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Haftom Temesgen Abebe,1,2 Yibrah Berhe Zelelow,3 Afework Mulugeta Bezabih,4 Mengistu Mitiku Ashebir,5 Getachew Redae Tafere,6 Alem Desta Wuneh,5 Medhanie Gebresilassie Araya,7 Nguse Kahsay Kiros,8 Molla Kahssay Hiluf,9 Mohamedawel Mohamedniguss Ebrahim,10 Tesfay Gebregzabher Gebrehiwot,5 Abadi Leul Welderufael,11 Abrahim Hassen Mohammed12 1Department of Biostatistics, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Laboratory Interdisciplinary Statistical Data Analysis, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Department of Obstetrics and Gynecology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 4Department of Nutrition, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 5Department of Health System, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 6Department of Environmental and Behavioral Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 7Department of Ear, Nose and Throat, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 8Tigrai Institute of Policy Studies, Mekelle, Ethiopia; 9Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia; 10Department of Surgery, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 11Department of Pediatric and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 12Tigrai Health Bureau, Mekelle, EthiopiaCorrespondence: Haftom Temesgen Abebe, Department of Biostatistics, College of Health Sciences, Mekelle University, P.O. Box 1871, Mekelle, Ethiopia, Email haftoma@gmail.comBackground: COVID-19 is one of the leading causes of morbidity and mortality and is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). A patient infected with SARS-CoV-2 is said to be recovered from the infection following negative test results and when signs and symptoms disappear. Different studies have shown different median recovery time of patients with COVID-19 and it varies across settings and disease status. This study aimed to assess time to recovery and its predictors among severely ill COVID-19 patients in Tigray.Methods: A total of 139 severely ill COVID-19 patients who were hospitalized between May 7, 2020 and October 28, 2020 were retrospectively analyzed. Cox proportional hazard regression model was fitted to identify the risk factors associated with the time duration to recovery from severe COVID-19 illness.Results: The median age of the patients was 35 years (IQR, 27– 60). Eighty-three (59.7%) patients recovered with a median time of 26 days (95% CI: 23– 27). The results from the multivariable analysis showed that the recovery time was lower for severely ill patients who had no underline comorbidity diseases (AHR=2.48, 95% CI: 1.18– 5.24), shortness of breath (AHR=2.08, 95% CI: 1.07– 3.98) and body weakness (AHR=2.62, 95% CI: 1.20– 5.72). Moreover, COVID-19 patients aged younger than 40 years had lower recovery time compared to patients aged 60 and above (AHR=4.09, 95% CI: 1.58– 10.61).Conclusion: The median recovery time of severely ill COVID-19 patients was long, and older age, comorbidity, shortness of breath, and body weakness were significant factors related with the time to recovery among the severely ill COVID-19 patients. Therefore, we recommended that elders and individuals with at least one comorbidity disease have to get due attention to prevent infection by the virus. Moreover, attention should be given in the treatment practice for individuals who had shortness of breath and body weakness symptoms.Keywords: COVID-19, comorbidity, cox proportional hazard regression, adjusted hazard ratio

Ali Haider Mohammed,1 Bassam Abdul Rasool Hassan,2 Abdulrasool M Wayyes,2 Sinan Subhi Farhan,3 Omar Abdulwahid Al-Ani,2 Ali Blebil,1 Juman Dujaili,1 Gamil Othman4 1School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500, Selangor, Malaysia; 2Department of Pharmacy, Al Rafidain University College, Baghdad, 10001, Iraq; 3Department of Anesthesia, College of Medical Science Technology, University of Mashreq, Baghdad, 10001, Iraq; 4Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana’a, YemenCorrespondence: Gamil Othman, Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana’a, Yemen, Email gamilqasem@yahoo.comBackground: Due to the COVID-19 global pandemic, the educational sector has undergone a series of changes which have affected both learners and students alike. As a result, the distortion of the students’ daily routine, isolation, social distancing and potential exposure to the COVID-19 virus changed almost all of the aspects of student life which has led to exhaustion of students, with both psychological and emotional challenges. Therefore, the main aim of this study is to determine the factors that have a significant impact on the level of lockdown fatigue among university students in the era of COVID-19.Methods: A cross sectional was undertaken for this study. A questionnaire was designed and then shared electronically with the respondents of this study. The respondents were 819 students from tertiary institutions in Iraq. Some of the scales used in ranking the responses of the participants are the Lockdown Fatigue scale, Brief Resilience Scale and Coping Behaviours questionnaire. Data analysis was.Results: Overall, the students had a high level of fatigue due to lockdown-measurement. Emptiness was one of the dominant feelings experienced by the students, along with concern for the safety and well-being of their own families. There was general agreement that students take a long time to return to normal routines after stressful events. The students also indicated that they cope with the lockdown through a variety of activities, ranging from making jokes about the situation to putting their faith in a higher power. Male student were less likely to suffer from lockdown-fatigue, however, studying in public university, being from urban areas, and studying in science field are the most significant factors that increase the level of lockdown. However, lower levels of lockdown fatigue were linked to significantly higher levels of personal resilience and coping abilities.Conclusion: High level of lockdown fatigue among students is noticed, and several factors have been identified. Therefore, it is helpful for students to consistently work on reinforcing positive habits which would help them to build resilience when they are subjected to stressful conditions and scenarios.Keywords: lockdown, COVID-19 pandemic, personal resilience, coping behaviours

Muhammed Hassan Nasr,1 Bassam Abdul Rasool Hassan,2 Noordin Othman,3 Mahmathi Karuppannan,4 Noorizan binti Abdulaziz,5 Ali Haider Mohammed,2,6 Mohammed Ahmed Alsarani,7 Mohammed Husain Eskembaji,7 Abdelmannan Mohamed Aman,8 Gamil Othman9 1Clinical Pharmacy Department, Faculty of Health Sciences and Nursing, Al-Rayan Colleges, Al-Madinah Al-Munawarah, Saudi Arabia; 2Department of Pharmacy, Al Rafidain University College, Baghdad, 10001, Iraq; 3Quality Use of Medicines in Umrah and Hajj Pilgrimage Research Group, Department of Clinical and Hospital Pharmacy, Faculty of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia; 4Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, 42300, Selangor, Malaysia; 5Clinical Pharmacy Department, Faculty of Pharmacy, Management and Science University, Shah Alam, Malaysia; 6School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500, Selangor, Malaysia; 7Laboratory Department, Medical Care Unit, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia; 8Family Medicine Department, Medical Care Unit, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia; 9Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana’a, YemenCorrespondence: Gamil Othman, Email gamilqasem@yahoo.comBackground: The link between the risk of type 2 diabetes mellitus (T2DM) and vitamin D deficiency has perplexed the medical society due to the controversy in the data available. Saudi Arabia (SA) is a sunny region; however, ample amount of data reported the increased prevalence of vitamin D deficiency along with T2DM. Thus, this study aimed to compare vitamin D deficiency between healthy and T2DM patients in SA, alongside with the risk factors associated with that.Methods: A cross-sectional study was conducted in the Medical Unit, Taibah University in Al-Madinah Al-Munawarah, SA, from November 2017 to May 2018. The involved participants were non-diabetics and T2DM men. Measuring vitamin D for T2DM and non-diabetics group was done by trained technicians. Data analysis was done via SPSS.Results: Sixty-four participants (T2DM group = 32; non-diabetics group = 32) were recruited, and the mean age of T2DM patients was 48.6 ± 10.4, while that of the non-diabetics was 42.4 ± 6.5. The mean of vitamin D level was found higher in the non-diabetic participants than in diabetic patients. There was statistically significant association between vitamin D deficiency and T2DM (P = 0.001). Besides, duration of diabetes was the only factor, found to be positively correlated with vitamin D deficiency in T2DM patients.Conclusion: Early screening for vitamin D serum-level is recommended for T2DM patients in Saudi Arabia. Therefore, early correction of vitamin D levels should be considered, and medical and scientific societies, along with other sectors such as the media, should highlight and increase the awareness of the importance of vitamin D and the seriousness of its deficiency.Keywords: T2DM, vitamin D deficiency, Saudi Arabia

