Drug Use Practices and Self-Treatment for Suspected Malaria in Ibadan, Nigeria.

Antimalarial drug failures have been reported anecdotally in Nigeria, and malarial self-treatment practices could be a contributing factor. This study was designed to assess the pattern of drug use practices and self-treatment options among caregivers in Ibadan, Nigeria. We carried out a descriptive cross-sectional study among 283 study participant pairs (children under 5 years of age with suspected malaria and their caregivers). Structured questionnaires were used as research instruments. The results indicated that most caregivers were mothers (88.8%), 69% of caregivers self-prescribed and self-managed malaria for children under 5 years old without immediate hospital visits, and 76.4% of the caregivers believed most recommended and available antimalarial drugs were ineffective. Generally, 44.2% of respondents preferred and used antibiotics as a treatment strategy for malaria, 13.2% used agbo (a locally made liquid extract of plants and roots), 12.5% used prayers, and 19.6% used antimalarial drugs. Overall, only 57.1% of respondents stated that they always complete the standard antimalarial dosage regimen. The choice of malaria self-treatment options was significantly linked to the level of education. The findings identified antibiotics, agbo, and prayers as the immediate choices for self-treating malaria disease in Ibadan. Furthermore, incomplete adherence to antimalarial drugs is a general practice in Ibadan. Malaria self-treatment policy and continuous education on antimalarial drug use tailored to the different literacy and education levels of the general public is hereby recommended to reduce the risk of development of parasite resistance to effective anti-malarial drugs.

Association Between Patient Factors and the Effectiveness of Wearable Trackers at Increasing the Number of Steps per Day Among Adults With Cardiometabolic Conditions: Meta-analysis of Individual Patient Data From Randomized Controlled Trials.

BACKGROUND: Current evidence supports the use of wearable trackers by people with cardiometabolic conditions. However, as the health benefits are small and confounded by heterogeneity, there remains uncertainty as to which patient groups are most helped by wearable trackers. OBJECTIVE: This study examined the effects of wearable trackers in patients with cardiometabolic conditions to identify subgroups of patients who most benefited and to understand interventional differences. METHODS: We obtained individual participant data from randomized controlled trials of wearable trackers that were conducted before December 2020 and measured steps per day as the primary outcome in participants with cardiometabolic conditions including diabetes, overweight or obesity, and cardiovascular disease. We used statistical models to account for clustering of participants within trials and heterogeneity across trials to estimate mean differences with the 95% CI. RESULTS: Individual participant data were obtained from 9 of 25 eligible randomized controlled trials, which included 1481 of 3178 (47%) total participants. The wearable trackers revealed that over the median duration of 12 weeks, steps per day increased by 1656 (95% CI 918-2395), a significant change. Greater increases in steps per day from interventions using wearable trackers were observed in men (interaction coefficient -668, 95% CI -1157 to -180), patients in age categories over 50 years (50-59 years: interaction coefficient 1175, 95% CI 377-1973; 60-69 years: interaction coefficient 981, 95% CI 222-1740; 70-90 years: interaction coefficient 1060, 95% CI 200-1920), White patients (interaction coefficient 995, 95% CI 360-1631), and patients with fewer comorbidities (interaction coefficient -517, 95% CI -1188 to -11) compared to women, those aged below 50, non-White patients, and patients with multimorbidity. In terms of interventional differences, only face-to-face delivery of the tracker impacted the effectiveness of the interventions by increasing steps per day. CONCLUSIONS: In patients with cardiometabolic conditions, interventions using wearable trackers to improve steps per day mostly benefited older White men without multimorbidity. TRIAL REGISTRATION: PROSPERO CRD42019143012; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143012.

Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: a randomised trial in Nigerian general practice.

