Search

Abstract Background Adoption of tele-rehabilitation among physiotherapists in developed countries has risen exponentially to complement conventional physical contact physiotherapy. However, many low- and middle-income countries like Nigeria where barriers to utilization of tele-physiotherapy were earlier identified still demonstrates limited evidence on its acceptance and adoption till date. Method This was a mixed-method design of quantitative and qualitative study, aimed at investigating acceptance and adoption of tele-rehabilitation among physiotherapists in Nigeria. Respondents comprised 331 physiotherapists practising in Nigeria and registered with the Medical Rehabilitation Therapists (Registration) Board of Nigeria (MRTB). Quantitative approach involved completion of a 33-item structured questionnaire shared as Google Forms to respondents’ WhatsApp and emails. Qualitative aspect involved in-depth interview with 12 physiotherapists at the clinics, using a 10-item semi-structured interview guide, and recorded with a voice recorder. Quantitative data was analysed using descriptive and inferential statistics at p

ContextStroke systems of care (SSOC) promote access to stroke prevention, treatment, and rehabilitation and ensure patients receive evidence-based treatment. Stroke patients living in rural areas have disproportionately less access to emergency medical services (EMS). In the United States, rural counties have a 30% higher stroke mortality rate compared to urban counties. Many states have SSOC laws supported by evidence; however, there are knowledge gaps in how states implement these state laws to strengthen SSOC.ObjectiveThis study identifies strategies and potential challenges to implementing state policy interventions that require or encourage evidence-supported pre-hospital interventions for stroke pre-notification, triage and transport, and inter-facility transfer of patients to the most appropriate stroke facility.DesignResearchers interviewed representatives engaged in implementing SSOC across six states. Informants (n = 34) included state public health agency staff and other public health and clinical practitioners.OutcomesThis study examined implementation of pre-hospital SSOCs policies in terms of (1) development roles, processes, facilitators, and barriers; (2) implementation partners, challenges, and solutions; (3) EMS system structure, protocols, communication, and supervision; and (4) program improvement, outcomes, and sustainability.ResultsChallenges included unequal resource allocation and EMS and hospital services coverage, particularly in rural settings, lack of stroke registry usage, insufficient technologies, inconsistent use of standardized tools and protocols, collaboration gaps across SSOC, and lack of EMS stroke training. Strategies included addressing scarce resources, services, and facilities; disseminating, training on, and implementing standardized statewide SSOC protocols and tools; and utilizing SSOC quality and performance improvement systems and approaches.ConclusionsThis paper identifies several strategies that can be incorporated to enhance the implementation of evidence-based stroke policies to improve access to timely stroke care for all patient populations, particularly those experiencing disparities in rural communities.

Benzodiazepines are an important class of heterocyclic compounds in organic chemistry. They are known for their diverse physicochemical and biological properties. Some benzodiazepine derivates are well-known drugs with diverse and strong pharmacophoric moiety. An immense number of pharmacological research on benzodiazepine heterocycles and their derivatives have recently been conducted to explore its numerous pharmacological potentials as better therapeutic candidates for the treatment of various disorders, benzodiazepines, however, are one of the main sources of interest for many medicinal chemists. Researchers are drawn to the benzodiazepine nucleus for the synthesis of new drugs because of its potent pharmacophoric moiety and ring shape. Due to the emergence of new pathogenic strains’ resistance to the presently available drugs, there has been a constant demand for more effective and selective drugs. Benzodiazepine moiety has all the desired qualities for selective drug candidates used as useful therapeutic agents. Given the importance of benzodiazepine moiety, the current review aims to assess benzodiazepine syntheses as well as their pharmacological properties for potential molecular targets in therapeutic development.

