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Abstract Background Cardiovascular diseases (CVD) are among the most prevalent and preventable chronic diseases in the 21st century The global burden of disease: 2004 update. The Report in Sections. A person’s risk of developing CVD can be reduced by adopting healthy lifestyles, spiritual and religious practices The American Heart Association Life’s Simple 7 in African Americans of the Jackson Heart Study. Fasting as a spiritual practice is not exempted from these benefits. Most world’s religions recommend a period of fasting. The obligatory Ramadan fasting in Islam may provide an interesting opportunity to reduce food intake and increase physical activity. The main objective of this study is to investigate the effect of Ramadan fasting on cardiovascular risk factors on healthy adult Muslims. Method The study was pre/post-test single arm intervention conducted at the staff clinic of Family Medicine department, AKTH, and Northwest, Nigeria. Kano. The study recruited healthy adults 18yrs and above not on any medications that can affect metabolic profiles consecutively from two weeks before Ramadan fasting of 2018 and the last week of Ramadan of the same year. The questionnaire included information on sociodemographic, clinical parameters and Lifestyle pattern. Result Thirty healthy volunteers were included in this study, 25 males (83.3%) and 5 females (16.7%). The mean age was 38.23 ± 6.35(SD). Twenty-five participants were married (83.3%) with 4 singles (13.3%) and 1 divorcee (3.3%). During Ramadan fasting, weight reduced (67.90 ± 11.61 versus 66.53 ± 12.13 4th week of Ramadan p-value

Abstract Background Cutaneous leishmaniasis (CL) in Ethiopia and some parts of Kenya is predominantly caused by Leishmania aethiopica. While skin-slit (SS) microscopy is routinely used for CL diagnosis, more sensitive molecular tests are available. The Loopamp™ Leishmania detection kit (Loopamp) is a robust loop-mediated isothermal amplification (LAMP) assay with the potential for implementation in primary healthcare facilities. In this study, we comparatively assessed the diagnostic accuracy of four methods currently used to diagnose CL: Loopamp, kinetoplast DNA (kDNA) PCR, spliced leader RNA (SL-RNA) PCR and SS microscopy. Methods A study on 122 stored tape disc samples of suspected CL patients was conducted in Gondar, northwestern Ethiopia. Routine SS microscopy results were obtained from all patients. Total nucleic acids were extracted from the tapes and subjected to PCR testing targeting kDNA and SL-RNA, and Loopamp. Diagnostic accuracy was calculated with SS microscopy as a reference test. The limit of detection (LoD) of Loopamp and kDNA PCR were determined for cultured L. aethiopica and Leishmania donovani. Results Of the 122 patients, 64 (52.5%) were identified as CL cases based on SS microscopy. Although the PCR tests showed a sensitivity of 95.3% (95% confidence interval [CI] 91.6–99.1), Loopamp only had 48.4% (95% CI 39.6–57.3) sensitivity and 87.9% (95% CI 82.1–93.7) specificity. The LoD of Loopamp for L. donovani was 100-fold lower (20 fg/µl) than that for L. aethiopica (2 pg/µl). Conclusions The Loopamp™ Leishmania detection kit is not suitable for the diagnosis of CL in Ethiopia, presumably due to a primer mismatch with the L. aethiopica 18S rRNA target. Further research is needed to develop a simple and sensitive point-of-care test that allows the decentralization of CL diagnosis in Ethiopia. Graphical Abstract

Abstract A low level of work autonomy is the bottleneck for the health service delivery and the quality of the service. Although work autonomy is the pillar of organizational commitment and a means of employee retention mechanism, information about the magnitude of work autonomy among health professionals is limited in Ethiopia. Therefore, this study aimed to assess work autonomy and its predictors among health professionals working in public hospitals of Northeast Ethiopia. Institution-based cross-sectional study was conducted from March 24 to April 24, 2021, among health professionals using a stratified sampling technique. Variables with a p-value of

Conventional GDP measurements often overlooks the significant contribution of the environment to a country’s long-term economic performance, leading to inaccurate assessments and the concealment of important environmental and economic benefits. The aim of this study is to estimate the level of environmental capital and sustainable income. To determine the contribution of environmental capital to GDP, the concept of the neoclassical growth model was used. This analytical approach begins by defining the two types of capital inputs, such as: human capital and environmental capital used in the production of final goods and services. The study found that the total share of environmental capital in GDP was 32% over the study period, while the contribution of environmental capital to gross national production fell from 39% in 2000 to 29% in 2018. The gap between GDP and sustainable GDP estimate also widened between 2003 and 2011. A comparison between GDP and sustainable GDP shows that environmental resource damage can account for up to 15.5% of GDP, leading to an overestimation of GDP. The decline in the share of environmental capital may have long-term implications for the potential of low-income countries to grow sustainably. Therefore, policymakers need to pay adequate attention to environmental capital investments to ensure the long-term sustainability of the economy. Institutions directly involved in GDP estimation also should have been transformed to a more comprehensive and environmental integrated GDP measurement.

Agricultural production is very risky, which can lead to significant shifts in income for individual farmers. De-risking input allocation due to production risk can change the level of technical efficiency. Therefore, the production risk component needs to be accounted for in the stochastic frontier model to produce unbiased estimates of technical efficiency. This study was conducted to assess the risks and efficiency of sesame production and to examine factors affecting farmers’ technical efficiency. A one-stage stochastic frontier model is used to estimate the production risk and technical inefficiency. The results show that the most suitable model for sesame production is the Cobb-Douglas function. The Cobb-Douglas model estimation shows that all agricultural inputs have a positive impact on sesame yield. Land and seeds are the most important factors in sesame production, followed by fertilizers, oxen, labour and chemicals. Fertilizers have been shown to reduce production risk, but oxen and chemicals are riskier. Sesame farmers have an average technical efficiency of 92.5%, indicating they can achieve 92.5% of their maximum production. A combination of farmer-specific factors could explain the differences in technical efficiency. Sesame farmers cannot achieve their planned production due to technical inefficiency and production risks. The study recommends that inputs for sesame production, such as fertilizers, should be easily accessible and inexpensive to increase technical efficiency and reduce production risk. Farmers should also be encouraged to adopt the best agronomic practices in sesame cultivation through improved support through extension services.

