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2019
Atere, CT, Ge T, Zhu Z, Liu S, Huang X, Shibistova O, Guggenberger G, Wu J.  2019.  Assimilate allocation by rice and carbon stabilisation in soil: effect of water management and Phosphorus fertilisation. Plant and Soil . 445:153–167.
Lawal, US, Oladokun TT, Ayodele TO.  2019.  Commercial Real Estate Investment in Ibadan Property Market: An Examination of the Risk-Return Characteristics.. Journal of Environmental Design.. 14(2):75-85..
Zhang, X, Wang X, Smarandache F, Jaiyeola TG, Lian T.  2019.  Singular Neutrosophic Extended Triplet Groups and Generalized Groups. Cognitive Systems Research. 57:32–40.
2018
Christianah, E, Mohammad F, Adebayo J, Lawal O, Kolawole B, Ikem R, Soyoye D.  2018.  Prevalence of Kock's diseases among diabetes patient attending state Specialist Hosital Akure South West Nigeria, 2018/11/02. Abstract
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Omotayo, O, Adeyinka S, L.N. U, J.T. F, O. S.  2018.  Household Travel Characteristics to Healthcare Facilities in Ondo State, Nigeria, 2018/09/01. Abstract

This study investigated the household travel characteristics of health consumers in Ondo State to the available healthcare facilities. The study uses data collected from 1,181 health consumers from forty-two (42) settlements across the three senatorial districts of the State. The findings revealed that while some of the healthcare patrons travelled below 400 meters to get to the nearest healthcare facility, many of them spent more money on trips to reach their healthcare facilities. This shows that the majority of people are ready to patronize any healthcare facility irrespective of the distance and cost. The further analysis revealed that distance, travel time, cost of transport and travel mode are significant to the utilization of healthcare facilities. To this end, more healthcare facilities should be provided and located closer to people within shortest possible distance, especially in Ondo North and Ondo South senatorial districts.

Akinyemi, RO, Akinwande K, Diala S, Adeleye O, Ajose A, Issa K, Owusu D, Boamah I, Yahaya IS, Jimoh AO, Imoh L, Fakunle G, Akpalu A, Sarfo F, Wahab K, Sanya E, Owolabi L, Obiako R, Osaigbovo G, Komolafe M, Fawale M, Adebayo P, Olowoyo P, Obiabo Y, Sunmonu T, Chukwuonye I, Balogun O, Adeoye B, Oladele F, Olowoniyi P, Adeyemi F, Lezzi A, Falayi AT, Fasanya M, Ogunwale K, Adeola O, Olomu O, Aridegbe O, Laryea R, Uvere E, Faniyan M, Melikam E, Tagge R, Akpa O, Akinyemi J, Arulogun O, Tiwari HK, Ovbiagele B, Owolabi MO.  2018.  Biobanking in a Challenging African Environment: Unique Experience from the SIREN Project, 2018. Biopreservation and Biobanking. 16(3) Abstract

Africa was previously insufficiently represented in the emerging discipline of biobanking despite commendable early efforts. However, with the Human, Heredity, and Health in Africa (H3Africa) initiative, biorepository science has been bolstered, regional biobanks are springing up, and awareness about biobanks is growing on the continent. The Stroke Investigative Research and Educational Network (SIREN) project is a transnational, multicenter, hospital and community-based study involving over 3000 cases and 3000 controls recruited from 16 sites in Ghana and Nigeria. SIREN aims to explore and unravel the genetic and environmental factors that interact to produce the peculiar phenotypic and clinical characteristics of stroke as seen in people of African ancestry and facilitate the development of new diagnostics, therapeutics, and preventative strategies. The aim of this article is to describe our experience with the development of the procedure for collection, processing, storage, and shipment of biological samples (blood, serum, plasma, buffy coat, red cell concentrates, and DNA) and brain imaging across coordinating and participating sites within the SIREN Project. The SIREN network was initiated in 2014 with support and funding from the H3Africa Initiative. The SIREN Biobank currently has 3015 brain images, 92,950 blood fractions (serum, plasma, red cell concentrates, and buffy coat) accrued from 8450 recruited subjects, and quantified and aliquoted good-quality DNA extracts from 6150 study subjects. This represents an invaluable resource for future research with expanding genomic and trans-omic technologies. This will facilitate the involvement of indigenous African samples in cutting-edge stroke genomics and trans-omics research. It is, however, critical to effectively engage African stroke patients and community members who have contributed precious biological materials to the SIREN Biobank to generate appropriate evidence base for dealing with ethical, legal, and social issues of privacy, autonomy, identifiability, biorights, governance issues, and public understanding of stroke biobanking in the context of unique African culture, language, and belief systems.

