA chains. PRIDB also identifies ProSite motifs in protein chains and FR3D motifs in RNA chains and provides links to these external databases, as well as to structure files in the PDB. An integrated JMol applet is provided for visualization of interacting atoms and residues in the context of the 3D complex structures. The current version of PRIDB contains structural information regarding 926 protein–RNA complexes available in the PDB (as of 10 October 2010). Atomic- and residue-level contact information for the entire data set can be downloaded in a simple machine-readable format. Also, several non-redundant benchmark data sets of protein–RNA complexes are provided.

Zziwa E, Kironchi G;, Gachene CK, Mugerwa S;, Mpairwe D. "Production systems, land cover change and soil factors affecting pastur e production in semi1arid Nakasongola.". 2011. Abstract

The current pace of rangeland degradation imparted by appalling land use and management systems is greatly limiting the potential of the soil resource to support pasture production in semi - arid rangeland s of Uganda. Our objectives were to determine the effects of land cover change and production systems on pasture biomass yield and to identify the critical soil factors affecting pasture production in Nakasongola. The area was stratified into three product ion systems and three land cover types from which six pasture and soil samples were collected following a Modified - Whittaker sampling method. Pasture biomass was significantly high (p < 0.0001) under herbaceous cover (2019 kg/ha) compared to woody (1302 kg /ha) and bare which had no pasture biomass. The settled production system had a significantly (p = 0.013) high pasture biomass (1266 kg/ha) compared to non settled (1102 kg/ha) and semi settled systems (953 kg/ha). Biomass yield was more associated with hi gh levels of organic matter (r = 0.91), calcium (r = 0.91), magnesium (0.83), nitrogen (r = 0.77) and base saturation (r = 0.88). It can be concluded that maintaining native vegetation cover of the rangelands and increasing levels of limiting nutrients are the major strategies for increasing pasture production in semi - arid rangelands of Nakasongola

Zaja OJ. "Siting text, culture, context and pedagogy in literary translation: a theorization of translation in cultural transfer with examples from selected texts in Kiswahili .". 2011. AbstractWebsite

The study of literary translation in Kiswahili has over a long period of time tended to gravitate towards systematic comparisons based on minimalist classical linguistic formalism. This is a scholarly fact that is attested to by a copious presence of academic dissertations, seminar papers as well as critical essays that have engaged literary translation in various ways and from several perspectives. However, most such studies are characterized by normative generalizations and a lack of clear theoretical rigor, which means that scholars have hardly asked; "in what ways has translation been used as a way of figuring out the relations between cultures, particularly in terms of its encounter with changed contexts, cultures, temporality and the pedagogy engendered in such changed circumstances?" This study has sought to move out of such restrictive stances so as to embrace and foreground what may be considered the muted reality of literary translation, a recognition that besides being essentially linguistic, literary translation is also an engagement that explores culture interaction, about which theorists and practitioners cannot afford to offer explications that are self-effacing. It argues that there is a prudent need to view literary translation as process of mediation between cultures, a means of perceiving words both in their abstract senses and in contexts of use, of treating linguistic forms and textual meanings as cues to the perception of cultural nuances, always amenable to inversions, revisions and reshuffling in the contexts of target cultures. In its broadest sense, this study is a critical theoretical rethinking of literary translation that points out the critical and crucial lapses and inadequacies that have characterized its research in Kiswahili. It points out the critical labyrinth in which such research has been entrapped as well as the puerile generalizations that have been generally emblematic of the studies overall. It outlines and critiques the theoretical lacunae that have punctuated literary translation studies in which it argues that such omissions have been nurtured by the use of single variable theories largely based on the minimalist theories of linguistics and language. It is also an engagement and interrogation of such theories which at the same time proposes a composite theoretical paradigm founded on culture, context, temporality and pedagogy and the interplay between them in informing both the theorizing and explications of literary translation. Instead of making arguments in favour of the fidelity of translation to the anterior text, it has argues in favour of the 'relevance' of any given translation to its specific time and domestic audience, to its environment and historical space. This is an emergent paradigm that is informed by contemporary theoretical advances in text linguistics, reader responses theories, text interaction and meaning retrieval, deconstructionism and postcolonialism. The overriding argument and, therefore, the thrust of this study, is that there is an urgent need for theoretical reorientation in which literary translation theorists and practitioners increasingly understand literary translation as cultural interaction, conceptualize it not merely as a form of linguistic exchange but also a process of interlingual exchange that participates in both text production and discursive formations.

Mugerwa S, Nyangito M, Mpairwe D, Bakuneeta C, Nderitul J, Zziwal E. "Termite assemblage structure on Grazing lands in Semi-arid Nakasongola." Agriculture and biology journal of North America. . 2011;2((5): ):848-859. Abstract

Termites are regarded as the primary cause of vegetation denudation in semi-arid
Nakasongola, Uganda. Despite their damage to ecosystem functioning, there have been
little efforts devoted to the description of the termite assemblage structure in the area.
The study therefore intended to describe the termite assem5lage structure with the
intension to develop sustainable termite management strategies. ihe survey yielded 16
termite spectes from eight genera, three sub-families and one family. Speciei from the
sub-family Macrotermitinae constituted 69% of the total number of species sampled.
Members from the genus Macrotermes were the dominant species and constituted 38%
of the total number of species sampled. The assemblage comprised of two feeding
groups namely Group ll and Group lV, with most of the species belonging to Group li
Most of the species were noted to nest in epigeal and hypogeal nests *itf, a few species
nesting in wood. Vegetation cover categories were noted to influence species richness.
Highest species richness (14 species) occurred in sparse vegetation category followed by
dense category (1'1) and the least (B species) occurring on bare ground. The termite
assemblage of Nakasongola was dominated by Macrotermes species which largely
forage on litter and nest in epigeal mounds.

Keywords: Composition, Diversity, Feeding_group, Nesting-sites

Thomas TK, Masaba R, Borkowf CB, Ndivo R, Zeh C, Misore A, Otieno J, Jamieson D, Thigpen MC, Bulterys M, Slutsker L, De Cock KM, Amornkul PN, Greenberg AE, Fowler MG. "Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding--the Kisumu Breastfeeding Study, Kenya: a clinical trial." PLoS Med.. 2011;8(3):e1001015. Abstract

Effective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention.

