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Abstract Background Bacterial pathogens such as Staphylococcus aureus colonize body surfaces of part of the human population, which represents a critical risk factor for skin disorders and invasive infections. However, such pathogens do not belong to the human core microbiomes. Beneficial commensal bacteria can often prevent the invasion and persistence of such pathogens by using molecular strategies that are only superficially understood. We recently reported that the commensal bacterium Staphylococcus lugdunensis produces the novel antibiotic lugdunin, which eradicates S. aureus from the nasal microbiomes of hospitalized patients. However, it has remained unclear if S. lugdunensis may affect S. aureus carriage in the general population and which external factors might promote S. lugdunensis carriage to enhance its S. aureus-eliminating capacity. Results We could cultivate S. lugdunensis from the noses of 6.3% of healthy human volunteers. In addition, S. lugdunensis DNA could be identified in metagenomes of many culture-negative nasal samples indicating that cultivation success depends on a specific bacterial threshold density. Healthy S. lugdunensis carriers had a 5.2-fold lower propensity to be colonized by S. aureus indicating that lugdunin can eliminate S. aureus also in healthy humans. S. lugdunensis-positive microbiomes were dominated by either Staphylococcus epidermidis, Corynebacterium species, or Dolosigranulum pigrum. These and further bacterial commensals, whose abundance was positively associated with S. lugdunensis, promoted S. lugdunensis growth in co-culture. Such mutualistic interactions depended on the production of iron-scavenging siderophores by supportive commensals and on the capacity of S. lugdunensis to import siderophores. Video Abstract Conclusions These findings underscore the importance of microbiome homeostasis for eliminating pathogen colonization. Elucidating mechanisms that drive microbiome interactions will become crucial for microbiome-precision editing approaches.

Histopathological studies have been established as effectual and sensitive tools for monitoring fish health. This study evaluated histopathological changes in African catfish fed with herbal additives. African Catfish juveniles (210) with an average weight of 117.3g and average length of 26.7cm were randomized into ten sub-groups and fed diets containing Allium sativum, Chromoleana odorata, and Talinum triangulare; 0.5%, 1.0%, and 3% concentrations, each of the herbal plants and 0% (control) for 42 days and changes in the visceral organs were investigated. Fish were sacrificed on the 43rd day and their visceral organs were collected and fixed in bouin’s fluid for 24h, washed with 10% formalin, and dehydrated through a graded series of ethanol. Collected organs were embedded in paraffin, sectioned at 4-5um thickness, stained with Hematoxylin and Eosin, and scanned with a light microscope. The intestine, gill, liver, and kidney of control and fish fed with 0.5% Allium sativum showed no damage. However, effects ranging from slight lamellae hyperplasia to noticeable lamellae hyperplasia were detected in the gills of the fish nurtured with 3.0% inclusion rates of C. odorata and T. triangulare. Epithelial necrosis and atrophy of tubules in the kidney at a 3.0 % inclusion rate of C. odorata were detected. In conclusion, Allium sativum, Chromoleana odorata, and Talinum triangulare could be included at lower inclusion rates of 0.5 – 1% into Clarias gariepinus feed for prime performance.

Abstract Extracting longitudinal image quantitative data, known as delta-radiomics, has the potential to capture changes in a patient’s anatomy throughout the course of radiation treatment for prostate cancer. Some of the major challenges of delta-radiomics studies are contouring the structures for individual fractions and accruing patients’ data in an efficient manner. The manual contouring process is often time consuming and would limit the efficiency of accruing larger sample sizes for future studies. The problem is amplified because the contours are often made by highly trained radiation oncologists with limited time to dedicate to research studies of this nature. This work compares the use of automated prostate contours generated using a deformable image-based algorithm to make predictive models of genitourinary and changes in total international prostate symptom score in comparison to manually contours for a cohort of fifty patients. Area under the curve of manual and automated models were compared using the Delong test. This study demonstrated that the delta-radiomics models were similar for both automated and manual delta-radiomics models.

Background. To investigate the impact of intrapatient variability (IPV) in the levels of immunosuppressant drugs on health outcomes after liver transplantation. Methods. A comprehensive systematic review and meta-analysis were conducted, examining literature from MEDLINE/PubMed, Embase, Web of Science, Cochrane Reviews, and Cochrane CENTRAL. Results. The analysis focused on acute rejection, graft survival, acute kidney injury, and cancer risk as health outcomes. Of 2901 articles screened, 10 met the inclusion criteria. The results indicate a 19% reduction in the risk of acute rejection in patients with lower IPV (RR = 0.81; 95% confidence interval, 0.66-0.99), although 6 studies found no significant association between high IPV and acute rejection. Contrasting results were observed for graft survival, with 1 study indicating worse outcomes for high IPV, whereas another reported no significant difference. High IPV was consistently associated with acute kidney injury across 3 studies. One study suggested a link between high IPV and hepatocellular carcinoma, although a meta-analysis for these outcomes was not feasible. Conclusions. These findings point to a marginal but statistically significant association between high IPV and an increased risk of acute rejection, highlighting the importance of precise management of immunosuppressive drugs in liver transplant recipients to enhance patient outcomes.

Pigeon pea (Cajanus cajan (L.) Millsp.), a potential legume as an economic source of protein, is commonly cultivated in tropical and subtropical regions of the world. It possesses medicinal properties and acts as a cash crop, benefiting low-income farmers economically. The identification of pigeon peas exhibiting drought tolerance has become crucial in addressing water scarcity issues in the agriculture sector. In addition, exploring the genetic diversity among genotypes is important for conservation, management of genetic resources, and breeding programs. The aim of this study was to evaluate the morpho-physiological and biochemical responses of selected pigeon pea genotypes under pot-induced water stress conditions through different field capacities as well as the genetic diversity using start codon targeted (SCoT) markers. A significant variation was observed for the physiological traits studied. The accumulation of fresh weight (FW) and dry weight (DW) was significantly reduced in moderate and severe drought stress conditions. The lowest % DW decrease was found in LM (35.39%), KAT (39.43%), and SM (46.98%) than other genotypes at severe drought stress. Analyses of physiological responses including the photosynthetic efficiency (Phi2), the chlorophyll content (SPAD), and the relative water content (RWC) revealed positive and negative correlations with various parameters, reflecting the impact of drought stress on the chlorophyll content. The results revealed that biochemical traits including the total phenolic content, soluble sugars, proline, total protein, total amino acids, and free amino acids were variably and significantly increased under water stress. Antioxidant enzyme activity levels, specifically ascorbate peroxidase (APX) and catalase, varied among the genotypes and in response to severe water stress, offering further insights into adaptive responses. The eight genotypes analysed by use of 20 SCoT markers revealed 206 alleles and an average of 10.3 alleles per locus. Genetic similarity ranged from 0.336 to 0.676, clustering the pigeon pea genotypes into two major groups by the unweighted pair group method of arithmetic averages (UPGMA) cluster analysis. Principal coordinate analysis (PCoA) explained 43.11% of genetic variation and based on analysis of molecular variance, a high genetic variation (80%) within populations was observed, emphasizing the potential for genetic improvement. Among the eight genotypes studied, LM and KAT were drought tolerant and genetically diverse and therefore could be used as parents for developing drought tolerance in pigeon pea.

BackgroundAllergen-specific immunotherapy (AIT) is able to restore immune tolerance to allergens in allergic patients. However, some patients do not or only poorly respond to current treatment protocols. Therefore, there is a need for deeper mechanistic insights and further improvement of treatment strategies. The relevance of the aryl hydrocarbon receptor (AhR), a ligand-dependent transcription factor, has been investigated in several inflammatory diseases, including allergic asthma. However, its potential role in AIT still needs to be addressed.MethodsA murine model of AIT in ovalbumin-induced allergic airway inflammation was performed in AhR-deficient (AhR-/-) and wild-type mice. Furthermore, AIT was combined with the application of the high-affinity AhR agonist 10-chloro-7H-benzimidazo[2,1-a]benzo[de]iso-quinolin-7-one (10-Cl-BBQ) as an adjuvant to investigate the effects of AhR activation on therapeutic outcome.ResultsAlthough AhR-/- mice suffer stronger allergic responses than wild-type mice, experimental AIT is comparably effective in both. Nevertheless, combining AIT with the administration of 10-Cl-BBQ improved therapeutic effects by an AhR-dependent mechanism, resulting in decreased cell counts in the bronchoalveolar fluid, decreased pulmonary Th2 and Th17 cell levels, and lower sIgE levels.ConclusionThis study demonstrates that the success of AIT is not dependent on the AhR. However, targeting the AhR during AIT can help to dampen inflammation and improve tolerogenic vaccination. Therefore, AhR ligands might represent promising candidates as immunomodulators to enhance the efficacy of AIT.

