CD4 and CD8 T-cell lymphocytes from penile squamous cell carcinoma tumors are more differentiated with higher PD-1 expression compared to lymphocytes in peripheral circulation.

AI-driven diagnosis of Lassa fever: Evidence from Nigerian clinical records.

Background: Antiretroviral therapy (ART) remains the primary treatment for Human immunodeficiency virus (HIV) infection, aiming to reduce viral replication and mortality, but this requires lifelong adherence. To achieve viral load suppression (VLS) (below 1,000 copies/ml), the World Health Organization (WHO) recommends annual VL measurements and enhanced adherence counselling (EAC). To determine the prevalence of VLS following EAC amongst the virally unsuppressed PLHIV at the Rivers State University Teaching Hospital (RSUTH) and factors influencing their virology outcomes. Methods: A retrospective descriptive review of records of 330 virally unsuppressed PLHIV, aged 18 years and more, from September 2021–March 2023. Sampling method: Random sampling method of those on comprehensive 3 sessions of monthly EAC. Ethical approval was obtained from the RSUTH ethical committee and an informed consent received from the ART management team. Data was collated and associations analysed with statistical significance set at p-value of<0.05. Results: The prevalence of VLS after EAC3 (three sessions) was 70.9%. Highest preponderances were among females (51.5%), middle aged (73.3%), unemployed (71.1%), those on first line ART regimen (71.3%), CD4 count of <200 cells/mm3 and statistically significant levels (p-value<0.01) in those who had < five years ART (79.5%). There were also significant logistic regression scores (4.119, p=0.042 and 41.173, p=0.000, respectively) for VLS levels after EAC2 and EAC3. Conclusions: Administration of at least three sessions of EAC with VL monitoring is helpful in achieving viral suppression in PLHWA.

Sickle cell anaemia (SCA), the most common monogenic disorder, affects 20-25million people globally and is prevalent in Sub-Saharan Africa, especially Nigeria, where the prevalence is 1-3%. Beyond its haematological complications, SCA is associated with chronic anaemia and oxidative stress, which may adversely affect ovarian function; however, this relationship remains poorly understood. This study aimed to evaluate ovarian reserve in women with SCA using Anti-Mullerian Hormone (AMH) and Antral Follicle Count (AFC) and assess the role of oxidative stress. This was a comparative cross-sectional study, conducted at Lagos State University Teaching Hospital, over a 6-month period, in which 75 women with SCA (HbSS) in a steady/stable clinical state and 75 age-matched women with normal haemoglobin genotype (HbAA), were consecutively recruited. Relevant data was collected with the aid of interviewer-administered structured questionnaires. The study participants had their body mass index (BMI), venous blood AMH levels and oxidative stress markers (superoxide dismutase, glutathione peroxidase and malondialdehyde) levels, and transvaginal ultrasound for AFC assessed according to standard. Women aged < 18 or > 45 years and women on antioxidant medications were excluded. Data were analyzed using relevant inferential statistics with significance level set at 0.05%. HbSS participants had significantly lower median AMH (1.52 ng/ml, IQR 1.0-2.1) and AFC (12.0, IQR 9.0-13.0) compared to the HbAA group (AMH 3.80 ng/ml, IQR 2.7-7.8; AFC 15.0, IQR 12.0-16.0; p < 0.001 for both). Age showed a significant negative correlation with AMH and AFC in HbSS women (r = -0.301, p = 0.010; r = -0.360, p = 0.001). Superoxide dismutase levels were significantly reduced in the HbSS group (median 1.50 vs. 2.00 nmol/ml, p < 0.001), while glutathione peroxidase and malondialdehyde levels did not differ significantly. BMI and parity also differed, with HbSS women more likely to be underweight and nulliparous. Women with HbSS exhibited significantly lower ovarian reserve markers and altered oxidative stress profiles compared to their HbAA counterparts, with age emerging as a key determinant of ovarian reserve in HbSS. Within the oxidative stress parameters assessed, no significant correlation with ovarian reserve markers was observed. These findings suggest that other disease-related factors, beyond the oxidative stress indices measured in this study, may contribute to ovarian dysfunction in SCA.

