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Objective: To explore the experiences of young people and their parents regarding the impact on school performance due to time away from school for orthodontic appointments and to explore their views about a possible extension to the current service. Design: A qualitative study using semi-structured interviews. Setting: UK district hospitals. Participants: A total of 11 pairs of interviewees: young people undergoing fixed appliances and their parents. Methods: Semi-structured interviews were conducted with young people and their parents. The interviews were audio recorded and transcribed verbatim. A framework approach was used to analyse the data. Results: A thematic analysis of the data identified five main themes which were as follows: (1) expectations of the treatment process and appointments; (2) impact of school absences and treatment; (3) appointments; (4) implications for young people, parents and others; and (5) satisfaction with treatment. These themes were then further subdivided and analysed. Conclusion: Young people and their parents felt that attending appointments for orthodontic treatment had minimal impact on a young person’s school performance. However, some young people did engage in coping mechanisms in order to ensure this was the case. Young people and their parents advised they were satisfied with the process of the treatment despite the time missed at school/work. Some young people and their parents saw a real benefit to appointments that could be fitted into a ‘NHS seven-day’ service model, but this did not apply to all interviewees.

The challenge of poverty has become widely known in Nigeria. Despite numerous economic development policies and strategic plans intended to eradicate it through the development of highly skilled labor and capital, the country's economy is still rife with social vices that have increased unemployment and led to starvation among the populace. This study examines and analyses the financial structure and business development in southwest Nigeria, driven by two primary research goals: to understand the significance of financing decisions determining entrepreneurial success or failure and to explore the critical factors essential for business survival and those that impact how businesses expand across Southwest Nigeria. The data collected were analyzed with the use of Descriptive Statistics and Partial least squares (PLS). Investigating the impact of financial structure on business development in Southwest Nigeria used a survey that engaged 8,395 established SMEs, representing 36% of all SMEs in the Southwest states of Nigeria. The primary data were collected using a structured questionnaire. The findings revealed the importance of reducing this stubborn economic destructor with the help of vital entrepreneurial business finance. This proves that business funding, particularly in southwest Nigeria, may act as an economic stimulant. Thus, the study findings are new and essential as they focus on a region of Nigeria that has not attracted much attention in the world of academia and research. This study closes the critical knowledge gap, providing insights into how regional businesses can develop through effective financial structures. It extends the existing body of knowledge, showing how affordable business financing acts as an economic stimulant to entrepreneurial development and expansion. Thus, this research recommended that business development be well established through well-structured policies, financed, and supported to help address the various social vices.

A regional value chain approach may help with efforts to promote the African single market for investment.

Although pesticides ensure the quality and quantity of agricultural produce, they have adverse effects on farmers, their families, and consumers. Therefore, in order to reduce the unpleasant effects of pesticide use, stakeholders would be well advised to extend guidance and precautions to end users. The objective of this study was to determine the pesticide handling behaviour and the effectiveness of pesticide information on pesticide handling knowledge and personal protective equipment (PPE) use among farmers in southwest Nigeria. One hundred and fifty-six farmers were interviewed using a structured questionnaire in December 2019 and January 2020. The results revealed that a one-third of the farmers dispose their pesticide residues on the field, only 3% of the farmers dispose the hazardous pesticide waste at a collection point, and 65% of them dispose the empty containers indiscriminately. The majority of farmers never use respirators (79%), hats (60%), and boots (57%) when applying pesticides. Knowledge of pesticide application and waste management is low (58% of respondents scored less than 10 on a knowledge scale of 0–14). The result of the regression model shows that information from pesticide labels and farmer-to-farmer exchanges significantly increase farmers’ knowledge of pesticide handling and PPE use. Our results suggest that the effectiveness of current information provision to smallholder farmers on the correct use of pesticides is not sufficient. Therefore, we highlight the need for pesticide companies, distributors, and government agencies to intensify and further develop their efforts to empower smallholder farmers to improve their knowledge and use of pesticides.

The importance of eggs in Nigerian nutrition cannot be overstated; being a complete diet, it remains a major supply of protein in infant, children and adult’s diets. The egg is a perishable animal product due to its high moisture and nutritional content, making it vulnerable to microbial assault and nutrient loss, especially during storage. The occurrence of egg glut during specific times of the year has become a nightmare for poultry farmers in Nigeria. Although techniques for preventing quality deterioration and wastage may not be an absolute solution, advanced steps such as egg powdering can be considered a long-term solution to egg glut and wastage, with numerous advantages over preservation and storage techniques. This paper thus reviews the causes, features and remedies for the egg glut situation in the contemporary Nigeria poultry industry, exploring its economic potentials, advantages and the prospects.

Management of industrial effluents is one of the major challenges affecting developing nations of the world. Many of these industries release their effluents indiscriminately into the environment without proper treatment, which has caused a great health hazards to the environment and living population of this nation. The aim of this study was to determine the effect of electromagnetic field on microbial load of industrial effluents from food and dairy industry at Akure, Ondo state, Nigeria. Bacteria were isolated and identified using biochemical and molecular methods. Microbiological analysis and physicochemical characterization of the industrial effluent were carried out to determine the effect of electromagnetic field on microbial load and physicochemical parameters of the industrial effluents. Eleven bacteria were isolated from the effluents, the morphological, microscopic and biochemical characteristics of the eleven isolated bacteria suggests the isolates to be Bacillus cereus, Bacillus subtilis ,Enterobacter aerogenes, Enterococcus faecalis, Lactococcous lactis, Micoccocus luteus, Pseudomonas aeruginosa, Proteus vulgaris, Rhodococcus equi, Serratia marcesans and Staphylococcous aureus. It was observed that electromagnetic field (EMF) had significant effect on the bacterial load of the industrial effluent. Mean differences was considered significant at P≤0.05. Bacterial load decreases as the magnitude of the EMF increases with time. The physicochemical analysis of the raw and EMF treated effluents revealed that EMF treated effluent had lower mean values of physicochemical. This outcome of study shows that Electromagnetic field treatment of effluent is effective in reducing the bacterial load of food and dairy industrial effluents, hence making the effluent safe for the environment to which it will be discharged. The method for the treatment can be developed and modified for effective use in industrial settings which will be of great economic importance to food and dairy industries and waste water management of developing nations.

