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The investment decisions of small-scale farmers in developing countries are conditioned by their financial environment. Binding credit market constraints and incomplete insurance can limit investment in activities with high expected profits. We conducted several experiments in northern Ghana in which farmers were randomly assigned to receive cash grants, grants of or opportunities to purchase rainfall index insurance, or a combination of the two. Demand for index insurance is strong, and insurance leads to significantly larger agricultural investment and riskier production choices in agriculture. The binding constraint to farmer investment is uninsured risk: when provided with insurance against the primary catastrophic risk they face, farmers are able to find resources to increase expenditure on their farms. Demand for insurance in subsequent years is strongly increasing with the farmer’s own receipt of insurance payouts, with the receipt of payouts by others in the farmer’s social network and with recent poor rain in the village. Both investment patterns and the demand for index insurance are consistent with the presence of important basis risk associated with the index insurance, imperfect trust that promised payouts will be delivered and overweighting recent events.

The study investigated how phytobiotic‐supplemented diets impact the growth performance, feed utilisation and resistance of Nile tilapia ( Oreochromis niloticus ) to Streptococcus agalactiae . Fish with a total mean initial mass (37.6 g) of 180 and a random stocking of 15 fingerlings per 150 L tank in triplicate were divided into four groups and fed isonitrogenous (299 g kg −1 crude protein) and isoenergetic (15.7 kJ g −1 gross energy) control diets supplemented with 1% turmeric ( Curcuma longa ; TUD), garlic ( Allium sativum ; GAD) and ginger ( Zingiber officinale ; GID) powder for 56 days. After the trial period, growth performance, feed utilisation and blood health were measured. Ten fish from each replicate were infected with S. agalactiae and mortality was observed for 14 days. The results showed a significantly higher weight gain (g), specific growth rate (SGR; %/day) and average daily growth (ADG; g) in GAD (80.3 ± 1.0, 2.04 ± 0.05 and 1.434 ± 0.02, respectively) and GID (77.03 ± 0.8, 2.0 ± 0.04 and 1.376 ± 0.01, respectively) compared to the control group (60.4 ± 2.5, 1.71 ± 0.02 and 1.079 ± 0.04, respectively). However, these metrics were not significantly higher in TUD (63.8 ± 2.2, 1.8 ± 0.05 and 1.139 ± 0.04, respectively) when compared to the control group. TUD, GAD and GID feed conversion ratio (FCR) and efficiency, as well as protein efficiency ratio (PER), were improved as compared to the control. The haemoglobin (HGB), haematocrit (HCT), platelets (PLTs), white blood cells (WBCs), serum biochemistry and respiratory burst activity (RBA) of TUD, GAD and GID were significantly better than the control. Lysozyme and bactericidal activities were also significantly improved in TUD, GAD and GID as compared to the control. Following the S. agalactiae infection, the fish survival rates of GAD (67.7%), GID (53.3%) and TUD (46.7%) were better than those of the control (26.3%). Dietary supplementation with the above‐mentioned phytobiotics in Nile tilapia culture can help to increase production in view of the current challenges posed by the increased incidence of disease in fish farms. They are recommended to enhance growth, immunity and resistance to disease.

The rapid advancement of the Internet of Vehicles (IoV) has led to a massive growth in data received from IoV networks. The cloud storage has been a timely service that provides a vast range of data storage for IoV networks. However, existing data storage and access models used to manage and protect data in IoV networks have proven to be insufficient. They are centralized and usually accompanied by a lack of trust, transparency, security, immutability, and provenance. In this paper, we propose VBlock, a blockchain-based system that addresses the issues of illegal modification of outsourced vehicular data for smart city management and improvement. We introduce a novel collusion-resistant model for outsourcing data to cloud storage that ensures the network remains tamper-proof, has good data provenance and auditing, and solves the centralized problems prone to the single point of failure. We introduced a key revocation mechanism to secure the network from malicious nodes. We formally define the system model of VBlock in the setting of a consortium blockchain. Our simulation results and security analysis show that the proposed model provides a strong security guarantee with high efficiency and is practicable in the IoV environment.

