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Moringa has been acclaimed to be beneficial especially in livestock production. Its leaves and green fresh pods are said to be rich in carotene and ascorbic acid with a good profile of amino acids while its twigs are reported to be very palatable to ruminants and have appreciable crude protein levels. However, Moringa oleifera leaf meal (MOLM) has been observed to contain higher pepsin and total soluble protein than other parts of the plant which makes it more suitable to monogastric animals. MOLM has been widely used in poultry production but with limited use in rabbits� diets; hence this study was conducted to determine the performance of weaner rabbits fed graded levels of MOLM. A total of 48 unsexed weaner rabbits of mean initial weight of 744.56�29.25 g were assigned to 4 experimental diets, namely T1, T2, T3 and T4 containing 0%, 15%, 30% and 45% MOLM, respectively, having 3 replicates and 4 animals per replicate. The results showed that the dry matter intake of T1-T4 ranged 53.17 - 55.31g/day. Though not significant, highest crude protein digestibility coefficient was recorded for experimental animals on diet T4 (71.36%) followed by diets T1 (69.67%), T2 (69.17%), T3 (68.25%), respectively. The keel length for T1, T2, T3, and T4 rabbits were 225.39, 201.64, 246.66 and 217.26cm, respectively Rabbits fed 30% MOLM were found to be most profitable numerically (N1320.10) while the least profit was obtained with 0% MOLM with N1305.40. Hence, it can be concluded that Moringa oleifera leaf meal (MOLM) can replace soya bean meal up to 45% in the nutrition of weaner rabbits.

Kusman Ibrahim,1 Erin M Kahle,2 Yodi Christiani,3 Suryani Suryani4 1Postdoctoral Fellow, School of Nursing, University of Michigan, USA; Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 2Department of Health Behavior and Biological Science, School of Nursing, and Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA; 3CREDOS Institute, Jakarta, Indonesia; 4Department of Mental Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, IndonesiaCorrespondence: Kusman Ibrahim, Email k.ibrahim@unpad.ac.idAbstract: Social media has been used widely in public health for understanding health risks and intervening to improve health. However, the utilization of social media for HIV prevention and control interventions has not been clearly characterized. We conducted a scoping review on the utilization of social media for HIV prevention and control to identify gaps in the literature and highlight opportunities for future research and intervention. A comprehensive search of seven databases was performed: PubMed, Embase, CINAHL Complete (EBSCO), PsycInfo (EBSCO), Scopus, and WOS (Science Citation Index Expanded (SCI-EXPANDED). The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a framework. A total of 790 articles were screened at the title and abstract level, and 78 were screened at the full-text level. Twenty-three articles met the eligibility criteria for review. We found that Facebook was still the most common social media service used to reach target populations. Lesbian, gay, bisexual and transgender (LGBT) individuals were the primary groups and were the most common targets of social media-based HIV prevention interventions. Outcomes of social media-based interventions, such as increased HIV testing, social networking and social support, condom use attitudes, behavioral skills, and research participation, were reported. Most social media-based interventions have emphasized HIV prevention, with fewer interventions focused on improving linkage to care and adherence to treatment among people living with HIV. Future studies may benefit from using social media for interventions to improve HIV-related outcomes in high-risk populations. This review highlights the potential and challenges of social media approaches for HIV/AIDS prevention and control.Keywords: AIDS, HIV, prevention and control, social media

