Health Institutions Research Articles

Frequency and pattern of acute kidney injury in patients with acute stroke

Background and objective: Stroke is a severe disease of the nervous system resulting in disability and death of the affected individual. Acute kidney injury (AKI) which is a clinical syndrome due to sudden renal function decline is considered as an important factor that increases fatality following a stroke. Thus, this study was conducted to determine the frequency and pattern of AKI in stroke patients and the outcome of patients with stroke and AKI. Methods: This study was a descriptive cross-sectional study, carried out at the Delta State University Teaching Hospital (DELSUTH), Oghara, Delta state, which is a public tertiary health institution in Delta state in a semi-urban area in southern Nigeria. Results: The mean age of patients was 58.9 ± 14.2 years. Slightly above half (53.7%) of the patients were males. Haemorrhagic stroke was the most common type of stroke. Hypertension was the most frequent co-morbid condition (59.0%). Twenty (14.9%) had acute kidney injury, of which stage one AKI was the most dominant (75.0%). Majority of the patients (79.9%) survived. Having sepsis was a significant factor associated with the presence of AKI. None of the clinical characteristics was associated with outcome of patients. Conclusion: The frequency of AKI in stroke patients was 14.9%, with majority of the patients presenting with stage 1 AKI. Presence of sepsis was a significant risk factor for development of AKI in patients with acute stroke, while hypertension was the most prevalent comorbid condition in patients with acute stroke, thus the need for continuous screening of stroke patients for hypertension.

Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors.

Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. The present study utilized a cross-sectional survey design following quantitative methods. This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. Research ethics approval was obtained from the researcher's university. Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.

Self-initiated protection behavior based on Magna Carta of women: Women health workers, teachers, and minimum-wage earners in the workplace

The problem of violence in the workplace continues to expand and it casts a shadow on organizational environments all around the world. This phenomenon extends to different fields or sectors and is pervasive throughout a wide range of job environments, such as those in the healthcare industry, educational institutions, local and informal economies, and service industries. The purpose of this study was to analyze the actions of working women when their rights had been/will be violated. This quantitative study was conducted in Zamboanga Peninsula, Philippines among women in academe (n=121) and health institutions (n=39), and women of minimum-wage earners (n=42). Findings indicated that working women in the region tend to seek information outside their organizations when violence will happen; they also seek information when their rights once were violated. In some instances, they would only file a complaint when they feel discriminated against and when equal rights in the workplace are not well implemented. Notably, minimum-wage earners and health workers are more likely to file a complaint than teachers. The findings resonate with broader societal patterns wherein hesitancy to report workplace violations are deeply embedded. Such behaviors perpetuate gender-based violence and hinder the development of gender-sensitive and conducive workplaces. To deconstruct the gender and development (GAD) limitations, interventions need to extend beyond the present organizational policies to instill a culture of empowerment and safety for all individuals, fostering an environment conducive to open discussions, proactive conflict resolution mechanisms, and reliable report systems.

Mortality and adverse events associated with statin use in primary care patients with depression: a real-world, population-based cohort study

BackgroundNew National Institute for Health and Care Excellence (NICE) guidance endorses the prescription of statins in larger population groups for the prevention of cardiovascular and cerebrovascular morbidity and mortality, especially...

Musculoskeletal System and Gait Characteristics in Patients with Osteogenesis imperfecta.

The aim of the study was to assess the muscoloskeletal system and spatiotemporal gait parameters of patients in three types of osteogenesis imperfecta. Retrospective observational study. The Department of Rehabilitation, Children's Memorial Health Institute in Warsaw, Poland. This study investigated individuals with various types of osteogenesis imperfecta: 33 with osteogenesis imperfecta I (aged 13.9), 16 with osteogenesis imperfecta III (aged 10.4), and 14 with osteogenesis imperfecta IV (aged, 15.8), as well as a reference group of 400 healthy individuals. The musculoskeletal assessment included: medical record review, clinical evaluation, functional tests, long bone deformity assessment via clinical and X-ray examination, and objective gait analysis with the Vicon Motion Systems (Ltd, Oxford, UK). The study revealed notable differences in clinical presentation, deformities within the musculoskeletal system, gait parameters across the various types of osteogenesis imperfecta (p < 0.001). The most affected gait parameters were: cadence, gait speed and step length. The greatest deformities of lower limbs and spine were presented in patients with osteogenesis imperfecta type III. These findings are significant for understanding gait abnormalities in osteogenesis imperfecta patients and designing customized physiotherapy programs to help them participate fully in daily life. Improvement of muscle strength is one of the key for easier engagement in activities like walking or stair-climbing.