BACKGROUND: In clinical practice, translating the benefits of a sustained physically active lifestyle on glycaemic control in patients with type 2 diabetes mellitus (T2DM) is difficult. A walking prescription may be an effective alternative. AIM: To examine the effect of a 10 000 steps per day prescription on glycaemic control of patients with T2DM. DESIGN AND SETTING: Forty-six adults with T2DM attending a general outpatient clinic were randomised into two equal groups. The intervention group was given goals to accumulate 10 000 steps per day for 10 weeks, whereas the control group maintained their normal activity habits. METHOD: Daily step count was measured with waist-mounted pedometer and baseline and endline average steps per day. Glycosylated haemoglobin (HbA1c), anthropometric, and cardiovascular measurements were also obtained. An intention-to-treat analysis was done. RESULTS: The average baseline step count was 4505 steps per day for all participants, and the average step count in the intervention group for the last 4 weeks of the study period was higher by 2913 steps per day (95% confidence interval [CI] = 1274 to 4551, F (2, 37.7) = 18.90, P<0.001). Only 6.1% of the intervention group participants achieved the 10 000 steps per day goal. The mean baseline HbA1c was 6.6% (range = 5.3 to 9.0). Endline HbA1c was lower in the intervention group than in the control group (mean difference -0.74%, 95% CI = -1.32 to -0.02, F = 12.92, P = 0.015) after adjusting for baseline HbA1c. There was no change in anthropometric and cardiovascular indices. CONCLUSION: Adherence to 10 000 steps per day prescription is low but may still be associated with improved glycaemic control in T2DM. Motivational strategies for better adherence would improve glycaemic control.

Comparative quantitative fatty acid analysis of triacylglycerols using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and gas chromatography.

Quantitative analyses of fatty acids from five triacylglycerol products, coconut oil, palm kernel oil, palm oil, lard and cocoa butter, were carried out using two analytical methods: matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) and gas chromatography (GC), in an effort to validate the application of MALDI-TOFMS in quantitative fatty acid analysis. For the GC analysis, transmethylated products were used, whereas, for the MALDI-TOF analysis, saponified products were used. Under MALDI-TOF conditions, the acids were detected as sodiated sodium carboxylates [RCOONa + Na](+) consistent with the mode of ionization that was previously reported. Thus, the MALDI-TOF mass spectrum of saponified coconut oil showed the presence of sodiated sodium salts of caprylic acid (7.5 +/- 0.67, m/z 189), capric acid (6.9 +/- 0.83, m/z 217), lauric acid (47.8 +/- 0.67, m/z 245), myristic acid (20.4 +/- 0.51, m/z 273), palmitic acid (9.8 +/- 0.47, m/z 301), linoleic acid (0.9 +/- 0.07, m/z 325), oleic acid (4.8 +/- 0.42, m/z 327) and stearic acid (2.0 +/- 0.13, m/z 329). Saponified palm kernel oil had a fatty acid profile that included caprylic acid (3.5 +/- 0.59), capric acid (4.7 +/- 0.82), lauric acid (58.6 +/- 2.3), myristic acid (20.9 +/- 1.5), palmitic acid (7.2 +/- 1.1), oleic acid (3.8 +/- 0.62) and stearic acid (1.2 +/- 0.15). Saponified palm oil gave myristic acid (0.83 +/- 0.18), palmitic acid (55.8 +/- 1.7), linoleic acid (4.2 +/- 0.51), oleic acid (34.5 +/- 1.5), stearic acid (3.8 +/- 0.26) and arachidic acid (0.80 +/- 0.22). Saponified lard showed the presence of myristic acid (1.5 +/- 0.24), palmitic acid (28.9 +/- 1.3), linoleic acid (13.7 +/- 0.67), oleic acid (38.7 +/- 1.4), stearic acid (12.8 +/- 0.64) and arachidic acid (2.4 +/- 0.35). Finally, for saponified cocoa butter, the fatty acid distribution was: palmitic acid (32.3 +/- 1.0), linoleic acid (2.6 +/- 0.35), oleic acid (34.9 +/- 1.7) and stearic acid (30.3 +/- 1.6). Quantitative gas chromatographic analysis of the corresponding methyl esters from these triacylglycerol products yielded data that were mostly in agreement with the MALDI-TOFMS data. The MALDI-TOF experiment, however, proved to be superior to the GC experiment, particularly with regard to baseline resolution of unsaturated acids. Furthermore, the ability of MALDI-TOFMS to detect low concentrations of fatty acids rendered it more sensitive than the GC methodology.

