An Accelerated Failure Time Model to Predict Cause-Specific Survival and Prognostic Factors of Lung and Bronchus Cancer Patients with at Least Bone or Brain Metastases: Development and Internal Validation Using a SEER-Based Study.

BACKGROUND: This study addresses the significant challenge of low survival rates in patients with cause-specific lung cancer accompanied by bone or brain metastases. Recognizing the critical need for an effective predictive model, the research aims to establish survival prediction models using both parametric and non-parametric approaches. METHODS: Clinical data from lung cancer patients with at least one bone or brain metastasis between 2000 and 2020 from the SEER database were utilized. Four models were constructed: Cox proportional hazard, Weibull accelerated failure time (AFT), log-normal AFT, and Zografos-Balakrishnan log-normal (ZBLN). Independent prognostic factors for cause-specific survival were identified, and model fit was evaluated using Akaike's and Bayesian information criteria. Internal validation assessed predictive accuracy and discriminability through the Harriel Concordance Index (C-index) and calibration plots. RESULTS: A total of 20,412 patients were included, with 14,290 (70%) as the training cohort and 6122 (30%) validation. Independent prognostic factors selected for the study were age, race, sex, primary tumor site, disease grade, total malignant tumor in situ, metastases, treatment modality, and histology. Among the accelerated failure time (AFT) models considered, the ZBLN distribution exhibited the most robust model fit for the 3- and 5-year survival, as evidenced by the lowest values of Akaike's information criterion of 6322 and 79,396, and the Bayesian information criterion of 63,495 and 79,396, respectively. This outperformed other AFT and Cox models (AIC = [156,891, 211,125]; BIC = [158,848, 211,287]). Regarding predictive accuracy, the ZBLN AFT model achieved the highest concordance C-index (0.682, 0.667), a better performance than the Cox model (0.669, 0.643). The calibration curves of the ZBLN AFT model demonstrated a high degree of concordance between actual and predicted values. All variables considered in this study demonstrated significance at the 0.05 level for the ZBLN AFT model. However, differences emerged in the significant variations in survival times between subgroups. The study revealed that patients with only bone metastases have a higher chance of survival compared to only brain and those with bone and brain metastases. CONCLUSIONS: The study highlights the underutilized but accurate nature of the accelerated failure time model in predicting lung cancer survival and identifying prognostic factors. These findings have implications for individualized clinical decisions, indicating the potential for screening and professional care of lung cancer patients with at least one bone or brain metastasis in the future.

Safety perception and determinants of complementary and alternative medicine usage among surgery out-patients in LAUTECH Teaching hospital, ogbomoso, Nigeria.

Objectives: The use of complementary and alternative medicine (CAM) stemmed from the search of humans for other means of relieving pain and managing diseases which has plagued its existence. CAM use is on the increase among the general population in both the developed and developing nations and also among surgical patients. There is therefore a need to ascertain the perceived adverse effects, the safety perception and the determinants of its use so as to improve the advocacy for adequate regulation. Methods: It was a cross-sectional study carried out among surgical outpatients in a tertiary hospital. One hundred and fifty patients between the ages of 18 and 85 years were recruited. An interviewer-administered questionnaire was used to collect data from each participant. Data was analyzed using SPSS version 22. Results: The lifetime prevalence of CAM use among the respondents was 76 % while the point/current prevalence was 37.3 %. The percentage of current users using CAM for surgical complaints was 30.4 %. Biological based therapy accounted for 110 (72 %) of CAM used and unbranded herbal products was responsible for more than two-third of it. Almost a third of the patients (46, 30.7 %) perceived that CAM is safe while 62 (41.3 %) were not sure of its safety. Only 15 (13.2 %) and 6 (5.3 %) have ever recorded side effects and drug interactions respectively. Older age group, income less than 10,000 Naira, positive safety perception and belief about CAM were identified as determinants of CAM usage. Conclusions: The prevalence of CAM usage among surgical outpatients was quite high and the major determinants of its use are the patient's age, safety perception and their level of income.

Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in oyo state, Nigeria.

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of #x003C;0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

Expectations and experiences of urban and rural in-school adolescents of adolescent reproductive health services in Oyo State.

