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Background Health care waste management is a challenge due to the composition of the waste generated within a health care facility, of which 85% is domestic waste, and at least 15% is hazardous waste or health care risk waste (has been in contact with blood, body fluids or tissues from humans and could cause disease). In this study, we evaluated the status quo of health care waste management plans (HCWMPs) and practices in public health care facilities in Gauteng Province, South Africa. Methods A situational analysis was employed in health care facilities (HCFs) that generated more than 20 kg ( N  = 42) of health care risk waste (HCRW) per day. Data was collected from officials responsible for the management of health care waste using a self-administered questionnaire whilst Chief Executive Officers/ managers of the HFCs were interviewed. Results The results showed that most (79.0%) of the health care waste officers (HCWOs) as well as management (84.6%) agreed to have HCWMPs in place. The majority (76.9%) of the HCFs have a dedicated person appointed to manage health care waste with the majority (67%) being environmental health practitioners. According to management, only 30.8% have formally appointed an integrated HCW committee. Only 11.7% of the HCWOs are guided by the Occupational Health and Safety Act to develop their HCWMPs with only 20.5% with health care waste minimisation strategies in place. Conclusion The study concluded that there is limited integration of HCWMPs as inadequate health and safety aspects, environmental pollution as well as community participation was reported. The novelty of the study is to contribute to a body of knowledge, information on the establishment of an effective health care waste management system in public health care facilities and for decision-making purposes.

The promise of novel technologies to increase access to radiotherapy in low- and middle-income countries (LMICs) is crucial, given that the cost of equipping new radiotherapy centres or upgrading existing machinery remains a major obstacle to expanding access to cancer treatment. The study aims to provide a thorough analysis overview of how technological advancement may revolutionize radiotherapy (RT) to improve level of care provided to cancer patients. A comprehensive literature review following some steps of systematic review (SLR) was performed using the Web of Science (WoS), PubMed, and Scopus databases. The study findings are classified into different technologies. Artificial intelligence (AI), knowledge-based planning, remote planning, radiotherapy, and scripting are all ways to increase patient flow across radiation oncology, including initial consultation, treatment planning, delivery, verification, and patient follow-up. This review found that these technologies improve delineation of organ at risks (OARs) and considerably reduce waiting times when compared with conventional treatment planning in RT. In this review, AI, knowledge-based planning, remote radiotherapy treatment planning, and scripting reduced waiting times and improved organ at-risk delineation compared with conventional RT treatment planning. A combination of these technologies may lower cancer patients’ risk of disease progression due to reduced workload, quality of therapy, and individualized treatment. Efficiency tools, such as the application of AI, knowledge-based planning, remote radiotherapy planning, and scripting, are urgently needed to reduce waiting times and improve OAR delineation accuracy in cancer treatment compared with traditional treatment planning methods. The study’s contribution is to present the potential of technological advancement to optimize RT planning process, thereby improving patient care and resource utilization. The study may be extended in the future to include digital integration and technology’s impact on patient safety, outcomes, and risk. Therefore, in radiotherapy, research on more efficient tools pioneers the development and implementation of high-precision radiotherapy for cancer patients.

This paper presents a comparative review of arsenite (As(III)), arsenate (As(V)), and fluoride (F−) for a better understanding of the conditions and factors during their adsorption with focus on (i) the isotherm adsorption models, (ii) effects of pH, (iii) effects of ionic strength, and (iv) effects of coexisting substances such as anions, cations, and natural organics matter. It provides an in-depth analysis of various methods of arsenite (As(III)), arsenate (As(V)), and fluoride (F-) removal by adsorption and the anions’ characteristics during the adsorption process. The surface area of the adsorbents does not contribute to the adsorption capacity of these anions but rather a combination of other physical and chemical properties. The adsorption capacity for the anions depends on the combination of all the factors: pH, ionic strength, coexisting substances, pore volume and particles size, surface modification, pretreatment of the adsorbents, and so forth. Extreme higher adsorption capacity can be obtained by the modification of the adsorbents. In general, pH has a greater influence on adsorption capacity at large, since it affects the ionic strength, coexisting anions such as bicarbonate, sulfate, and silica, the surface charges of the adsorbents, and the ionic species which can be present in the solution.

