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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.

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.

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.

Abstract Background Exposure to chemical toxins, including insecticides, harms bodily organs like the brain. This study examined the neuroprotective of thymoquinone on the cypermethrin’s harmful effects on the histoarchitecture of the dentate gyrus and motor deficit in the dentate gyrus. Methods Forty adult male rats (180–200 g) were randomly divided into 5 groups (n = 8 per group). Groups I, II, III, IV, and V received oral administration of 0.5 ml of phosphate-buffered saline, cypermethrin (20 mg/kg), thymoquinone (10 mg/kg), cypermethrin (20 mg/kg) + thymoquinone (5 mg/kg), and cypermethrin (20 mg/kg) + thymoquinone (10 mg/kg) for 14 days respectively. The novel object recognition test that assesses intermediate-term memory was done on days 14 and 21 of the experiment. At the end of these treatments, the animals were euthanized and taken for cytoarchitectural (hematoxylin and eosin; Cresyl violet) and immunohistochemical studies (Nuclear factor erythroid 2-related factor 2 (Nrf2), Parvalbumin, and B-cell lymphoma 2 (Bcl2). Result The study shows that thymoquinone at 5 and 10 mg/kg improved Novelty preference and discrimination index. Thymoquinone enhanced Nissl body integrity, increased GABBAergic interneuron expression, nuclear factor erythroid 2-derived factor 2, and enhanced Bcl-2 expression in the dentate gyrus. It also improved the concentration of nuclear factor erythroid 2-derived factor 2, increased the activities of superoxide dismutase and glutathione, and decreased the concentration of malondialdehyde level against cypermethrin-induced neurotoxicity. Conclusion thymoquinone could be a therapeutic agent against cypermethrin poisoning.

Background: Cutaneous melanoma (CM) is a significant contributor to skin cancer-related mortality globally and in Canada. Despite the well-established link between ultraviolet (UV) radiation exposure and skin cancer risk, there remains a gap in population-level interventions and persistent misconceptions about sun exposure and impact of environment on individual behavior. Objective: The current study provides an ecological analysis using latest available data (2011-2017) to define geographic/environmental contributors to the CM landscape in Canada. Methods: Utilizing Canadian Cancer Registry and Canadian Urban Environmental Health Research Consortium data, we analyzed 39,605 CM cases occurring in Canada from 2011 to 2017. Environmental data, including UV radiation, greenspace (normalized difference vegetation index), temperature, heat events, and precipitation was used to evaluate the effect of environment on CM incidence rates across Forward Sortation Area postal codes. Results: Forward Sortation Areas with increased CM incidence were associated with higher annual average temperature, snowfall, heat events, normalized difference vegetation index, and vitamin D-weighted UV exposure. Conversely, factors associated with decreased incidence included an increased annual highest temperature, rain precipitation, and a longer duration of heat events. Limitations: This study is subject to ecological bias and findings should be interpreted with caution. Conclusion: This study further substantiates associations between specific environmental factors and CM incidence.

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.

Organic dye pollutants present in wastewater pose a significant global challenge. Among pollutants, the synthetic dye Rhodamine B (RB) stands out due to its non-biodegradable nature and associated neurotoxic, carcinogenic, and respiratory irritant properties. Extensive research has been conducted on the efficacy of adsorption and photodegradation techniques for the removal of RB from wastewater. While adsorption and advanced oxidation processes (AOPs) have gained considerable attention for their effectiveness in recent years, the underlying behaviors and mechanisms of these technologies remain incompletely understood. Therefore, a comprehensive summary of recent research progress in this domain is imperative to clarify the basics and present the up-to-date achievements.This review provides an in-depth exploration of the fundamentals, advancements, and future trajectories of RB wastewater treatment technologies, mainly encompassing adsorption and photodegradation. This work starts with a general introduction of outlining the sources, toxicity, and diverse applicable removal strategies. Subsequently, it thoroughly examines crucial techniques within non-photochemical, photochemical, and adsorption technologies, such as UV light assisted AOP, catalyst assisted AOP, ozonation, Fenton system, electrochemical AOP, and adsorption technology. The primary objective is to furnish a broad overview of these techniques, elucidating their effectiveness, limitations, and applicability. Following this, the review encapsulates state-of-the-art computational simulations pertaining to RB adsorption and interactions with clays and other adsorbents. Lastly, it delves into column adsorption of RB dye, and elucidates various influencing factors, including bed height, feed concentration, pollutant (RB) feeding or flow rate, and column regeneration. This panoramic review aims to provide valuable insights into suitable techniques, research gaps, and the applicability of non-photochemical, photochemical, and adsorption technologies in the treatment of wastewater containing RB dye.

Abstract Iron storage proteins, e.g., vertebrate ferritin, and the ferritin-like bacterioferritin (Bfr) and bacterial ferritin (Ftn), are spherical, hollow proteins that catalyze the oxidation of Fe2+ at binuclear iron ferroxidase centers (FOC) and store the Fe3+ in their interior, thus protecting cells from unwanted Fe3+/Fe2+ redox cycling and storing iron at concentrations far above the solubility of Fe3+. Vertebrate ferritins are heteropolymers of H and L subunits with only the H subunits having FOC. Bfr and Ftn were thought to coexist in bacteria as homopolymers, but recent evidence indicates these molecules are heteropolymers assembled from Bfr and Ftn subunits. Despite the heteropolymeric nature of vertebrate and bacterial ferritins, structures have been determined only for recombinant proteins constituted by a single subunit type. Herein we report the structure of Acinetobacter baumannii bacterioferritin, the first structural example of a heteropolymeric ferritin or ferritin-like molecule, assembled from completely overlapping Ftn homodimers harboring FOC and Bfr homodimers devoid of FOC but binding heme. The Ftn homodimers function by catalyzing the oxidation of Fe2+ to Fe3+, while the Bfr homodimers bind a cognate ferredoxin (Bfd) which reduces the stored Fe3+ by transferring electrons via the heme, enabling Fe2+ mobilization to the cytosol for incorporation in metabolism.

