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Abstract Background and Aim Globally, over 180,000 children develop cancers yearly, with about 80% residing in low‐ or middle‐income countries where cancer‐associated mortality is also high. In The Gambia, cumulative incidence rate of 27.6 childhood cancers/million population was reported between 2002 and 2011. The current study appraised newly‐established pediatric oncological services in The Gambia. Methods In this prospective registry study, children with cancer who presented at the pediatric units, Edward Francis Small Teaching Hospital, Banjul, between November 2022 and October 2023 were assessed. Data on sociodemographic variables, mode of admission and presentation, tumor type, diagnostic methods, and challenges such as laboratory support, treatment, use of blood/blood products; and eventual outcome were analyzed. Results The median (interquartile range, IQR) age at presentation of the 44 children was 36.0 (22.3–117.0) months. Wilms tumor was the most common tumor 12 (27.3%); followed by leukemia 11 (25.0%); germ cell tumor 8 (18.2%); lymphoma 6 (13.6%); retinoblastoma 4 (9.1%); rhabdomyosarcoma 2 (4.5%) and one central nervous system tumor (2.3%). The median(IQR) duration of symptoms before presentation was 48 (21–90) days, presentation to diagnosis 7.5 (3–20.8) days, and first symptom to diagnosis 62.5 (32–126.8) days. Treatment refusal and abandonment rates were 20.5% and 13.6%, respectively. Families of 93.8% of children could not procure cytotoxic drugs due to nonavailability, high cost, or both. Adequate laboratory monitoring was only available in 6.8%, and none had platelet concentrate transfusion or radiotherapy. The nine (20.5%) who completed treatment are currently being followed up, 10(22.7%) are still receiving chemotherapy, while 2(4.5%) were referred. Eight (18.2%) died, predominantly from metastasis (75%) and severe drug toxicities (25%). Conclusion Late presentation and diagnosis, poverty, unavailability of drugs, suboptimal or lack of laboratory testing, blood product, adjuvant medications, and psychosocial supports contributed to high treatment refusal, abandonment, and mortality. These daunting challenges can be ameliorated with regular community sensitization, frequent cancer auditing, and strong political will.

Abstract There is conflicting evidence on the role of lipid biomarkers in breast cancer (BC), and no study to our knowledge has examined this association among African women. We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association of lipid biomarkers—total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides—with odds of BC overall and by subtype (Luminal A, Luminal B, HER2-enriched and triple-negative or TNBC) for 296 newly diagnosed BC cases and 116 healthy controls in Nigeria. Each unit standard deviation (SD) increase in triglycerides was associated with 39% increased odds of BC in fully adjusted models (aOR: 1.39; 95% CI: 1.03, 1.86). Among post-menopausal women, higher total cholesterol (aOR: 1.65; 95% CI: 1.06, 2.57), LDL cholesterol (aOR: 1.59; 95% CI: 1.04, 2.41), and triglycerides (aOR: 1.91; 95% CI: 1.21, 3.01) were associated with increased odds of BC. Additionally, each unit SD increase in LDL was associated with 64% increased odds of Luminal B BC (aOR 1.64; 95% CI: 1.06, 2.55). Clinically low HDL was associated with 2.7 times increased odds of TNBC (aOR 2.67; 95% CI: 1.10, 6.49). Among post-menopausal women, higher LDL cholesterol and triglycerides were significantly associated with increased odds of Luminal B BC and HER2 BC, respectively. In conclusion, low HDL and high LDL are associated with increased odds of TN and Luminal B BC, respectively, among African women. Future prospective studies can definitively characterize this association and inform clinical approaches targeting HDL as a BC prevention strategy.