Policymakers and tax authorities in developing countries face challenges in comprehending the determinants of tax-compliance behavior. This study employs empirical investigation to explore the factors that influence taxpayers’ voluntary and enforced tax compliance behaviors. Data were collected through a survey questionnaire distributed to 400 taxpayers using simple random sampling and analyzed using an ordered logit model. The results validate the assumptions of the slippery slope framework, showing that trust significantly impacts voluntary tax compliance and that a strong tax authority’s power contributes to more enforced tax compliance in Ethiopia. Additionally, the interaction between trust and power has a more significant effect on enforced tax compliance. This study also emphasizes the importance of improving trust in increasing tax compliance. Moreover, factors such as equity, fairness, tax knowledge, effective tax usage, and taxpayer morale contribute to tax compliance. By identifying factors that contribute to tax compliance, the findings of this research provide valuable insights for tax authorities in Ethiopia and other developing countries in devising strategies to combat tax evasion. This includes implementing a fair tax regime, enhancing the perceived value of public services financed by tax payments, increasing tax knowledge activities to help people understand the importance of paying taxes, and fortifying frameworks to minimize extravagant spending for maintaining public trust and ensuring effective and efficient use of taxpayers’ money.

The main goal of the short-term hydrothermal scheduling (HS) challenge is to drastically reduce the large fuel cost of producing power by scheduling the hydrothermal energy producers while taking power balance restrictions, the reservoir's storage restrictions, the water's gross discharge, and the thermal power generators' and hydropower plants' operating restrictions into account. Many algorithms have been employed to solve this similar problem, and relevant research have been published in the literature; nevertheless, their scope is limited in terms of the number of 16 iterations required to achieve the solution state and the solution state itself. In order to solve the HS problem, this article suggests applying an improved cuckoo search (CS) algorithm known as the fresh manner cuckoo search (FMCS) algorithm, a modified variant of the conventional CS. The suggested FMCS

Introduction: Wide-awake local anesthesia and no tourniquet (WALANT) represents a revolutionary technique for hand surgeons who dismiss tourniquets and sedation. In this study, we present our experience with the WALANT technique in primary flexor tendon injuries of the hand. Patient and methods: This prospective research was carried out on 30 patients undergoing hand primary, flexor tendon repair surgery. Flexor tendon injury zones 2, 3, 4, and 5 were included. WALANT was prepared and injected. The tendons were surgically managed by a cruciate single cross-stitched locked 4-strand technique. The pain was assessed using a visual analog scale (VAS) score. The range of motion (ROM) of affected fingers was assessed according to the Strickland evaluation system. Results: There was a highly significant relationship between the patient's compliance with physiotherapy and obtained ROM of the affected finger with a P value

Abstract Background Benign peripheral nerve sheath tumors (BPNSTs) include schwannomas and neurofibromas. About 10% of soft tissue sarcomas are malignant peripheral nerve sheath tumors (MPNSTs), which are invasive and aggressive tumors. These can happen occasionally or after radiation exposure. Up to 90% of schwannomas are made up of differentiated neoplastic Schwann cells. Malignant transformation of schwannomas is rare. Methods We collected the medical records of all patients (including their family histories), performed comprehensive physical and neurological assessments, and checked for the presence of a Tinel-like sign, as well as screening for neurofibromatosis (NF) signs. Magnetic resonance imaging (MRI), nerve conduction studies, and ultrasound were done for all cases. Results We have operated on 21 patients with age range 29–52 years. The mean age was 39.4 years. 14 of these patients were females and 7 were males. The presenting symptoms were just swelling at nerve site in 14 patients, spontaneous pain at the nerve sites in 7 patients, and sensory deficit at the nerve distribution sites in 9 patients. The other 12 patients were sensory intact and only 7 patients had motor deficit. Postoperatively all patients had improved motor and sensory deficit and none of intact patients were worsened. Preoperatively we did MRI to show important nearby vascular structure anatomical abnormalities and we ordered nerve studies to all patients that showed abnormalities, which was only in 9 patients. Gross total resection was done in 18 patients and other 3 cases had partial resection to avoid sensory and motor deficits. The pathological analysis revealed 11 schwannomas and 10 neurofibromas. With 1 year follow up there was no recurrence in any patients. Conclusion Benign pheripheral nerve sheath tumours are safely resected without increased sensory and motor deficits after surgery and with improve clinical outcome with no recurrence on follow up.

With rapid progress in power conversion efficiencies, perovskite solar cells (PSCs) have shown great potential as next-generation low-cost, efficient solar cell devices. Ultra-thin pure and Brdoped MoTe2 monolayer materials are promising candidates for alternative electron transport material in perovskite solar cell applications. The electronic, and optical properties of these materials were calculated using projector augmented plane wave (PAW) based on popular density-functional theory (DFT). These properties were calculated using Pardew-BurkeErnzerhof generalized gradient approximation (PBE-GGA). The band structure for the considered materials has been determined using full relativistic spin-orbital coupling (SOC). Our results indicate that pure and Br-doped 2D-MoTe2 were n-type semiconductors and had direct band gap energies of 1.01 and 1.21 eV respectively. The optical properties of the materials such as relative dielectric constant, transmission and reflectivity are presented. Using these properties, the 1-D solar cell capacitance simulator (SCAPS-1D) software was used to design solar cells based on monolayer pure and Br-doped MoTe2 as an electron transport layer (ETL). The maximum efficiencies of these cells are 13.121%, and 24.016% with VOC of 1.067 V and 1.186 V, JSC of 21.678 mA/cm2 and 25.251 mA/cm2, and FF of 56.720% and 80.139% were realized with the pure and Br-doped ETLs respectively. The performance of our solar cells is comparable to traditional Si-based solar cells. The results show how monolayer pure and Br-doped MoTe2 can serve as a suitable ETL material for perovskite solar cells.

Abstract Diabetes mellitus shares a large proportion of kidney failure. Despite many patients suffering from diabetes mellitus and its complications in Dessie City, no study was conducted in the study area that shows the prevalence and associated factors of chronic kidney disease among diabetes mellitus patients. Therefore, this study aims to assess the prevalence of chronic kidney disease and its associated factors among adult diabetes mellitus patients attending Dessie Referral Hospital, South Wollo, Northeast Ethiopia. An institutional-based cross-sectional study was conducted at Dessie Referral Hospital among 267 randomly selected adult diabetic patients. Data were collected using questionnaires administered by interviewers. The glomerular filtration rate was estimated from serum creatinine levels. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26 software. Multi-variable logistic regression was used to determine the strength of association for the associated factors of chronic kidney disease. Variables with a p value

Canine pathologies refer to the various diseases, disorders, and abnormalities that can affect a dog’s different body systems and cause mortality. The primary aim of this study was to investigate the common pathologies that are associated with the mortality of dogs in Ilorin, Kwara State. A retrospective review of post-mortem records from 7 years was undertaken at a necropsy unit of the Department of Veterinary Pathology, University of Ilorin. Data collected included age, sex, breed, disease pathogens, and year. A total of 150 dog carcasses were presented for necropsy during the period between January 2016 and December 2022. In this study, the cases used were confirmed based on PCR results in some cases, bacterial culture and isolation, parasite identification, gross lesions, and histopathological findings in other cases. Descriptive statistics were employed to evaluate the effect of disease pathogens on age, sex, and breed distribution patterns associated with the mortality of dogs. The prevalence of viral infection among other diseases was statistically significant (34.00%; OR = 0.53; P

