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Orbital metastases, although rare, originate from systemic breast cancer in up to 35% of patients. Metastases more commonly arise from invasive lobular carcinomas than from invasive ductal carcinomas. Due to the diagnostic challenge of determining the primary site for the metastases, immunohistochemistry is essential. Clinical and radiological information are usually insufficient. This disease typically progresses quickly and has a poor prognosis. We report the case of a 55-year-old female who presented in 2017 with a left breast carcinoma and defaulted treatment during many different stages, then returned three years later with a right orbital mass which was confirmed to be a breast cancer metastasis on biopsy.

Aspalathus linearis (‘rooibos’) is a polymorphic perennial shrub native to the drier, northwestern part of the Fynbos Biome in the Cape Floristic Region. It is cultivated on a large scale and wild‐harvested on a small scale to produce rooibos tea, a traditional herbal drink. Rooibos is a post‐fire pioneer germinating from fire‐stimulated soil‐stored seed, while some ecotypes also resprout post‐fire. We aimed to improve understanding of the ecology and utilization of the species and its ecotypes in the wild. We surveyed 45 populations of wild rooibos across the species' range, distinguishing four ecotypes, and assessing their environmental preferences, density, demographics, extent, and effects of harvesting and fire on population health. Populations appeared demographically healthy with low incidences (average 5%) of mortality and stressed plants (9%). Reseeder and resprouters recruited equally from seed (seedlings comprised 4% of populations) and both exhibited wide‐ranging population densities (25 to 30,000 plants.ha−1). Population densities were higher where fires were more frequent and in younger post‐fire vegetation. Seedlings occurred in vegetation of all ages, implying some inter‐fire recruitment. The mean fire return period in surveyed populations was long (26 years) by fynbos standards (10–20 years), but rooibos persisted well in old vegetation suggesting that fires at high or low frequency do not pose significant threats to the species. Generally, harvesting levels were low at landscape and population scales; < 45% of sites on private land were subject to harvesting and there < 50% of plants showed evidence of harvesting. Illegal and overharvesting were uncommon (< 3% of sites). Population health and plant vigor were mostly unaffected by harvesting, suggesting that harvesting does not presently have large‐scale detrimental effects on wild rooibos.

Water meter under-registration results in apparent losses and lost revenue for municipalities. Municipalities should scientifically determine the optimal replacement periods for the meters in their particular municipality, as this would result in the formulation and implementation of appropriate meter replacement strategies and a reduction of apparent losses due to water meter inaccuracies. A water meter management database was analysed using the relative meter error method to determine if a relationship exists between domestic water meter age, total registered volume and accuracy, as well as the volume of apparent water losses caused by inaccuracies due to domestic water meter age and total registered volume. The net present value chain (NPVCn) method was used to determine the optimal domestic water meter replacement period. This study found no relation between water meter age and total registered volume. A relation was found between water meter age and accuracy and well as between total registered volume and accuracy. The median relative meter error was found to decrease with increasing water meter age and to increase from under-registration to over-registration as the total registered volume increased. The study also determined the volume of apparent water losses caused by domestic water meter inaccuracies due to age and total registered volume for this particular municipality to be 1.814 kL∙meter−1∙month−1, which translated to 2.81% of the municipality’s total system input volume. The optimal water meter replacement period of the municipality was determined using the NPVCn method to be at water meter ages of 9, 12 and 16 years and total registered volumes of 3 971, 5 162 and 6 750 kL at discount rates of 10%, 8% and 6%, respectively. This means that the municipality can now proactively replace its water meters so as to minimize the impact of meter inaccuracies on non-revenue water.

Amylase is elevated in the foregut and has been used to confirm anastomotic integrity after pancreatic surgery. The physiological activity of pancreatic enzymes in the ileum has been studied in healthy volunteers but not quantitated with the simple and readily available amylase measurements employed with serum tests. We aim to quantitate the levels of amylase in the terminal ileum. This was a prospective, non-randomised, non-blinded, consecutive cohort study conducted at the Royal Brisbane and Women’s Hospital. Consecutive patients undergoing routine surgery with an ileostomy were invited to participate in the study. Ileostomy effluent was collected and analysed daily for the first 5 post-operative days. This validation cohort included 8 males and 3 females, with a mean age of 49 years. Median daily amylase levels ranged from 4470 U/L to 23,000 U/L, with no specimens falling within the laboratory serum reference range of 40 to 130 U/L. Two specimens were not available on day one post-operative due to complete ileus. The sample size of 11 patients is small but was considered sufficient given that 55 effluent specimens were anticipated for analysis. Amylase levels remain highly elevated as the enzyme transits through the length of the small intestine and measured in the terminal ileum, and can be readily quantitated by the existing testing methodology routinely available.