Early warning and response surveillance (EWARS) systems were widely used during the early COVID-19 response. Evaluating the effectiveness of EWARS systems is critical to ensuring global health security. We describe the Centers for Disease Control and Prevention (CDC) global COVID-19 EWARS (CDC EWARS) system and the resources CDC used to gather, manage, and analyze publicly available data during the prepandemic period. We evaluated data quality and validity by measuring reporting completeness and compared these with data from Johns Hopkins University, the European Centre for Disease Prevention and Control, and indicator-based data from the World Health Organization. CDC EWARS was integral in guiding CDC’s early COVID-19 response but was labor-intensive and became less informative as case-level data decreased and the pandemic evolved. However, CDC EWARS data were similar to those reported by other organizations, confirming the validity of each system and suggesting collaboration could improve EWARS systems during future pandemics.

Acknowledging the critical role of English for Specific Purposes (ESP) in shaping professional and academic success across various fields, the research delves into the nuanced interplay between gender and academic discipline in shaping the ESP needs of higher education students. The investigation investigates the impact of gender and academic discipline on Chilean dentistry and business administration students' perceived lack, want, and need for English for Specific Purposes (ESP). Drawing on sociocultural theory and self-determination theory, a mixed-methods model that involved data collected from 94 dentistry and 121 business administration students was adopted. Findings revealed significant gender differences: males reported greater perceived lack, whereas females exhibited higher want and need for English, suggesting gender influences ESP perception and necessitates customized learning strategies. Contrarily, academic discipline did not significantly affect ESP perceptions, challenging assumptions that ESP needs are strictly discipline-dependent and highlighting a generalized demand for English proficiency across fields. The findings demonstrate the importance of gender-sensitive and flexible ESP programs that cater to diverse learner needs while considering broader educational and individual factors. The study implies that educational practitioners should develop ESP curricula that not only address specific professional terminologies and situations but also reflect an understanding of the roles gender and discipline play in language learning. This approach could foster more effective and inclusive language education tailored to the varied aspirations and requirements of students in different fields.

BACKGROUND: Little is known about penile high-risk human papillomavirus (hrHPV) among men who have sex with men (MSM) in low- and middle-income countries. We aimed to determine the incidence, clearance, and persistence of penile hrHPV among Rwandan MSM. METHODS: We enrolled 350 MSM (345 with valid human papillomavirus [HPV] results) aged ≥18 years. At each visit (6-12 months apart), we collected penile PreservCyt specimens and blood for HPV and HIV testing, as well as sociodemographic and behavioral variables. HPV testing was performed with the Ampfire assay. Penile hrHPV incidence and clearance per 1000 person-months of follow-up, as well as prevalent and incident persistence, were computed and compared by HIV status. RESULTS: The mean (SD) age was 27.7 (6.7) years and 19.4% were living with HIV. Penile hrHPV incidence was 34.8 (95% CI, 29.1-41.8) per 1000 person-months of follow-up. HPV-16 (11.7; 95% CI, 9.26-14.9) and HPV-59 (6.1; 95% CI, 4.52-8.39) had the highest incidence rates. Prevalent and incident persistence was 47.5% and 46.6%, respectively. HPV-66 (33.3%), HPV-52 (30.8%), and HPV-16 (29.2%) had the highest prevalent persistence and HPV-33 (53.8%), HPV-31 (46.7%), and HPV-16 (42.6%) the highest incident persistence. No differences were found by HIV status except for HPV-45 (higher in MSM with HIV). CONCLUSIONS: We found high incidence and prevalent/incident persistence of penile hrHPV among Rwandan MSM. This highlights the importance of preventive strategies for HPV-associated anogenital cancers.

