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Dr Adnan al-Bursh was head of orthopaedics at al-Shifa Hospital, the largest medical facility in the Gaza Strip. Some have anecdotally called him the best orthopaedic surgeon in the land. When hostilities knocked the front door of al-Shifa hospital, instead of heading south as ‘requested’ by the Israeli Occupation Force (IOF), he went north to continue serving his people until his arrest in December 2023. On 19 April 2024, news reached the world that Dr al-Bursh died in prison, likely from torture

Abstract Background Pregnancy-related anxiety significantly impacts maternal and fetal health in low- and middle-income countries (LMICs), including those within Sub-Saharan Africa (SSA). Most studies conducted to evaluate pregnancy-related anxiety in LMICs have utilized scales developed in high-income countries, despite significant variations in pregnancy-related anxiety due to socioeconomic and cultural contexts. This review surveyed existing literature in order to identify which scales have been used to measure pregnancy-related anxiety in SSA. Methods A systematic search was conducted in PubMed, Health and Psychosocial Instruments, and APA PsycNet for relevant studies published in the English language up to March 22, 2023. Eligible studies focused on anxiety in pregnant populations within SSA, using validated scales or tools. Screening followed PRIMSA guidelines, with blinded review at the abstract/title level and subsequent full-text review. Data was extracted and analyzed to identify trends and characteristics of the screening tools used. Results From 271 articles, 37 met inclusion criteria, identifying 24 different tools used to measure anxiety in pregnant women in SSA. The most common tools were the Generalized Anxiety Disorder 7-item scale (seven uses), State-Trait Anxiety Inventory (five uses), and the Self-Reporting Questionnaire 20 (five uses). Seven tools were pregnancy-specific, with only two designed specifically for SSA: the Risk Factor Assessment (RFA), and the 4-Item Screening Tool. Studies were most frequently conducted in South Africa, followed by Tanzania, Ethiopia, Nigeria, and Ghana. Conclusions This scoping review illustrates that only two tools (the RFA and 4-item Screening Tool) were created to assess pregnancy-related anxiety specifically in SSA. This highlights the need for more culturally sensitive tools tailored to the specific contexts of pregnant populations in SSA.

Saat ini pemerintah terus mendorong masyarakat untuk memanfaatkan EBT di Indonesia untuk mencapai target bauran sebanyak 23 % di tahun 2025. Pada penelitian ini dilakukan perancangan PLTS atap on-grid pada salah satu industri yang bergerak di bidang pengolahan bahan pangan hewani. PLTS digunakan untuk melayani beban penerangan dengan standar kelayakan mengikuti panduan EBTKE ESDM (SNI 8395:2017) dan sistem instalasi pemasangan berdasarkan PUIL 2011. Berdasarkan hasil perancangan digunakanlah modul surya jenis monocrystalline 410 Wp sebanyak 108 unit dan satu unit inverter 40 kW yang menghasilkan energi sebesar 63.032,58 kWh/tahun dan pengurangan emisi gas karbon dioksida (CO2) sebanyak 78.790,725 ton/tahun. Hasil kelayakan ekonomi dengan investasi awal Rp. 548.890.000, menghasilkan NPV Rp. 72.019.012, BCR 1,11, dan payback period pada tahun ke-18. Hasil tersebut menunjukkan bahwa PLTS dapat melayani beban penerangan dan melakukan penghematan energi listrik sebesar penggunaan beban penerangan harian di industri.

Disiplinler arası çalışmaların önemi son yıllarda giderek artmaktadır. Sosyal bilimler özelinde ise disiplinler arası geçişler ve etkileşimler güncel çalışmalarda daha fazla yer almaktadır. Modern dışı toplulukları inceleyen antropoloji ile modern toplumları inceleyen sosyolojinin kesişim alanları en çok kent araştırmalarında kendisini göstermektedir. Sosyoloji açısından kent demografik, ekonomik, siyasi vb. yapısal açıdan ele alınırken, antropolojinin metoduyla kente yaklaşmak daha mikro alanların keşfedilmesine yol açmıştır. Günümüz kentleri üzerine yapılan sosyolojik çalışmalar, sosyal problemler ve kamusal politikalar ekseninde şekillenmektedir. Fakat kentler arası kültürel farklılıklar ve yerel dinamikleri keşfedici analizler ortaya çıkmamaktadır. Bu makalenin amacı kent araştırmalarında antropolojik eğilimlerin yeni araştırma konuları (meseleler) ortaya çıkardığını böylece özgün yaklaşımlar sunulduğunu göstermektedir. Çağdaş kent toplumunu antropolojik yöntemlerle araştırmak, kente özgü keşfedilmemiş yeni alt kültür gruplarını veya insan ölçeğini merkeze alan gündelik rutinlerin keşfedilmesini sağlamıştır.

The experimental research was carried out to study the tribological behaviour of materials used in the manufacture of rotary dryer blades (based on abrasive/abrasive-erosive wear analysis of the blades) using the Baroid tester. The test program included 2 series of tests consisting of subjecting the specimens to a wear process, generated by friction between their test surface and a rotating granite roller. Each set of tests was by specific parameters characterized: test medium, rotational speed of the granite roller, pressing force of the roller on the specimen surface, test time, number of test cycles. The test results highlight the erosion phenomenon (abrasive erosion) responsible for the damage of the rotary dryer blades and the conditions of accentuation of specific wear phenomena.