Abstract Background The association between obesity and breast cancer (BC) has been extensively studied among US, European and Asian study populations, with often conflicting evidence. However, despite the increasing prevalence of obesity and associated conditions in Africa, the continent with the highest age-standardized BC mortality rate globally, few studies have evaluated this association, and none has examined in relation to molecular subtypes among African women. The current analysis examines the association between body composition, defined by body mass index (BMI), height, and weight, and BC by molecular subtype among African women. Methods We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between measures of body composition and BC and molecular subtypes among 419 histologically confirmed cases of BC and 286 healthy controls from the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) case-control study. Results Higher BMI (aOR: 0.79; 95% CI: 0.67, 0.95) and weight (aOR: 0.83; 95% CI: 0.69, 0.98) were associated with reduced odds of BC in adjusted models, while height was associated with non-statistically significant increased odds of BC (aOR: 1.07, 95% CI: 0.90, 1.28). In pre/peri-menopausal, but not post-menopausal women, both higher BMI and weight were significantly associated with reduced odds of BC. Further, higher BMI was associated with reduced odds of Luminal A, Luminal B, and HER2-enriched BC among pre/peri-menopausal women, and reduced odds of triple-negative BC among post-menopausal women. Conclusions Higher BMI and weight were associated with reduced odds of BC overall and by molecular subtype among West African women. Larger studies of women of African descent are needed to definitively characterize these associations and inform cancer prevention strategies.

Breast cancer is now the commonest cancer in most sub-Saharan African countries. Few studies of the epidemiology and genomics of breast cancer and its molecular subtypes in these countries have been done. The African Female Breast Cancer Epidemiology (AFBRECANE) study, a part of the Human Heredity and Health in Africa (H3Africa) initiative, is designed to study the genomics and epidemiology of breast cancer and its molecular subtypes in Nigerian women. We link recruitment of breast cancer cases at study sites with population-based cancer registries activities to enable ascertainment of the incidence of breast cancer and its molecular subtypes. We use centralized laboratory processing to characterize the histopathological and molecular diagnosis of breast cancer and its subtypes using multiple technologies. By combining genome-wide association study (GWAS) data from this study with that generated from 12,000 women participating in our prospective cohort study of cervical cancer, we conduct GWAS of breast cancer in an entirely indigenous African population. We test associations between dietary intakes and breast cancer and focus on vitamin D which we measure using dietary intakes, serum vitamin D, and Mendelian randomization. This paper describes the AFBRECANE project, its design, objectives and anticipated contributions to knowledge and understanding of breast cancer.

Background: Nigeria reports the highest age-standardized mortality rate for breast cancer (BC) among African countries and disproportionately high rates of high-grade cancer. Histological grade is a strong predictor of mortality, and evidence suggests that educational attainment influences cancer outcomes. Objective: We characterize the association between educational trends across the life-course and BC grade at diagnosis. Methods: Data on 224 BC patients enrolled in the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Nigerian Women (MEND) study was analyzed. Participant and parental (mother and father) education was categorized as low (primary school or less) or high (secondary school or greater). Accordingly, the educational trend across the life-course was determined for each participant relative to each parent: stable high, increasing, decreasing, or stable low. BC grade was classified as high (grade 3) or low (grades 1–2). Findings: About 34% of participants, 71% of fathers, and 85% of mothers had low education. Approximately one-third of participants were diagnosed with high-grade BC. Participants with low-grade BC were more likely to have highly educated fathers (p = 0.04). After adjusting for age, comorbidities, marital status and mammogram screening, participants with highly educated fathers were 60% less likely to have high-grade BC (aOR 0.41; 95% CI 0.20 to 0.84) compared to those with less-educated fathers. Stable high life-course education relative to father was also associated with a significantly lower likelihood of having high-grade BC (aOR 0.36; 95% CI 0.15 to 0.87) compared to stable low life-course education. No significant associations were observed for the participant’s education, mother’s education, or life-course education relative to mother. Conclusions: Early-life socioeconomic status (SES) may influence BC grade. This deserves further study to inform policies that may be useful in reducing high-grade BC in Nigeria.