To (1) establish whether the erythrocyte sedimentation rate (ESR) at admission is related to mortality in dogs hospitalized in the ICU; (2) observe and evaluate the ESR trend during 48-72h of hospitalization and determine how it relates to mortality; and (3) test whether ESR is a marker of sepsis. Prospective study using residual K3-EDTA blood samples of hospitalized dogs. ICU of a university teaching hospital. A total of 124 hospitalized dogs were included in the study. Sixty of the 124 dogs were used to test whether ESR is a marker of sepsis. The ESR was measured on residual EDTA blood samples collected from hospitalized dogs as part of clinical evaluation. A total of 32 dogs died during hospitalization, while 92 were discharged. The ESR at admission (T0) was significantly higher in nonsurvivors (28mm/h) compared with survivors (11mm/h) (p=0.03). Forty-one dogs had ESR monitored at T1 (24h postadmission) and T2 (48-72h postadmission). An increase in the ESR from T0 to T2 was seen in nonsurvivors (p<0.01; medians: T0, 22mm/h, T1, 37mm/h, T2, 42mm/h). Survivors showed a decrease in the ESR from T0 to T2 (p<0.01; medians: T0, 12mm/h, T1, 14mm/h, T2, 5mm/h). Twenty-eight dogs were diagnosed with sepsis and had a higher ESR than nonseptic dogs (35 vs. 10mm/h; p<0.0001). A cutoff of 22mm/h may differentiate septic dogs from nonseptic dogs, with a sensitivity of 76% and a specificity of 81% (area under the curve=0.8; p<0.0001). The ESR at admission can predict the mortality of hospitalized dogs. Its monitoring during hospitalization may add prognostic information. Given the challenges involved in screening septic patients, point-of-care testing may easily evaluate the ESR when used alongside other indicators.

Assessment of Medication Therapy Management in Patients on Haemodialysis at the Yaoundé University Teaching Hospital, Cameroon

The goal of this study was to describe the use of and complications associated with the administration of lyophilized platelets (LPs) in dogs with thrombocytopenia-associated hemorrhage and those with nonthrombocytopenia-associated hemorrhage. Secondary objectives were to report pretransfusion and posttransfusion values, including PCV, total plasma protein concentration, platelet count, blood product administration, and overall survival. Retrospective study between 2018 and 2022. Two university veterinary teaching hospitals. Sixty-eight dogs that received LPs. Thirty-five dogs received LPs due to thrombocytopenia-associated hemorrhage, and 33 dogs received LPs due to nonthrombocytopenia-associated hemorrhage. The platelet count was lower in dogs with thrombocytopenia-associated hemorrhage, both before (p<0.001) and after LP administration (p<0.001), compared with dogs with nonthrombocytopenia-associated hemorrhage. Dogs with thrombocytopenia-associated hemorrhage had lower PCV values before LP administration (p=0.007), but no difference was noted at 6-12 or 12-24h after LP administration. There was no difference in the transfusion of other blood products (p=0.620) or in survival to discharge (p=1.000). Potential complications were noted in 6% of dogs. LP administration may be considered for a variety of conditions, including both thrombocytopenia-associated hemorrhage and nonthrombocytopenia-associated hemorrhage.

Academic entitlement has emerged as a pervasive and increasingly problematic issue in higher education worldwide. This review synthesizes existing international and Chinese research to clarify the definition, characteristics, and multidimensional consequences of academic entitlement for students, teachers, institutions, and the broader academic environment. Although academic entitlement has been extensively examined in Western contexts, empirical research on this construct among Chinese college students remains scarce&amp;mdash;despite China&amp;rsquo;s large undergraduate population and the growing incidence of uncivilized or entitlement-related academic behaviors. Drawing on cultural, educational, and empirical perspectives, this article argues that investigating academic entitlement among Chinese college students is both necessary and urgent. The review further identifies current research gaps and proposes three key directions for advancing academic entitlement studies in China: (a) developing localized measurement tools and diverse research methods, (b) expanding sampling coverage across different regions and types of institutions, and (c) exploring cultural consistencies and differences in academic entitlement within the Chinese sociocultural context. This work aims to deepen the understanding of academic entitlement and provide guidance for future research, educational policy, and university teaching practices in China.