In low-resource settings, it is challenging to ascertain the burden and causes of under-5 mortality as many deaths occur outside health facilities. We aimed to determine the causes of childhood deaths in rural Gambia using verbal autopsies (VA). We used WHO VA questionnaires to conduct VAs for deaths under-5 years of age in the Basse and Fuladu West Health and Demographic Surveillance Systems (HDSS) in rural Gambia between September 01, 2019, and December 31, 2021. Using a standardized cause of death list, two physicians assigned causes of death and discordant diagnoses were resolved by consensus. VAs were conducted for 89% (647/727) of deaths. Of these deaths, 49.5% (n = 319) occurred at home, 50.1% (n = 324) in females, and 32.3% (n = 209) in neonates. Acute respiratory infection including pneumonia (ARIP) (33.7%, n = 137) and diarrhoeal diseases (23.3%, n = 95) were the commonest primary causes of death in the post-neonatal period. In the neonatal period, unspecified perinatal causes of death (34.0%, n = 71) and deaths due to birth asphyxia (27.3%, n = 57) were the commonest causes of death. Severe malnutrition (28.6%, n = 185) was the commonest underlying cause of death. In the neonatal period, deaths due to birth asphyxia (p-value<0.001) and severe anaemia (p-value = 0.03) were more likely to occur at hospitals while unspecified perinatal deaths (p-value = 0.01) were more likely to occur at home. In the post-neonatal period, deaths due to ARIP (p-value = 0.04) and diarrhoeal disease (p-value = 0.001) were more likely to occur among children aged 1-11 months and 12-23 months respectively. According to VA analysis of deaths identified within two HDSS in rural Gambia, half of deaths amongst children under-5 in rural Gambia occur at home. ARIP and diarrhoea, and the underlying cause of severe malnutrition remain the predominant causes of child mortality. Improved health care and health-seeking behaviour may reduce childhood deaths in rural Gambia.

Background The migration of healthcare professionals from developing countries to more developed nations poses a significant challenge to healthcare systems in low- and middle-income countries. This study aimed to determine the proportion of doctors in Ghana who intend to migrate abroad and to identify the sociodemographic and \"pull and push\" factors that influence their intention. Methodology A cross-sectional survey was conducted among doctors in Ghana between March 1, 2024, and March 15, 2024, via an online-based semi-structured questionnaire. Doctors working in Ghana, regardless of nationality, were included. Descriptive statistics and logistic regression analyses were conducted to identify factors associated with the intention to emigrate. Statistical significance was set at a p -value of < 0.05. Results Almost all the doctors who responded to the questionnaire consented to participate (99.4%, 641/645). More than half (53.8%, n = 345) of the respondents were medical officers. Most respondents intended to migrate to practice abroad (71.8%, n = 460). The United States (59.7%), the United Kingdom (39.1%), and Canada (34.8%) were the most preferred destinations. After adjusting for covariates, young doctors between 20–29 years [(Adjusted Odd Ratios) AOR = 2.69, 95% CI = 1.13—6.39)], male doctors (AOR = 1.53, 95% CI = 1.04—2.25), doctors in lower professional ranks, and doctors in the field of diagnostics (AOR = 5.70, 95% CI = 1.16 – 28.03) had significantly higher odds of intending to migrate. In descending order of magnitude, the respondents strongly agreed that better remuneration (1.22 ± 0.63), better quality of life (1.22 ± 0.67), better working conditions (1.26 ± 0.69), and better postgraduate training (1.41 ± 0.80) were pull factors. The push factors were economic challenges (1.17 ± 0.49), a lack of a conducive working environment (1.56 ± 0.86), slow career progression (1.95 ± 1.07), excessive workload (2.07 ± 0.12), personal circumstances (2.26 ± 1.19), and poor postgraduate training (2.48 ± 1.22). Conclusion A substantial proportion of doctors in Ghana are considering emigration, driven by a combination of attractive opportunities abroad and challenging conditions in Ghana. Addressing these issues through improved remuneration, better working environments, and enhanced career development and training opportunities is crucial to retaining healthcare professionals.