Abstract The present study synthesized magnetite-pectin-chitosan (MPC), which is a nanocomposite adsorbent through partial reduction co-precipitation method. Its structure and morphology were characterized by Scanning Electron Spectroscopy (SEM), X-ray diffraction (XRD), Fourier Transform Infrared Spectrometry (FT-IR) and Vibrating Sample Magnetometry (VSM). One studied the adsorption of Lanthanum and Cerium ions onto MPC in a batch system as a function of initial pH of solution, contact time, initial concentration and temperature. When the initial pH of the solution increased, the La(III)/Ce(III) ions augmented as well. The optimum pH for La/Ce adsorption was 5 and the maximum adsorption achieved within 30 min. The thermodynamics parameters such as enthalpy ( $$\Delta {\text{H}}^\circ$$ Δ H ∘ ), entropy ( $$\Delta {\text{S}}^\circ$$ Δ S ∘ ) and Gibbs free energy changes ( $$\Delta {\text{G}}^\circ$$ Δ G ∘ ) were calculated with the results suggesting that the adsorption was exothermic and spontaneous. To determine the adsorption characteristics, models of Langmuir, Dubinin-Radushkevich, Freundlich, Temkin and Flory–Huggins adsorption isotherms were performed. Langmuir isotherm model enabled the data of adsorption to be described very well. The adsorption capacity was seen to be 8.17 mg/g and 9.72 mg/g for lanthanum and cerium, respectively. The adsorption kinetics of MPC indicated that the adsorption process fit the Pseudosecond-order (PSO) model. Based on these data, it is concluded that short operating time, eco-friendly technology, and easy to apply MPC can be used for La(III)/Ce(III) ions removal.

Teff (Eragrostis tef) is a staple crop and holds the biggest share of grains cultivated area in Ethiopia, consequently, a large quantity of Teff straw is produced. The Teff straw was pretreated for the first time with Chromium-based Metal-Organic Framework, MIL-101(Cr), assisted hydrothermal method at temperatures ranging from 160 to 240 °C for 1/2, 1, or 2 h time independently. With an increase of pretreatment severity, the yield of total reducing sugar (TRS) was increased until reaching maximum (185 mg g−1). The identified optimum hydrothermal pretreatment condition, (180 °C and 1 h), had a feature of higher TRS yield and lower furfural concentration. The morphological analysis showed that treated Teff straw had degraded structure, higher surface area, and distorted bundles than native Teff straws. This study insight into MOFs’ application in lignocellulose biomass processing, and optimizing the pretreatment condition of Teff straw biomass.

Hospitality services play a crucial role in shaping tourist satisfaction and revisiting intention toward destinations. Traditional feedback methods like surveys often fail to capture the nuanced and real-time experiences of tourists. Digital platforms such as TripAdvisor, Yelp, and Google Reviews provide a rich source of user-generated content, but the sheer volume of reviews makes manual analysis impractical. This study proposes integrating aspect-based sentiment analysis with zero-shot learning to analyze online tourist reviews effectively without requiring extensive annotated datasets. Using pretrained models like RoBERTa, the research framework involves keyword extraction, sentence segment detection, aspect construction, and sentiment polarity measurement. The dataset, sourced from TripAdvisor reviews of attractions, hotels, and restaurants in Central Java, Indonesia, underwent preprocessing to ensure suitability for analysis. The results highlight the importance of aspects such as food, accommodation, and cultural experiences in tourist satisfaction. The findings indicate a need for continuous service improvement to meet evolving tourist expectations, demonstrating the potential of advanced natural language processing techniques in enhancing hospitality services and customer satisfaction.

Drug abuse is a rising psychological concept in many countries, and its use among individuals is increasing. Therefore, this study aimed to assess the Knowledge and demographic factors associated with drug abuse among male pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. This study used a cross-sectional design targeting male entry-level pharmacy and nursing students in their first and second years of Bachelor of Nursing and Doctor of Pharmacy courses. Of them, 85.3 % of the pharmacy and 75.3 % of nursing students thought that cocaine causes drug addiction, followed by heroin (pharmacy 80.7 %; nursing students 71 %), and morphine (pharmacy 75.2 %; nursing students 59.1 %). In this study, 52 % (n = 105) claimed low awareness, whereas 48 % (n = 97) indicated good understanding regarding drug addictions. Furthermore, the mean knowledge score among pharmacy students was higher (7.073 ± 2.570) in comparison to nursing (5.806 ± 2.494) (t = 3.540; p = 0. 0001). In addition, the father’s occupation was found to be significantly associated with the mean knowledge score of drug addiction (F = 2.667; p = 0.034). According to the findings, 52 % of male students had insufficient knowledge about drugs that cause addiction. Age, course of study, and father's occupation all had a substantial impact on knowledge scores. The knowledge score on the complications of addictive substances was not significantly associated with the characteristics of the students (p = 0.05). As a result, we advocate for the introduction of educational initiatives that educate students about the harmful consequences of drug addiction and how to avoid issues.