Regenerative engineering is a field that seeks to regenerate complex tissues and biological systems, rather than simply restore and repair individual tissues or organs. Since the first introduction of regenerative engineering in 2012, numerous research has been devoted to the development of this field. Biodegradable polymers such as polyphosphazenes in particular have drawn significant interest as regenerative engineering materials for their synthetic flexibility in designing into materials with a wide range of mechanical properties, degradation rates, and chemical functionality. These polyphosphazenes can go through complete hydrolytic degradation and provide harmlessly and pH neutral buffering degradation products such as phosphates and ammonia, which is crucial for reducing inflammation in vivo. Here, we discuss the current accomplishments of polyphosphazene, different methods for synthesizing them, and their applications in tissue regeneration such as bones, nerves, and elastic tissues.

Mismatch-repair deficiency in solid tumors predicts their response to PD-1 blockade. Based on this principle, pembrolizumab is approved as standard of care for patients with unresectable or metastatic microsatellite instability–high (MSI-H) cancer. Despite this success, a large majority of metastatic colorectal cancer patients are not MSI-H and do not benefit from checkpoint blockade treatment. Predictive biomarkers to develop personalized medicines and guide clinical trials are needed for these patients. We, therefore, asked whether immunohistologic stratification of metastatic colorectal cancer based on primary tumor PD-L1 expression associated with the presence or absence of extracellular mucin defines a subset of metastatic colorectal cancer patients who exhibit a preexisting antitumor immune response and who could potentially benefit from the checkpoint blockade. To address this, we studied 26 advanced metastatic colorectal cancer patients treated with pembrolizumab (NCT01876511). To stratify patients, incorporation of histopathologic characteristics (percentage of extracellular mucin) and PD-L1 expression at the invasive front were used to generate a composite score, the CPM (composite PD-L1 and mucin) score, which discriminated patients who exhibited clinical benefit (complete, partial, or stable disease) from those patients with progressive disease. When validated in larger cohorts, the CPM score in combination with MSI testing may guide immunotherapy interventions for colorectal cancer patient treatment.

Supplementary figures 1-6 and tables 1-3

supplementary methods, tables and figures Supplementary Table S1. Demographics of patients from clinical trial NCT01876511 Supplementary Table S2. Demographics of untreated CRC patients Supplementary Table S3. Target genes and specific primer/probes gene expression assay used for Taqman PCR Supplementary Table S4. Summary statistics of immune related gene expression between responder (R) and non-responder (NR) mCRC treated with pembrolizumab, sorted by Wilcoxon-Mann Whitney p-value Supplementary Table S5. Significant p values (p

Table components of supplementary figures

Supplementary figures. Figures S1-S5

Purpose:Clinical trials with immune checkpoint inhibition in sarcomas have demonstrated minimal response. Here, we interrogated the tumor microenvironment (TME) of two contrasting soft-tissue sarcomas (STS), rhabdomyosarcomas and undifferentiated pleomorphic sarcomas (UPS), with differing genetic underpinnings and responses to immune checkpoint inhibition to understand the mechanisms that lead to response.Experimental Design:Utilizing fresh and formalin-fixed, paraffin-embedded tissue from patients diagnosed with UPS and rhabdomyosarcomas, we dissected the TME by using IHC, flow cytometry, and comparative transcriptomic studies.Results:Our results demonstrated both STS subtypes to be dominated by tumor-associated macrophages and infiltrated with immune cells that localized near the tumor vasculature. Both subtypes had similar T-cell densities, however, their in situ distribution diverged. UPS specimens demonstrated diffuse intratumoral infiltration of T cells, while rhabdomyosarcomas samples revealed intratumoral T cells that clustered with B cells near perivascular beds, forming tertiary lymphoid structures (TLS). T cells in UPS specimens were comprised of abundant CD8+ T cells exhibiting high PD-1 expression, which might represent the tumor reactive repertoire. In rhabdomyosarcomas, T cells were limited to TLS, but expressed immune checkpoints and immunomodulatory molecules which, if appropriately targeted, could help unleash T cells into the rest of the tumor tissue.Conclusions:Our work in STS revealed an immunosuppressive TME dominated by myeloid cells, which may be overcome with activation of T cells that traffic into the tumor. In rhabdomyosarcomas, targeting T cells found within TLS may be key to achieve antitumor response.

Supplemental Figures description. S1-S5

Objective To assess the impact of the COVID-19 pandemic on physical abuse in young children, we compared the following before and during the pandemic: (1) skeletal survey volume, (2) percent of skeletal surveys revealing clinically unsuspected (occult) fractures, and (3) clinical severity of presentation. We hypothesized that during the pandemic, children with minor abusive injuries would be less likely to present for care, but severely injured children would present at a comparable rate to prepandemic times. We expected that during the pandemic, the volume of skeletal surveys would decrease but the percentage revealing occult fractures would increase and that injury severity would increase. Methods We conducted a retrospective study of children younger than 2 years undergoing skeletal surveys because of concern for physical abuse at a tertiary children's hospital. Subjects were identified by querying a radiology database during the March 15, 2019–October 15, 2019 (pre–COVID-19) period and the March 15, 2020–October 15, 2020 (COVID-19) period, followed by chart review to refine our population and abstract clinical and imaging data. Results Pre–COVID-19, 160 skeletal surveys were performed meeting the inclusion criteria, compared with 125 during COVID-19, representing a 22% decrease. No change was observed in identification of occult fractures (6.9% pre-COVID vs 6.4% COVID, P = 0.87). Clinical severity of presentation did not change, and child protective services involvement/referral decreased during COVID. Conclusions Despite a >20% decrease in skeletal survey performance early in the pandemic, the percent of skeletal surveys revealing occult fractures did not increase. Our results suggest that decreases in medical evaluations for abuse did not stem from decreased presentation of less severely injured children.

