Search

Abstract Background Lung cancer (LC) has poor survival outcomes mainly due to diagnosis at late stages. This study explored the anticipated time to seek medical advice for possible LC symptoms and barriers to early presentation in Palestine. Methods This cross-sectional study recruited adult participants from hospitals, primary healthcare centers, and public spaces of 11 governorates using convenience sampling. A modified, translated-into-Arabic version of the validated LC awareness measure was used to assess LC symptom awareness, the time needed to seek medical advice and barriers to early presentation. Results A total of 4762 participants were included. The proportion that would immediately seek medical advice for possible LC symptoms varied according to the symptoms’ nature. For respiratory symptoms, this ranged from 15.0% for ‘painful cough’ to 37.0% for ‘coughing up blood’. For non-respiratory symptoms, this ranged from ‘4.2% for ‘unexplained loss of appetite’ to 13.8% for ‘changes in the shape of fingers or nails’. Participants with good LC symptom awareness were more likely to seek medical advice within a week of recognizing most LC symptoms. About 13.0% would delay their visit to see a doctor after recognizing an LC symptom. The most reported barriers were emotional with ‘disliking the visit to healthcare facilities’ (59.8%) as the leading barrier. Conclusion LC respiratory symptoms were more likely to prompt early seeking of medical advice. Good LC symptom awareness was associated with a higher likelihood of help-seeking within a week. Educational interventions are needed to promote LC awareness and address the perceived barriers to early presentation in low-resource settings, such as Palestine.

PURPOSEHaving an accurate knowledge of what truly increases the likelihood of developing lung cancer (LC) may help people make better decisions about lifestyle changes that could potentially lower their risk. This study assessed current beliefs in LC causation myths among Palestinians and explored factors associated with displaying good recognition of such myths.METHODSA national cross-sectional study was conducted from July 2019 to March 2020. A modified version of the Cancer Awareness Measure-Mythical Causes Scale was used for data collection. The awareness level of LC causation myths was determined based on the number of myths recognized to be incorrect: poor (0-4), fair (5-9), and good (10-13).RESULTSA total of 4,817 participants completed the questionnaire of 5,174 approached (response rate = 93.1%). In total, 4,762 participants were included in the final analysis. Myths unrelated to food were more commonly recognized than food-related myths. The food-related myth most frequently recognized was eating burnt food (n = 1,427; 30.0%) followed by drinking from plastic bottles (n = 1,389; 29.2%). The food-related myth least commonly recognized was eating food containing additives (n = 737; 15.5%). The most frequently recognized myth unrelated to food was having a physical trauma (n = 2,903; 61%), whereas the least was using cleaning products (n = 1,140; 23.9%). Only 287 participants (6%) displayed good awareness. Having a chronic disease and knowing someone with cancer were associated with a decrease in the likelihood of displaying good awareness. Conversely, participants who were smoking cigarettes/shisha and those recruited from hospitals had an associated increase in the likelihood of displaying good awareness.CONCLUSIONThis study found very poor awareness of LC causation myths, with only 6% recognizing ≥10 myths. Initiatives addressing LC mythical causes are needed.

Abstract Background The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness. Methods Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0–4), fair (5–9), and good (10–14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection. Results Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was ‘worsening in an existing cough’(n = 3884, 81.6%) while the least recognized was ‘a cough that does not go away for two or three weeks’(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was ‘persistent tiredness or lack of energy’(n = 3205, 67.3%) while the least recognized was ‘persistent shoulder pain’(n = 1170, 24.6%). A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers. Conclusion About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.

Objectives To evaluate lung cancer (LC) risk factor awareness among Palestinians and identify factors associated with good awareness.Design Cross-sectional study.Settings Participants were recruited using convenience sampling from hospitals, primary healthcare centres (PHCs) and public spaces located at 11 governorates in Palestine.Participants Of 5174 approached, 4817 participants completed the questionnaire (response rate=93.1%). A total of 4762 questionnaires were included: 2742 from the West Bank and Jerusalem (WBJ) and 2020 from the Gaza Strip. Exclusion criteria were working or studying in a health-related field, having a nationality other than Palestinian and visiting oncology departments or clinics at the time of data collection.Tool A modified version of the validated LC Awareness Measure was used for data collection.Primary and secondary outcomes The primary outcome was LC risk factor awareness level as determined by the number of factors recognised: poor (0–3), fair (4–7) and good (8–10). Secondary outcomes include the recognition of each LC risk factor.Results Smoking-related risk factors were more often recognised than other LC risk factors. The most recognised risk factors were ‘smoking cigarettes’ (n=4466, 93.8%) and ‘smoking shisha (waterpipes)’ (n=4337, 91.1%). The least recognised risk factors were ‘having a close relative with LC’ (n=2084, 43.8%) and ‘having had treatment for any cancer in the past’ (n=2368, 49.7%).A total of 2381 participants (50.0%) displayed good awareness of LC risk factors. Participants from the WBJ and the Gaza Strip had similar likelihood to display good awareness (50.6% vs 49.1%). Being≥45 years, having higher education and monthly income, knowing someone with cancer and visiting hospitals and PHCs seemed to have a positive impact on displaying good awareness.Conclusion Half of study participants displayed good awareness of LC risk factors. Educational interventions are warranted to further improve public awareness of LC risk factors, especially those unrelated to smoking.