PURPOSE: To elucidate the role of metabolic dysregulation and associated DNA methylation changes on breast cancer risk and aggressive subtypes among Nigerian women. We describe the design and methods of a collaborative molecular epidemiology study of breast cancer in Nigerian hospitals. METHODS: The Mechanisms for Novel and Established Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) study was designed as a matched case-control study of 350 patients, age 18 to 75 years, with newly diagnosed, treatment-naïve breast cancer and 350 age-matched healthy controls from surrounding geographic areas. Patients with breast cancer seen for initial diagnosis at four large tertiary hospitals in southwest Nigeria and one affiliated private hospital were recruited. Healthy female controls were selected from a cohort of 4,000 healthy women recruited as part of the Human Heredity and Health (H3) in Africa Chronic Kidney Disease Case-Control Study in Nigeria. Tumor and adjacent normal tissue, and blood and saliva samples were collected for molecular and epigenetic assays. RESULTS: Although recruitment is ongoing, a total of 416 patients have been recruited to date, with tumor and blood samples obtained from at least 310 patients. Data on age-matched (± 6 months) controls have also been obtained and harmonized. Lipid assays for 350 pathologically verified cases and 350 age-matched controls is underway, and pathologic characterization of tumors (including immunohistochemistry for subtyping) is ongoing. Data on DNA methylation for tumors and adjacent normal tissue are expected by the end of the study period. CONCLUSION: The MEND study will provide a unique, high-quality source of data to evaluate the contribution of metabolic dysregulation such as obesity, diabetes, hypertension, and metabolic syndrome to the biology of breast cancer among Nigerian women and foster collaborative studies relevant for women of African descent globally.

Key Clinical Message Spindle epithelial tumor with thymus‐like differentiation (SETTLE) is a rare tumor of the thyroid gland occurring in children and young adults. This report presents SETTLE as a tumor that can also affect young children (under fives). Although majority of the reports were in Caucasians, the tumor can affect all races.

Heavy motorisation in the wake of increasing urbanisation is one of the significant transport problems cities face today. There are practical measures under the panoply of urban vehicle access regulations (UVARs) used to stimulate sustainable mobility behaviour changes in the urban population and reduce reliance on passenger car travel. However, the adoption and implementation of such measures are often riddled with challenges, particularly building public acceptability and preserving social justice. Overcoming these challenges will also require cities to understand how the mobility needs of residents change over time. Considering the limitations of conventional data-collection and monitoring approaches, this study explored and analysed the public perception of UVARs over 12 years through natural language processing techniques using social media as a data source. The results show that UVARs are a prominent topic in public discussion and that the average sentiment expressed in tweets tended to be more positive than negative, with a gradual increase observed over the 12-year study period. In addition, the patterns observed in the data and the topics modelled were consistent with the events and talking points in society related to UVARs. Hence, this study demonstrates that social media data can help policymakers assess public sentiments during the ideation, design, implementation, and operational phases of UVARs and other transport policy measures.

Using waste materials in road construction is a sustainable technique that will promote waste reduction, a cleaner environment, cost savings in road construction projects, and serve as an alternative material. This study evaluated the performance of hospital waste ash (HWA) modified asphalt mixtures. The modified asphalt mixtures were produced using HWA as mineral filler at 0%–100% at an interval of 10% by weight. The performance of the mixtures was evaluated with the Marshall, Cantabro, and retained strength index (RSI) tests. The Marshall parameters indicate that the modified asphalt mixtures met the General Specification for Roads and Bridges of Nigeria with satisfactory results. Except for mixes prepared with 90% and 100%, HWA-modified mixtures fulfill the RSI and Cantabro durability requirement at up to 80% filler content. However, to ensure the optimum performance of the HWA-modified asphalt mixtures, a 40% HWA is recommended.