IntroductionPoverty poses a significant barrier to accessing healthcare globally, particularly in relation to antenatal care (ANC) visits and the use of childbirth facilities, both of which are crucial for women’s health and fetal well-being. In Somaliland, only 47% of pregnant women attend healthcare facilities for ANC, with a mere 33% receiving care from skilled birth attendants. Despite this, no previous studies have examined the relationship between poverty and maternal healthcare utilization in Somaliland. This study aims to investigate the effect of poverty on maternal healthcare utilization with focus on ANC visits and the choice of place of birth in Somaliland.MethodUtilizing data from the 2020 Somaliland Demographic Health Survey, a cross-sectional study design was employed, analyzing a nationally representative sample. The sample size used in this study was 3,183 women of reproductive age. Descriptive analysis, negative binomial regression, and multinomial logistic regression were conducted using Stata version 18.0. Diagnostic tests, including Chi-square − 2log likelihood statistic, Akaike Information Criterion, and Bayesian Information Criterion, were employed to evaluate model fit.ResultsPoverty, as indicated by wealth quintile, was associated with reduced ANC visits (adjusted incidence rate ratio (aIRR) = 0.884, 95% CI: 0.791–0.987) among women in poorer households compared to those in richer households. Women in Togdheer, Sool, and Sanaag regions had lower ANC visit rates compared to Maroodi Jeex region (aIRR = 0.803, 95% CI: 0.687–0.939; aIRR = 0.710, 95% CI: 0.601–0.839; aIRR = 0.654, 95% CI: 0.558–0.768, respectively). Women from poorer households had lower probabilities of opting for public health facilities (adjusted relative risk ratio (aRRR) = 0.457, 95% CI: 0.352–0.593) and private health facilities (aRRR = 0.195, 95% CI: 0.111–0.341) over home births compared to women in richer households. Women in Togdheer, Sool, and Sanaag regions had lower probabilities of choosing public (aRRR range: 0.331–0.175) and private (aRRR range: 0.350–0.084) health facilities for delivery over home births compared to women in Maroodi Jeex region.ConclusionPoverty significantly impedes maternal healthcare utilization, contributing to lower ANC attendance and preference for home births over public or private health facility births. Addressing these disparities requires initiatives to eliminate financial barriers, such as user fees, and enhance equitable access through community-based health insurance and improved healthcare infrastructure.

Abstract Background The COVID-19 pandemic had a profound impact on healthcare and ophthalmology services globally. Numerous studies amongst various medical and surgical specialties showed a reduction in patient attendance and surgical procedures performed. Prior published ophthalmic literature focused on specific types of procedures and were usually single centre. The current study attempts to quantify the impact on a larger scale, namely that of sub-Saharan Africa, and to include all ophthalmic subspecialties. Methods This is a retrospective analysis of the surgical records from 17 ophthalmology centres in seven countries located in East, Central, West and Southern Africa. The date of declaration of the first lockdown was used as the beginning of the pandemic and the pivot point to compare theatre records one year prior to the pandemic and the first year of the pandemic. We examined the total number of surgical procedures over the two year period and categorized them according to ophthalmic subspecialty and type of procedure performed. We then compared the pre-pandemic and pandemic surgical numbers over the two year period. Results There were 26,357 ophthalmic surgical procedures performed with a significant decrease in the first year of the pandemic (n = 8942) compared to the year prior to the pandemic (n = 17,415). The number of surgical procedures performed was lower in the first year of the pandemic compared to the year prior to the pandemic by 49% [Incidence rate ratio (IRR) 0.51, 95% CI 0.41–0.64), 27% (0.73, 0.55–0.99), 46% (0.54, 0.30–0.99), 40% (0.60, 0.39–0.92) and 59% (0.41, 0.29–0.57) in sub-Saharan Africa (4 regions combined), West, Central, East and Southern Africa, respectively]. The number of surgical procedures in the different sub-specialty categories in sub-Saharan Africa (4 regions combined) was significantly lower in the first year of the pandemic compared to the year prior to the pandemic, except for glaucoma (IRR 0.72, 95% CI 0.52–1.01), oncology (0.71, 0.48–1.05), trauma (0.90, 0.63–1.28) and vitreoretinal (0.67, 0.42–1.08) categories. Conclusion This study provides insight into the impact of the COVID-19 pandemic in multiple regions and countries on the African continent. The identification of which surgical subspecialty was most affected by the COVID-19 pandemic in each region allows for better planning and resource allocation to address these backlogs.

The purpose of the current study was to study the impact of dietary supplementation of various levels of vitamin E and inorganic selenium (Sodium selenite) on daily egg weight, egg mass and egg production, accumulative egg per hen per week, final body weight gain for males, and feed conversion in both males and females of Japanese quail birds (Coturnix coturnix japonica). The study was conducted in the nutritional laboratory at the Veterinary Techniques Department/ Kalar Technical Institute /Garmian Polytechnic University in the Iraqi Kurdistan region for eight weeks from Apr 15 2021 to Jul 15 2021. In this study 128 birds (12 weeks old) were employed, they were raised in a cage system, measuring 50 width inches x 60 lengths inches × 60 height inches. Four supplemented dietary treatments from the experimental birds were designed as different levels of food regimens, and then each treatment was subdivided equally into eight replicated cages. The used experimental diets were: 0 = the basal diet (control) with no additions, T1 = 1.0-gram vitamin E and selenium mixture/kg diet, T2 = 1.5-gram vitamin E and selenium mixture/kg diet, T3 = 2-gram vitamin E and Selenium mixture/kg diet. As a result of this study, egg production (HD%/week), egg accumulation (eggs per hen per week), egg mass (gram per day), feed intake (gram per day), and feed conversion ratio (kilogram feed per kilogram egg) were altered significantly (P0.01). In conclusion, it was shown that vitamin E and sodium selenite were effective supplementary nutrients for enhancing the reproductive performance of Japanese quail hens, so it is recommended to use this diet in different poultry farms in order to increase some productive and reproductive features levels. [AJVS 2024; 17(2.000): 95-104]

