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The World Health Organization Regional Office for Africa (WHO/AFRO) faces members who encounter annual disease epidemics and natural disasters that necessitate immediate deployment and a trained health workforce to respond. The gaps in this regard, further exposed by the COVID-19 pandemic, led to conceptualizing the Strengthening and Utilizing Response Group for Emergencies (SURGE) flagship in 2021. This study aimed to present the experience of the WHO/AFRO in the stepwise roll-out process and the outcome, as well as to elucidate the lessons learned across the pilot countries throughout the first year of implementation. The details of the roll-out process and outcome were obtained through information and data extraction from planning and operational documents, while further anonymized feedback on various thematic areas was received from stakeholders through key informant interviews with 60 core actors using open-ended questionnaires. In total, 15 out of the 47 countries in WHO/AFRO are currently implementing the initiative, with a total of 1,278 trained and validated African Volunteers Health Corps-Strengthening and Utilizing Response Groups for Emergencies (AVoHC-SURGE) members in the first year. The Democratic Republic of Congo (DRC) has the highest number (214) of trained AVoHC-SURGE members. The high level of advocacy, the multi-sectoral-disciplinary approach in the selection process, the adoption of the one-health approach, and the uniqueness of the training methodology are among the best practices applauded by the respondents. At the same time, financial constraints were the most reported challenge, with ongoing strategies to resolve them as required. Six countries, namely Botswana, Mauritania, Niger, Rwanda, Tanzania, and Togo, have started benefiting from their trained AVoHC-SURGE members locally, while responders from Botswana and Rwanda were deployed internationally to curtail the recent outbreaks of cholera in Malawi and Kenya.

To alleviate challenges related to mobility, travel planning, and time management, individuals commonly encounter the necessity of locating points of interest (POIs) that either share the same physical building or are situated within interconnected buildings. However, existing search engines face difficulties in retrieving groups of places based on keywords and topological relations among their respective regions, for instance, when a user wants to find a residential building that is connected to a green area. This is primarily due to their limited consideration of POIs as mere points in space, rather than recognizing the polygonal geometries of their boundaries. In this work, we present a spatial search solution based on textual and topological query parameters for efficiently retrieving groups of POIs whose neighborhoods and boundaries satisfy specific restrictions. To perform this type of search efficiently, we propose the Topo‐MSJ algorithm, building upon the well‐established “Multi‐Star‐Join” (MSJ) algorithm, by including an efficient approach to handle queries with topological requirements. To assess the effectiveness of our solution, we conduct a performance evaluation by comparing the execution time of Topo‐MSJ with equivalent spatial SQL queries. The experimental analysis, performed on real datasets, reveals that Topo‐MSJ exhibits a faster execution time compared with equivalent SQL queries, additionally providing a simplified spatial pattern query notation. [ABSTRACT FROM AUTHOR]