J.P. S, A.M. G, G. C, P. L, Z. Q. "The World Health Organization multicountry survey on maternal and newborn health: study protocol." BMC Health Serv Res. 2011;11:286-303. Abstract

Background: Effective interventions to reduce mortality and morbidity in maternal and newborn health already exist. Information about quality and performance of care and the use of critical interventions are useful for shaping improvements in health care and strengthening the contribution of health systems towards the Millennium Development Goals 4 and 5. The near-miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in maternal and newborn health care. This paper presents the methods of the World Health Organization Multicountry Study in Maternal and Newborn Health. The main objectives of this study are to determine the prevalence of maternal near-miss cases in a
worldwide network of health facilities, evaluate the quality of care using the maternal near-miss concept and the criterion-based clinical audit, and develop the near-miss concept in neonatal health.

Methods/Design: This is a large cross-sectional study being implemented in a worldwide network of health facilities. A total of 370 health facilities from 29 countries will take part in this study and produce nearly 275,000 observations. All women giving birth, all maternal near-miss cases regardless of the gestational age and delivery status and all maternal deaths during the study period comprise the study population. In each health facility, medical records of all eligible women will be reviewed during a data collection period that
ranges from two to three months according to the annual number of deliveries.

Discussion: Implementing the systematic identification of near-miss cases, mapping the use of critical evidence-based interventions and analysing the corresponding indicators are just the initial steps for using the maternal nearmiss concept as a tool to improve maternal and newborn health. The findings of projects using approaches similar to those described in this manuscript will be a good starter for a more comprehensive dialogue with governments, professionals and civil societies, health systems or facilities for promoting best practices, improving quality of care and achieving better health for mothers and children.

Ahangar S, Zaz M, Shah M, Wani SN. "Perforated subhepatic appendix presenting as gas under diaphragm." Indian Journal of Surgery. 2010;72:273-274. AbstractWebsite
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Zhou X, An J, Wu X, Lu R, Huang Q, Xie R, Jiang L, Qu J. "Relative axial myopia induced by prolonged light exposure in {C}57BL/6 mice." Photochemistry and photobiology. 2010;86:131-137. Abstract

Ambient lighting is essential for ocular development in many species, however, disruption in diurnal lighting cycle can affect the development in refraction and axial growth of the eye. This study investigated the effects of prolonged daily lighting on refraction and various optical components of the eye by raising C57BL/6 mice under three different light/dark cycles (18/6, 12/12 and 6/18). Egr-1 mRNA expression, apoptosis and histology of the retina and size of the scleral fibrils were evaluated in these three lighting cycles. Results showed that there was a trend of myopic development, increasing vitreous chamber depth and thinning of the retina in eyes from 6/18 to 18/6 groups. Retinal Egr-1 mRNA expression and diameter of scleral fibrils were reduced with the prolongation of daily lighting from 6/18 to 18/6. However, retinal apoptosis was not detected in all the groups. These results suggest that prolonged lighting can induce axial myopia in inbred mice. This model, which uses mice with similar genetic backgrounds, provides an alternative to the currently available models and therefore is useful for evaluation of refractive errors caused by changes in environmental illumination.

Sanes JR, Zipursky LS. "Design principles of insect and vertebrate visual systems." Neuron. 2010;66:15-36. Abstract

A century ago, Cajal noted striking similarities between the neural circuits that underlie vision in vertebrates and flies. Over the past few decades, structural and functional studies have provided strong support for Cajal's view. In parallel, genetic studies have revealed some common molecular mechanisms controlling development of vertebrate and fly visual systems and suggested that they share a common evolutionary origin. Here, we review these shared features, focusing on the first several layers-retina, optic tectum (superior colliculus), and lateral geniculate nucleus in vertebrates; and retina, lamina, and medulla in fly. We argue that vertebrate and fly visual circuits utilize common design principles and that taking advantage of this phylogenetic conservation will speed progress in elucidating both functional strategies and developmental mechanisms, as has already occurred in other areas of neurobiology ranging from electrical signaling and synaptic plasticity to neurogenesis and axon guidance.

Sanes JR, Zipursky LS. "{DESIGN} {PRINCIPLES} {OF} {INSECT} {AND} {VERTEBRATE} {VISUAL} {SYSTEMS}." Neuron. 2010;66:15-36. AbstractWebsite

A century ago, Cajal noted striking similarities between the neural circuits that underlie vision in vertebrates and flies. Over the past few decades, structural and functional studies have provided strong support for Cajal’s view. In parallel, genetic studies have revealed some common molecular mechanisms controlling development of vertebrate and fly visual systems and suggested that they share a common evolutionary origin. Here, we review these shared features, focusing on the first several layers - retina, optic tectum (superior colliculus) and lateral geniculate nucleus in vertebrates, and retina, lamina and medulla in fly. We argue that vertebrate and fly visual circuits utilize common design principles, and that taking advantage of this phylogenetic conservation will speed progress in elucidating both functional strategies and developmental mechanisms, as has already occurred in other areas of neurobiology ranging from electrical signaling and synaptic plasticity to neurogenesis and axon guidance.

Blacher RJ, Muiruri P, Njobvu L, Mutsotso W, Potter D, Ong'ech J, Mwai P, Degroot A, Zulu I, Bolu O, Stringer J, Kiarie J, Weidle PJ. "How late is too late? Timeliness to scheduled visits as an antiretroviral therapy adherence measure in Nairobi, Kenya and Lusaka, Zambia." AIDS Care. 2010;22(11):1323-31. Abstract

Collecting self-reported data on adherence to highly active antiretroviral therapy (HAART) can be complicated by patients' reluctance to report poor adherence. The timeliness with which patients attend visits might be a useful alternative to estimate medication adherence. Among Kenyan and Zambian women receiving twice daily HAART, we examined the relationship between self-reported pill taking and timeliness attending scheduled visits. We analyzed data from 566 Kenyan and Zambian women enrolled in a prospective 48-week HAART-response study. At each scheduled clinic visit, women reported doses missed over the preceding week. Self-reported adherence was calculated by summing the total number of doses reported taken and dividing by the total number of doses asked about at the visit attended. A participant's adherence to scheduled study visits was defined as "on time" if she arrived early or within three days, "moderately late" if she was four-seven days late, and "extremely late/missed" if she was more than eight days late or missed the visit altogether. Self-reported adherence was <95% for 29 (10%) of 288 women who were late for at least one study visit vs. 3 (1%) of 278 who were never late for a study visit (odds ratios [OR] 10.3; 95% confidence intervals [95% CI] 2.9, 42.8). Fifty-one (18%) of 285 women who were ever late for a study visit experienced virologic failure vs. 32 (12%) of 278 women who were never late for a study visit (OR 1.7; 95% CI 1.01, 2.8). A multivariate logistic regression model controlling for self-reported adherence found that being extremely late for a visit was associated with virologic failure (OR 2.0; 95% CI 1.2, 3.4). Timeliness to scheduled visits was associated with self-reported adherence to HAART and with risk for virologic failure. Timeliness to scheduled clinic visits can be used as an objective proxy for self-reported adherence and ultimately for risk of virologic failure.

