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Trends in health care delivery systems have shifted as a result of the modern uses of biomaterials in medicine. Contrary to traditional medicine, modern healthcare are now useful in solving problems that were considered impossible some years back. One of the most significant factors to the most recent advancements in implant development has been the use of calcium based materials in the creation of necessary implants in the form of soft and hard tissues. With the advent of naturally sourced materials in the manufacturing of biomaterials, lots of attention are now focused on the different sources of agro-based resources that can be used for the product developments. These agro-based materials are now been considered for sustainable and ecological purposes in several areas of applications globally in the recent times. Hence, the review was carried out with focus on the sources, relevance, processing techniques and applications of tricalcium phosphate based biomaterials in modern day healthcare delivery. This review provides a historical and prospective picture of the crucial functions that materials based on tricalcium phosphate will play in fulfilling human requirements for medication.

This study assessed the impact of hybrid reinforcement from natural and synthetic materials on the wear and mechanical properties of epoxy-based composite materials needed for biomedical applications. Hydroxyapatite was synthesized from eggshells using the hydrothermal method, while wool fiber was obtained from cow hair. The hybrid reinforced composites were developed by blending hydroxyapatite particles and the fibers by hand layup method in an open mold production process, with specified amounts of 3–15 wt % reinforcement. The characterized properties included tensile and flexural strengths, impact energy, wear resistance, and hardness. A scanning electron microscopy study was conducted to analyze the adhesion between the matrix and reinforcements at the interface, providing valuable insights into the overall integrity of the composites. The results showed a significant increase in the properties of the hybrid reinforced composites when compared with the pristine sample. In particular, the 6 wt% reinforced composite enhanced 61.14 % in tensile strength and 160.79 % enhanced 61.14 % in tensile strength and 160.79 % in flexural strength. Thus, the study shows that substituting synthetic fibers with hybrid organic-based reinforcement offers a viable approach for developing sustainable materials with improved mechanical properties suitable for biomedical applications.

Key Clinical Message Despite the name, eosinophilia is not essential for diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS syndrome). Early recognition and stopping the offending drug are vital to managing this condition, as it can otherwise lead to high mortality rates.

Key clinical message Neuromyelitis optica spectrum disorder is an autoimmune disease, rarely presents with antiphospholipid syndrome. Diagnosis and management of NMOSD are challenging in the background of diverse presentations, especially in resource‐limited settings. Abstract Neuromyelitis optica spectrum disorder (NMOSD) is a progressive demyelinating autoimmune condition resulting from the autoantibodies produced against aquaporin‐4 (AQP‐4) proteins which are widely distributed in astrocytes in the nervous system. In the setting of NMOSD, it is very crucial to consider other autoimmune diseases as differential diagnoses or co‐occurrences due to the diversity of symptoms. NMOSD co‐exists with other autoimmune diseases such as myasthenia gravis, thyroid disease, ankylosing spondylitis, pernicious anemia, thrombotic thrombocytopenic purpura, ulcerative colitis, and systemic lupus erythematosus. Few cases of antiphospholipid syndrome co‐existing with NMOSD have been reported. In resource‐limited settings, the published data are scarce, and therefore, autoimmune diseases are poorly studied. Therefore, late diagnosis and delayed treatment initiation pose long‐term sequelae and hence poor prognosis. Here, we present a case of an African woman in her early 40s presenting with bilateral progressive loss of vision, transverse myelitis, extensive longitudinal hyperintense T2 cervical lesion, and AQP‐4 autoantibody keeping with NMOSD. The co‐existence of antiphospholipid syndrome, in this case, was supported by a history of recurrent pregnancy loss and positive antiphospholipid antibodies. This case underscores the importance of individualized‐based medicine, especially in resource‐limited settings.

Key Clinical Message Gastric adenocarcinoma can present uncommonly. This emphasizes the need for intensified vigilance in the absence of typical gastrointestinal symptoms, particularly in areas where infectious diseases are common. Abstract Gastric adenocarcinoma, a common advanced‐age global malignancy is typically associated with abdominal symptoms. However, atypical presentations such as back pain and respiratory distress particularly in younger patients represent diagnostic challenges. We present a case of a late‐30s male who presented initially with back pain, shortness of breath, and constitutional symptoms. A diagnosis of tuberculosis was established presumptively with immediate initiation of treatment. Later on, he presented with abdominal pain and intractable vomiting. Oesophagoduodenoscopy (OGD), tissue histology, and immunohistochemistry confirmed a diffuse type gastric adenocarcinoma. He died as a result of complications from an advanced disease. This particular instance emphasizes the importance of maintaining a high index of skepticism even in atypical presentations, as well as the significance of prompt OGD alongside potential genetic testing if any. Gastric adenocarcinoma should be contemplated by clinicians in a variety of clinical scenarios, especially when handling younger patients from settings with limited resources to facilitate timely diagnosis and effective treatment.