Owolabi, MO, Sarfo F, Akinyemi R, Gebregziabher M, Akpa O, Akpalu A, Wahab K, Obiako R, Ovbiagele B, Sarfo FS, Akinyemi R, Gebregziabher M, Akpa O, Akpalu A, Obiako R, Ovbiagele B, Tiwari HK, Arnett D, Lackland D, Adeoye AM, Akin O, Ogbole G, Jenkins C, Arulogun O, Ryan IM, Armstrong K, Olowoyo P, Komolafe M, Osaigbovo G, Obiabo O, Chukwuonye I, Adebayo P, Adebayo O, Omololu A, Otubogun F, Olaleye A, Durodola A, Olunuga T, Akinwande K, Aridegbe M, Fawale B, Adeleye O, Kolo P, Appiah L, Singh A, Adamu S, Awuah D, Saulson R, Agyekum F, Shidali V, Ogah O, Oguntade A, Umanruochi K, Iheonye H, Imoh L, Afolaranmi T, Calys-Tagoe B, Okeke O, Fakunle A, Akinyemi J, Akpalu J, Ibinaiye P, Agunloye A, Sanni T, Bisi A, Efidi C, Bock-Oruma A, Melikam S, Olaniyan L, Yaria J, Odo CJ, Lakoh S, Ogunjimi L, Salaam A, Oyinloye L, Asaleye C, Sanya E, Olowookere S, Makanjuola A, Oguntoye A, Uvere E, Faniyan M, Akintunde A, Kehinde I, Diala S, Adeleye O, Ajose OA, Onyeonoro U, Amusa AG, Owusu D, Mensah Y, Owolabi L.  2018.  Dominant modifiable risk factors for stroke in Ghana and Nigeria (SIREN): a case-control study, 2018. The Lancet Global Health. 6(4) Abstract

Background: Sub-Saharan Africa has the highest incidence, prevalence, and fatality from stroke globally. Yet, only little information about context-specific risk factors for prioritising interventions to reduce the stroke burden in sub-Saharan Africa is available. We aimed to identify and characterise the effect of the top modifiable risk factors for stroke in sub-Saharan Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) study is a multicentre, case-control study done at 15 sites in Nigeria and Ghana. Cases were adults (aged ≥18 years) with stroke confirmed by CT or MRI. Controls were age-matched and gender-matched stroke-free adults (aged ≥18 years) recruited from the communities in catchment areas of cases. Comprehensive assessment for vascular, lifestyle, and psychosocial factors was done using standard instruments. We used conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% CIs. Findings: Between Aug 28, 2014, and June 15, 2017, we enrolled 2118 case-control pairs (1192 [56%] men) with mean ages of 59·0 years (SD 13·8) for cases and 57·8 years (13·7) for controls. 1430 (68%) had ischaemic stoke, 682 (32%) had haemorrhagic stroke, and six (<1%) had discrete ischaemic and haemorrhagic lesions. 98·2% (95% CI 97·2–99·0) of adjusted PAR of stroke was associated with 11 potentially modifiable risk factors with ORs and PARs in descending order of PAR of 19·36 (95% CI 12·11–30·93) and 90·8% (95% CI 87·9–93·7) for hypertension, 1·85 (1·44–2·38) and 35·8% (25·3–46·2) for dyslipidaemia, 1·59 (1·19–2·13) and 31·1% (13·3–48·9) for regular meat consumption, 1·48 (1·13–1·94) and 26·5% (12·9–40·2) for elevated waist-to-hip ratio, 2·58 (1·98–3·37) and 22·1% (17·8–26·4) for diabetes, 2·43 (1·81–3·26) and 18·2% (14·1–22·3) for low green leafy vegetable consumption, 1·89 (1·40–2·54) and 11·6% (6·6–16·7) for stress, 2·14 (1·34–3·43) and 5·3% (3·3–7·3) for added salt at the table, 1·65 (1·09–2·49) and 4·3% (0·6–7·9) for cardiac disease, 2·13 (1·12–4·05) and 2·4% (0·7–4·1) for physical inactivity, and 4·42 (1·75–11·16) and 2·3% (1·5–3·1) for current cigarette smoking. Ten of these factors were associated with ischaemic stroke and six with haemorrhagic stroke occurrence. Interpretation: Implementation of interventions targeting these leading risk factors at the population level should substantially curtail the burden of stroke among Africans. Funding: National Institutes of Health.

