Knowledge, attitude, and perception of low back pain and activities that may prevent it among adolescents in Nigeria

Background: Awareness of activities that may result in low back pain (LBP) among adolescents is fundamental in preventing adulthood LBP. Objective: The aim of this study was to investigate adolescents' knowledge, attitude, and perception of LBP and activities that may prevent LBP in Kano, North-western, Nigeria.Methods: This was a cross-sectional survey involving 400 school-going adolescents recruited using a multistage random sampling technique. Data was analysed using descriptive statistics and Chi-square test with 0.05 set as level of significance. Results: The mean age of the respondents was 16.0±1.50 years. LBP annual prevalence was 34.2%, with more girls (31.1%) reporting having LBP compared to boys (28.4%). More than half (59.3%) of the respondents had poor knowledge of LBP and activities that may prevent it. However, they had a good attitude (63%) and perception (74%) of LBP and activities that may prevent it. There was no significant association of levels of knowledge, attitude, and perception of LBP and activities that may prevent LBP with gender, age, and class of study (p > 0.05). Conclusion: Adolescents in Kano, North-western Nigeria had poor knowledge of LBP and activities that may prevent it. Therefore, there is a need to embark on an LBP prevention program among adolescents in Kano, North-western Nigeria. Keywords: Low back pain; prevention; adolescents; knowledge; attitude; perception

Optimized Model Simulation of a Capacitated Vehicle Routing problem based on Firefly Algorithm

This paper presents an optimized solution to a capacitated vehicle routing (CVRP) model using firefly algorithm (FFA). The main objective of a CVRP is to obtain the minimum possible total travelled distance across a search space. The conventional model is a formal description involving mathematical equations formulated to simplify a more complex structure of logistic problems. These logistic problems are generalized as the vehicle routing problem (VRP). When the capacity of the vehicle is considered, the resulting formulation is termed the capacitated vehicle routing problem (CVRP). In a practical scenario, the complexity of CVRP increases when the number of pickup or drop-off points increase making it difficult to solve using exact methods. Thus, this paper employed the intelligent behavior of FFA for solving the CVRP model. Two instances of solid waste management and supply chain problems is used to evaluate the performance of the FFA approach. In comparison with particle swarm optimization and few other ascribed metaheuristic techniques for CVRP, results showed that this approach is very efficient in solving a CVRP model

Utilizing Deep Machine Learning for Prognostication of Oral Squamous Cell Carcinoma—A Systematic Review

Peer reviewe

The practicality of the use of liquid biopsy in early diagnosis and treatment monitoring of oral cancer in resource- limited settings

An important driving force for precision and individualized medicine is the provision of tailor-made care for patients on an individual basis, in accordance with best evidence practice. Liquid biopsy(LB) has emerged as a critical tool for the early diagnosis of cancer and for treatment monitoring, but its clinical utility for oral squamous cell carcinoma (OSCC) requires more research and validation. Hence, in this review, we have discussed the current applications of LB and the practicality of its routine use in Africa; the potential advantages of LB over the conventional “gold-standard” of tissue biopsy; and finally, practical considerations were discussed in three parts: pre-analytic, analytic processing, and the statistical quality and postprocessing phases

Physicians and AIDS Care: Does Knowledge Influence Their Attitude and Comfort in Rendering Care?

Adequate knowledge, positive attitude, and feeling of comfort are important factors in providing compassionate care to patients. The purpose of this study was to assess physicians\u2019 knowledge, attitude and global comfort in caring for patients with AIDS (PWA), to determine the sociodemographic variables that could influence physicians\u2019 attitude and global comfort, and to identify any relationship between their knowledge, attitude and comfort. Consultants and residents (N=211) in two Nigerian teaching hospitals were surveyed using a two-part questionnaire. Part I elicited sociodemographic and previous AIDS encounter information, and Part II assessed knowledge, attitude and global comfort with AIDS patients care. Nigerian physicians showed satisfactory knowledge, but they harbored negative attitude and low level of comfort in caring for PWA. Previous AIDS care experience, age and being a consultant or a senior resident influenced attitude, while male gender and knowing someone with AIDS influenced global comfort. Knowledge is weakly but positively associated with attitude, while attitude is modestly associated with comfort. The study reinforced the need for an ongoing education focused on experiential learning, and professional socialization in order to influence physicians\u2019 attitude and enhance their feeling of comfort when caring for PWA