Objectives We determined the prevalence and risk factors of hypertension among public servants of Ejisu Juaben municipality. Results The overall prevalence of hypertension was 29.3% (95%CI:22.5–36.1%) and only 8.6% of the participants were aware of their hypertensive status. Respondents who were > 40 years were twice as likely to develop hypertension compared to those who were ≤ 40 years [adjusted odds ratio (AOR) = 2.37, 95% confidence interval (CI) 1.05–5.32]. Those who were married were 2.54 times more likely to be hypertensive compared with those unmarried [AOR = 2.54, 95%CI: 1.06–6.08]. Compared to health workers, Judicial and Security service workers were almost five times more likely to be hypertensive [AOR = 4.77, 95%CI: 1.20–18.96]. Being overweight [AOR = 2.25, 95%CI: 1.06–6.41] and obese [AOR = 4.80, 95%CI: 1.82–12.91] was associated with increased odds of hypertension. The prevalence of hypertension among the participants in this study is high. Employee wellness programs are needed at workplaces and the Ghana Health Service must adopt targeted intervention programs such as regular screening for non-communicable diseases and promotion of physical activities at the workplace.

Civil structural component detection plays an integral role in Structural Health Monitoring (SHM) pre and post-construction. Challenges including but not limited to labor-intensiveness, cost, and time constraints associated with traditional methods make it a less opti-mal approach in SHM. Despite the success of deep convolutional neural networks in diverse detection problems, the required computational resources are a challenge. This has led to rendering a chunk of resource-constrained edge nodes less applicable with deep convolutional neural networks. In this paper, a computational-efficient deep convolutional neural network is presented based on Gabor filters and a color Canny edge detector. Generic Gabor filters are generated and used as initializers in the computational-efficient deep convolutional neural network presented, afterward trained on building components data. Next, extensive offline and online experimentation with a resource-constrained edge node is conducted and evaluated using diverse metrics. The computational-efficient detection model demonstrates to be effective in detection and via NVIDIA GPU profiler, we observe conservation of around 30% of computational resources during training. The computational-efficient detection model adduces almost a 3% mean average precision higher than two state-of-the-art detectors and records a promising frame processing rate during the online experimentation.

Heavy metal contamination in aquatic ecosystems poses a serious threat to both fish and human health. The research evaluated the levels of five major heavy metals, cadmium, lead, arsenic, copper, and mercury, and six physicochemical properties, including temperature, pH, dissolved oxygen (DO), electrical conductivity, salinity, and total dissolved solids (TDSs), in the Barekese Reservoir and its tributaries in Ghana’s Ashanti Region. The study hypothesizes that heavy metal contamination in the Barekese Reservoir and its tributaries varies seasonally and spatially, with some levels exceeding international safety standards. Sampling was conducted over 2 months, representing both wet and dry seasons, using a spatially stratified method. Water and sediment were sampled from three designated zones spanning the reservoir and its connecting tributaries, while fish samples ( Coptodon zillii and Sarotherodon galilaeus ) were obtained from local fishermen. All samples were analyzed using atomic absorption spectroscopy. Sediment contamination was evaluated using the geo‐accumulation index (I‐geo), contamination factor (CF), and pollution load index (PLI). Lead, cadmium, mercury, and arsenic in treated water (TW) and in samples from the reservoir and its tributaries were higher than the World Health Organization (WHO)‐recommended limits for drinking water, while copper levels remained below permissible limits. In sediments, cadmium and copper concentrations surpassed the USEPA guideline values, whereas lead, arsenic, and mercury levels remained within safe limits. Physicochemical parameters across all sampling points were within WHO acceptable ranges. The I‐geo indicated moderate cadmium pollution (1 < I‐geo ≤ 2) at the Dam site, Subinso, and tributary sampling points. High CF values were recorded for cadmium, arsenic, and mercury in sediments from the reservoir and tributaries. Arsenic concentrations in fish tissues ranged between 0.03 ± 0.02 and 0.36 ± 0.12 mg kg −1 , while mercury levels varied from 2.79 ± 0.37 to 5.50 ± 0.04 mg kg −1 , both of which were significantly above the WHO’s recommended limits of 0.01 mg kg −1 for arsenic and 0.004 mg kg −1 for mercury. The findings highlight potential public health risks, recommending awareness creation about consuming contaminated fish and untreated water, and promoting sustainable land use practices in the reservoir’s catchment to mitigate heavy metal pollution.