Yanny Trisyani,1 Etika Emaliyawati,1 Aan Nuraeni,1 Ristina Mirwanti,1 Kusman Ibrahim,2 Iqbal Pramukti,3 Titin Sutini,4 Donny Nurhamsyah1 1Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 2Department of Medical Surgical Nursing, University of Padjadjaran, Sumedang, West Java, Indonesia; 3Department of Community Nursing, Padjadjaran University, Sumedang, West Java, Indonesia; 4Department of Mental Health Nursing, Padjadjaran University, Sumedang, West Java, IndonesiaCorrespondence: Yanny Trisyani, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Ir. Soekarno KM. 21, Hegarmanah, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +6281222073465, Fax +622287793411, Email yanny.trisyani@unpad.ac.idBackground: COVID-19 still continue to spread and affects most nations globally to date. In this context, community knowledge, attitudes, and practices (KAP) toward COVID-19 are the most important for controlling and preventing the infectious pandemic disease.Objective: This study aimed to investigate the factors associated with community practices related to COVID-19.Methods: Cross-sectional study was conducted on 330 residents of Sumedang District, Indonesia. Selection of the sample using stratified random sampling. KAP toward COVID-19 was measured using the WHO questionnaire which is valid and reliable. The data were analyzed using the Rasch model, Pearson correlation, and linear regression.Results: This study revealed that most respondents tend to answer correctly on the sociality and disease transmission knowledge (+2.08 logit; SE 1.63), incorrectly in conceptual knowledge (logit measure − 2.05; SE 0.45), tended to have a positive attitude (+1.6 logit; 0.54) and practice (+1.63 logit; SE 0.61). Based on the results of the Wright map, the most challenging statement for respondents was to use masks. Knowledge and attitude were significantly associated with the practice of COVID-19 prevention (p< 0.001). Attitude is the dominant factor influencing society practice towards COVID-19 (Stand. Estimate= 0.2737; 95% CI=0.1608– 0.378; p< 0.001) and knowledge play an important role in improving COVID-19 prevention behaviour.Conclusion: New insight from this research shows that even attitude is the most dominant factor, yet this study also indicated that knowledge is critical for positive attitudes of society to support COVID-19 prevention practices. Since, knowledge is the basis for positive attitudes in preventing the transmission of Covid 19. Therefore, health education that explicates concepts, sociality and disease transmission is important to boost attitudes of the society in the practice of Covid 19 prevention.Keywords: attitude, COVID-19, Indonesia, knowledge, practice

Chlamydia trachomatis (CT) infections are among the sexually transmitted diseases known to increase the risk for human immunodeficiency virus infection. Serum samples from 34 consenting AIDS patients which attended the Government-approved Antiretroviral Treatment (ART) Facility at the National Institute for Pharmaceutical Research and Development (NIPRD), Abuja between April 2005 and March 2006 were screened by enzyme immunoassay (EIA) for the presence of anti-CT antibodies using ImmunoComb® Chlamydia Bivalent IgG Test kit (Orgenics, Israel). Anti-CT antibodies were detected in ten (29.4%) of the thirty-four patients tested. The detection rate was higher among the females (33.3%) than the males (23.1%). Patients of the age group 31-45 years had the highest detection of anti-C. trachomatis antibodies, followed by those of age group 16-30 years. The result of the present study suggests the presence of anti-CT antibodies in AIDS patients, and reinforces the need for routine screening for anti-CT antibodies as a necessary intervention to reduce the burden of chlamydial diseases and to reduce the risk of HIV and its spread in Nigeria. The outcome of this study also provides justification for the possible inclusion of anti-chlamydial agents in the National AIDS Management Plan to treat associated C. trachomatis infections.