BackgroundThe syndemic of HIV, substance use (SU), and mental illness has serious implications for HIV disease progression among women. We described co-utilization of HIV care, SU treatment, and mental health treatment among women with or at risk for HIV.MethodsWe included data from women with or at risk for HIV (n = 2559) enrolled in all 10 sites of the Women's Interagency HIV Study (WIHS) from 2013 to 2020. Current SU was defined as self-reported, non-medical use of drugs in the past year, excluding use of only marijuana. Tobacco and alcohol were assessed separately. We described co-utilization of SU treatment, tobacco and alcohol use treatment, HIV care, and mental health care in the past year among women who were eligible for each service. We compared service utilization by those who did/did not utilize SU treatment using Wald Chi-square tests.ResultsAmong women with current SU (n = 358), 42% reported utilizing SU treatment. Among those with current SU+HIV (n = 224), 84% saw their HIV provider, and 34% saw a mental health provider. Among women with current SU+heavy alcohol use (n = 95), 18% utilized alcohol use treatment; among current SU+tobacco use (n = 276), 8% utilized tobacco use treatment. Women who utilized SU treatment had higher utilization of alcohol use treatment (59% vs. 5%; P

Abstract Background Hearing impairment, a widespread sensory deficit, disproportionately affects low- and middle-income countries. Various hearing assessment methods exist, each with limitations. Pure tone audiometry (PTA), the gold standard, is subjective, unsuitable for children, expensive, and requires expertise. Smartphone hearing tests are emerging as cost-effective, user-friendly alternatives, but they cannot measure bone conduction and occasionally yield false thresholds. Aim This study aims to compare smartphone-based hearing tests with PTA in patients at the Aminu Kano Teaching Hospital’s ENT Clinic. Methods A cross-sectional descriptive study enrolled participants aged 18 and above, including those with normal hearing and varying degrees of hearing loss. Each participant underwent a smartphone hearing test, screening PTA, and diagnostic PTA. The results were analyzed using SPSS version 22. Results The study included 92 subjects (184 ears) aged 18–68 years. Smartphone tests accurately detected 94.3% of ears with normal hearing and 97.5% of ears with hearing loss based on screening PTA. At higher frequencies, the smartphone detected 98.4% of ears with hearing loss, showing a strong positive correlation with PTAv results. At speech frequencies, the smartphone detected 100% of ears with hearing loss, again showing a positive correlation. At lower frequencies, the smartphone detected 73% of ears with hearing loss, showing a positive correlation but with a significant statistical difference. Conclusion The smartphone hearing test exhibited a strong positive correlation with screening PTAv in hearing assessment, without a statistically significant difference. This suggests that smartphone hearing tests could serve as a viable alternative for hearing assessments, particularly in low-resource settings. This research has implications for improving access to hearing healthcare in resource-constrained regions.

Background: Mental health problems are common in the elderly; they often go unnoticed, ignored, untreated, or considered part of normal aging. About a quarter of the Nigerian population have mental health problems, out of which 3.26% are elderly. Aim: This study aimed to determine the prevalence, types, and factors associated with mental illnesses among the elderly. Materials and Methods: This was a community-based cross-sectional survey of the elderly. Four hundred and two elderly people were selected by a multistage sampling technique and were interviewed using semi-structured questionnaires. Data analysis was done using the IBM SPSS Statistics version 22.0. Descriptive statistics were summarized using proportion and presented in frequency tables. Bivariate analyses were done using the Chi-square test and logistic regression analyses. The level of significance was set at a 95% confidence interval with P < 0.05. Results: The prevalence of mental illness among the elderly respondents was 35.8%. Of all the mental illnesses, generalized anxiety disorder ranked the highest (15.4%), followed by current alcohol dependence (14.9%). The factors found to be associated with mental illness in the elderly included monogamous family type (odds ratio [OR] = 0.211, P = 0.034) and monthly income

This study investigates the impact of Gum Arabic on the geotechnical properties of subgrade soil materials, a non-traditional soil stabilization technique. Given the need for sustainable and locally available alternatives in road construction, the study aims to assess how different percentages of Gum Arabic affect the physical and mechanical behavior of soil. The research aims to provide sustainable and locally available alternatives in road construction. Three soil samples were treated with varying percentages of Gum Arabic, (1.5%, 3%, 6% and 12%), and standard geotechnical tests were conducted under both soaked and unsoaked conditions. The results showed that the average natural moisture content of the soils was 7.9%, 2.2%, and 4.6%. The addition of Gum Arabic increased the peak maximum dry density of the soil samples by 8.02%, 1.88, and 7.88%. The maximum unsoaked California Bearing Ratio (CBR) values of soil samples were 32.1%, 81.7%, and 48.7%, respectively. Whereas, maximum soaked CBR values of soils S1, S2 and S3 obtained at 1.5%, 6% and 1.5% additions of gum Arabic were 8.4%, 28.7% and 16.9% respectively. The study recommends using 3% Gum Arabic to improve the CBR property of soil samples. The application of Gum Arabic showed significant improvements in soil behavior under both soaked and unsoaked conditions.