Senna didymobotrya is one of the emerging invasive weeds in East and South Africa. One of the solutions for weed management involves isolating cellulose and converting it into valuable materials. In this research, the isolation of cellulose was optimized by the Plackett-Burman design (PBD) and response surface methodology using Box-Behnken design (BBD), both of which are statistical empirical models. The maximum isolated cellulose yield was 37.5% (w/w) using sulfuric acid 1.75% (w/v), sodium chlorite 3% (w/v) at pH of 3.5, and potassium hydroxide 6% (w/v) treatment. Each chemical treatment was done by heating the mixture at 90°C for 2 hrs. The cellulose yield obtained (37.5% (w/w)) was higher than the preoptimized value of 35.5% (w/w). The dewaxed powder of the weed, isolated cellulose, and commercial cellulose was characterized side by side for comparison using FTIR, XRD, SEM, and TGA/DTA. All the characterizing methods indicated that the isolated material was cellulose. Even though the intensity of FTIR and XRD graphs of the isolated cellulose was higher than the commercial cellulose, the crystallinity index calculated from XRD analysis showed that the commercial cellulose (83%) was higher than the isolated cellulose (78%). The TGA/DTA indicates that the isolated cellulose and commercial cellulose had comparable thermal stability, both stable at up to 360°C. Therefore, using this optimized method, cellulose isolation from S. didymobotrya opens avenues for converting cellulose into valuable materials like carboxymethyl cellulose, cellulose hydrogel, and cellulose nanocrystals.

Since 2020, many compounds have been investigated for their potential use in the treatment of SARS-CoV-2 infection. Among these agents, a huge number of natural products and FDA-approved drugs have been evaluated as potential therapeutics for SARS-CoV-2 using virtual screening and docking studies. However, the identification of the molecular targets involved in viral replication led to the development of rationally designed anti-SARS-CoV-2 agents. Among these targets, the main protease (Mpro) is one of the key enzymes needed in the replication of the virus. The data gleaned from the crystal structures of SARS-CoV-2 Mpro complexes with small-molecule covalent inhibitors has been used in the design and discovery of many highly potent and broad-spectrum Mpro inhibitors. The current review focuses mainly on the covalent type of SARS-CoV-2 Mpro inhibitors. The design, chemistry, and classification of these inhibitors were also in focus. The biological activity of these inhibitors, including their inhibitory activities against Mpro, their antiviral activities, and the SAR studies, were discussed. The review also describes the potential mechanism of the interaction between these inhibitors and the catalytic Cys145 residue in Mpro. Moreover, the binding modes and key binding interactions of these covalent inhibitors were also illustrated. The covalent inhibitors discussed in this review were of diverse chemical nature and origin. Their antiviral activity was mediated mainly by the inhibition of SARS-CoV-2 Mpro, with IC 50 values in the micromolar to the nanomolar range. Many of these inhibitors exhibited broad-spectrum inhibitory activity against the Mpro enzymes of other coronaviruses (SARS-CoV-1 and MERS-CoV). The dual inhibition of the Mpro and PLpro enzymes of SARS-CoV-2 could also provide higher therapeutic benefits than Mpro inhibition. Despite the approval of nirmatrelvir by the FDA, many mutations in the Mpro enzyme of SARS-CoV-2 have been reported. Although some of these mutations did not affect the potency of nirmatrelvir, there is an urgent need to develop a second generation of Mpro inhibitors. We hope that the data summarized in this review could help researchers in the design of a new potent generation of SARS-CoV-2 Mpro inhibitors., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Substance abuse admission to health facilities following the pandemic is often met with challenges. COVID-19 is causing an insurmountable psychosocial impact on the whole of mankind. Marginalized communities, particularly those with substance use disorders (SUDs), are also likely to suffer from greater psychosocial burden., Objectives: This study sought to evaluate substance abuse trends before and during the pandemic., Methods: A cross-sectional study was conducted among patients attending selected government hospitals in Malaysia. Data from the year 2018 to 2021 was utilized., Results: A total of 9,606 patients consisting of 7881 males and 1725 females were identified. Most of the patients involved with substance abuse from 2018 to 2021 were males, aged between 26 and 44 years old, Malays, high school students, singles, workers of private sectors and those residing in urban areas. The most abused substances over the four years were tobacco (61.8%), followed by amphetamine-type stimulants (ATS) (43.1%), alcohol (39.7%), cannabis (17.2%), opioids (13.0%), and kratom (8.8%). Those who worked in the private sector and were self-employed or unemployed were more associated with substance abuse during the pandemic compared to those who worked in the government sector. Those with a history of psychiatric illness were more associated with abuse of substances during the pandemic than those without the history (adjusted OR: 1.18, 95% CI 1.09-1.29, p <0.001)., Conclusions: Targeted exploration of factors affecting substance abuse in Malaysia is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in Malaysia., Competing Interests: The authors report no conflicts of interest., (Copyright: © 2024 Muhamad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The investigation aimed to assess the impacts of magnesium sulphate (MgSO4) iontophoresis and high-power pain-threshold ultrasound (HPPT-US) on pain, range of motion (ROM), and functional activity in physical therapy students suffering from mechanical cervical pain., Methods: Typically, 75 males aged 19 to 30 years suffering from mechanical neck pain were enrolled in this investigation. Participants were divided at random into three groups. Group A received iontophoresis plus conventional physical therapy program, Group B received HPPTUS along with conventional therapy, and Group C received conventional therapy only. The outcomes were pain evaluated by visual analog scale (VAS) and Digital Electronic Pressure Algometer, cervical range of motion measured by Myrin gravity reference goniometer, and Arabic Neck disability index (ANDI) evaluate neck function., Results: The differences within and between groups were detected utilizing a mixed-design multivariate analysis of variance (MANOVA). The within- and between-group analysis of all outcome measures revealed that there were statistically significant differences at post-intervention between high-power ultrasound and conventional group at all variables and also between iontophoresis and conventional group, but there was no statistically significant variation between high-power ultrasound and iontophoresis., Conclusion: MgSO4 iontophoresis and HPPT-US are effective in decreasing pain, improving neck function, and improving neck ROM in subjects with mechanical neck pain who have active myofascial trigger points (MTrPs) on the upper fibers of the trapezius with no superiority of one over the other., Trail Registration: The study was registered in the Clinical Trials Registry (registration no: NCT05474898) 26/7/2022., (© 2024. The Author(s).)