This research aims to identify the factors affecting the provisions of loan losses in the conventional private commercial banks operating in Syria, where the provisions contribute in the face of the risks that banks can be exposed to during the exercise of various activities. To achieve the goal of the research, annual data were collected from the financial statements of the 11 traditional private commercial banks operating in Syria, during the period from 2009 to 2009. The dependent variable that expresses loan loss provisions was measured by the ratio of loan loss provisions / total direct credit facilities, and the independent variables represented by the size of the bank, the ratio of Non-performing loans, the rate of loan growth was measured using the natural logarithm of total assets in the bank, loans Nonperforming / total direct credit facilities, annual change in loan growth, respectively. (1) For the purpose of analyzing the data, the random effects model was used to test the relationship between the dependent variable and the independent variables, and the data was analyzed using the Eviews 10 program. The results of the study showed that there is no effect of the rate of loan growth and the Syrian crisis in the provisions of loan losses, while the effect of the bank size, non-performing loans ratio, was positive in the provisions of loan losses. يهدف هذا البحث إلى التّعرف على العوامل المؤثّرة في مخصّصات خسائر القروض في المصارف التّجاريّة التّقليديّة الخاصّة العاملة في سورية، حيثُ تساهم المخصّصات في مواجهة المخاطر التي يمكن أن تتعرّض لها المصارف أثناء ممارستها للأنشطة المختلفة. لتحقيق هدف البحث تمّ جمع بيانات سنويّة من القوائم الماليّة للمصارف التّجاريّة التّقليديّة الخاصّة العاملة في سورية والبالغ عددها (11) مصرفاً وذلك خلال الفترة من عام 2017-2009. وقد تم قياس المتغير التّابع الّذي يعبّر عن مخصّصات خسائر القروض من خلال نسبة مخصّصات خسائر القروض / إجمالي التّسهيلات الائتمانيّة المباشرة، أمّا المتغيرات المستقلّة والمتمثلة في حجم المصرف، نسبة القروض المتعثرة، معدّل نمو القروض فقد تم قياسها باستخدام اللّوغاريتم الطّبيعي لإجمالي الأصول في المصرف، القروض المتعثّرة / إجمالي التّسهيلات الائتمانيّة المباشرة، التّغير السّنوي في نمو القروض على التوالي.([1]) وبغرض تحليل البيانات تمّ استخدام نموذج التّأثيرات العشوائيّة لاختبار العلاقة بين المتغير التّابع والمتغيرات المستقلّة، وتمّ تحليل البيانات بالاعتماد على برنامج EViews 10. أظهرت نتائج الدّراسة عدم وجود أثر لمعدّل نمو القروض والأزمة السّورية في مخصّصات خسائر القروض، بينما كان أثر حجم المصرف ونسبة القروض المتعثرة إيجابي في مخصّصات خسائر القروض. (1) يوجد العديد من محددات مخصّصات خسائر القروض منها ما هو داخلي مثل (حجم المصرف، نسبة القروض المتعثرة، معدل نمو القروض) ومنها ما هو خارجي مثل (معدل النمو في الناتج المحلي الإجمالي الحقيقي ومعدل التّضخم وسعر الصرف وغيرها من العوامل الخارجية). ولكن في هذه الدراسة سيتم الاقتصار على دراسة العوامل الداخلية فقط، بالإضافة إلى إدخال متغير وهمي هو الأزمة السّورية.

Aim: Scant information is available about the prevalence of diabetic polyneuropathy, as well as the applicability of screening tools in sub-Saharan Africa. We aimed to investigate these issues in Zanzibar (Tanzania). Methods: One hundred consecutive diabetes patients were included from the diabetes clinic at Mnazi Mmoja Hospital. Clinical characteristics were recorded. Further, we investigated: a) self-reported numbness of the lower limbs, b) ten-point monofilament test, c) the Sibbald 60-s Tool and d) nerve conduction studies (NCS, using an automated handheld point-of-care device, the NC-stat DPNCheck). Results: Mean age was 54 years, 90% had type 2 diabetes, and with 9 year average disease duration. Mean HbA1c was 8.5% (69 mmol/mol), blood pressure 155/88 mmHg. Sixty-two% reported numbness, 61% had positive monofilament and 79% positive Sibbald tool. NCS defined neuropathy in 45% of the patients. Only the monofilament showed appreciable concordance with the NCS, Cohenâs κ 0.43. Conclusions: The patient population was characterised by poor glycaemic control and hypertension. In line with this, neuropathy was rampant. The monofilament test tended to define more cases of probable neuropathy than the NCS, however specificity was rather low. Plantar skin thickening may have led to false positives in this population. Overall concordance was, however, appreciable, and could support continued use of monofilament as a neuropathy screening tool. The NC-stat DPNCheck could be useful in cases of diagnostic uncertainty or for research purposes in a low resource setting. Keywords: Diabetes mellitus, Sub-Saharan Africa, Diabetic polyneuropathy (DPN), Nerve conduction studies, NC-stat DPNCheck

