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In this paper, an Improved Healthcare monitoring of Coronary Heart Diseaseframework is developed for patients in time-series fashion using DL (deep learning) model. The model uses DL called Convolutional Neural Network (CNN)via radial basis function integrated with artificial neural network to classify the time-series data from the electrodes. When choosing the algorithm that will be used to determine the forecast, the level of accuracy that is provided by an algorithm is one of the factors that is taken into consideration. The classification is carried out in a time-series fashion and the results of which are monitored in timely fashion. A ML (machine learning) model is designed using Python simulation, and time series data is validated using the suggested model. Data of a reputed medical university was used for testing encompassing 335 records with 36 clinical features. The accuracies, precisions, recalls, and f-measures of the suggested model's performances were assessed. This approach is used to determine whether the strategy that has been presented is the one that will prove to be the successful in the long run.

Abstract Background Pediatric physiotherapists help children to achieve their optimal physical development. The present study was aimed to evaluate the out-patient pediatric conditions managed by physiotherapists in Federal Medical Centre, Abeokuta, Nigeria (FMCA). Methods The present study included all children attended to at Pediatric Unit (outpatient) of FMCA in the period between the beginnings of May 20121 to the end of May 2022. The clinic runs every Tuesdays and Thursdays. All children below and equals to 15 years of age were included. Complete clinical, socio-demographic characteristics of patients and parents were manually scrapped from the electronic medical records (EMR) of the hospital. Descriptive statistics was used to present the results. Results During this period a total of 160 patients presented with different disorders were seen. There were 100 males (62.5%) and 60 females (37.5%). Cerebral palsy which can be classified as a neurological disorder was the most common condition managed (63.7%). Obstetric brachial palsy injury (OBPI), injection palsy, post-immobilization stiffness, congenital talipes equinivarus, and among others were managed during this period. Cerebral palsy was common among males, obstetric brachial palsy injury, and injection palsy. Cerebral palsy patients had late presentation for physiotherapy (1–5 years). Only 2 patients out of 11 with OBPI came for early physiotherapy. There is higher risk for cerebral palsy and OBPI among primiparous mothers. Conclusions It was concluded that neurological disorders are the most common pediatric cases managed by physiotherapists in Federal Medical Centre, Abeokuta, with cerebral palsy having higher prevalence.

Abnormal metabolism is a hallmark of cancer cells. Accumulating evidence suggests that metabolic changes are likely to occur before other cellular responses in cancer cells upon drug treatment. Therefore, the metabolic activity or flux in cancer cells could be a potent biomarker for cancer detection and treatment monitoring. Magnetic resonance (MR)-based sensing technologies have been developed with hyperpolarized molecules for real-time flux analysis, but they still suffer from low sensitivity and throughput. To address this limitation, we have developed an innovative miniaturized MR coil, termed micro-slab MR coil, for simultaneous analysis of metabolic flux in multiple samples. Combining this approach with hyperpolarized probes, we were able to quantify the pyruvate-to-lactate flux in two different leukemic cell lines in a non-destructive manner, simultaneously. Further, we were able to rapidly assess flux changes with drug treatment in a single hyperpolarization experiment. This new multi-sample system has the potential to transform our ability to assess metabolic dynamics at scale.

Climate adaptation plans are an effective way to manage a marine ecosystem and support climate change research. However, in developing nations that have to deal with the impacts of climate change, there is little follow-up and no measures on whether these climate adaptation plans are implemented effectively and yield the desired results. This report contains a detailed analysis of a climate adaptation plan implemented in Tabasco, Mexico, that sought to decrease vulnerability to the impacts of climate change. This report consists of a background on the climate adaptation plan in Tabasco and a comprehensive, step-by-step comparison of this plan to the the UNFCCC framework for adaptation. Lastly, this report is complete with two case studies in Tabasco and policy recommendations for improved climate adaptation plans and government involvement in climate policy. The purpose of this report is to determine that despite the completion status of the climate adaptation plan, the goals outlined in this plan were not achieved satisfactorily and did not reduce vulnerability to the impacts of climate change. Mexico has faced challenges in effectively implementing conservation tools, ranging from weak enforcement to poor coordination between national, state, and local authorities. Ultimately, this report outlines the importance of a comprehensive and stakeholder-inclusive approach to climate change policy and planning, especially in the global south.