Background and Aim: Despite the plethora of drugs currently available, neurodegenerative diseases are leading cause of morbidity and mortality globally. Hence, there is a need for the development of more alternatives that are safe, efficient, and effective. In Nigeria, the leaves of Cnidoscolus aconitifolius are used ethnomedicinally for the management of central nervous system related disorders such as convulsion and anxiety. In this study, we evaluated some neuropharmacological effects of the methanol leaf extract of C. aconitifolius (CAE) in mice. Methods: Different groups of mice (n = 5) were administered 100, 200 and 400 mg/kg of CAE and then evaluated for sedative-hypnotic, anxiolytic, antidepressant, anticonvulsant, and muscle relaxant properties using standard protocols. Results: The onset of sleep was significantly reduced (P < 0.001), and sleep duration was significantly (P < 0.01) prolonged at doses of 200 and 400 mg/kg. All doses of the extract significantly (P < 0.05) reduced the number of head dips in hole-board test. In elevated plus maze test, the dose of 400 mg/kg increased (P < 0.05) the number of open arm entries without altering the time spent in the open arms of the maze. At 400 mg/kg, there was a significant (P < 0.05) reduction in the duration of immobility in forced swimming test. Doses of 200 and 400 mg/kg of the extract reduced (P < 0.05) the duration of immobility in the tail suspension test. The extract did not exhibit any anticonvulsant effect either in chemically induced or electrically induced models, and there was no significant alteration in motor coordination in extract-treated mice. Conclusion: Our results showed that CAE possesses sedative-hypnotic and antidepressant properties but lack anticonvulsant, anxiolytic and muscle relaxant actions in mice.

This research provides a comprehensive literature overview and bibliometric evaluation of multi-agent system (MAS) implementation in energy demand response (DR) to identify gaps. The review encompasses 39 relevant papers from searches in three academic databases, focusing on studies published from 2012 to the middle of 2023. The review includes MAS frameworks, optimization algorithms, communication protocols, market structures and evaluation methodologies. Bibliometric analysis of 587 documents from the search on the Scopus database identified prolific authors, influential articles and collaborative networks within the field. The findings reveal growing research interest in implementing an MAS for DR, focusing on integrating intelligent agents into electricity grids to enable effective load management and enhance grid stability. Additionally, the review outlines potential research directions, including exploring advanced MAS techniques, interoperability challenges, policy implications and the integration of renewable energy sources.

Abstract Providing intravenous (IV) fluids to a patient with signs or symptoms of hypoperfusion is common. However, evaluating the IV fluid ‘dose–response’ curve of the heart is elusive. Two patients were studied in the emergency department with a wireless, wearable Doppler ultrasound system. Change in the common carotid arterial and internal jugular Doppler spectrograms were simultaneously obtained as surrogates of left ventricular stroke volume (SV) and central venous pressure (CVP), respectively. Both patients initially had low CVP jugular venous Doppler spectrograms. With preload augmentation, only one patient had arterial Doppler measures indicative of significant SV augmentation (i.e., ‘fluid responsive’). The other patient manifested diminishing arterial response, suggesting depressed SV (i.e., ‘fluid unresponsive’) with evidence of ventricular asynchrony. In this short communication, we describe how a wireless, wearable Doppler ultrasound simultaneously tracks surrogates of cardiac preload and output within a ‘Doppler Starling curve’ framework; implications for IV fluid dosing are discussed.

Pesticide residues and heavy metal content of cassava, yam, cocoyam, potato, water yam and carrot were evaluated by gas chromatography–mass spectrometry and atomic absorption spectroscopy. The detected pesticide residues in the samples were 2,4-dichlorophenoxyacetic acid, glyphosate, hexachlorobenzene (HCB), dichlorobiphenyl, aldrin, endosulfan, profenofos, g-chlordane, carbofuran, biphenyl, heptachlor, lindane and t-Nonachlor. The concentration of HCB ranged between 0.0799 ± 0.06 mg/kg and 0.1596 ± 0.00 mg/kg, which was greater than the permitted maximum limit of 0.5 mg/kg established by the US Environmental Protection Agency. The concentration of aldrin and profenofos detected was lower than the predetermined maximum allowed limits. Endosulfan concentrations in cocoyam (0.2500 mg/kg) and potato (0.3265 mg/kg) were higher than the limits allowed by the Canadian Department of Industrial Research. The heavy metals detected in these samples include cobalt, nickel, lead, manganese, chromium, arsenic and mercury in at least one of the samples evaluated. There was not much difference between the concentration of cobalt in yam (0.036 mg/kg) and the maximum allowed concentration (0.043 mg/kg). Lead was detected in potatoes and carrots but was below detectable concentration in cassava, yam, cocoyam and water yam. Similarly, cocoyam was found to have a significant mercury content (0.658 mg/kg), but mercury content was below detectable concentrations in cassava, yam and water yam. Significance: Heavy metal pollutants and pesticide residues can impair human health, and their presence in food can cause various illnesses and health issues. It is important to prevent exposure to these contaminants and ensure that food is safe by identifying and monitoring them. Farmers may provide consumers with more assurance that their products are safe by identifying and monitoring pesticide residues and heavy metal contamination in these food crops. Overall, it is crucial to find and monitor pesticide residues and heavy metal contamination in food to safeguard customer confidence, ensure legal compliance and preserve human health.

Summary: Background: The Global Breast Cancer Initiative (GBCI) Framework, launched by the World Health Organisation (WHO) in 2023, emphasises assessing, strengthening, and scaling up services for the early detection and management of breast cancer. This study aims to determine the feasibility of monitoring the status of breast cancer control in the 21 Asian National Cancer Centers Alliance (ANCCA) countries based on the three GBCI Framework key performance indicators (KPIs): stage at diagnosis, time to diagnosis, and treatment completion. Methods: We reviewed published literature on breast cancer control among 21 ANCCA countries from May to July 2023 to establish data availability and compiled the latest descriptive statistics and sources of the indicators using a standardised data collection form. We performed bivariate Pearson's correlation analysis to measure the strength of correlation between stage at diagnosis, mortality and survival rates, and universal health coverage. Findings: Only 12 (57%) ANCCA member countries published national cancer registry reports on breast cancer age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR). Indonesia, Myanmar, and Nepal had provincial data and others relied on WHO's Global Cancer Observatory (GLOBOCAN) estimates. GLOBOCAN data differed from the reported national statistics by 5–10% in Bhutan, Indonesia, Iran, the Republic of Korea, Singapore, and Thailand and >10% in China, India, Malaysia, Mongolia, and Sri Lanka. The proportion of patients diagnosed in stages I and II strongly correlated with the five-year survival rate and with the universal health coverage (UHC) index. Three countries (14%) reported national data with >60% of invasive breast cancer patients diagnosed at stages I and II, and a five-year survival rate of >80%. Over 60% of the ANCCA countries had no published national data on breast cancer staging, the time interval from presentation to diagnosis, and diagnosis to treatment. Five (24%) countries reported data on treatment completion. The definition of delayed diagnosis and treatment completion varied across countries. Interpretation: GBCI's Pillar 1 KPI correlates strongly with five-year survival rate and with the UHC index. Most ANCCA countries lacked national data on cancer staging, timely diagnosis, and treatment completion KPIs. While institutional-level data were available in some countries, they may not represent the nationwide status. Strengthening cancer surveillance is crucial for effective breast cancer control. The GBCI Framework indicators warrant more detailed definitions for standardised data collection. Surrogate indicators which are measurable and manageable in country-specific settings, could be considered for monitoring GBCI indicators. Ensuring UHC and addressing health inequalities are essential to early diagnosis and treatment of breast cancer. Funding: Funding for this research article's processing fee (APC) will be provided by the affiliated institution to support the open-access publication of this work. The funding body is not involved in the study design; collection, management, analysis and interpretation of data; or the decision to submit for publication. The funding body will be informed of any planned publications, and documentation provided.

