Search

Summary . Background: Nocturnal enuresis (NE) is believed to be commoner in children with homozygous sickle cell disease (SCD-SS) than in those with normal haemoglobin. The reasons for this have not been established and its prevalence and pattern have not been adequately described in the tropics. Objective: To determine the prevalence and describe the pattern of nocturnal enuresis in children with SCD-SS in the Guinea Savannah region of Nigeria. Method: A cross-sectional case-controlled study was carried out on randomly selected steady state children with SCD-SS attending the Haematology Clinic of the Department of Paediatrics at Ahmadu Bello University Teaching Hospital, Zaria. A structured questionnaire was used to collect historical and clinical data from the patients. Age-dependent definition of NE was used in analyzing data. Results: One hundred and fifty (47.1 percent) of the 360 children with SCD-SS studied had NE. The rate was significantly higher than that obtained in control children. Whereas significantly more male than female control children had NE, the difference did not reach statistical significance in those with SCD-SS. Mariy home caregivers used potentially harmful methods in attempts to control NE. Socioeconomic factors and family history did not play significant role in the prevalence of NE. Conclusion: Nocturnal enuresis is commoner in children with SCD-SS than in otherwise normal children, even in the Guinea Savannah region of Nigeria. It is suggested that NE in SCD-SS may not be innocuous.

Introduction: Human cryptosporidiosis is a zoonotic disease and is increasingly recognized as a major public health problem. It is associated with significant effects on growth, physical and cognitive functions and excess mortality especially among children. Aim: To determine the prevalence of Cryptosporidium oocyst excretion in children less than 5years with diarrhoea in ABUTH Zaria. Methods: Children aged 0 to 59 months managed in paediatrics wards of ABUTH for diarrhoea were studied between July 2008 and June 2009. Stool specimens obtained from these subjects were analysed for Cryptosporidium oocysts using the modified ZN staining technique. Results: A total of 185 children were enrolled. There were 78 (42.2%) boys and 107(57.8%) girls. A total of 33 children studied excreted oocysts in their stools, giving a prevalence of Cryptosporidium oocysts of 17.8%. The highest rate (21.7%) was observed in children aged between 13 and 36 months, and no oocysts were observed in stools of neonates. Oocyst excretion was observed to be commoner in the rainy season. Conclusion: Cryptosporidium is a common cause of diarrhoea among under-five children in our environment. It was commoner after infancy and in the rainy season. Recommendation: Routine screening for Cryptosporidium should be part of evaluation of diarrhoeal illness especially in children beyond the neonatal age group.

Introduction: Leaving hospital care prematurely could threaten the healthy survival of and expose children to a risk of harmful alternatives. It is also a concern and a challenge to healthcare providers and the health system. A better understanding of itscharacteristic could help mitigate the impact on children. Objective: To determine the prevalence, types of, and reasons for premature hospital discharge amongst children. Methods: We carried out a threeyear retrospective review of case notes of children who were taken away from hospital admission by their parents/caregivers before they were due for discharge. Socio-demographic, clinical and discharge information were collected and data was entered into Microsoft® Excel® for Mac 2011 (Version 14.1.0), cleaned and analysed. Results were presented as percentages, statistical means and standard deviations, tables and charts. Results: There were 56 cases of premature discharge out of 2858 admissions, giving a prevalence of 2.0%. Under-five children constituted 65.4%, with a male: female ratio of 2.3:1. Thirty-one (55.3%) children were absconded with while 25 (44.7%) were taken away by caregivers against medical advice. The commonest diagnoses were protein-energy malnutritionand pneumonia and majority were from poor socio-economic family background. The commonest reasons for discharge AMA were unaffordable costs and perception of improvement of child’s medical condition. Conclusion: Socio-economic factors were significant determinants of utilization of in-patient hospital services for the children studied. There is a need for provision of affordable health care as well as efficient discharge policy to protect children from potential risksassociated with premature hospital discharge.

Background: Hepatitis C virus (HCV) is a major public health problem for Human Immunodeficiency virus (HIV) infected population. Both infections share same routes of transmission, and quite often co-exist, with dual infections associated with reciprocal and mutually more rapid progression than either infection alone. Co-infection also adversely impacts on the course and management of both infections. This study was carried out to document the prevalence and determinantsof HCV sero-positivity in HIVinfected children. Methodology: A total of 132 HIVinfected children attending the Paediatric Antiretroviral Clinic were recruited as subjects. Another 132 HIV negative children matched for age and sex were recruited as controls. Relevant demographic data was taken from each child. Blood samples were also obtained from each child and from their mothers when available, and assayed for the presence of anti-HCV using a membranebased immune-assay kit. Results: The sero-prevalence of HCV antibodies was 9.8% among HIV-infected children and 3.0% among the controls. This was a statistically significant difference (p = 0.042, Fisher exact). HCV sero-postivity was more frequent in children after 5 years of age in both subjects (92.3%) and controls (100.0%). Injection at patent medicine vendor (PMV) was noted to be the most risky practice leading to HCV in children, with more than thrice the chances of HCV sero-positivity than in those who didn’t receive injections at PMV. Four mothers of the HIV-infected children were co-infected with HCV and none in the control group. All 4 children of these dually infected mothers were also co-infected. Controlling for other factors, children of HIV infected mothers were more than twice as likely to have HCV antibody aschildren whose mothers were HIV negative (RR = 2.67). Similarly, HCV infected mothers have 12% greater chance of transmitting HCV to their children than noninfected mothers and children delivered vaginally were 1.6 timesmore likely to have HCV antibody than those delivered via caesarean section. Conclusions: The prevalence of anti-HCV in HIV-infected children is significantly higher than that of HIV uninfected peers. Factors strongly associated with HCV sero -positivity identified are maternal HIV and HCV infections, vaginal delivery and injections at patent medicine vendor.