Introduction: Ultrasonography (USG) of thyroid nodules is a safe, non-invasive and effective method for evaluation of nodular thyroid masses. They give a clear cut characteristic of the thyroid nodule besides their site, shape, size and number. However, its efficacy and role in differentiating nodules as benign and malignant is not well documented. Aim: To investigate the diagnostic accuracy of USG and colour doppler in differentiating a malignant thyroid nodule from a benign lesion. Materials and Methods: The present cross-sectional study was carried out among 52 patients clinically diagnosed with thyroid, from January 2018 to June 2019. After obtaining ethical approval and informed consent, USG and colour doppler were performed on these participants. The findings were evaluated based on hypoechogenicity, microcalcification, vascularity. The diagnostic accuracy of USG and colour doppler was evaluated in terms of sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) in comparison with the postsurgical histopathology findings. Results: Forty two nodules were benign while 10 were malignant. It was observed that the sensitivity was 100% for detection of halo and presence of vascularity. The specificity was 97.6% for calcification and 76.2% for vascularity. Assessment of lymph node had higher sensitivity (70%) and specificity (100%) with high positive (100%) and negative (93.3%) predictive values. Conclusion: Ultrasound and colour doppler imaging features such as inhomogeniety, presence of vascularity, halo and lymph node with malignant features had excellent histopathological correlation with malignancy.

Background: This study was designed to determine the hepatoprotective effect of partially purified fractions from Pterocarpus mildbraedii extract on carbon tetrachloride (CCl4) intoxicated rats. Methods: The methanol extract of P. mildbraedii was subjected to solvent partitioning using n-hexane, chloroform, ethylacetate and water. Separation of fractions with proven antioxidant activity was achieved by chromatographic techniques. Acute toxicity and hepatoprotective studies of the methanol sub-fraction 6 (Me 6), methanol sub-fraction 7 (Me 7) and methanol sub-fraction 8 (Me 8) from P. mildbraedii extract on carbon tetrachloride (CCl4) intoxicated Wister rats. Results: Intoxication of rats with CCl4 resulted in significant (p 0.05) in the activities of the liver enzymes, MDA level, total and direct bilirubin in dose-dependent manner. There were significant (p

PurposeTriple-negative breast cancer (TNBC) often metastasizes to the central nervous system (CNS) and has the highest propensity among breast cancer subtypes to develop leptomeningeal disease (LMD). LMD is a spread of cancer into leptomeningeal space that speeds up the disease progression and severely aggravates the prognosis. LMD has limited treatment options. We sought to test whether the common anti-helminthic drug mebendazole (MBZ) may be effective against murine TNBC LMD.MethodsA small-molecule screen involving TNBC cell lines identified benzimidazoles as potential therapeutic agents for further study. In vitro migration assays were used to evaluate cell migration capacity and the effect of MBZ. For in vivo testing, CNS metastasis was introduced into BALB/c athymic nude mice through internal carotid artery injections of brain-tropic MDA-MB-231-BR or MCF7-BR cells. Tumor growth and spread was monitored by bioluminescence imaging and immunohistochemistry. MBZ was given orally at 50 and 100 mg/kg doses. MBZ bioavailability was assayed by mass spectrometry.ResultsBioinformatic analysis and migration assays revealed higher migratory capacity of TNBC compared to other breast cancer subtypes. MBZ effectively slowed down migration of TNBC cell line MDA-MB-231 and its brain tropic derivative MDA-MB-231-BR. In animal studies, MBZ reduced leptomeningeal spread, and extended survival in brain metastasis model produced by MDA-MB-231-BR cells. MBZ did not have an effect in the non-migratory MCF7-BR model.ConclusionsWe demonstrated that MBZ is a safe and effective oral agent in an animal model of TNBC CNS metastasis. Our findings are concordant with previous efforts involving MBZ and CNS pathology and support the drug's potential utility to slow down leptomeningeal spread.