Jenkins, C, Ovbiagele B, Arulogun O, Singh A, Calys-Tagoe B, Akinyemi R, Mande A, Melikam ES, Akpalu A, Wahab K, Sarfo FS, Sanni T, Osaigbovo G, Tiwari HK, Obiako R, Shidali V, Ibinaiye P, Akpalu J, Ogbole G, Owolabi L, Uvere E, Taggae R, Adeoye AM, Gebregziabher M, Akintunde A, Adebayo O, Oguntade A, Bisi A, Ohagwu K, Laryea R, Olowoniyi P, Yahaya IS, Olowookere S, Adeyemi F, Komolafe M, Fawale MB, Sunmonu T, Onyeonoro U, Imoh LC, Oguike W, Olunuga T, Kolo P, Ogah OS, Efidi R, Chukwuonye I, Bock-Oruma A, Owusu D, Odo CJ, Faniyan M, Ohnifeman OA, Ajose O, Ogunjimi L, Johnson S, Ganiyu A, Olowoyo P, Fakunle AG, Tolulope A, Farombi T, Obiabo MO, Owolabi M.  2018.  Knowledge, attitudes and practices related to stroke in Ghana and Nigeria: A SIREN call to action, 2018. PLoS ONE. 13(11) Abstract

Introduction Stroke is a prominent cause of death, disability, and dementia in sub-Saharan Africa (SSA). The Stroke Investigative Research and Education Network works collaboratively with stroke survivors and individuals serving as community controls to comprehensively characterize the genomic, sociocultural, economic and behavioral risk factors for stroke in SSA. Purpose In this paper, we aim to: i) explore the attitudes, beliefs, and practices related to stroke in Ghana and Nigeria using the process of qualitative description; and ii) propose actions for future research and community-based participation and education. Methods Stroke survivors, their caregivers, health care professionals, and community representatives and faith-based leaders participated in one of twenty-six focus groups, which qualitatively explored community beliefs, attitudes and practices related to stroke in Ghana and Nigeria. Arthur Kleinman’s Explanatory Model of Illness and the Social Ecological Model guided the questions and/or thematic analysis of the qualitative data. We hereby describe our focus group methods and analyses of qualitative data, as well as the findings and suggestions for improving stroke outcomes. Results and discussion The major findings illustrate the fears, causes, chief problems, treatment, and recommendations related to stroke through the views of the participants, as well as recommendations for working effectively with the SIREN communities. Findings are compared to SIREN quantitative data and other qualitative studies in Africa. As far as we are aware, this is the first paper to qualitatively explore and contrast community beliefs, attitudes, and practices among stroke survivors and their caregivers, community and faith-based leaders, and health professionals in multiple communities within Nigeria and Ghana.

G.O., O, D. J, P.A. M, T.D. B, L.J.J. G, M.A. E, W.L. A, C.A. L, C.C. L, A. O, P.B. O, B.S. A, undefined, Bello S.A., P. D, R. A, C. O, S. O-Y, G. P-R, O.M. O, O. J, T. H, F. A, L.O. A-R, A.V. O, L. M, M.L. M, J.C. M, A.A. A.  2018.  Identification of paternal uniparental disomy on chromosome 22 and a de novo deletion on chromosome 18 in individuals with orofacial clefts. Mol Genet Genomic Med. 6(6 ):924-932.
M.A., E, H. L, M. L, W.L. A, L.J.J. G, P.A. M, T. B, W. D, P. D, P.B. O, B.S. A, R.O. B, G.O. O, F. O, R. A, C. O, O. J, E. A-A, L.A. R, M.O. O, F.K.N A, Bello S.A., P. A, P. T, F. A, T. H, Y. D, A. H, G. P-R, S. O-Y, M.M. D, P.E. G, M.L. M, A.A. A, J.C M, R.A. C, A. B.  2018.  Loss-of-function GRHL3 variants detected in African patients with isolated cleft palate.. J Dent Res. 97(1 ):41–48.p22_-_eshete_et_al._2018-loss-of-fxn-jdr.pdf
Waitt, C, Olagunju A, Nakalema S, Kyohaire I, Owen A, Lamorde M, Khoo S.  2018.  Plasma and breast milk pharmacokinetics of emtricitabine, tenofovir and lamivudine using dried blood and breast milk spots in nursing African mother–infant pairs. Journal of Antimicrobial Chemotherapy. AbstractDownload (Open Access)