Radiation Shielding Properties of Synthetic Ca-Al2O3 Polymer Based Composites

Ionizing radiation exposure from medical diagnostic equipment, industries, nuclear research facilities, and nuclear weapon development has led to health impacts such as cancer and acute radiation syndrome, necessitating the use of proper radiation shielding. The optical and radiation shielding capabilities of Ca-Al2O3 polymer-based composites were explored in this article. The composites were made by combining synthesized Aluminum oxide (Al2O3) with calcium (Ca) formed from Periwinkle shells, Snail shells, and Seashells and calcining them at 1000 oC for 13 hours. The synthesized Ca-Al2O3 powders were dispersed into polymeric materials in a ratio of 1:1 using an effective melt-mixing process, then cast in a 10 cm by 10 cm square Mold with a thickness of 10 mm and allowed to set overnight at ambient temperature. The composite samples obtained were transferred to the Nigerian Nuclear Regulatory Agency (NNRA) in Ibadan for radiographic examinations and analyses. X-ray transmission through the manufactured composites samples was investigated using a well-collimated point source. The produced x-rays' initial intensity (Io) was determined. With the sample in front of the detector, the transmitted x-ray beam (I) was measured. The measurements were repeated three times for each composite sample, and the average value was calculated. Using relevant and referenced equations, the linear attenuation coefficient, half-value layer, relaxation length, and absorbance for each sample were calculated. The radiation shielding composites' x-ray photon absorptions were determined using transmission data by Beer's Lambert law. The XRF results revealed that the calcined samples were mostly calcium with only a few traces of other elements, with percentage calcium quantities of approximately 32, 37, and 34 for snail shells, seashells, and periwinkle shells, respectively, and the XRD result confirmed the Al2O3 polymorphs at approximately 32o and 57 o and the Aluminum phase at 46 o. For the three radiation shielding composites under investigation, the x-ray photon transmittance is quite low at 40 keV to 60 keV and comparatively high at 100 keV to 200 keV. From 100 keV to 200 keV, the transmittance of periwinkle shells and snail shell calcium sources polymer-based composites was similar, and their differences became significant at lower energies. For Ca-Al2O3 polymer-based composites with calcium contents sourced from seashells, periwinkle shells, and snail shells, the maximum linear attenuation coefficients were 1.0 cm-1, 0.79 cm-1, and 0.65 cm-1, respectively. At 60 keV and below, the radiation shielding composites have the highest attenuation coefficient. The half-value layer (HVL) of all the samples under investigation reduced abruptly at 40 and 60 keV and grew linearly as the energy increased from 100 to 200 keV. The relaxation length is comparatively low at 40 and 60 keV compared to other x-ray sources utilized at higher energies. Each radiation shielding composite's properties are determined by the amount of calcium present in the samples. Over a certain photon energy range (40 keV–200 keV), the Ca-Al2O3 polymer-based composites with calcium contents sourced from seashells were found to have higher x-ray attenuating characteristics than other composites. The attenuating capacity of all the composites under this study can be enhanced by increasing the radiation shielding composite thickness.     &nbsp

Emerging histopathologic markers in early-stage oral tongue cancer : A systematic review and meta-analysis

Although there are many histopathologic prognosticators, grading of early oral tongue squamous cell carcinoma (OTSCC) is still based on morphological cell differentiation which has low prognostic value. Here we summarize the emerging histopathological markers showing powerful prognostic value, but are not included in pathology reports. Using PubMed, Scopus, Ovid Medline, and Web of Science databases, a systematic literature search was preformed to identify early OTSCC studies that investigated the prognostic significance of hematoxylin-eosin-based histopathologic markers. Our meta-analysis showed that tumor budding was associated with overall survival (hazard ratio [HR] 2.32; 95% CI 1.40-3.84; p < 0.01) and disease-specific survival (DSS) (1.89; 95% CI 1.13-3.15; p = 0.02). Worst pattern of invasion was associated with disease-free survival (DFS) (1.95; 95% CI 1.04-3.64; p = 0.04). Tumor-stroma ratio was also associated with DFS (1.75, 95% CI 1.24-2.48; p < 0.01) and DSS (1.69; 95% CI 1.19-2.42; p < 0.01). Tumor budding, worst pattern of invasion, and tumor-stroma ratio have a promising prognostic value in early OTSCC. The evaluation and reporting of these markers is cost-effective and can be incorporated in daily practice.Peer reviewe