Predicting maize crop yields especially in maize production is paramount in order to alleviate poverty and contribute towards food security. Many regions experience food shortage especially in Africa because of uncertain climatic changes, poor irrigation facilities, reduction in soil fertility and traditional farming techniques. Therefore, predicting maize crop yields helps policymakers to make timely import and export decisions to strengthen national food security. However, none of the published work has been done to predict maize crop yields using machine learning in Eswatini, Africa. This paper aimed at applying machine learning (ML) to predict maize yields for a single season in Eswatini. A ML model was trained and tested using open-source data and local data. This is done by using three different data splits with the opensource predictor data consisting of 48 data points each with 7 attributes and open-source response data consisting of 48 data points each with a single attribute, adjusted R² values were 0.784 (at 70:30), 0.849 (at 80:20), and 0.878 (at 90:10) before being normalized, 1.00 across the board after normalization, and 0.846 (at 70:30), 0.886 (at 80:20), and 0.885 (at 90:10) after backward elimination. At the second attempt, it is done by using the combined predictor data of 68 data points with 7 attributes each and combined response data of 68 data points with a single attribute each, with the same data splits and methods adjusted R² values were 0.966 (at 70:30), 0.972 (at 80:20), and 0.978 (at 90:10) before being normalized, 1.00 across the board after normalization, and 0.967 (at 70:30), 0.973 (at 80:20), and 0.978 (at 90:10) after backward elimination.

This paper presented a new multilingual language for Automated Teller Machine (ATM) in Uganda which serves as an extension to the existing Languages. The existing ATMs have only English, Kiswahili and Luganda as the only available languages. Hence, findings revealed that there are still some prevalent languages e.g. Ateso language that are widely spoken among the people of Uganda which the present ATMs in the country have not captured. The objective of this paper was to propose the integration of the new language (Ateso language) to the existing languages. In this paper, a new language was adopted when it was realized that some people especially in the Buganda region could not manage to interact with the ATMs because they were illiterate. The developed multilingual system prototype was tested using some empirical data and was found to successfully imitate ATM transactions in the local Uganda languages. The results of the study supported the positive impacts on customers that reside in the rural areas since its improved interaction of more users on the ATMs. This paper demonstrated the use of Ateso language for different transactions on the ATM system. The implementation by the banking institutions can aid the ATM users to make more flexible decisions on the usage of the ATM machines.

INTRODUCTION:Worldwide, three Influenza-A virus subtypes (i.e., H1N1, H1N2 and H3N2) in swine are of major public health importance because of involvement in Influenza pandemics. In Nigeria, the existence of these subtypes in pigs has not been well studied. This study aimed at determining the prevalence and correlates of Influenza-A viruses circulating in piggery workers and pigs in Oke-aro and Goshen communities in Lagos, Nigeria to inform decision making in Influenza-A infection prevention and control. METHODS: Nasal swabs and blood samples were taken from 197 consenting piggery workers and 281 randomly selected pigs to determine the prevalence of Influenza-A viruses using Reverse Transcriptase Polymerase Chain Reaction test (RT-PCR) for Influenza antigens and Enzyme Linked Immunosorbent Assay (ELISA) for Influenza antibodies. An interviewer administered questionnaire was used to collect information on demography, Influenza-A related symptoms experienced, personal hygiene and management practices from the piggery workers. We performed univariate and bivariate analyses to determine the prevalence of Influenza-A and its correlates. RESULTS: The sero-prevalence of Influenza-A among the piggery workers and pigs by ELISA was 87% and 67% respectively. All piggery workers and pigs nasal swabs tested negative for Influenza-A viruses by RT-PCR. The mean age of piggery workers was 41 (SD 13.6) years and 60% were females. Forty two percent were farm attendants, 38.0% were pig farmers and the rest butchers. Most (48.0%) had muscle pain at the time of data collection. Butchers had significantly (OR = 0.00, 95% CI 0.00 , 0.59) higher odds of being sero-positive for Influenza-A than farmers. Piggery workers who used personal protective equipment (i.e., gloves and boots) were less likely to be sero-positive to Influenza-A. CONCLUSION: Piggery workers and pigs in Oke-aro and Goshen communities, Lagos had previous exposures to Influenza-A viruses; however, evidence of recent exposure could not be established. We encourage regular use of personal protective equipment among piggery workers.