Abstract Background Medicinal plant contains multiple bioactive compounds with therapeutic potentials. Due to their availability, affordability, and minimal known side effects, they are widely practiced. Identification, quantification, and establishment of their interaction with physiological enzymes help in the standardization of plant-based medicinal extracts. In this study, gas chromatography/flame ionization detector (GC–FID) and high-performance liquid chromatography (HPLC) analysis were used to determine the bioactive components in the ethanol extract of Newbouldia laevis stem bark. The antioxidant activity of the extract was determined. Enzyme inhibitory potency of the flavonoids’ components was investigated against acetylcholinesterase, butyrylcholinesterase, phospholipase A2, α-glucosidase, and α-amylase. Results Analysis of ethanol extract of N. laevis stem-bark revealed alkaloids (0.37%), tannins (1.82 mg/TEq/g), flavonoids (5.85 mg/QEq), steroids (0.11 mg/10 g) and glycosides (0.08 mg/10 g). The HPLC fingerprint of flavonoids showed high concentrations (mg/100 g) of catechin (47.11), apigenin (15.68), luteolin (18.90), kaempferol (41.54), and quercetin (37.64), respectively. In vitro 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging ability of the extract was exhibited at 150 and 200 mg/mL, respectively. At 300 mg, most in vitro antioxidant potentials (lipid peroxidation, metal chelating ability, hydroxyl, nitric oxide, sulfide oxide radicals scavenging abilities) were obtained. The extract showed varying inhibitory abilities (> 50%) on acetylcholinesterase, butyrylcholinesterase, phospholipase A2, α-glucosidase and α-amylase at 300 mg/mL, IC50 of 129.46, 237.10, 169.50, 251.04 and 243.06 mg/mL, respectively, with inhibition constants (Ki) of 3.92, 1.63, 1.11, 2.95 and 2.11. Results showed an affinity for the targeted enzymes with free energies higher than the standard drugs. Conclusion The results revealed that the N. laevis stem bark possesses antioxidant activity and enzyme inhibitory activity on the physiological enzyme that has been implicated in diabetes. In vitro and in silico inhibition of these physiological enzymes by extract suggests that the stem bark can be effective in ameliorating the complications associated with diabetes mellitus.

Incidence data from 17-year veterinary neoplasm surveillance and registration were reviewed. Most of the neoplastic cases diagnosed in Nigerian veterinary teaching hospitals (VTHs) were in the avian (49%) and canine species (44%). Fewer cases were recorded in the equine (3.2%), bovine (2.4%), ovine (1.5%), caprine (0.3%) and porcine (0.15%) species. Marek’s disease was the most prevalently diagnosed neoplastic disease of domestic animals in Nigerian VTHs from 2000–2017. Also, the Nigerian local breed had a higher mean distribution than any other dog breed and this was statistically significant (p < 0.05). Nearly all of the neoplastic cases diagnosed, were found in females (60.4%) and so the mean distribution of sex was statistically significant (p < 0.05). The digestive system, with 296 (46.25%) cases, was the anatomic location where the majority of the neoplastic cases were found. However, the mean distribution of different neoplastic anatomic sites was not statistically significant (p > 0.05). In conclusion, little emphasis is given to the appropriate diagnosis and recording of neoplastic cases that are diagnosed. The study provides information regarding the prevalence and distribution of tumours in different animal species consulted in Nigeria veterinary teaching hospitals. To illustrate all of this, ArcGIS software was used. Veterinary clinicians, pathologists and epidemiologists from Nigeria may benefit from the results of this study by freely accessing some specific data regarding the breed, the age group or the gender of some animal species diagnosed with different tumours.

Widespread frontoparietal activity is consistently observed in recognition memory tests that compare studied (“target”) versus unstudied (“nontarget”) responses. However, there are conflicting accounts that ascribe various aspects of frontoparietal activity to mnemonic evidence versus decisional processes. According to Signal Detection Theory, recognition judgments require individuals to decide whether the memory strength of an item exceeds an evidence threshold—the decision criterion—for reporting previously studied items. Yet, most fMRI studies fail to manipulate both memory strength and decision criteria, making it difficult to appropriately identify frontoparietal activity associated with each process. In the current experiment, we manipulated both discriminability and decision criteria across recognition memory and visual detection tests during fMRI scanning to assess how frontoparietal activity is affected by each manipulation. Our findings revealed that maintaining a conservative versus liberal decision criterion drastically affects frontoparietal activity in target versus nontarget response contrasts for both recognition memory and visual detection tests. However, manipulations of discriminability showed virtually no differences in frontoparietal activity in target versus nontarget response or item contrasts. Comparing across task domains, we observed similar modulations of frontoparietal activity across criterion conditions, though the recognition memory task revealed larger activations in both magnitude and spatial extent in these contrasts. Nonetheless, there appears to be some domain specificity in frontoparietal activity associated with the maintenance of a conservative versus liberal criterion. We propose that widespread frontoparietal activity observed in target versus nontarget contrasts is largely attributable to response bias where increased activity may reflect inhibition of a prepotent response, which differs depending on whether a person maintains a conservative versus liberal decision criterion.

Abstract Background Little data exist on the time spent by emergency department (ED) personnel providing intravenous (IV) fluid to ‘responsive’ versus ‘unresponsive’ patients. Methods A prospective, convenience sample of adult ED patients was studied; patients were enrolled if preload expansion was indicated for any reason. Using a novel, wireless, wearable ultrasound, carotid artery Doppler was obtained before and throughout a preload challenge (PC) prior to each bag of ordered IV fluid. The treating clinician was blinded to the results of the ultrasound. IV fluid was deemed ‘effective’ or ‘ineffective’ based on the greatest change in carotid artery corrected flow time (ccFT∆) during the PC. The duration, in minutes, of each bag of IV fluid administered was recorded. Results 53 patients were recruited and 2 excluded for Doppler artifact. There were 86 total PCs included in the investigation comprising 81.7 L of administered IV fluid. 19,667 carotid Doppler cardiac cycles were analyzed. Using ccFT∆ ≥ + 7 ms to discriminate ‘physiologically effective’ from ‘ineffective’ IV fluid, we observed that 54 PCs (63%) were ‘effective’, comprising 51.7 L of IV fluid, whereas, 32 (37%) were ‘ineffective’ comprising 30 L of IV fluid. 29.75 total hours across all 51 patients were spent in the ED providing IV fluids categorized as ‘ineffective.’ Conclusions We report the largest-known carotid artery Doppler analysis (i.e., roughly 20,000 cardiac cycles) in ED patients requiring IV fluid expansion. A clinically significant amount of time was spent providing physiologically ineffective IV fluid. This may represent an avenue to improve ED care efficiency.

Paratesticular tumours are tumours that arise from the testicular tunics, spermatic cord, epididymis, or vestigial remnants. The tumours are rare and account for approximately 5% of intrascrotal neoplasms. About 75% of these tumours arise from the spermatic cord. Paratesticular tumours most commonly manifest as painless scrotal masses. Alternatively, the tumour may be incidentally noticed when a scrotal ultrasound scan is done for another intrascrotal pathology such as hydrocele, inguinoscrotal hernia, epididymo-orchitis, or suspected testicular tumour. We present a case of metastatic paratesticular tumour in a 21-year-old Nigerian male, who presented at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, in September 2018 at the age of 19 years with a painless right hemiscrotal mass. The patient was clinically evaluated with scrotal ultrasonography, testicular tumour markers, and liver function test. Biopsy specimen obtained was ignorantly discarded by the patient who was subsequently lost to follow-up. Histologic diagnosis of mesenchymal tumour (myxoid liposarcoma) was made two years after his initial presentation when he developed both inguinal and retroperitoneal lymph node metastasis at the age of 21 years. He was evaluated as clinical stage IV disease and then commenced on chemotherapy after baseline investigations. Our objective of presenting this report is to highlight the effect of delayed diagnosis in the management outcome, challenges in the provision of resources in low- and middle-income countries, and to emphasise the rarity of the tumour in our subregion.