Ali Qais Blebil,1,2 Juman Abdulelah Dujaili,1,2 Ali Haider Mohammed,1,2 Kaeshaelya Thiruchelvam,3 Shaun Lee,1 Ramadan Elkalmi,4 Yee Chang Soh,5 Audrey Yong,6 Rohullah Roien7 1School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; 2Department of Pharmacy, Al Rafidain University College, Baghdad, 10001, Iraq; 3School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia; 4Department of Pharmacology, Faculty of Medicine, Sabha University, Sabha, Libya; 5Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia; 6Faculty of Pharmacy, Mahsa University, Selangor, Malaysia; 7Medical Research Centre, Kateb University, Kabul, 1004, AfghanistanCorrespondence: Rohullah RoienMedical Research Centre, Kateb University, Kabul, 1004, Afghanistan, Tel +93 785454093, Email rohullahroien@kateb.edu.afIntroduction: There is a predicted growth of up to 17% in an older adult of Malaysian above 60 years of age by 2040. This will increase the workload of almost every healthcare provider to ensure optimal geriatric care.Purpose: This study aimed to assess pharmacy students’ knowledge and attitudes towards geriatric pharmacy education and older patients to determine their preparation in delivering appropriate medical care to the geriatric population.Methods: Self-administered questionnaires were distributed among pharmacy students in different Malaysian universities. The survey included several sections to assess multiple aspects such as sociodemographic information, assessment of knowledge using a validated 28-item Geriatric Knowledge Assessment Scale (GKAS), and attitudes towards geriatrics education.Results: The response rate was around 70% of the respondents. The mean (± standard deviation) age of the cohort was 22.28 (± 1.12) years. Despite around 78% of pharmacy students claiming that their knowledge of geriatric care is adequate, their GKAS score showed that only around 20% have high geriatric knowledge. Around 80% of them showed a positive attitude on the importance of taking courses focused on geriatric care and demonstrated interest to further knowledge and training in geriatric care. However, more than half of the students were uncertain of their answers towards their attitudes regarding older patients.Conclusion: Given the growing role of pharmacists in the ageing population, this study highlights the importance of geriatric care education among potential pharmacists. Therefore, we urge the need to improve/develop geriatrics education and training into the pharmacy curriculum to ensure sufficient preparation for actual practice after graduation.Keywords: geriatric care, older adult, pharmacy students, knowledge, attitude, Malaysia

A robust control algorithm for tracking a wheeled mobile robot navigating in a pre-planned path while passing through the road’s roundabout environment is presented in this article. The proposed control algorithm is derived from both the kinematic and dynamic modelling of a non-holonomic wheeled mobile robot that is driven by a differential drive system. The road’s roundabout is represented in a grid map and the path of the mobile robot is determined using a novel approach, the so-called laser simulator technique within the roundabout environment according to the respective road rules. The main control scheme is experimented in both simulation and experimental study using the resolved-acceleration control and active force control strategy to enable the robot to strictly follow the predefined path in the presence of disturbances. A fusion of the resolved-acceleration control–active force control controller with Kalman Filter has been used empirically in real time to control the wheeled mobile robot in the road’s roundabout setting with the specific purpose of eliminating the noises. Both the simulation and the experimental results show the capability of the proposed controller to track the robot in the predefined path robustly and cancel the effect of the disturbances.

A novel technique called laser simulator approach for visibility search graph-based path planning has been developed in this article to determine the optimum collision-free path in unknown environment. With such approach, it is possible to apply constraints on the mobile robot trajectory while navigating in complex terrains such as in factories and road environments, as the first work of its kind. The main advantage of this approach is the ability to be used for both global/local path planning in the presence of constraints and obstacles in unknown environments. The principle of the laser simulator approach with all possibilities and cases that could emerge during path planning is explained to determine the path from initial to destination positions in a two-dimensional map. In addition, a comparative study on the laser simulator approach, A* algorithm, Voronoi diagram with fast marching and PointBug algorithms was performed to show the benefits and drawbacks of the proposed approach. A case study on the utilization of the laser simulator in both global and local path planning has been applied in a road roundabout setting which is regarded as a complex environment for robot path planning. In global path planning, the path is generated within a grid map of the roundabout environment to select the path according to the respective road rules. It is also used to recognize the real roundabout from a sequence of images during local path planning in the real-world system. Results show that the performance of the proposed laser simulator approach in both global and local environments is achieved with low computational and path costs, in which the optimum path from the selected start position to the goal point is tracked accordingly in the presence of the obstacles.

Background Doxorubicin (DOX) is a potent antineoplastic agent used in treating various adult and pediatric cancers, but it tends to provoke dose-dependent cardiotoxicity. Ezetimibe (EZE), a cholesterol-lowering drug, has been reported to possess defensive actions against oxidative stress and inflammation, which are two of the main proposed mechanisms underlying the development of DOX-induced cardiotoxicity (DIC), hence, we aimed to inspect the possible protective effect of EZE against DIC in rats. Methods 24 adult male Wistar rats were allocated into four groups of six: control, DOX, 10 mg/kg EZE plus DOX and 20 mg/kg EZE plus DOX. At the end of the study, the experimental rats were anesthetized and blood samples were collected for biochemical analysis, after which the hearts were excised and heart tissue samples were obtained for biochemical and gene expression analyses. Results Pretreatment with EZE at a dose of 10 or 20 mg/kg alleviated cardiac damage induced by DOX, as EZE blunted the rise in serum levels of cardiac injury biomarkers, including cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Additionally, pretreating rats with EZE at either dose mitigated DOX-induced oxidative stress by elevating the levels of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx), with consequent reduction in the lipid peroxidation biomarker malondialdehyde (MDA) in cardiac tissues. Furthermore, pretreatment with either dose of EZE hindered DOX-mediated inflammation, where EZE suppressed cardiac nuclear factor-kappa B (NF-κB) signaling and negatively regulated the gene expression of its downstream proinflammatory cytokines, including tumor necrosis factor-alpha (TNF-α) with either dose and interleukin-1 beta (IL-1β) with the higher one. Conclusions Our findings indicate that EZE exhibited cardioprotection against DIC in rats, which makes EZE an interesting area for further investigations, animal- and human-wise, that can pave the way for a potential clinical application in preventing DIC in the future.

Background Methotrexate (MTX) is a classical folic acid antagonist widely used in the treatment of malignant and non-malignant disorders. However, its clinical application is often restricted by concomitant adverse effects, including renal damage. Numerous studies have highlighted the role of oxidative stress and inflammation in mediating MTX-related nephrotoxicity. Therefore, the current study aimed to explore the possible renoprotective action of Citronellol (CT), a natural compound with prominent antioxidant and anti-inflammatory activities, against nephrotoxicity induced by MTX. Methods To fulfill our objective, 24 adult male Wistar rats were randomly allocated into four groups: control, MTX, 100 mg/kg CT plus MTX and 200 mg/kg CT plus MTX. At the end of the study, the experimental rats were anesthetized, blood samples were collected for biochemical assays, and the kidneys were surgically removed for biochemical and gene expression analyses, after which all rats were sacrificed by exsanguination. Results Compared to the MTX-treated group, our results revealed that pre-supplementation with 100 or 200 mg/kg CT remarkably ameliorated renal damage biomarkers, including serum urea, serum creatinine, and kidney injury molecule-1 (KIM-1). In addition, pre-treatment with 100 or 200 mg/kg CT enhanced the activity of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx), diminished renal malondialdehyde (MDA) contents, and attenuated inflammation by suppressing renal nuclear factor kappa B (NF-κB) signaling and diminishing tumor necrosis factor-alpha (TNF-α) gene expression. Moreover, pre-treatment with 200 mg/kg CT markedly reduced interleukin-1 beta (IL-1β) gene expression. Conclusion Our findings demonstrate, for the first time, that CT can serve as a new promising agent for mitigating nephrotoxicity induced by MTX through its antioxidant and anti-inflammatory properties.