Nigeria has the highest global prevalence of sickle cell disease (SCD), necessitating effective preventive measures to control the disease. Prenatal diagnosis (PND) is a key early intervention for SCD, yet there is a shortage of studies in Northern Nigeria focusing on mothers of children with SCD. These mothers not only carry the burden of the disease but also face the risk of having more affected children, making them vital stakeholders in managing and controlling SCD. This study assessed the awareness and acceptability of prenatal diagnosis PND for SCD among mothers of children with the disease. A cross-sectional study was conducted involving 297 mothers of children with SCD attending the Paediatric Haematology clinic at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Data were collected via an interviewer-administered questionnaire addressing the characteristics of the children and mothers, as well as their awareness, attitudes, and acceptability of PND. SPSS version 23 was used for data analysis, with a p-value < 0.05 considered statistically significant. Most participants (90.9%) were of Hausa ethnicity and 97.0% were of Islamic faith. A majority (77.8%) had less than tertiary education, and 57.9% lacked personal income. Nearly 41% had more than one child affected by SCD, and about one-fifth had lost a child to SCD complications. Only 22.2% of mothers had heard of PND, mostly from healthcare workers, and just 0.3% had undergone the procedure. After receiving information about PND, 93.3% were willing to accept it, though 45% of those who declined cited religious beliefs. Factors associated with PND acceptance included the mother's education and the child's SCD severity. Awareness of PND among at-risk mothers is low, yet most expressed willingness to accept it. Educational level and disease severity were associated with PND acceptability.

Background: Labour pain is the most significant and universal experience associated with childbirth, and it is the most dreadfully anticipated part of labour. Aim: This study assessed the knowledge, attitude and rate of request for labour analgesia among postpartum women in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife. Methods: The study adopted a descriptive research design, and a sample size of 164 was selected with a purposive sampling method. A structured questionnaire was used for data collection among postpartum women after obtaining their informed consent and ethical approval. Data collected were analysed using the Statistical Package for Social Sciences (SPSS) version 25. Results: Findings show that more than half (53%) had poor knowledge and 47% had good knowledge on the use of pain relief in labour. In addition, their attitude was very poor (67.9%), and only 32.1% had a good attitude, while 90.9% desired pain relief during their last labour. However, 19.5% reported having requested any pain relief during their last labour, and 70.3% reported not being given labour pain relief promptly when they requested, but 60.4% reported they would request pain relief in their next labour. Hypothesis testing showed that there is a relationship between knowledge of labour analgesia and attitude towards it, and between knowledge and rate of request for labour analgesia. Conclusion: This study concluded that pregnant women had poor knowledge of pain relief during labour. Therefore, there is a need for health interventions like health education programmes at antenatal clinics aimed at providing detailed information on pain relief and formulation of policies that will ensure that pain relief measures are readily available for all.

Background: Informed consent is a fundamental ethical and legal requirement in medical practice. Despite the requirement of a valid informed consent, there is a wide gap in the actual knowledge of its concepts and practices among surgical healthcare professionals. Aim: This study assessed the knowledge and practices of informed consent among surgical healthcare professionals at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Osun State, Nigeria. Methods: A cross-sectional descriptive design was used for this study. Samples were selected from 140 surgical healthcare professionals using proportional allocation, and assessed with a pre-tested questionnaire adapted from the Professional and Clinical Standards of the Royal College of Surgeons. Data were analysed using descriptive statistics. Bivariate logistic regression was used for inferential statistics. A statistically significant association was determined at p&lt;0.05. Results: The mean age of the respondents was 39.38±9.07years. The majority of the respondents were female, married, Yoruba, and Christian. Surgical ward nurses and the general surgery speciality were the most represented. The mean clinical experience was 12.26±8.26years. 71.4% and 72.9% of the respondents had good knowledge and good practice of informed consent, respectively. There was a significant association between knowledge and informed consent practices [OR= 2.364 (95% CI: 1.073–5.208), p = 0.033]. Conclusions: Surgical healthcare professionals at OAUTHC have good knowledge and practice of informed consent. Good knowledge was significantly associated with good informed consent practices. Regular workshops and training programmes should be implemented to enhance the understanding of the ethical, legal, and cultural aspects of informed consent among surgical professionals.

