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ObjectiveTo explore the effects of Ginkgo biloba extract (GBE) on cardiac microvascular endothelial cells (CMECs) under oxygen and glucose deprivation/reperfusion (OGD/R) condition and its molecular mechanisms. MethodsAn OGD/R-induced injury model was established in CMECs. According to different intervention, CMECs were divided into four groups: normoxia blank control group (WT group), WT + GBE group, OGD/R group, and OGD/R + GBE group. Cell apoptosis was detected by flow cytometry technology in each group. The oxidative stress was examined by MitoSox staining. The migration abilities were measured by scratch assay. The expressions of PERK/eIF2α/CHOP, nuclear factor kappa B (NF-κB), and endothelial cell function markers were detected by Western blotting. ResultsCompared with the WT group, the endothelial cell apoptosis level in the OGD/R group significantly increased, with markedly aggravated cellular dysfunction. The expressions of p-NF-κB, vascular cell adhesion molecule-1 (VCAM-1), and intercellular cell adhesion molecule-1 (ICAM-1) were significantly upregulated (P＜0.05), and the activation of the CHOP signaling pathway was notably enhanced (P＜0.05). After intervention with GBE, endothelial cell apoptosis caused by OGD/R injury was significantly reduced, oxidative stress and inflammation levels were markedly downregulated, and the expression of p-NF-κB was considerably decreased (P＜0.05), while the CHOP signaling pathway was notably inhibited (P＜0.05). Furthermore, it was found that GBE could promote expression of SIRT6 to regulate the above molecules, thereby alleviating cardiac microvascular endothelial cell injury under OGD/R condition. On the contrary, when SIRT6 was knocked down, the protective effects were significantly reduced. ConclusionsGBE improves endothelial cell dysfunction, endoplasmic reticulum stress, and endothelial cell apoptosis caused by OGD/R injury by promoting the expression of SIRT6 protein, thus regulating the NF-κB inflammatory pathway and CHOP signaling pathway.

Abstract Introduction HIV/AIDS is a global public health issue affecting 40.4 million lives. Barbershops and beauty salons pose health risks due to the use of sharp tools, which can transmit blood-borne diseases like HIV. Somalia Over 45% of HIV-positive. Training and capacity building can enhance service quality and prevent disease transmission. This study assessed the knowledge, attitudes, and prevention practices of HIV/AIDS transmission and prevention among barbing and beauty salon operators in Somalia. Methods A cross-sectional study was conducted among 400 barbers and beauty salon operators in Districts Mogadishu selected using multistage sampling techniques from September 2023 to June 2024. A structured questionnaire was used to assess their knowledge, attitude and practice about HIV/AIDs transmission and prevention. The factors associated with the knowledge, attitude and practice of the barbers and beauty salon operators about HIV/AIDs were explored using multiple logistic regression. Data was analyzed using Stata Version 15. Results The mean age of the participants was 27±6.6 years. Regarding sex, the vast majority of the participants (65.3%) were males Only 23.0% (92/400) had good knowledge, and 19.0% (76/400) had a good attitude, in addition, 6.5% (26/400) had good practice towards HIV transmission and prevention. Participants with secondary education showed higher odds of having a good attitude than those with primary and non-formal education though the difference was not significant (AOR = 2.3 (0.87-5.95), p = 0.094 Conclusion Barbers’ awareness and education about HIV/AIDS and age-related factors contributing to infection spread are poor, and local health authorities could significantly reduce the spread of these pathogens through occupational hazards training.

Abstract Background The ongoing conflict in Sudan leads to widespread displacement and increased mortality, significantly impacting the mental health of populations in conflict zones. This study aims to fill the gap and assess the level of stress, depression, and anxiety among Khartoum University undergraduate students in war-afflicted regions. Methods A cross-sectional study among 443 undergraduate students Was conducted using cluster and stratified sampling techniques. Data was collected using a valid questionnaire in a period of one month and analyzed using SPSS and a regression model to assess factors affecting distress. Results The study shows high levels of psychological distress, particularly among female students. Median anxiety and stress levels were 12.50 and 14.00, respectively, for women, significantly higher than those for men (p

