Medical students\u27 knowledge of HPV, HPV vaccine, and HPV-associated head and neck cancer

On the basis of their training, medical students are considered the best case scenario among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = -1.53; 95% CI: -2.53, -0.52), as did nonwhite students (β = -1.05; 95% CI: -2.07, -0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC

Enhanced syngas production from glycerol dry reforming over Ru promoted -Ni catalyst supported on extracted Al2O3

Crude glycerol, a by-product of biodiesel production, has drawn considerable attention to the importance of glycerol valorization through dry reforming reaction to obtain syngas. The selection of suitable catalysts is significantly important to enhance the catalytic activity in glycerol dry reforming (GDR) reactions. Hence, Ru with different loadings (i.e. 1%, 2%, 3%, 4%, 5%) doped in 15% Ni-extracted Al2O3(EA) was evaluated as catalyst via GDR process in this study. The catalyst prepared by ultrasonic-impregnation assisted technique was subjected to 8 h of CO2 reforming of glycerol. The reactant conversions and products yield was in the order of 3%Ru-15%Ni/EA > 5%Ru-15%Ni/EA > 4%Ru-15%Ni/EA > 2%Ru-15%Ni/EA > 1%Ru-15%Ni/EA > 15%Ni/EA, while the quantity of carbon deposited was in the order 15%Ni/EA > 1%Ru-15%Ni/EA > 2%Ru-15%Ni/EA > 4%Ru-15%Ni/EA > 5%Ru-15%Ni/EA > 3%Ru-15%Ni/EA. 3%Ru-15%Ni/EA attained the greatest glycerol conversions of 90%, H2 yield of 80% and CO yield of 72% with the lowest carbon deposition of 7.38%. The dispersion of Ni particles on EA support evidently improved after the promotion step with Ru, which minimized the agglomeration of Ni and smaller crystallite size. In addition, the introduction of Ru increased the oxygen storage capacity which significantly reduced the formation of carbon during the reaction. GDR's optimal reaction temperature obtained over 3%Ru-15%Ni/EA catalysts was at 1073 K (i.e. 93% glycerol conversion; 87% H2 yield; 79% CO yield). Over a 72 h time on stream at 1073 K, 3%Ru-15%Ni/EA catalyst had superior catalytic activity and stability. Overall, 3%Ru-15%Ni/EA catalyst was more coke-resistant than other promoted catalysts due to its accessible structure, higher oxygen storage capacity, moderate basicity, uniformly dispersed Ni phase and stronger Ru/Ni-EA interaction

A search for appropriate anchor tenants in shopping malls in Lagos metropolis

Anchor tenant which have been regarded as tenants in shopping mall that propel visitation and activities in the mall has been studied majorly in line with its impact on customers, other shopping outlets and generally on the mall. There appears to be no work on a search for the constituents of anchor tenant in the mall. This happens to be the crux of the present study with emphasis on three notable malls in Lagos Metropolis, The Palms Mall, Ikeja City Mall and Adeniran Ogunsanyan Shopping Mall. A total of 207 questionnaires were distributed to customers of the mall using the mall intercept approach of which a cumulative response rate of 81% was achieved. Data collated which was geared towards ascertaining the stores/products offered that attract the customers to the malls was rated on a likert scale of 5 and analysed using the Relative Importance Index and result substantiated with the chi-square test of significance both at the 0.05% and 0.01% level of significance. The study advocated that mix of the plethoric of Departmental Stores (4.7917); Entertainment centres (4.6250); clothing foot wares and accessories (4.5833); Electronics and electrical appliances (4.4881); food and beverage (4.4583); food stuff (4.2381); Watches, jewellery and ornament (4.1904); and Financial Services (4.0000) will be best suited as anchor tenants in the study area

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Coinfection of Rotavirus, Adenovirus and Norovirus among Children with Diarrhea in South-South, Nigeria

This study aims to determine the prevalence of co-infection of Norovirus, Rotavirus and adenovirus among children under 5 years of age with diarrhea in South-South, Region, Nigeria. This study included a total of 405 children with diarrhea within the age range 0-5 yrs. Faecal specimens were collected in well screwed capped containers and analyzed withing 4 hrs of collection for Norovirus using a lateral flow immunochromatographic test kit (Biopanada, United Kingdom). The specimen were analyzed using Cromatest Rotavirus/ Adenovirus combo rapid immunoassay kit (Cromatest, Linear Chemicals Spain) according to manufacturer's instruction. The Prevalence of norovirus, Adenovirus and Rotavirus was 18.5%, 15.5% and 9.9% respectively. Norovirus and Adenovirus co-infection were the commonest 5.7% with the least being Norovirus and Rotavirus coinfection 2.5%.The prevalence of coinfection of norovirus with Rotavirus and Adenovirus was significantly higher among children 0-1-year-old (P=0.003).&nbsp; There is evidence that norovirus is the leading cause of viral induced diarrhea in our study area. There is need for routine screening for co-infection of viral aetiologic agents of gastroenteritis to improve patients' outcomes and ensure proper patient management.&nbsp; Key words: Norovirus, Rotavirus, Adenovirus, Children