The study reported isolation, identification and antibiotic susceptibility of Escherichia coli isolated from raw meat from Modakeke and Ile-ife, Osun State, Nigeria, with the view to determining the antibiogram profiling of the bacterial isolates. In this study, five samples of fresh meat were collected from different abattoirs in Ile-Ife and Modakeke, Osun State. Isolates of Escherichia coli were isolated, identified morphologically based on their growth on nutrient agar and subjected to antibiotic susceptibility test on Mueller Hinton agar. The mean microbial load from the meat samples ranged from 8.85 x 102cfu/ml to 5.77 x 104cfu/ml. A total of 69 E. coli isolates were recovered from the meat sampled. All the isolates appeared cream, translucent, entire, convex, circular, smooth and glistering. The isolates were identified as Gram negative rods, non-motile, lactose fermenters, positive for indole test and negative for citrate utilization test. All the E. coli isolates were resistant to augmentin, ceftriazone, nitrofurantoin and gentamycin. 98.55% of E. coli isolated was resistant to amoxillin and the least resistant was recorded in ofloxacin (8.70%). However, 91.30% of the E. coli isolates was sensitive to ofloxacin, 81.16% to ciprofloxacin and 36.23% to pefloxacin while none was sensitive to augmentin, ceftriazone, nitrofurantoin and gentamycin. A total of 19 different multiple antibiotic resistance patterns were observed among the isolates. Thirty isolates (43.48%) showed multiple antibiotic resistance to 5 and 10 different antibiotic types each. The study concluded that occurrence of E. coli infection is high in the study area with high level of multiple antibiotic resistance.

Background In much of eastern and southern Africa, the incidence of HIV and other sexually transmitted infections (STIs) remains high despite the scale-up of promising biomedical and behavioral interventions. Studies have documented the crucial role of transactional sex – the exchange of money, material support or goods in, sexual relationships – and heavy alcohol use in driving HIV/STI incidence and influencing men’s and women’s health outcomes. Existing policy responses to this challenge have largely focused on interventions to reduce women’s engagement in transactional sex such as vocational training and cash transfers for economic empowerment. However, the effectiveness of these interventions has been hindered by the relative lack of programs targeting men’s behavior. There is a vital need for interventions that can reduce men’s engagement in risky behaviors that increase HIV/STI risk. We describe here a protocol for an economic intervention to reduce men’s engagement in HIV risk behaviors in Kenya. Methods We will conduct a randomized controlled trial among income-earning men in Kenya who are aged 18–39 years and self-report alcohol use and engagement in transactional sex. The study will enroll 1,500 participants and randomize them to a control group or savings group. The savings group will receive access to a savings account that includes lottery-based incentives to save money regularly, opportunities to develop savings goals/strategies, and text message reminders about their saving goals. The control group will receive basic health education. Over a period of 24 months, we will collect qualitative and quantitative data from participants and a subset of their female partners. Participants will also be tested for HIV and other STIs at baseline, 12, and 24 months. Discussion The findings from this study have the potential to address a missing element of HIV/STI prevention efforts in Sub-Saharan Africa by promoting upstream and forward-looking behavior and reducing the risk of acquiring HIV/STIs in a high HIV/STI burden setting. If this study is effective, it is an innovative approach that could be scaled up and could have great potential for scientific and public health impact in Kenya. Trial registration : Registered on ClinicalTrials.gov on May 23, 2022. Link: https://clinicaltrials.gov/ct2/show/NCT05385484. Registration number: NCT05385484

Freedom of expression suffered a major setback in Nigeria when the federal government placed an indefinite suspension on twitter in the country, much to the displeasure and criticism of many from within and without. Even though Nigerians found an alternative means of accessing the social media application through the use of virtual private networks (VPN), the rippling effect of the ban from the social, political and economic viewpoint leaves much to be desired. After a prolonged tussle between the Nigerian government and the American based company which lasted over 100 days, the government finally agreed to have the ban lifted. This study through the use of secondary data investigates the emerging and contending issues surrounding the suspension. Findings reveal that the entire fiasco was quite avoidable had either of the parties not attempt to test waters.

Photoplethysmography (PPG) is an optical technique that monitors blood oxygen saturation levels, typically with the use of pulse oximeters. Conventional pulse oximetry estimates the ratio of light absorbed at two wavelengths. Attempts have been made to improve the precision of these measurements by using polarized light, with the tradeoff of requiring multiple sequential measurements. We demonstrate a novel PPG technique that uses radially polarized light generated by a light-emitting diode (LED) to obtain single-shot, blood oxygen-saturation measurements using a single wavelength at a rate of 50 fps. Our work, to the best of our knowledge, presents both a novel use of a vector beam and a first demonstration of vector-beam generation using LEDs.