Abstract Recently, dolutegravir (DTG)-based combined therapy, a more effective and safer first-line antiretroviral therapy (ART), has been recommended by the World Health Organization for the treatment of Human Immunodeficiency Virus (HIV) since July 2018. However, its effectiveness in CD4+ T-cells count recovery and viral load suppression has not been studied yet in Ethiopia, where HIV is endemic. Therefore, we aimed to conduct a pilot assessment on the effect of DTG-based therapy on CD4+ T-cell count and viral load count among people living with HIV (PLWH) in Ethiopia. A longitudinal prospective cohort study was conducted from July 2020 to February 2021. 109 PLWH who are ART naive but plan to initiate DTG-based therapy were recruited. HIV viral ribonucleic acid (RNA) copies were determined using polymerase chain reaction. To compute the difference in viral load and CD4+ T-cell counts between the baseline, 3rd, and 6th months, a Friedman test was used. The study included 109 PLWH who had never received antiretroviral medication. Participants taking DTG-based treatment showed significantly decreasing median (IQR) values of viral load count (copies/mL) from 446,812 (237649.5–732994.5) at baseline to 34 (23.5–46) at 3 months and 0.0 (0–19) at 6 months of treatment follow-up. Although the treatment increases the proportion of participants with HIV-1 RNA 50 copies/mL from 0 (0% at baseline) to 87 (79.8%) and 100 (91.7%) at the 3rd and 6th months of treatment, respectively, On the other hand, the CD4+ T-cell count increased significantly during treatment: median (IQR): 209 (81.5–417.5) versus 291 (132–522) versus 378 (181–632.5) cells/L at baseline, the 3rd and 6th months of the treatment follow-up period, respectively. We found dolutegravir-based therapy was a promising option with high virological suppression rates and CD4+ T-cell count recovery, demonstrating a restoration of cellular immunity. Moreover, Viral load suppression rates were high after the initiation of the treatment. We recommend further research should be conducted with a larger number of participants to acquire greater awareness of the treatment outcomes.

The rise in the emphasis on oral diseases has elevated the need to automate the diagnostic process of such diseases. Fortunately, the availability of modern computing devices has made the automated diagnosis of teeth readily possible using deep learning. Despite this, concerns about the accuracy and function of automated diagnosis remain among patients. To showcase the performance of such algorithms, we propose two approaches for the task of teeth diagnosis utilizing Orthopantomograms (panoramic radiographs): 1) a direct classification approach; and 2) a hybrid approach that combines a deep learning model with a traditional classifier. The results revealed that all ten chosen deep learning models experienced a similar or improved performance when used in conjunction with a machine learning classifier. In particular, Vision Transformer (ViT) performed the best with a record accuracy of 96% using both the direct and hybrid approaches. However, the hybrid framework combining AlexNet with a Support Vector Machine achieved an accuracy of 94%, and although it falls short of ViT in terms of performance, it comprises far fewer parameters. This highlights the approach’s effectiveness in improving performance without the need to use a deeper model, making it well-suited for clinical adoption where efficiency is important.

Due to complex nature of metabolic pathways, E. coli metabolic model kinetic parameters are difficult to detect experimentally. Thus, obtaining accurate kinetic data for all reactions in an E. coli metabolic model is a technically-challenging process. So, Garra Rufa-inspired Optimization (GRO) Algorithm is applied to the primary metabolic network of E. coli as a model to estimate small-scale kinetic parameters and increase the kinetic accuracy. Also, the Differential Algebraic Equations (DAE) is used to represent the glycolysis, phosphotransferase system, pentose phosphate, the TCA cycle, gluconeogenesis, glyoxylate, and acetate production pathways of Escherichia coli in the metabolic network. Based on the behavior of the Garra Rufa fish, a route is modelled in which particles are sorted into groups and each group is guided by the best value. In addition, the fitness of the group leaders determines whether or not these particles are able to switch groups. In this study, experimental data was used to estimate seven kinetic parameters. However, the numerical results of The Relative Error (RE) and the Mean Error (ME) reveal that the observed and anticipated data are in line with the results. As a result of this new method, it was discovered that small-scale and even whole-cell dynamic models can be estimated accurately.

In this paper, we study the performance of the two-way relay network (TWRN) with NOMA-based transmission, where the information is exchanged during three time slots. To provide a fair comparison, we also examine the performance of a three-time-slot (3T) OMA-based transmission scheme. In the following, these schemes are referred to as 3T-NOMA-TWRN and 3T-OMA-TWRN. In the 3T-NOMA-TWRN scheme, each transceiver simultaneously transmits two symbols with different powers to exploit the multiplexing gain, implemented through the power-domain NOMA technique. The performance of both schemes is analyzed in terms of the outage probability, the ergodic sum-rate, and their asymptotic behaviors. The outage and rate performances of the schemes are enhanced by optimizing the power allocation coefficients, especially in the NOMA-based scheme. The proposed power allocation algorithm imposes negligible overhead because of considering the closed-form expressions of the outage probability and the ergodic sum-rate as the objective function. For the NOMA-based scheme, we propose sub-optimal power allocation strategies that closely approximate the optimal solution. The validity of the analytical results is confirmed by extensive numerical examples. The results show that the 3T-NOMA-TWRN scheme outperforms its OMA-based counterpart in terms of the outage probability and the ergodic sum-rate, especially in the high-rate and high-SNR regimes. Additionally, the 3T-NOMA-TWRN scheme significantly outperforms the existing two-time-slot (2T)-NOMA-TWRN scheme in the high-SNR regime. However, in the low-SNR regime, only in some cases, the situation changes in favor of the 2T-NOMA-TWRN scheme. Surprisingly, the performance of the 3T-OMA-TWRN scheme can significantly surpass that of the 2T-NOMA-TWRN scheme in certain situations, depending on the rate and SNR regimes and the network geometry. Furthermore, the 3T-NOMA-TWRN scheme significantly reduces the TWRN performance sensitivity to the location of relay node, which is a critical concern in both the 3T-OMA-TWRN and 2T-NOMA-TWRN schemes, especially in the latter case.

Abstract Background The prevalence of ischemic stroke (IS) caused by small-artery disease (SAD) is increasing recently. The present study aimed to report the risk factors, clinical presentations and outcome in patients presented with IS due to SAD with follow up for one year. The present study included 100 patients with IS due to SAD diagnosed on the basis of clinical and radiological findings. All patients were submitted to careful history taking, thorough clinical examination and standard laboratory work-up. Assessment of neurological functions was achieved using the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Cognitive functions were evaluated using Trail making test, Stroop color word test, Arithmetic test, Vocabulary test, Wechsler adult intelligence scale IV digit span forward assessment and backward assessment. Magnetic resonance imaging (MRI) was done using a standard 1.5 Tesla unit. According to radiological findings, patients were classified into three groups: GI (n = 40) with IS due to SAD, GII (n = 30) with IS due to SAD plus internal watershed infarcts and GIII (n = 30) with IS due to SAD plus large artery infarctions (n = 30). Results Comparison between the three groups regarding the reported risk factors identified significantly lower frequency of hyperlipidemia in GI patients as compared to GII and GIII patients (35.0% versus 60.0% and 66.7% respectively, p = 0.018). Clinically, it was shown that GI patients had significantly higher frequency of dizziness, dysphasia and tinnitus in comparison to the other two groups. It was also shown that those patients had significantly lower mean cortical thickness at the end of follow up (3.12 ± 0.9 versus 2.22 ± 0.8, p = 0.031). Finally, MRI brain volumetric study showed significantly decreased total cerebral cortical volume (TCCV) (589,456 ± 1689 versus 559,152 ± 1459) and total cerebral white matter volume (TCWMV) (521,546 ± 1785 versus 501,306 ± 1259) at the end of follow up. Conclusions Ischemic stroke caused by small artery disease is related to poor outcome with deterioration of cognitive functions.