Iyus Yosep,1 Suryani Suryani,1 Henny Suzana Mediani,2 Ai Mardhiyah,2 Kusman Ibrahim3 1Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia; 2Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia; 3Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, IndonesiaCorrespondence: Iyus Yosep, Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Ir. Soekarno KM. 21, Hegarmanah, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +6281394665577, Fax +6202287793411, Email iyus.yosep@unpad.ac.idAbstract: The pressure of learning on students causes mental health problems in students. This can disrupt the student’s academic process. The previous review still focused on the impact of digital mindfulness on students, but did not describe the various types of digital mindfulness on students’ mental health. A digital image of mindfulness is needed to be a reference for health workers in providing health services to students. The purpose of this study is to describe types of digital-based mindfulness method to improve mental health in university students. The method used in this study was a scoping review. The databases used were CINAHL, PubMed, and Scopus. Search strategy used PRISMA for Scoping Review with keywords namely mindfulness, digital, mental health, and students. The inclusion criteria in this study were student samples, digital-based mindfulness therapy, randomized control trial and quasi-experiment designs, and publication year in the last 10 years (2014– 2023). We found that 11 articles about digital-based mindfulness therapy is effective in improving mental health in college students. The types of digital mindfulness carried out are education, counseling, and meditation. Range of samples are 54– 561 university students. In addition, there are also counseling services and therapy training guided by facilitators. Information is presented through video and audio that can be accessed at any time by students. Application development is needed by adding monitoring and evaluation features to monitor student compliance in conducting mindfulness therapy and counseling schedules. Then, the role of health workers through holistic mental health services by involving families can improve the process of developing services for students optimally.Keywords: digital, mindfulness, mental health, students

Nita Fitria,1,&ast; Putri Karisa,2,&ast; Tertianto Prabowo,3,&ast; Ahmad Kharisma Ramadhan,4,&ast; Muhamad Gustaf Al Fajar,2,&ast; Setiawan,5,&ast; Kusman Ibrahim,6,&ast; Aditya Salya,7,&ast; Raini Diah Susanti8,&ast; 1Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia; 2Professional Nursing Student, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia; 3Department of Physical Medicine & Rehabilitation, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 4Department of Design Product, Faculty of Art and Design, Bandung Institute of Technology, Bandung, West Java, Indonesia; 5Department of Basic Medical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 6Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia; 7Department of Management, Faculty of Economic and Business, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia; 8Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia&ast;These authors contributed equally to this workCorrespondence: Nita Fitria, Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia, Tel +62 811-2015-188, Email nita.fitria@unpad.ac.idBackground: The mobilization characteristics of nurses’ work, such as standing, walking, and transferring patients for a long time, can increase the risk of musculoskeletal disorders. Repetitive activities nurses perform can cause foot problems such as discomfort and insecurity, characterized by increased lactic acid levels. Anthropometric shoes are specifically designed to reduce complaints on nurses’ feet.Purpose: This study aimed to determine the effect of individual anthropometric shoes on lactic acid levels in nurses at the hospital.Methods: This study used a mixed-method study design. This study involved 71 nurses in the quantitative study and 15 nurses in the qualitative study. Nurses in Emergency Room, Central Surgical Installation, Inpatient Room, Intensive Care Unit, and Outpatient Installation were randomly selected using a stratified random sampling technique. The instruments used were the Accutrend Lactacyd tool, demographic questionnaire and interview questionnaire. Bivariate data analysis was using Statistical Package for Social Sciences (SPSS) and qualitative data analysis using thematic analysis.Results: This mixed-method study shows that anthropometric shoes can reduce nurses’ lactic acid levels. In the quantitative study; there was a significant difference in lactic acid levels of nurses before and after using anthropometric shoes with the average results of measuring lactic acid levels, namely pre-test (22.48 mg/dL) and post-test (16.27 mg/dL), with a p-value (0.000). The qualitative study data revealed positive results related to increased nurse knowledge, positive views on the effect of shoes on nurse performance, and the impact of using anthropometric shoes in providing comfort and safety, such as decreased muscle fatigue and pain.Conclusion: The findings of this study highlight the effect of individualized anthropometric shoes on lactic acid levels in nurses in Indonesian hospitals. It is essential to conduct further research and evaluate the results in a broader setting to ensure that anthropometric shoes can directly affect lactic acid levels.Keywords: anthropometric shoes, lactic acid, nurses, Indonesia