Capacity building and community of practice for women community health workers in low-resource settings: long-term evaluation of the Mobile University For Health (MUH)

BackgroundLebanon has been facing a series of crises, significantly increasing health challenges, and straining its healthcare infrastructure. This caused deficiencies in the system's ability to attend to population health needs, and it profoundly impacted vulnerable and refugee communities who face additional challenges accessing healthcare services. In response, the Global Health Institute at the American University of Beirut designed and implemented the Mobile University for Health (MUH), which promotes task-shifting through capacity building complemented by communities of practice (CoP). The program aimed to prepare vulnerable women to assume the role of community health workers (CHW) within their communities, and to promote positive health knowledge and behaviours.MethodsA mixed-methods approach was used to evaluate MUHs' three certificates (women's health, mental health and psychosocial support, and non-communicable diseases). Implementation took place between 2019 and 2022, with 83 CHWs graduating from the program. Short-term data including knowledge assessments, course evaluations, and community member feedback surveys were collected. 93 semi-structured interviews with CHWs and 14 focus group discussions with community members were conducted to evaluate the long-term impact of the capacity building and CoP components.ResultsData revealed multiple strengths of the initiative, including increased access to education for the community, effectiveness of blended learning modality, successful planning and delivery of CoP sessions, and improved knowledge, skills, and health behaviours over time. The supplementary CoP sessions fostered trust in CHWs, increased community empowerment, and increased leadership skills among CHWs. However, some challenges persisted, including limited access to healthcare services, implementation logistical issues, difficulties with some aspects of the learning modality, and some resistance within the communities.ConclusionMUH promoted and improved positive health knowledge and behaviours within targeted vulnerable populations in Lebanon. The supplementary CoP component proved instrumental in empowering CHWs and enhancing their impact within their communities. The study highlights the need for ongoing training and support for CHWs and underscores the importance of continued investment and adaptation of such initiatives through a gendered lens. This evaluation provides evidence on the successes of a capacity building model that has strong potential for scale and replication across health topics in conflict-affected contexts.

New Tools for Data Harmonization and Their Potential Applications in Organ Transplantation.

In organ transplantation, accurate analysis of clinical outcomes requires large, high-quality data sets. Not only are outcomes influenced by a multitude of factors such as donor, recipient, and transplant characteristics and posttransplant events but they may also change over time. Although large data sets already exist and are continually expanding in transplant registries and health institutions, these data are rarely combined for analysis because of a lack of harmonization. Promoted by the digitalization of the healthcare sector, effective data harmonization tools became available, with potential applications also for organ transplantation. We discuss herein the present problems in the harmonization of organ transplant data and offer solutions to enhance its accuracy through the use of emerging new tools. To overcome the problem of inadequate representation of transplantation-specific terms, ontologies and common data models particular to this field could be created and supported by a consortium of related stakeholders to ensure their broad acceptance. Adopting clear data-sharing policies can diminish administrative barriers that impede collaboration between organizations. Secure multiparty computation frameworks and the artificial intelligence (AI) approach federated learning can facilitate decentralized and harmonized analysis of data sets, without sharing sensitive data and compromising patient privacy. A common image data model built upon a standardized format would be beneficial to AI-based analysis of pathology images. Implementation of these promising new tools and measures, ideally with the involvement and support of transplant societies, is expected to produce improved integration and harmonization of transplant data and greater accuracy in clinical decision-making, enabling improved patient outcomes.