Abstract African communities that have been forced to leave their homes experience a considerably greater susceptibility to malaria as a result of densely populated living conditions, restricted availability of healthcare, and environmental influences. Internally displaced individuals frequently live in large settlements with restricted availability to drinking water, essential sanitation, and medical services, intensifying the spread of malaria. As a result, the occurrence of malaria is significantly more common among refugees and internally displaced individuals compared to those who are not displaced. This leads to greater rates of illness and death, especially among young people. Insufficient monitoring worsens the condition, leading to delayed identification and medical intervention, and contributing to a higher incidence of severe malaria and deaths. Furthermore, these communities are faced with economic consequences that contribute to the continuation of poverty and the worsening of socio-economic inequalities. Furthermore, the psychological impact of malaria, which is marked by feelings of anxiety and uncertainty, is particularly severe in vulnerable populations such as displaced children and pregnant women, aggravating the overall burden. Hence, addressing malaria in displaced populations in Africa requires comprehensive and well-coordinated strategies. Advanced diagnostic and surveillance technologies are essential for promptly identifying and treating malaria, providing chances to monitor and control its spread effectively. Collaboration among healthcare, policy, and humanitarian sectors is crucial for implementing comprehensive solutions that incorporate enhanced diagnostics, surveillance, and socio-psychological support. Active involvement of the community, usage of Community Health Workers, and regular collection of surveillance data are crucial in increasing awareness, directing control efforts, and tackling the specific difficulties encountered by displaced groups. Moreover, the implementation of environmental management, the incorporation of health services, and the utilization of adaptable healthcare interventions are essential for reducing the effects of malaria. To mitigate the impact of malaria and improve health outcomes among displaced populations in Africa, it is crucial to focus on these specific areas.

Abstract Background Globally, immunization prevents an estimated 2–3 million deaths from illnesses that can be prevented by vaccination. The predictors of Pentavalent and Measles immunization dropout were not investigated sufficiently. Therefore, this analysis was meant to determine the coverage, burden, and predictors of Pentavalent and Measles immunizations in Ethiopia. Materials and methods This study was a further analysis of the Mini Ethiopian Demographic Health Survey (EDHS) 2019, conducted with a nationally representative sample. In this study, immunization data was collected from a total sample of 3208 children of which 2004 (34.8%) children who received pentavalent 1 were considered for this study. Univariable, bi-variable, and multilevel mixed effect analysis was done using STATA version 17 Software. The mixed-effect model with the lowest AIC and BIC (information criteria) was chosen. A factor was designated as a significant predictor of immunization dropout if its p-value was less than 0.05 at 95% CI. The best-fitting model among the fitted models was ultimately chosen using the Akaike and Bayesian Information Criteria (AIC and BIC). Result The mean age of the head of the household was 37.6. The majority (68.9%) of the residents were from rural areas and of the total population, 64.9% have no formal education. Being residents of Afar increased the odds of dropping out by 3.28 (AOR = 3.28; 95% CI: 1.12, 9.56), whereas being residents of Addis Ababa reduced their odds of dropping out from prentavalent 3 by 68.1% (AOR = 0.319; 95% CI: 0.122, 0.833) compared to their Tigray counterparts. The dropout rate of Pentavalent 1 to measles 1 vaccination was 4.33 times higher among residents of Afar (AOR = 4.33; 95% CI: 1.38, 13.56). As the level of wealth increases, the quintile increases from poorer to richer compared to those in the poorest wealth quantile category, and marital status also affects the immunization dropout rate of their children. Conclusions Immunization coverage of Ethiopian children was low and the dropout from pentavalent 1 and measles vaccination was high compared to the national and international targets to improve immunization coverage and reduce dropout. So different cost-effective interventions like Education provision for the community, decision-making facilitation, behavioral change support, and multi-system participation were required to increase vaccination coverage and reduce the vaccine dropout among children in Ethiopia.

Plant diversity in southern Yemen is crucial for maintaining rangeland ecosystem functions. This diversity contributes to the resilience of local pastoral communities, by providing essential forage and resources. However, high stocking density has led to the overuse of palatable species, resulting in increased competition for forage. This study evaluates the nutritional value of 25 indigenous forage species from the natural rangelands of Lahij Governorate. Significant variations were observed among the Forage species, with moisture content ranging from 4 to 39.6%, crude protein from 5.5 to 21.4%, non-fiber carbohydrates from 31.8 to 66.4%, crude fiber from 8.3 to 42.65%, and ash content from 9.2 to 34.6%. Clitoria ternatea, Lycium barbarum, Senegalia mellifera, Vigna sinensis, Albizia lebbeck, and Acacia trees with crude protein content higher than 16% showed substantial potential as livestock feed due to their favorable proximate compositions. Incorporating these high-potential species into regular livestock diets could significantly enhance the sustainability and productivity of pastoral systems in southern Yemen, addressing the current fodder shortage.