Background Close contact between an infectious and susceptible person is an important factor in respiratory disease transmission. Information on social contacts and mixing patterns in a population is crucial to understanding transmission patterns and informing transmission models of respiratory infections. Although West Africa has one of the highest burdens of respiratory infections, there is a lack of data on interpersonal contact and mixing patterns in this region. Methods Between January and November 2022, we conducted a cross-sectional, social contact survey within the population of the Central and Upper River Regions of The Gambia. Selected participants completed a questionnaire about their travel history and social contacts, detailing the number, intensity, location, frequency, duration, and age of contacts. We calculated age-standardized contact matrices to determine contact patterns in the population. Results Overall, individuals made an average of 12.7 (95% CI: 12.4–13.0) contacts per day. Contact patterns were mostly age-assortative and 84.5% of all contacts were physical. School-aged children (5–14 years) had the highest mean number of physical contacts (11.3, 95% CI: 10.9–11.8) while the < 1-year age group had the fewest contacts (9.4, 95% CI: 9.1–9.8). A large proportion of contacts (78%) occurred at home. Daily number of contacts increased with household size. While we did not observe any effect of gender on contact patterns, there were seasonal variations in contact type. Non-physical contacts were higher during the dry season compared to the rainy season. In contrast, there were more physical contacts in the rainy season compared to the dry season. Conclusions In rural Gambia, social contact patterns were primarily driven by household mixing. Most contacts were physical and mostly age-assortative, particularly among school-aged children. Our data can improve infectious disease transmission models of respiratory pathogens in high-transmission settings, which are valuable for optimizing the delivery of different interventions.

Rationale The effectiveness of immunisation with pneumococcal conjugate vaccine (PCV) has been demonstrated in many countries. However, the global impact of PCV is limited by its cost, which has prevented its introduction in some countries. Reducing the cost of PCV programmes will facilitate further vaccine introductions and improve the sustainability of PCV in low-income countries when they transition from subsidised vaccine supply. We are conducting a large, population-level, cluster-randomised field trial (PVS) of an alternative reduced-dose schedule of PCV compared to the standard schedule. We are also conducting a nested sub-study at the individual level to investigate the immunogenicity of the two schedules and their effects on pneumococcal carriage acquisition (PVS-AcqImm). Methods and design PVS-AcqImm is a prospective, cluster-randomised trial of an alternative schedule of one dose of PCV scheduled at age 6 weeks with a booster dose at age 9 months compared to the standard of three primary doses scheduled at 6, 10, and 14 weeks of age. Sub-groups within the alternative schedule group receive yellow fever vaccine separately or co-administered with PCV at 9 months of age. The primary endpoints are (a) concentrations of vaccine-type anti-pneumococcal IgG at 18 months of age, (b) proportions with yellow fever neutralising antibody titre ≥ 1:8 4 weeks after separate or co-administration of PCV and yellow fever vaccines, and (c) rate of nasopharyngeal vaccine-type pneumococcal acquisition from 10–14 months of age. Participants and field staff are not masked to group allocation while measurement of the laboratory endpoints is masked. Approximately equal numbers of participants are resident in each of 28 randomly allocated geographic clusters (14 clusters in each group); 784 enrolled for acquisition measurements and 336 for immunogenicity measurements. Purpose This statistical analysis plan (SAP) describes the PVS-AcqImm cohort and follow-up criteria to be used in different analyses. The SAP defines the endpoints and describes how adherence to the interventions will be presented. We describe the approach to analyses and how we will account for the effect of clustering. Defining the SAP prior to the conduct of analysis will avoid bias in analyses that may arise from prior knowledge of trial findings. Trial registration ISRCTN, ISRCTN7282161328. Registered on 28 November 2019. https://www.isrctn.com/ISRCTN72821613 . Protocol: MRCG SCC number 1670, LSHTM Ref 17683. Current protocol version: 6.0, 24 May 2021. Version: 1.0 (5 April 2023); SAP revisions—none.