This study aimed to evaluate the effects of substituting a crude palm oil (CPO) diet with palm-pressed fibre oil (PPFO) on laying hens' performance, egg production, carcass characteristic and egg quality. A total of 150 Hisex Brown laying hens were randomly assigned to five treatments: a basal diet containing 4% CPO (T1-control) and basal diets in which CPO was substituted by 25% (T2), 50% (T3), 75% (T4) or 100% (T5) PPFO. These diets were fed to laying hens ad libitum for 16 weeks. Compared to the T1 diet, dietary treatments T2, T3 and T4 had no significant effect (P > 0.05) on the feed intake, body weight gain, feed conversion ratio, egg number, egg production, egg weight and egg mass of the laying hens during the entire experimental period. Nonetheless, a significant (P < 0.05) reduction in feed intake, egg number, egg production and egg mass were observed in hens fed T5 compared to those fed the T1 (control) diet. Except for heart and spleen weights, other carcass characteristics were not affected by treatment (P < 0.05). Skin yellowness and breast meat redness increased significantly (linearly, P < 0.05) with increasing proportions of PPFO. Likewise, yolk colour scores increased in proportion to the dietary level of PPFO (linearly, P < 0.05). These findings suggest that PPFO can be used as a novel, cost-effective lipid source at a level of 3% in layer diets as a substitute for CPO to improve eggs' quality parameters without any harmful effects on laying performance., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

The cattle egret (B. ibis) as a common wader birds in Egypt, they act a sole reservoir for many parasites and play a vital role in their life cycle and their distribution in their environment. The study was conducted from September 2020 to August 2021. A total of 180 B. ibis were collected from Al Qantara Gharb, Ismailia province, Egypt. Parasite species identification infecting cattle egret included morphological and morphometric characteristics based on light and scanning microscopy. Additionally, utilizing the partial small subunit ribosomal RNA (18S rRNA, ITS2 and ITS1) gene sequence, maximum parsimony was used to infer the phylogeny of the recovered species. The morphological and molecular studies revealed three helminths. Only one nematode (Desportesius invaginatus, linstow,1901) and two trematodes (Patagifer bilobus, Dietz,1909 and Apharyngostrigea cornu, Zeder,1800) have been identified. The cattle egret (B. ibis) are protagonists in the life cycle of many parasites. The study is considered the first in Egypt to fill the gap of phylogenetic analysis of three helminths; two of them (A. cornu and P. bilobus) were the first to be molecular phylogenetically analyzed in Egypt. The molecular data provided set the conspecific relation of the three identified helminths species with other related helminths. The new identified sequences will help in founding the basis for forthcoming identifications of other helminths species from cattle egret in Egypt and prospective view to possible parasitic assemblage affecting egret population and other animal populations in their environment., Competing Interests: Declaration of competing interest Not Applicable., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Proprotein Convertase Subtilisin/Kexin type-9 (PCSK-9) inhibitors have recently used in the management of different cardiac complications. Several clinical trials demonstrated their effectiveness in patients with hypercholesterolemia. However, the effectiveness of these medications in patients with heart diseases is still controversial. To review and summarize the clinical trials pertaining to the use and effectiveness of PCSK-9 inhibitors in heart diseases and to discuss the pharmacotherapy of these agents. A review was conducted of all clinical trials with PCSK-9 inhibitors for heart diseases registered at ClinicalTrials.gov since inception up to and including January 19th, 2024. These trials were retrieved. Data from these trials were extracted manually, categorized and analyzed. The number of identified clinical trials was 25,371. After screening and excluding irrelevant studies, 12 studies met the search criteria. The majority of these studies were conducted in the US. The total number of patients in these studies was 27,700. Alirocumab and Evolocumab were the most frequently used PCSK-9 inhibitors. This review identified only a few clinical trials on PCSK-9 inhibitors in heart disease patients. Therefore, it is recommended to conduct more randomized controlled clinical trials on PCSK-9 inhibitors in this patient population., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Competing Interests: No potential conflicts of interest relevant to this article were reported.