In romantic literature of Iraqi style, particularly in Sa’di’s lyric poems, the cruelty and oppression of the sweetheart and the degradation and contempt of the lover in front of her are proposed abundantly. Despite the holiness which the love has in Persian literature,it is sometimes thought of as an obstacle on the way of lover. The research question is: are concepts and aims beyond the worldly love? To answer this question, one-fourth of Sa’di’s lyric poems were examined based on the analysis of political-social dispute. The result of the research represented that with such content-makings, the poet is the representative of the nation. He protests loudly against the cruelty and oppression of the beloved person who can bethe symbol of despotic and autocratic kings. The metaphor of "love is obstacle" indicates the conflict of lover-beloved one’s dispute. The metaphor of "love is trap" shows that the sweetheart attempts to dominate the lover thoroughly. This image conforms to lord and former, or shepherd and herd idea between governors and inferiors. The simile of the beloved person in the position of king and the approach to oppose against her has a more conscious schema in Sa’di’s lyric poems compared to those of other poets. Sa’dibelieves in accepting the obstacle. By this technique, he projects the peace-seeking of the public against the quarreling of the dominant class. Criticism against the power within the framework of love provides this possibility untilSa’di proposes his critical view directly.

Abstract Introduction Gastric cancer is the fifth most common cancer worldwide and the fourth most common cause of cancer-related death. Two molecular subtyping classifications were recently introduced: The Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG) classifications. Methods We classified a cohort of 283 gastric cancer patients undergoing surgery at Helsinki University Hospital between 2000 and 2009. We constructed a tumour tissue microarray immunostained for the following markers: microsatellite instability (MSI) markers MSH2, MSH6, MLH1, and PMS2; p53; E-cadherin; and EBERISH. Results In the univariate survival analysis for disease-specific survival, the Epstein–Barr virus (EBV) -positive subtype exhibited the worst prognosis with a hazard ratio (HR) of 2.49 (95% confidence interval [CI] 1.19–5.25, p = 0.016) compared with the most benign subtype, chromosomal instability (CIN). Using TCGA’s classification, the genetically stable (GS) and MSI subtypes exhibited a worse survival compared with CIN (HR 1.73 [95% CI 1.15–2.60], p = 0.009 and HR 1.74 [95% CI 1.06–2.84], p = 0.027, respectively). Using the ACRG classification, the p53 aberrant subtype exhibited the best prognosis, whereas wild-type p53, MSI, and the epithelial–mesenchymal transition (EMT) subtypes exhibited poorer prognoses (EMT: HR 1.90 [95% CI 1.30–2.77], p

This study investigates the relationships between students' self-concept, self-efficacy, and achievement in mathematics, considering contextual factors such as socioeconomic status, gender, and immigration background, by using Swedish data from PISA 2003 and 2012. Additionally, these relationships between the two types of schools in Sweden are compared. In Sweden, the school system generally includes municipally-run schools (public) and independent schools (also funded by the state but run privately). Findings indicate a positive correlation between robust mathematics self-concept and self-efficacy and enhanced mathematics performance. Notably, students with better socioeconomic status exhibit heightened levels of mathematical self-concept and self-efficacy, corresponding to superior mathematics outcomes. Gender nuances reveal that, despite superior mathematical performance, girls report less positive self-concept and self-efficacy in mathematics than boys. Surprisingly, mathematics self-concept tends to have a closer association with achievement in independent schools than in public schools, while mathematics self-efficacy influences achievement more in public schools than in independent schools. Besides, independent school students' mathematics achievement is more associated with socioeconomic status and gender compared to their public-school peers. Immigration background seems to play a more important role in predicting mathematics achievement in public schools than in independent schools.

The study aimed to investigate students' psychological, cognitive, and social well-being in 6th Grade and the relations to academic achievement in compulsory school, as measured by grades in 9th Grade. Due to reports from Swedish authorities and research, students' self-reported well-being has decreased during the last decade. Data from the Swedish longitudinal project Evaluation Through Follow-up was analyzed with confirmatory factor analysis and structural equation modelling. By using data from two birth cohorts (1998: N = 7 684 and 2004: N = 9 437), differences in well-being across the two cohorts could be investigated. Cognitive ability, parental education, and gender were also accounted for. Statistically significant cohort and gender differences were found, where cohort 2004 was disadvantaged in all three well-being dimensions, and girls were disadvantaged in psychological and social well-being. Psychological well-being was negatively related to academic achievement, indicating that students who experienced more school-related stress performed higher than students who experienced less stress. Cognitive well-being was positively related to academic achievement. Possible causes of the decrease in well-being may be changes in the educational and assessment system, which meant that cohort 2004 went through compulsory school with a stronger focus on results and grades than earlier cohorts.