Microbial Fuel Cell (MFC) is a promising technology for harnessing energy from organic compounds. However, the low power generation of MFCs remains a significant challenge that hinders their commercial viability. In this study, we reported three distinct modifications to the stainless-steel mesh (SSM), carbon cloth, and carbon felt electrodes using carbon powder (CP), a mixture of CP and ferrum, and a blend of CP with sodium citrate and ethanol. The MFC equipped with an SSM and CP anode showed a notable power density of 1046.89 mW.m-2. In comparison, the bare SSM anode achieved a maximum power density of 145.8 mW m-2. Remarkably, the 3D-modified SSM with a CP anode (3D-SSM-CP) MFC exhibited a substantial breakthrough, attaining a maximum power density of 1417.07 mW m-2. This achievement signifies a significant advancement over the performance of the unaltered SSM anode, underscoring the effectiveness of our modification approach. Subsequently, the 3D-SSM-CP electrode was integrated into single-chamber MFCs, which were used to power a LoRaWAN IoT device through a power management system. The modification methods improved the MFC performance while involving low-cost and easy fabricating techniques. The results of this study are expected to contribute to improving MFC's performance, bringing them closer to becoming a practical source of renewable energy.

The evaluation of publication growth is a vital indicator to assess any branch of knowledge. The present study aimed to investigate the Scopus-indexed publications on orthodontics produced by the Arab League Nations in the last two decades (2002–2021). Quantitative research method based on bibliometric analysis has been used and the meta-data for the study was retrieved from Elsevier's Scopus database on November 14, 2022. The bibliographic description of all types of literature published on orthodontics from 2002 to 2021 by the authors affiliated with the Arab countries has been downloaded. The selected bibliometric indicators of the data were analyzed by using Microsoft Excel, VOSviewer and SPSS software. The Arab League Nations contributed 5.02 % to global orthodontic research. This segment has demonstrated an amazing escalation of documents from a global perspective between 2002 and 2021 from 1.24 % to 10.94 %. Slightly more than 60 % of documents were published during the last five years of study (2017–2021). The highest number of documents (41 %) was produced by Saudi Arabia, whereas documents contributed by Jordan gained the maximum citation impact. The majority of collaboration was done with the United States, but documents produced in collaboration with Turkey gained the highest citation impact. The paper highlighted that the share of Arab League Nations in orthodontic research has been growing, and Saudi Arabia emerged as the most productive country. The constructive evolution of orthodontic literature with international collaboration display an ambitious approach by Arab countries.

BackgroundTime management is a widely ignored concern in all types of organizations, including the healthcare system, despite its crucial role in the achievement of personal and organizational goals. Therefore, determining the practice of time management and its associated factors among health professionals is of paramount importance.ObjectiveWe aimed to assess time management practice and associated factors among health professionals working in public and private hospitals in Dessie City, Northeast Ethiopia.MethodsA comparative cross-sectional study was conducted from 24 March to 24 April 24 2021 among 660 health professionals (220 from private hospitals and 440 from public hospitals), who were randomly selected using a stratified sampling technique. A self-administered questionnaire was used to collect data. A multivariable binary logistic regression model was run separately for public and private hospitals. A p-value of < 0.05 and a 95% confidence interval were reported to be statistically significant.ResultsA total of 615 participants responded to the survey, which resulted in a response rate of 93.2%. The magnitude of good time management practice among health professionals in both public and private hospitals was reported to be 57.1% (95% CI: 53.5–60.8%). However, the magnitude differed between public [50.1% (95% CI:45.5–54.7%)] and private hospitals [70.9% (95% CI: 63.5–76.7%)]. Living with families (AOR: 5.39, 95% CI: 1.84–15.77), satisfaction with compensation and benefits (AOR: 7.83, 95% CI: 1.97–31.16), satisfaction with work autonomy (AOR: 7.10, 95% CI: 1.94–25.95), and having a good plan (AOR: 3.42, 95% CI: 1.15–10.13) were statistically significant predictors of time management practice in private hospitals. Satisfaction with an organizational policy and strategy (AOR: 2.34, 95% CI: 1.25–4.36), performance appraisal (AOR: 1.95, 95% CI: 1.13–3.36), work autonomy (AOR: 1.92, 95% CI: 1.12–3.27), and the good approach of employees toward time (AOR: 2.12, 95% CI: 1.26–3.58) were statistically significant predictors of time management practice in public hospitals.ConclusionThe magnitude of a good time management practice in public and private hospitals in the study area was low. The practice was observed to be higher in private hospitals than in public hospitals. The study revealed that the magnitude and associated factors of time management practice vary between hospitals, indicating the need for targeted intervention.

The Last Planner System (LPS) is a production planning and control system based on Lean Construction (LC) principles. Effectively implementing the LPS in the construction industry remains challenging, impeding the realization of LC principles. Automation of planning and control in the LPS has gained attention to address this challenge. However, research exploring the state-of-the-art of such automation and its impacts on realizing LC principles is still lacking. Therefore, this study performed a systematic literature review of 112 relevant studies, identifying 50 functionalities and associated benefits of automation across six LPS stages, with the lookahead planning stage having the maximum functionalities. Analyzing their interactions with LC principles revealed that automated planning and control in the LPS can support achieving ten LC principles. Future research directions are suggested in areas such as constraint management, knowledge reuse, dynamic replanning, and construction workforce training.