Background: Identifying characteristics of diabetic patients receiving home healthcare will help in designing services that respond to their conditions and improve their health status and quality of life. The aim of this study was to describe the demographic, clinical, and biomedical characteristics of diabetic patients receiving HHC. Methods and Results: We used a descriptive cross-sectional design, and data were collected from 251 medical records of diabetic patients in two home healthcare centers in Saudi Arabia. The collected data included demographic, clinical, and biomedical profile variables. The average age was 74.7±11.6 years, with most patients (93.2%) aged 60 or older. The most common treatment modality was multiple daily insulin injections with or without oral medication (38.6%), followed by oral medication with sulfonylurea (19.9%). Pressure injury was the most reported complication/comorbidity, affecting 33.1% of patients. Cerebrovascular disease came next, affecting 20.7% of patients, followed by cardiovascular disease, ischemic heart disease, and nephropathy, affecting 12.3%, 10%, and 6.4% of patients, respectively. Only 4.2% of patients experienced hypoglycemia, and only 5.6% of patients were hospitalized due to DM complications. The mean HbA1c was 7.6±1.7%, with approximately 71.7% of the diabetic patients having HbA1c8% (P

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale.

Toni Rahmat Jaelani,1 Kusman Ibrahim,1 Jonny Jonny,2 Sri Hartati Pratiwi,1 Hartiah Haroen,1 Nursiswati Nursiswati,1 Bunga Pinandhita Ramadhani2 1Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia; 2Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, IndonesiaCorrespondence: Toni Rahmat Jaelani, Faculty of Nursing, Padjadjaran University, Jalan Ir. Soekarno Km. 21 Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +62-813-2211-0115, Fax +62-022-7795596, Email toni15003@mail.unpad.ac.idBackground: Peritoneal dialysis (PD) training is essential to ensure patient independence and prevent life-threatening complications, such as peritonitis. The International Society for Peritoneal Dialysis (ISPD) recommends that every PD unit worldwide implement local PD training programs with the goal of improving self-care capabilities. This scoping review aims to give an overview of recent literature and recommendations on PD training programs aiming to improve the quality of care and outcomes for PD patients.Methods: The literature search was conducted using the PC (Population, Concept) approach. The population of interest in this study is PD patients, and the study concept is the PD training program. Several databases were used to conduct the literature search, including PubMed, Science Direct, and CINAHL. The search process began from July 2022 until January 2023. The inclusion criteria for the search included research articles and recommendations.Results: The search yielded 22 articles recommending training programs lasting from 5– 8 days, with 1– 3-hour sessions and a nurse-to-patient ratio of 1:1. A cumulative training time of 15 hours or more is recommended to enhance patient independence and reduce peritonitis rates. Home-based or in-unit PD training, conducted by experienced nurses using adult learning strategies, has shown significant value in improving self-care and preventing peritonitis. Evaluating training outcomes should encompass knowledge, skills, and attitudes, and the impact on peritonitis rates. Training programs should be flexible and consider physiological and psychosocial barriers to achieving the best results.Conclusion: There are a variety of strategies for dialysis training concerning duration, session length, patient-to-trainer ratio, timing, methods, location, compliance, and the need for retraining. More evidence is needed to assess the impact of PD patient training programs on self-care capabilities and peritonitis incidence. Future studies should investigate the effects of training programs on compliance, self-efficacy, and patient and nurse perspectives.Keywords: training program, peritoneal dialysis, chronic kidney disease, patient education, nursing

Introduction: To investigate the use of a tubular retractor to provide access to the craniovertebral junction (CVJ) sparing the soft palate with the aim of reducing complications associated with traditional transoral approach but yet allowing adequate decompression of the CVJ. Materials and methods: Twelve consecutive patients with severe myelopathy (JOA-score less than 11) from ventral CVJ compression were operated between 2014-2020 using a tubular retractor assisted transoral decompression. Results: All patients improved neurologically statistically (p=0.02). There were no posterior pharynx wound infections or rhinolalia. There was one case with incomplete removal of the lateral wall of odontoid and one incidental durotomy. Conclusions: A Tubular retractor provides adequate access for decompression of the ventral compression of CVJ. As the tubular retractor pushed away the uvula, soft palate and pillars of the tonsils as it docked on the posterior pharyngeal wall, the traditional complications associated with traditional transoral procedures is completely avoided.