Abstract For prostate cancer (PCa) patients treated with definitive radiotherapy (RT), acute and late RT-related genitourinary (GU) toxicities adversely impact disease-specific quality of life. Early warning of potential RT toxicities can prompt interventions that may prevent or mitigate future adverse events. During intensity modulated RT (IMRT) of PCa, daily cone-beam computed tomography (CBCT) images are used to improve treatment accuracy through image guidance. This work investigated the performance of CBCT-based delta-radiomic features (DRF) models to predict acute and sub-acute International Prostate Symptom Scores (IPSS) and Common Terminology Criteria for Adverse Events (CTCAE) version 5 GU toxicity grades for 50 PCa patients treated with definitive RT. Delta-radiomics models were built using logistic regression, random forest for feature selection, and a 1000 iteration bootstrapping leave one analysis for cross validation. To our knowledge, no prior studies of PCa have used DRF models based on daily CBCT images. AUC of 0.83 for IPSS and greater than 0.7 for CTCAE grades were achieved as early as week 1 of treatment. DRF extracted from CBCT images showed promise for the development of models predictive of RT outcomes. Future studies will include using artificial intelligence and machine learning to expand CBCT sample sizes available for radiomics analysis.

Hitherto, the myriad of researches conducted on biofuels coupled with their poor oxidative stabilities, show that none of these studies has considered monitoring the corrosive effects of Schinzochytrium sp. microalgae biodiesel on diesel engines. In this study, corrosion behaviors of mild steel (MS), aluminum (Al) and copper (Cu) were compared via immersion tests in preheated schinzochytrium sp. microalgae biodiesel and its blends at room temperature and 60 °C for 1200 h. Property-variation of the individual/blended fuels, corrosion rates/products of the metals, and their morphologies were examined. For the metals, the corrosion rates are in the order of Al

KRAS G12C mutations are critical in the pathogenesis of multiple cancer types, including non-small cell lung (NSCLC), pancreatic ductal adenocarcinoma (PDAC), and colorectal (CRC) cancers. As such, they have increasingly become a target of novel therapies in the management of these malignancies. However, the therapeutic success of KRAS G12C inhibitors to date has been far more limited in CRC and PDAC than NSCLC. In this review, we briefly summarize the biochemistry of KRAS targeting and treatment resistance, highlight differences in the epidemiology of various G12C-mutated cancers, and provide an overview of the published data on KRAS G12C inhibitors for various indications. We conclude with a summary of ongoing clinical trials in G12C-mutant CRC and a discussion of future directions in the management of this disease. KRAS G12C mutation, targeted therapies, colorectal cancer, non-small cell lung cancer, pancreatic cancer, drug development.

Oral squamous cell carcinoma (OSCC) is characterized by high incidence, mortality, post-management recurrence and metastatic rates as well as poor prognosis. This study was designed to identify molecular diagnostic and predictive signatures of OSCC in Nigerian cases. It was a retrospective-prospective case-control study spanning a 12 year period using 74 OSCC tissue blocks as well as benign epithelial lesions which served as control from which DNA was extracted and profiled for rs7528484 and rs760805 in RUNX3 gene by restriction fragment length polymorphism-PCR. Demography of the tissue blocks was recorded. Computed data were presented as frequencies/percentages. Association between RUNX3 polymorphism and patient's gender, age, tumor location, histology was assessed by Pearson's χ2 test at α0.05, Monte-Carlo exact test and Odds Ratios (OR) at Confidence Interval (CI) of 95%. Only rs7528484 was successfully genotyped with a distribution of 52.7% homozygote normal (CC), 28.4% heterozygote mutant (CT) and 18.9% homozygote mutant (TT). Gender and histology was generally significantly associated with genotypes/alleles. Genotypes CT and TT as well as the mutant allele T, showed odds of predicting OSCC. It appears that rs7528484 in RUNX3 might be common in patients suffering from OSCC. Individuals carrying the mutant allele could also be more susceptible to OSCC development.

We investigated the interaction of DNA nucleobases [adenine (A), guanine (G), thymine (T), and cytosine (C)] with single-layer Ti3C2 MXene using Van der Waals (vdW)-corrected density functional theory and non-equilibrium Green’s function methods. All calculations were benchmarked against graphene. We showed that depending on the initial vertical height of a nucleobase above the Ti3C2 surface, two interaction mechanisms are possible, namely, physisorption and chemisorption. For graphene, DNA nucleobases always physisorbed onto the graphene surface irrespective of the initial vertical height of the nucleobase above the graphene sheet. The PBE+vdW binding energies for graphene are high (0.55–0.74 eV) and follow the order G > A > T > C, with adsorption heights in the range of 3.16–3.22 Å, indicating strong physisorption. For Ti3C2, the PBE+vdW binding energies are relatively weaker (0.16–0.20 eV) and follow the order A > G = T > C, with adsorption heights in the range of 5.51–5.60 Å, indicating weak physisorption. The binding energies for chemisorption follow the order G > A > T > C, which is the same order for physisorption. The binding energy values (5.3–7.5 eV) indicate very strong chemisorption (∼40 times larger than the physisorption binding energies). Furthermore, our band structure and electronic transport analysis showed that for physisorption, there is neither significant variation in the band structure nor modulation in the transmission function and device density of states. The relatively weak physisorption and strong chemisorption show that Ti3C2 might not be capable of identifying DNA nucleobases using the physisorption method.

Background: The study evaluated the effects of regular blood donation on serum transferrin and soluble transferrin receptor levels at Wenchi Methodist Hospital. Methods: This was a hospital-based cross-sectional study conducted at the Medical Laboratory Department of the Wenchi Methodist Hospital in the Bono Region of Ghana. A total of eighty-nine (89) venous blood samples from apparently healthy blood donors were analyzed. Complete blood count parameters were analyzed using an automated haematology analyzer and serum transferrin and transferrin receptor using ELISA. The data were analyzed using SPSS version 22.0. Results: Haemoglobin (p

A major challenge in the biodiesel industry is the availability of high-quality vegetable oil feedstocks. Thus, there is a continuous search for quality biodiesel feedstock whose production will trigger economic impact on the agricultural sector, minimize land degradation and without significant disruption to the food chain. In this work, we extracted and analysed oil from neglected and underutilized Cucumeropsis mannii seeds for their potential in biodiesel production. The oil content of C. mannii seed was 40.8 ± 0.56%. GC-MS analysis of the oil revealed the presence of 47.0% saturated fatty (predominantly palmitic acid, stearic acid) and 53.0% of unsaturated fatty acids (predominantly oleic, linoleic and erucic acids). The physicochemical properties were determined and values were as follows: iodine value (111.07 ± 0.15 g/100 g), saponification value (192.03 ± 0.37 mg/kg of oil), peroxide value (2.60 ± 0.10 meq/kg), acid value (4.20 ± 0.02 mgKOH/g) free fatty acid (2.51 ± 0.02%), relative density (0.93 ± 0.02), the refractive index at 28 °C (1.46 ± 0.04) and viscosity at 30 °C (3.00 ± 0.10 mm2/s). The fuel properties namely, cloud point, pour point, flash point and caloric value were determined and the values were 3.03 ± 0.11 °C, 1.00 ± 0.10 °C, 279.04 ± 0.99 °C and 31.10 ± 0.11 MJ/kg, respectively. In addition, the protein content of the defatted seed was found to be 47.4 ± 0.61 g/100 g. The defatted protein-rich cakes can be upgraded as a food additive; thus the C. mannii seed oil can serve as biodiesel feedstock without altering the food chain. These characteristics demonstrate the potential of C. mannii oil as a high-quality feedstock for biodiesel production. We envisage that its utilization as biodiesel feedstock will improve the market value of these seeds, thus supporting the economic development of local farmers in rural areas.