Vehicle-to-Everything (V2X) communication is rapidly emerging as a pivotal technology in the Internet of Things (IoT) landscape, aimed at enhancing road safety, traffic efficiency, and energy conservation. The advent of 5G networks provides an excellent platform for optimizing and scaling V2X interactions through high-speed data transfer, low latency, and broad bandwidth capabilities. This article delves into the multifaceted applications of V2X communication, facilitated by 5G technology, to build a comprehensive, interactive, and dynamic transportation ecosystem. V2X encompasses various paradigms like Vehicle-to-Vehicle (V2V), Vehicle-to-Infrastructure (V2I), and Vehicle-to-Pedestrian (V2P), each of which contributes uniquely to a safer and more efficient road environment. Through case studies, the article evaluates the performance and scalability of V2X over 5G networks and compares it with previous generations of mobile networks. Furthermore, the article explores the challenges in integrating 5G-enabled V2X into existing infrastructures, including compatibility issues, cybersecurity, and data privacy. Additionally, it discusses the prospective benefits of smart cities, autonomous vehicles, and Intelligent Transportation Systems (ITS). Finally, the paper concludes with an overview of emerging trends in V2X technologies, such as edge computing, artificial intelligence, and blockchain, that have the potential to revolutionize vehicular communication systems further. The article is a comprehensive guide for policymakers, researchers, and industry experts interested in the cutting-edge advancements in V2X communications via 5G networks.

Background: Due to the rising complexity of decision-making processes, there is a growing need for machine-learning models that can be easily understood. Ensuring the ethical use of AI in different fields requires establishing trust and understanding in the results generated by models. Objective: This article explores tactics and approaches that help improve the clarity and comprehension of intricate decision-making models. Our study aims to investigate methods that enable end users, domain experts, and decision analysts to understand and trust the results produced by these models. Methodology: This article examines the inherent difficulties in adequately managing the trade-off between model interpretability and complexity. We recommend determining the most favorable point of balance in this context. The study investigates many approaches, such as formulating novel algorithms that prioritize the importance of characteristics, providing instructive explanations, and building transparent model architectures. Results: The practical significance and promise of interpretable models are shown via specific examples and applications in finance, healthcare, autonomous systems, and healthcare. The examples above demonstrate how interpretability promotes assurance, enables ethical consideration, and reduces possible biases within complex models. Conclusion: Developing understandable models for complex decision-making processes goes beyond academic endeavors. It leads to the ethical and appropriate deployment of AI. This publication is an excellent resource for academics, practitioners, and policymakers engaged in creating, assessing, and implementing interpretable models. The purpose of developing these models is to facilitate dependable and transparent decision-making in many fields.

Background: Integrating drone technology into emergency medical services (EMS) provides a tremendous opportunity to improve the efficiency and responsiveness of medical treatments in critical circumstances. Traditional ambulance dispatch systems have road congestion and remote site access issues, resulting in longer emergency response times. Objective: This study aims to assess the effectiveness of deploying drones as a complement to traditional ambulance services, emphasizing reducing response times and improving patient outcomes in emergency circumstances. Methods: A mixed-methods approach was used, which included a investigation of response times and patient outcomes before and after the deployment of emergency drones in a pilot location. In addition, interviews with EMS staff were undertaken to evaluate operational problems and advantages. A simulation model was also created to forecast probable national implications. Results: Emergency drones significantly reduced response times, with an average drop of 30% in metropolitan regions and up to 50% in rural or hard-to-reach areas. Preliminary patient outcome data revealed a promising trend in survival rates for crucial instances such as cardiac arrests. Despite initial drone integration and coordination issues, EMS workers reported improved operational efficiency and patient care. Conclusion: Emergency drones are a promising innovation in EMS, potentially transforming how emergency medical treatment is given. Drones might play a vital role in the future of emergency medical care, particularly in locations where traditional ambulance response is hampered. Further study and pilot programs are required to investigate the scalability of drone technology in emergency medical response systems worldwide.

Background: Given the pervasive connectivity and integration of the Internet of Things (IoT) devices into daily life, system security is of utmost significance in the modern era. The article examines escalating concerns regarding the security of the Internet of Things, its inherent vulnerabilities, and the necessary precautions required to safeguard our interconnected global environment. Objective: With forecasts indicating that the IoT ecosystem will comprise over 50 billion interconnected devices by 2030, the alarming 300% increase in IoT intrusions over the past year underscores the urgency of addressing this issue. Methodology: In this article, IoT security challenges are divided into three primary categories which include device vulnerabilities, network vulnerabilities, and data security vulnerabilities. Results: Our findings emphasize the necessity for end users, developers, and manufacturers to follow security best practices and take part in security training. The study discovered that successful DDoS attacks use infected IoT devices 65% of the time and there is still legacy firmware on 70% of those devices making them susceptible. Possible solutions that are currently under investigation include secure elements, machine learning anomaly detection intrusion detection systems, and blockchain-based device authentication. Most prominently, proactive IoT security solutions have reduced 85% of the security vulnerabilities for organizations; it is truly a remarkable achievement. Conclusion: Understanding the security dynamic of the IoT ecosystem is a very demandable job as it keeps on changing, and so does the knowledge about it. To ensure that the IoT remains powerful and transformative in a connected society, this article will take a look further into the increasing risks, vulnerabilities, scary stats as well as effective solutions. It underscores the need for strong measures to protect security and greater awareness.

We report a 31-year-old patient with acute fulminant myocarditis, resulting in cardiogenic shock that necessitated mechanical circulatory support, who improved dramatically after treatment with intravenous (IV) pulse steroids. A coordinated multidisciplinary team was the key secret in the cure of this critical patient. In this case study, we focus on the role of IV pulse steroids in the treatment of fulminant lymphocytic myocarditis.

Abstract Background Both obesity and depression pose significant public health challenges. Understanding the age-gender differences in the BMI-depression associations is crucial, especially in the Saudi context, where cultural norms, lifestyle factors, and socio-economic conditions may significantly influence these associations. We aimed to explore and elucidate these associations in Saudi adults, considering age and gender as crucial factors. Methods The research utilized a cross-sectional web-based survey to examine the impact of age and gender on the associations between BMI and depression. The study included 4,683 Saudi adults aged 18–60 years. The questionnaire assessed socio-demographics, lifestyle factors, chronic illnesses, and self-reported height and weight to calculate BMI. Depression Inventory-II (BDI-II), a self-reported scale, was used to evaluate depression, categorizing participants into depression and non-depression groups. A snowball convenience sampling was utilized, with clear inclusion and exclusion criteria established to mitigate potential biases. Data analysis was stratified by age and gender, and binary logistic regression was utilized to determine the associations between depression and BMI, incorporating odds ratios (ORs) in both crude and adjusted forms, along with 95% confidence intervals (CIs). Results The prevalence of depression was found to be 43.3%, while 21% of participants were classified as obese. Notably, individuals in the depression group were significantly older, predominantly female, and more likely to reside in the Western and Southern regions of Saudi Arabia. They had lower family income, were more frequently non-smokers, had a higher prevalence of chronic diseases, and had higher BMI. Moreover, obese individuals had significantly higher depression scores (p