Maria Komariah,1,&ast; Shakira Amirah,2,&ast; Sidik Maulana,3 Muhammad Fahd Abdurrahman,2 Kusman Ibrahim,4 Hesti Platini,4 Juan Alessandro Jeremis Maruli Nura Lele,5 Kelvin Kohar,6 Laili Rahayuwati,7 Mohd Khairul Zul Hasymi Firdaus8 1Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 2Undergraduate Medical Education, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia; 3Nursing Internship Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 4Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 5Undergraduate Medical Education, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia; 6Clinical Clerkship Program, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo, Central Hospital, Jakarta, Indonesia; 7Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 8Department of Medical-Surgical Nursing, Faculty of Nursing, International Islamic University Malaysia, Kuala Lumpur, Malaysia&ast;These authors contributed equally to this workCorrespondence: Maria Komariah, Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM. 21, Hegarmanah, Jatinangor, Kabupaten, Sumedang, West Java, 45363, Indonesia, Tel + 6281294686288, Email maria.komariah@unpad.ac.id Shakira Amirah, Email shakira.amirah@ui.ac.idBackground: The COVID-19 pandemic continues, and this condition has caused many cases in various countries around the world, resulting in more than 6 million deaths worldwide. Herbal medicines can act as immunomodulators, anti-inflammatories, antioxidants, antimicrobials, and others depending on the type and content of the herbs used. Previous studies have shown that several types of herbs, such as Echinacea purpurea, Curcumin or Turmeric, Nigella sativa, and Zingiber officinale, have proven their effectiveness as herbal plants for COVID-19.Methods: We conducted a comprehensive literature search through five databases, namely, PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of phytopharmaceuticals until July 12, 2022. We used the Cochrane RoB 2.0 for the quality assessment of the study.Results: Phytopharmaceuticals significantly improved patients’ recovery rate (OR = 3.54; p < 0.00001) and reduced deaths (OR = 0.24; p < 0.0001) compared to the control group. Phytopharmaceuticals also performed as a protective factor for COVID-19 clinical symptoms, such as dyspnea (OR = 0.42; p < 0.05) and myalgia (OR = 0.31; p = 0.02) compared to the control group. However, there is no statistically significant effect on cough (OR = 0.76; p = 0.61) and fever (OR = 0.60; p < 0.20). The results were not affected by patients’ covariates [hypertension, diabetes mellitus, and cardiovascular diseases (meta-regression p > 0.05)].Conclusion: Herbal medicine has the potential as an adjuvant therapy in the management of COVID-19.Keywords: adjuvant therapy, COVID-19, herbal medicine, systematic review

Kusman Ibrahim,1 Laili Rahayuwati,2 Yusshy Kurnia Herliani,1 Iqbal Pramukti2 1Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 2Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, IndonesiaCorrespondence: Kusman Ibrahim, Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM. 21, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +62-81321281117, Fax +62 22-7795596, Email k.ibrahim@unpad.ac.idBackground: Human immunodeficiency virus remains a major public health problem in Indonesia. People living with HIV (PLWH) have various health problems as result from disease progression that impacts their health care needs. This study aims to explore health care needs and to test the factors associated with health care needs among people living with HIV.Methods: A cross-sectional descriptive study design was undertaken with 243 respondents completing a self-reported HIV-Health Care Need Questionnaire. Participants were recruited using the purposive sampling technique from six HIV clinics in West Java, Indonesia. The data were analyzed using descriptive and multiple logistic regression statistical techniques.Results: The majority of the subjects were diagnosed within less than 5 years and have been receiving antiretroviral therapy. Nursing care was indicated as the most needed, offered, and received care. Emergency financial assistance, legal services, insurance premiums, and nutritional intervention were perceived as gaps between needed and received. Characteristics such as age, educational background, having HIV manager, and income were significantly correlated to nutritional care (p< 0.05). Nutritional care was increased by 3.96% if PLWH having HIV manager (CI: 1.17– 13.38, p< 0.05).Conclusion: Addressing the gap between health care needs and health offered was important to ensure that care was received appropriately. Continuing assessment of health care needs can provide direction to deliver appropriate care and ensure a comprehensive continuum of care for PLWH.Keywords: continuum of care, continuity of patient care, health services, HIV testing, needs