Peters PJ, Stringer J, McConnell MS, Kiarie J, Ratanasuwan W, Intalapaporn P, Potter D, Mutsotso W, Zulu I, Borkowf CB, Bolu O, Brooks JT, Weidle PJ. "Nevirapine-associated hepatotoxicity was not predicted by CD4 count ≥250 cells/μL among women in Zambia, Thailand and Kenya." HIV Med.. 2010;11(10):650-60. Abstract

The aim of the study was to determine risk factors for developing severe hepatotoxicity (grade 3 or 4 hepatotoxicity) and rash-associated hepatotoxicity (rash with ≥ grade 2 hepatotoxicity) among women initiating nevirapine-based antiretroviral therapy (ART).

Stringer JSA, McConnell MS, Kiarie J, Bolu O, Anekthananon T, Jariyasethpong T, Potter D, Mutsotso W, Borkowf CB, Mbori-Ngacha D, Muiruri P, Ong'ech JO, Zulu I, Njobvu L, Jetsawang B, Pathak S, Bulterys M, Shaffer N, Weidle PJ. "Effectiveness of non-nucleoside reverse-transcriptase inhibitor-based antiretroviral therapy in women previously exposed to a single intrapartum dose of nevirapine: a multi-country, prospective cohort study." PLoS Med.. 2010;7(2):e1000233. Abstract

Intrapartum and neonatal single-dose nevirapine (NVP) reduces the risk of mother-to-child HIV transmission but also induces viral resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. This drug resistance largely fades over time. We hypothesized that women with a prior single-dose NVP exposure would have no more than a 10% higher cumulative prevalence of failure of their NNRTI-containing antiretroviral therapy (ART) over the first 48 wk of therapy than would women without a prior exposure.

Mutua FM, Zaki AF. "Analyses of Annual Droughts in Kenya Using an Objective Annual Rainfall Drought Index." Journal of Met and Related Sciences. 2010;4:21-23.
Wagacha JM, Steiner U, Dehne H-W, Zuehlke S, Spiteller M, Muthomi J, Oerke E-C. "Diversity in Mycotoxins and fungal species infecting wheat in Nakuru District, Kenya." Journal of Phytopathology. 2010;157:527-535.Website
Maina J, Steiner U, H.DEHNE, Zuehlke S, M.SPITELLER, Muthomi J, OERKE E. "Diversity in mycotoxins and fungal spp infecting wheat in Nakuru." INSTITUTE OF SCINCE AND RESOURCE CONSERVATION. 2010;158(1439):527-537.diversity_in_mycotoxins_and_fungal_spp_infecting_wheat_in_nakuru.pdf
Z. Q. "Editorial Maternal Health." J. Obst. Gynae. East Central. Afr . 2010;22(2):i-iii. Abstract

As we approach 2015 the time for achieving the MDG’s let us take stock of the progress made towards MDG 5 whose targets and indicators are as listed:-
Goal 5: improve maternal health
• Target 5A: reduce by three quarters, between 1990 and 2015, the maternal mortality ratio
o Indicator 5.1: maternal mortality ratio
o Indicator 5.2: proportion of births attended by skilled health personnel
• Target 5B: achieve, by 2015, universal access to reproductive health
o Indicator 5.3: contraceptive prevalence rate
o Indicator 5.4: adolescent birth rate
o Indicator 5.5: antenatal care coverage (at least one visit and at least four visits) one visit
o Indicator 5.6: unmet need for family planning.
Most of the statistics for the above indicators have not changed much between the KDHS of 2003 and 2008/9. The maternal mortality has increased from 414 in 203 to 488 in 2008 and the target of reduction three quarters from 1990 to 2015 seems more of a dream considering we need a figure of 170 by 2015.

Dambolena JS, Zunino MP, Lopez AG, Rubinstein HR, Zygadlo JA, Mwangi JW, Thoithi GN, Kibwage IO, Mwangi JM, Mwalukumbi JM, Kariuki ST. "Essential oils composition of Ocimum basilicum L. and Ocimum gratissimum L. From Kenya and their inhibitory effects on growth and fumonisin production by Fusarium verticillioides." Innovative Food Science and Emerging Technologies. 2010;11:410-414.
ZL T, CS K, DW M. "Prevalence of non thyroidal illness among HIV patients on HAART." East African Medical Journal. 2010;87(1):34-41.
Z.P. Q, C. S-K, S.M. M. "Rapid assessment of partograph utilization in selected maternity units in Kenya." East Afr Med J. 2010;87(6):235-41. Abstract

BACKGROUND:
Prolonged labour causes maternal and perinatal morbidity and mortality. Its sequela include obstructed labour, uterine rupture, maternal exhaustion, postpartum haemorrhage, puerperal sepsis, obstetric fistula, stillbirths, birth asphyxia and neonatal sepsis. These complications can be reduced by using the partograph to assess the progress of labour. The Ministry of Health, Kenya has adopted this tool for labour management in the country and the standardised partograph is recommended for use in all delivery units.

OBJECTIVE:
To determine the utilisation of the partograph in the management of labour in selected health facilities in Kenya.

DESIGN:
A descriptive cross sectional study.

SETTING:
Nine health facilities -ranging from a tertiary hospital to health centre, including public private and faith based facilities in four provinces in Kenya.

RESULTS:
All facilities apart from Pumwani Maternity Hospital and one health centre were using the partograph. The correct use was low, the knowledge on the use of the tool was average and there was minimal formal training being provided. Staff shortage was listed as the most common cause of not using the tool. Contractions were recorded 30-80%, foetal heart rate 53-90% and cervical dilatation 70-97%. Documentation of state of the liquor, moulding and descent as well as maternal parameters such as pulse, and blood pressure and urinalysis were minimally recorded. Supplies for monitoring labour such as fetoscopes and blood pressure machines were in short supply and sometimes not functional. Overall, the poor usage was contributed to staff shortages, lack of knowledge especially on interpretation of findings, negative attitudes, conflict between providers as to their roles in filling the partograph, and senior staff themselves not acting as role models with regards to the use, advocacy and implementation of the partograph.

CONCLUSION:
The partograph was available in most units. However, accurate recording of parameters to monitor the foetus, the mother and progress of labour as recommended was mostly not done. Shortage of staff, lack of knowledge, lack of team work, lack of supplies and negative attitude among healthcare providers were some of the obstacles noted to hamper partograph use.