Abstract The present study focuses on the green synthesis of a novel Z-scheme SnS₂/HAp photocatalyst using Ocimum tenuiflorum (tulsi) leaf extract as a stabilizing agent. This approach not only emphasizes sustainability but also adds value to waste by extracting hydroxyapatite (HAp) from Labeo rohita fish scales, addressing the challenge of their disposal. The synthesized photocatalyst was thoroughly characterized using a range of analytical techniques to evaluate its crystal structure, optical properties, morphology, and elemental composition. The photocatalytic activity of the SnS₂/HAp composite was assessed through the degradation of gentian violet (GV) dye, a representative organic pollutant. Various reaction parameters were optimized to enhance the degradation efficiency, and the photocatalyst’s performance was further tested across different water matrices. Under optimal conditions, the SnS₂/HAp photocatalyst achieved a maximum photodegradation efficiency of 97.49% with a rate constant of 0.0494 min− 1 for GV dye. Additionally, it exhibited an efficiency greater than 70% against other emerging pollutants via advanced oxidation processes (AOP). The enhanced photocatalytic activity was attributed to the formation of a Z-Scheme heterojunction between SnS2 and HAp, which enhanced the charge separation efficiency and delayed the charge recombination. The study also demonstrated the photocatalyst’s remarkable reusability, maintaining high performance over five cycles and across various water environments. This highlights its potential as a sustainable solution for the removal of organic pollutants from aqueous streams. Finally, a Z-scheme electron transport mechanism is proposed to explain the photodegradation process of GV dye using the SnS₂/HAp photocatalyst.

Abstract Introduction Primary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India’s Chhattisgarh state. Methods We conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care. Results On an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population’s health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure. Conclusion HWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population’s acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

Background: Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes. PATIENTS AND METHODS: This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10–16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30). Results: A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle. Conclusions: Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.

Abstract Background The aim of this study was to determine the cutting efficiency of different diamond rotary instrument types for sectioning monolithic zirconia and lithium disilicate anatomical crowns. Materials and methods The study used 30 diamond rotary instruments divided into three groups: Zirconia cutting diamond bur (White Z), super coarse grit diamond bur (KBlack), and medium coarse grit diamond bur (KBlue); Two subgroups were assigned based on the crown materials including monolithic zirconia (5YSZ) and lithium disilicate (e.max) ceramics. The cutting efficiency was assessed by measuring the time required to fully section the crowns, followed by scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) of the dental burs before use and after every sectioned crown. A three-way ANOVA examined the effects of bur type, material type, and sectioning stage. If interaction exists, one-way ANOVA was used to compare the different subgroups, followed by the Tukey post hoc test. The significance level was assigned at α ≤ 0.05. Results The results exhibited various cutting efficiencies among diamond rotary instruments and ceramic crown materials. White Z demonstrated superior cutting efficiency of zirconia crown compared with KBlack and KBlue for the first cutting cycles (p ≤ 0.05); the results tend to be more comparable at the third cutting cycle. However, the super coarse diamond bur exhibited higher efficiency in cutting lithium disilicate crowns than white Z and KBlue burs through all three cutting cycles(p ≤ 0.05). The diamond bur-cutting efficiency diminished after each use, irrespective of the bur type or the crown material (p ≤ 0.05); this was represented by the reduction of carbon and increased nickel matrix ratio after each bur usage. Conclusion White Z diamond bur showed higher cutting efficiency of zirconia in the first two cutting cycles; super coarse diamond bur is more efficient for cutting lithium disilicate crown in all of the cutting cycles. The amount of diamond on the burs reduced after each use, with no great impact on the material type when sectioning lithium disilicate and 5YSZ crowns. Clinical significance This study provides valuable insights for dental practitioners in selecting the appropriate diamond rotary instrument for crown sectioning. Practitioners can minimize the risk of damage and reduce the time required for crown removal, improving patient outcomes.

Abstract Atopic dermatitis often begins in infancy and follows a chronic course of exacerbations and remissions. The etiology is complex and involves numerous factors that contribute to skin barrier defect and inflammation. In the Middle East, the burden of atopic dermatitis is understudied. Epidemiological data specific to the Gulf region are scarce but reveal a prevalence of up to about 40% in the United Arab Emirates. Region-specific factors, such as the climate and the frequency of consanguineous marriages, may affect atopic dermatitis incidence, prevalence, and evolution over time. A panel of experts predominantly from the United Arab Emirates analyzed the evidence from published guidelines, and considered expert guidance and local treatment practices to develop clear recommendations for the management of atopic dermatitis in the United Arab Emirates. They encourage a systematic approach for the diagnosis and treatment, using disease severity scores and quality-of-life measurement tools. Treatment recommendations take into consideration both established therapies and the approved systemic biologics dupilumab and tralokinumab, and the Janus kinase inhibitors baricitinib, upadacitinib, and abrocitinib.

Abstract Large language models (LLMs) like ChatGPT have potential applications in medical education such as helping students study for their licensing exams by discussing unclear questions with them. However, they require evaluation on these complex tasks. The purpose of this study was to evaluate how well publicly accessible LLMs performed on simulated UK medical board exam questions. 423 board-style questions from 9 UK exams (MRCS, MRCP, etc.) were answered by seven LLMs (ChatGPT-3.5, ChatGPT-4, Bard, Perplexity, Claude, Bing, Claude Instant). There were 406 multiple-choice, 13 true/false, and 4 "choose N" questions covering topics in surgery, pediatrics, and other disciplines. The accuracy of the output was graded. Statistics were used to analyze differences among LLMs. Leaked questions were excluded from the primary analysis. ChatGPT 4.0 scored (78.2%), Bing (67.2%), Claude (64.4%), and Claude Instant (62.9%). Perplexity scored the lowest (56.1%). Scores differed significantly between LLMs overall (p

Abstract Tropical montane forest ecosystems are pivotal for sustaining biodiversity and essential terrestrial ecosystem services, including the provision of high-quality fresh water. Nonetheless, the impact of montane deforestation and climate change on the capacity of forests to deliver ecosystem services is yet to be fully understood. In this study, we offer observational evidence demonstrating the response of air temperature and cloud base height to deforestation in African montane forests over the last two decades. Our findings reveal that approximately 18% (7.4 ± 0.5 million hectares) of Africa’s montane forests were lost between 2003 and 2022. This deforestation has led to a notable increase in maximum air temperature (1.37 ± 0.58 °C) and cloud base height (236 ± 87 metres), surpassing shifts attributed solely to climate change. Our results call for urgent attention to montane deforestation, as it poses serious threats to biodiversity, water supply, and ecosystem services in the tropics.

Background: As the most widespread eating disorder in the world now, binge eating disorder (BED) is a mental condition characterized by recurrent periods of excessive food consumption and an inability to regulate one’s portion sizes. The utilization of a bupropion–naltrexone (NB) combination has been suggested as a potential therapeutic approach for BED. Assessing the effectiveness of NB in the treatment of BED and its accompanying obesity is the purpose of this research. Methods: A comprehensive search was conducted in order to obtain any pertinent articles. PubMed, Scopus, Web of Science, and Cochrane Clinical Trials were consulted against in the databases that were searched. In our final meta-analysis, we incorporated interventional or observational studies that documented the effects of NB therapy for binge eating in adults. We also examined the difference in the mean change between the NB and placebo groups, as well as the disparity in outcomes before and after treatment. Results: This study shows that the use of an NB combination is associated with a statistically significant reduction in the weight, BMI, and Binge Eating Scale (BES) of the patients compared to their weight before treatment with MD: −8.52 (95% CI: −10.01–−6.94, p < 0.00001), MD: −4.95 (95%CI: −9.72–−0.17, p = 0.04), and MD: −7.66 (95%CI: −14.36–0.96, p = 0.02), respectively. The absolute mean change was statistically significantly higher in the drug combination group compared to the placebo group. Conclusions: NB showed efficacy in the improvement of the weight and psychiatric symptoms associated with BED and this provides a promising treatment option.