Effects of Metreleptin in Patients with Generalized Lipodystrophy Before vs After the Onset of Severe Metabolic Disease.

Leptin replacement therapy with metreleptin improves metabolic abnormalities in patients with generalized lipodystrophy (GLD). Determine how timing of metreleptin initiation in the clinical course of GLD affects long-term metabolic health. Retrospective analysis of patients ≥ 6 months old with congenital (n=47) or acquired (n=16) GLD treated with metreleptin at the National Institutes of Health since 2001. Least squares means (LSM) for HbA1c, insulin area under the curve (AUC) from oral glucose tolerance tests, triglycerides, urine protein excretion, platelets, transaminases, and aspartate aminotransferase (AST) to Platelet Ratio Index (APRI) for early and late treatment groups, defined by baseline metabolic health, were analyzed during median 72 (24, 108) months follow-up. Compared to late groups, early groups based on metabolic status had higher mean±SEM insulin AUC (20831±1 vs 11948±1), lower HbA1c (5.3±0.3 vs 6.8±0.3%), triglycerides (101±1 vs 193±1 mg/dL), urine protein excretion (85±1.5 vs 404±1.4 mg/24 hr), ALT (30±1 vs 53±1 U/L), AST (23±1 vs 40±1 U/L), and APRI (0.22±1.3 vs 0.78±1.3), and higher platelets (257±24 vs 152±28 K/µL) during follow-up (P<0.05). Compared to patients ≥6 years old at baseline, patients <6 years had lower HbA1c (4.5±0.5 vs 6.4±0.2%) and higher AST (40±1vs 23±1 U/L) during follow (P<0.05). Patients with GLD who initiated metreleptin before the onset of severe metabolic complications had better long-term control of diabetes, proteinuria, and hypertriglyceridemia. Early treatment may also result is less severe progression of liver fibrosis, but further histological studies are needed to determine the effects of metreleptin therapy on liver disease.

Prevalence of Klebsiella pneumoniae and Acinetobacter baumannii in Urine Samples of Pregnant Women in South-East, Nigeria

Background: Pregnancy induces so many changes in the woman’s body that likely predisposes them to Klebsiella pneumoniae and Acinetobacter baumannii which causes Urinary Tract Infections (UTIs). Aims: To determine the prevalence of Klebsiella pneumoniae and Acinetobacter baumannii in urine samples of pregnant women attending ante-natal clinics at three health institutions within the study area. Study Design: This study was a descriptive cross-sectional study. Place and Duration of Study: Department of Microbiology Federal University Teaching Hospital, Owerri, Teaching Hospital Orlu and General Hospital Okigwe, Imo State between October 2021 and February 2022. Methodology: Urine samples were collected aseptically from 408 pregnant women between 18-45 years and analyzed by culturing onto the surface of freshly prepared MacConkey and Chromogenic agar plates for the isolation of Klebsiella pneumoniae and Acinetobacter baumannii respectively and confirmed by appropriate biochemical tests. Results: From the results, there was a prevalence rate of 145/408 (35.54%) for both isolates with Klebsiella pneumoniae being more dominant with a prevalence rate of 96/408 (23.53%) as against Acinetobacter baumannii that was 49/408 (12.01%). The highest prevalence of the isolates was seen in the Owerri zone with a prevalence rate of 37 (9.07%) for Klebsiella pneumoniae and 23 (5.64%) for Acinetobacter baumannii, respectively. The highest age-specific prevalence of the isolates within the three zones was observed in the 24–29-year-olds with a prevalence rate of 42 (10.29%) in the Owerri zone. In contrast, the prevalence of both organisms was higher in pregnant women in their third trimester of pregnancy with a prevalence rate of 72 (17.65%) and in multigravida women with a prevalence rate of 217 (53.2%). Conclusion: The results from this study showed that these isolates are becoming more predominant in causing both symptomatic and asymptomatic urinary tract infections in pregnant women, hence regular check-ups and proper treatments of urinary tract infections in pregnant women should be encouraged.