Reproductive health information and services are fundamental to health, well-being and opportunities for women and young people, yet throughout the world, women and youths do not have access to quality reproductive health care thereby exposing them to unplanned pregnancy, teen birth, induced abortion as well as increased exposure to sexually transmitted diseases, HIV inclusive. This study is meant to explore the expectation of adolescents of an adolescent reproductive health services as well as to assess the experiences of those who had visited an ARHS at the centers. It was a descriptive cross-sectional prospective study, analytic in design using a multistage sampling technique where 452 secondary school pupils in both rural and urban communities were interviewed using a pretested validated questionnaire. Data was analyzed using SPSS version 21. Chi square was used to test for association between both rural and urban adolescents in issues relating to their expectation and experiences, with P-value of <0.05. More of the respondents in the urban communities (73,32.4%) have the expectation that Adolescent Reproductive Health Services (ARHS) should be provided in an existing health service with special attention to adolescents while a larger percentage of those who preferred a special adolescent health institution were from the rural communities (122, 54.2%) which was statistically significant with a P-value of 0.001. More of respondents from the rural communities also expect that contraception services should be provided in an ARHS center while life skill services are expected by more of the respondents from the urban communities (122, 55.6%). More of the rural community respondents (57,25.3%) expect that fee at the ARHS centers should be provided at a subsidized rate while more of the urban dwellers have the expectation that services provided should be free of charge. For respondents who had been to an ARHS center, more of the urban respondents were attended to by a Medical doctor and a large percentage (34, 94.4%) of those who had visited ARHS center before professed to be satisfied with the services rendered there. Expectations from adolescents from ARHS are very high. However, most of them prefer a free of charge service as well as a service area nearer to residential area. Confidentiality and having a young health professional at the service centers cannot be overemphasized in the provision of quality ARHS.

Efficacy Of Microporous Tape In The Prevention Of Abnormal Post-Surgical Scars Among A Black Population.

BACKGROUND: A scar can be defined as a mark or a blemish resulting from a healed wound. All surgical incisions give rise to scars and approximately 15% have excessive scars. Some scars are thin lines which are almost unnoticeable, whereas others become abnormal when the amount of fibrosis is excessive or suboptimal or when it causes functional disability or aesthetic distress to the patient. The conversion of normal scarring to hypertrophic scarring occurs six to eight weeks after surgery as a result of increasing scar tension. Thus, scar support especially with the use of microporous tape is critical during this period. Objectives were to determine the efficacy of microporous tape in the prevention of abnormal post-surgical scars. METHODS: A randomized control study which compared the limb scar outcome between post-surgical patients who underwent scar taping with microporous tape and those who did not. The scars were assessed at six weeks, three months and six months after surgery using the Patient and Observer Scar Assessment Scale. The test group had microporous tape applied to their scars over a period of six months and worn twenty-four hours daily. The tapes were changed every fortnight or whenever they fell off. The data was analyzed using SPSS-22. The categorical variables, the relative scar height, the scar width and the OSAS score were compared using the Chi-square test and the independent t-test respectively. RESULTS: At six weeks, 48.8% of non-taped scars and 97.6% of taped scars were normal; at three months 75.6% of non-taped scars and 2.4% of taped scars were abnormal while at 6 months 80.5% of non-taped scars and none of the taped scars were abnormal. CONCLUSIONS: Microporous tape is an effective modality for preventing abnormal scarring in postsurgical patients.

Awareness and Utilization of Adolescent Reproductive Health Services among In-School Adolescents in Urban and Rural Communities in Oyo State.

INTRODUCTION: Adolescents require a range of scientifically accurate sexual and reproductive health information and services. Adolescent reproductive health services (ARHSs) are an integral part of adolescent health and it is pertinent that adolescents know about them to be able to benefit from them. This study was to assess the awareness and utilization of adolescents in Oyo State about ARHSs. MATERIALS AND METHODS: A descriptive cross-sectional study carried out among in-school adolescents where 225 respondents each were selected for the rural and urban groups using a multi-stage sampling technique. Data were collected using a semi-structured questionnaire, and analysis was performed with SPSS version 22. RESULTS: A total of 225 rural and 225 urban respondents participated in this study, with a mean age of 14.3 ± 1.93 and 13.9 ± 2.03 for rural and urban respondents, respectively. Few of the respondents (59, 13.1%) were aware of the existence of ARHS, of which, 34 (57.6%) were of the urban respondents and 25 (42.4%) were from the rural respondents. Only 36 (7.8%) of respondents had ever utilized ARHS with 22 (61.1%) from urban communities. The major reason why almost half of 207 (49.6%) of the adolescents had never been to a facility rendering ARHS before was that they did not know where to go, which was higher among the rural respondents. CONCLUSIONS: Awareness of ARHSs was lower among rural respondents, leading to poor utilization of such service. It is, therefore, recommended that more youth-friendly environments should be made available and accessible to adolescents, especially in rural areas (114, 53.3%).