Background In much of eastern and southern Africa, the incidence of HIV and other sexually transmitted infections (STIs) remains high despite the scale-up of promising biomedical and behavioral interventions. Studies have documented the crucial role of transactional sex—the exchange of money, material support, or goods, in sexual relationships—and heavy alcohol use in contributing to men’s and women’s health outcomes. Existing policy responses to this challenge have largely focused on women, through the provision of pre-exposure prophylaxis (PrEP) or structural interventions such as education subsidies and cash transfers. However, the effectiveness of these interventions has been hindered by the relative lack of interventions and programs targeting men’s behavior. We describe the protocol for a study that will test an economic intervention designed to reduce men’s engagement in HIV/STI-related risk behaviors in Kenya. Methods We will conduct a randomized controlled trial among income-earning men in Kenya who are aged 18–39 years and self-report alcohol use and engagement in transactional sex. The study will enroll 1500 participants and randomize them to a control group or savings group. The savings group will receive access to a savings account that includes lottery-based incentives to save money regularly, opportunities to develop savings goals/strategies, and text message reminders about their savings goals. The control group will receive basic health education. Over a period of 24 months, we will collect qualitative and quantitative data from participants and a subset of their female partners. Participants will also be tested for HIV and other STIs at baseline, 12, and 24 months. Discussion The findings from this study have the potential to address a missing element of HIV/STI prevention efforts in sub-Saharan Africa by promoting upstream and forward-looking behavior and reducing the risk of acquiring HIV/STIs in a high HIV/STI burden setting. If this study is effective, it is an innovative approach that could be scaled up and could have great potential for scientific and public health impact in Kenya. Trial registration ClinicalTrials.govNCT05385484. Registered on May 23, 2022

Introduction: People living with HIV/AIDs (PLWHA) are also prone to mental health problem such as depression. However, there is limited evidence on the effects of care giver counselling on the level of depression among people living with HIV/AIDs. This study aimed to determine factors associated with depression and the effects of care giver counselling and follow up on depression among PLWHA attending Federal Teaching Hospital, Ido-Ekiti, Nigeria. Methods: This study has two parts. The first part addressed the descriptive aspect of the study while in the second part, an experimental study was performed on 64 depressed HIV patients (32 intervention group and 32 in the control group). These 64 respondents were randomly screened out of 351 consenting PLWHA in the hospital using Zung’s self-rating depression scale. A systematic random sampling technique was employed to allocate participants to the groups, with the first client of the 64 participants allocated to the control group and the next client allocated to intervention group. On-phone counselling of a minimum of 30 minutes (once in a week) was done for the patients in the experimental group for a month after which a post intervention assessment was done for both intervention and control groups. Bar chart and descriptive statistics were employed to explain the data. Yate’s Chi-squared statistics was employed to find out statistical associations between the groups while the p-values were consequently reported. Results: The age of the studied subjects ranged between 21-80 years with a mean age of 41.53 (±9.06). One hundred forty-nine (42.5%) of the 351 subjects were found to have one form of depression or the other. Of 351 subjects, 57.5% were not depressed, 17.1% had mild depression, 10.3% had moderate depression and 15.1% had severe depression. One hundred two (29.1%) of 351 respondents came from a severely dysfunctional family, while 193(55.0%) from a moderately dysfunctional family and 56(16%) from highly functional family. The percentage of the intervention group that suffered severe depression reduced from 40.6% to 6.2% after the intervention as opposed to a marginal reduction of 34.4% to 31.2% in the control group without intervention (p-value

Starter cultures for ‘ogi’ production were selected with the aim of improving processing technique, lysine and methionine levels of ‘ogi’, a lactic acid fermented weaning food. Technological features of microorganisms from fermenting raw materials were screened to develop quality starter cultures. Lactobacillus brevis XO43 and Saccharomyces cerevisiae OY4 were finally selected and used as starter cultures in a pilot plant study. Fermentation with starter cultures showed constant final pH level of 3.35 in modified substrates after fermentation unlike spontaneously fermented; and significantly higher acidity (%TTA) indicative of faster fermentation. Addition of sugar (2%w/w) and soybean flours (1% w/w) also increased the acid levels during fermentation. Fermentation of dehulled maize grains fortified with glucose (2%w/w) alone by starter cultures shows the best quality in all the parameters considered except the available niacin yield. It is 24% higher than oven-dried ‘ogi’ flour from the traditional process and 11% higher than unprocessed whole maize grains. The methionine is 92% and 77% higher than the traditionally prepared ‘ogi’ and whole maize grains, respectively. The total amino acids level of the sample was 32% more than the traditionally fermented ‘ogi’ flour and 55% more than maize grains. Although, the soluble protein level was 23% lesser than the unfermented whole maize grains, it was 12% more than the dehulled maize substrate and ‘ogi’ from traditional process. Fermentation of corn into ‘ogi’ led to losses in the initial quantity of niacin. Starter cultures significantly improve the nutrients such as lysine, methionine, total amino acids, soluble protein and niacin more than spontaneous fermentation. Dehulling of grains, dewatering and oven drying significantly reduce nutrients. ‘Ogi’ fermentation process with the use of starter cultures and dehulled maize guarantee organoleptic qualities, improve ‘ogi’ production and create a better nutritional products.

The development of entrepreneurship in recent times has aroused the interest of women entrepreneurs to be imaginative and revolutionary. The study investigates the challenges confronting women entrepreneurs in Ekiti State Southwest Nigeria, thus common in most developing countries. The research establishes whether, in a male-dominated society, lack of education and business visibility is an obstacle that hinders women’s success, and are discriminated against. The findings reveal that family pressures, unexposed markets, lack of education, impede the success of women entrepreneurs, and in a male-dominated society, they are unjustly discriminated towards. The study suggests that governments of developing nations should provide financial assistance and mentoring services to women entrepreneurs to enhance their economic activities and performance, hence strengthen their access to finance and enable them to achieve entry into international markets. The research relied on secondary data obtained from literary analysis; which included articles, journals, online sources, and dissertations on women entrepreneurs.