Effect of Psychoeducation on Reducing Burden Among Primary Caregivers of People with Schizophrenia

Schizophrenia is a serious psychological illness that needs long-term treatment. Family members, especially those who care for a patient at home, experience the burden of providing long-term care. Psychoeducational intervention may enhance the caregiver’s outcomes. The major goal of the study was to explore the effect of psychoeducation on reducing the burden among primary carers of people with schizophrenia. In this study, thirty-two participants (32 caregivers) were purposefully selected based on the National Institute of Mental Health (NIMH). A personal information form and the Bangla version of the Zarit Burden Interview scale were administered. Total participants were divided by simple randomization into two groups (i.e., experimental and control groups). Following the baseline evaluation by questionnaire, the experimental group of 16 caregivers received two sessions of psychoeducation, but the control group of the same number of caregivers did not. The effectiveness of psychoeducation was evaluated using a pretest-posttest control group design. Findings suggested that psychoeducation decreased the level of burden, and after the intervention, the mean score of the experimental group was lower than that of the control group. These findings found that the psychoeducation intervention had a positive outcome in reducing the burden on caregivers of patients who deal with schizophrenia. Jagannath University Journal of Life and Earth Sciences, 9(1): 81–94, 2023 (June)

Anti-Asian biases in federal grant reviews: Commentary on Yip et al. (2021).

Prior to the 2021 American Psychologist special issue "Rendered Invisible: Are Asian Americans a Model or a Marginalized Minority?" (Yip et al., 2021), only seven articles on Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations were published in the journal in 3 decades. The special issue interrogated sources of invisibility and marginalization of AANHPIs not only in the field of psychology but also in the broader national landscape. The current commentary provides a deeper dive into one of the primary drivers of AANHPI invisibility, anti-Asian biases encountered during the federal grant review process, which contributes to low funding rates and insufficient research on AANHPI communities. Despite comprising over 6% of the U.S. population, less than 1% of the National Institutes of Health's funding portfolio supports science on AANHPI populations. This qualitative study revealed thematic barriers encountered during National Institutes of Health grant reviews. A one-time survey was circulated to professional scientific networks to obtain open-ended responses regarding applicants' and reviewers' experiences proposing research with AANHPI samples, resulting in data from N = 16 respondents. Respondents were asked to indicate their role in the review process (e.g., investigator, applicant, reviewer, other) and to provide open-ended responses detailing experiences of bias. Thematic coding revealed six principal themes: (1) invalidation, (2) limited reviewer knowledge, (3) oppression Olympics, (4) White comparison groups, (5) model minority myth, and (6) homogeneity of AANHPI groups. Building off these themes, this commentary concludes with five actionable policy and institutional recommendations aimed at achieving a more inclusive national research enterprise for AANHPI investigators and communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Surgical methods of treatment for tibial diaphyseal fractures

Background. Bone fractures are a public health concern. In recent years, there has been an upward trend in body weight of people of all age groups. Obesity has long been thought to help protect against fractures, but recent studies have shown that for every 5 cm increase in waist circumference, the risk of any fracture is 3 % higher. The purpose: according to the meta-analysis of modern medical literature, to determine the main directions of surgical treatment for long bone fractures, their advantages, and disadvantages, including in overweight patients, the features of diaphyseal fracture fixation in overweight patients. Materials and methods. A meta-analysis of special literature from scientific databases was conducted: Cochrane Library, Scopus, National Library of Medicine — National Institutes of Health, ReLAB-HS Rehabilitation Resources Repository. One hundred and thirty articles were analyzed, from them 31 were selected, which, in our opinion, reflect the purpose of the study. Results. All methods of surgical fixation of fractures have their advantages and disadvantages. The frequency of nonunions caused by intramedullary fixation of the femoral shaft can reach 10 %, and varus/valgus and rotational deformities and shortening can also be observed. But the use of locking screws prevents the occurrence of most complications. When fixing the fractures with plates, the main complications are related to superficial and deep infections, which were more often observed in overweight patients. The analysis demonstrated that in overweight and obese patients, the main complicating factor is not the method for fixing the fracture zone, but factors related to the health of the patient himself. So, despite the fact that the results of treatment of fractures in patients with normal weight and obesity did not have a statistically significant difference, an increase in cardiovascular complications, exacerbation of chronic respiratory diseases was observed. Moreover, it is the presence of concomitant diseases that often makes surgical intervention impossible. Conclusions. There is a large amount of research on surgical methods of fixing tibial diaphyseal fractures, but data on the choice of fixation method in overweight and obese patients as a separate approach were not found. There are data on complicating factors of excess weight in the treatment of fractures and surgical interventions. Systematic studies related specifically to the algorithm for choosing the method of fracture fixation and complications have also not been found.