BackgroundWe investigated whether there exists an association between dietary acid load and kidney function decline in women living with HIV (WLWH) receiving antiretroviral therapy (ART).SettingOne thousand six hundred eight WLWH receiving ART in the WIHS cohort with available diet data and a baseline estimated glomerular filtration rate (eGFR) ≥15 mL/minute/1.73 m2.MethodsA brief dietary instrument conducted from 2013 to 2016 under the Food Insecurity Sub-Study was used for assessing fruits and vegetables (FV) and protein intake. A mixed-effects model with random intercept and slope was used to estimate subjects' annual decline rate in eGFR and the association between FV intake and eGFR decline, adjusting for sociodemographics, serum albumin, comorbidities, time on ART, ART drugs, HIV markers, and baseline eGFR. We evaluated whether markers of inflammation mediated the effect of FV intake on decline in eGFR, using causal mediation analysis.ResultsWe found a dose-response relationship for the association of FV intake and eGFR decline, with lesser annual decline in eGFR in the middle and highest tertiles of FV intake. An increase of 5 servings of FV intake per day was associated with a lower annual eGFR decline (-1.18 [-1.43, -0.94]). On average, 39% of the association between higher FV intake and slower eGFR decline was explained by decreased levels of inflammation.ConclusionsPlant-rich diet was associated with slower decline in kidney function. Inflammation is a potential path through which diet may affect kidney function. The findings support an emerging body of literature on the potential benefits of plant-rich diets for prevention of chronic kidney disease.

Food insecurity disproportionately affects people with HIV and women in the United States (US). More evidence is needed to understand the interplay between levels of food insecurity and levels of antiretroviral therapy (ART) adherence over time, as well as how food insecurity relates to engagement in HIV care. We used random effects models with longitudinal data from the US Women's Interagency HIV Study to estimate the (1) adjusted associations of current and 6-month lagged food security with ART adherence categories (n = 1646), and (2) adjusted associations of food security with engagement-in-care (n = 1733). Very low food security was associated with a higher relative risk of ART non-adherence at prior and current visits compared with food security, and this association increased across non-adherence categories. Very low food security was associated with lower odds of receiving HIV care and higher odds of a missed visit. Food insecurity among US women with HIV is associated with poorer engagement in care and degree of ART non-adherence over time.

Recently, attention has been shifting toward the perspective of the existence of plants and microbes as a functioning ecological unit. However, studies highlighting the impacts of the microbial community on plant health are still limited. In this study, fungal community (mycobiome) of leaf, root, and soil of symptomatic leaf-spot diseased (SS) oil palm were compared against asymptomatic (AS) trees using ITS2 rRNA gene metabarcoding. A total of 3,435,417 high-quality sequences were obtained from 29 samples investigated. Out of the 14 phyla identified, Ascomycota and Basidiomycota were the most dominant accounting for 94.2 and 4.7% of the total counts in AS, and 75 and 21.2% in SS, respectively. Neopestalotiopsis is the most abundant genus for AS representing 8.0% of the identified amplicons compared to 2.0% in SS while Peniophora is the most abundant with 8.6% of the identified amplicons for SS compared to 0.1% in AS. The biomarker discovery algorithm LEfSe revealed different taxa signatures for the sample categories, particularly soil samples from asymptomatic trees, which were the most enriched. Network analysis revealed high modularity across all groups, except in root samples. Additionally, a large proportion of the identified keystone species consisted of rare taxa, suggesting potential role in ecosystem functions. Surprisingly both AS and SS leaf samples shared taxa previously associated with oil palm leaf spot disease. The significant abundance of Trichoderma asperellum in the asymptomatic root samples could be further explored as a potential biocontrol agent against oil palm disease.