Abstract Comprehensive biomedical proteomic datasets are accumulating exponentially, warranting robust analytics to deconvolute them for identifying novel biological insights. Here, we report a strategic machine learning (ML)-based feature extraction workflow that was applied to unveil high-performing protein markers for high-grade serous ovarian carcinoma (HGSOC) from publicly available ovarian cancer tissue and serum proteomics datasets. Diagnosis of HGSOC, an aggressive form of ovarian cancer, currently relies on diagnostic methods based on tissue biopsy and/or non-specific biomarkers such as the cancer antigen 125 (CA125) and human epididymis protein 4 (HE4). Our newly developed ML-based approach enabled the identification of new serum proteomic biomarkers for HGSOC. The performance verification of these marker combinations using two independent cohorts affirmed their outperformance against known biomarkers for ovarian cancer including clinically used serum markers with >97% AUC. Our analysis also added novel biological insights such as enriched cancer-related processes associated with HGSOC.

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.

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.

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.

AbstractIn the field of medicine, uncertainty is inherent. Physicians are asked to make decisions on a daily basis without complete certainty, whether it is in understanding the patient’s problem, performing the physical examination, interpreting the findings of diagnostic tests, or proposing a management plan. The reasons for this uncertainty are widespread, including the lack of knowledge about the patient, individual physician limitations, and the limited predictive power of objective diagnostic tools. This uncertainty poses significant problems in providing competent patient care. Research efforts and teaching are attempts to reduce uncertainty that have now become inherent to medicine. Despite this, uncertainty is rampant. Artificial intelligence (AI) tools, which are being rapidly developed and integrated into practice, may change the way we navigate uncertainty. In their strongest forms, AI tools may have the ability to improve data collection on diseases, patient beliefs, values, and preferences, thereby allowing more time for physician-patient communication. By using methods not previously considered, these tools hold the potential to reduce the uncertainty in medicine, such as those arising due to the lack of clinical information and provider skill and bias. Despite this possibility, there has been considerable resistance to the implementation of AI tools in medical practice. In this viewpoint article, we discuss the impact of AI on medical uncertainty and discuss practical approaches to teaching the use of AI tools in medical schools and residency training programs, including AI ethics, real-world skills, and technological aptitude.

# Background In basketball, changing direction is one of the primary mechanisms of anterior cruciate ligament (ACL) injury, often occurring within complex game situations with high cognitive demands. It is unknown how visual attention affects sidestep cutting kinematics during the entire energy absorption phase of the cut in an ecologically valid environment. # Purpose The purpose of this research was to study the effect of added cognitive load, in the form of increased visual attentional demands, on sidestep cutting kinematics during the energy absorption phase of the cut in an ecologically valid environment. # Study Design Crossover Study # Methods Fifteen male basketball players (aged 22.1 ± 2.3) performed ten sidestep cutting movements without (BASE) and with (VIS) a visual attention dual task. 3D kinematics of the hip, knee and ankle were recorded utilizing Xsens IMU motion capture. Temporal kinematics were analyzed using Statistical Parametric Mapping. Discrete time point kinematics were additionally analyzed at initial contact (IC) and at peak knee flexion utilizing paired t-tests. Effect sizes were calculated. # Results Hip flexion was significantly reduced in the VIS condition compared to the BASE condition (p

Background:. The paucity of pain management options in resource-limited settings is a significant and systemically unaddressed problem. To improve global health equity, it is important to bridge this gap in care without introducing the peril of opioid dependence. We present a proof-of-concept case series wherein virtual reality (VR) was successfully used to manage discomfort in patients undergoing burn dressing changes in sub-Saharan Africa. Methods:. Nine patients presenting with burn injuries of variable severity underwent routine stabilization and dressing as part of standard-of-care treatment. During dressing changes, a VR intervention consisting of the Dream Flight interactive game displayed on an Oculus Quest 2 headset was offered to patients. Patient mood scores were collected before VR initiation and at the conclusion of the dressing change by a translator using the Youth Feelings Scale. Results:. There were no adverse events associated with use of the VR headset and no patients elected to terminate the VR during their procedure. Patients and physicians subjectively reported satisfaction with the device’s utility in the procedure. Before VR initiation, the 95% confidence interval for patient mood score was 4.89 ± 1.725. After VR initiation, the 95% confidence interval for patient mood score was 8.78 ± 1.40. Conclusions:. Our results of this proof-of-concept case series to suggest both feasibility of use and positive influence on patient discomfort and periprocedural satisfaction. We propose that VR should be explored as an analgesic alternative and/or adjunct to narcotics in resource-limited countries, particularly for high-pain, low-duration procedures.

Congenital ichthyoses are relatively uncommon skin disorder s wi th worldwide occurrence. The ichthyoses are heterogenous disorders of keratinisation characterised by scaling of the skin of varying severity. This report describes a case of congenital ichthyosis in a preterm, male Hausa infant which happened to be the first case managed at the OOUTH, Sagamu. The infant was managed using stringent thermoregulat ion, optimal hydration, use of topical emollient and antibiotics. Although, the skin disorder resolved within fifteen days of treatment, the infant thereafter developed inguinoscrotal hernia and hydrocephalus necessitating surgical consult. The case is reported to highlight the good outcome of the cutaneous disorder following conservative management in a low-resource setting.

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.