Background and purpose: Glioblastoma (GBM) patients face a strongly unfavorable prognosis despite multimodal therapy regimens. However, individualized mortality prediction remains imprecise. Harnessing routine radiation planning cranial computed tomography (CT) scans, we assessed cervical body composition measures as novel biomarkers for overall survival (OS) in GBM patients. Materials and methods: We performed threshold-based semi-automated quantification of muscle and subcutaneous fat cross-sectional area (CSA) at the levels of the first and second cervical vertebral body. First, we tested this method’s validity by correlating cervical measures to established abdominal body composition in an open-source whole-body CT cohort. We then identified consecutive patients undergoing radiation planning for recent GBM diagnosis at our institution from 2010 to 2020 and quantified cervical body composition on radiation planning CT scans. Finally, we performed univariable and multivariable time-to-event analyses, adjusting for age, sex, body mass index, comorbidities, performance status, extent of surgical resection, extent of tumor at diagnosis, and MGMT methylation. Results: Cervical body composition measurements were well-correlated with established abdominal markers (Spearman’s rho greater than 0.68 in all cases). Subsequently, we included 324 GBM patients in our study cohort (median age 63 years, 60.8% male). 293 (90.4%) patients died during follow-up. Median survival time was 13 months. Patients with below-average muscle CSA or above-average fat CSA demonstrated shorter survival. In multivariable analyses, continuous cervical muscle measurements remained independently associated with OS. Conclusion: This exploratory study establishes novel cervical body composition measures routinely available on cranial radiation planning CT scans and confirms their association with OS in patients diagnosed with GBM.

Introduction Chronic conditions, such as diabetes, obesity, heart disease and depression, are highly prevalent and frequently co-occur with food insecurity in communities served by community health centres in the USA. Community health centres are increasingly implementing ‘Food as Medicine’ programmes to address the dual challenge of chronic conditions and food insecurity, yet they have been infrequently evaluated.Methods and analysis The goal of this quasi-experimental study was to evaluate the effectiveness of Recipe4Health, a ‘Food as Medicine’ programme. Recipe4Health includes two components: (1) a ‘Food Farmacy’ that includes 16 weekly deliveries of produce and (2) a ‘Behavioural Pharmacy’ which is a group medical visit. We will use mixed models to compare pre/post changes among participants who receive the Food Farmacy alone (n=250) and those who receive the Food Farmacy and Behavioural Pharmacy (n=140). The primary outcome, fruit and vegetable consumption, and secondary outcomes (eg, food security status, physical activity, depressive symptoms) will be collected via survey. We will also use electronic health record (EHR) data on laboratory values, prescriptions and healthcare usage. Propensity score matching will be used to compare Recipe4Health participants to a control group of patients in clinics where Recipe4Health has not been implemented for EHR-derived outcomes. Data from surveys, EHR, group visit attendance and produce delivery is linked with a common identifier (medical record number) and then deidentified for analysis with use of an assigned unique study ID. This study will provide important preliminary evidence on the effectiveness of primary care-based strategies to address food insecurity and chronic conditions.Ethics and dissemination This study was approved by the Stanford University Institutional Review Board (reference protocol ID 57239). Appropriate study result dissemination will be determined in partnership with the Community Advisory Board.

Abstract Characterization and further development of underutilized/underexploited indigenous tropical seed oils are essential to supplement both nutritional and industrial needs of an ever-increasing African (and global) population. Before now and to our best knowledge, the previous research involved Canarium schweinfurthii Engl. fruit specific to Nigeria appear to have been more on the evaluation of seed, pulp, and essential oils (from the seed), but much less on the pulp oil. To supplement existing information, this current work has aimed to biochemically characterize the Soxhlet-extracted pulp oil of C. schweinfurthii fruit gathered from a community situated in the South-east of Nigeria. Specifically, the biochemical characterization comprised the determinations of proximate compositions, lipid peroxidation, fatty acid profile, as well as carotenoids, sterols, and tocopherols. Processing the fruit sample to pulp oil involved, among others, oven-drying, and grinding, prior to the Soxhlet extraction. Results of proximate components of C. schweinfurthii pulp oil showed the following trend: crude fat content (~ 49.32%) > carbohydrates (~ 37.93%) > moisture content (~ 8.62%) > ash content (~ 3.74%) > crude protein content (~ 0.39%) values. The lipid peroxidation attributes comprised acid (~ 23.60 mg KOH/g), peroxide (~ 33.91 mEq. O2/kg), iodine (~ 58.3 g/100 g), and saponification (~ 138.21 mg KOH/g) values. In addition to the free (~ 13.8%), saturated (~ 9.74%), and unsaturated (~ 90.26%) fatty acids, a total of fifteen (15) fatty acid methyl esters (FAMEs) spectral peaks were found, from caprylic acid (C8:0) to lignoceric acid (C24:0). Total tocopherol concentration amounted to ~ 73 mg/100 g, which comprised α, β, γ-tocopherol, and δ-tocotrienol, with fair concentrations of carotenoids and sterols. Overall, the C. schweinfurthii pulp oil—biochemically competitive with a high concentration of unsaturated fatty acid, tocopherol, and sterol, suggests strong industrial promise.

Antibiotic resistance has posed a major public health challenge because of antibiotics misuse, overdose, underdose, ignorance of antibiotics usage and substandard production from producers, thus entailing the need for an alternative antibiotic agent production. Here, a commonly used antibiotic plant, Chrysophyllum albidum leaf, was used to produce silver nanoparticles (AgNPs) and was characterized using XRD, FTIR, DSC and DLS. The characterization data showed the production of six (6)-week stable AgNPs, with high antioxidant properties and amylase, glucosidase and cholinesterases inhibition properties. Similarly, the product exhibited stable antibiotics properties on Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus after six (6) weeks of storage at 4 °C.

The aim of this research was to model the performances of energy and exergy on a Trombe wall system to enable an adequate thermal comfort. The main equations for the heat transfer mechanisms were developed from energy balances on subcomponents of the Trombe wall with the specification of the applicable initial and boundary conditions. During the incorporation of the PCM on the Trombe wall, the micro-encapsulation approach was adopted for better energy conservation and elimination of leakage for several cycling of the PCM. The charging and discharging of the PCM were equally accommodated and incorporated in the simulation program. The results of the study show that an enhanced energy storage could be achieved from solar radiation using PCM-augmented system to achieve thermal comfort in building envelope. In addition, the results correspond with those obtained from comparative studies of concrete-based and fired-brick augmented PCM Trombe wall systems, even though a higher insolation was used in the previous study.

Abstract We report the photoelectrocatalysis of diclofenac sodium using a reactor consisting of Ag-BiVO4/BiOI anode and Ag-BiOI cathode. The electrodes were prepared through electrodeposition on FTO glass and modified with Ag nanoparticles through photodeposition. The structural and morphological studies were carried out using XRD, SEM, and EDS which confirmed the successful preparation of the materials. The optical properties as observed with UV-DRS revealed that the electrodes were visible light active and incorporation of metallic Ag particles on the surface increased the absorption in the visible light region. Presence of p-n heterojunction in the anode led to decrease in the spontaneous recombination of photoexcited electron–hole pairs as seen in the photocurrent response. The results from photoelectrocatalytic degradation experiments revealed that replacing platinum sheet with Ag-BiOI as counter electrode resulted in higher (92%) and faster removal of diclofenac sodium as evident in the values of apparent rate constants. The reaction mechanism further revealed that efficiently separated photogenerated holes played a major role in the degradation of the pharmaceutical. The prepared electrodes showed good stability and impressive reusability. The reports from this study revealed that the dual photoelectrodes system has a great potential in treating pharmaceutical polluted wastewater using visible light irradiation.