Zavala DE, Bokongo S, Ime JA, Mpanga SI, Mtonga RE, Aminu ZM, Odhiambo W, Olupot-Olupot P. "Special section: a multinational injury surveillance system pilot project in Africa.". 2010.
Nyongesa FW, Aduda BO, Rahbar N, Obwoya SK, Zimba J, Yakub I, Soboyejo WO. "Thermal Shock Resistance of a Kyanite-Based (Aluminosilicate) Ceramic." Experimewntal Mechanics. 2010;DOI 10(April 2010). AbstractWebsite

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Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders.  Old stems and leaves are chewed for the management of toothaches and sore throats. 
Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity.  The toxicity of the extracts was assessed using the brine shrimp lethality bioassay.
 
The root extract gave the highest in vitro antimalarial activity against a mulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 mg/ml). The stem and leaf extracts had insignificant antiplasmodial activity.  The leaf, stem and root extracts had bacterial or fungal growth even at very high concentrations of 10 mg/ml. The LD50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 mg/ml respectively.
The in vitro anti malarial activity of the root extract in part supports the ethnobotanical use of the plant to manage malaria.
 KEY WORDS
Clematis, Ranunculaceae, antimalarial, brine shrimp, antimicrobial

Rahbar N, Aduda BO, Zimba J, Obwoya SK, Nyongesa FW, Yakub I, Soboyejo WO. "Thermal Shock Resistance of a Kyanite-Based (Aluminosilicate) Ceramic." Experimental Mechanics. 2010. Abstract

Abstract This paper presents the results of a combined experimental and theoretical study of microstructure and thermal shock resistance of an aluminosilicate ceramic. Shock-induced crack growth is studied in sintered structures produced from powders with different particle size ranges. The underlying crack/microstructure interactions and toughening mechanisms are elucidated via scanning electron microscopy (SEM). The resulting crack-tip shielding levels (due to viscoelastic crack bridging) are estimated using fracture mechanics concepts. The implications of the work are discussed for the design of high refractory ceramics against thermal shock.

Keywords Viscoelastic crack bridging . Crack-tip shielding . Thermal shock . Refractory ceramics

Bett RC, Johansson K, Zonabend E, Malmfors B, Ojango J, Okeyo M, Philipsson J. "Trajectories of Evolution and Extinction in the Swedish Cattle Breeds.". 2010. Abstract

An assessment of the current status and possible future dynamics of the domestic animal species is a critical step in the management of Animal Genetic Resources (AnGR). Permanent extinction of livestock breeds is considered to be the main reason for the loss of genetic diversity (Scherf, 2000). So far, the pace of the extinction process of livestock breeds has outstripped the creation of new breeds leading to a remarkable loss of genetic diversity (Gandini et al., 2004). The FAO’s Global Databank for AnGR predicts the loss of breeds at one breed per month (DAD-IS web). In this paper, the terms evolution and extinction are defined and illustrated using examples from the Swedish cattle breeds. Thereafter, the dynamics of the Swedish cattle breeds mentioned in DAD-IS and the status given as regards their endangerment/extinction are described. In addition, an analysis on the actual situation was conducted, to verify whether the breed is really endangered, extinct or has just evolved in one way or another for sustainable use.

Zablon O. Ochomo, Elisha Opiyo WO-O(E) KLNJMKR, J. A. "Agent Based Model For Localized Secure Payment Systems Integration.". 2010. Abstract
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Milatovic D, Montine TJ, Zaja-Milatovic S, Madison JL, Bowman AB, Aschner M. "Morphometric analysis in neurodegenerative disorders." Current Protocols in Toxicology. 2010:12-16. AbstractWebsite
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Yu P-F, Hu Z-H, Wang X-B, Guo J-M, Cheng X-D, Zhang Y-L, Xu Q. "Solid pseudopapillary tumor of the pancreas: a review of 553 cases in {Chinese} literature." World journal of gastroenterology: WJG. 2010;16:1209. AbstractWebsite
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AM G, M W, M M, Z Q, G P. "Active management of the third stage of labour without controlled cord traction: a randomized non-inferiority controlled trial." Reprod Health. 2009;6(2). Abstract

BACKGROUND:
The third stage of labour refers to the period between birth of the baby and complete expulsion of the placenta. Some degree of blood loss occurs after the birth of the baby due to separation of the placenta. This period is a risky period because uterus may not contract well after birth and heavy blood loss can endanger the life of the mother. Active management of the third stage of labour (AMTSL) reduces the occurrence of severe postpartum haemorrhage by approximately 60-70%. Active management consists of several interventions packaged together and the relative contribution of each of the components is unknown. Controlled cord traction is one of those components that require training in manual skill for it to be performed appropriately. If it is possible to dispense with controlled cord traction without losing efficacy it would have major implications for effective management of the third stage of labour at peripheral levels of health care.

OBJECTIVE:
The primary objective is to determine whether the simplified package of oxytocin 10 IU IM/IV is not less effective than the full AMTSL package.

METHODS:
A hospital-based, multicentre, individually randomized controlled trial is proposed. The hypothesis tested will be a non-inferiority hypothesis. The aim will be to determine whether the simplified package without CCT, with the advantage of not requiring training to acquire the manual skill to perform this task, is not less effective than the full AMTSL package with regard to reducing blood loss in the third stage of labour.The simplified package will include uterotonic (oxytocin 10 IU IM) injection after delivery of the baby and cord clamping and cutting at approximately 3 minutes after birth. The full package will include the uterotonic injection (oxytocin 10 IU IM), controlled cord traction following observation of uterine contraction and cord clamping and cutting at approximately 3 minutes after birth. The primary outcome measure is blood loss of 1000 ml or more at one hour and up to two hours for women who continue to bleed after one hour. The secondary outcomes are blood transfusion, the use of additional uterotonics and measure of severe morbidity and maternal death.We aim to recruit 25,000 women delivering vaginally in health facilities in eight countries within a 12 month recruitment period.

MANAGEMENT:
Overall trial management will be from HRP/RHR in Geneva. There will be eight centres located in Argentina, Egypt, India, Kenya, Philippines, South Africa, Thailand and Uganda. There will be an online data entry system managed from HRP/RHR. The trial protocol was developed following a technical consultation with international organizations and leading researchers in the field. EXPECTED OUTCOMES: The main objective of this trial is to investigate whether a simplified package of third stage management can be recommended without increasing the risk of PPH. By avoiding the need for a manual procedure that requires training, the third stage management can be implemented in a more widespread and cost-effective way around the world even at the most peripheral levels of the health care system. This trial forms part of the programme of work to reduce maternal deaths due to postpartum haemorrhage within the RHR department in collaboration with other research groups and organizations active in the field.