Aim and background: This current study aimed to load 5-flucytosine (5-FCY) into spanlastic nanovesicles (SPLNs) to make the drug more efficient as an antifungal and also to load the 5-FCY into a hydrogel that would allow for enhanced transdermal permeation and improved patient compliance.Methods: The preparation of 5-FCY-SPLNs was optimized by using a central composite design that considered Span 60 (X1) and the edge activator Tween 80 (X2) as process variables in achieving the desired particle size and entrapment efficiency. A formulation containing 295.79 mg of Span 60 and 120.00 mg of Tween 80 was found to meet the prerequisites of the desirability method. The optimized 5-FCY-SPLN formulation was further formulated into a spanlastics gel (SPG) so that the 5-FCY-SPLNs could be delivered topically and characterized in terms of various parameters.Results: As required, the SPG had the desired elasticity, which can be credited to the physical characteristics of SPLNs. An ex-vivo permeation study showed that the greatest amount of 5-FCY penetrated per unit area (Q) (mg/cm2) over time and the average flux (J) (mg/cm2/h) was at the end of 24 h. Drug release studies showed that the drug continued to be released until the end of 24 h and that the pattern was correlated with an ex-vivo permeation and distribution study. The biodistribution study showed that the 99mTc-labeled SFG that permeated the skin had a steadier release pattern, a longer duration of circulation with pulsatile behavior in the blood, and higher levels in the bloodstream than the oral 99mTc-SPNLs. Therefore, a 5-FCY transdermal hydrogel could possibly be a long-acting formula for maintenance treatment that could be given in smaller doses and less often than the oral formula.

Sea-shells, periwinkle-shells, and snail-shells were pulverized into 35.5 µm particle sizes. Using a two-roll Rheomixer with a rotor speed of 60 rpm for 10 minutes, the particles were thoroughly mixed with the binders in ratio 2:1 and placed in the compression mold of dimension 15 cm by 3 cm by 3 cm using a force of 1.5 kN. The Rockwell hardness tester on scale B with a 1.56 mm steel ball, optical microscope and Flexural tester were used to characterize the composites. Thermo-gravimetric analyzer and Fourier Transform Infrared (FTIR) Spectrometer were used to characterize the shell particles. According to the results, epoxy resin (bisphenol-A-diglycidyl ether poly) and hardener (isophoromediamine) composites containing periwinkle shell particles had the highest hardness number of 48 and could withstand maximum flexural load of 5.5 MPa ether poly) and hardener (isophoromediamine) proved to be the best epoxy resin. All the shell particleS functional groups were visible in the FTIR analysis with varying transmittances at their respective wavenumbers. Optical micrographs of the composites showed uniform distribution of the reinforcement and the matrix, thermo-gravimetric analyses demonstrated good thermal stability of the shell-particles up to 250 ◦C

BackgroundDespite substantial literature on symptoms and long-term health implications associated with COVID-19; prevalence and determinants of post-acute COVID-19 fatigue (PCF) remain largely elusive and understudied, with scant research documenting health-related quality of life (HRQoL). Hence, prevalence of PCF and its associated factors, and HRQoL among those who have survived Covid-19 within the general population of Saudi Arabia (KSA) is the subject under examination in this research.MethodsThis cross-sectional study was conducted on 2063 individuals, selected from the KSA’s general population, using a non-probability sampling approach. An online survey was used to employ a self-administered questionnaire to the participants, which included socio-demographic information, the patient’s COVID-19 infection history, 12-item Short Form Health Survey (SF-12) to assess quality of life, and Chalder Fatigue Scale (CFS) (CFQ 11) to evaluate the extent and severity of fatigue. Data were analyzed using SPSS version 26. A p