Blood smears examination and prevalence of malaria in Addis Zemen Town, Northwest Ethiopia (2013–2021): a retrospective study

IntroductionIn Ethiopia, malaria is one of the major public health and socioeconomic problems, though tremendous efforts have been made. Currently, the country has a plan to eliminate malaria by 2030. To achieve this plan, epidemiological studies associated with malaria prevalence with gender, age groups, species types, and seasons are essential. Therefore, the aim of this study was to assess the prevalence of malaria from 2013 to 2021 in Addis Zemen town, Northwest Ethiopia.MethodsA retrospective study was conducted at assess the trend of malaria prevalence over the last nine years using recorded blood smear reports in the laboratory logbook from governmental health institutions. Trends in malaria cases and the proportion of genders, age groups, species, and seasons over time were compared. The data were analyzed using the SPSS-23 software package.ResultsThe overall malaria prevalence between 2013 and 2021 was 10.4%. From all confirmed cases, the minimum and maximum prevalence of malaria cases were recorded in 2018 (2%) and 2016 (33.2%) years, respectively. The infectious rate of males (59.3%) was significantly higher than that of females (40.7%) (p < 0.0001). In all survey periods, all age groups were infected by malaria parasites; the majority of the cases were between 15 and 45 years (57%) older than others. Statistically, a greater proportion of P. falciparum (80.1%) was recorded than P. vivax (18.5%) (p < 0.0001). Malaria cases were occurring throughout each month. The relative highest peaks of total malaria cases were observed during the months of September, October, and November. Seasonally, the highest infection rate was observed during spring (40.20%) compared to other seasons.ConclusionsIn conclusion, the study revealed that malaria transmission remained high, which affected males more than females and potentially reproductive ages. Two of the most important Plasmodium species were identified and found during all reviewed months and years, though P. falciparum was the most prevalent. Hence, the problem can be alleviated by using season-based long-lasting insecticide treated nets, regularly overseeing ongoing irrigation activity, overseeing the reduction of the water level of the Sheni River, health education, and providing immediate patient treatment.

Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China

BackgroundThe public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement.MethodsWe used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences.ResultsThe total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones.ConclusionsThe public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

The Worldview-Open Society, the Worldview-Controlling State and Non-Profit Welfare Actors: Norway as a Case

Abstract Diaconal actors, constituting the main share of health and caring institutions within the non-profit sector in Norway, face challenges as well as opportunities. The article analyzes the political framework that diaconal actors do operate under. Opportunities include strong political acknowledgements of the societal role of non-profit actors, decisions on increasing the overall share of their service provision, tender competitions reserved for non-profit actors, and the Norwegian emphasis on a worldview-open society. The authorities do also emphasize diversity as positive. The article demonstrates different understandings of requirements for being termed non-profit. Not only the actor itself must specify in its articles of association that profits must be reinvested to promote social purposes; recently the government has emphasized that also the owner(s) of actors must an establish such a non-profit social purpose in their articles of association. Specific examples are given of how Norwegian authorities act as promoters of a worldview-open society and a worldview-controlling state.

Dynamics of cognitive variability with age and its genetic underpinning in NIHR BioResource Genes and Cognition cohort participants.