Background Oral squamous cell carcinoma (OSCC) comprises most oral malignancies worldwide and is closely associated with modifiable risk factors such as tobacco and alcohol use. Late-stage presentation is common and contributes significantly to poor treatment outcomes. This study aimed to delineate demographic, clinicopathological features, and radiation-induced toxicities among OSCC patients treated at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 2014 and 2019. Methods A retrospective, cross-sectional review of 119 histologically confirmed OSCC cases was conducted. Data included patient demographics, tumour characteristics, alcohol consumption and smoking, treatment modality, and acute radiation-related toxicities. Descriptive statistics and inferential analyses were performed using SPSS version 24.0. Associations between categorical variables were tested using chi-square and Fisher’s exact tests; p -values < 0.05 were considered statistically significant. Results Among 119 patients, 71% were male ( n  = 84) with a mean age of 59.6 years. Black African patients constituted 67% of the cohort. The tongue (30%) and floor of mouth (25%), others were the most common tumour subsites. Most tumours were moderately differentiated (53%), and over 85% presented with stage III or IV disease. Tobacco use was reported in 94% of males and 66% of females, with alcohol use in 73% and 49%, respectively. A significant association was found between combined substance use and higher-grade tumours ( p  = 0.04). All patients experienced at least one radiation-induced toxicity, with mucositis (61%) and dermatitis (62%) being most frequent. Toxicities were significantly more prevalent in patients receiving concurrent chemoradiotherapy ( p  < 0.01). Conclusion The study highlights the predominance of advanced-stage OSCC in older males with high-risk habits and underscores the urgent need for early detection strategies and public health interventions. High toxicity rates necessitate enhanced patient education and supportive care during treatment.

Landfill gas to energy (LFGE) projects were implemented in the Republic of South Africa (RSA) to diversify the energy mix and transition to a green economy. This study provides an overview of the status of LFGE in RSA and identifies major factors that inhibit the adoption and utilization of this technology, using existing data from 2010–2020 from electronic databases, namely, ScienceDirect, Taylor & Francis, Google Scholar, Sage Open, Springer Link, Sabinet, and IEEE Xplore, and using a combination of keywords and Boolean functions. This study revealed that, although RSA has made significant progress in the adoption and utilization of landfill gas (LFG) through the seventeen (17) planned LFGE projects, only six (6) are operational and generate 15 MWof electricity supplied to the local grid in the KwaZulu-Natal, Western Cape, and Gauteng Province. The waste-to-energy (WtE) sources such as LFGE are not given priority, and the country continues to invest in coal-fired power stations, owing to the abundance, availability, and low cost of coal reserves, which will supply coal for the next 200 years. The study identified factors inhibiting LGFE projects in RSA, which included the lack of sanitary landfill sites, LFG monitoring, funding, skills, research, and development. Potential LFGE in RSA is evident, however, except for limited processing facilities, economic investment, and public awareness. Suggestions for further research on the techno-economic and policy assessments are provided in the study. This study contributes to synthesizing evidence of the status of LFGE, insights on state-of-the-art technologies of WtE and the associated challenges in the waste management sector, identifying the potential for LFGE, and LFGE in the circular economy, and building a foundation for future research on WtE such as LFGE. Moreover, it also offers a reference for policymakers, decision-makers, researchers in the waste management sector on the technologies of WtE, LFGE, and potential to reduce waste generated.