Background: Breast milk transfer of first-line ART from mother to infant is not fully understood.

Objectives: To determine the concentrations of lamivudine, emtricitabine and tenofovir in maternal blood, breast milk and infant blood from breastfeeding mother–infant pairs.

Methods: Intensive pharmacokinetic sampling of maternal dried blood spots (DBS), dried breast milk spots (DBMS) and infant DBS from 30 Ugandan and 29 Nigerian mothers receiving first-line ART and their infants was conducted. DBS and DBMS were collected pre-dose and at 5–6 timepoints up to 12 h following observed dosing. Infant DBS were sampled twice during this period. Lamivudine, emtricitabine and tenofovir were quantified using LC-MS/MS, with non-compartmental analysis to calculate key pharmacokinetic parameters.

Results: Peak concentrations in breast milk from women taking lamivudine and emtricitabine occurred later than in plasma (4–8 h compared with 2 h for lamivudine and 2–4 h for emtricitabine). Consequently, the milk-to-plasma (M:P) ratio of lamivudine taken once daily was 0.95 (0.82–1.15) for AUC0–12, whereas for AUC12–20 this was 3.04 (2.87–4.16). Lamivudine was detectable in 36% (14/39) of infants [median 17.7 (16.3–22.7) ng/mL]. For 200 mg of emtricitabine once daily, the median M:P ratio was 3.01 (2.06–3.38). Three infants (19%) had measurable emtricitabine [median 18.5 (17.6–20.8) ng/mL]. For 300 mg of tenofovir once daily, the median M:P ratio was 0.015 (0–0.03) and no infant had measurable tenofovir concentrations.

Conclusions: Emtricitabine and lamivudine accumulate in breast milk and were detected in breastfeeding infants. In contrast, tenofovir penetrates the breast milk to a small degree, but is undetectable in breastfeeding infants.

Owolarafe, OK, Adetifa BO, Oyekanmi AC, Lemikan TG, Samuel TM.  2018.  Assessment of fufu production technologies in Ogun State, Nigeria. Arid Zone Journal of Engineering, Technology and Environment. 14:547–558., Number 4 Abstract
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2017
Odetoyin, BW, Labar AS, Lamikanra A, Aboderin AO, Okeke IN.  2017.  Classes 1 and 2 Integrons in Faecal {{Escherichia}} Coli Strains Isolated from Mother-Child Pairs in {{Nigeria}}, aug. PLOS ONE. 12(Nübel, Ulrich, Ed.).:e0183383., Number 8: {Public Library of Science} Abstract

Background Antimicrobial resistance among enteric bacteria in Africa is increasingly mediated by integrons on horizontally acquired genetic elements. There have been recent reports of such elements in invasive pathogens across Africa, but very little is known about the faecal reservoir of integron-borne genes. Methods and findings We screened 1098 faecal Escherichia coli isolates from 134 mother-child pairs for integron cassettes by PCR using primers that anneal to the 5' and 3' conserved ends of the cassette regions and for plasmid replicons. Genetic relatedness of isolates was determined by flagellin and multi-locus sequence typing. Integron cassettes were amplified in 410 (37.5%) isolates and were significantly associated with resistance to trimethoprim and multiple resistance. Ten cassette combinations were found in class 1 and two in class 2 integrons. The most common class 1 cassette configurations were single aadA1 (23.4%), dfrA7 (18.3%) and dfrA5 (14.4%). Class 2 cassette configurations were all either dfrA1-satIaadA1 (n = 31, 7.6%) or dfrA1-satI (n = 13, 3.2%). A dfr cassette was detected in 294 (31.1%) of trimethoprim resistant strains and an aadA cassette in 242 (23%) of streptomycin resistant strains. Strains bearing integrons carried a wide range of plasmid replicons of which FIB/Y (n = 169; 41.2%) was the most frequently detected. Nine isolates from five different individuals carried the dfrA17-aadA5-bearing ST69 clonal group A (CGA). The same integron cassette combination was identified from multiple distinct isolates within the same host and between four mother-child pairs. Conclusions Integrons are important determinants of resistance in faecal E. coli. Plasmids in integroncontaining strains may contribute to dispersing resistance genes. There is a need for