BackgroundComorbidity in patients with hypertension presents a significant challenge to effective disease management, leading to worsened health outcomes due to increased complications, higher healthcare costs, and elevated mortality rates. In resource‐limited settings like Ethiopia, the prevalence of comorbid disorders among patients with hypertension remains poorly understood. This lack of understanding is particularly alarming as noncommunicable diseases are on the rise, and the health systems in these areas are often inadequate. While different studies have assessed the prevalence and risk factors of hypertension, there is limited knowledge regarding the prevalence of comorbidity and related factors among patients with hypertension, particularly in Southern Ethiopia. To effectively develop integrated methods for the prevention, early diagnosis, and management of hypertension, a thorough understanding of the associated comorbidities and related factors is essential. Therefore, this study is aimed at determining the prevalence of comorbidity and its associated factors among patients with hypertension in healthcare facilities of Southern Ethiopia.MethodsAn institution‐based cross‐sectional study was conducted among patients with hypertension aged ≥ 18 years attending follow‐up at Dilla University Teaching Hospital from November 30, 2022, to January 30, 2023. A systematic random sampling technique was used to recruit 190 hypertensive patients from a hypertension registration logbook, collected using a pretested, structured‐administered questionnaire and supplemented by a medical record review. The data collection tool was translated into the Amharic language and back‐translated to ensure consistency. The data was analyzed using STATA Version 14. To characterize the data, descriptive statistics were applied. To determine the factors that are associated with comorbidity among patients with hypertension, a logistic regression model was fitted. Model fitness was checked using the Hosmer–Lemeshow goodness‐of‐fit test (p‐value = 0.633), indicating an adequate model fit. In the end, an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated and interpreted, and a p‐value of less than 0.05 was used to declare statistical significance.ResultThe prevalence of comorbidity among patients with hypertension was 56.8% (95% CI: 49.7%–63.7%). Several factors were found to be significantly associated with comorbidity. Patients aged 55 years and above were over four times more likely to have comorbid conditions (AOR = 4.42, 95% CI: 2.65–7.68), while those residing in urban areas had nearly seven times higher odds of comorbidity (AOR = 6.67, 95% CI: 2.73–8.72). Likewise, alcohol consumption (AOR = 3.50, 95% CI: 2.94–11.31), cigarette smoking (AOR = 4.87, 95% CI: 1.23–6.53), and having a body mass index (BMI) ≥ 25 kg/m2 (AOR = 4.55, 95% CI: 2.78–10.91) were independently associated with a higher likelihood of comorbidity. Conversely, being physically active was inversely associated with comorbidity, reducing the odds by nearly half (AOR = 0.52, 95% CI: 0.24–0.89).ConclusionMore than half of the patients with hypertension had at least one comorbid condition. Sociodemographic, behavioral, and clinical factors were significantly associated with these comorbidities. Based on our findings, we recommend routine screening for comorbid conditions, the implementation of educational programs to increase patient awareness about the risks of alcohol consumption and smoking, the promotion of healthy lifestyle practices, and improved access to healthcare services to ensure early detection and comprehensive management of hypertension and its related comorbidities.

Information and communication technology has a very significant place in the education process that involves teachers and instruction. This paper therefore, focuses on the challenges and prospects of ICT integration in the teaching and learning process and use of ICT in Nigeria education system. The paper further explore the place of ICT in teaching and learning, importance of ICT integration in education and theoretical models for successful implementation of ICT in teacher education which include the transmission models which concerns itself with drill and practice, the learner centered model, which emphasizes the learner to be given the opportunity to explore and discover concepts on the ir own while the participatory model advocates for learning activities to be carried out in social environments. The paper therefore concludes that everything of human endeavor is at the mercy of ICT tools. This is because ICT has been commonly accepted and proven to been engine for the 21st century and beyond as it is capable of charting the economic, religion, cultural, legal and social life of nations, particularly that of emerging economics through speedy information transmission, high level decision making reduced cost in resources and vast opportunities for information sharing which is accepted as an imperative pattern. This therefore calls for proper teacher training in ICT in this era and its subsequent application in instructional delivery .This paper therefore, recommend among others that integration of ICT in teacher education should be the focus of government, as the will not only increase the quantity of teaching and learning in schools and colleges but also bring about motivation of the young children to learn.

Prevalence of urinary tract infection and the validity of urine analysis in the diagnosis of uti in febrile under-fives at Nnamdi Azikiwe University Teaching Hospital, Nnewi: a cross-sectional study.