Students' comfort and adaption in university dormitories is important for their learning. By controlling different environmental parameters (temperature, humidity, air velocity, etc.,) this can provide a great satisfaction in students' dormitory. In the present study, investigation was performed in students' dormitories in university in Chongqing, China. A survey was conducted on students' thermal comfort in typical university dormitories during winter in Chongqing, Southwest China. This also included on-site and continuous measurements of indoor physical parameters and filling out questionnaires about thermal sensation, thermal comfort, and adaptive behaviours by the students. Results showed that staying for longer periods in regions with a colder climate in winter, improved students' adaptability to lower temperature, closely correlated to behavioural and psychological processes. Although the thermal conditions varied in the international students' and Chinese students' dormitories, the thermal environmental conditions in the students' dormitories were poorer. The average indoor air temperature was 18.7°C and 18.1°C in the international students' and Chinese students' dormitories, respectively, which fell outside the ASHRAE thermal comfort zone, with higher indoor relative humidity. In addition, Chinese students felt more comfortable and satisfied with indoor air temperature and relative humidity compared to international students, evidently showing a higher adaptability to a severe colder winter climate. The study provides information that can support comfort researchers, designers, and policy makers towards improved design in student's dormitories and sustainable dormitory buildings.

IntroductionCervical cancer (CaCx) is a leading cause of cancer-related deaths among women in South Africa, often presenting at advanced stages and requiring chemoradiotherapy. In South Africa, the burden is disproportionately high among women living with HIV, with limited access to radiotherapy further compounding treatment challenges. Despite this documented disparity, limited data exist on patients in a South African context. This protocol describes the research methodology to assess patterns of care, treatment delays, interruptions and survival outcomes in patients with advanced CaCx, addressing an urgent need for local data in low-income and middle-income countries to provide evidence-based improvements in care.Methods and analysisThe Cervical Cancer Cohort at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH-CCC), initiated in 2023, is a mixed retrospective and prospective single-centre study investigating the characteristics, challenges and outcomes of patients with advanced CaCx. It includes women aged ≥18 years with a histopathological diagnosis of stage IB3–IVA CaCx treated at CMJAH Radiation Oncology. The retrospective component covers data from September 2018 to August 2023. Data collection is complete and the team is currently conducting quality control. The prospective component began in October 2023 and aims to enrol participants over 2 years, with follow-up for up to 3 years. The study is ongoing, and an extension for continued enrolment beyond September 2025 is being sought. Participants provide baseline data on demographics, socioeconomic status, cultural influences and healthcare access, with updates every 3 months. When necessary, the next of kin provides follow-up information. The study aims to inform strategies to improve outcomes and reduce the CaCx burden in South Africa.Ethics and disseminationEthics approval for this study was obtained from the Human Research Ethics Committee (Medical) at the University of the Witwatersrand in Johannesburg, South Africa, with an ethical clearance certificate (MM221001 MED22-09-085). The results will be widely distributed through presentations at national and international conferences and published in peer-reviewed open-access journals, ensuring wide access to the results.

Bladder cancer (BCa) is one of the most common urological cancers and remains a leading cause of cancer-related mortality worldwide. Bladder cancer is associated with a range of risk factors, with smoking being one of the most significant contributors. In addition to smoking, exposure to certain chemicals, particularly aromatic amines found in industries such as dye, rubber, leather, and textiles, also increases the risk of bladder cancer. In low-and-middle countries with lower Human Development Index (HDI), data on the underlying causes, incident rate, modes of presentation, treatment, and prognosis of bladder cancer remains unclear and often appear to be inadequate. This study aimed to assess the prevalence, mode of presentation, treatment, and risk factors associated with bladder cancer in Johannesburg, South Africa. By examining these factors, the study seeks to identify possible patterns or predisposing factors that contribute to the development and progression of bladder cancer, which could generate insights that could help to reduce the significant morbidity and mortality associated with this cancer. This retrospective study analyzed secondary data from 115 patients who were treated in the radiation oncology unit of an academic hospital between January 2010 and December 2020. By reviewing the medical records of these patients, the study aimed to gather comprehensive information on the prevalence of bladder cancer, modes of presentation, treatment approaches, and associated risk factors. Bladder cancer in this study was assessed using a comprehensive analysis of patient data on demographics, risk factors, clinicopathological aspects, and the specific therapies received. A comparison of patients with squamous cell carcinoma (SCC) and transitional cell carcinoma (TCC) of the bladder was conducted as part of this study. This comparison aimed to explore differences in demographic profiles, risk factors, clinicopathological characteristics, and treatment outcomes between these two histological subtypes. A total of 115 patients presenting with bladder cancer symptoms were referred to the academic hospital for evaluation and treatment. The incidence rate of bladder cancer was highest among patients with a mean age of 60.7 ± 14.9. Males constituted 60.9% of the cases, resulting in a male-to-female ratio of 1.6:1. The most common risk factors associated with bladder cancer complications included smoking, being male, black ethnicity and increasing age. Transitional cell carcinoma remained the most prevalent histological subtype at the academic hospital, compared to squamous cell carcinoma (SCC). Patients with transitional cell carcinoma (TCC) were more likely to be older (odds ratio (OR): 1.03, 95% Confidence Interval (CI): 1.01-1.06, p = 0.029), male (OR: 2.60, 95% CI:1.10-6.04, p = 0.030). The study also found that most of the TCC cases were among black patients, though white patients were four times more likely to present with TCC compared to SCC (OR:4.22, 95% CI: 1.43-12.48, p = 0.009). Bladder cancer is still widespread in LMICs, with lower HDI, with elderly males being at risk. To aggressively prevent mortality and morbidity from bladder cancer, bladder cancer health awareness must be maintained to improving prevention, as well as early detection, management and comprehensive patient care and health services for bladder cancer patients. These findings highlight the importance of targeted screening and prevention strategies for high-risk groups, particularly older males with a history of smoking.