Abstract Background Sensitive, robust, and fast point-of-care tests are needed for cutaneous leishmaniasis (CL) diagnosis. The recently developed CL Detect rapid test (InBios) for detecting Leishmania peroxidoxin antigen has been evaluated in several studies. However, diagnostic performances were controversial. Therefore, this systematic review and meta-analysis aimed to determine the pooled sensitivity and specificity of CL Detect for CL diagnosis. Methods PubMed, Scopus, EMBASE, ScienceDirect, and Google Scholar were sources of articles. We included studies reporting the diagnostic accuracy of CL Detect and CL-suspected patients in the English language. The methodological qualities of the included studies were appraised using the quality assessment of diagnostic accuracy studies-2 (QUADAS‐2). Meta-analysis was conducted using Stata 14.2 and R software. Results A total of 9 articles were included. The study sample size ranged from 11 to 274. The sensitivities of the individual studies ranged from 23 to 100%, and the specificities ranged from 78 to 100%. Pooled sensitivity and specificity were 68% (95% CI, 41–86%) and 94% (95% CI, 87–97%), respectively. AUC displayed 0.899. Pooled sensitivity was lower (47%, 95% CI, 34–61%) when PCR was used as a reference than microscopy (83%, 95% CI, 39–97%). Pooled sensitivity was lower (48%, 95% CI, 30–67%) for all lesion durations compared to ≤ 4 months (89%, 95% CI, 43–99%). Conclusions CL Detect has poor sensitivity and does not meet the minimal sensitivity of 95% of target product profiles designed for CL point-of-care tests. Currently, the CL Detect test looks unsuitable for CL diagnosis, despite its high specificity. Findings are limited by the low number of studies available. Further large-scale studies are recommended. Systematic review registration PROSPERO CRD42022323497.

The railway is one of the cheapest methods to transport people and heavy goods. It is safer than highways. In Iraq, many railways connect the south country with the middle and north, which are old, damaged, and need to continued maintenance. Iraq needs to construct new lines of the rail track with low-cost, less maintenance, and highly stable structure, which requires understanding the behavior of rail track under train loads and the pattern of distribution of deformations, stresses, and strains inside the body of rail track and know the layer which more effected by changing the strength of ballast layer by change modulus of elasticity of it. This paper investigates the influence of modulus of elasticity of the ballast layer on the behavior of railways and the positions of deformation, stresses, and strains in the rail track which is most affected by the change in the modulus of elasticity and the value of the effect. The finite element approach was considered in this study using Abaqus Ver. 6.14-4 program. The investigation outcomes displayed that when the ballast layer’s modulus of elasticity E increase by 100 MPa, the value of deformation in the rail track is affected in all layers, and the value of decreased is 6.8 % for rail, 6.9 % for ballast, and 6.7 % for the sub-ballast layer. Therefore the strain of the sub-ballast layer is affected by the change modulus of elasticity of the ballast layer more than other ballast and subgrade. Also, the result shows that stresses in the rail are the only part of the rail track affected by the change in the ballast layer’s modulus of elasticity E, while the other layers are unaffected. So the increase in E of the ballast layer affects the layer beneath it, which is the sub-ballast layer.

The study analyzed the psychometric properties of business studies achievement test for senior secondary schools in Nigeria. One research question guided the study. The study adopted an instrumentation design. The area of the study was Anambra State. The population of the study consists of all 23,077 students and 586 business studies teachers in two hundred and sixty-one senior secondary schools in Anambra State. Taro Yamane formula was used to determine the sample size of the study, which is 630 made up of 393 students in SS1 and 238 business studies teachers in Anambra State. A multi-stage sampling procedure involving two stages was adopted for this study. Proportionate stratified and purposive sampling techniques were employed at the first and second stages respectively. Items were subjected to item analysis to determine the difficulty and discriminatory indices. The study revealed that 125 items were found to be appropriate for inclusion in the business studies achievement test, these test's items met the criteria for item difficulty index and item discrimination. Based on the findings of the study it was recommended that teachers of business studies like commerce, accounting, and office practice among others should employ the created business studies Achievement Test. The BSAT items should be used as a model when creating other accomplishment exams for senior secondary schools in business studies.

The estimation of carbon dioxide emissions in relation to the life cycle of road pavements is pivotal to quantify their sustainability at the design stage. This preliminary study assesses the carbon budgets concerning the production of aggregates and asphalt to build a new roadway stretch located close to Oslo (Norway), leveraging digital tools and environmental product declarations. First, the software Trimble Novapoint estimates the necessary quantity take-offs. Afterwards, the amounts of CO2 generated during the production of the construction materials are appraised for the four main industries operating nearby. The results based on the corresponding environmental product declarations indicate that the carbon budgets show very small discrepancies among the considered suppliers.

The physical properties of crystalline compounds are highly essential for predicting their applications in various nanodevices. Density functional theory is very useful in that regard. Herein, some physical properties such as structural stability, and electronic, optical and mechanical properties of two-phase bulk WSe2 have been comparatively investigated by first principle calculations. Band structure calculations elucidate that the materials are indirect band gap semiconductors having band gap energy in the range 1-1.5 eV. It was observed that the hexagonal crystal has higher absorption coefficients compared to the trigonal phase. Analysis of elastic constants of the materials carried out using the Born criteria method indicates that all systems are mechanically stable at room temperature. Our findings are in close agreement with the previous experimental and theoretical results, this further suggests that the materials are promising in optoelectronics applications.

Abstract Mathematical modeling of the emergent dynamics of gene regulatory networks (GRN) faces a double challenge of (a) dependence of model dynamics on parameters, and (b) lack of reliable experimentally determined parameters. In this paper we compare two complementary approaches for describing GRN dynamics across unknown parameters: (1) parameter sampling and resulting ensemble statistics used by RACIPE (RAndom CIrcuit PErturbation), and (2) use of rigorous analysis of combinatorial approximation of the ODE models by DSGRN (Dynamic Signatures Generated by Regulatory Networks). We find a very good agreement between RACIPE simulation and DSGRN predictions for four different 2- and 3-node networks typically observed in cellular decision making. This observation is remarkable since the DSGRN approach assumes that the Hill coefficients of the models are very high while RACIPE assumes the values in the range 1-6. Thus DSGRN parameter domains, explicitly defined by inequalities between systems parameters, are highly predictive of ODE model dynamics within a biologically reasonable range of parameters.