Zinc oxide (ZnO) transparent thin films with different oxygen flow rates (0.5, 1.0, and 1.5)Litter/min. were prepared by thermal evaporation technique on glass substrate at a temperature of 200℃ with rate (10±2)nm sec-1, The crystallinity and structure of these films were analyzed by X-ray diffraction (XRD). It exhibits a polycrystalline hexagonal wurtzite structure and the preferred orientation along (002) plane. The Optical properties of ZnO were determined through the optical transmission method using ulta violet–Visible spectrophotometer with in wave length (300-1100)nm. The optical transmittance of the ZnO films increases from 75% to 85% with increase flow rate of O2, and the optical band gap of ZnO films was found to be increased from (3.0) eV to (3.2) eV with increase flow rate of oxygen.The refractive index of ZnO flims increased from (1.1) to (1.27) with increase flow rate of O2 .

Flavin adenine dinucleotide (FAD) interacts with flavoproteins to mediate oxidation-reduction reactions required for cellular energy demands. Not surprisingly, mutations that alter FAD binding to flavoproteins cause rare inborn errors of metabolism (IEMs) that disrupt liver function and render fasting intolerance, hepatic steatosis, and lipodystrophy. In our study, depleting FAD pools in mice with a vitamin B2-deficient diet (B2D) caused phenotypes associated with organic acidemias and other IEMs, including reduced body weight, hypoglycemia, and fatty liver disease. Integrated discovery approaches revealed B2D tempered fasting activation of target genes for the nuclear receptor PPARα, including those required for gluconeogenesis. We also found PPARα knockdown in the liver recapitulated B2D effects on glucose excursion and fatty liver disease in mice. Finally, treatment with the PPARα agonist fenofibrate activated the integrated stress response and refilled amino acid substrates to rescue fasting glucose availability and overcome B2D phenotypes. These findings identify metabolic responses to FAD availability and nominate strategies for the management of organic acidemias and other rare IEMs.

Background Left atrial appendage occlusion (LAAO) is increasingly used as an alternative to oral anticoagulation for stroke prevention in select patients with atrial fibrillation. Data on outcomes in racial and ethnic minority individuals are limited. This analysis assessed differences in the use and outcomes of LAAO by race and ethnicity in a large national registry. Methods and Results This analysis acquired data on patients who underwent WATCHMAN FLX implantation from the retrospective NCDR (National Cardiovascular Data Registry) LAAO registry through September 2022. All patients with an attempted WATCHMAN FLX implantation and known race and ethnicity were included. Baseline characteristics and 1‐year event rates were compared. A total of 97 185 patients were analyzed; 87 339 were White individuals (90%), 3750 Black individuals (3.9%), and 2866 Hispanic individuals (Hispanic/Latinx), 2.9%). Black and Hispanic patients were younger, with a higher incidence of prior stroke and significant bleeding compared with White patients. Black and Hispanic patients were treated with LAAO in smaller numbers relative to their proportion of the US population. Rates of procedural success were similar between groups. Though direct oral anticoagulants were prescribed in most patients across the groups, dual and single antiplatelet therapy were prescribed more often in Black patients. Black patients had significantly higher rates of 1‐year death and bleeding compared with White and Hispanic patients. Conclusions Patients from racial and ethnic minority groups comprise a disproportionately small fraction of all patients who undergo LAAO. Black and Hispanic patients were younger but had significantly higher comorbidities compared with White patients. Procedural success was similar among the groups, but Black patients experienced higher rates of death and bleeding at 1 year.

The role of artificial intelligence (AI) in education has been extensively studied, focusing on its ability to enhance learning and teaching processes. However, the precise impact of AI adoption on academic performance in open and distance learning (ODL) remains largely unexplored. This systematic literature review critically evaluates AI's impact on academic performance within ODL environments. Drawing from a curated selection of 64 papers from an initial pool of 700, spanning from 2017 to 2023 and sourced from Scopus, Google Scholar, and Web of Science, this study delves into the multifaceted role of AI in enhancing learning outcomes. The meta-analysis reveals a diverse methodological landscape: machine learning methods, employed in 29.69 % of the studies, stand out for their ability to predict academic achievement, which is matched in prevalence by classical statistical methods. Although less common at 3.13 %, hybrid methods are a burgeoning area of research, while a significant 40.63 % of works prioritise nonempirical methods, focusing on theoretical analysis and literature reviews. This investigation highlights the critical factors driving AI adoption in education and its tangible benefits for student performance. It identifies a crucial literature gap: the absence of a process-based framework designed to forecast AI's educational impacts with greater precision, especially across gender and regional lines. By proposing this framework, this study contributes to the academic discourse on AI in education. It underscores the urgent need for structured methodologies to navigate the challenges and opportunities of AI integration. This framework, aligned with UNESCO's 2030 educational objectives, promises to bridge educational divides, ensuring equitable access to quality education across diverse demographics. The findings advocate for future research to design, refine, and test such a framework, paving the way for more inclusive and effective educational technologies in ODL settings.