BackgroundSubstance use (SU) contributes to poor health outcomes, yet limited data exist to inform strategies to optimize SU treatment among persons with human immunodeficiency virus (HIV). We describe SU and SU treatment utilization among women with and without HIV in the Women's Interagency HIV Study (WIHS).MethodsWe included data from women enrolled in WIHS from 2013 to 2020. Current SU was self-reported, nonmedical use of drugs in the past year, excluding use of only marijuana. SU treatment utilization was self-reported use of a drug treatment program in the past year. Multivariable regression models were used to investigate associations between participant characteristics and SU treatment.ResultsAmong 2559 women (1802 women living with HIV [WWH], 757 women without HIV), 14% reported current SU. Among those with current SU (n = 367), 71% reported crack/cocaine followed by 40% reporting opioids, and 42% reported any treatment in the past year. The most common treatments were methadone (64%), Narcotics Anonymous (29%), inpatient programs (28%), and outpatient programs (16%). Among women using opioids (n = 147), 67% reported methadone use in the past year compared to 5% using buprenorphine/naloxone. Multivariable analysis showed lower odds of treatment utilization among WWH with concurrent alcohol or marijuana use. Visiting a psychiatrist/counselor was associated with higher odds of treatment. Among WWH, SU treatment was not associated with HIV-related clinical outcomes.ConclusionsTreatment utilization was high, especially for methadone use. Our results highlight opportunities for accessing SU treatment for WWH, such as the need to prioritize buprenorphine and comprehensive, wraparound services in HIV care settings.

The study investigates the effects of Learning-By-Doing Instructional Strategy (LBDIS) and parents' education in determining secondary school students' attitude towards agricultural science. The research design adopted was a pre-test, post-test, non-randomized control group quasi-experimental design involving 2×2 factorial matrix. The sample comprised fifty-three students from two schools (intact classes) with twenty-three and thirty in experimental and control groups, respectively. The Agricultural Science Attitude Scale (ASAS) and Skills Performance Rating Scale were the instruments developed by the researchers. ASAS was administered as pre and post-tests but SPRS was used after each lesson. Three hypotheses were formulated and tested, and then the data collected were analyzed with the use of frequency counts, percentages, means, standard deviation, ANCOVA, F-ratio and Multiple Classification Analysis (MCA). Results reveal that there is a significant difference between experimental and control group students' post-test mean scores of attitude towards learning agricultural science. Additionally, no significant main effect of parents' education level on the students' attitude learning in agricultural science is found. As part of the recommendations, the provision of instructional strategies like LBDIS that can assist to build and boost learners' attitude towards the learning of agricultural science should be emphasized and put in use in classroom practices.

ObjectiveTo test whether substance use mediates the associations between gender-based violence (GBV) and suboptimal adherence to antiretroviral therapy (ART), and GBV and poor engagement in care, among women living with HIV (WLHIV) in the United States (US).DesignWe analyzed longitudinal data collected among 1717 WLHIV in the Women's Interagency HIV Study (WIHS).MethodsFrom 2013 to 2017, WLHIV completed semi-annual assessments on GBV, substance use, and HIV treatment and care. Adjusted multilevel logistic regression models were built to estimate the impact of GBV on; suboptimal (

Neuropsychiatric complications are common among women with HIV (WWH). The pathophysiological mechanisms underlying these complications are not fully known but likely driven in part by immune modulation. We examined associations between T-cell activation states which are required to mount an effective immune response (activation, co-stimulation/normal function, exhaustion, senescence) and neuropsychiatric complications in WWH. 369 WWH (78% HIV RNA undetectable/