Pantothenate synthetase protein plays a pivotal role in the biosynthesis of coenzyme A (CoA), which is a crucial molecule involved in a number of cellular processes including the metabolism of fatty acid, energy production, and the synthesis of various biomolecules, which is necessary for the survival of Mycobacterium tuberculosis ( Mtb ). Therefore, inhibiting this protein could disrupt CoA synthesis, leading to the impairment of vital metabolic processes within the bacterium, ultimately inhibiting its growth and survival. This study employed molecular docking, structure-based virtual screening, and molecular dynamics (MD) simulation to identify promising phytochemical compounds targeting pantothenate synthetase for tuberculosis (TB) treatment. Among 239 compounds, the top three (rutin, sesamin, and catechin gallate) were selected, with binding energy values ranging from -11 to -10.3 kcal/mol, and the selected complexes showed RMSD (<3 Å) for 100 ns MD simulation time. Furthermore, molecular mechanics generalized Born surface area (MM/GBSA) binding free energy calculations affirmed the stability of these three selected phytochemicals with binding energy ranges from -82.24 ± 9.35 to -66.83 ± 4.5 kcal/mol. Hence, these identified natural plant-derived compounds as potential inhibitors of pantothenate synthetase could be used to inhibit TB infection in humans., Competing Interests: Author VD was employed by company Quanta Calculus. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chouhan, Tiwari, Mishra, Gupta, Kumar, Almuqri, Ibrahim, Basher, Chaudhary, Dwivedi, Verma and Kumar.)

Despite efforts in improving medication safety, medication administration errors are still common, resulting in significant clinical and economic impact. Studies conducted using a valid and reliable tool to assess clinical impact are lacking, and to the best of our knowledge, studies evaluating the economic impact of medication administration errors among neonates are not yet available. Therefore, this study aimed to determine the potential clinical and economic impact of medication administration errors in neonatal intensive care units and identify the factors associated with these errors. A national level, multi centre, prospective direct observational study was conducted in the neonatal intensive care units of five Malaysian public hospitals. The nurses preparing and administering the medications were directly observed. After the data were collected, two clinical pharmacists conducted independent assessments to identify errors. An expert panel of healthcare professionals assessed each medication administration error for its potential clinical and economic outcome. A validated visual analogue scale was used to ascertain the potential clinical outcome. The mean severity index for each error was subsequently calculated. The potential economic impact of each error was determined by averaging each expert's input. Multinomial logistic regression and multiple linear regression were used to identify factors associated with the severity and cost of the errors, respectively. A total of 1,018 out of 1,288 (79.0%) errors were found to be potentially moderate in severity, while only 30 (2.3%) were found to be potentially severe. The potential economic impact was estimated at USD 27,452.10. Factors significantly associated with severe medication administration errors were the medications administered intravenously, the presence of high-alert medications, unavailability of a protocol, and younger neonates. Moreover, factors significantly associated with moderately severe errors were intravenous medication administration, younger neonates, and an increased number of medications administered. In the multiple linear regression analysis, the independent variables found to be significantly associated with cost were the intravenous route of administration and the use of high-alert medications. In conclusion, medication administration errors were judged to be mainly moderate in severity costing USD 14.04 (2.22-22.53) per error. This study revealed important insights and highlights the need to implement effective error reducing strategies to improve patient safety among neonates in the neonatal intensive care unit., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Henry Basil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Physical restraints (PRs) are frequently used in adult critical care units to protect staff and prevent self-harm, despite the fact that they represent significant safety risks. Restraint complications may have an impact on the patient's long- and short-term outcomes. This integrative review aimed to meticulously evaluate existing evidence pertaining to physical restraint practices in adult critical care settings. The review was specifically geared towards examining the prevalence of PR, identifying influential factors, elucidating the role of nurses in PR implementation, exploring nurses' experiences in caring for patients under restraint, and scrutinizing the complications associated with PR application., Method: This integrative review included the studies published between January 2009 and December 2019 and the literature search was conducted in July 2020. The databases searched included EBSCOhost, Ovid, ProQuest, PubMed, Wiley Online Library, SCOPUS, and ScienceDirect. The keywords included in the search were restraint, critical care, intensive care, ICU, mechanical ventilation, intubation, nursing, and experience. A checklist based on the CASP checklist and the JBI Critical Appraisal Tool was used to assess the methodological quality., Results: The findings were evaluated and summarized into seven key topics after twenty-one publications were found to be evaluated. i) High prevalence of PR application in adult critical care unit; ii) determinants of PR applications; iii) types of PR in adult critical care units; iv) decision maker of PR; v) moral and ethical dilemma in PR application; vi) awareness and guidelines for PR applications; vii) common complications and use of sedation, analgesics, antipsychotic drugs in PR application., Conclusion: The number of days PR is used is related to the risk of an adverse event. In order to standardize nursing practice, ICU nurses require greater training on the ideas of PR use. Evidence-based recommendations will assist critical care nurses in making the best judgments possible concerning the use of PR., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Kavumpurath J et al.)