Climate change impacts are posing greater risks to biodiversity, food security, and livelihood in Africa, specifically in arid and semi-arid environments. In Ethiopia, the genus Balanites Del., which belongs to the monogeneric family called Balanitaceae, has the multipurpose B. aegyptiaca and B. rotundifolia. However, these species are overlooked and endangered by climate change, and their species distributions are not well documented and understood in Ethiopia. Therefore, this study aimed to model the habitat suitability of these two species using current occurrence data, climate, and landscape data and predict their distribution under climate change. Occurrence points of B. aegyptiaca (n = 224) and B. rotundifolia (n = 80) were collected from field surveys and herbarium. Bioclimatic (WorldClim.v2), soil, and landscape variables were used in the ensemble species distribution models (SDMs) using six algorithms (GLM, GAM, BRT, RF, MARS, and SVM). The ensemble SDMs under the current climate showed that the Central Ethiopian Rift Valley is highly suitable habitats for B. aegyptiaca accounting for an area of 114,517 km2, and the Southern Ethiopian Rift Valley is highly suitable habitats for B. rotundifolia accounting for an area of 41,373 km2. The performance of ensemble SDM under the current climate for B. aegyptiaca showed 0.95 AUC, 0.80 TSS, 0.79 COR, and 0.87 deviance; and that of B. rotundifolia with 0.90 AUC, 0.80 TSS, 0.80 COR, and 0.50 deviance. Temperature annual range (Bio07) and precipitation seasonality (Bio15) for B. aegyptiaca; and precipitation of driest quarter (Bio17) and annual precipitation (Bio12) for B. rotundifolia are the most key bioclimatic variables that affect their distributions. The ensemble SDMs under SSP2-45 and SSP5-85 (HadGEM3-GC31-LL) climates showed that the highly suitable areas will remain suitable for both species (B. aegyptiaca with 116,934 km2 area cover (ΔA = +2.1%) and 125,757 km2 area cover (ΔA = +7.5%) and B. rotundifolia with 29,547 km2 area cover (ΔA = −28.6%) and 50, 894 km2 area cover (ΔA = +23%), respectively). The findings of this study implicated that the Ethiopian Rift Valley region in general for B. aegyptiaca and the Southern Rift Valley of Ethiopia for B. rotundifolia are suitable areas for conservation and sustainable use of the species.

Background Diagnosing hospital-acquired pneumonia (HAP) (ventilator-associated pneumonia (VAP) and non-ventilator associated pneumonia (Non-VAP)) is still a hot issue. Soluble urokinase plasminogen activator receptor (suPAR) is prognostic in critically ill children with sepsis regarding mortality prediction. Our aim was to evaluate suPAR levels in children with HAP.Methods An observational, prospective study was conducted on 45 children diagnosed HAP (VAP and Non-VAP) and 40 healthy controls. Paediatric Sequential Organ Failure assessment Score (pSOFA) was assessed for each patient. Plasma suPAR levels were measured with ELISA on the day of diagnosis.Results On comparison levels of plasma suPAR for the children with HAP with the healthy control group, no statistically significant difference was observed (148 pg/mL (22.4–1939.7) and 184.4 pg/mL (31.6–1311.7), respectively, (p=0.32). suPAR was significantly increased in children with elevated pSOFA score on the day of diagnosis of pneumonia (p=0.034). suPAR was significantly increased in children with shock (p=0.005). suPAR levels was negatively correlated with oxygen saturation (rs=0.31,p=0.048). suPAR was not significantly correlated with C reactive protein.Conclusions suPAR can be used as a predictor for severity of illness in children with HAP. We firmly know that plasma suPAR, a novel marker, could indicate the disease if carried out on larger patient groups.

This study was conducted to determine the pathological findings and molecular investigation of bacteria flora associated with the lesions in the lungs and livers of goats slaughtered for public consumption at the Ilorin, abattoir. A total of 450 samples (240 lungs and 210 livers) were collected and examined from goats slaughtered at the Ipata slaughterhouse in Ilorin, Kwara State. Of this number, 58 (24.17%; 95% CI = 19.19–29.96) lungs and 17 (8.10%; 95% CI = 5.17–12.58) livers revealed gross and microscopic pathological lesions as a result of bacterial pathogens. Based on gross examination, lung lesions were categorized into bronchopneumonia (27.59%), congestion (22.41%), interstitial pneumonia (17.24%), hemorrhages (13.77%), emphysematous (10.34%), and hyperemia (8.62%). In the liver, hepatic congestion 8 (47.06%) was the most observed gross lesion. Others included hepatic enlargement (29.41), hepatic fibrosis (17.65%), and hepatic abscess (5.88%). The molecular investigation revealed lung pathological lesions were as a result of Klebsiella species (51.72%) and Bacillus species (48.28%), while Escherichia species (52.94%) and Salmonella species (47.06%) were detected in the liver. The molecular analysis showed that the bacteria organisms detected in this study did not fully cluster with similar species from other parts of the world. The infection caused by these bacteria showed histopathological lesions in the lungs and livers. There is need for more studies to further characterize these bacteria species detected from Red Sokoto breeds of goats in-depth.

Photovoltaic (PV) system reliability and durability investigations are essential for industrial maturity and economic success. Recently, PV systems received much interest in Iraq due to many reasons—for instance, power shortage, global warming and pollution. Despite this interest, the precise economic implications of PV system reliability in harsh climates like Iraq remain uncertain. This work assesses the economic implications of PV system component reliability and soiling in Iraq using field experience and historical data. This study identifies the most common failure modes of PV systems installed in Iraq and similar climatic regions, and also ranks their severity. Simulations explore scenarios of PV module degradation rates, inverter lifetimes, soiling rates, and cleaning intervals, revealing that soiling has the most detrimental effect, with cleaning frequency leading to Levelized Cost of Electricity (LCOE) losses of over 30%, depending on the location. Inverter lifetime contributes to LCOE losses between 4 and 6%, depending on the PV system’s location. This study also evaluates the impact of tilt angle as a mitigation strategy for reducing soiling loss and its economic implications, finding that installing PV modules at higher tilt angles could reduce the economic impact of soiling by approximately 4.4%. Additionally, the optimal cleaning strategy identified is fully automated dry cleaning with robots, outperforming other strategies economically. Overall, the findings highlight that the LCOE in Iraq is relatively high compared to the global weighted average for utility-scale PV systems, primarily due to high soiling and degradation rates. The LCOE varies within the country, influenced by different degradation rates. This study aims to assist PV stakeholders in Iraq and the Middle East and North Africa (MENA) region in accurately estimating solar bankability; moreover, increasing reliability by minimizing the technical and financial risks by considering key parameters specific to these regions.

AbstractCredit risk in financial institutions has been widely debated among experts and legislators as a substantial risk to the financial industry’s health. In addition to examining bank-specific and macroeconomic reasons, the study examines the impacts of political institutions and macroprudential regulations on credit risk in Ethiopia. Using panel data from 2011–2019 and employing dynamic ordinary least squares, the findings imply that political institutions have significant positive links to credit risk. It also found that macroprudential policy helps to control bank risk and reduce exposure in the banking industry. The results indicate that banks with larger sizes and profitability have less credit risk. The findings support the’skimping’ and “dark side of diversification” hypotheses; retaining a higher loan-to-asset ratio, cost-effectiveness, and diversity of the banking commercial model reduces credit quality by promoting credit risk. A higher inflation rate reduces credit risk by increasing borrowers’ potential to service their debts when lending rates are fixed. GDP and the exchange rate have little influence on credit risk. The outcomes of this study provide significant implications for authorities and bankers in developing countries such as Ethiopia in the understanding of credit risk-determining elements to implement prudential rules and remedial management policies.