Biogas, a methane-rich renewable energy source produced via anaerobic digestion, has the potential to replace traditional biomass fuels in Africa, where over 70% of households rely on fuelwood and agricultural residues for cooking. However, biogas adoption remains limited in low- and middle-income countries (LMICs) like Botswana due to policy, economic, and technical barriers. This study assesses the status of biogas technology in Botswana, identifying key challenges and opportunities for its development and integration into the country's energy system. A review of literature from Scopus, ScienceDirect, Web of Science, Taylor & Francis, Google Scholar, and SpringerLink, along with grey literature from 2012 to 2022, was conducted to analyse biogas potential, existing policies, and barriers to adoption. Botswana faces several challenges in biogas development, including a heavy reliance on coal (∼90% of electricity generation), a lack of formal policies supporting methane recovery, outdated waste management regulations, low technical capacity, and limited public awareness. Despite these obstacles, the country has an estimated biogas potential of 360–750 million m³ per year, primarily from its cattle population exceeding 2 million, yet this resource remains underutilized. Conclusion: Addressing policy gaps, increasing investment, and implementing capacity-building initiatives could enhance biogas adoption, reducing dependence on fossil fuels and contributing to a circular economy. This review synthesizes fragmented information on Botswana's biogas sector, providing a comprehensive assessment of barriers and opportunities while highlighting future directions such as landfill gas recovery and agro-waste methane extraction.

Changing climate patterns are a major contributing factor in the failure of government initiatives and sustainable crop production, particularly for subsistence smallholder farming systems in Botswana. These challenges faced by small-scale farmers require more than just programs and policy implementation; continuous assessment is essential to achieve their mandate. Moreover, there is limited research in Botswana to provide an understanding of issues related to policy implementation and the progression of crop production after the implementation of these policies. Therefore, this systematic review aims to evaluate government-implemented programs and policies for promoting sustainable crop production in Botswana, examining their successes, failures and providing recommendations for sustainable crop production. PRISMA guidelines were followed for systematic review via the Google Scholar database, and inclusion and exclusion criteria were observed for the eligibility of the assessed articles. The major findings indicate that several programs and national policies for sustainable crop production have been implemented in Botswana over the past decades. However, crop production continues to decline despite governmental efforts. The increasing adverse effects of climate change have contributed to the failure of government efforts. To advance sustainable crop production and resilience to climate change, the following adaptation approaches are recommended: efficient and sustainable use of water resources in agriculture, policy reformation, capacity building, regional collaboration, and climate-smart agriculture. Moreover, extensive evaluations are necessary for policies and implemented programs. This includes timely adjustments to policies on the basis of feedback from monitoring and evaluating specific, measurable indicators of ongoing policies and programs. Furthermore, engaging relevant stakeholders and local community members in the monitoring and evaluation process can enhance the relevance and accuracy of implemented government policies or programs.