TRIAL REGISTRATION:
ACTRN12608000434392

J.R. N, A. A, Z.P. Q, C.S. K. "Gestational thyrotoxicosis associated with emesis in early pregnancy." East Afr Med J. 2009;86(2):55-8. Abstract

OBJECTIVES:
To determine the thyroid profile and the prevalence of gestational thyrotoxicosis among women with emesis during early pregnancy.

DESIGN:
A descriptive cross-sectional study.

SETTING:
Kenyatta National Hospital acute gynaecology ward and the ante-natal clinic.

SUBJECTS:
Seventy two women presenting with emesis up to 16 weeks gestation.

MAIN OUTCOME MEASURES:
The levels of FT3, FT4, TSH and beta-hCG during the first 16 weeks of gestation. Correlation between the thyroid hormones and beta-hCG as well as the severity of vomiting was also done.

RESULTS:
The point prevalence of gestational thyrotoxicosis was 8.3%. There was a significant positive correlation between beta-hCG levels and FT3 and FT4 (P-values < 0.05), and a significant negative correlation between beta-hCG and TSH (P < 0.05). Correlation between the severity of vomiting and the thyroid hormones as well as beta-hCG was not statistically significant. Patients' age ranged from 14-38 years (median 26). Majority of the women studied were at a gestation of 8 to 11 weeks (38.9%). Most patients (84.7%) had one to five episodes of vomiting per day. Peak beta-hCG was at 12-15 weeks gestation.

CONCLUSIONS:
Thyrotoxicosis does occur among women with emesis in pregnancy in this set-up. Screening for it may be beneficial to such women and also those with high serum beta-hCG levels above the median for the gestational age.

J.R DRNDUNGU, A DRAMAYO, Z.P DRQURESHI, C PROFSEKKADE-KIGONDU. "Gestational thyrotoxicosis associated with emesis in early pregnancy." E.A.M.J. 2009;86(2):55-58. Abstract

OBJECTIVES:
To determine the thyroid profile and the prevalence of gestational thyrotoxicosis among women with emesis during early pregnancy.
DESIGN:
A descriptive cross-sectional study.
SETTING:
Kenyatta National Hospital acute gynaecology ward and the ante-natal clinic.
SUBJECTS:
Seventy two women presenting with emesis up to 16 weeks gestation.
MAIN OUTCOME MEASURES:
The levels of FT3, FT4, TSH and beta-hCG during the first 16 weeks of gestation. Correlation between the thyroid hormones and beta-hCG as well as the severity of vomiting was also done.
RESULTS:
The point prevalence of gestational thyrotoxicosis was 8.3%. There was a significant positive correlation between beta-hCG levels and FT3 and FT4 (P-values < 0.05), and a significant negative correlation between beta-hCG and TSH (P < 0.05). Correlation between the severity of vomiting and the thyroid hormones as well as beta-hCG was not statistically significant. Patients' age ranged from 14-38 years (median 26). Majority of the women studied were at a gestation of 8 to 11 weeks (38.9%). Most patients (84.7%) had one to five episodes of vomiting per day. Peak beta-hCG was at 12-15 weeks gestation.
CONCLUSIONS:
Thyrotoxicosis does occur among women with emesis in pregnancy in this set-up. Screening for it may be beneficial to such women and also those with high serum beta-hCG levels above the median for the gestational age.

Willems P, Ogira PN, Mutua F, Abdo G, Kabubi J, Fahmi AH, Sonbol M, Lotfy A, Kimaro TA, Mkhandi S, Opere A, Ibrahim YA, Kizza M, Tadesse L, Motaleb AM, Farid S, Zaki A, Al-Weshah R. "Regional Flood Frequency Analysis for the River Nile Basin." Mededelingen der Zittingen van de Koninklijke Academie voor Overzeese Wetenschappen. 2009;55(4):555-570. AbstractLirias

Regional differences have been investigated in the probabilities of high and low river flow extremes along the river Nile basin in eastern Africa. This has been done on the basis of statistical extreme value analysis applied to about one hundred flow gauging stations spread over the basin. The statistical analysis results have been combined with physical sub-basin characteristics such as topography and land use. The research has been conducted within the framework of the FRIEND/Nile project, which focuses on regional hydrology research cooperation between the main Nile countries (Egypt, Sudan, Ethiopia, Kenya, Tanzania, Uganda) and the Flemish universities. The high- and low-flow statistics developed can be used in water engineering and civil engineering design applications. Of equal importance are the supratechnical research outputs, among which enhancement of water-related transboundary research cooperation in the Nile region. During the course of the project, trust among the researchers and water managers from the different Nile countries gradually increased, data sharing enhanced, and politically sensitive issues (on transboundary water sharing) became debatable.

Zhang H, Thekisoe OMM, Kyan H, Yamagishi J, Inoue N, Nishikawa Y, Zakimi S. "Toxoplasma gondii: Sensitive and rapid detection of infection by loop-mediated isothermal amplification (LAMP) method.". 2009. Abstract

Loop-mediated isothermal amplification (LAMP) method amplifies DNA with high specificity, sensitivity and rapidity. In this study, we used a conserved sequence in the 200- to 300-fold repetitive 529 bp gene of Toxoplasma gondii to design primers for LAMP test. Detection limit of T. gondii LAMP assay with the primers is 1 pg/μL of T. gondii DNA, which was evaluated using 10-fold serially diluted DNA of cultured parasites. Furthermore, LAMP and conventional PCR methods were applied for amplification of the T. gondii DNA extracted from the lymph nodes taken from pigs which were suspected to be Toxoplasma infection. As a result, 76.9% (70/91) and 85.7% (78/91) of the samples were positive on PCR and LAMP analyzes, respectively. Therefore, the LAMP has a potential to be applied as an alternative molecular diagnostic tool for detection of T. gondii infection from veterinary samples. This is the first study, which applies the LAMP method to diagnose Toxoplasma from veterinary samples.

Zimmermann MB. "Iodine deficiency." Endocrine reviews. 2009;30:376-408. AbstractWebsite
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S.M M, Z. Q, J. K. "Birth preparedness among antenatal clients." East Afr Med J. 2008;85(6):275-83. Abstract

OBJECTIVE:
To evaluate birth preparedness and complication readiness among antenatal care clients.

DESIGN:
A descriptive cross- sectional study.

SETTING:
Antenatal care clinic at Kenyatta National Hospital, Nairobi, Kenya.

SUBJECTS:
Three hundred and ninety four women attending antenatal care at Kenyatta National hospital were interviewed using a pre-tested questionnaire between May 2006 and August 2006. Clients who were above 32 weeks gestation and had attended the clinic more than twice were recruited. Systematic sampling was used to select the study participants with every third client being interviewed.