Aim: This research assessed the mutagenicity and DNA damage of a novel type of nano-hydroxyapatite-silica glass ionomer cement (nano-HA-SiO2-GIC) and a conventional GIC (cGIC) using Ames and Comet assays. Methods: Cell viability was tested on human periodontal ligament fibroblasts (HPLFs) using 3.125 mg/ml, 6.25, 12.5, 25, 50, 100 and 200 mg/ml, on both types of GICs employing MTT assay. For the Comet assay, HPLFs were treated with IC50, IC25 and IC10 of test materials and the tail moments were measured. In the Ames test, four genotypic variants of strains of Salmonella typhimurium (TA100, TA98, TA1537 and TA1535) and a strain of Escherichia coli (WP2 uvrA) were employed. The material tested was extracted using sterile distilled water (0.2 g per ml) at 37 °C for 72 h. This was considered as 100 %, which was diluted to 50, 25, 12.5 and 6.25 % utilizing sterile distilled water. These five concentrations were incubated with the bacterial strains with and without metabolic activation (S9), along with appropriate positive controls. The number of revertant colonies was used to evaluate the outcome. Results: The highest cell viability (159.4 %) for nano-HA-SiO2-GIC was noticed at 3.125 mg/ml, while the lowest (24.26 %) was observed at 200 mg per ml. IC50, IC25 and IC10 values were 95.27, 51.4 and 20.1 mg/ml for cGIC, 106.9, 55.8 and 22.9 mg/ml for nano-HA-SiO2-GIC, respectively. The IC10 of both test materials showed no significant DNA damage compared to that of the negative control based on the Comet assay. The plate treated with nano-HA-SiO2-GIC showed less than double the average number of revertant colonies compared to that of negative control with regard to the Ames test. Conclusions: It can be concluded that nano-HA-SiO2-GIC is non-mutagenic based on the Ames test and did not cause DNA damage at the lowest concentration of IC10 based on the Comet assay.

Abstract Background Macrosomia is a forgotten health problem that directly or indirectly affects maternal and neonatal health outcomes. There is a lack of evidence on the factors that affect macrosomia in eastern Ethiopia. This study aimed to assess the determinants of macrosomia among newborns delivered in Jigjiga City, Eastern Ethiopia. Methods An institutional-based case-control study was conducted among 82 cases and 164 controls in Jigjiga City from June 25 to August 24, 2023. Bivariable and multivariable logistic regression were used to identify the determinants of macrosomia. An adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association, and the statistical significance was declared at a p-value

Introduction Mesenchymal stem cells (MSCs) have promising regenerative properties in tissue repair and anti-inflammatory responses. This study aimed to investigate the effects of MSCs and their combination with micronized purified flavonoid fraction (MPFF) in a croton oil-induced hemorrhoids model on tissue edema, inflammation, and underlying molecular mechanisms. Material and methods MSCs were isolated and characterized for their adherence, differentiation capacity, and immunophenotyping. Croton oil-induced hemorrhoid mouse models were established to assess tissue edema, inflammation, tumor necrosis factor (TNF-α) expression, transforming growth factor-β (TGF-β) expression, collagen ratio, and MMP-9 activity. The effects of MSCs and their combination with MPFF (diosmin-hesperidin) were evaluated through histological examinations, western blot analysis, and gelatin zymography. Results Characterization confirmed the MSCs’ plastic adherence, osteogenic differentiation potential, and immunophenotype (positive for CD90 and CD29, negative for CD45 and CD31). Treatment with MSCs alone or in combination with MPFF significantly reduced tissue edema, inflammation, TNF-α expression, and MMP-9 activity. Additionally, MSCs increased TGF-β expression, and collagen type I/III ratio, and accelerated wound healing by resolving inflammation. Conclusions These findings suggest that MSCs play a crucial role in modulating TNF-α, TGF-β, collagen remodeling, and MMP-9 activity, highlighting their promising role in hemorrhoid treatment and wound healing processes. Further research is warranted to fully elucidate the intricate mechanisms and optimize MSC-based therapies for clinical applications in hemorrhoidal disease management.