IntroductionStroke survivors develop cognitive impairment, which significantly impacts their quality of life, their families, and the community as a whole but not given attention. This study aims to determine the incidence and predictors of post-stroke cognitive impairment (PSCI) among adult stroke patients admitted to a tertiary hospital in Dodoma, Tanzania.MethodologyA prospective cohort study was conducted at tertiary hospitals in the Dodoma region, central Tanzania. A sample size of 158 participants with the first stroke confirmed by CT/MRI brain aged ≥ 18 years met the criteria. At baseline, social-demographic, cardiovascular risks and stroke characteristics were acquired, and then at 30 days, participants were evaluated for cognitive functioning using Montreal Cognitive Assessment (MoCA). Key confounders for cognitive impairment, such as depression and apathy, were evaluated using the Personal Health Questionnaire (PHQ-9) and Apathy Evaluation Scale (AES), respectively. Descriptive statistics were used to summarise data; continuous data were reported as Mean (SD) or Median (IQR), and categorical data were summarised using proportions and frequencies. Univariate and multivariable logistic regression analysis was used to determine predictors of PSCI.ResultsThe median age of the 158 participants was 58.7 years; 57.6% of them were female, and 80.4% of them met the required criteria for post-stroke cognitive impairment. After multivariable logistic regression, left hemisphere stroke (AOR: 5.798, CI: 1.030-32.623, p = 0.046), a unit cm3 increase in infarct volume (AOR: 1.064, 95% CI: 1.018-1.113, p = 0.007), and apathy symptoms (AOR: 12.259, CI: 1.112-89.173, p = 0.041) had a significant association with PSCI.ConclusionThe study revealed a significant prevalence of PSCI; early intervention targeting stroke survivors at risk may improve their outcomes. Future research in the field will serve to dictate policies and initiatives.

There is no doubt that plagiarism has become a growing ethical dilemma which hits the scientific research world and publishing. Recent studies have shown a considerable concern about the issue to gain a deep insight into the phenomenon, understand its roots and find solutions to prevent or at least minimize its spread. The Algerian legislator has realised that plagiarism is a plague that tarnishes the reputation of Algerian universities worldwide therefore finding the ways to deter it becomes a necessity. In a move to fight against this phenomenon, legal measures have been taken into action. Those measures presented in the ministerial resolution n°933 and 1082 equate plagiarism to criminal and immoral behaviour and set preventive and punitive regulations to ensure integrity in academia. The research in hand aims at investigating the issue of plagiarism from a legal perspective. It sheds light on analysing the legal measures taken by the Algerian authorities to deter plagiarism and assessing their efficacy in reality. The study shows the multidimensionality of the phenomenon therefore it recommends a myriad of approaches to deter it.

In order to advance the development of bio-composite materials, studies are being carried out on the potentials of using reinforcements from a natural origin in polymer matrixes. In this study, thermal conductivity, water absorption, and mechanical properties of calcined eggshell particles-treated sisal fiber hybrid reinforced epoxy composites were investigated in order to ascertain its potentials for use as structural materials. Calcined eggshell particulate (CEP) was obtained from chicken eggshell while treated sisal fibers (TSF) were obtained from the Agave sisalana plant. Both processed reinforcements were incorporated into an epoxy matrix using the hand lay-up method for the development of the bio-composites. Thermal, water absorption and mechanical behavior tests were carried out on the developed composites and the control sample. Analysis of the results showed that the presence of the bio-fillers in the epoxy matrix enhances the insulating, resistance to water uptake, and mechanical properties of the composites compared to the unreinforced epoxy matrix. It was concluded that these bio-fillers could be effectively used as reinforcements in a polymer matrix for the production of green composites.

Key Clinical Message Progressive supranuclear palsy (PSP) has many clinical features overlapping with other Parkinson syndromes and differentiation on clinical ground is difficult. This case highlights how a brain MRI can help diagnose PSP in settings with limited resources where histological diagnosis is difficult. Abstract Progressive supranuclear palsy (PSP) may be challenging to diagnose due to its widely acknowledged clinical complexity and challenges with diagnosis confirmation, particularly in resource‐poor settings where the ability to obtain confirmatory tests is highly complicated, leading to an inaccurate or incomplete diagnosis of PSP. This paper discusses using brain magnetic resonance imaging (MRI) to diagnose PSP, and a review of relevant literature addresses the diagnostic value of MRI in PSP.

The milk’s natural flora, or the starter, can preserve cheesemaking and allow for microbial competition. This investigation aimed to improve cheese safety and assess its characteristics using probiotic cell pellets (LCP) or cell-free extracts (CFS). Cheese samples were collected from different areas to investigate the current contamination situation. Six CFSs of probiotics were assessed as antifungal against toxigenic fungi using liquid and solid media and their aflatoxin reduction impact. The most effective CFS was chosen for cheese coating in nanoemulsion. Coated cheese with CFS, LCP, and LCP-CFS was assessed against control for changes in chemical composition, ripening indications, rheological properties, and microbiology. Results showed significant contamination levels in the collected samples, and toxic fungi were present. Lactobacillus rhamnosus CFS has aflatoxins reducibility in liquid media. During cheese ripening, uncoated cheese showed higher fat, protein, salt content, soluble nitrogen, total volatile fatty acids, tyrosine, and tryptophan contents than coated samples, except for LCP-coating treatment. Cheese rheology indicated that coating treatments had the lowest hardness, cohesiveness, gumminess, chewiness, and springiness compared to uncoated cheese. Uncoated cheese had the highest yeast and mold counts compared to the treated ones. The LCP-CFS-coated cheese showed no Aspergillus cells for up to 40 days. Uncoated Ras cheese recorded slightly lower flavor, body, texture, and appearance scores than coated cheeses. In conclusion, coating cheese with L. rhamnosus nanoemulsion has antifungal and antiaflatoxigenic properties, even for LCP, CFS, and CFS-LCP, which could extend cheese shelf life.