BackgroundMisinformation poses a serious challenge to clinical and policy decision-making in the health field. The COVID-19 pandemic amplified interest in misinformation and related terms and witnessed a proliferation of definitions. ObjectiveWe aim to assess the definitions of misinformation and related terms used in health-related literature. MethodsWe conducted a scoping review of systematic reviews by searching Ovid MEDLINE, Embase, Cochrane, and Epistemonikos databases for articles published within the last 5 years up till March 2023. Eligible studies were systematic reviews that stated misinformation or related terms as part of their objectives, conducted a systematic search of at least one database, and reported at least 1 definition for misinformation or related terms. We extracted definitions for the terms misinformation, disinformation, fake news, infodemic, and malinformation. Within each definition, we identified concepts and mapped them across misinformation-related terms. ResultsWe included 41 eligible systematic reviews, out of which 32 (78%) reviews addressed the topic of public health emergencies (including the COVID-19 pandemic) and contained 75 definitions for misinformation and related terms. The definitions consisted of 20 for misinformation, 19 for disinformation, 10 for fake news, 24 for infodemic, and 2 for malinformation. “False/inaccurate/incorrect” was mentioned in 15 of 20 definitions of misinformation, 13 of 19 definitions of disinformation, 5 of 10 definitions of fake news, 6 of 24 definitions of infodemic, and 0 of 2 definitions of malinformation. Infodemic had 19 of 24 definitions addressing “information overload” and malinformation had 2 of 2 definitions with “accurate” and 1 definition “used in the wrong context.” Out of all the definitions, 56 (75%) were referenced from other sources. ConclusionsWhile the definitions of misinformation and related terms in the health field had inconstancies and variability, they were largely consistent. Inconstancies related to the intentionality in misinformation definitions (7 definitions mention “unintentional,” while 5 definitions have “intentional”). They also related to the content of infodemic (9 definitions mention “valid and invalid info,” while 6 definitions have “false/inaccurate/incorrect”). The inclusion of concepts such as “intentional” may be difficult to operationalize as it is difficult to ascertain one’s intentions. This scoping review has the strength of using a systematic method for retrieving articles but does not cover all definitions in the extant literature outside the field of health. This scoping review of the health literature identified several definitions for misinformation and related terms, which showed variability and included concepts that are difficult to operationalize. Health practitioners need to exert caution before labeling a piece of information as misinformation or any other related term and only do so after ascertaining accurateness and sometimes intentionality. Additional efforts are needed to allow future consensus around clear and operational definitions.

This study examined the status of climate smart small ruminant production practices in Kwara State, Nigeria. About 105 small ruminant breeders were selected for the study. The data were analysed the use of frequency count, percentage, mean score, Binary Logistic Regression and Pearson product moment correlation. The result revealed that about 60% of the breeders were females and the mean years of experience in small ruminant production was 7 years. The result of most of the frequently used climate smart small ruminant production practices of the respondents showed that provision of medication to sick animals and cultivation of crops along with rearing of animals (90.5%), feeding with supplementary feeds, isolation of sick animals and vaccination of animals (92.4%); provision of shade through Planting of trees to reduce heat stress (93.3%); feeding with crop residues and building and maintenance of pens (96.2%) and grazing on pasture/grassland (97.1%). About 90.5% of the breeders have high status on the use of climate smart small ruminant production practices. Disease outbreak and high mortality (mean=2.07) was the highest ranked factors affecting the small ruminant breeders. The result of Binary Logistic Regression showed that educational level (B=3.985), membership of social group (B=6.083), access to extension services (B= 13.941) and years of experience (B= -0.544) were the determinant factors of the use of climate smart small ruminants production practices. This study therefore recommends that breeders should be provided with veterinary services and extension services.