Abstract Background and Aims This study aimed to understand the relationship between body mass index (BMI), diabetes and hypertension history, and other risk of hypertension among Ghanaians. Methods The BMI data are categorized according to the World Health Organization (WHO) definition. The data were obtained from the WHO Study on global AGEing and adult health (WHO SAGE) Ghana Wave 2. Descriptive statistics were used to summarize the variables, and the association between these variables and hypertension was assessed using the χ². Multivariable logistic regression was used to examine the relationship between hypertension and different BMI levels and other variables. Results Obesity class II individuals have about a 4‐fold higher risk of developing hypertension compared to underweight individuals. Obesity class III, class I, and preobesity individuals have approximately a 3‐fold higher risk. Normal weight is associated with increased hypertension risk. Both males and females show a significant increase in hypertension risk across all BMI categories. History of hypertension is linked to a 2.2‐fold increased risk. Diabetes history is associated with hypertension when considering other factors. Elevated hypertension risk is observed among married, divorced, and widowed males then never married males. Only widowed females showed an increased risk. Older age significantly increases hypertension risk, particularly in females. Vegetable servings reduce hypertension risk, while fruit servings are associated with an increased risk. Vigorous exercise increases hypertension risk, particularly in females. Conclusion Regular check‐ups are recommended for married, divorced, and widowed males, focusing on blood pressure (BP) levels. Regular exercise from young age helps lower BP in later years. Individuals with a history of hypertension should follow BP control measures. Encouraging the consumption of the right combination of vegetables and fruits can help lower BP. Female tobacco smoking should be strongly discouraged due to a 54% increased risk of developing hypertension.

[This corrects the article DOI: 10.1371/journal.ppat.1011461.].

Purpose – The impact of diversification on bank stability and risk remains an ongoing topic of discussion with inconclusive results. Hence, this study investigated the implications of income diversification on bank stability within African markets. Design/methodology/approach – The study utilised longitudinal financial data on 45 countries from 2000 to 2017 and employed static and dynamic panel model estimation. Findings – The results of the study suggest income diversification technique could improve financial stability throughout typical and crisis periods which validate portfolio management theory. The study also confirms the “too big to fail” hypothesis, extensive diversifying over an optimal range negatively impacts stability. Banks with a high level of liquidity, a higher operating efficiency and a larger deposit ratio become more resilient. Banking capital regulations found to be the appropriate monitoring instrument for lowering risks and maintaining stability. However, profitability was found to have a positive effect on bank risk-taking. The finding also suggests that political institutions have substantial, direct implications that are positively related to bank fragility. Macroeconomic factors such as gross domestic product (GDP) growth and inflation also influenced bank stability. Practical implications – This study has important implications for bankers, regulators and academicians concerned about the effect of diversification on a bank’s risk-taking or stability in developing economies. Originality/value – To the best of the author’s knowledge, this is the first study on Africa to analyse the quadratic influence of income diversification and the effects of political institutions on the level of bank stability.

Rationale: Noma and necrotizing fasciitis are rapidly destructive gangrenous infections with different patterns of spread. This study aimed to present a case of concurrently occurring noma and necrotizing fascitis in a 3-year-old child. Patient Concern: A 3-year-old child with a low socioeconomic background presented with a main complaint of a painful wound on the gum, upper lip, and chest region. Diagnosis: Thorough history and examination revealed simultaneously occurring noma lesion extending from the inner labial mucosa to the upper lip and NF on the chest region on background anemia and malnutrition. Intervention: The patient was successfully treated with antibiotics, serial wound debridement, and supportive therapy. Outcome: The length of hospital stay was 6 weeks and there was uneventful healing. The patient is being followed up for complete resolution. Lessons: In this study, noma and NF were found to occur concurrently in a patient with malnutrition and anemia and Klebsiella species were the isolates in both wounds and could have been the common causative agent for both.

In this study, we evaluated the impact of viral variant, in addition to other variables, on within-host viral burden, by analysing cycle threshold (Ct) values derived from nose and throat swabs, collected as part of the UK COVID-19 Infection Survey. Because viral burden distributions determined from community survey data can be biased due to the impact of variant epidemiology on the time-since-infection of samples, we developed a method to explicitly adjust observed Ct value distributions to account for the expected bias. By analysing the adjusted Ct values using partial least squares regression, we found that among unvaccinated individuals with no known prior exposure, viral burden was 44% lower among Alpha variant infections, compared to those with the predecessor strain, B.1.177. Vaccination reduced viral burden by 67%, and among vaccinated individuals, viral burden was 286% higher among Delta variant, compared to Alpha variant, infections. In addition, viral burden increased by 17% for every 10-year age increment of the infected individual. In summary, within-host viral burden increases with age, is reduced by vaccination, and is influenced by the interplay of vaccination status and viral variant.

Key Clinical Message Intussusception is the telescoping or invagination of the proximal part of the gastrointestinal tract into an adjacent section. It is rare in adults, accounting for 1% of adult bowel obstruction. Adult presentation of intussusception is variable, with nonspecific, vague symptoms like abdominal pain, nausea, vomiting, and rectal bleeding. Abdominal computed tomography (CT) scans have the highest sensitivity in the diagnosis of intussusception. The classical findings of intussusception are the target sign and mesenteric vessels lined within the bowel lumen. An abdominal CT scan can reveal a cloverleaf figuration, fluid‐filled ileal loops, superior mesenteric venous (SMV) occlusion, and concerns about ongoing sealed perforation or fistulization. Our patient is an 86‐year‐old female who was diagnosed with a jejunal–jejunal long‐segment intussusception, gastro‐enteric fistula, and SMV occlusion with distal reconstitution. The patient responded well to conservative treatment and was discharged for follow‐up.

The importance of each person's healthcare should be viewed as fundamental in the modern world due to the rise in various health issues. A decrease in the proportion of doctors is caused by an increase in the number of cases. The diagnosis is consequently delayed, or some patients are overlooked. As a result, people become more reliant on doctors for checkups. In order to retain each patient's digital identification, in light of all these worries, health and medical care systems have begun to connect and interact with the internet of things (IoT). Many health disorders in the healthcare system go undiagnosed resulting from a shortage of doctors and other medical experts, as well as a lack of access to healthcare services. These IoT-based healthcare options, on the other hand, have made it possible for patients and medical professionals to continuously track and analyze patient data. In this study, IoT for healthcare systems is discussed. These included applications, structures, and potential design snags and issues. It has been demonstrated that these systems could be very beneficial to people, especially during the (Covid-19) pandemic's global isolation and the growing challenges in treating patients intelligently. This paper also presents a survey study on the use of IoT in smart healthcare, its applicability, the future directions for its development, and a review of past researchers' applications.