Characterization of partially transesterified poly(beta-hydroxyalkanoate)s by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) was used for the characterization of a partially transesterified poly(beta-hydroxyalkanoate) (PHA), a polymer produced by the bacterial strain Alcaligenes eutrophus with saponified vegetable oils as the sole carbon sources. The transesterification was carried out separately under acidic and basic conditions to obtain PHA oligomers weighing <10 kDa. The intact oligomers were detected in their cationized forms, [M + Na]+ and [M + K]+, by MALDI-TOFMS. A composition analysis, using the MALDI-TOF spectra, indicated that the oligomers obtained via acid catalysis contained a methyl 3-hydroxybutyrate end group, and those obtained by base catalysis had a methyl crotonate (olefinic) end group. In addition to hydroxybutyrate (HB), the oligomers were found to contain a small percentage of hydroxyvalerate, which was independently confirmed by gas chromatography/mass spectrometry. In comparison, analysis of a commercial PHA polymer, transesterified under identical conditions, showed only the presence of HB, i.e., a pure poly(HB) homopolymer.

Detection of cationic surfactants in oral rinses and a disinfectant formulation using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Three commercial oral rinses and one commercial disinfectant formulation were analyzed for the presence of cationic surfactants using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) in the positive ion mode. The product labels on these formulations indicate the presence of cetylpyridinium chloride, tetraalkylammonium or trialkylbenzylammonium chlorides. The resulting MALDI-TOF mass spectra only showed cetylpyridinium, tetraalkylammonium, and trialkylbenzylammonium ions, apparently due to the dissociation of the salts in the ion source. We confirmed the presence of cetylpyridinium salt in the three oral formulations, whereas the disinfectant formulation consisted of a complex mixture of the salts of dioctyldimethylammonium, didecyldimethylammonium, benzylmyristyldimethylammonium, decyloctyldimethylammonium, benzyldecyldimethylammonium, and benzylcetyldimethylammonium. This work demonstrates again the potential for using meso-tetrakis(pentafluorophenyl)porphyrin as a matrix in the MALDI-TOFMS analysis of low molecular weight compounds. This study also demonstrates that the mode of ionization of quaternary ammonium compounds (cationic surfactant salts) under MALDI conditions is by dissociation, leading to the detection of only the positively charged moieties.

Cathepsin B and complement C3 are major comigrants in the estrogen-induced peroxidase fraction of rat uterine fluid.

The luminal fluid of estrogen or DES-stimulated uterus of immature rats contains 10-12 isoforms of peroxidase between pI 4.5-6.0. N-terminal amino acid sequencing of diaminobenzidine-peroxidase bands eluted from IEF and SDS-PAGE gels showed the presence of cathepsin B and the complement family of proteins as the major comigrants. Sequential treatment of uterine fluid by cation, anion, and size exclusion chromatography resulted in a five-fold purification of peroxidase having a specific activity of 273 units/mg. Mass spectrometric studies of bands isolated from SDS-PAGE gels from the size-exclusion purified peroxidase fraction showed the presence of complement C3 along with novel previously uncharacterized proteins. Two dimensional electrophoresis followed by N-terminal amino acid sequencing confirmed the presence of cathepsin B isoforms and isoforms of a novel protein at approximately 87 kDa. Identification by mass spectrometry from the database for this novel protein was inconclusive but could most likely be a candidate for estrogen-induced peroxidase. Results conclusively prove that cathepsin B and complement C3 are major proteins in the estrogen-induced peroxidase fraction of uterine fluid.