In a public health crisis, communication plays a vital role in making sure policies and recommendations from the government level get disseminated accurately to its people and is only considered as effective when the public accepts, supports, complies to, and engages in policies or behaves as per governments’ recommendations. Adopting the multivariate audience segmentation strategy for health communication, this study uses a data-driven analytical method to (1) identify audience segments of public health crisis communication in Singapore based on knowledge, risk perception, emotional responses, and preventive behaviors; and (2) characterize each audience segment according to demographic factors, personality traits, information processing styles, and health information preferences. Results (N = 2033) from a web-based questionnaire executed in August 2021 have identified three audience segments: the less-concerned (n = 650), the risk-anxious (n = 142), and the risk-majority (n = 1,241). This study offers insights to how audiences of public health crisis communication perceive, process, and respond to information directed to them during the pandemic, thereby informing policy makers to tailor more targeted public health communication interventions in promoting positive attitude and behavior change.

We analyzed national forest inventory data collected from circa 2000–2018 across 37 states in the eastern United States to better understand the influence of forest health related canopy disturbances on the regeneration and recruitment dynamics of upland oaks (Quercus). We found low levels of oak recruitment across all disturbance types examined but limited evidence of any direct effects from the type of disturbance on the population of regenerating oaks. The general lack of differences in oak regeneration response between forest health disturbances and disturbances caused by harvested or non-disturbed plots does not indicate that the effects of forest health disturbances were benign, however. Instead, low level of oak recruitment across all disturbance types highlights the pervasiveness of the trend of shifting composition in once oak-dominated forests where oak is absent or sparse in the regeneration layer. Our results show that oak recruitment was higher when oak was present as advance reproduction prior to disturbance from any cause examined. Collectively, these results lead us to conclude that the widespread inadequacy of oak advance reproduction in mature oak-dominated forests is the prevailing threat to oak forest health and sustainability. We suggest the status of advance reproduction be treated as a co-morbidity when weighing the risk and potential outcomes from other threats to upland oak forests in the eastern United States.

Color sensing is a technique for identifying physical changes in materials based on appearance assessment. Dirt deposition on solar panels can change their physical appearance and performance. Considering that dirt accumulation on solar panels needs monitoring to make efficient cleaning schedules, reduce unnecessary costs, and optimize solar panel output generation. Color sensing can achieve fast, accurate, and economical dirt detection, unlike the use of robotic cameras, mathematical formulae, and considering varying output current and voltage methods. Here, we introduce a method that detects and removes dirt on solar panels based on TCS3200 and Arduino Uno components. The approach targets (i.) Panel color measurement, calibration, threshold selection process, (ii.) comparison of color measurement values, and (iii.) align further calibration in response to discoloration of solar panels. This method aims to correct the dirt detection methods previously in use. Hence, a high-speed rolling brush arrangement is designed to improve the cleaning of the solar panel without using water. Further investigations of the panel's color may require some improvement in terms of increasing the sensitivity of the color sensor even with increased distance from the solar panel. Combining multiple color sensors may also be necessary.

Abstract Background Arm and shoulder problems (ASP), including lymphedema, were common among women with breast cancer in high-income countries before sentinel lymph node biopsy became the standard of care. Although ASP impair quality of life, as they affect daily life activities, their frequency and determinants in Sub-Saharan Africa remain unclear. Methods All women newly diagnosed with breast cancer at the Namibian, Ugandan, Nigerian, and Zambian sites of the African Breast Cancer-Disparities in Outcomes (ABC-DO) cohort study were included. At each 3-month follow-up interview, women answered the EORTC-QLQ-Br23 questionnaire, including three ASP items: shoulder/arm pain, arm stiffness, and arm/hand swelling. We estimated the cumulative incidence of first self-reported ASP, overall and stratified by study and treatment status, with deaths treated as competing events. To identify determinants of ASP, we estimated cause-specific hazard ratios using Cox models stratified by study site. Results Among 1476 women, up to 4 years after diagnosis, 43% (95% CI 40–46), 36% (33–38) and 23% (20–25), respectively, self-reported having experienced arm/shoulder pain, stiffness and arm/hand swelling at least once. Although risks of self-reported ASP differed between sites, a more advanced breast cancer stage at diagnosis, having a lower socioeconomic position and receiving treatment increased the risk of reporting an ASP. Conclusion ASP are very common in breast cancer survivors in Sub-Saharan Africa. They are influenced by different factors than those observed in high-income countries. There is a need to raise awareness and improve management of ASP within the African setting.

Herein, a sulphate enhanced photoelectrochemical degradation method using peroxymonosulfate (PEC/PMS) and FTO-Bi2WO6 as photoanode is reported. The FTO-Bi2WO6 electrode was fabricated through electrodeposition and calcination route. The FTO-Bi2WO6 produced a good photocurrent response of up to 6.62 μAcm−2 with an applied potential of 1.5 V (vs Ag/AgCl). When the electrode was applied for PEC/PMS degradation of pharmaceuticals, 98%, 83% and 79% removal was recorded for sulfamethoxazole, diclofenac chloride and tetracycline, respectively within 90 min with a bias potential of 1.0 V and 3 mM PMS. Hence, the PEC/PMS system with FTO-Bi2WO6 photoanode is suitable for the removal of pharmaceuticals in wastewater.

PurposeRespiratory motion of locally advanced non-small cell lung cancer (LA-NSCLC) adds to the challenge of targeting the disease with radiotherapy (RT). One technique used frequently to alleviate this challenge is an internal gross tumor volume (IGTV) generated from manual contours on a single respiratory phase of the 4DCT via the aid of deformable image registration (DIR)-based auto-propagation. Through assessing the accuracy of DIR-based auto-propagation for generating IGTVs, this study aimed to identify erring characteristics associated with the process to enhance RT targeting in LA-NSCLC.Methods4DCTs of 19 patients with LA-NSCLC were acquired using retrospective gating with 10 respiratory phases (RPs). Ground-truth IGTVs (GT-IGTVs) were obtained through manual segmentation and union of gross tumor volumes (GTVs) in all 10 phases. IGTV auto-propagation was carried out using two distinct DIR algorithms for the manually contoured GTV from each of the 10 phases, resulting in 10 separate IGTVs for each patient per each algorithm. Differences between the auto-propagated IGTVs (AP-IGTVs) and their corresponding GT-IGTVs were assessed using Dice coefficient (DICE), maximum symmetric surface distance (MSSD), average symmetric surface distance (ASSD), and percent volume difference (PVD) and further examined in relation to anatomical tumor location, RP, and deformation index (DI) that measures the degree of deformation during auto-propagation. Furthermore, dosimetric implications due to the analyzed differences between the AP-IGTVs and GT-IGTVs were assessed.ResultsFindings were largely consistent between the two algorithms: DICE, MSSD, ASSD, and PVD showed no significant differences between the 10 RPs used for propagation (Kruskal–Wallis test, ps > 0.90); MSSD and ASSD differed significantly by tumor location in the central–peripheral and superior–inferior dimensions (ps < 0.0001) while only in the central–peripheral dimension for PVD (p < 0.001); DICE, MSSD, and ASSD significantly correlated with the DI (Spearman’s rank correlation test, ps < 0.0001). Dosimetric assessment demonstrated that 79% of the radiotherapy plans created by targeting planning target volumes (PTVs) derived from the AP-IGTVs failed prescription constraints for their corresponding ground-truth PTVs.ConclusionIn LA-NSCLC, errors in DIR-based IGTV propagation present to varying degrees and manifest dependences on DI and anatomical tumor location, indicating the need for personalized consideration in designing RT internal target volume.