Abstract Background Most children with developmental disabilities (DD) live in low- and middle-income countries, but access to services is limited, impacting their ability to thrive. Pilot study findings of the World Health Organization’s Caregiver Skills Training (WHO CST) intervention, which equips caregivers with strategies to facilitate learning and adaptive behaviours in children with DD, are promising but evidence from an appropriately powered trial delivered by non-specialist facilitators is lacking. This study will investigate the effectiveness and the resource impacts and costs and consequences of the WHO CST intervention in four sites in rural and urban Kenya and Ethiopia. Methods This is a 2-arm multi-site hybrid type-1 effectiveness implementation cluster randomised controlled superiority trial. After baseline assessments (T0) are completed by participants in clusters comprising 7 to 10 caregiver-child dyads, the clusters will be randomised to either the WHO CST intervention arm or a waitlist enhanced care as usual control arm. Further assessments will be completed at endpoint (T1, 18 ± 2 weeks after randomisation) and follow-up (T2, 44 ± 2 weeks after randomisation). The intervention comprises three individualised home visits and nine group sessions with trained non-specialist facilitators. Participants in the control arm will receive the intervention after completing follow-up assessments. We aim to recruit 544 child-caregiver dyads, evenly distributed across the two arms and countries. The co-primary outcomes are the child-focused Child Behavior Checklist (assessing emotional and behavioural problems) and the caregiver-focused Pediatric Quality of Life Inventory (assessing caregiver quality of life), both assessed at endpoint. Secondary outcome measures comprise the two co-primary outcomes at follow-up and ten additional outcome measures at endpoint, assessing stigma-based experiences, depressive symptoms, household food insecurity, child disciplinary strategies and beliefs, CST knowledge and skill competencies, caregiver and child quality of life, social support, and children’s communication modes and functions. After quantitative follow-up assessments are completed, a mixed-methods evaluation approach will be used to investigate implementation processes and acceptability, feasibility, and potential sustainability of the intervention. Discussion The study’s findings will provide evidence of the effectiveness and resource impacts and costs and consequences of a non-specialist-delivered intervention in under-resourced contexts in one low-income and one middle-income country in East Africa. Findings will inform future research, intervention, and policy efforts to support children with DD and their families in under-resourced majority world contexts. Trial registration Pan African Clinical Trial Registry PACTR202310908063134. Registered on October 16, 2023.

Graph coloring game is one of application in graph theory. The goal in this article is determine game chromatic number of tadpole graph, broom graph, and tribune graph. The graphs are simple, connected, and undirected and thus eligible for playing graph coloring game. Given two players with the first player is called A and second player is called B coloring vertex of graph G with a set of colors C={c_1,c_2,c_3, ..., c_k}. A must to make sure that all vertex of G has colored and B must try to prevent A coloring of all vertex. The first step was taken by A as first player, two players take turns coloring vertex of graph G, with rule that every vertex have different color from the neighbourhood. If all vertex of graph G have been colored, then A win or B win if some vertex hasn’t colored. The smallest number of k if A has a strategy to win at graph G with k color, then k called game chromatic number which is denoted by χ_g (G). The strategy to win this game is coloring the biggest degree of vertex in graph first. The result obtained from this paper is A win the game with the strategy of first coloring the largest degrees of vertex. So, exact of game chromatic number of tadpole graph is 3, broom graph is 2 or 3 with several conditions, and tribune graph is 3 or 4 with several conditions.

Autism and other developmental disabilities are common in low- and middle-income countries. The World Health Organization developed the caregiver skills training programme to address the needs of families having children with developmental disabilities globally. This study explored the acceptability and feasibility of the caregiver skills training programme facilitated by non-specialists in rural Ethiopia, where contextual factors such as poverty, stigma and low literacy may affect training delivery. In-depth interviews were conducted with caregivers (n = 19) and four focus groups with non-specialist facilitators (n = 8) in two rural pilot tests of the caregiver skills training programme. Results suggested that participants experienced the caregiver skills training programme as acceptable and relevant for their context but suggested some modifications to improve the programme. Caregivers' accounts showed that facilitation by non-specialists was acceptable; facilitators emphasised the importance of supervision throughout the programme. Participants indicated that the home visit and group training modalities were acceptable and feasible. Facilitators indicated that some caregiver skills training programme topics were difficult to explain to caregivers; the concept of formalised play between caregiver and child was particularly foreign to caregivers. Lack of available toys made it difficult to practise some of the caregiver skills programme training exercises. These findings may have relevance to non-specialist delivery of the caregiver skills programme training and other parent-mediated interventions in low-resource contexts.