Cyanide is a minor constituent of crude syngas whose content depends on the feedstock and gasification procedure. It is a known poison to metal catalysts and inhibits iron-containing enzymes like carbon monoxide dehydrogenase of acetogenic organisms. Therefore, it is considered a component that has to be removed from the gas stream prior to use in chemical synthesis or syngas fermentation. We show that the growth rate and maximum biomass concentration of Clostridium ljungdahlii are unaffected by cyanide at concentrations of up to 1.0 mM with fructose as a carbon source and up to 0.1 mM with syngas as a carbon source. After the culture is adapted to cyanide it shows no growth inhibition. While the difference in growth is an increasing lag-phase with increasing cyanide concentrations, the product spectrum shifts from 97% acetic acid and 3% ethanol at 0 mM cyanide to 20% acetic acid and 80% ethanol at 1.0 mM cyanide for cultures growing on (fructose) and 80% acetic acid and 20% ethanol at 0.1 mM cyanide (syngas).

Computed tomography (CT) imaging plays a crucial role in various medical applications, but noise in projection data can significantly degrade image quality and hinder diagnosis accuracy. Iterative algorithms for tomographic image reconstruction outperform transform methods, especially in scenarios with severe noise in projections. In this paper, we propose a method to dynamically adjust two parameters included in the iterative rules during the reconstruction process. The algorithm, named the parameter-extended expectation-maximization based on power divergence (PXEM), aims to minimize the weighted extended power divergence between the measured and forward projections at each iteration. Our numerical and physical experiments showed that PXEM surpassed conventional methods such as maximum-likelihood expectation-maximization (MLEM), particularly in noisy scenarios. PXEM combines the noise suppression capabilities of power divergence-based expectation-maximization with static parameters at every iteration and the edge preservation properties of MLEM. The experimental results demonstrated significant improvements in image quality in metrics such as the structural similarity index measure and peak signal-to-noise ratio. PXEM improves CT image reconstruction quality under high noise conditions through enhanced optimization techniques.

Background: Soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) are among the most prevalent neglected tropical diseases (NTDs), affecting 1.5 billion globally, with a significant burden in sub-Saharan Africa, particularly Nigeria. These diseases impair health and contribute to socio-economic challenges, especially in children, undermining educational and future economic prospects. The 2030 NTD Roadmap highlights Mass Drug Administration (MDA) as a critical strategy for controlling these NTDs, targeting vulnerable populations like school-age children. Despite some successes, challenges persist, indicating the need for deeper insights into program implementation. This study focuses on the perspectives of health workers implementing MDA in selected local government areas (LGAs) of Ogun State, Nigeria, aiming to identify challenges and enablers that align with the broader NTD 2030 goals., Methodology/principal Findings: The study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria, between July and September 2022. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control program's efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization., Conclusions/significance: The MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the program's reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the program's sustainability and success., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Akinsolu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Eggs offer a range of essential nutrients that could support skeletal health as individuals age. Maintaining bone density is crucial for reducing the risk of fractures and improving overall mobility and quality of life in later years. Understanding the potential benefits of habitual egg consumption on bone mass density among older people is essential, given that the natural decline in bone mass density occurs with age. This area of research has not garnered sufficient attention basically because of the mixed reactions and conflicting reports about the safety of egg consumption especially among the older adults. This scoping review aims to systematically examine the existing literature to map the evidence regarding the association between habitual egg consumption and bone mass density in older adults' individuals. The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines to ensure methodological rigor and transparency. Five electronic databases were searched for published pieces of literature. While high egg intake has been linked to increased mortality and dyslipidemia, eggs contain compounds like Ovo transferrin and carotenoids that may benefit bone health. As aging increases vulnerability to bone fragility and fractures, it's crucial to provide comprehensive dietary recommendations. The complex relationship between egg consumption, cholesterol, and health highlights the need for nuanced assessment. Overall, eggs present a potentially valuable dietary component for promoting bone health in aging populations. Limited research on the link between egg consumption and bone mass density in older adults highlights the need for further investigation. Concerns about cholesterol have overshadowed potential benefits. Given aging populations and bone health challenges, exploring eggs' role in preventing falls and fractures is essential for a proactive approach to older adults' well-being., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Olagunju et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Pregnancy and postpartum periods are crucial stages for women's mental health, and women living with HIV are particularly susceptible to depression and psychological stress due to various factors. This study investigated the prevalence and associated factors of depression and perceived stress among women living with HIV during their perinatal period in Ibadan, Nigeria., Methods: A cross-sectional survey was conducted in three HIV treatment centers in Ibadan, Nigeria, among women living with HIV between the ages of 19 and 49 who were either pregnant or had given birth within the last 2 years. The study was conducted from September 2022 to December 2022. An interviewer-administered questionnaire was used to collect the data from the participants. Ethical approval and informed consent were obtained, and data were analyzed using the Statistical Package for Social Science version 26., Results: The study included 402 participants, of whom 69.0 and 78.0% reported symptoms of depression and perceived stress, respectively. However, 15.2% of the participants have comorbid depression and stress. Positive partner status was significantly associated with lower perceived depression, while gestational age between 29 and 40 weeks was significantly associated with lower perceived stress. The co-occurrence of depression and perceived stress was associated with partner status, income level, family support, gestational age, and years on antiretroviral therapy., Conclusion: The high prevalence of depression, perceived stress, and their co-occurrence among women living with HIV during the perinatal period call for incorporating mental health care into routine maternal healthcare for all women, particularly those living with HIV. This finding emphasizes the need for public health efforts to prioritize perinatal mental health and improve access to care and support for women and their partners., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Akinsolu, Abodunrin, Lawale, Bankole, Adegbite, Adewole, Olagunju, Ola, Dabar, Sanni-Adeniyi, Gambari, Njuguna, Salako and Ezechi.)