The cytotoxic, antioxidant, anticancer, and antibacterial properties of ethanolic extracts from Phragmanthera austroarabica is of interest. Plants of P. austroarabica were gathered from the southern Saudi Arabian region of Albaha. P. austroarabica extract was assessed using DPPH (2, 2-diphenyl-1-picrylhydrazyl). The German Collection of Microorganisms and Cell Cultures (DSMZ) cancer cell lines used in this investigation. The cytotoxic activity of P. austroarabica extract was explored against MCF-7 breast and A549 lung cancer cell lines, along with doxorubicin as a positive control. In both treated cells, P. austroarabica showed a remarkable activity via suppressing the cell's survival. In terms of IC50 (concentration equivalent to a survival rate of 50%), MCF-7 breast cancer cells were more sensitive to P. austroarabica extract.) DPPH colorimetric assay was employed to assess the antioxidant properties of P. austroarabica extract, the antioxidant activity was increased along with increment of extract concentrations. The leaves aqueous extract of P. austroarabica inhibited the growth of S. aureus by 6.3±0.12 mm and 24±0.43 mm and 15±0.56 mm respectively for seed, leaf and stem at concentrations 50 µl. However, the same concentrations inhibited the growth of E. coli by 25±0.75, 0.00 mm and 24±0.18 mm, following the same order. Different superscript letters indicate means that are significantly different at level (p<0.05). Minimal inhibitory concentrations (MIC) of P. austroarabica ethanolic extracts against the tested microorganisms were 1.5, 1.6 and 1.5, respectively for seed, leaf and stem against Staph. Aureus and were 1.2, 0.00 and 1.2, respectively for seed, leaf and stem against E. coli ., Competing Interests: The authors declare that they have no conflicts of interest., (© 2024 Biomedical Informatics.)

Introduction: Improving breastfeeding practices does not always link to interventions relying only on improving nutrition awareness and education but needs cultural and behavioral insights ., Aim: This study aimed to evaluate the changes in core breastfeeding indicators as a result of the use of social marketing (SM) approach for improving breastfeeding practices of Egyptian women and the physical growth of infants aged 6 to 12 months. The core breastfeeding indicators were: Early initiation of breastfeeding within one hour of birth, Predominant and exclusive breastfeeding to 6 months (EBF), Bottle feeding with formula, continued breastfeeding to 1 and 2 years, and responsiveness to cues of hunger and satiety., Methods: A quasi-experimental longitudinal study with a posttest-only control design was done over 3 years in three phases; the first was in-depth interviews and formative research followed by health education and counseling interventions and ended by measuring the outcome. Motivating mothers' voluntary behaviors toward breastfeeding promotion "feeding your baby like a baby" was done using SM principles: product, price, place, and promotion. The interventions targeted 646 pregnant women in their last trimester and delivered mothers and 1454 women in their childbearing period. The statistical analysis was done by using SPSS program, version 26., Results: Most mothers showed significantly increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn) (p < 0.05). Breastfeeding initiation, exclusive breastfeeding under 6 months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till 2 years, were significantly increased (from 30%, 23%, 56%, and 32% to 62%, 47.3%, 69%, and 43.5% respectively). The girls who recorded underweight results over boys during the first year of life were significantly improved (p < 0.01) after the intervention (from 52.1% to 18.8% respectively). At the same time, girls found to be obese before the intervention (15.6%) became no longer obese., Conclusions: Improvement for the majority of the key breastfeeding indicators and physical growth of infants indicates that raising a healthy generation should start by promoting breastfeeding practices that are respectable to societal norms., (© 2024. The Author(s).)

Combinations of apoptotic inducers are common clinical practice in breast cancer. However, their efficacy is limited by the heterogeneous pharmacokinetic profiles. An advantageous alternative is merging their molecular entities in hybrid multitargeted scaffolds exhibiting synergistic activities and uniform distribution. Herein, we report apoptotic inducers simultaneously targeting DNA and CDK-2 (cyclin-dependent kinase-2) inspired by studies revealing that CDK-2 inhibition sensitizes breast cancer to DNA-damaging agents. Accordingly, rationally substituted pyrimidines and triazolopyrimidines were synthesized and assayed by MTT against MCF-7, MDA-MB231, and Wi-38 cells compared to doxorubicin. The N -(4-amino-2-((2-hydrazinyl-2-oxoethyl)thio)-6-oxo-1,6-dihydropyrimidin-5-yl)acetamide 5 and its p-nitrophenylhydrazone 8 were the study hits against MCF-7 (IC 50 = 0.050 and 0.146 μM) and MDA-MB231 (IC 50 = 0.826 and 0.583 μM), induced DNA damage at 10.64 and 30.03 nM, and inhibited CDK-2 (IC 50 = 0.172 and 0.189 μM). 5 induced MCF-7 apoptosis by 46.75% and disrupted cell cycle during S phase. Docking and MD simulations postulated their stable key interactions., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Studies have identified Coenzyme Q10 (CoQ10) as a promising agent in improving idiopathic male infertility; however, its role in chemically or environmentally induced testicular dysfunction is not well-established. We investigated the potential of CoQ10 to attenuate methotrexate (MTX)-induced testicular damage and to identify molecular targets of CoQ10 effects. Wistar rats received a single intraperitoneal dose of 20 mg/kg MTX on the fifth day of the 10-day experimental protocol. 100 mg/kg CoQ10 was given orally daily for ten days, alone or combined with MTX. The testes of MTX-treated animals showed thickened tunica albuginea, distortion of seminiferous tubules with a marked reduction of germinal lining, a few primary spermatocytes with no spermatozoa, apoptotic cells, congested sub-capsular and interstitial blood vessels, and interstitial edema. Reduction of reproductive hormones and increased oxidative, inflammatory, and apoptotic biomarkers levels were also seen in the MTX-treated rats. CoQ10 + MTX-treated rats were protected against MTX-induced testicular histological changes and showed improvement in testosterone, luteinizing-, and follicle-stimulating hormone serum levels compared to the MTX group. The testes of the CoQ10 + MTX-treated rats showed reduced malondialdehyde, myloperoxidase, tumor necrosis factor -α, interleukin-6 and -1β and Bax: Bcl2 ratio and enhanced glutathione, and catalase compared to MTX alone. CoQ10 enhanced MTX-induced downregulation of Nrf2 and PPAR-γ signaling and modulated its downstream targets, the inducible nitric oxide synthase, NF-κB, Bax, and Bcl2. In conclusion, CoQ10 targeted the Nrf2-PPAR-γ signaling loop and its downstream pathways, mitigating MTX-induced oxidative stress-related damages and alleviating the testicular dysfunction MTX caused. Our data suggest Nrf2-PPAR-γ signaling as a potential therapeutic target in testicular toxicity, where oxidative stress, inflammation, and apoptosis trigger damage., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