A leading explanation for translational failure in neurodegenerative disease is that new drugs are evaluated late in the disease course when clinical features have become irreversible. Here, to address this gap, we cognitively profiled 21,051 people aged 17-85 years as part of the Genes and Cognition cohort within the National Institute for Health and Care Research BioResource across England. We describe the cohort, present cognitive trajectories and show the potential utility. Surprisingly, when studied at scale, the APOE genotype had negligible impact on cognitive performance. Different cognitive domains had distinct genetic architectures, with one indicating brain region-specific activation of microglia and another with glycogen metabolism. Thus, the molecular and cellular mechanisms underpinning cognition are distinct from dementia risk loci, presenting different targets to slow down age-related cognitive decline. Participants can now be recalled stratified by genotype and cognitive phenotype for natural history and interventional studies of neurodegenerative and other disorders.

Objective response after immune checkpoint inhibitors in a chemotherapy-refractory pMMR/MSS metastatic rectal cancer patient primed with experimental AlloStim® immunotherapy

BackgroundImmune Checkpoint Inhibitor (ICI) immunotherapy is most effective in immune effector cell infiltrated ‘hot’ tumor lesions, such as occurs in deficient mismatch repair, microsatellite instability high (dMMR/MSI-H) colorectal cancer (CRC). However, most all metastatic CRC tumors are mismatch repair proficient/microsatellite stable (pMMR/MSS) ‘cold’ lesions, without significant immune cell infiltration, and are unresponsive to ICI. AlloStim®, is an experimental, allogeneic immunomodulatory cell therapy designed to convert ‘cold’ metastatic tumor lesions to ‘hot’ inflamed lesions. After AlloStim® immunotherapy, this cold to hot inflammatory mechanism can make it difficult to distinguish between pseudoprogression and actual progression on restaging CT scans, as inflamed metastatic lesions can appear larger and occult disease can appear as new small lesions.MethodsTo explore whether radiological progression after AlloStim® immunotherapy is due to immune-flare or disease progression, we administered a short course of a combination ICI therapy to a pMMR/MSS chemotherapy-refractory metastatic colorectal cancer patient enrolled in the StimVax Phase IIb clinical study that presented with radiological progression after AlloStim® immunotherapy. Our rationale was that an accelerated response to ICI should occur if the lesions were inflamed, while if the enlarged lesions were due to disease progression there would not be a response.ResultsHere we report a rapid, significant reduction in tumor burden in response to ICI administration in an AlloStim® primed pMMR/MSS mCRC patient with retroperitoneal and lung metastases.ConclusionThis rare objective response to ICIs in a pMMR/MSS mCRC patient supports further evaluation of the combination of AlloStim® with ICI immunotherapy in MSS mCRC and other cold or ICI refractory tumors.Trial registrationNational Library of Medicine (NLM) at the National Institutes of Health (NIH). Registered 22 June 2020, https://clinicaltrials.gov/study/NCT04444622.

Joint EANM-SNMMI guideline on the role of 2-[18F]FDG PET/CT in no special type breast cancer : (endorsed by the ACR,ESSO, ESTRO, EUSOBI/ESR, and EUSOMA).

There is much literature about the role of 2-[18F]FDG PET/CT in patients with breast cancer (BC). However, there exists no international guideline with involvement of the nuclear medicine societies about this subject. To provide an organized, international, state-of-the-art, and multidisciplinary guideline, led by experts of two nuclear medicine societies (EANM and SNMMI) and representation of important societies in the field of BC (ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA). Literature review and expert discussion were performed with the aim of collecting updated information regarding the role of 2-[18F]FDG PET/CT in patients with no special type (NST) BC and summarizing its indications according to scientific evidence. Recommendations were scored according to the National Institute for Health and Care Excellence (NICE) criteria. Quantitative PET features (SUV, MTV, TLG) are valuable prognostic parameters. In baseline staging, 2-[18F]FDG PET/CT plays a role from stage IIB through stage IV. When assessing response to therapy, 2-[18F]FDG PET/CT should be performed on certified scanners, and reported either according to PERCIST, EORTC PET, or EANM immunotherapy response criteria, as appropriate. 2-[18F]FDG PET/CT may be useful to assess early metabolic response, particularly in non-metastatic triple-negative and HER2+ tumours. 2-[18F]FDG PET/CT is useful to detect the site and extent of recurrence when conventional imaging methods are equivocal and when there is clinical and/or laboratorial suspicion of relapse. Recent developments are promising. 2-[18F]FDG PET/CT is extremely useful in BC management, as supported by extensive evidence of its utility compared to other imaging modalities in several clinical scenarios.