Iterative reconstruction of density pixel images from measured projections in computed tomography has attracted considerable attention. The ordered-subsets algorithm is an acceleration scheme that uses subsets of projections in a previously decided order. Several methods have been proposed to improve the convergence rate by permuting the order of the projections. However, they do not incorporate object information, such as shape, into the selection process. We propose a block-iterative reconstruction from sparse projection views with the dynamic selection of subsets based on an estimating function constructed by an extended power-divergence measure for decreasing the objective function as much as possible. We give a unified proposition for the inequality related to the difference between objective functions caused by one iteration as the theoretical basis of the proposed optimization strategy. Through the theory and numerical experiments, we show that nonuniform and sparse use of projection views leads to a reconstruction of higher-quality images and that an ordered subset is not the most effective for block-iterative reconstruction. The two-parameter class of extended power-divergence measures is the key to estimating an effective decrease in the objective function and plays a significant role in constructing a robust algorithm against noise.

The problem of tomographic image reconstruction can be reduced to an optimization problem of finding unknown pixel values subject to minimizing the difference between the measured and forward projections. Iterative image reconstruction algorithms provide significant improvements over transform methods in computed tomography. In this paper, we present an extended class of power-divergence measures (PDMs), which includes a large set of distance and relative entropy measures, and propose an iterative reconstruction algorithm based on the extended PDM (EPDM) as an objective function for the optimization strategy. For this purpose, we introduce a system of nonlinear differential equations whose Lyapunov function is equivalent to the EPDM. Then, we derive an iterative formula by multiplicative discretization of the continuous-time system. Since the parameterized EPDM family includes the Kullback-Leibler divergence, the resulting iterative algorithm is a natural extension of the maximum-likelihood expectation-maximization (MLEM) method. We conducted image reconstruction experiments using noisy projection data and found that the proposed algorithm outperformed MLEM and could reconstruct high-quality images that were robust to measured noise by properly selecting parameters.

We give a novel approach for obtaining an intensity-modulated radiation therapy (IMRT) optimization solution based on the idea of continuous dynamical methods. The proposed method, which is an iterative algorithm derived from the discretization of a continuous-time dynamical system, can handle not only dose-volume but also mean-dose constraints directly in IMRT treatment planning. A theoretical proof for the convergence to an equilibrium corresponding to the desired IMRT planning is given by using the Lyapunov stability theorem. By introducing the concept of "acceptable," which means the existence of a nonempty set of beam weights satisfying the given dose-volume and mean-dose constraints, and by using the proposed method for an acceptable IMRT planning, one can resolve the issue that the objective and evaluation are different in the conventional planning process. Moreover, in the case where the target planning is totally unacceptable and partly acceptable except for one group of dose constraints, we give a procedure that enables us to obtain a nearly optimal solution close to the desired solution for unacceptable planning. The performance of the proposed approach for an acceptable or unacceptable planning is confirmed through numerical experiments simulating a clinical setup., Competing Interests: The authors declare no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Ryosei Nakada et al.)