Abidoye, I, Ayoola O, Idowu B, Aderibigbe A, Loto O.  2017.  Uterine artery Doppler velocimetry in hypertensive disorder of pregnancy in Nigeria, 2017/12/29. 17 Abstract

Aim of the study: To evaluate the value of uterine artery Doppler indices and waveformpattern in predicting fetuses at risk for intrauterine growth restriction in hypertensive
disorders of pregnancy. Materials and methods: This was a prospective cross-sectional
study including 80 pregnant subjects with hypertensive disorders of pregnancy and two
control groups. Uterine artery Doppler sonography was performed in all study participants.
Uterine artery Doppler indices across the groups were compared using the analysis
of variance (ANOVA) while the presence of prediastolic notch was analyzed with the Chi
Square test. Results: For the hypertensive disorders of pregnancy group, resistivity index
> 0.66 had a sensitivity of 50.0%, specificity of 69.1% and a positive predictive value of
22.2% for predicting intrauterine growth restriction. The odds ratio was 2.2 with a 95%
confidence interval of 0.6–7.8. The presence of prediastolic notching had a sensitivity of
100.0%, specificity of 96.0% and a positive predictive value of 80.0% for predicting intrauterine
growth restriction. The odds ratio was 22.7 with a 95% confidence interval of
7.5–68.5. Conclusion: Uterine artery Doppler sonography is useful for predicting fetuses
at risk for intrauterine growth restriction in hypertensive disorder of pregnancy. Prediastolic
notching is more sensitive and more specific than uterine artery resistivity index in
predicting fetuses at risk of intrauterine growth restriction in established hypertensive
disorder of pregnancy.

Soyoye, D, Ayandele CO, Anizor C, Owolabi F, Ala O, Yusuff O, Ezekpo O, Lawal-Bello A, Adewusi T, Ikem R, Kolawole B.  2017.  Burden of obesity and hypertension in Nigerians with type 2 diabetes mellitus seen in a tertiary health facility, 2017/10/20. Abstract
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Adeoye, AM, Ovbiagele B, Kolo P, Appiah L, Aje A, Adebayo O, Sarfo F, Akinyemi J, Adekunle G, Agyekum F, Shidali V, Ogah O, Lackland D, Gebregziabher M, Arnett D, Tiwari HK, Akinyemi R, Olagoke OO, Oguntade AS, Olunuga T, Uwanruochi K, Jenkins C, Adadey P, Iheonye H, Owolabi L, Obiako R, Akinjopo S, Armstrong K, Akpalu A, Fakunle A, Saulson R, Aridegbe M, Olowoyo P, Osaigbovo G, Akpalu J, Fawale B, Adebayo P, Arulogun O, Ibinaiye P, Agunloye A, Ishaq N, Wahab K, Akpa O, Adeleye O, Bock-Oruma A, Ogbole G, Melikam S, Yaria J, Ogunjimi L, Salaam A, Sunmonu T, Makanjuola A, Farombi T, Laryea R, Uvere E, Kehinde S, Chukwuonye I, Azuh P, Komolafe M, Akintunde A, Obiabo O, Areo O, Kehinde I, Amusa AG, Owolabi M.  2017.  Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa, 2017. Global Heart. 12(2) Abstract