ABSTRACT This paper investigates the fixed‐time (FXT) synchronization issue of fuzzy memristive neural networks (MNNs) via using incomplete Beta functions from the view of improving the estimate accuracy of settling time (ST). First, the parameter mismatching issue brought by the switching characteristics of the memristor is handled through the convex analysis method. Then, a new FXT stability theorem that provides a more accurate ST estimation is derived by using incomplete Beta functions. Furthermore, based on this result, some new sufficient conditions are obtained to ensure the FXT synchronization of considered fuzzy MNNs via designing a class of control schemes by introducing a new saturation function as well as using some inequality techniques. Significantly, the introduced FXT controller can achieve synchronization aim at bounded ST and it is not affected by the system's initial values. Finally, a numerical example is provided to verify the affectivity of introduced results.

This study investigates the impact of uncertainties on the non-performing loans/ finance (NPL/NPF) of conventional and Islamic banks in the MENA region using data from 2005 to 2022. Based on inclusion and exclusion criteria and the purposive sampling technique, 92 banks were selected from 13 MENA countries, 42 of which are Islamic and 50 of which are conventional banks. The study used two estimation methods: Augmented Mean Group (AMG) and two-step Generalized Method of Moments (GMM) to estimate the relationship between uncertainty and NPL/NPF. These estimation methods were chosen for their ability to provide unbiased results in the presence of cross-sectional dependence and deal with endogeneity. The study revealed that world pandemic uncertainty had a negative and significant influence on the NPL of conventional banks while showing a positive and significant influence on the NPF of Islamic banks. US trade policy uncertainty was found to have a negative and significant influence on the NPL of conventional banks. In contrast, it exhibited a positive and significant influence on the NPF of Islamic banks. We discovered a positive and significant influence of US sovereign debt risk uncertainty on the NPL/NPF of conventional and Islamic banks in the MENA region. The findings revealed a negative and significant influence of oil price uncertainty on the NPL/NPF of conventional and Islamic banks in the MENA regions. These findings reassure us that bank in the MENA region should adopt and tailor risk strategies based on sector-specific responses, engage in proactive risk monitoring, and maintain loan quality amid economic uncertainties.

The study focuses on synthesizing, characterizing, and evaluating escin-loaded glutaraldehyde-albumin nanoparticles (NPs) against lung cancer A549 cells. The NPs were characterized using various methods, including UV–visible spectroscopy, photoluminescence, XRD, DLS, and TEM and SEM analyses. The cytotoxic effects of the NPs were evaluated using the WST-1 assay against A549 cells, and the expression of apoptotic proteins and oxidative stress markers was measured. The NPs were validated through FT-IR and DLS studies, and the WST-1 assay results showed that the synthesized albumin-escin NPs effectively inhibited A549 cells, induced apoptosis, and increased ATPase activity, and LDH enzyme release. The expression of apoptotic proteins and oxidative markers increased, while antiapoptotic protein and antioxidant levels were reduced in the albumin-Escin NPs-treated A549 cells. The study suggests that albumin-escin NPs have the potential as a promising anticancer agent against lung cancer by decreasing cell viability and promoting apoptosis.