The objective of the study was to describe a single incision laparoscopic approach to ovariectomy (OVE) and ovariohysterectomy (OVH) in companion pigs. Additionally, we aimed to compare complications and outcomes between production breed and miniature pigs. Descriptive clinical case series. Twenty intact female, client-owned companion pigs. Records from a university teaching hospital were reviewed for pigs undergoing elective OVE or OVH by single incision laparoscopic surgery (SILS) over 1 year (2023-2024). Patient signalment, presenting complaint, surgical and anesthetic techniques as well as complications were recorded. Patient follow-up was obtained by owner phone communication at least 1 year postoperatively. Complications and outcomes were compared between production breed and miniature pig populations with Mann-Whitney and χ2 testing for continuous and categorical variables, respectively. Production breed (9/20, 45%) and miniature pigs (11/20, 55%) underwent SILS OVE (16/20, 80%) or OVH (4/20, 20%). SILS OVE was successfully performed in all cases. SILS OVH was achieved in one case (25%) in which the uterus was near-normal; additional OVH procedures (3/4, 75%) performed on miniature pigs with an abnormal uterus were converted to open because of challenges with tissue manipulation. No difference in complications or outcomes was noted between production breed and miniature pigs. SILS OVE appears to be a feasible and safe surgical option for both production breed and miniature pigs, with no significant differences observed between groups, while SILS OVH is feasible in select cases. Single incision laparoscopic OVE is a safe and viable alternative to traditional three port laparoscopy for production breed and miniature companion pigs. SILS is an adequate technique for OVH in select patients, suggesting that further investigation of laparoscopy for porcine OVH is warranted.

Needle prick injuries (NPIs) remain a significant occupational hazard among healthcare workers, particularly nurses who frequently handle sharp instruments. The objectives were to investigate nurse’s knowledge, awareness of needle prick injury and adherence to standard precautions in prevention, identify factors influencing compliance with preventive measures, and explore reporting practices while recommending strategies for improvement. A descriptive cross-sectional design was employed, involving nurses across various units of the hospital. Data were collected using a structured, self-administered questionnaire and analyzed using descriptive and inferential statistics. Findings revealed a notable prevalence of needle prick injuries among respondents, with varying levels of knowledge and awareness about risks and prevention. Although most nurses demonstrated awareness of standard precautions, adherence to these practices was inconsistent, largely influenced by workload, availability of protective equipment, and institutional support. Reporting of needle prick injuries was suboptimal due to fear of blame, lack of time, and inadequate reporting systems. The study concludes that while awareness of NPI prevention is relatively high, gaps remain in compliance and reporting. It recommends regular training, strict enforcement of safety protocols, provision of adequate protective materials, and establishment of an effective injury reporting and follow-up system to minimize the incidence of needle prick injuries among nurses in Lagos State University Teaching Hospital (LASUTH).

Caudal type homeobox transcription factor 2 (CDX2) is a nuclear factor that belongs to the caudal-related family of CDX homeobox genes, which are normally expressed in the intestinal mucosa. When expressed in the stomach, CDX2 signifies metaplastic mucosal changes. This study aimed to determine the expression of CDX2 in biopsies with various lesions along the Correa pathway of gastric carcinogenesis. This study was conducted at the University Teaching Hospital in Lusaka, Zambia. This cross-sectional study utilising archival gastric biopsies and stained them for CDX2 expression using standard immunohistochemical techniques. Data analysis was performed using Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. A total of 148 samples were analyzed in this study, of which 67 (49%) were from women and 69 (51%) were from men. The median age was 55 years, IQR 45-66. Overall, CDX2 expression was observed in 12 (8%) samples. Aggregated by stage along the Correa pathway, CDX2 positivity was 11% in GIM, 20% in dysplasia, and 23% in gastric cancer. None of the samples with normal gastric mucosa, non-atrophic gastritis, or chronic atrophic gastritis showed CDX2 expression. There was no association between CDX2 expression and age (p=1.0), sex (p=0.09), HIV (p=0.62), biomass smoke exposure (0.14), or Helicobacter pylori infection (p=1.0). No statistically significant difference was observed in CDX2 expression between complete and incomplete intestinal metaplasia. In conclusion, the expression of CDX2 increases with the severity of lesions along the Correa pathway and could potentially be used as a biomarker of gastric carcinogenesis.