Abstract Background A fistula is an unusual communication between the skin and an inward organ or between the organs. The current study aimed to determine the role of magnetic resonance imaging (MRI) in the diagnosis, description, and classification of fistula-in-ano. Additionally, the study aimed to compare the MRI findings with the operative findings, which is considered the gold standard in our study. Methods The present study is a prospective study and was carried out on a group of 61 patients: 52 males and 9 females with a mean age of 41 years, who were suspected to have perianal fistulae presented clinically with discharge or localized pain or were asymptomatic. A preoperative MRI was conducted for fistula-in-ano evaluation in these patients from October 2019 till the end of October 2021. A surgeon conducted a physical examination of all patients to document the number and location of cutaneous openings following a full medical history. The MRI images were evaluated and interpreted by multiple expert radiologists who had more than 5 years of experience in analyzing MRI. In the cases (in 3 cases, 4.92%) where there were discrepancies in their interpretations, a senior radiologist’s evaluation was considered the final result and was confirmed surgically. Subsequently, the MRI findings were correlated with surgical findings to indicate the specificity, sensitivity, and accuracy of such MRI findings. Results The MRI technique was the routine (i.e., without contrast administration) technique in 36 (59.02%) patients, with contrast administration in 21 (34.43%) patients and with anesthesia/sedation (uncomfortable, anxious, and claustrophobic patients need to minimize their motion artifact to improve the quality and obtain more detailed images) in 4 (6.56%) patients. The MRI pathology of the studied patients revealed normal findings in 1 (1.64%) patient, anal fissure/early developing tract in 6 (9.84%) patients, and established tract (sinus/fistula) in 54 (88.52%) patients. Park’s and St. James's University Hospital classifications were utilized to categorize the patients, with the most common fistula types based on the Park’s classification: intersphincteric (44.3%) and transsphincteric (29.5%). Based on the St. James’s classification, grade 1 (intersphincteric (34.4%)) and grade 4 (transsphincteric with abscess/side branch (16.4%)) were the most prevalent. A substantial consensus was reached between MRI and surgery findings for classifying tracts, side branches, and abscesses formation with sensitivity, specificity, and accuracy of 100%, 85.71%, and 98.36%, respectively. Conclusions MRI is a valuable tool in managing patients with perianal fistulas due to its ability to detect hidden areas of infection (such as abscesses) and secondary extensions. These factors contribute to the high recurrence rate after surgery. Additionally, MR imaging can define the anatomical relationships between the fistula and anal sphincters, helping to predict the likelihood of fecal incontinence following surgery.

Abstract This article aims to suggest an improved estimator for estimation of population median using auxiliary information under simple random sampling. The expression for the bias and mean square error are obtained up to first order approximation. We determine the MLE of the optimal values of the describing scalars. The proficiency of the suggested estimator is evaluated in comparison to the preliminary estimators using the MSE threshold. The suggested estimators are compared numerically to the ones that are currently studied in this study. The performance and novelty of the estimators was evaluated using real data sets and a simulation study. To check the efficiency of estimators empirical and theoretical study has been studied. Based on numerical result it is to be noted that our suggested estimator is more efficient as compared to existing estimators which is considered in this article in terms of least MSE and greater PRE.

Abstract Background In the livestock industry, Foreign Body Syndrome is a devastating disease condition. Feeding management, lacking of food discrimination, and eating chopped food increase the risk of swallowing sharp foreign bodies in bovine species. In addition to the honeycomb cells shape of the reticulum, the contractions of the reticular wall, gravid uterine pressure, and parturition efforts, foreign bodies can penetrate the reticular wall, causing cascade of problems including traumatic reticulitis, traumatic reticuloperitonitis, and traumatic pericarditis. The present study was carried out to evaluate the diagnostic significance of cardiac troponin I rapid test cassette and other cardiac biomarkers including serum cardiac troponin I (cTn I), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase enzyme (AST), in confirmed cases of traumatic pericarditis (TP) and/or traumatic reticuleoperitonitis (TRP) in cattle and buffaloes. Methods A total number of 30 animals (22 cattle and 8 buffaloes) with different signs such as anorexia, jugular distension, brisket edema, and signs of pain (reluctance to move, arching back, and abduction of the forelimbs) were included in the present study. Based on case history, clinical signs, ferroscopic, pericardiocentesis, radiographic and ultrasonographic examinations, TP were confirmed in cattle (n = 10) and buffaloes (n = 8) while TRP were confirmed only in cattle (n = 12). Additionally, 20 clinically healthy animals (n = 10 cattle and 10 buffaloes) were used as a control group. Blood samples were collected for determination of blood level of Tn-I, and activity of CK-MB, LDH, and AST. Results The obtained results revealed a highly significant increase in serum cTn I in diseased cattle with TP and TRP (P = 0.00), while buffaloes with TP showed no significant changes in serum cTn I (P = 0.111). Both diseased cattle and buffaloes showed increased serum activities of CK-MB, AST, and LDH enzyme. On the other hand, cardiac troponin I rapid test cassette failed to detect cTn I in diseased animals. Conclusion The study concluded that the cardiac troponin I rapid test cassette did not have a diagnostic significance and could not be used as a point-of-care under field condition for diagnosis of TP and TRP in large ruminants. However, the serum troponin I level is helpful in diagnosis of TP and TRP in cattle. Although cardiac biomarkers have some diagnostic values in TP and TRP, the traditional diagnostic methods (clinical, radiography and ultrasonography examinations) are crucial for thorough evaluation of TP/TRP cases in bovine.

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

This study is concerned with investigating the oscillatory properties of a general class of neutral differential equations. Neutral equations are characterized by being rich in both practical and theoretical aspects. We obtain criteria that guarantee the oscillation of solutions to a fourth-order neutral differential equation with multiple delays. Considering the canonical case, we obtain some new relations and inequalities that help in obtaining improved criteria. We use the reduction method to relate the oscillation of the studied equation to a first-order equation. We apply the results to a special case. Through this application, we evaluated the efficiency of the new results in the oscillation test compared to previous results in the literature.

Abstract Background Cervical cancer is the second most common malignancy in Ethiopia and first in some African countries. It is six times more likely to occur in positive cases of the human immunodeficiency virus than in the general population. If diagnosed and treated early enough, cervical cancer is both treatable and preventable. However, among Ethiopian women who test positive for HIV, the uptake of cervical cancer screening is low. Its determinant factors were not well studied in the study area. Hence, this study was aimed at filling this information gap. Objective To assess uptake of cervical cancer screening services and associated factors among HIV-positive women attending an adult antiretroviral treatment clinic at public hospitals in Addis Ababa, Ethiopia, June 1–30, 2022. Methods A cross-sectional investigation was carried out in a hospital. 407 participants in all were chosen using the systematic sampling technique. A pretested interviewer-administered questionnaire was used to collect the data from respondents. The data were entered into Epi data version 4.6 and exported to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analysis was employed. Adjusted odds ratio with its 95% confidence interval and p value 45 years old (AOR = 0.18, 95% CI: 0.053–0.644), number of children (3 children) (AOR = 0.19, 95% CI:0.036-0.979), perception of being susceptible to cervical cancer (AOR = 6.39, 95% CI: 1.79–22.74), knowledge of cervical cancer and its screening (AOR = 19.34, 95% CI: 7.87–47.75), and positive attitude towards cervical cancer screening (AOR = 8.06, 95% CI:3.62–17.91) were significantly associated factors with the uptake of cervical cancer screening. Conclusion and recommendation in this study, Age > 45 years, having less than three children, feeling susceptible, knowing about cervical cancer and screening, and having a positive attitude toward cervical cancer screening were significant factor of uptake of cervical cancer screening service. There is a need to strengthen the policy and health education on safe sexual practices and healthy lifestyles through information dissemination and communication to scale up screening service utilization.