Syngas Production via Methane Dry Reforming: A Novel Application of SmCoO3 Perovskite Catalyst

In this study, SmCoO3 perovskite catalyst have been synthesized by the sol-gel citrate method and for the first time, applied as catalyst for the production of syngas (H2 and CO) via methane dry reforming reaction. The perovskite catalyst was characterized (pre- and post-reaction) to determine its physicochemical properties. Characterization of the calcined perovskite catalyst showed the formation of perovskite structure only. No other crystalline phases were detected. Prior to the catalytic test, the effects of reducing SmCoO3 perovskite catalyst with H2 (for activation) in the methane dry reforming reaction were investigated. Results showed no significant effects of H2 reduction on the activity of the SmCoO3 perovskite catalyst. This suggests that there was an in-situ reduction of SmCoO3 which was confirmed by XRD analysis of spent catalyst. Subsequently, reactant gases (CO2 and CH4) with partial pressure ranged 6.8-60.8 kPa and reaction temperature ranged 973-1073 K were employed for the reaction study. Results from the catalytic activity yielded maximum conversion of 93% for both reactants, at reactants partial pressure of 20.3 kPa (stoichiometric point). In addition, syngas with maximum percentage yield of 67% and 65% for H2 and CO, respectively, was produced from the methane dry reforming reaction. Used catalyst characterization showed the existence of carbon deposit which could have emanated from methane decomposition

Syngas Production from Methane Dry Reforming over SmCoO3 Perovskite Catalyst: Kinetics and Mechanistic Studies

The kinetics of the methane dry (CO2) reforming over the SmCoO3was investigated in the temperature ranged 973e1073 K by varying the CH4and CO2partial pressures. Based on detailed study of the reaction mechanism, a mechanistic model is proposed from which a kinetic model is derived. The mechanistic pattern assumes adsorption of CH4on reduced Co, followed by methane cracking and carbon deposition. CO2 reacts with Sm2O3 to form Sm2O2CO3 and the oxycarbonates react with carbon to produce CO. The power law and LangmuireHinshelwood kinetic model which is established on this mechanism were able to forecast the kinetic results

Statewide variability in predictors of survival among geographically and racially diverse breast cancer cohorts

Introduction: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free breast cancer screening, case management, patient navigation, and connection to treatment for medically underserved and economically-disadvantaged women aged 40-64 years. The aim of this study was to identify differences in predictors of survival between all women diagnosed with breast cancer in South Carolina versus those enrolled in the SC NBCCEDP. Methods: We established a retrospective cohort of breast cancer patients diagnosed from 2004 to 2015 using the South Carolina Central Cancer Registry. Sociodemographic (e.g., race, age) and clinical variables were abstracted from the registry. We linked registry data to county-level variables to determine levels of social deprivation and residence in a health care professional shortage area using the Robert Graham Center\u27s Social Deprivation Index (SDI) and the Health Provider Shortage Area (HPSA) designation. Potential exposure variables (e.g., SDI, hormone receptor status, age, HER2 receptor status, time to first treatment, region, insurance status, cancer stage, year of diagnosis, rurality, NBCCEDP enrollment, race, marital status, cancer grade, HPSA designation) were entered into a Cox proportional hazard model to identify significant predictors of survival. The multivariable model utilized a backward elimination process to obtain the best fitting model at a pvalue \u3c0.05 for each cohort of survivors (NBCCDP participants and all other breast cancer survivors). Results: A total of 34,518 breast cancer patients were diagnosed during this time out of which 873 (2.5 %) were NBCCEDP participants. Overall, there were nine significant predictors namely race, cancer stage, age, hormone receptor status, HER receptor, cancer grade, marital status, insurance status, and diagnosis year. Among NBCCEDP participants, there were four significant predictors namely cancer stage, age, hormone status, and region. Region was the only significant predictor variable unique to NBCCEDP participants with those living in the Midlands region having an adjusted hazard ratio of 1.8; 95% CI: 1.1-2.8 compared with participants who lived in Lowcountry region. Overall, in both cohorts, race was one of the significant independent predictor variables with Black women having an adjusted hazard ratio of 1.2; 95% CI: 1.1-1.3 compared with white women. Conclusions: Survival was significantly poorer among NBCCEDP participants living in the Midlands region, and Black women overall. To reduce survival disparities and enhance efficiency of NBCCEDP, efforts directed at enhancing support and eliminating barriers to timely detection and treatment should be focused on NBCCEDP participants living in the Midlands region of the state and Black women generally