Purpose: The World Health Organization (WHO) defined triage as the action of sorting and prioritizing patients based on the estimation of the urgency for intervention. This approach is used as the basis for identification of those patients who require immediate medical intervention and those who can safely wait. Locally triage is the process including the initial assessment followed by the prioritization of patients needing emergency care and assigns them according to their actual need or likely benefit from immediate medical treatment. To assess the compliance with triage protocols among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare. Methodology: The total sample size were 109 but the participants enrolled in the study were 101because 8 participants voluntary did not want to participate to the study (they refused to sign consent form) a prospective cross-sectional study was conducted among health workers in the surgical department (CHUB staff 70), and the emergency department (CHUB staff 31), making a total of 101 participants across both departments. The participants ’knowledge of triage tool was assessed and their level of compliance with triaging. The training on the triage tool was provided among healthcare providers managing traumatic patients attending the emergency and outpatient surgery department at University Teaching Hospital of Butare, and after one moth of intervention the reassessment was also done about the level of compliance with triage tool following training received. Findings: A total of 101 participants were included, the majority being nurses (63.4%). Most respondents reported that the current triage protocols effectively addressed the needs of trauma patients (86.1%) and that adherence to these protocols significantly or somewhat improved patient outcomes (95%). Compliance monitoring was limited, with over one-third (36.6%) stating that outcomes were never reviewed. However, urgent cases were largely well prioritized (89.1%). About one-fifth (20.8%) acknowledged adverse outcomes due to non-compliance with triage protocols. Nearly half (49.5%) of participants reported challenges to implementation, mainly related to lack of training, monitoring, and updated tools. Training interventions were associated with improvements in outcome review practices, prioritization of urgent cases, and reduction of adverse outcomes related to non-compliance. Unique Contribution to Theory, Practice and Policy: In both department participants emphasized the need for ongoing training and to increase staffing as key strategies for further enhance level of compliance and strengthen the triage process in both the emergency and outpatient surgery departments.

BackgroundComplications from pregnancy, primarily post-partum hemorrhage, including infections like HIV, are the leading causes of maternal mortality in sub-Saharan Africa (SSA). Blood products are not always available for obstetric emergencies because of chronic shortages in SSA countries. Understanding the quantity of blood products used by pregnant and post-partum women with and without HIV infections could inform strategies for the appropriate use of blood in resource-limited settings.MethodsA prospective study was conducted of medical charts of all pregnant or postpartum (42 days following delivery) women who presented to the obstetrics ward at the University Teaching Hospital (UTH) Zambia and had blood ordered during their hospital stay from November 2016 to March 2017. ed data from the requisition forms included age, hospital ward, clinical indication for blood transfusion, transfusion history, pregnancy history, blood components requested, number of units requested, and date and time of the request. Data extracted from blood bank records included blood issue date, number of units issued, and pre-transfusion hemoglobin. Variables extracted from the patient’s chart included age, HIV status, pregnancy history, blood component transfused, delivery method, labor complications, and transfusion outcome/adverse events.ResultsA total of 1086 blood requests and charts of women were reviewed in the study at UTH. Blood requests for women living with HIV (WLHIV) and women without HIV infection were 265 (24.4%) and 821 (75.6%), respectively. Of the 1034 blood requests received, WLHIV represented 40.2% (103) of antepartum (n = 256) requests and 38.9% (n = 303) of postpartum (n = 778) blood requests. Of the 43% (465) women who received a transfusion, 47.1% (125) were WLHIV and 41.4% (340) were women without HIV infection. Pregnancy-related indications for transfusion in WLHIV were other 92 (34.7%), postpartum hemorrhage 26 (9.8%), complications of ectopic pregnancy 23 (8.6%), acute anemia 11 (4.1%), placenta abruption 8 (3.0%), uterine rupture 3 (1.1%), disseminated intravascular coagulation (DIC) and HELLP syndrome 1 (0.3%).ConclusionHIV infection’s contributory role in blood demand and use among pregnant women in Zambia may be smaller than previously thought. However, findings suggest that continued investments in hemovigilance and appropriate blood use within the clinical setting could improve rational blood use in low-resource settings and maternal outcomes.

Life-cycle assessment is crucial for evaluating materials’ environmental impact and guiding the development of low-carbon and sustainable buildings. However, conventional LCA methods often overlook critical impacts during the operation and maintenance stage. To address this gap, this study proposes an improved framework using four composite indicators to enable systematic evaluation of six wall materials across China’s five climate zones. Using a university teaching building in the Hot Summer and Cold Winter Zone as a case study, this study quantitatively analyzed the economic viability and carbon reduction potential of each material. Results indicate that lower thermal conductivity does not necessarily imply superior economic and carbon reduction performance. Factors including the material carbon emission factor, cost, and thermal properties, must be comprehensively considered. Buffering materials also exhibit climate dependency—WPM and BWPM (moisture-buffering plastering mortars) perform better in hot–humid zones than temperate zones. All five buffer materials reduce operational energy consumption; WPM and BWPM stand out with 15.7% and 16.7% life-cycle cost savings and 17.3% and 18.0% carbon emission reductions, respectively. This study addresses the limitations of traditional LCC/LCA and provides theoretical and practical support for scientific material selection and low-carbon building design.