Background: The emergency care of time-sensitive injuries and illnesses is increasingly recognized as an essential component of effective health care systems. However, many low- and middle-income countries (LMICs) lack healthcare providers formally trained in the care of emergency conditions. The Disease Control Priorities 3 project estimates that effective emergency care systems could avert up to half of all premature deaths in LMICs. Nigeria, a lower-middle income country of nearly 200 million people in Sub-Saharan Africa, could save approximately 100,000 lives per year with an effective emergency care system. The World Health Organization developed the Basic Emergency Care (BEC) course to train frontline healthcare workers in the management of emergency conditions in low resource settings. In this study we describe our work implementing the BEC course Nigeria. Methods: This study was designed as a mixed methods research analysis comparing pre- and post- course examination results and surveys to evaluate participant knowledge acquisition and levels of confidence with management of various emergency conditions. Thirty-two participants were involved in the course which took place over four days at the Lagos University Teaching hospital. Quantitative data was analyzed using Stata 14.2 (College Station, TX). Paired data sets were analyzed using McNemar's chi-squared. Unpaired data sets were analyzed using a Wilcoxon signed-rank test. Results: Post-course test scores showed significant improvement (p-value

Abstract Background Incidence of breast cancer continues to rise in low- and middle-income countries, with data from the East African country of Tanzania predicting an 82% increase in breast cancer from 2017 to 2030. We aimed to characterize treatment pathways, receipt of therapies, and identify high-value interventions to increase concordance with international guidelines and avert unnecessary breast cancer deaths. Methods Primary data were extracted from medical charts of patients presenting to Bugando Medical Center, Tanzania, with breast concerns and suspected to have breast cancer. Clinicopathologic features were summarized with descriptive statistics. A Poisson model was utilized to estimate prevalence ratios for variables predicted to affect receipt of life-saving adjuvant therapies and completion of therapies. International and Tanzanian guidelines were compared to current care patterns in the domains of lymph node evaluation, metastases evaluation, histopathological diagnosis, and receptor testing to yield concordance scores and suggest future areas of focus. Results We identified 164 patients treated for suspected breast cancer from April 2015–January 2019. Women were predominantly post-menopausal (43%) and without documented insurance (70%). Those with a confirmed histopathology diagnosis (69%) were 3 times more likely to receive adjuvant therapy (PrR [95% CI]: 3.0 [1.7–5.4]) and those documented to have insurance were 1.8 times more likely to complete adjuvant therapy (1.8 [1.0–3.2]). Out of 164 patients, 4% (n = 7) received concordant care based on the four evaluated management domains. The first most common reason for non-concordance was lack of hormone receptor testing as 91% (n = 144) of cases did not undergo this testing. The next reason was lack of lymph node evaluation (44% without axillary staging) followed by absence of abdominopelvic imaging in those with symptoms (35%) and lack of histopathological confirmation (31%). Conclusions Patient-specific clinical data from Tanzania show limitations of current breast cancer management including axillary staging, receipt of formal diagnosis, lack of predictive biomarker testing, and low rates of adjuvant therapy completion. These findings highlight the need to adapt and adopt interventions to increase concordance with guidelines including improving capacity for pathology, developing complete staging pathways, and ensuring completion of prescribed adjuvant therapies.

Religion plays a vital role in the formation of conscience and therefore is very important in determining how people co-exist in a society. Nigerian citizens live in regions other than their ethnic geographical areas, but they are not recognised as people of the same destiny and subjects of equal rights. The long period of military dictatorship that truncated the country’s democracy since the civil war gave Nigerians a constitution which adopted the Sharia legal system within a purported secular state. This encouraged a wide range of religious fanaticism and led to various demands for human rights, which has become a worrisome issue to concerned Nigerians. This article used secondary sources of data, such as newspaper publications and journal articles to examine the impact of religion on the state of the Nigerian nation today. The article calls for the harmonisation of Christianity and Islamic teachings in line with the secularity of the Nigerian state in order to reduce the increasing tensions in the country and make the journey to nationhood more realistic. Contribution: This article proposes that the secularity of the Nigerian state has to be maintained by political and religious leaders in order to attain purposeful nationhood and achieve sustainable and genuine development of the country.

Exfoliated graphite is a 2D carbon material that has recently received great attention owing to its remarkable analytical merits such as fast electron migration, ease of surface regeneration, high-temperature resistance, ability to withstand high-current density, excellent conductivity, and sensitivity. Due to its excellent analytical signature, an exfoliated graphite electrode has been reportedly used in the construction of sensors and biosensors for various applications. This electrode can be used alone or blended with several nanomaterials/semiconductors for the degradation of various organic pollutants in wastewater. Despite the outstanding results reported in the use of exfoliated graphite electrodes for various analytical applications, very few reports were documented in the literature. Therefore, this review elaborated on the importance of exfoliated graphite electrodes for electrochemical analysis.

PURPOSE Brain drain is the migration of educated and skilled individuals from a less developed region or country to a more economically established one. The Trump administration proposed a merit-based immigration plan. This article addresses its potential impact on health care delivery in low- and middle-income countries (LMICs) and their preparedness to deal with it. MATERIALS AND METHODS Data on immigration policies, numbers of international medical graduates practicing in high-income countries (HICs), various scientific exchange methods, and efforts for capacity building in LMICs. RESULTS Talented individuals seek to advance their knowledge and skills, and may stay in HICs because of greater rewards and opportunities. HICs also rely on immigrant international medical graduates to supplement their physician workforces. CONCLUSION Ambitious individuals from LMICs need and should have opportunities to advance their education and training in more advanced countries. LMICs should increase their educational efforts, research capabilities, infrastructures, and living conditions to better serve their own populations and reduce their brain drain phenomenon.

PURPOSEThe burden of cancer is growing in low- and middle-income countries (LMICs), including sub-Saharan Africa. Ensuring the delivery of high-quality cancer care in such regions is a pressing concern. There is a need for strategies to identify meaningful and relevant quality measures that are applicable to and usable for quality measurement and improvement in resource-constrained settings.METHODSTo identify quality measures for breast cancer care at Butaro Cancer Center of Excellence (BCCOE) in Rwanda, we used a modified Delphi process engaging two panels of experts, one with expertise in breast cancer evidence and measures used in high-income countries and one with expertise in cancer care delivery in Rwanda.RESULTSOur systematic review of the literature yielded no publications describing breast cancer quality measures developed in a low-income country, but it did provide 40 quality measures, which we adapted for relevance to our setting. After two surveys, one conference call, and one in-person meeting, 17 measures were identified as relevant to pathology, staging and treatment planning, surgery, chemotherapy, endocrine therapy, palliative care, and retention in care. Successes of the process included participation by a diverse set of global experts and engagement of the BCCOE community in quality measurement and improvement. Anticipated challenges include the need to continually refine these measures as resources, protocols, and measurement capacity rapidly evolve in Rwanda.CONCLUSIONA modified Delphi process engaging both global and local expertise was a promising strategy to identify quality measures for breast cancer in Rwanda. The process and resulting measures may also be relevant for other LMIC cancer facilities. Next steps include validation of these measures in a retrospective cohort of patients with breast cancer.

PURPOSE Globally, breast cancer represents the most common cause of cancer death among women. Early cancer diagnosis is difficult in low- and middle-income countries, most of which are unable to support population-based mammographic screening. Triage on the basis of clinical breast examination (CBE) alone can be difficult to implement. In contrast, piezo-electric palpation (intelligent Breast Exam [iBE]) may improve triage because it is portable, low cost, has a short learning curve, and provides electronic documentation for additional diagnostic workup. We compared iBE and CBE performance in a screening patient cohort from a Western mammography center. METHODS Women presenting for screening or diagnostic workup were enrolled and underwent iBE then CBE, followed by mammography. Mammography was classified as negative (BI-RADS 1 or 2) or positive (BI-RADS 3, 4, or 5). Measures of accuracy and κ score were calculated. RESULTS Between April 2015 and May 2017, 516 women were enrolled. Of these patients, 486 completed iBE, CBE, and mammography. There were 101 positive iBE results, 66 positive CBE results, and 35 positive mammograms. iBE and CBE demonstrated moderate agreement on categorization (κ = 0.53), but minimal agreement with mammography (κ = 0.08). iBE had a specificity of 80.3% and a negative predictive value of 94%. In this cohort, only five of 486 patients had a malignancy; iBE and CBE identified three of these five. The two cancers missed by both modalities were small—a 3-mm retro-areolar and a 1-cm axillary tail. CONCLUSION iBE performs comparably to CBE as a triage tool. Only minimal cancers detected through mammographic screening were missed on iBE. Ultimately, our data suggest that iBE and CBE can synergize as triage tools to significantly reduce the numbers of patients who need additional diagnostic imaging in resource-limited areas.