BackgroundWe aimed to determine the household distribution and viability of Chlamydia trachomatis (Ct) from the eyes, face, and hands during the initial two visits of a year-long fortnightly cohort study in geographically defined adjacent households.Methods/findingsWe enrolled 298 individuals from 68 neighbouring households in Shashemene Woreda, Oromia, Ethiopia. All individuals above 2 years of age residing in these households were examined for signs of trachoma. Swab samples were taken from the conjunctiva, faces, and hands and analysed for the presence and viability of Ct. Ct viability was determined using reverse transcription (RT) PCR. At the initial visit, out of 298 individuals, 133 (44.5%) were children aged 2-9 years. Among these children, 27/133 (20.3%) had trachomatous inflammation-follicular (TF), while 8/133 (6.0%) had trachomatous inflammation-intense (TI). Ct (omcB or pORF2) was detected in 16/133 (12.0%) eye swabs, 14/105 (13.5%) face swabs, and 11/105 (10.5%) hand swabs from children aged 2-9 years. Among these children at visit one, 12/14 (85.7%) with Ct on faces and 9/11 (81.8%) with Ct on hands also had detectable ocular Ct. The severity of the disease worsened from the first visit to the second, and no participants showed clearance of the disease within the two-week period. Ct infection was associated with TF (P = 0.002) and TI (P = 0.060). At visit one, among children aged 2-9 years, viable Ct was detected in 12/16 (75.0%) ocular, 6/14 (42.9%) face, and 4/11 (36.4%) hand swab samples. All viable Ct detected on the faces and hands were identified from individuals with viable ocular infections. Among caregivers whose child tested positive for Ct on their hands, 3 caregivers also had Ct on their hands, accounting for 20% (3 out of 15). Additionally, among caregivers whose child tested positive for Ct on their faces, 2 caregivers had Ct on their faces, which accounts for 14.3% (2 out of 14). In two participants, we detected Ct on the hands of ocular-negative children at the initial visit and later detected ocular Ct at the second visit.Conclusion/significanceUsing RT-qPCR assay to detect Ct omp2 mRNA to define viability offers a new, informative perspective of trachoma transmission in this community in Ethiopia. The presence of viable Ct on the faces and hands of individuals living in households with people with current ocular Ct infection supports the hypothesis that hands and faces are important routes for transmission of trachoma. This highlights the importance of targeted interventions to address these sites of Ct carriage to help interrupt transmission.

BackgroundEvery day throughout the world more than 4,000 infants and young children die because colostrum feeding was not initiated within an hour of birth as recommended by the World Health Organization (WHO)/United Nations Children’s Fund. Even though breastfeeding is common in Ethiopia, the widespread belief that colostrum feeding causes morbidity and mortality among neonates still exists.ObjectiveTo assess the colostrum feeding practice and It’s associated factors among mothers who come for Post-natal care at Asella Referral and Teaching Hospital, Asella Town, Southeast Ethiopia from November 20, 2023, to January 25, 2024.MethodThis study employed an institutional-based cross-sectional study among 301 surveyed postnatal care mothers from November 20, 2023, to January 25, 2024. Systematic random sampling was employed to select study participants. A pretest was performed to check the reliability and clarity of the study questionnaires. The tool to examine the practice of colostrum feeding and related aspects was modified from earlier studies. The collected data were input into Epi Info version 7.2.5.0 and exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regression analyses were used to identify variables associated with the practice of colostrum feeding. The variables with significant association were identified based on p-value < 0.05.ResultsIn this study, 301 study participants took part, with a 99% response rate. The mean age of mothers was found to be 27.13 ± 5.46. This study’s overall prevalence of practice was 57.8% (95% CI, 52.2–63.35). Being Urban residence (AOR = 4.05, 95%CI: 2.18–7.52), health education counseling (AOR = 4.31, 95%CI: 1.27–10.73), and favorable attitude toward colostrum milk (AOR = 6.64, 95% CI: 3.61–12.2) were factors significantly associated with colostrum feeding practice.Conclusion and recommendationsIn comparison to WHO recommendations, the study area had a low rate of colostrum feeding practice. Additionally, this study also identified factors associated with maternal colostrum feeding practice level such as urban residence, counseling on timely initiation of breastfeeding during antenatal care, and good maternal attitude toward colostrum feeding. Therefore, Health education dissemination should be given to postnatal mothers regarding the importance of colostrum feeding.