Stromal categorization in early oral tongue cancer

Stromal categorization has been used to classify many epithelial cancer types. We assessed the desmoplastic reaction and compared its significance with other stromal characteristics in early (cT1-2N0) oral tongue squamous cell carcinoma (OTSCC). In this multi-institutional study, we included 308 cases treated for early OTSCC at five Finnish university hospitals or at the A.C. Camargo Cancer Center in Sao Paulo, Brazil. The desmoplastic reaction was classified as immature, intermediate, or mature based on the amount of hyalinized keloid-like collagen and myxoid stroma. We compared the prognostic value of the desmoplastic reaction with a stromal grading system based on tumor-stroma ratio and stromal tumor-infiltrating lymphocytes. We found that a high amount of stroma with a weak infiltration of lymphocytes was associated statistically significantly with a worse disease-free survival with a hazard ratio (HR) of 2.68 (95% CI 1.26-5.69), worse overall survival (HR 2.95, 95% CI 1.69-5.15), and poor disease-specific survival (HR 2.66, 95% CI 1.11-6.33). Tumors having a high amount of stroma with a weak infiltration of lymphocytes were also significantly associated with a high rate of local recurrence (HR 4.13, 95% CI 1.67-10.24), but no significant association was found with lymph node metastasis (HR 1.27, 95% CI 0.37-4.35). Categorization of the stroma based on desmoplastic reaction (immature, intermediate, mature) showed a low prognostic value for early OTSCC in all survival analyses (P> 0.05). In conclusion, categorization of the stroma based on the amount of stroma and its infiltrating lymphocytes shows clinical relevance in early OTSCC superior to categorization based on the maturity of stroma

Expression Patterns of ER, PR, Her-2/neu and p53 in Association with Nottingham Tumor Grade: A retrospective hospital-based study

Objectives: Histological grading has been an integral part of cancer diagnosis for a long time. Recent molecular studies show that breast cancer is a heterogeneous disease, and several molecular changes may accumulate over time to influence treatment response. As a result, employing reliable molecular biomarkers to monitor these modifications may help deliver personalized treatment. However, this may be unrealistic in the resource-limited parts of the world. Thus, we studied the expression pattern of hormone receptors and p53 tumor suppressor using immunohistochemistry (IHC) in breast cancer (BC) compared to the traditional tumor grade. Methods: Two hundred and five (n =205) cases were investigated. The Modified Bloom-Richardson score system was adopted in grading the tumors. Tissue sections of the cases were stained with specific primary antibodies (at dilutions of 1:60 for estrogen (ER) and progesterone receptors (PR), 1:350 for human epidermal growth factor (Her-2/neu), and 1:50 for p53. The Chi-square test was used to determine the association between the tumor grade and IHC markers. Results: Invasive ductal carcinoma of no-specific type (190 cases;92.7%) was predominant. Grade II tumor (n =146; 71.22%) was the most frequent. Hormone receptors (ER+; n =227 and PR+; n =145) had 62.0% and 70.7% positive cases; 34.2% (n =70) were positive for Her-2/neu, while 76.1% (n =156) were positive for p53. We observed strong associations between Nottingham grade and expression patterns of ER (P ˂ 0.01), PR (P ˂ 0.001), Her-2/neu (P ˂ 0.001), and p53 (P =0.001). Conclusion: Nottingham grade has a high degree of concordance with the patterns of expression of hormone receptors, Her-2/neu, and p53, suggesting that it may play an important role in connection with the predictive and prognostic biomarkers for BC. Keywords: Breast cancer, Her-2/neu, hormone receptor, Nottingham grade, p53 mutation

The Practicality of the Use of Liquid Biopsy in Early Diagnosis and Treatment Monitoring of Oral Cancer in Resource-Limited Settings

An important driving force for precision and individualized medicine is the provision of tailor-made care for patients on an individual basis, in accordance with best evidence practice. Liquid biopsy(LB) has emerged as a critical tool for the early diagnosis of cancer and for treatment monitoring, but its clinical utility for oral squamous cell carcinoma (OSCC) requires more research and validation. Hence, in this review, we have discussed the current applications of LB and the practicality of its routine use in Africa; the potential advantages of LB over the conventional &ldquo;gold-standard&rdquo; of tissue biopsy; and finally, practical considerations were discussed in three parts: pre-analytic, analytic processing, and the statistical quality and postprocessing phases. Although it is imperative to establish clinically validated and standardized working guidelines for various aspects of LB sample collection, processing, and analysis for optimal and reliable use, manpower and technological infrastructures may also be an important factor to consider for the routine clinical application of LB for OSCC. LB is poised as a non-invasive precision tool for personalized oral cancer medicine, particularly for OSCC in Africa, when fully embraced. The promising application of different LB approaches using various downstream analyses such as released circulating tumor cells (CTCs), cell free DNA (cfDNA), microRNA (miRNA), messenger RNA (mRNA), and salivary exosomes were discussed. A better understanding of the diagnostic and therapeutic biomarkers of OSCC, using LB applications, would significantly reduce the cost, provide an opportunity for prompt detection and early treatment, and a method to adequately monitor the effectiveness of the therapy for OSCC, which typically presents with ominous prognosis