Introduction: Multiparametric MRI (mpMRI) parameters of pT3a prostate cancer have not been examined in large cohort studies. Therefore, we aimed to identify factors associated with up-staging of mpMRI cT3a in post-operative histopathological confirmation. Methods: Retrospective analysis of a prospectively maintained database of a single UK cancer centre. Only cT3a cases who underwent robotic-assisted radical prostatectomy (RARP) were included (N = 383). MRI and specimen histopathology was reviewed independently by expert uro-radiologists and uro-histopathologists, respectively. Factors included age, BMI, prostate-specific antigen (PSA) level, biopsy international society of urological pathology (ISUP) grade, Prostate Imaging Reporting & Data System (PI-RADS®) score, tumour size, tumour coverage of gland (%), gland weight and surgical margins were analysed as predictors of pT3a prostate cancer. Results: N = 383. Mean age 66 years (58–71), mean BMI 27.1 kg/m2 (25.0–30.0). 314 (82.0%) cases down- unchanged or down-staged, and 69 (18.0%) cases upstaged. PSA level (P = 0.002), PI-RADS score (P < 0.001) and ISUP grade (P < 0.001) are positively associated with upstage categories. ISUP grade ≥3 (OR 5.45, CI 1.88, 9.29, P < 0.002), PI-RADS score ≥4 (OR 3.92, CI 1.88–9.29, P < 0.001) and tumour coverage (OR 1.06, CI 1.05–1.08, P < 0.001) significantly positively associated with upstaging disease, with concurrent decreased probability of downstaging (OR 0.55, 0.14, 0.44, respectively, P < 0.05). Tumour coverage was positively correlated with increasing positive surgical margins (P < 0.05). Capsular contact > 15 mm was very unlikely to be upstaged (OR 0.36, CI 0.21–0.62, P < 0.001), aligning with published results past the widely accepted significant level for extracapsular disease on MRI. Conclusion: The study has identified PSA level, ISUP, PI-RADS score, tumour volume and percentage coverage are key predictive factors in cT3a upstaging. This study uniquely shows tumour coverage percentage as a predictor of cT3a upstaging on mpMRI. ISUP is the strongest predictor, followed by PI-RADS score and tumour coverage of gland. Multi-institutional studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Manokwari Regency's Bakaro Recreation Park is a project to develop a lively and sustainable recreational area for the locals and tourists. This multipurpose park will combine recreational elements including playgrounds, green areas, walking trails, picnic sites, and lodging areas with the natural beauty of the surrounding landscape. Additionally, the design will include aspects that pay tribute to the region's indigenous traditions, which means it is heritage in the site. Environmental sustainability is one of the project's main objectives, with an emphasis on eco-friendly landscaping employing local flora and landscape elements. In summary, Bakaro Recreation Park aims to create a treasured place for leisure while representing environmental preservation and community pride by integrating nature, recreation, culture, and sustainability harmonically. [ABSTRACT FROM AUTHOR]

Objectives: A toxicology team providing round-the-clock consultations for poisoning was established in Changi General Hospital in November 2014. This study aims to describe the epidemiology of patients referred to this service in 2015. Methods: A retrospective electronic and paper records review of all patients referred to the toxicology service from January to December 2015 was performed for demographics, poisoning, clinical, and outcome data. The cases were graded for poisoning severity score (PSS), likelihood of poisoning exposure and relative contribution to fatality for death cases. Results: A total of 306 cases were referred to this service in 2015. The median age was 34 years with majority being females (54%). The most common cause of poisoning was deliberate self-harm (62%) and the most common route of poisoning was oral (85%). Analgesics (21%) and sedatives (19%) were the most common poisoning classes. Six per cent of patients received decontamination and 17% received antidotes. The likelihood of poisoning exposure was probable to definite certainty for 85% of the cases. Mild poisoning (PSS 0–1) constituted 76% of the cohort, while 22% had moderate to severe poisoning (PSS 2–3). Out of the five fatalities, three were exposure-related fatalities contributing to a fatality rate of 1%. Fifty-four per cent of patients were admitted to the emergency department observation unit, 17% to general inpatient wards and 9% to either intensive care unit or high dependency wards. Conclusions: Although most poisoning cases resulted in mild clinical effects, a small but significant number of severe acuity cases occurred in this cohort.

This article discusses the use of Chat Generative Pre-Trained Transformer (ChatGPT) and other large language models (LLMs) in the field of urology. The study aimed to test ChatGPT's treatment recommendations for prostate cancer patients against those made in a real-world multidisciplinary team (MDT) meeting. The European Association of Urology (EAU) guidelines were linked to ChatGPT, and the AI's recommendations were compared to the MDT meeting outcomes. The results showed that ChatGPT recommended treatment options that were concordant with the decisions made in the MDT meeting. The study suggests that ChatGPT can be a valuable tool in streamlining and speeding up MDT meetings, but it does not replace the role of clinicians in selecting treatment options. The article acknowledges the ethical and legal issues associated with the use of AI technologies in healthcare and emphasizes the need for responsible use and reporting. [Extracted from the article]