A deferral takes place when donors fail to meet the eligibility criteria for donating blood during their visit to a blood collection site. Deferral periods, which can be either permanent or temporary, are implemented to protect the well-being of both the donor and the recipient. This study aimed to investigate the frequency of deferrals and the various factors contributing to them. A retrospective analysis was conducted at the Transfusion Medicine Unit of Hospital Universiti Sains Malaysia (USM), utilizing data obtained from blood donors during the period from January 2022 to June 2023. The research included a cohort of 18,751 donors who visited our transfusion unit for blood donation. Data, including gender, age, and reasons for deferral, were collected by reviewing the records of donors who were deferred. Descriptive statistics were employed to analyze the data of deferral blood donors. Out of 18,751 blood donors, 3,533 (18.84%) were deferred, consisting of 1,267 males (35.86%) and 2,266 females (64.14%). The age group of 18-25 years accounted for the highest number, comprising 1,875 donors (53.07%). Among the deferred cases, 53.33% were first-time donors, followed by 25.28% regular donors and 21.40% lapsed donors. The deferral of blood donors resulted from various reasons. The most common cause of overall deferral among blood donors was low hemoglobin (38.33%), followed by upper respiratory tract infections (8.38%), chronic medical illness (7.08%), and high blood pressure (7.02%). Temporary deferrals were more prevalent than permanent deferrals, accounting for 91.57% of cases compared to 8.43% for permanent deferrals. Voluntary non-remunerative blood donors constitute the backbone for a safe and reliable blood supply in transfusion services. Utilizing a comprehensive database will enable effective counseling of temporarily deferred donors, providing insights into the reasons for their deferral, the expected duration, and the appropriate treatments. This information is crucial for motivating these donors to recruit again in the donor pool. Public education initiatives aimed at raising awareness about the causes of deferral and promoting regular health check-ups can play a pivotal role in minimizing these deferrals., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Zahidin et al.)

Study Objectives: Sleep-disordered breathing (SDB) is common in the Veteran population. In this retrospective study, we investigated the prevalence of comorbid central and obstructive SDB and the response rate to PAP among Veterans., Methods: Veterans were screened from a single VA medical center who had polysomnography (PSG) study from 2017 to 2021 to ascertain the presence, severity, and type of SDB by measuring the apnea-hypopnea index (AHI) and central apnea index (CAI). Patients were excluded if they did not have complete studies (diagnostic and PAP titration studies). The inclusion criteria for these analyses were central sleep apnea (CSA) defined as AHI ≥ 10 events/hour and CAI ≥ 5 events/hour. Diagnostic "CSA only" was defined as AHI ≥ 10 events/hour and CAI ≥ 50% of AHI. "OSA only" was defined if AHI ≥ 10 events/hour and CAI < 5 events/hour. Comorbid central and obstructive sleep apnea (COSA) was defined if AHI ≥ 10 events/hour and CAI > 5 events/hour but < 50% of AHI. The responsiveness to PAP therapy was determined based on the CAI < 5 events/hour on the titration study., Results: A total of 90 patients met the inclusion criteria and from those 64 Veterans were found to have COSA (71%), 18 (20%) were CSA only, and 8 (9%) were OSA only. A total of 22 (24.4%) Veterans diagnosed with CSA or COSA were responsive to PAP therapy. Sixty days after treatment initiation, both responsive and nonresponsive groups had significant decreases in AHI and CAI ( p  < 0.05)., Conclusions: Comorbid central and obstructive SDB is common among Veterans. The response to PAP therapy is suboptimal but improves over time., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)