Low-speed wind tunnel experiments are conducted to study the aerodynamic performance of a half-span delta wing with 45° leading-edge sweep at subsonic flow regime. The experiments are carried out at a Reynolds number of 8.37 × 105, a free-stream Mach number of 0.1 and angles of attack up to 25°, in steps of 5°. The test model was designed with thirty-two pressure taps fixed on its surfaces (sixteen on each side). Multi-tube manometers were connected to these taps using long tubes to enable recording the pressure readings. Surface pressure distributions and aerodynamic characteristics were calculated at different span-wise locations along the non-dimensional chord-wise distance. Results exhibited that most lift on the studied wing is generated in the region close to the leading edge for all the studied incidence angles. Additional lift is created in the region close to the root chord rather than the tip chord, whereas drag forces increases from tip to root. This can be attributed to the formation of trailing edge vortexes due to the flow separation at the wing leading edge that produces more drag, hence suppressing lift. The study showed also that angle of attack increases the drag coefficient from tip to root, especially at high angle of attack, indicating unfavourable behaviour for manoeuvring. Moreover, the angle of attack increased the pitching moment coefficient up to 10° before it drops sharply until it reaches the tip of the wing model.

Background: COVID-19 provided a real challenge for evidence synthesis due to the rapid growth of evidence. We aim to assess the impact of including all studies versus including larger studies only in systematic reviews when there is plethora of evidence. We use a case study of COVID-19 and chronic kidney disease (CKD). Methods: The review team conducted a systematic review of multiple databases. The review assessed the effect of CKD on mortality in patients with COVID-19. We performed a sensitivity analysis to assess the effect of study size on the robustness of the results based on cutoffs of 500, 1000 and 2000 patients. Results: We included 75 studies. Out of which there were 40 studies with a sample size of >2,000 patients, seven studies with 1,000-2,000 patients, 11 studies with 500-1,000 patients, and 17 studies with Conclusions: These findings suggested that, in prognosis reviews, it could be acceptable to limit meta-analyses to larger studies when there is abundance of evidence. Specific thresholds to determine which studies are considered large will depend on the context, clinical setting and number of studies and participants included in the review and meta-analysis.

Background: Tricuspid valve disease is most commonly functional, however, organic affection still accounts for one fourth of cases. Rheumatic fever which is endemic in Egypt is a main cause of organic affection. Current practice largely relies on tricuspid valve repair; however, it has been difficult to determine optimal procedure. Objectives: Herein, we study the outcome of replacement versus repair in such patients. Patients and methods: A prospective study was conducted on 300 consecutive patients with rheumatic heart disease showing severe tricuspid valve affection underwent tricuspid valve surgery, between 2014 and 2018. The patients were divided into two groups; TVR group (n=150) which included patients who underwent tricuspid valve replacement and TVr group (n=150) which included patients who underwent tricuspid valve repair. Diagnosis and follow up were done by echocardiography. Peri-operative variables, clinical outcome, morbidity, mortality, and follow up data were recorded. Results: Mean follow-up was 4±1.32 years. In-hospital mortality was 6 patients (4%) in TVR group and 3 patients (2%) in TVr group (P value ≥ 0.05). Postoperative low cardiac output syndrome and stroke were significantly higher in the repair group. Postoperative RV dysfunction, renal impairment, renal failure and chest re-exploration were significantly higher in the replacement group. Severe tricuspid regurgitation was reported in 19 patients (12.6%) of the repair group on follow up. Conclusion: Tricuspid valve repair is preferable to replacement to avoid the drawbacks of prosthesis. However, tricuspid valve replacement is feasible with comparable survival outcome and the progressive nature of the rheumatic disease may recommend replacement.