Abstract Background Observational studies have elucidated the associations between dietary factors and hypertension. Nevertheless, the exploration of these relationships using Mendelian randomization remains scarce currently. Methods The Mendelian randomization approach investigated the potential causal relationships between 16 dietary factors and hypertension. To achieve this, we identified genetic variants associated with these dietary factors by utilizing data from European-descent genome-wide association studies with a stringent significance threshold (P

Driven by agency disputes on real earnings management and board characteristics, this study examines the relationship between board independence, audit quality and earnings management. Using the information of quoted service firms on the Nigerian Exchange Group. The analysis of the data was conducted using multiple regression analysis, utilising a sample of 160 observations from Nigeria, an emerging market spanning from 2014 to 2023. Our results demonstrate that board independence does not mitigate real earnings management. However, we find that Big4 auditor reduces real earnings management and improves the quality of financial reporting. These results show that for a percentage increase of independent directors, the smoothening of earnings decreases while a significant number of services do not engage Big4 auditors in reporting the quality of their financial statements. Especially in a setting where the capital market is still in the process of developing and where legal protection and law enforcement are lacking, the findings of this research could prove to be beneficial to regulators in their efforts to limit the occurrence of earnings management and to enhance financial reporting quality.

The current global trend in the nutrition, epidemiologic and demographic transitions collectively alarms the need to pursue a sustainable protein diet that respects ecosystem and biodiversity from alternative sources, such as algae, fungi and edible insects. Then, changing the nutrition reality is extremely important to impede the global syndemic of obesity, undernutrition and climate change. This review aims to synthesize the published literature on the potential roles of alternative proteins and their derived bioactive peptides in preventive and clinical nutrition, identify research gaps and inform future research areas. Google Scholar and PubMed databases from their inception up to 30 June 2024 were searched using keywords to access pertinent articles published in English language for the review. Overall, proteins derived from algae, fungi, and edible insects are high-quality proteins as animal sources and demonstrate significant potential as a sustainable source of bioactive peptides, which are metabolically potent and have negligible adverse effects. They show promise to prevent and treat diseases associated with oxidative stress, obesity, diabetes, cancer, cardiovascular disease (especially hypertension), and neurodegenerative diseases. Given the abundance of algae, fungi and insect peptides performed in vitro or in vivo animals, further clinical studies are needed to fully establish their safety, efficacy and practical application in preventive and clinical nutrition. Additionally, social and behavioral change communication strategies would be important to increase health awareness of nutritional benefits and promote consumer acceptance of alternative protein sources.

The infant gut microbiota undergoes significant changes during early life, which are essential for immune system maturation, nutrient absorption, and metabolic programming. Among the various microbial metabolites, short-chain fatty acids (SCFAs), primarily acetate, propionate, and butyrate, produced through the fermentation of dietary fibers by gut bacteria, have emerged as critical modulators of host-microbiota interactions. SCFAs serve as energy sources for colonic cells and play pivotal roles in regulating immune responses, maintaining gut barrier integrity, and influencing systemic metabolic pathways. Recent research highlights the potential neuroprotective effects of SCFAs in pediatric populations. Disruptions in gut microbiota composition and SCFA production are increasingly associated with a range of pediatric health issues, including obesity, allergic disorders, inflammatory bowel disease (IBD), and neurodevelopmental disorders. This review synthesizes current knowledge on the role of microbiota-derived SCFAs in pediatric health, emphasizing their contributions from gut development to neuroprotection. It also underscores the need for further research to unravel the precise mechanisms by which SCFAs influence pediatric health and to develop targeted interventions that leverage SCFAs for therapeutic benefits.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) marked by persistent inflammation of the mucosal lining of the large intestine, leading to debilitating symptoms and reduced quality of life. Emerging evidence suggests that an imbalance of the gut microbiota plays a crucial role in UC pathogenesis, and various signaling pathways are implicated in the dysregulated immune response. Probiotics are live microorganisms that confer health benefits to the host, have attracted significant attention for their potential to restore gut microbial balance and ameliorate inflammation in UC. Recent studies have elucidated the mechanisms by which probiotics modulate these signaling pathways, often by producing anti-inflammatory molecules and promoting regulatory immune cell function. For example, probiotics can inhibit the nuclear factor-κB (NF-κB) pathway by stabilizing Inhibitor of kappa B alpha (IκBα), dampening the production of proinflammatory cytokines. Similarly, probiotics can modulate the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway, suppressing the activation of STAT1 and STAT3 and thus reducing the inflammatory response. A better understanding of the underlying mechanisms of probiotics in modulating pathogenic signaling pathways in UC will pave the way for developing more effective probiotic-based therapies. In this review, we explore the mechanistic role of probiotics in the attenuation of pathogenic signaling pathways, including NF-κB, JAK/STAT, mitogen-activated protein kinases (MAPKs), Wnt/β-catenin, the nucleotide-binding domain (NOD)-, leucine-rich repeat (LRR)- and pyrin domain-containing protein 3 (NLRP3) inflammasome, Toll-like receptors (TLRs), interleukin-23 (IL-23)/IL-17 signaling pathway in UC.

Purpose – This study investigates the moderating role of political capacity (PC) in the relationship between public entrepreneurship (PE) and local government performance (LGP) in Niger State, Nigeria, using structural equation Modelling (SEM). Methodology – This study is a quantitative research based on a sample of 1,396 employees from four local government areas in Niger State, Nigeria. A non-probability sampling method was utilized, and the data were analyzed using STATA version 17 to obtain descriptive statistics, perform a normality test, assess factor loadings, and conduct correlation and SEM analyses. Findings – The analysis revealed that the mean values of public entrepreneurship, political capacity, and local government performance were low. The SEM analysis found that political capacity significantly moderates the relationship between public entrepreneurship and local government performance and establishes a direct relationship between public entrepreneurship, political capacity, and the performance of local governments. Implications – This study suggests that political capacity should be considered in the administration of local governments, as it can lead to more effective management of municipalities. Originality – No previous research has explored the relationship between political capacity, public entrepreneurship, and local government performance using SEM in the context of local government administration.

Background: Diabetes mellitus is becoming major health challenge with continually increasing burden. High costs of conventional medicines and numerous side effects associated with them, on the other hand, easy availability and accessibility of traditional herbal medicines calls upon experimental investigations to validate their effect on lowering blood glucose level. Methods: The dried fruit of Rosa abyssinica was macerated with 70 % ethanol and the extract's in vitro antidiabetic activity was investigated using dinitrosalisylic acid method for alpha amylase inhibitory activity. Furthermore, the in vivo hypoglycemic and Antihyperglycemic effects of various doses of the extract (100, 200 and 400 mg/kg) was determined on normoglycemic, glucose loaded (1500 mg/kg) and Streptozotocine (180 mg/kg)-induced diabetic mice models. Results: The acute oral toxicity study revealed the plant showed no toxic effect on swiss albino mice at 2000 mg/kg. The in vitro alpha amylase inhibitory activity study showed that the extract has comparable IC50 value of 21.37 ± 4.252 μg/ml with the standard drug acarbose (IC50 value of 26.72 ± 3.59 μg/ml). On the other hand, in normal mice, none of the dose levels except at 400 mg/kg significantly reduces blood glucose level. This is in contrast to the oral glucose tolerance test, which the extract produced significant reduction at 60, 90 and 120 min following glucose challenge. The 70 % ethanolic fruit extracts of Rosa abyssinica also experienced profound antidiabetic activity in streptozotocin-induced diabetic model. In the single-dose study, both RAFE200 and RAFE400 demonstrated a significant (P˂0.05) reduction in blood glucose levels at 1, 2, 3, and 4 h. Similarly, in the repeated-dose study, RAFE200 and RAFE400 not only significantly reduced blood glucose levels but also produced a notable improvement in animal body weight. Conclusion: The 70 % ethanolic fruit extracts of Rosa abyssinica have shown significant in vitro alpha amylase inhibition effect and an in vivo blood glucose level lowering effects in diabetic mice.Therefore, this study supports the traditional use of Rosa abyssinica in the management of diabetes mellitus.