Background: Kidneys exposure to toxins can cause injuries, leading to their functional impairments. Traditionally, plants have been used for the treatment of renal disorders and numerous medicinal plants have been tested for their nephroprotective effects, in such cases as gentamicin (GM) and cisplatin (Cisp)-induced nephrotoxicity. This study assessed the ability of Acalypha wilkesiana’s extract to counteract its toxic effect based on the biochemical, histological and proinflammatory cytokines components in rats. Methods: Thirty-six male Wistar rats were randomly divided into nine groups (n=4 each) and administered the following treatments: a) normal control (1 mL/kg body weight normal saline from days 1-10); b) nephrotoxin (GM 120 mg/kg, days 2-7; or Cisp 7 mg/kg on day 3); c) standard drug (120 mg/kg Silymarin plus GM or Cisp, days 1-10); and, d) extract groups (100 or 250 mg/kg, days 1-10 plus GM). Blood samples were collected and subjected to hematological and biochemical evaluations while kidney tissue samples were examined for histopathological alterations, pro- and antioxidants, and expression of pro-inflammatory cytokines. Results: Treatment of the rats pre-exposed to GM or Cisp with the extract decreased the serum creatinine, urea and MDA levels. The GST and GPx levels were also restored in rats. Glomerular atrophy with tubular epithelial necrosis induced by either nephrotoxin was restored to near normal. The expression of COX-2 following the administration of either nephrotoxin was reversed after treatment with the extract. Conclusion: The A. wilkesiana extract exhibited significant nephroprotective property, which could potentially be regarded as a promising alternative to the management of renal diseases.

Abstract Pharmaceuticals have been classified as emerging water pollutants which are recalcitrant in nature. In the quest to find a suitable technique in removing them from contaminated water, photoelectrocatalytic oxidation method has attracted much attention in recent years. This report examined the feasibility of degrading ciprofloxacin and sulfamethoxazole through photoelectrocatalytic oxidation using FTO-BiVO4/Ag2S with p-n heterojunction as anode. BiVO4/Ag2S was prepared through electrodeposition and successive ionic layer adsorption/reaction on FTO glass. Structural and morphological studies using XRD, SEM, EDS and diffusive reflectance UV-Vis confirmed the successful construction of p-n heterojunction of BiVO4/Ag2S. Electrochemical techniques were used to investigate enhanced charge separation in the binary electrode. The FTO-BiVO4/Ag2S electrode exhibited the highest photocurrent response (1.194 mA/cm−2) and longest electron lifetime (0.40 ms) than both pristine BiVO4 and Ag2S electrodes which confirmed the reduction in recombination of charge carriers in the electrode. Upon application of the prepared FTO-BiVO4/Ag2S in photoelectrocatalytic removal of ciprofloxacin and sulfamethoxazole, percentage removal of 80% and 86% were achieved respectively with a low bias potential of 1.2 V (vs Ag/AgCl) within 120 min. The electrode possesses good stability and reusability. The results obtained revealed BiVO4/Ag2S as a suitable photoanode for removing recalcitrant pharmaceutical molecules in water.

Background: Suxamethonium has been shown to have a superior modification of the convulsion associated with ECT compared to other muscle relaxants. The dosage of suxamethonium used in ECT varies widely based on the experiences of practitioners. The study aimed to determine and compare the effectiveness and side effect profile of 0.5 mg/kg and 1 mg/kg in modified ECT. Subjects and Methods: This was a prospective randomized crossover study, comparing the effects of suxamethonium at a dose of 0.5 mg/kg, and 1.0 mg/kg in 27 patients who had a total of 54 sessions of modified ECT. The primary outcome parameters were quality of convulsion and onset and duration of apnoea. The secondary outcome parameters were hemodynamic variables, arterial oxygen saturation, delayed recovery, muscle pain, vomiting, headache, prolonged convulsion, and serum potassium. Data collected were entered into proforma and analyzed using Statistical Package for Social Sciences (SPSS) version 17.0. Parametric variables are presented as means and standard deviations while non-parametric variables are presented as frequencies and percentages. The level of significance (P-value) was considered at 0.05. Results: Sixteen patients (59%) had acceptable convulsion modification with 0.5 mg/kg suxamethonium compared to 23 patients (85%) with the use of 1.0 mg/kg suxamethonium (P = 0.016). There was no statistically significant difference in the duration of convulsion, the onset of apnoea, and the duration of apnoea with the two doses. Changes in heart rate, blood pressure, arterial oxygen saturation, and serum potassium level that accompany the mECT were comparable with the two doses of suxamethonium studied. Conclusions: A better modification of convulsion with comparable hemodynamic and side effect profile is achieved during mECT with the use of 1.0 mg/kg suxamethonium compared to 0.5 mg/kg.

Food insecurity and undernourishment constitute a major challenge in Africa and the world at large. To meet key nutritional targets and tackle the menace of undernourishment, we need to exploit available but underutilised food crops. A common underutilised food crop with the potential to improve daily nutrition is tiger nut. This potential is evidenced in the number of essential amino acids detected, which constitute 74.425% of the entire amino acids detected, in addition to important minerals and vitamins. The nutritional composition of the yellow variety of tiger nut (Cyperus esculentus) was determined using the standard methods of high-performance liquid chromatography and UV-spectroscopy. Ten amino acids were identified and quantified, including six essential amino acids, of which valine had the highest concentration (67.59 μg/100 g), followed by leucine (3.019 μg/100 g), phenylalanine (1.767 μg/100 g), lysine (0.946 μg/100 g), histidine (1.048 μg/100 g) and tryptophan (0.055 μg/100 g). The other amino acids were proline (24.124 μg/100 g), cysteine (1.269 μg/100 g), glycine (0.024 μg/100 g), and glutamine (0.022 μg/100 g). Monosaccharides detected were ribose (41.76%), glucose (21.52%), sedoheptulose (17.94%), fructose (4.566%), rhamnose (1.78%) and mannose (1.58%), whilst disaccharides detected were sucrose (87.66%) and maltose (11.39%). Mineral concentrations were K 144.80 ± 1.10 mg/100 g, Ca 94.39 ± 0.02 mg/100 g, Na 83.92 ± 0.04 mg/100 g, Fe 19.36 ± 0.54 mg/100 g, Mg 17.63±0.13 mg/100 g, Cu 13.28±0.05 mg/100 g and Zn 5.18±0.01 mg/100 g Vitamins A, B2, C and E were detected and quantified as 53.93±1.03, 7.61±1.20, 31.70±1.25 and 128.75±0.74 μg/100 g, respectively. The chemical and nutritional properties of the yellow variety of tiger nut suggest that it is rich in essential amino acids, minerals, and some vitamins. Hence, it should be recommended to persons with nutritional deficiencies as it is cheap and available all year round. Significance: • The nutritional composition of the yellow tiger nut will assist in meeting the recommended daily intake of essential amino acids, monosaccharides, disaccharides, minerals, and vitamins, thus contributing towards solving the challenge of food insecurity and malnutrition, particularly in the African sub-region. • The rich concentration of these nutrients could be harnessed in the biofortification of food materials known to be deficient in one nutrient or another. • These important attributes of tiger nut, if harnessed, will add value to this underutilised crop and enhance the economic livelihood of the local farmers.

MnO2@GO, NiO@GO and MnO2@NiO@GO electrodes were hydrothermally fabricated for applications in supercapacitor energy storage devices. Because of its large surface area and low electrical resistance, graphene oxide (GO) was added to the nanocomposites during electrode fabrication. The mutual co-operation of diverse components and composites with GO increased the performance, longevity, and hardness of electrodes. The greatest specific capacitance measured by cyclic voltammetry (CV) at 10 ​mV/s scan rates and GCD at 1.0 A/g current density for MnO2@GO, NiO@GO, and MnO2@NiO@GO, respectively, was 652, 425, 985 and 773, 487, 1141 ​F/g for MnO2@GO, NiO@GO, and MnO2@NiO@GO. Performances of various electrodes clearly show that composites of two transition metal oxides/GO had better performance when compared to single transition metal oxide/GO and the addition of graphene oxide enhanced the supercapacitive performances of the electrodes.