BACKGROUND: Atherosclerosis begins in youth, partly driven by excess weight(EW) and abnormal lipids. Despite pediatric obesity worsening, lipids improved.Given the relation between EW and abnormal lipids, changes in normal weight (NW) youth may be relevant. We examined the proportions and temporal trendsof youth with abnormal lipids who were NW versus EW. METHODS AND RESULTS: Analysis was done from National Health and Nutrition Examination Surveys (NHANES)1988–2016. Data was extracted for 10–20 year olds measured with anthropometrics and lab testing to determine proportions of NW versus EW with total cholesterol(TC) >190mg/dL, high density lipoprotein cholesterol (HDL-C) 145 mg/dL (N=14,785). In survey-weighted regression analysis, a weight-status interaction term was used to examine effect modification in the lipid temporal trend. Over time, EW prevalence increased while dyslipidemia decreased (trend p value

The aim of the study is to evaluate and compare the antibacterial activity of ethanolic stem extract of (Wild African nutmeg) Pycnanthus angolensis (Welw.) and some commercially available toothpaste against bacteria isolated from the hidden resident mouth cavity microfora. Bacteria were isolated from swabs of apparently healthy individuals and were identified using Staining procedure biochemical tests and the use of Bergey’s manual of bacteria identification The assay for antibacterial activity of Pycnanthus angolensis stem bark extract and the four toothpastes were determined using agar well diffusion method. The Gram positive bacteria isolated were Streptococcus sangus, Streptococcus ratti, Stomatococcus mucilaginous., Peptostreptococcus sp., and Streptococcus mutans and the Gram negative bacteria were Veillonella atypical, Veillonella parvula, Veillonella dispar and Acidiaminococcus sp. Oral B toothpaste showed maximum efficacy of inhibition with inhibition zone diameter as wide as 20 mm at 100 mg/ml. Percentage frequency distribution of antibacterial activity of conventional toothpaste (Close-up) against hidden resident mouth cavity microfora depicts Acidaminococcus sp.13%, Veillonella parvula (10%), Veillonella dispar (12%), Peptostreptococcus sp.(12%), Stomatococcus mucilaginous.(9%), Streptococcus ratti (13%), Veillonella atypical (11%), Streptococcus sangus (9%) and Streptococcus mutans (11%), Percentage frequency distribution of antibacterial activity of conventional toothpaste (Oral B toothpaste) against hidden resident mouth cavity microfora reveals Acidaminococcus sp.(11%,) Veillonella dispar (11%), Veillonella parvula (10%), Peptostreptococcus sp. (12%), Stomatococcus mucilaginous.(15%), Streptococcus ratti (11%), Veillonella atypical (8%), Streptococcus sangus (10%), and Streptococcus mutans (12%), Percentage frequency distribution of antibacterial activity of conventional toothpaste (MyMy toothpaste) against hidden resident mouth cavity microfora depicts Acidaminococcus sp.(12%), Veillonella dispar (9%), Veillonella parvula (8%), Peptostreptococcus sp.(10%), Stomatococcus mucilaginous.(16%), Streptococcus ratti (9%), Veillonella atypical (15%),Streptococcus sangus (9%) and Streptococcus mutans (12%), Percentage frequency distribution of antibacterial activity of conventional toothpaste (Olive toothpaste) against hidden resident mouth cavity microfora shows Acidaminococcus sp.(9%), Veillonella dispar (10%), Veillonella parvula (10%), Peptostreptococcus sp.(12%), Stomatococcus mucilaginous.(13%), Streptococcus ratti (10%) ,Veillonella atypical (17%), Streptococcus sangus (7%), and Streptococcus mutans (12%). Pycnanthus Angolensis stem bark extract inhibited the growth of the oral bacterial isolates with of zones of inhibition diameter ranging from 6 mm to 17 mm at a concentration of 100mg/ml. Secondary metabolite (Phytochemical) screening shows the presence of flavonoids, tannins, saponins, alkaloids, reducing sugars, steroid, phenol, terpenoid, pyrrolozidine alkaloid, glycoside and cardiac glycoside with glycoside and terpenoid most present. However, anthraquinones and volatile oil were absent. With menial antibacterial activity, P. angolensis can be use in the formulation of herbal toothpaste. It should be advocated that Pycnanthus angolensis should be added to our convention toothpaste to improve the functional ingredient of the toothpaste and Plant-based traditional knowledge has become a recognized tool in search for new sources of drugs. It is clear that the use of these herbal plants can offer a platform for further research.

Objectives: The health conditions of women are broad, and range from pregnancy, gynaecological conditions to overall health/wellness. Ethnomedicinal investigation on plants used in the management of women-related health disorders was conducted in Bode herbal market, Ibadan, Southwestern Nigeria to further emphasize the role of herbal medicine in reproductive health. Methodology and Results: Ten herb sellers (all females; age range, 35 – 57; mean, 45.80; SD, 7.41) were interviewed in the local language (Yoruba) and their responses recorded. Recipes used in the management of arthritis, fibroid (uterine and menopausal), and obesity/overweight were documented. Thirty (38) plant species belonging to 24 plant families are profiled. The family Fabaceae had the highest number of species (n=7) while stem bark was the most frequently used (37%) plant part. Methods of preparations were mainly decoction and steeping of botanicals in alcohol. Administration includes taking one tot/half-a-glass cup, 2 (morning and night) to 3 times daily. Conclusion and Application of Findings: This study documents and further emphasizes the role of medicinal plants in female reproductive health. Although some of the plants reported here have been cited for the management of diseases such as skin infections and malaria/yellow fever, published reports on their use for women-related health disorders are limited. This research finds application in reproductive disorders in women and alternative approach to health care systems. These plants are presented for experimentation and scientific validation. Efforts should be made to conserve these plants, especially those that show promising bioactivity. Key words: Women, Arthritis, Fibroid, Obesity, Medicinal plant, Nigeria