Background Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown. Objectives We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study. Methods SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and LVH are being collected and compared using standard techniques. Results This preliminary analysis included only 725 stroke patients (mean age 59.1 ± 13.2 years; 54.3% male). Fifty-five percent of the stroke subjects had LVH with greater proportion among women (51.6% vs. 48.4%; p < 0.001). Those with LVH were younger (57.9 ± 12.8 vs. 60.6 ± 13.4; p = 0.006) and had higher mean systolic and diastolic blood pressure (167.1/99.5 mm Hg vs 151.7/90.6 mm Hg; p < 0.001). Uncontrolled blood pressure at presentation was prevalent in subjects with LVH (76.2% vs. 57.7%; p < 0.001). Significant independent predictors of LVH were age <45 years (adjusted odds ratio [AOR]: 1.91; 95% confidence interval [CI]: 1.14 to 3.19), female sex (AOR: 2.01; 95% CI: 1.44 to 2.81), and diastolic blood pressure > 90 mm Hg (AOR: 2.10; 95% CI: 1.39 to 3.19; p < 0.001). Conclusions The prevalence of LVH was high among stroke patients especially the younger ones, suggesting a genetic component to LVH. Hypertension was a major modifiable risk factor for stroke as well as LVH. It is envisaged that the SIREN project will elucidate polygenic overlap (if present) between LVH and stroke among Africans, thereby defining the role of LVH as a putative intermediate cardiovascular phenotype and therapeutic target to inform interventions to reduce stroke risk in populations of African ancestry.

Adeoye, AM, Ogah OS, Ovbiagele B, Akinyemi R, Shidali V, Agyekum F, Aje A, Adebayo O, Akinyemi JO, Kolo P, Appiah LT, Iheonye H, Kelechukwu U, Ganiyu A, Olunuga TO, Akpa O, Olagoke OO, Sarfo FS, Wahab K, Olowookere S, Fakunle A, Akpalu A, Adebayo PB, Nkromah K, Yaria J, Ibinaiye P, Ogbole G, Olumayowa A, Lakoh S, Calys-Tagoe B, Olowoyo P, Innocent C, Tiwari HK, Arnett D, Godwin O, Ayotunde B, Akpalu J, Obiora O, Joseph O, Omisore A, Jenkins C, Lackland D, Owolabi L, Isah S, Dambatta AH, Komolafe M, Bock-Oruma A, Melikam ES, Imoh LC, Sunmonu T, Gebregziabher M, Olabisi O, Armstrong K, Onyeonoro UU, Sanya E, Agunloye AM, Ogunjimi L, Arulogun O, Farombi TH, Obiabo O, Obiako R, Owolabi M.  2017.  Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans, 2017. Global Heart. 12(2) Abstract

Background Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans. Objectives The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results Patients' mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability.

Owolabi, M, Sarfo F, Howard VJ, Irvin MR, Gebregziabher M, Akinyemi R, Bennett A, Armstrong K, Tiwari HK, Akpalu A, Wahab KW, Owolabi L, Fawale B, Komolafe M, Obiako R, Adebayo P, Manly JM, Ogbole G, Melikam E, Laryea R, Saulson R, Jenkins C, Arnett DK, Lackland DT, Ovbiagele B, Howard G.  2017.  Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors, 2017. Stroke. 48(5) Abstract

Background and Purpose - The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA). Methods - SIREN (Stroke Investigative Research and Educational Network) is a large multinational case-control study in West Africa - the ancestral home of 71% AA - whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies. Results - There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3 years, respectively (P<0.0001). Hemorrhagic stroke was more frequent among IA (27%) compared with AA (8%) and EA (5.4%; P<0.001). Lacunar strokes were more prevalent in IA (47.1%), followed by AA (35.1%) and then EA (21.0%; P<0.0001). The frequency of hypertension in decreasing order was IA (92.8%), followed by AA (82.5%) and then EA (64.2%; P<0.0001) and similarly for diabetes mellitus IA (38.3%), AA (36.8%), and EA (21.0%; P<0.0001). Premorbid sedentary lifestyle was similar in AA (37.7%) and EA (34.0%) but lower frequency in IA (8.0%). Conclusions - Environmental risk factors such as sedentary lifestyle may contribute to the higher proportion of ischemic stroke in AA compared with IA, whereas racial factors may contribute to the higher proportion of hypertension and diabetes mellitus among stroke subjects of African ancestry.