IntroductionCardiac Dyssynchrony is prevalent among patients with heart failure with high cost of care and potentially poor outcomes. Nevertheless, little is known about cardiac dyssynchrony among heart failure patients, especially in developing countries. This study aims at assessing the predictors and outcomes of cardiac dyssynchrony among heart failure patients attending the cardiology department at Benjamin Mkapa Referral Hospital in Dodoma, central Tanzania.MethodsThe study will follow a prospective longitudinal design involving participants aged 18 years and above with heart failure attending the Cardiology Department at Benjamin Mkapa Hospital. Heart failure will be identified based on Framingham's score and patients will be enrolled and followed up for six months. Baseline socio-demographic and clinical characteristics will be taken during enrollment. Outcomes of interest at six months include worsening of heart failure, readmission and death. Continuous data will be summarized as Mean (SD) or Median (IQR), and categorical data will be summarized using proportions and frequencies. Binary logistic regression will be used to determine predictors and outcomes of Cardiac Dyssynchrony among patients with heart failure.

Abstract The efficacy of vaccine storage is significantly impacted by temperature fluctuations within the cooler, often exacerbated by using phase change materials in existing cooler designs for remote areas. These materials can undergo uneven melting and phase separation, leading to temperature instability and vaccine potency loss. In response to this challenge, the present study introduces a novel design of a portable, locally‐made solar‐powered cooler optimized for longer storage periods. The cooler's performance in terms of temperature distribution, airflow dynamics, and the coefficient of performance (COP) is meticulously examined through computational fluid dynamics (CFD) simulations. The simulated results were validated using experimental data from the open literature, ensuring accuracy and reliability. The findings indicate that the developed cooler achieves significant improvements over traditional models. For instance, the current model reaches a temperature of +12°C in just 84 min, compared to 208 min, as reported in the literature results. Moreover, the current model reaches a temperature of −12°C in 195 min and it has energy efficient with a COP of 4.5. Statistical analysis further confirms the reliability of the simulation results, with root mean square and mean absolute percentage errors of 6.587 and 24.2%, respectively. Additionally, a comparative study of five insulative materials highlights polyurethane (Po) as the top performer, with a heat transfer performance of 14.3%, followed by feather fiber (Fe) (18.7%), fly ash (Fl) (19.8%), fiberglass (Fi) (21.9%), and coconut fiber (Co) (25.9%). Notably, net present value (NPV) of $689.336 and $448.01 was obtained for economic analysis of the current model over the existing model, showing the feasibility of the study. Hence, the cooler's effectiveness in storing vaccines in isolated regions exceeds that of conventional models, providing a hopeful solution to tackle vital challenges in vaccine distribution and preservation.

This study investigated the effect of the online, flipped classroom model on learners' self-directed learning using the descriptive correlation design. A total of 181 students from three public universities that applied the online flipped classroom approach participated in the study. The finds reveal that students did very well in their self-management through the online flipped classroom. They were methodical, self-disciplined, and confident in their ability to search out new information. Furthermore, they were systematic in organizing their learning activity. The students were able to access the lecture notes on their own time, which increased their understanding of the material. The synchronous aspect of the flipped classroom had a positive correlation with student desire for learning and self-control. This suggests that the more students are exposed to synchronous activities, the greater their desire for learning and their self-control in the process of learning. Therefore, synchronous experiences are essential for students to be self-controlled and for them to have a desire for learning

In this study, wear resistance and some selected physical properties of pawpaw–glass fiber hybrid reinforced epoxy composites were investigated. Two different layers of pawpaw stem—linear and network structures—were extracted and chemically modified. Hybrid reinforced composites were developed comparatively from the two fiber structures and glass fiber using hand lay-up in an open mold production process. The wear resistance was studied via the use of a Taber Abrasion Tester while selected physical properties were also investigated. The influence of the fiber structure on the properties examined revealed that network structured pawpaw fiber was the best as reinforcement compared to the linearly structured fiber. The addition of these vegetable fibers to epoxy resin brought about improved thermal conductivity and increased the curing rate while the wear resistance of the corresponding developed composites were enhanced by 3 wt% and 15 wt% of fibers from linear and network pawpaw fibers. It was noticed that linearly structured pawpaw fiber had its best result at 3 wt% while network structured pawpaw fiber had its best result at 15 wt%.