Fish is an important part of the human diet, are at the top of the aquatic food chain with a high propensity to accumulating contaminants like heavy metals and polychlorinated biphenyls (PCBs) which are toxic to humans. The objective of this study was to evaluate the relationship between condition factor (physiologic wellbeing) of the fishes, PCBs, and heavy metal accumulation.Ten adult fish species three each of Chrysichthys nigrodigitatus, Trachinotus teraia, Liza dumerilli, Tilapia guieensis, Pseudotolithus elongatus, Pomadasys jubelini, Polydactylus quadrifilis, Caranx hippos, Sphyreana barracuda, Arius heudoloti,were acquired at Epe Lagoon. Ten adult fish species three each of Argentina silus, Gadus chalcogrammus, Gadus morhua, Atlantic mackerel, Micropogonias undulatus, Urophycis sp., Chrysichthys nigrodigitatus, Oreochromis niloticus, Clupea harengus, Trachurus trachurus, imported into Lagos were purchased. The fish species’ condition factor was determined. The heavy metals were determined using AAS while PCB level was determined using GC-MS. Iron, mercury, zinc, arsenic, nickel and copper levels correlated positively with the condition factor in the local fishes while in the imported fishes, cadmium, iron, zinc, nickel, copper and lead levels correlated positively to the condition factor. The levels of PCBs in both the local and imported fishes were non-detectable. It is concluded that the lead, copper, arsenic, zinc, mercury and cadmium in both the imported and local fishes were within permissible limits compared with the FAO/WHO maximum permissible limits. The positive correlation of some heavy metals to the fishes’ condition factor infers that these metals might be altering physiologic activities in the fishes. Keywords: Condition factor; Heavy metals; Polychlorinated biphenyl; Fish

In a bid to complement the lost reserves from fossils, recent advances in research are tailored towards producing hydrogen as an alternative source of fuel which is aimed at fostering a globally sustainable and reliable energy-economy. In this work, hydrogen was produced from formic acid (FA) using a new technology that involves the use of copper nanoparticles (CuNPs) supported on triethanolamine. The CuNP-catalysts of variant concentrations (i.e. 0.6–1.2 M) were synthesized using the conventional chemical deposition method. Also, a novel approach that bothers on the application of the Differential Method of Analysis (DMA) was used in determining the kinetic parameters for the FA-dehydrogenation. Based on the results, the volume of H2 produced varied with time, pH, concentration and catalyst-size. At 6 h, the 1 M CuNPs gave the highest volume (815 mL) of hydrogen with corresponding pH, particle size and approximate conversion of 3.19, 1.5 nm and 100% respectively, whereas, over extended periods i.e. over 6 h, the approximate volume-conversions of FA increased insignificantly for all catalysts. According to the investigation, the optimum CuNP-catalyst concentration required to produce 815 mL H2 in 6 h is 1 M. The decomposition was a first-order-type with a rate constant (k-value) of 1.0041 s−1.

Infants who appear neurologically well and have fractures concerning for abuse are at increased risk for clinically occult head injuries. Evidence of excess variation in neuroimaging practices when abuse is suspected may indicate opportunity for quality and safety improvement.To quantify neuroimaging practice variation across children's hospitals among infants with fractures evaluated for abuse, with the hypothesis that hospitals would vary substantially in neuroimaging practices. As a secondary objective, factors associated with neuroimaging use were identified, with the hypothesis that age and factors associated with potential biases (ie, payer type and race or ethnicity) would be associated with neuroimaging use.This cross-sectional study included infants with a femur or humerus fracture or both undergoing abuse evaluation at 44 select US children's hospitals in the Pediatric Health Information System (PHIS) from January 1, 2016, through March 30, 2020, including emergency department, observational, and inpatient encounters. Included infants were aged younger than 12 months with a femur or humerus fracture or both without overt signs or symptoms of head injury for whom a skeletal survey was performed. To focus on infants at increased risk for clinically occult head injuries, infants with billing codes suggestive of overt neurologic signs or symptoms were excluded. Multivariable logistic regression was used to investigate demographic, clinical, and temporal factors associated with use of neuroimaging. Marginal standardization was used to report adjusted percentages of infants undergoing neuroimaging by hospital and payer type. Data were analyzed from March 2021 through January 2022.Covariates included age, sex, race and ethnicity, payer type, fracture type, presentation year, and hospital.Use of neuroimaging by CT or MRI.Of 2585 infants with humerus or femur fracture or both undergoing evaluations for possible child abuse, there were 1408 (54.5%) male infants, 1726 infants (66.8%) who were publicly insured, and 1549 infants (59.9%) who underwent neuroimaging. The median (IQR) age was 6.1 (3.2-8.3) months. There were 748 (28.9%) Black non-Hispanic infants, 426 (16.5%) Hispanic infants, 1148 (44.4%) White non-Hispanic infants. In multivariable analyses, younger age (eg, odds ratio [OR] for ages3 months vs ages 9 to12 months, 13.2; 95% CI, 9.54-18.2; P .001), male sex (OR, 1.47; 95% CI, 1.22-1.78; P .001), payer type (OR for public vs private insurance, 1.48; 95% CI, 1.18-1.85; P = .003), fracture type (OR for femur and humerus fracture vs isolated femur fracture, 5.36; 95% CI, 2.11-13.6; P = .002), and hospital (adjusted range in use of neuroimaging, 37.4% [95% CI 21.4%-53.5%] to 83.6% [95% CI 69.6%-97.5%]; P .001) were associated with increased use of neuroimaging, but race and ethnicity were not. Publicly insured infants were more likely to undergo neuroimaging (62.0%; 95% CI, 60.0%-64.1%) than privately insured infants (55.1%; 95% CI, 51.8%-58.4%) (P = .001).This study found that hospitals varied in neuroimaging practices among infants with concern for abuse. Apparent disparities in practice associated with insurance type suggest opportunities for quality, safety, and equity improvement.