Zhu, Z, Ge T, Xiao M, Yuan H, Wang, T., Liu S, Atere CT, Wu J.  2017.  Belowground carbon allocation and dynamics under rice cultivation depends on soil organic matter content. Plant and Soil. 410:247–258.
Waitt, C, Diliiy Penchala S, Olagunju A, Amara A, Else L, Lamorde M, Khoo S.  2017.  Development, validation and clinical application of a method for the simultaneous quantification of lamivudine, emtricitabine and tenofovir in dried blood and dried breast milk spots using LC–MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci. 1060:300-307. AbstractDownload (Open Access)

Objectives: To present the validation and clinical application of a LC–MS/MS method for the quantification of lamivudine (3TC), emtricitabine (FTC) and tenofovir (TFV) in dried blood spots (DBS) and dried breast milk spots (DBMS).

Methods: DBS and DBMS were prepared from 50 and 30 μL of drug-spiked whole blood and human breast milk, respectively. Following extraction with acetonitrile and water, chromatographic separation utilised a Synergi polar column with a gradient mobile phase program consisting of 0.1% formic acid in water and 0.1% formic acid in acetonitrile. Detection and quantification was performed using a TSQ Quantum Ultra triple quadrupole mass spectrometer. The analytical method was used to evaluate NRTI drug levels in HIV-positive nursing mothers-infant pairs.

Results: The assay was validated over the concentration range of 16.6–5000 ng/mL for 3TC, FTC and TFV in DBS and DBMS except for TFV in DBMS where linearity was established from 4.2–1250 ng/mL. Intra and inter-day precision (%CV) ranged from 3.5–8.7 and accuracy was within 15% for all analytes in both matrices. The mean recovery in DBS was >61% and in DBMS >43% for all three analytes. Matrix effect was insignificant. Median AUC0-8 values in maternal DBS and DBMS, respectively, were 4683 (4165–6057) and 6050 (5217–6417) ng h/mL for 3TC, 3312 (2259–4312) and 4853 (4124–6691) ng h/mL for FTC and 1559 (930–1915) and 56 (45–80) ng h/mL for TFV. 3TC and FTC were quantifiable (>16.6 ng/mL) in DBS from 2/6 and 1/6 infants respectively whereas TFV was undetectable in all infants.

Conclusions: DBS and DBMS sampling for bioanalysis of 3TC, FTC and TFV is straightforward, robust, accurate and precise, and ideal for use in low-resource settings.

Neary, M, Lamorde M, Olagunju A, Darin KM, Merry C, Byakika-Kibwika P, Back DJ, Siccardi M, Owen A, Scarsi KK.  2017.  The Effect of Gene Variants on Levonorgestrel Pharmacokinetics when Combined with Antiretroviral Therapy containing Efavirenz or Nevirapine. Clinical Pharmacology & Therapeutics . (DOI: 10.1002/cpt.667) AbstractJournal Website

Reduced levonorgestrel concentrations from the levonorgestrel contraceptive implant was previously seen when given concomitantly with efavirenz. We sought to assess whether single nucleotide polymorphisms (SNPs) in genes involved in efavirenz and nevirapine metabolism were linked to these changes in levonorgestrel concentration. SNPs in CYP2B6, CYP2A6, NR1I2 and NR1I3 were analysed. Associations of participant demographics and genotype with levonorgestrel pharmacokinetics were evaluated in HIV-positive women using the levonorgestrel implant plus efavirenz- or nevirapine-based ART, in comparison to ART-naïve women using multivariate linear regression. Efavirenz group: CYP2B6 516G>T was associated with lower levonorgestrel log10 Cmax and log10 AUC. CYP2B6 15582C>T was associated with lower log10 AUC. Nevirapine group: CYP2B6 516G>T was associated with higher log10 Cmax and lower log10 Cmin . Pharmacogenetic variations influenced subdermal levonorgestrel pharmacokinetics in HIV-positive women, indicating that the magnitude of the interaction with non-nucleoside reverse transcriptase inhibitors (NNRTIs) is influenced by host genetics.

Shacklett, BL, Derdeyn CA, Folayan MO, Landovitz RJ, Anthony C, Behrens A-J, Hope TJ, Landais E, Leal L, Marrazzo JM, Morris L, Mugo N, Ngure K, Noseda V, Ranasinghe S, Tully DC, Voronin Y, Warren M, Wibmer CK, Xie IY, Scarlatti G, Thyagarajan B.  2017.  HIVR4P 2016, partnering for prevention: conference summary and highlights. . AIDS Research and Human Retroviruses Journal . :.doi:10.1089/AID.2017.0125.