MAIN OUTCOME MEASURES:
Health education on birth preparedness, knowledge of danger signs, preparations for delivery and emergencies.

RESULTS:
Over 60% of the respondents were counselled by health workers on various elements of birth preparedness. Eighty seven point three per cent of the respondents were aware of their expected date of delivery, 84.3% had set aside funds for transport to hospital during labour while 62.9% had funds for emergencies. Sixty seven per cent of the respondents knew at least one danger sign in pregnancy while only 6.9% knew of three or more danger signs. One hundred and nine per cent of the respondents did not have a clear plan of what to do in case of an obstetric emergency. Level of education positively influenced birth preparedness.

CONCLUSIONS:
Education and counselling on different aspects of birth preparedness was not provided to all clients. Respondents knowledge of danger signs in pregnancy was low. Many respondents did not know about birth preparedness and had no plans for emergencies.

S.M M, J. K, Z. Q. "Contraceptive use among HIV infected women attending Comprehensive Care Centre." East Afr Med J. 2008;85(4):171-7. Abstract

OBJECTIVE:
To determine contraceptive use among HIV infected women attending Comprehensive Care Centre at Kenyatta National Hospital.

DESIGN:
Hospital based cross-sectional descriptive study.

SETTING:
Comprehensive Care Centre (CCC), Kenyatta National Hospital.

SUBJECTS:
The study group was non-pregnant HIV positive women on follow up at the CCC. A total of 94 HIV infected women were interviewed between May 2006 and August 2006 through a pretested interviewer administered questionnaire. Consecutive women willing to participate in the study were interviewed.

MAIN OUTCOME MEASURES:
Current contraceptive use, contraceptive methods, source of contraception, reproductive intention and unmet need of family planning.

RESULTS:
The mean age of the respondents was 34 years, 47.9% were married, all had formal education and 74.6% were employed. Eighty six percent of the respondents did not have reproduction intentions in the next two years; however, only 44.2% of the respondents were using contraception. Condoms were the most popular (81.5%) contraceptive method. Female condom was used by 10.5% of the respondents. Norplant was the only long-term contraceptive method and was used by only 2.6%. Dual method of contraception was practiced by 13.5% of the respondents. Majority of the respondents obtained contraceptives from private sector (42.9%) with less than 10% getting them from CCC. The unmet need for family planning among the study group was 30%. Marital status and regular sexual partner were significantly associated with contraceptive use.

CONCLUSION:
Although majority of respondents did not have reproduction intentions in the next two years, use of contraception was low with only 44% being on a method. Use of long-term contraceptive methods was low among respondents. Majority of the respondents obtained contraceptives away from CCC. The unmet need for family planning was high at 30%.

S.M. M, Z.P. Q, J. K. "Emergency preparedness among antenatal clients at Kenyatta National Hospital." J. Obst. Gynae. East Central. Afr.. 2008;20(1):4-12 . Abstract

Background
All women are at risk of complications during pregnancy and delivery. Most complications cannot be predicted and therefore all pregnant women should be prepared to respond appropriately when complications arise. Such advance preparations can help prevent life threatening delays in recognizing and responding to complications.
According to Kenya Demographic Health Survey (KDHS) 2003, majority of women (60%) still deliver at home where skilled care is not available and if a complication arise it may be disastrous.
Emphasis on emergency preparedness during antenatal care is a cost effective intervention, which can thus reduce maternal deaths and morbidity by avoiding delays at decision making and transport to health facilities in the event of obstetric emergencies.

Objective: To evaluate emergency preparedness among antenatal care clients at Kenyatta National Hospital.

Methods: This was a descriptive cross-sectional study done at the antenatal care clinic at Kenyatta National Hospital. A total of 394 women attending antenatal care at Kenyatta National hospital were interviewed using a pre-tested questionnaire between May 2006 and August 2006. Clients who were above 32 weeks gestation and had attended the clinic more than twice were recruited. Systematic sampling was used to select the study participants with every third client being interviewed.

Results: The mean age of the respondents was 28.4 years with a range of 18-42 years. All the respondents had formal education, 91.7% were married and 41.1% were employed. Over 60% of the respondents were informed by health workers about danger signs in pregnancy. A third of the respondents knew at least one danger sign in pregnancy while only 6.9% knew of three or more danger signs. Only 62.9% of the respondents had funds set aside for emergency purposes. 10.9& of the respondents did not have a clear plan of what to do incase of an obstetric emergency. Level of education positively influenced knowledge of danger signs.

Conclusion
Education and counseling on danger signs was not provided to all clients. Respondents’ knowledge of danger signs in pregnancy was low. Most respondents did not have plans for emergencies.

Wall DH, Bradford MA, John MGST, Trofymows JA, Behan-Pelletier V, Bignell DE, Dangerfield JM, Parton WM, Rusek, J. FOI, Voight, W., Wolters V, Gardel HZ, Ayuke FO, Bashford R, Beljakova OI, Bohlen PJ, Brauman A, Flemming S, Henschel JR, Johnson DL, Jones TF, Kovarova, M., Kranabetter JM, Kutny L, Kuo-Chuan L, Maryati M, Masse D, Pokarzhevskii A, Rahman H, Sabara MG, Joerg-Alfred S, Swift MJ, Varela A, Vasconcelos HL, White D, Zou X. "Global decomposition experiment shows soil animal impacts on decomposition are climate- dependent." Global Change Biology. 2008;14:2661-2677. Abstract

Climate and litter quality are primary drivers of terrestrial decomposition and, based on evidence from multisite experiments at regional and global scales, are universally factored into global decomposition models. In contrast, soil animals are considered key regulators of decomposition at local scales but their role at larger scales is unresolved. Soil animals are consequently excluded from global models of organic
mineralization processes. Incomplete assessment of the roles of soil animals stems from the difficulties of manipulating invertebrate animals experimentally across large geographic gradients. This is compounded by deficient or inconsistent taxonomy. We report a global decomposition experiment to assess the importance of soil animals in C mineralization, in which a common grass litter substrate was exposed to natural decomposition in either control or reduced animal treatments across 30 sites distributed from 431S to 681N on six continents. Animals in the mesofaunal size range were recovered from the litter by Tullgren extraction and identified to common specifications, mostly at the ordinal level. The design of the trials enabled faunal contribution to be evaluated against abiotic parameters between sites. Soil animals increase decomposition rates in temperate and wet tropical climates, but have neutral effects where temperature or moisture constrain biological activity. Our findings highlight that faunal influences on
decomposition are dependent on prevailing climatic conditions. We conclude that (1) inclusion of soil animals will improve the predictive capabilities of region- or biomescale decomposition models, (2) soil animal influences on decomposition are important at the regional scale when attempting to predict global change scenarios, and (3) the statistical relationship between decomposition rates and climate, at the global scale, is robust against changes in soil faunal abundance and diversity.