The COVID-19 pandemic resulted in an unprecedented shift from face-to-face to online teaching with a subsequent deleterious impact on the quality of teaching delivery within medical education Our aim was to demonstrate the feasibility of utilizing a novel approach to interactive, online simulated history-taking.The session was designed for students attending a virtual work-experience programme and is founded upon gamification principles. History-taking is a humanistic social process requiring effective communication skills and recognition of verbal and non-verbal cues. The session enabled students to directly instruct a passive clinician to take a history from a simulated patient actor, incorporating both verbal and non-verbal actions. This novel teaching method is analogous to Freire’s work, highlighting the importance of the learner being an active participant, thus enabling experiential learning This interactive approach required a simulated patient actor, a passive clinician and a verbal instructor to be present. Students were presented with a case scenario and viewed the interaction between the simulated patient actor and passive clinician online via a video conferencing service (in this case, Zoom). Students provided instructions to the passive clinician using the typed chat function. These typed instructions were relayed by the verbal instructor to the passive clinician via an earpiece and the passive clinician would then embody these instructions. This allowed students to work as a group to directly elicit a history and witness their instructions being actioned. Examples of instructions included questions to verbalize, adjustments to body language and alteration of the tone of voice. Following good student instruction, the passive clinician gradually grew in competence and confidence throughout the scenario, thus allowing real-time, interactive feedback of their history-taking approach. The session concluded with a reflection of the communication traits that helped to gain an effective history from the patient using a debrief model.

The COVID-19 pandemic has necessitated a transition from traditional face-to-face teaching to virtual equivalents, sometimes at the expense of teaching quality and student engagement Our aim was to demonstrate the feasibility of a novel gamified online simulation approach to teaching the management of acutely unwell patients.Using elements of gamification and interactive film, this virtual session was designed to teach prospective medical students the ‘A to E’ approach of managing an acutely unwell patient. The management of an acutely unwell patient is an iterative and dynamic process that requires one to manage uncertainty and constantly re-evaluate the clinical situation. The session was designed using interactive film, with students given the ability to influence a clinician’s actions and subsequent changes of clinical scenario dictated by student live-vote. This interactive and engaging approach allowed students to reflect-in-action and be active learners, in line with an experiential pedagogy Students attended a live session using a video conferencing service (Zoom) and their responses to clinical scenarios were recorded using an online voting tool (Mentimeter). Students were provided with a case history of an unwell patient and presented with an opening video. The session required video options to be pre-recorded to reflect the numerous potential avenues within the scenario as dictated by the students’ chosen actions. Depending on overall student voting consensus, pre-recorded videos of the clinician’s actions and changes to the clinical scenario were subsequently shown. For example, if the appropriate clinical action was selected, students would progress through the A-E approach. Students effectively guided the clinician to manage the unwell patient, with iterative and real-time feedback provided throughout the scenario. The session was concluded with a debrief, explanation of the case and key learning points.

Background: Nigeria is among the top five countries in the world with the highest under-five mortality rates. In addition to the general leading causes of under-five mortality, studies have shown that disparities in sociocultural values and practices across ethnic groups in Nigeria influence child survival, thus there is a need for scientific validation. Methods: The approach commonly adopted in multilevel modeling of the under-five mortality rate in Nigeria is to consider child death status as a binary outcome variable. In this manner, information about the time localization of mortality risk is lost in the process. This study quantified the impact of socioeconomic and demographic factors, proximate and biological determinants, and environmental factors on the risk of under-five mortality in Nigeria using a Bayesian hierarchical hazard model with time to death outcomes. The Exponential, Gamma, Log-normal, Weibull, and Cox hazard models in a mixed effect framework with spatial components were considered, and the best model was selected for inference. In addition, the Kaplan Meier survival curve, Nelson Aalen hazard curve, and components survival probabilities were estimated. Results: Findings show that gender, maternal education, household wealth status, source of water and toilet facility, residence, mass media, frequency of antenatal and postnatal visits, marital status, place of delivery, multiple births, who decide healthcare use, use of bednet are significant risk factors of child mortality in Nigeria. The mortality risk is high among the maternal age group below 24 and above 44years, and birth weight below 2.5Kg and above 4.5Kg. The under-five mortality risk is severe in Kebbi, Kaduna, Jigawa, Adamawa, Gombe, Kanu, Kogi, Nasarawa, Plateau, Sokoto states in Nigeria. Conclusions: This study accentuates the need for special attention for the first two months after childbirth as it is the age group with the highest expected mortality. A practicable way to minimize death in the early life of children is to improve maternal health care service, promote maternal education, encourage delivery in healthcare facilities, positive parental attitude to support multiple births, poverty alleviation programs for the less privileged, and a prioritized intervention to Northern Nigeria.

Lower limb reconstruction is performed to replace like with like and achieve tissue durability. Free flaps are a method of reconstruction commonly used to manage cases of lower limb deficits. However, the failure rate is 8.5%, with venous thrombosis and congestion playing a significant role. Despite this, preoperative venous mapping of recipient site before free flap reconstruction is not routinely practiced, often resulting in pathologies remaining unidentified until the intraoperative stage. The aim of the review was to evaluate the existing literature on the topic of lower limb preoperative venous assessment, screening, and its effect on lower limb free flap survival. Five different databases were searched from their inception to August 2021. The search terms and included studies were independently reviewed by two investigators for their eligibility. Eleven articles were eligible for inclusion, with a combined patient population of 99, and 107 flaps were identified to have lower limb pathology at the donor or recipient vein. Venous pathology was detected preoperatively in 69 veins using ultrasound duplex scanning and computed tomography angiography; of them, 3 (4.34%) resulted in failure. In comparison, 38 veins were diagnosed with venous pathology intraoperatively; of them, 5 (13.85%) failed. The studies evaluated in this review demonstrated that preoperative screening for venous pathology showed a higher flap survival rate. It can therefore be inferred that developing a standardized preoperative process for identifying venous issues in lower limb free flap reconstruction may improve outcomes. This can be explored in future research, with a focus on assessing the validity and efficacy of such screening tools, and their role in the management of patients identified with venous pathology.