Interface risks are inherent in every construction project from start to finish. Identifying and managing these risks effectively in every project phase is crucial for actualising project objectives. This paper shows a comprehensive framework showing several relationships between project stakeholders and how the interface risks between them that influence project execution are identified and managed for the overall construction project success. Firstly, a literature review on interfaces and interface risks and a discussion on how organisations managed interface risks were carried out, and secondly, the collection of quantitative data was conducted by means of structured online questionnaires. The sample consisted of 205 construction project professionals who were selected randomly. This group included individuals with various roles in the construction industry. The data were analysed using descriptive statistical methods, including factor analysis, reliability assessment, and calculations of frequencies and percentages. The results showed all the factors, work cultures, and organisational approaches that influence interface risk management and ways to identify and manage interface risks effectively. Effective stakeholder management is crucial for effective interface risk management since many interface risks are created by the numerous stakeholders involved in the project and the proposed frameworks will effectively mitigate the consequences and causes of interface risks. Effectively mitigating these risks involves effective stakeholder management, building information modelling volume strategy, and creating a virtual construction model during the construction phase; in addition, construction supply chain risks must be carefully identified during the interfaces establishment stages; interface risks must be carefully identified during the conceptualisation; and the planning, construction, and execution stages and standard methods and procedures must be defined to effectively identify and manage interface risks as the occur in the project lifecycle plus implementing the proposed risk mitigation frameworks.

Tuberculosis (TB) is the leading cause of death from infectious disease worldwide, predominantly affecting low- and middle-income countries (LMICs), where resources are limited. As such, countries need to be able to choose the most efficient interventions for their respective setting. Mathematical models can be valuable tools to inform rational policy decisions and improve resource allocation, but are often unavailable or inaccessible for LMICs, particularly in TB. We developed TIME Impact, a user-friendly TB model that enables local capacity building and strengthens country-specific policy discussions to inform support funding applications at the (sub-)national level (e.g. Ministry of Finance) or to international donors (e.g. the Global Fund to Fight AIDS, Tuberculosis and Malaria). TIME Impact is an epidemiological transmission model nested in TIME, a set of TB modelling tools available for free download within the widely-used Spectrum software. The TIME Impact model reflects key aspects of the natural history of TB, with additional structure for HIV/ART, drug resistance, treatment history and age. TIME Impact enables national TB programmes (NTPs) and other TB policymakers to better understand their own TB epidemic, plan their response, apply for funding and evaluate the implementation of the response. The explicit aim of TIME Impact’s user-friendly interface is to enable training of local and international TB experts towards independent use. During application of TIME Impact, close involvement of the NTPs and other local partners also builds critical understanding of the modelling methods, assumptions and limitations inherent to modelling. This is essential to generate broad country-level ownership of the modelling data inputs and results. In turn, it stimulates discussions and a review of the current evidence and assumptions, strengthening the decision-making process in general. TIME Impact has been effectively applied in a variety of settings. In South Africa, it informed the first South African HIV and TB Investment Cases and successfully leveraged additional resources from the National Treasury at a time of austerity. In Ghana, a long-term TIME model-centred interaction with the NTP provided new insights into the local epidemiology and guided resource allocation decisions to improve impact.

Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to develop, test and apply a fully integrated health systems resource planning and health impact tool for mental, neurological and substance use (MNS) disorders. A new module of the existing UN strategic planning OneHealth Tool was developed, which identifies health system resources required to scale-up a range of specified interventions for MNS disorders and also projects expected health gains at the population level. We conducted local capacity-building in its use, as well as stakeholder consultations, then tested and calibrated all model parameters, and applied the tool to three priority mental and neurological disorders (psychosis, depression and epilepsy) in six low- and middle-income countries. Resource needs for scaling-up mental health services to reach desired coverage goals are substantial compared with the current allocation of resources in the six represented countries but are not large in absolute terms. In four of the Emerald study countries (Ethiopia, India, Nepal and Uganda), the cost of delivering key interventions for psychosis, depression and epilepsy at existing treatment coverage is estimated at US$ 0.06-0.33 per capita of total population per year (in Nigeria and South Africa it is US$ 1.36-1.92). By comparison, the projected cost per capita at target levels of coverage approaches US$ 5 per capita in Nigeria and South Africa, and ranges from US$ 0.14-1.27 in the other four countries. Implementation of such a package of care at target levels of coverage is expected to yield between 291 and 947 healthy life years per one million populations, which represents a substantial health gain for the currently neglected and underserved sub-populations suffering from psychosis, depression and epilepsy. This newly developed and validated module of OneHealth tool can be used, especially within the context of integrated health planning at the national level, to generate contextualised estimates of the resource needs, costs and health impacts of scaled-up mental health service delivery.

Many research efforts have identified funding as a critical factor responsible for the delays in the execution of construction projects. These funding challenges affect the client and contractors alike. However, there is limited information on why delays occur in sponsored projects with evidently adequate funding. Therefore, the study focuses on exploring the factors that impact the cash flow during the execution of sponsored construction projects. The multiple-site case-study method of qualitative research was adopted, involving five universities benefiting from the infrastructure funding provided by a government agency in Nigeria. The Delphi technique was used for data collection and analysis, complemented with interviews. The findings identified six factors causing the delays. They were divided into internal and external factors. The internal factors are faulty contractor selection processes resulting in delays by contractors and the failure to complete appropriate phases of a project. The external factors include the delays in the project management system of the funding agency in terms of inspection, monitoring, evaluation and progress certification. The research identified that the combined effect of internal and external factors negatively impacts the project cash flow, which in turn influences project delivery delays. Therefore, this study recommends improvements in the in-house contractor selection processes and the decentralisation of the project inspection, monitoring and evaluation operations of the funding agency. This will facilitate timely inspection, audit, and progress certification, enabling the early release of the second tranche of the project fund. This will ameliorate the negative effects arising due to low cash flow and associated delays in project delivery.

This study investigates the factors leading to the classification of locomotives as long-standing (out of service for over 50 days) in South Africa. It focuses on trends in train incidents, identifying 363 longstanding locomotives with unscheduled maintenance, collisions, and vandalism listed as the primary incident types. Time series decomposition uncovered a seasonal pattern, and correlation analysis showed significant relationships among these incident categories. The Prophet model was selected for forecasting, predicting an increase in incidents related to maintenance, collisions, and vandalism. The study emphasises the need for further research on the impact of incidents on safety, operations, and personnel, as well as the effectiveness of safety training programmes. The findings stress the importance of understanding incident trends and their implications for railway safety and operational efficiency, providing insights for strategies to mitigate the impact of train incidents in South Africa.

The construction of physics-based simulators for use in Evolutionary Robotics (ER) can be complex and time-consuming. Alternative simulation schemes construct robotic simulators from empirically-collected data. Such empirical simulators, however, also have associated challenges. This paper therefore investigates the potential use of Artificial Neural Networks, henceforth simply referred to as Neural Networks (NNs), as alternative robotic simulators. In contrast to physics models, NN-based simulators can be constructed without requiring an explicit mathematical model of the system being modeled, which can simplify simulator development. The generalization abilities of NNs, along with NNs’ noise tolerance, suggest that NNs could be well-suited to application in robotics simulation. Investigating whether NNs can be effectively used as robotic simulators in ER is thus the endeavour of this work. Two robot morphologies were selected on which the NN simulators created in this work were based, namely a differentially steered robot and an inverted pendulum robot. Accuracy tests indicated that NN simulators created for these robots generally trained well and could generalize well on data not presented during simulator construction. In order to validate the feasibility of the created NN simulators in the ER process, these simulators were subsequently used to evolve controllers in simulation, similar to controllers developed in related studies. Encouraging results were obtained, with the newly-evolved controllers allowing experimental robots to exhibit obstacle avoidance, light-approaching behaviour and inverted pendulum stabilization. It was thus clearly established that NN-based robotic simulators can be successfully employed as alternative simulation schemes in the ER process.