Keywords: climate decomposition index, decomposition, litter, mesofauna, soil biodiversity, soil
carbon, soil fauna

Zavalaa, Diego E; Bokongo S; JSIM; MRMOWAIA; E. "Implementing a hospital based injury surveillance system in Africa: lessons learned.". 2008. Abstract

A multinational injury surveillance pilot project was carried out in five African countries in the first half of 2007 (Democratic Republic of the Congo, Kenya, Nigeria, Uganda and Zambia). Hospitals were selected in each country and a uniform methodology was applied in all sites, including an injury surveillance questionnaire designed by a joint programme of the Pan American Health Organization and the United States Centres for Disease Control and Prevention. A total of 4207 injury cases were registered in all hospitals. More than half of all injury cases were due to road traffic accidents (58.3%) and 40% were due to interpersonal violence. Self-inflicted injuries were minimal (1.2% of all cases). This report provides an assessment of the implementation of the project and a preliminary comparison between the five African countries on the context in which inter-personal injury cases occurred. Strengths and weaknesses of the project as well as opportunities and threats identified by medical personnel are summarized and discussed. A call is made to transform this pilot project into a sustainable public health strategy.

Z. Q. "Obstetrical emergencies in relation to millennium development goals." East Afr Med J. 2008;85(2):53-5. Abstract

At the turn of this century, 189 countries endorsed the Millennium Declaration and signed up to meeting eight goals. "These eight commitments are simple but powerful objectives that every man and woman can easily understand and support. They are also different from other bold pledges that became broken promises over the past 50 years: first, because they have unprecedented political support; second, because they are measurable and time-bond, with most of this agenda meant to be attained by the year 2015; and third - and most important - because they are achievable." Koffi Annan.

Children are the future of society and their mothers the guardians of that future: Childbirth is a very special life changing event - a joyful experience when all goes well but it can also be a difficult period bringing with it new problems as well as the potential for suffering. When obstetric emergencies occur, if not dealt with immediately they can cause severe morbidity or mortality for the mother or baby or both.

Zaja JO. "Publicizing the Private: Femini st Locution in Taarab Songs and performance .". 2008. AbstractWebsite

Scholars have for long deliberated and debated what is truly public and private in the articulation of feminist agendas in the world of Kiswahili artistic compositions. This is true for the various written literary texts in all genres as well as the diverse strands of taarab music/poetry compositions. The issues that are central in animating feminist locution in these art forms and which contribute to the incessant making and re-making of the feminist public and private spaces are neither fixed nor immutable—hence the shifting of these factors from time to time dictate the nature and essence of the contestations of what ought to be public and private. In other words, given that women’s voice in both are forms—song and written literature—are ever changi ng, so too is the discussion of what is rightly perceive d as public or private. Thus, what constitutes public and pr ivate in the myriad interests of feminist discourses and therefore what animates locution in such discourses is dependent on concrete material interests as well as the relations those interests evoke. These interests are central in informing disputations with other contending interests, occasioning either expressions of dissatisfaction or affirmation. Consequently, strategic and pragmatic political positioning, control schisms and schemes, ge nder relations and mate rial contestations ar e always constant and continuous themes that get critically nuanc ed in these disputati ons—hence the gist of these compositions. There has been much animated critiquing of feminist image presentations and gender articulation in Kiswahili writing, but there has not been sim ilar and thorough going interest shown in the Swahili taarab song. Yet it is a sphere that is predominantly and conspicuously female in terms of its subject matter, compositi on and performance, a sphere in which there is a subtle politicization and public ization of supposedly private feminist concerns. However, the few studies on the Swahili taarab song and pe rformance have indeed pointed out that the whole taarab discourse is an intimately fema le sphere that foster s and advances women’s voices (Fair, L. 2001, Askew, K. M. 2002). Taarab songs have a long a nd rich history as a medium of social commentary among the inhabitants of the East African coast. This is a hi story that dates back to the last quarter of the 19 th century (1870 onwards) during the reign of Sultan Seyyid Bargash in the Zanzibar Sultanate. Taarab at that time was essentially an elite court music sang in Arabic within the courts of the ruling Arab elite, the merchant cl ass as well as the land owing aristocracy. It was as such inevitably performed on imported E gyptian and Arabic music instruments. Its transition to Kiswahili and therefore, its movement away from the sultan’s courts to the general public is credited to Siti binti Saad a woman of sl ave ancestry (Askew, ibid), who having observed and internalized th e intricacies of taarab music, its artistry and potential as a 2 terrain for social articulation, started com posing and singing taarab songs in Kiswahili. Taarab songs are as such sung Swahili oral poetry, primarily by women as singers and performers and less often as composers. (It should be noted, however, many taarab songs have multiple composers in the sense that one pe rson will be credited with the poem, another with music arrangement and a nother with singing. It is not uncommon for one person to combine all the credits). Taarab, as Askew (102- 3) explains, takes its name from the Arabic tarabun meaning joy, pleasure, delight, rapture, amus ement, entertainment, music, or ecstasy, a complete engagement with music. It is impe rative to add that this “complete engagement with music” spanning poetic composition, music arrangement and performance, is not essentially a private affair but rather a publicly accessible ar t form whose rendition spans both private and public interests, and in which wh at is sung is not only open to multiple interpretations, but also constitutes social action deployed to ne gotiate socioeconomic relations. Both Fair and Askew are agreed that, taarab songs are composed as social commentaries in which women as “composers” respond to and tr ansform local debates about class, gender and social relations into vers e and weave personal and communal experiences into songs, sung as personal statements on mo rals, relations and pr obity. The taarab song lyrics are embellished poetic compositions, rich in literary devices through which the songs ridicule socially unacceptable and deviant beha vior, praise and insult, warn and admonish perceived or imaginary personal or collectiv e enemies. The messages in the songs are sometimes products of true life experiences, po pular beliefs and discer nible lifestyles. They also reflect the nature of relations to social institutions, modes of inte rrelations or material circumstances. They may also be protests to or affirmations of social morals/behaviors such as greed, idleness, gossip, rumour and all manner of abhorrent sexual misconduct. Furthermore, they are also expressions of j oy, elation and personal or collective triumph. In essence, the songs are intricate yet generalized responses to soci al realities, beliefs, traditions, material conditions and institutional dynamics normally projected as personal or collective needs, desires, losses, miseries— in a word, various forms of social, economic and political struggles. They are in essence subtle strategies deployed to question, analyz e and reshape material and social relations. They are strata gems set out to publici ze and politicize private struggles—thus bringing into the public domai n subjects routinely muted, yet important at pointing out marginalized social act ors and competing alliances. By using extracts from three popular taarab s ongs, this paper examines how the taarab song lyrics in performance are viable sphe res for publicizing private pillow business. 3 Analyses of both the songs and their performances show clearly that they intricately articulate desires either denied or unful filled, with nuanced enunciations where the private and the public mutually interconnect a nd interrelate. Consequently the songs are an exposé, depiction and a rendition of underlying interactions tied to multiple and variable feminist locutions. Primarily, this paper, demonstrates how such locutions considered private are enabled— literally aired—through the public performance, recording and airplay of taarab songs