Determination of the fatty acid composition of saponified vegetable oils using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

A method using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) for the determination of the fatty acid composition of vegetable oils is described and illustrated with the analysis of palm kernel oil, palm oil, olive oil, canola oil, soybean oil, vernonia oil, and castor oil. Solutions of the saponified oils, mixed with the matrix, meso-tetrakis(pentafluorophenyl)porphyrin, provided reproducible MALDI-TOF spectra in which the ions were dominated by sodiated sodium carboxylates [RCOONa + Na]+. Thus, palm kernel oil was found to contain capric acid, lauric acid, myristic acid, palmitic acid, oleic acid, and stearic acid. Palm oil had a fatty acid profile including palmitic, linoleic, oleic, and stearic. The relative percentages of the fatty acids in olive oil were palmitoleic (1.2 +/- 0.5), palmitic (10.9 +/- 0.8), linoleic (0.6 +/- 0.1), linoleic (16.5 +/- 0.8), and oleic (70.5 +/- 1.2). For soybean oil, the relative percentages were: palmitoleic (0.4 +/- 0.4), palmitic (6.0 +/- 1.3), linolenic (14.5 +/- 1.8), linoleic (50.1 +/- 4.0), oleic (26.1 +/- 1.2), and stearic (2.2 +/- 0.7). This method was also applied to the analysis of two commercial soap formulations. The first soap gave a fatty acid profile that included: lauric (19.4% +/- 0.8), myristic (9.6% +/- 0.5), palmitoleic (1.9% +/- 0.3), palmitic (16.3% +/- 0.9), linoleic (5.6% +/- 0.4), oleic (37.1% +/- 0.8), and stearic (10.1% +/- 0.7) and that of the second soap was: lauric (9.3% +/- 0.3), myristic (3.8% +/- 0.5), palmitoleic (3.1% +/- 0.8), palmitic (19.4% +/- 0.8), linoleic (4.9% +/- 0.7), oleic (49.5% +/- 1.1), and stearic (10.0% +/- 0.9). The MALDI-TOFMS method described in this communication is simpler and less time-consuming than the established transesterification method that is coupled with analysis by gas chromatography/mass spectrometry (GC/MS). The new method could be used routinely to determine the qualitative fatty acid composition of vegetable oils, and, when fully validated by comparison with standard analytical methodologies, should provide a relatively fast quantitative measurement of fatty acid mixtures and/or soap formulations that contain saturated and unsaturated hydrocarbon moieties.

Analysis of some commercial polysorbate formulations using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Analyses of polysorbate formulations (Tween 20, Tween 40, Tween 60, and Tween 80) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS) reveal a complex mixture of oligomers that include polyethylene glycols, polyethylene glycol esters, isosorbide polyethoxylates, sorbitan polyethoxylates, polysorbate monoesters, polysorbate diesters, and sorbitol polyethoxylate esters. The MALDI-TOF mass spectra for these formulations show the presence of sodiated molecules in which the major signals are attributed to the presence of polyethylene glycols, isosorbide polyethoxylates, and sorbitan polyethoxylates. Additionally, the complexity of the spectra was correlated to the constituent fatty acid moieties in the polysorbate formulations. Thus Tween 20 showed the presence of polysorbate monolaurates, polysorbate monomyristates, and polysorbate monopalmitates. Tween 40 contained polysorbate mono- and dipalmitates. Tween 60 contained polysorbate monopalmitates and polysorbate monostearates. For the Tween 80, mass assignment for polysorbate monooleates and polysorbate dioleates was equivocal, because both of these oligomeric series have the same molecular weight as the sorbitan polyethoxylates, and thus the Tween 80 MALDI-TOF spectrum appeared to be the least complicated of the four commercial polysorbate formulations.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry of cod liver oil and the effect of analyte/matrix concentration on signal intensities.

