Understanding the key processes of excellence as a prerequisite to establishing academic centres of excellence in Africa.

BACKGROUND: Africa's economic transformation relies on a radical transformation of its higher education institutions. The establishment of regional higher education Centres of Excellence (CoE) across Africa through a World Bank support aims to stimulate the needed transformation in education and research. However, excellence is a vague, and often indiscriminately used concept in academic circles. More importantly, the manner in which aspiring institutions can achieve academic excellence is described inadequately. The main objective of this paper is to describe the core processes of excellence as a prerequisite to establishing academic CoE in Africa. METHODS: The paper relies on our collaborative discussions and real-world insight into the pursuit of academic excellence, a narrative review using Pubmed search for a contextual understanding of CoEs in Africa supplemented by a Google search for definitions of CoEs in academic contexts. RESULTS: We identified three key, synergistic processes of excellence central to institutionalizing academic CoEs: participatory leadership, knowledge management, and inter-disciplinary collaboration. (1) Participatory leadership encourages innovations to originate from the different parts of the organization, and facilitates ownership as well as a culture of excellence. (2) Centers of Excellence are future-oriented in that they are constantly seeking to achieve best practices, informed by the most up-to-date and cutting-edge research and information available. As such, the process by which centres facilitate the flow of knowledge within and outside the organization, or knowledge management, is critical to their success. (3) Such centres also rely on expertise from different disciplines and 'engaged' scholarship. This multidisciplinarity leads to improved research productivity and enhances the production of problem-solving innovations. CONCLUSION: Participatory leadership, knowledge management, and inter-disciplinary collaborations are prerequisites to establishing academic CoEs in Africa. Future studies need to extend our findings to understand the processes key to productivity, competitiveness, institutionalization, and sustainability of academic CoEs in Africa.

Dosimetric comparison between microSelectron iridium-192 and flexi cobalt-60 sources in high-dose-rate brachytherapy using Geant4 Monte Carlo code.

Purpose: Manufacturing of miniaturized high activity iridium-192 (192Ir) sources have been made a market preference in modern brachytherapy. Smaller dimensions of the sources are flexible for smaller diameter of the applicators, and it is also suitable for interstitial implants. Presently, cobalt-60 (60Co) sources have been commercialized as an alternative to 192Ir sources for high-dose-rate (HDR) brachytherapy, since 60Co source have an advantage of longer half-life comparing with 192Ir source. One of them is the HDR 60Co Flexisource manufactured by Elekta. The purpose of this study was to compare the TG-43 dosimetric parameters of HDR flexi 60Co and HDR microSelectron 192Ir sources. Material and methods: Monte Carlo simulation code of Geant4 (v.11.0) was applied. Following the recommendations of AAPM TG-43 formalism report, Monte Carlo code of HDR flexi 60Co and HDR microSelectron 192Ir was validated by calculating radial dose function, anisotropy function, and dose-rate constants in a water phantom. Finally, results of both radionuclide sources were compared. Results: The calculated dose-rate constants per unit air-kerma strength in water medium were 1.108 cGy h-1U-1 for HDR microSelectron 192Ir, and 1.097 cGy h-1U-1 for HDR flexi 60Co source, with the percentage uncertainty of 1.1% and 0.2%, respectively. The values of radial dose function for distances above 22 cm for HDR flexi 60Co source were higher than that of the other source. The anisotropic values sharply increased to the longitudinal sides of HDR flexi 60Co source, and the rise was comparatively sharper to that of the other source. Conclusions: The primary photons from the lower-energy HDR microSelectron 192Ir source have a limited range and are partially attenuated when considering the results of radial and anisotropic dose distribution functions. This implies that a HDR flexi 60Co radionuclide could be used to treat tumors beyond the source compared with a HDR microSelectron 192Ir source, despite the fact that 192Ir has a lower exit dose than HDR flexi 60Co radionuclide source.

Efficacy of Nanoparticles in dose enhancement with high dose rate of Iridium-192 and Cobalt-60 radionuclide sources in the Treatment of Cancer: A systematic review.

ABSTRACTS: A key challenge in radiation therapy is to maximize the radiation dose to cancer cells while minimizing damage to healthy tissues. In recent years, the introduction of remote after-loading technology such as high-dose-rate (HDR) brachytherapy becomes the safest and more precise way of radiation delivery compared to classical low-dose-rate (LDR) brachytherapy. However, the axially symmetric dose distribution of HDR with single channel cylindrical applicator, the physical "dead-space" with multichannel applicators, and shielding material heterogeneities are the main challenges of HDR brachytherapy. Thus, this review aimed to quantitatively evaluate the dose enhancement factor (DEF) produced by high atomic number nanoparticles (NPs) which increases the interaction probability of photons mainly through the photoelectric effect induced in the great number of atoms contained in each nanoparticle. The NPs loaded to the target volume create a local intensification effect on the target tissue that allows imparting the prescribed therapeutic dose using lower fluxes of irradiation and spare the surrounding healthy tissues. An electronic database such as PubMed/Medline, Embase, Scopus, and Google Scholar was searched to retrieve the required articles. Unpublished articles were also reached by hand from available sources. The dose is increased using the high atomic number of nanoparticle elements under the high dose iridium radionuclide whereas the cobalt-60 radionuclide source did not. However, much work is required to determine the dose distribution outside the target organ or tumor to spare the surrounding healthy tissues for the iridium source and make compressive work to have more data for the cobalt source.

Prevalence, Perception and Predictors of Concomitant Herbal Medicine Use among HIV/AIDS and Tuberculosis Patients in Metekel Zone, Northwest Ethiopia: A Cross-Sectional Study.

Background: The use of herbal medicine is common in Ethiopia. However, evidence on the extent and predictors of concomitant use of herbal medicine with conventional treatment among HIV/AIDS and tuberculosis patients is limited. Objective: To assess the extent of concomitant use of herbal medicine with conventional therapy and associated factors among HIV/AIDS and tuberculosis patients in Metekel Zone, Northwest Ethiopia. Method: A cross-sectional study was conducted from January to March 2020. HIV/AIDS and tuberculosis patients who visited the health facilities during the study were interviewed face-to-face using a structured and pretested questionnaire. The descriptive statistics and univariate and multivariate logistic regression analyses were conducted using SPSS version 25. A P-value of <0.05 was considered significant. Results: 412 patients on conventional treatment were included in this study; 355 (86.2%) were HIV patients, and 57 (13.8%) were TB patients. More than half, 217 (52.7%) participants reported using herbal medicine while on conventional therapy. Among those who claimed to have used herbal medicines, 32 (14.7%) received herbal medicine from traditional healers. About four of five herbal users did not disclose their use to their healthcare providers. The type of health facility on follow-up (P=0.03), disease status (P=0.01), occupation (P=0.02), discontinuing ART (P=0.03), and encountering side (P=0.04) were the determinant factors for the use of herbal medicine among our study participants. Conclusion: In the Metekel Zone, concomitant consumption of herbal medication is common among HIV/AIDS and tuberculosis patients. Furthermore, most patients did not disclose the healthcare practitioners about their herbal use. Therefore, healthcare practitioners must assess and counsel patients regarding the potential adverse effects and herb-drug interaction to optimize therapy.