IntroductionEthiopia has one of the highest maternal death rates in the world, with 412 deaths for every 100,000 live births. A qualified healthcare professional's care during pregnancy, delivery, and the postnatal period is crucial to saving the lives of the mother and her child. The continuum of maternity health services in Ethiopia is still shallow, despite efforts to increase the use of these services. This study's goal was to evaluate the magnitude and factors influencing the entire continuum of care for maternal health services in Chiro City in 2024.MethodsA community-based cross-sectional study was conducted from 15 January to 15 February 2024, among mothers who gave birth in the last year preceding the data collection period in Chiro City, Eastern Ethiopia. Data were collected through face-to-face interviews using a structured questionnaire. Multivariable logistic regression analysis was done to identify determinants of the complete continuum of care. A P-value of

BackgroundCoronavirus disease 2019 (COVID-19) caused by the coronavirus SARS-CoV-2, has emerged as a rapidly spreading contagious disease across the globe. Recent studies showed that people with diabetes mellitus, severe obesity, and cardiovascular disease are at higher risk of mortality from COVID-19. It has been suggested that the increased risk is due to the chronic inflammatory state associated with type 2 diabetes. This study aimed to evaluate the efficacy of pioglitazone, a strong insulin sensitizer with anti-inflammatory properties, in improving the clinical outcomes of patients with type 2 diabetes admitted with moderate–severe COVID-19.MethodWe enrolled 350 patients with type 2 diabetes who were admitted to hospitals in Qatar and Kuwait with COVID-19. Patients were randomized to receive, in a double-blind fashion, pioglitazone (n = 189) or a matching placebo (n = 161) for 28 days. The study had two primary outcomes: (1) the incidence of a composite outcome composed of (a) the requirement for mechanical ventilation, (b) death, and (c) myocardial damage; and (2) an increase in C-reactive protein (CRP) levels.ResultsThe first primary outcome occurred in 28 participants (8%), and the secondary outcome occurred in 17. Treatment with pioglitazone showed a significant reduction in interleukin (IL)-3 levels compared with placebo treatment (mean (SD) 2.73 (± 2.14) [95% CI: 0.02, 1.1], p = 0.043 vs. 2.28 (± 1.67) [95% CI: − 0.23, 0.86], p = 0.3, respectively), with no effect seen in the levels of other inflammatory markers. Even though not significant, a few of the patients on pioglitazone exhibited serum troponin levels > 3 times higher than the normal range seen in patients on placebo. On the other hand, more patients on pioglitazone were admitted to the ICU than those with placebo, and no significant difference in the CRP reduction was observed between the two groups.ConclusionThe results of the present study demonstrate that pioglitazone treatment did not independently provide any additional clinical benefit to patients with type 2 diabetes admitted with a COVID-19 infection.Clinical trial registrationhttps://clinicaltrials.gov, identifier NCT04604223.

A smooth and dense surface of the base paper is advantageous when the goal is to apply a liquid coating as a barrier layer. For such a base paper, non-wood fibers derived from wheat straw could be an alternative to wood fibers. In this research paper, wheat straw pulp was refined with different beating levels (up to 600 revolutions) followed by different calendering pressure loads (up to 50 N/mm) to test its influence on mechanical and surface properties. Alkyl ketene dimer (AKD) was used as sizing agent with concentrations up to 0.2 wt% followed by a mineral-based precoating to test its influence on the smoothness. Eucalyptus pulp was chosen as a benchmark. After beating, the initial Schopper-Riegler degrees of 28 °SR increased to 56 °SR. Beating also increased the tensile index from 24 to 49 Nm/g, the burst index from 1.2 to 2.8 kPa·m²/g, and the tear index decreased from 3.3 to 2.8 mN·m2/g. Calendering reduced the initial roughness of 370 mL/min to 30 mL/min. When precoated and calendered again, the value was lowered to 15 mL/min. In summary, wheat straw paper is a relevant alternative to wood-derived base paper to produce barrier papers. Compared to eucalyptus, wheat straw paper showed better smoothness and much lower air permeability indicating excellent suitability for barrier coating.

Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually observed incidentally during autopsies or imaging studies, they may at times cause concern due to associated clinical symptoms. This report presents a case of unilateral accessory flexor carpi ulnaris (AFCU) muscle observed in a human male cadaver aged 78 years. During routine cadaveric dissection, an anomalous AFCU muscle was observed in the left forearm of a human male cadaver aged 78 years. Standard institutional guidelines pertaining to the use of human cadaver for teaching and research were followed. A thorough literature review about the flexor carpi ulnaris (FCU) through the PubMed, Embase and Google scholar databases was undertaken, using the keywords – accessory flexor carpi ulnaris muscle, aberrant flexor carpi ulnaris muscle and anatomical variation of flexor carpi ulnaris muscle. Relevant gross anatomical findings were recorded and photographed. AFCU was identified on the medial aspect of the distal third of the left forearm. The AFCU was found originating from the ante-brachial fascia and the fascia covering the FCU on the left forearm, forming a small separate belly deep to the main muscle. It terminated as a thin tendon running alongside the hypothenar muscles and attached distally to the base of the proximal phalanx of the little finger. The AFCU was found to be innervated by a branch of the ulnar nerve. Awareness about the rare AFCU muscle is clinically important as a possible cause of ulnar nerve compression but also as a possible graft in reconstruction surgeries.

Abstract Background In pre-hospital setting, ambulance provides emergency care and means of transport to arrive at appropriate health centers are as vital as in-hospital care, especially, in developing countries. Accordingly, Ethiopia has made several efforts to improve accessibility of ambulances services in prehospital care system that improves the quality of basic emergency care. Yet, being a recent phenomenon in Ethiopia, empirical studies are inadequate with regard to the practice and determinants of ambulance service utilization in pre-hospital settings. Hence, this study aimed to assess the ambulance service utilization and its determinants among patients admitted to the Emergency Departments (EDs) within the context of pre-hospital care system in public hospitals of Jimma City. Method A cross-sectional study design was used to capture quantitative data in the study area from June to July 2022. A systematic sampling technique was used to select 451 participants. Interviewer-administered questionnaire was used to collect data. Data analysis was done using SPSS version 26.0; descriptive and logistic regressions were done, where statistical significance was determined at p < 0.05. Results Ambulance service was rendered to bring about 39.5% (of total sample, 451) patients to hospitals. The distribution of service by severity of illnesses was 48.7% among high, and 39.4% among moderately acute cases. The major determinants of ambulance service utilization were: service time (with AOR, 0.35, 95%CI, 0.2-0.6 for those admitted to ED in the morning, and AOR, 2.36, 95%CI, 1.3-4.4 for those at night); referral source (with AOR, 0.2, 95%CI, 0.1-0.4 among the self-referrals); mental status (with AOR, 1.9, 95%CI, 1-3.5 where change in the level of consciousness is observed); first responder (AOR, 6.3 95%CI, 1.5-26 where first responders were the police, and AOR, 3.4, 95%C1, 1.7-6.6 in case of bystanders); distance to hospital (with AOR,0.37, 95%CI, 0.2-0.7 among the patients within ≤15km radius); and prior experience in ambulance use (with AOR, 4.1,95%CI, 2.4-7). Conclusion Although the utilization of ambulance in pre-hospital settings was, generally, good in Jimma City; lower levels of service use among patients in more acute health conditions is problematic. Community-based emergency care should be enhanced to improve the knowledge and use of ambulance services.