Background: Independent and safe medication self-management is essential for successful aging. Nevertheless, how older adults with cognitive frailty (CF) self-manage medications at their own homes remain elusive., Objective: This study aimed at assessing the medication self-management capability of home-dwelling older adults with CF and exploring the ways, perceived challenges and barriers in medication self-management., Methods: A convergent mixed-method study design was used. The medication management capability of 16 CF individuals aged ≥ 60 years on ≥ 1 long-term prescription drugs were assessed using the Drug Regimen Unassisted Grading Scale (DRUGS). Virtual in-depth interviews were also performed between July-August 2022 using a semi-structured interview guide. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analysed using a thematic analysis approach guided by Bailey and colleagues' model of medication self-management., Results: The mean DRUGS summary score was 96.86 [standard deviation (SD) 3.74] with highest performance scores observed in medication access (100 %) and lowest performance score in medication identification (91.46 %). Informants were able to independently take their medications and they tended to organise their medication intakes according to mealtime even though some admitted missing medication doses due to forgetfulness. Informants had difficulties with recalling drug names, with little awareness of self-monitoring their own health conditions and the effects of medications. Misconceptions towards medications, difficulties in accessing medications, reduced mobility and worsening health conditions could potentially deter informants from safe and independent medication self-management. In contrast, trust in doctors and a desire to achieve treatment goal could motivate medication self-management., Conclusion: The findings revealed knowledge gaps among older adults with CF in identifying their medications and self-monitoring which warrant reinforcement by healthcare professionals to ensure chronic safe medication use. Future studies should evaluate strategies to enhance medication safety in terms of self-monitoring in individuals with CF., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background and Objectives: The rational for the Somaliland national harmonised curriculum (NHC) was driven by shared concern about the quality of medical education., Process: The Ministry of Education and Science and the Ministry of Health Development produced a Medical Education Policy 2018. Policy objectives included the development of the NHC and accreditation for medical schools that met the standards of the World Federation for Medical Education (WFME). Two bodies were asked to oversee these aims: the National Health Professions' Commission (NHPC) and the National Commission of Higher Education (NCHE). Between 2018 and 2020, a collaborative approach between the Somaliland government, medical school stakeholders, King's Global Health Partnership's (KGHP) volunteers and the Tropical Health Education Trust (THET) team was used to design the 6-years NHC. The NHC structure, content and delivery were grounded by WFME standards, health needs of the local population, student focused and active learning methods, and feasibility of implementation in medical schools., Outcomes: The NHC comprises details about the educational outcomes, curriculum model and framework, educational principles, instructional and learning methods, core as well as optional content, and assessment strategy., Conclusions: The approach used to develop the NHC ensured it is bespoken for Somaliland. Ongoing evaluation of patient and population needs, each medical school's review of programme implementation and outcomes will inform continuous revision and renewal.

Background: Forward head posture (FHP) decreases the neck position sense and creates tension in the neck muscles, which inversely affects the mechanics of the distal joints through body myofascia. Thus, this study investigated the effects of FHP on neck and ankle joint position sense, and conducted a comparison between the joint position sense of the right and left ankle., Methods: Fifty-seven subjects were assigned according to the craniovertebral angle (CVA) into the FHP group (CVA <49°; n = 27) or the control group (CVA >49°; n = 30). Head and ankle joint repositioning accuracy was measured by using a cervical range-of-motion device and an isokinetic dynamometer, respectively., Results: There was a significant increase in the joint position error (JPE) of the cervical flexion, extension, and right and left side bending motions of the FHP group compared to the control group (P < .05). There were significant increases in the JPE of the right and left ankle dorsiflexion and plantarflexion of the FHP group compared to the healthy group (P < .05). Moreover, the JPE of the right ankle dorsiflexion and plantarflexion of the FHP group were significantly higher than the left ankle (P < .05)., Conclusions: The FHP decreases the position sense of cervical flexion, extension, and right and left side bending motions, and the plantarflexion and dorsiflexion of both ankle joints, especially the right ankle joint.

Breast cancer continues to be the most frequent cancer worldwide. In practice, successful clinical outcomes were achieved via targeting DNA. Along with the advances in introducing new DNA-targeting agents, the "sugar approach" design was employed herein to develop new intercalators bearing pharmacophoric motifs tethered to carbohydrate appendages. Accordingly, new benzimidazole acyclic C-nucleosides were rationally designed, synthesized and assayed via MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay to evaluate their cytotoxicity against MCF-7 and MDA-MB-231 breast cancer cells compared to normal fibroblasts (Wi-38), compared to doxorubicin. (1S,2R,3S,4R)-2-(1,2,3,4,5-Pentahydroxy)pentyl-1H-5,6-dichlorobenzimidazole 7 and (1S,2R,3S,4R)-2-(1,2,3,4,5-pentahydroxy)pentyl-1H-naphthimidazole 13 were the most potent and selective derivatives against MCF-7 (half-maximal inhibitory concentration [IC 50 ] = 0.060 and 0.080 µM, selectivity index [SI] = 9.68 and 8.27, respectively) and MDA-MB-231 cells (IC 50  = 0.299 and 0.166 µM, SI = 1.94 and 3.98, respectively). Thus, they were identified as the study hits for mechanistic studies. Both derivatives induced DNA damage at 0.24 and 0.29 μM, respectively. The DNA damage kinetics were studied compared to doxorubicin, where they both induced faster damage than doxorubicin. This indicated that 7 and 13 showed a more potent DNA-damaging effect than doxorubicin. Docking simulations within the DNA double strands highlighted the role of both the heterocyclic core and the sugar side chain in exhibiting key H-bond interactions with DNA bases., (© 2023 Deutsche Pharmazeutische Gesellschaft.)