Softball is a sport that requires a good coordination between physical and technical aspects. Anaerobic fatigue can be a factor affecting the execution of softball batting techniques. However, an in-depth understanding of the impact of anaerobic fatigue on biomechanical variables in the batting technique context is still under-explored. This study aimed to identify and analyze the effect of anaerobic fatigue on changes in biomechanical variables in softball batting techniques. The purpose of this study was to evaluate how anaerobic fatigue affects key biomechanical variables in softball batting techniques. This information is expected to provide additional insight into the importance of anaerobic fitness in improving the performance of softball athletes. This study used experimental method with a pretest-posttest design. The subjects were experienced softball players selected using purposive sampling. Anaerobic fatigue was induced using a high-intensity training protocol. The biomechanical variables measured included bat swing speed, swing angle, and shot precision. Measurements were taken before and after the training. Data were analyzed using a paired t-test to examine significant changes. The study showed that anaerobic fatigue had a significant effect on key biomechanical variables in softball batting techniques. There was a significant decrease in bat swing speed and batting precision after anaerobic fatigue. The average bat swing speed before fatigue was 3.60 m/s, which decreased to 2.14 m/s after fatigue. In addition, the swing angle and batting precision also showed significant changes, with a lower left knee angle approaching the ground in the pre-fatigue group. This study found empirical evidence supporting the effect of anaerobic fatigue on biomechanical variables in softball batting technique. These results provide an important contribution to the general understanding of the relationship between anaerobic fatigue and technical performance in softball. Therefore, athlete trainings and preparations need to pay attention to anaerobic fitness aspects to maintain optimal performance during the game.

Clinical trials, the empirical discipline of medical experimentation conducted on human subjects, have engendered a paradigm shift in medical research. The need for new clinical studies is paramount in the Middle East and North Africa (MENA) region, with its rising cancer incidence and demand for efficient oncology treatments. This paper comprehensively reviews the challenges, opportunities, and future directions of phase I oncology clinical trials in the MENA region. Early-phase trials are vital in determining drug dosage and assessing toxicity, bridging the gap between preclinical research and clinical practice. Considering the unique landscape of MENA, this review explores regulatory aspects, specific hurdles faced, potential advantages, and areas for improvement in conducting these trials. Various future directions can be pursued to maximize the potential of phase I oncology trials in MENA. While regulatory bodies like the Ministry of Health adhere to the International Conference on Harmonization–Good Clinical Practice guidelines, a unified system meeting high standards would yield better results. Strengthening research infrastructure, establishing research centers, incorporating clinical trial education into the curriculum, and improving access to medical facilities are crucial. Enhancing consumer understanding of research would facilitate increased participation and promote sustainability in trial recruitment. Navigating various funding sources would open the door for more funding opportunities. Collaborations between academia, industry, and regulatory bodies, both international and local, should be fostered to promote knowledge sharing, resource pooling, and harmonization of standards. Such collaborations would contribute to the sustainability of clinical trial activities by leveraging collective expertise, sharing research infrastructure, and distributing the burden of regulatory compliance. By adopting these strategies, the MENA region can advance its capacity to conduct early phases of oncology trials and contribute significantly to the global medical research landscape.

Background: Age, smoking, sleep duration, sleep quality, and obesity are risk factors that can affect the amount of sperm concentration, morphology, and motility. The aim of this study is to assess the lifestyle effects: age, smoking, sleep duration, sleep quality, and obesity on the amount of concentration, morphology, and motility of sperm. Materials and Methods: The study utilized an analytical observational approach with a cross-sectional design. The study subjects comprised 70 male partners of infertile couples admitted to the Sekar Fertility Clinic at the Dr. Moewardi General Hospital between March and August 2022. The study assessed variables including age, body mass index (BMI), smoking status, sleep duration, sleep quality, sperm concentration, sperm morphology, and sperm motility. Furthermore, the data were analyzed using univariate, bivariate, and multivariate methods with SPSS 25 software.Results: The research findings demonstrate that obesity is significantly associated with abnormal sperm concentration (OR=40.07; CI=3.90-411.67; P=0.002). Furthermore, moderate or heavy smoking is significantly associated with abnormal sperm concentration (OR=17.45; CI=1.83-166.15; P=0.013) and sleep quality with severe disorders (OR=5.73; CI=1.12-29.21; P=0.036). Moreover, obesity is significantly associated with abnormal sperm motility (OR=12.97; CI=2.66-63.15; P=0.002), while moderate or heavy smoking (OR=5.89; CI=1.23-28.20; P=0.026) and poor sleep duration (OR=6.21; CI=1.43-26.92; P=0.015) also exhibit significant associations with abnormal sperm motility. However, no significant findings were observed regarding sperm morphology. Conclusions: The findings of this study indicate that obesity, moderate or heavy smoking, and sleep quality have statistically significant effects on sperm concentration, while obesity, moderate or heavy smoking, and sleep duration have statistically significant effects on sperm motility. However, no statistically significant influence was observed on sperm morphology. Further research with larger sample sizes and more diverse populations is needed to validate these findings and explore other potential factors that may impact male fertility.