Abstract B cells are important in tuberculosis (TB) immunity, but their role in the human lung is understudied. Here, we characterize B cells from lung tissue and matched blood of patients with TB and found they are decreased in the blood and increased in the lungs, consistent with recruitment to infected tissue, where they are located in granuloma associated lymphoid tissue. Flow cytometry and transcriptomics identify multiple B cell populations in the lung, including those associated with tissue resident memory, germinal centers, antibody secretion, proinflammatory atypical B cells, and regulatory B cells, some of which are expanded in TB disease. Additionally, TB lungs contain high levels of Mtb-reactive antibodies, specifically IgM, which promotes Mtb phagocytosis. Overall, these data reveal the presence of functionally diverse B cell subsets in the lungs of patients with TB and suggest several potential localized roles that may represent a target for interventions to promote immunity or mitigate immunopathology.

Abstract Background Female sex workers (FSWs) face an elevated risk of developing mental health disorders and alcohol use disorders (AUD), which in turn increase their vulnerability to HIV and other sexually transmitted infections (STIs) and other negative outcomes. To effectively address both of these health issues, it is crucial to understand the shared key determinants underlying these illnesses, which is a substantial knowledge gap in Ethiopia and elsewhere in the world. Therefore, this study aimed to identify the common key determinants of depression and AUD among FSWs in Ethiopia using a bivariate multivariable ordinal logistic model. Methods We analyzed cross-sectional biobehavioral data collected in 2020 from 16 cities and major towns in Ethiopia using the respondent-driven sampling (RDS) technique, which involved a total of 6,085 FSWs. FSWs who had lived at the study sites for at least a month before the study period were deemed eligible for recruitment. Major depressive disorder (DD) and AUD were screened using the Patient Health Questionnaire (PHQ9) and alcohol use disorder identification test (AUDIT), respectively. We used descriptive statistics to summarize study population characteristics and bivariate multivariable ordinal logistic regression (BMOLR) to identify common determinants of DD and AUD combined and their nonnormal correlation. Results Among 6085 FSWs screened for DD and AUD, 13.5% and 4.0% have met the criteria for moderate and severe depressive disorder, respectively, and 20.3% and 34.7% have met the AUDIT criteria for harmful or hazardous behavior and alcohol dependence, respectively. FSW with experience of inconsistent condom use, condom failure, violence, mobility, use of any drugs, non-paying partners, abortion, and selling sex for more than five years were associated with an increase in the severity of both disorders. A high average income from selling sex and the number of paying partners reduced the severity of depression and increased the level of alcohol dependence. Being HIV positive and ever having anal sex were associated only with an increase in depression. Conclusion Major DD and AUD are prevalent among FSWs in Ethiopia. The findings revealed that common key determinants, which exacerbated the severity of both disorders, were also risk factors for HIV and other STIs. Consequently, integrated STI strategies are essential in the screening, referral, and treatment of depression and AUD. Intervention packages should encompass determinants of depression and AUD, including condom utilization, drug use, mobility between towns, abortion, violence, and counseling services. Additionally, strategies to ensure economic security should be incorporated.

Photovoltaic modules are impacted by overheating, which degrades their conversion efficiency and shortens their lifespan. This work attempts to study the cooling potential for a hybrid photovoltaic/thermal (PV/T) system by employing CuO and Fe2O3 nanofluids with 0.2% and 0.3% volume fractions (φ), circulated in a heat exchanger attached at the rear side of the PV module to lower the temperature of the PV cells and improve its energy and exergy efficiencies. Consequently, a 2D numerical model was analysed given the energy balance across the PV/T system layers, which is evaluated in line with measured experimental data. The results indicate that the successfully synthesised nanomaterials could improve the performance of the nanofluids and increase the heat exchange between PV/T system layers, reducing the PV cells’ temperature by 23.49% and 34.58% when cooling by CuO and Fe2O3 nanofluids at φ=0.3%. Compared to the uncooled PV module, the electrical efficiency has increased by 9.21% and 10.30%, while thermal efficiency increased by 38.9% and 43.3% under cooling with CuO and Fe2O3 nanofluids, respectively. Thereby, the exergy destruction (exergy losses) and entropy generation have decreased by about 26% and 68% when cooling with Fe2O3 nanofluid, which improved the exergy efficiency by 13% more than CuO nanofluid.

A few studies have investigated the morphology and mineralogy of the salt deposits in Iraq. These deposits have amassed in substantial amounts as a result of the rise in temperature, specifically during the summer season. This study aims to analyze and characterize the mineral composition, morphology, and salt crystallization of the sabkhas and sea salt. The physicochemical tests (X-ray Diffraction, X-ray fluorescence, Field Emission Scanning Electron Microscopy, and energy dispersive spectroscopy) were used in this study. Samples were collected from sabkha salts in Diyala, Al-Emara, and the sea salt in Al-Basra. These locations exhibit an important and unique distribution of precipitated salt. The study showed that a semi-arid to arid climate in small pools located in specific locations led to the generation of Sabkhas and sea salt through saltwater evaporation. After processing the samples, the half-and-quarter method was used to obtain a 20-gram sample from the investigated bulk substance. According to the XRD analysis, halite is the main evaporite mineral present in the samples, with calcite, anhydrate, gypsum, and bischofite following it in decreasing order of abundance. The predominant trace elements include sulfur (S), magnesium (Mg), calcium (Ca), aluminum (Al), silicon (Si), iron (Fe), and molybdenum (Mo). Sea salt from the Al-Fao in Al-Basra exhibits exceptional mineral concentration and forms cubic-shaped crystals due to excellent evaporation of seawater. The most common crystallization patterns found in sabkhas and sea salt consist of hopper shapes, cubic crystals, rhombic crystals, cryptocrystals, and tabular shapes. Each of these forms of crystallization occurs at ambient temperatures.

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

This research aims to use numerical methods to analyze concrete beams with different reinforcement ratios. Two software packages – ABAQUS and OpenSeesPy – were employed to achieve this task. Empirical stress–strain relationships were utilized to forecast the concrete’s stress–strain behavior. The numerical analysis results were compared with previously published experimental results, and the findings showed a reasonable similarity. The results were consistent with the published laboratory results, particularly for ultimate and yield loads, with no more than 10% differences. However, the ultimate deflection variation was higher. For the first control beam, denoted as B 2−12, ABAQUS predicted a 24.64% difference in ultimate deflection, while OpenSeesPy predicted a 35.83% difference for the second beam, sampled as B 2–16. However, the ultimate deflection for the remaining beams differed by less than 10%. Meanwhile, the difference in yield deflection was greater than in ultimate deflection, with OpenSeesPy showing a maximum difference of 18.51%. The maximum ductility was found to occur at a reinforcement ratio equal to 0.0016. Additionally, OpenSeesPy was faster than ABAQUS in computation while still producing satisfactory agreement with experimental results.

Abstract Background & aims Eosinophilic ascites is non-common and challenging disease. This study aimed to describe the clinical presentation and treatment of eosinophilic ascites. Methods This was a prospective single-center study that included cases with eosinophilic ascites who were admitted to Tropical Medicine and Gastroenterology Department, Assiut University Hospital, Assiut, Egypt, during the period between May 2020 to May 2023. The clinical presentation, investigations, treatment, and follow-up data of the included patients were collected and analyzed. Results Seventeen cases of eosinophilic ascites were included in the study. The main presenting manifestations were abdominal pain (47.1%), and abdominal pain with distension (29.4%). Two patients presented with a picture of intestinal obstruction. Moderate ascites was found in 10 patients (58.8%) by ultrasound. Eosinophilia in the peripheral hemogram was detected in 76.5% of the study population. Endoscopic examination showed gastro-duodenitis in 9 patients (52.9%) and duodenitis in 4 patients (23.5%). All patients showed complete improvement and disappearance of ascites after starting steroids within two weeks. Eleven patients (64.7%) relapsed after discontinuation of steroids. Conclusion Eosinophilic ascites is an uncommon cause of ascites that is often underdiagnosed. The relapse rate after stopping treatment is high but with excellent response to retreatment.