Introduction Prior research has highlighted the psychosocial impact of infectious diseases on individuals and the community at large. However, little is known about the psychosocial implications of COVID-19. This study set out to determine the rate as well as correlates of anxiety and depressive symptoms among persons managed as in-patients for COVID-19 in Lagos, Nigeria. Materials and methods We conducted an online survey between April to June ending 2020 using a consecutive sampling technique of persons positive for COVID-19 and who were managed as in-patients across five (5) treatment centres in Lagos, Nigeria. The survey collected information on demographic as well as clinical data including suicidality. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Results There were one hundred and sixty participants in total. The mean age of respondents was 36.4 (±9.7) years with a higher proportion (56.9%) being males. With regards to diagnosis, 28.1% and 27.5% of the respondents were categorised as probable cases of depression and anxiety respectively, while 3.8% respondents reported suicidal ideation. Majority of the respondents (61.9%) reported the fear of infecting their loved ones. The variables that showed association with psychiatric morbidity were a past history of an emotional concern, employment status, guilt about infecting others and boredom. Conclusion This study revealed a high burden of psychological/psychiatric morbidity among persons treated for COVID-19, particularly persons who have had prior emotional concerns. The findings from this study reiterate the need to pay attention to the mental health of people during disease outbreaks and to incorporate psychosocial interventions as part of the management package.

OBJECTIVES: To explore the relative risks of preterm birth—both overall and stratified into 3 groups (late, moderate, and extreme prematurity)—associated with maternal race, ethnicity, and nativity (ie, birthplace) combined. STUDY DESIGN: This was a retrospective cross-sectional cohort study of women delivering a live birth in Pennsylvania from 2011 to 2014 (n = 4 499 259). Log binomial and multinomial regression analyses determined the relative risks of each strata of preterm birth by racial/ethnic/native category, after adjusting for maternal sociodemographic, medical comorbidities, and birth year. RESULTS: Foreign-born women overall had lower relative risks of both overall preterm birth and each strata of prematurity when examined en bloc. However, when considering maternal race, ethnicity, and nativity together, the relative risk of preterm birth for women in different racial/ethnic/nativity groups varied by preterm strata and by race. Being foreign-born appeared protective for late prematurity. However, only foreign-born White women had lower adjusted relative risks of moderate and extreme preterm birth compared with reference groups. All ethnic/native sub-groups of Black women had a significantly increased risk of extreme preterm births compared with US born non-Hispanic White women. CONCLUSIONS: Race, ethnicity, and nativity contribute differently to varying levels of prematurity. Future research involving birth outcome disparities may benefit by taking a more granular approach to the outcome of preterm birth and considering how nativity interacts with race and ethnicity.

Heart valve disease is associated with high morbidity and mortality worldwide resulting in hundreds of thousands of heart valve replacements each year. Tissue engineered heart valves (TEHVs) have the potential to overcome the major limitations of traditional replacement valves; however, leaflet retraction has led to the failure of TEHVs in preclinical studies. As native unmodified hyaluronic acid (HA) is known to promote healthy tissue development in native heart valves, we hypothesize that adding unmodified HA to fibrin-based scaffolds common to tissue engineering will reduce retraction by increasing cell-scaffold interactions and density of the scaffolds. Using a custom high-throughput culture system, we found that incorporating HA into millimeter-scale fibrin-based cell-populated scaffolds increases initial fiber diameter and cell-scaffold interactions, causing a cascade of mechanical, morphological, and cellular responses. These changes lead to higher levels of scaffold compaction and stiffness, increased cell alignment, and less bundling of fibrin fibers by the cells during culture. These effects significantly reduce scaffold retraction and total contractile force each by around 25%. These findings increase our understanding of how HA alters tissue remodeling and could inform the design of the next generation of tissue engineered heart valves to help reduce retraction. Statement of significance Tissue engineered heart valves (TEHVs) have the potential to overcome the major limitations of traditional replacement valves; however, leaflet retraction induced by excessive myofibroblast activation has led to failure in preclinical studies. Developing valves are rich in hyaluronic acid (HA), which helps maintain a physiological environment for tissue remodeling without retraction. We hypothesized that adding unmodified HA to TEHVs would reduce retraction by increasing cell-scaffold interactions and density of the scaffolds. Using a high-throughput tissue culture platform, we demonstrate that HA incorporation into a fibrin-based scaffold can significantly reduce tissue retraction and total contractile force by increasing fiber bundling and altering cell–mediated matrix remodeling, therefore increasing gel density and stiffness. These finding increase our knowledge of native HA's effects within the extracellular matrix, and provide a new tool for TEHV design.

Introduction: “Long COVID” is a multisystem disease that lasts for 4 or more weeks following initial symptoms of COVID-19. In the UK, at least 10% of patient report symptoms at 12 weeks following a positive COVID-19 test. The aims of this quality improvement survey were to explore patients’ acute and post-acute “long” COVID-19 symptoms, their experiences of community services and their recommendations for improving these services. Methods: Seventy patients diagnosed with COVID were randomly selected from 2 large socially and ethnically diverse primary care practices. Of those contactable by telephone, 85% (41/48) agreed to participate in the quality improvement survey. They were interviewed by telephone using a semi-structured questionnaire about community services for COVID-19 patients. Interviews lasted 10 to 15 minutes. Results: Forty-nine percent of patients reported at least 1 post-acute COVID-19 symptom. The most common were severe fatigue (45%), breathlessness (30%), neurocognitive difficulties (such as poor memory), poor concentration and “brain fog” (30%), headaches (20%), and joint pain (20%). Many patients felt isolated and fearful, with scant information about community resources and little safety netting advice. Patients also expected more from primary care with over half (56%) recommending regular phone calls and follow up from healthcare staff as the most important approach in their recovery. Conclusions: In line with patients’ requests for more support, the practices now routinely refer patients with long COVID to an on-site social prescriber who explores how they are getting on, refers them to the GP or practice nurse when required, and sign posts them to support services in the community.