Mureithi MW, Finn A, Ota MO, Zhang Q, Davenport V, Mitchell TJ, Williams NA, Adegbola RA, Heyderman RS. "T Cell memory response to pneumococcal protein antigens in an area of high pneumococcal carriage and disease.". 2008. Abstract

Streptococcus pneumoniae is a leading cause of vaccine-preventable disease worldwide. Pneumococcal protein antigens are currently under study as components of potential vaccines that offer protection against multiple serotypes. We have therefore characterized T cell pneumococcal immunity acquired through asymptomatic carriage. Methods. Peripheral blood mononuclear cells from 40 healthy Gambian adults were stimulated with supernatants derived from S. pneumoniae strain (D39), 2 isogenic mutant strains lacking either pneumolysin or choline binding protein A, and recombinant pneumolysin. Immune responses were measured by cellular proliferation and by interleukin-10 (IL-10) and interferon-g (IFN-g) enzyme-linked immunosorbent spot and bioplex cytokine assays. Nasopharyngeal swabs were cultured to determine carriage rates. Results. S. pneumoniae nasopharyngeal carriage was detected in 60% of individuals. Both effector and resting (or central) CD4+ T cell memory were frequently present to a range of pneumococcal antigens. However, the level of the effector memory response did not relate to current nasopharyngeal carriage. Pneumolysin was not immunodominant in these T cell responses but induced a distinct proinflammatory profile (high IFN-g, IL-12[p40], and L-17 levels and low IL-10 and IL-13 levels). Conclusions. In this population, T cell–mediated immunological memory potentially capable of pathogen clearance and immune surveillance is common but is not associated with the absolute interruption of pneumococcal carriage. How this naturally acquired immune memory influences pneumococcal vaccine efficacy remains to be determined.

Abdulrahman M, Maina EN, Morris MR, Zatyka M, Raval RR, Banks RE, Wiesener MS, Richards FM, Johnson CM, Latif F, Maher ER. "Identification of novel VHL targets that are associated with the development of renal cell carcinoma." Oncogene. 2007;26(11):1661-72. Abstract

von Hippel-Lindau (VHL) disease is a dominantly inherited family cancer syndrome characterized by the development of retinal and central nervous system haemangioblastomas, renal cell carcinoma (RCC) and phaeochromocytoma. Specific germline VHL mutations may predispose to haemangioblastomas, RCC and phaeochromocytoma to a varying extent. Although dysregulation of the hypoxia-inducible transcription factor-2 and JunB have been linked to the development of RCC and phaeochromocytoma, respectively, the precise basis for genotype-phenotype correlations in VHL disease have not been defined. To gain insights into the pathogenesis of RCC in VHL disease we compared gene expression microarray profiles in a RCC cell line expressing a Type 1 or Type 2B mutant pVHL (RCC-associated) to those of a Type 2A or 2C mutant (not associated with RCC). We identified 19 differentially expressed novel VHL target genes linked to RCC development. Eight targets were studied in detail by quantitative real-time polymerase chain reaction (three downregulated and five upregulated by wild-type VHL) and for six genes the effect of VHL inactivation was mimicked by hypoxia (but hypoxic-induction of smooth muscle alpha-actin 2 was specific for a RCC cell line). The potential role of four RCC-associated VHL target genes was assessed in vitro. NB thymosin beta (TMSNB) and proteinase-activated receptor 2 (PAR2) (both downregulated by wt pVHL) increased cell growth and motility in a RCC cell line, but aldehyde dehydrogenase (ALDH)1 and ALDH7 had no effect. These findings implicate TMSNB and PAR2 candidate oncogenes in the pathogenesis of VHL-associated RCC.

and R. S. Malele, Mwangi JW, Thoithi GN, Kibwage IO, López ML, Zunino MP, López AG, Zygadlo JA, Oliva MM, Demo MS. "Essential oil of Cymbopogon winterianus Jowitt from Tanzania: Composition and antimicrobial activity." J. Essential Oil Bearing Plants. 2007;10:83-87.
Aboge GO, Jia H, Kuriki H, Zhou J, Nishikawa Y, Igarashi I, Fujisaki K, Suzuki H, Xuan X. "Molecular characterization of a novel 32-kDa merozoite antigen of Babesia gibsoni with a better diagnostic performance by enzyme-linked immunosorbent assay.". 2007. Abstract

We cloned and expressed 3 novel gene encoding a 32-kDa merozoite protein of Babesia gibsoni (BgP32). The length of nucleotide sequence of the cD;\' A \\'3. 1-1-6-1 bp with an open reading frame of 969 bp. The truncated recombinant BgP32 (rBgP32) without a signal peptide and Cvterrninal hydrophobic sequence was expressed in Escherichia coli as a oluble glutathione- -rran ferase (GST) fusion protein. We stern blotting demonstrated that the native protein was 32-kDa, consistent with molecular weight of thc predicted mature polypeptide. Enzyme-linked irnmunosorbent assay (ELISA) using rBgP32 detected specific antibodi s from 8 days to 541 days post-infection in the sequential sera from a dog experimentally infected wirh B. gibsoni. Moreover. the antigen did not cross-react with B. canis subspecies and closely related protozoan parasites, indicating that rBgP32 is a specific diagnostic antigen. Analysis of 47 era taken from dogs with anaemic signs re ealed that rBgP32 detected a higher proportion of B. gibson! seroposirive sample' (77%) than its previou Iy identified rBgPSO (68%) homologue. These results indicate that the BgP32 is a novel immunodominant antigen of B. gibsoni, and rBgP32 might be useful for diagno is of B. gibsoni infection

Bulsara KR, Zomorodi A, Provenzale JM. "Anatomic variant of the posterior cerebral artery." American Journal of Roentgenology. 2007;188:W395. AbstractWebsite
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