Application of Data Mining Techniques in Biopsy Interpretation and Staging of Carcinoma Cancer Disease: A Case Study of Northeastern Nigeria

This paper introduces an innovative framework tailored for carcinoma cancer staging in northeastern Nigeria, employing data mining techniques and machine learning algorithms, with analysis conducted using the WEKA toolkit. Given the challenges in healthcare systems, especially in cancer diagnosis and treatment, this study aims to enhance diagnostic precision thorough analysis of biopsy reports. By assessing Support Vector Machine (SVM) and decision tree algorithms using datasets from six tertiary health institutions, the framework demonstrates promising outcomes in accurately determining cancer malignancy stage. SVM exhibits high accuracies in staging breast and prostate cancer, while decision tree algorithms show notable accuracy rates in staging skin cancer. These results highlight the potential of machine learning in advancing cancer diagnosis and treatment planning, particularly in resource-constrained settings, and pave the way for the development of computer-aided diagnostic tools tailored for carcinoma cancer staging in northeastern Nigeria.

Viral load suppression and its predictor among HIV seropositive people who receive enhanced adherence counseling at public health institutions in Bahir Dar, Northwest Ethiopia. Retrospective follow-up study.

For those HIV seropositive people with high viral loads, the World Health Organization recommends more counseling before changing ART regimens. A high viral load can lead to increased HIV transmission and lower survival rates. Clients with viral loads above 1000 copies/mL should receive enhanced adherence counseling for 3-6 months before switching. Despite enhanced adherence counseling programs, most countries struggle with viral load suppression. Little is known about viral load suppression in Ethiopia and the research area after counseling. This study aims to assess viral load suppression and its predictors among HIV-positive individuals receiving enhanced adherence counseling in Bahir Dar, Northwest Ethiopia, in 2022. An institution-based retrospective follow-up study was conducted among randomly selected 546 clients on Enhanced Adherence Counseling at public health facilities in Bahir Dar city. The Epicollect5 mobile application was used to collect the data, which was then exported to Stata version 14 for analysis. A Log-Binomial regression model was fitted for each explanatory variable. Variables having a p-value <0.25 in bivariate analysis were entered into a multivariable Log-Binomial regression model. Finally, an adjusted risk ratio with a 95% confidence interval and a p-value <0.05 was used to measure the strength of the prediction. Following enhanced adherence counseling, 312 (57.1%) people had their viral load suppressed. Absence of recurrent OI (ARR 1.40; CI 1.03-1.91), EAC stay less than 3 months (ARR 1.54; CI 1.19-1.99), EAC stay 3-6 months (ARR 1.38; CI 1.12-1.69), once-daily ARV dose regimen (ARR 1.28; CI 1.03-1.58), baseline viral load of 2879.00 copies/ml (ARR 1.30, CI 1.06-1.60), being orthodox Tewahido Christian (ARR 0.37; CI 0.18-0.75) were significant predictors of viral load suppression after Enhanced Adherence Counseling. Most importantly, this study found that most people had suppressed viral loads after receiving enhanced adherence counseling. Significant predictors of viral load suppression included recurrent OI, length of stay on EAC, daily ARV dosing regimen, baseline viral load, and religion. Clients with a high baseline viral load and those who experience recurring opportunistic infections should get extra care during EAC sessions.