Cod liver oil (CLO) is known to contain a complex mixture of triacylglycerols (TAGs) in which the component fatty acids include: myristic (C(14:0), M), C(14:1) (M(1)), palmitic (C(16:0), P), palmitoleic (C(16:1), P(1)), stearic (C(18:0), S), oleic (C(18:1), O), linoleic (C(18:2), L), arachidic (C(20:0), A), C(20:1) (A(1)), eicosapentaenoic (EPA, C(20:5), A(5)), docosanoic (C(22:0), D), docosaenoic (C(22:1), D(1)), and docosahexaenoic (DHA, C(22:6), D(6)). Because of the presence of EPA and DHA in cod liver oil, it has been used for several generations as a nutritional supplement, and recommended for the relief of various physiological ailments including arthritis, depression, and high blood pressure. Consequently, it was of interest to develop a sample preparation protocol that would enable rapid screening of such a chemically complex and nutritionally useful oil. Thus, we have analyzed two commercial brands of cod liver oil by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS). There was no significant difference between the mass spectral profile of the two CLO brands. alpha-Cyano-4-hydroxycinnamic acid, dissolved in acetonitrile/tetrahydrofuran, was used as the matrix. MALDI-TOFMS produced only sodiated triacylyglycerol molecules [M + Na](+). Based on the sodiated TAGs, 64 TAG assignments were made, and these include MM(1)L, MML, MMO and MMS, M(1)P(1)L MP(1)L, P(1)P(1)P, PPP, P(1)P(1)Ln, P(1)PLn, PPL, PPO, P(1)LnLn, PLnLN, PLLn, PLL, POL, POO, P(1)A(6)Ln, P(1)A(5)Ln, P(1)A(5)L, PA(5)L PA(5)O, PP(1)D(6), OOL, OOO, SOO, SSS, P(1)LnD(6), PLnD(6), PLD(6), POD(6) (or P(1)A(5)A(1)), PA(5)A(1), OLA, OLA(1), SLA(1), SOA(1), SSA, LA(5)A(5) (or P(1)A(5)D(6)), OA(5)A(5) (or PA(5)D(6)), SA(5)A(5), LnA(1)A(5), OOD(6), SOD(6), SSD(6), LA(1)D(6), OA(1)D(6), OA(5)D(6), SA(5)D(6), SA(5)D(5), D(6)A(1)O, D(6)A(1)S, D(1)A(1)O, DA(1)O, D(1)D(6)O, and DD(6)O. The sample preparation method developed in this study could be used for the routine screening of oils that contain similar types of polyunsaturated TAGs.

Exocrine secretions of bees V. Terpenoid esters in the Dufour's secretions ofPanurginus bees (Hymenoptera: Andrenidae).

The volatile components of Dufour's gland extracts were analyzed in two species of HolarcticPanurginus bees:Panurginus pontentillae andP. atramontensis. Two terpenoid esters, citronellyl citronellate and citronellyl geranate, were identified inP. pontentillae, whereas only the latter was inP. atramontensis. Citronellyl citronellate was identified in pollen ball extracts ofP. pontentillae. Mandibular gland extracts from male and femaleP. pontentillae contained neral and geranial. The significance of the Dufour's gland secretion in andrenid systematics and its function in the Andrenidae are discussed.

Volatile components of the occipital gland secretion of the bactrian camel (Camelus bactrianus).

The male Bactrian camel's occipital scent gland produces a series of steroids including 5α-androst-16-en-3-one in addition to a series of fatty acids and γ-dodecalactone. 3-Methylbutanoic acid is the most volatile of the acids which include hexanoic, a decenoic, and the saturated acids from C15 to C25 with the exception of C24. The constitution of this secretion changes appreciably with the season.

Constituents of temporal gland secretion of the African elephant,Loxodonta africana.

Temporal gland secretion (TGS), obtained from 15 different mature African elephants in Kruger National Park was analyzed for volatile constituents. Only five volatile components were present.p-Cresol was present in all samples, but phenol was found as an appreciable component of only one sample and as trace amounts in six others. Three sesquiterpenes were identified, the latter two being new natural products:E-farnesol, farnesol hydrate (3,7,11-trimethyl-2,10-dodecadien-1,7-diol), and farnesol dihydrate (3,7,11-trimethyl-2-dodecen-1,7,11-triol). These sesquiterpenes represent the first isolated from mammals. Ten samples of TGS, serum, and saliva were assayed for cholesterol, urea, and proteins including several enzymes.