The escalating levels of carbon dioxide (CO₂) emissions present a critical challenge to global sustainability, considering that CO2 is the primary cause of climate change. This dilemma presents a unique opportunity: converting waste CO₂ into useful resources. This review provides an in-depth analysis of CO₂ sources and waste streams, examining their potential as feedstocks for various industrial processes. By reviewing cutting-edge conversion technologies—such as catalysis, electrochemical, and photochemical methods—this work emphasizes how revolutionary ideas in Carbon Capture and Utilization (CCU) can play a pivotal role in reducing greenhouse gas emissions while generating both environmental and economic advantages. Through a systematic review of case studies and success stories in Carbon Capture and Utilization (CCU), the review illustrates the practical viability of these technologies. Additionally, the challenges facing CCU implementation, including economic, technical, and policy-related barriers, are explored. The review fills a critical gap by providing a comprehensive overview of both the current state and future potential of CO₂ utilization. Finally, it outlines future directions, emphasizing the need for interdisciplinary approaches, policy frameworks, and technological advancements to fully realize the potential of harnessing CO₂ for sustainable solutions.

Despite the importance of respectful pregnancy care, birthing people experience high rates of mistreatment in clinical settings in the United States. In light of persistent racialized maternal and infant health inequities, doula care is increasingly promoted as an intervention. Limited research has examined healthcare providers’ experiences with doulas. As part of an evaluation of community doula programs in San Francisco, California, we interviewed physicians (n ​= ​11), certified nurse-midwives (n ​= ​7), and nurses (n ​= ​10) who worked in hospitals and clinics where doula clients receive care. Using reflexive thematic analysis, we identified two themes around how providers perceive doulas to affect pregnancy-related care. First, providers described doulas fostering accountability at multiple levels. Providers described how their personal sense of accountability to patients increased in the presence of doulas; at times, this mitigated racism and implicit bias in clinical settings. Additionally, through the partnership between the community doula organization and local hospitals, doulas engaged in bidirectional feedback with providers, creating opportunities for institutional-level accountability. Second, providers perceived doulas to bridge gaps in care for pregnant and birthing people by providing services, such as continuous labor support, that are not realistic for clinicians to provide. This analysis contributes to the broader literature on doula care by describing mechanisms through which doulas improve pregnancy-related care. Doulas may be critical for birthing people who are most likely to experience mistreatment due to racism and other dimensions of oppression. Future research should explore facilitators and barriers to developing partnerships between clinical sites and doula organizations and the long-term effects of these partnerships on health equity.

ProblemIn the United States, Black women are disproportionately impacted by inequities in maternal health.BackgroundCommunity doula support may improve birth outcomes and experiences, including lower rates of preterm birth and low birthweight and increases in positive birthing experiences. Few studies have explored client experiences with doula care, specifically community doula care.AimTo explore Black doula clients' motivations for seeking and experiences with community doula care.MethodsData are from a mixed methods process evaluation of an organization providing free community doula services in San Francisco, California. We conducted two rounds of qualitative interviews with doula clients who identified as Black or Pacific Islander between August 2019 and March 2020. Interviews explored clients' knowledge of, experiences with, and motivations for seeking doula care and their perceptions of the services they received. We utilized a Rapid Assessment Process to synthesize findings and thematic analysis.FindingsClients' motivations for seeking doula care included general lack of support and knowledge of mistreatment experienced by Black women in hospital settings. Doulas provided support in the form of information about the perinatal period and clients' rights, advocacy in hospital settings, and connection to resources beyond pregnancy and birth. Some clients described doulas as helping them stay focused and make decisions during difficult labor experiences and described positive birth experiences despite experiencing complications.ConclusionCommunity doulas play an instrumental role in the birth experiences of Black women and birthing people. Efforts should be made to expand access to this needed support via policy and hospital practices.