Background: Medical schools use different evaluation methods after students undergo a period of instruction for certification of acquisition of requisite skills and competencies required for registration. Despite a global trend towards adoption of OSCE format to test competencies, its adoption in medical schools in Nigeria has been relatively slow and local experiences with its use are limited. We describe the development and administration of OSCE for the formative assessment of undergraduate medical students of Kaduna state university at the end of paediatrics clinical rotation. Methodology: OSCE was developed and conducted to assess clinical skills of 20 undergraduate medical students at the end of clinical posting in paediatrics. Students rotated through a series of clinical encounters arranged in ten stations in a circuit, each for a short duration of five minutes. Clinical tasks were carefully chosen to reflect learning objectives of the posting using standardized patients while scoring was done using task-specific and validated checklists by the same assessors. Results: A range of clinical competencies in different clinical scenarios, including history taking, physical examination and basic clinical skills was examined using this format. The conduct was resource intensive with much time spent during the selection of the competencies and appropriate standardized patients to be tested, standardization of checklists, briefing assessors and choosing appropriate venue as well as preparation of stations. Unfamiliarity with OSCE by both some students and assessors was a major challenge. Conclusions: OSCE is a feasible way of assessing a wide range of clinical competencies of medical students during paediatric rotation in our setting.

This study assesses the activity concentration of Radon in underground water around Bagwai and Shanono artisan gold mining Sites in Kano State, Northwestern Nigeria. A total of (39) underground water samples, including sixteen (16) from boreholes and twenty-three (23) from hand-dug wells, were randomly collected. The activity concentration of Radon was analyzed using a portable radon detector, Rad7, from DURRIDGE Company. The results show that the radon concentration in all the water samples ranges from 4.13 to 45.24 Bq/l, with an average value of 20.13 Bq/l. The calculated total annual effective dose due to both ingestion and inhalation for different age groups ranges from 42.40, 57.60 and 65.30 (µSv/y) to 457.10, 622.06 and 704.60 (µSv/y), with an average value of 203.32, 276.70 and 313.51 (µSv/y) for adults, children, and infants respectively. The total excess lifetime cancer risk for different age groups varies from 0.00149, 0.00202 and 0.0247 to 0.0160, 0.0220 and 0.0247 with mean values of 0.00703, 0.00956 and 0.0109 for adults, children, and infants. The obtained results are higher than the internationally recommended limits set by USEPA of 4 to 40Bq/l and the International Commission on Radiological Protection (ICRP) value of 0.1mS/y; thus, the water in the study area is not suitable for drinking and other domestic purposes. Hence, remedial action needs to be taken by the authorities to ensure the continuous utilization of water within the study area.

Sarah Musa,1 Ayman Al-Dahshan,2 Rajvir Singh3 1Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar; 2Department of Medical Education, Hamad Medical Corporation, Doha, Qatar; 3Department of Adult Cardiology, Heart Hospital Hamad Medical Corporation, Doha, QatarCorrespondence: Sarah Musa, Email smusa@phcc.gov.qaBackground: COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years’ service closure.Methods: A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection.Results: A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg− 1min− 1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex.Conclusion: The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.Keywords: COVID-19, lockdown, lifestyle behavior, physical activity, obesity, stress, sleep

A new series of chiral 4,5-dihydro-1H-[1,2,4]-triazoline molecules, featuring a β-ᴅ-glucopyranoside appendage, were synthesized via a 1,3-dipolar cycloaddition reaction between various hydrazonyl chlorides and carbohydrate Schiff bases. The isolated enantiopure triazolines (8a–j) were identified through high-resolution mass spectrometry (HRMS) and vibrational spectroscopy. Subsequently, their solution structures were elucidated through NMR spectroscopic techniques. Single-crystal X-ray analysis of derivative 8b provided definitive evidence for the 3-D structure of this compound and revealed important intermolecular forces in the crystal lattice. Moreover, it confirmed the (S)-configuration at the newly generated stereo-center. Selected target compounds were investigated for anti-tumor activity in 60 cancer cell lines, with derivative 8c showing the highest potency, particularly against leukemia. Additionally, substituent-dependent anti-fungal and anti-bacterial behavior was observed.

Sarah Musa,1 Ismail Dergaa,1 Rawia Al Shekh Yasin,2 Rajvir Singh3 1Department of Preventative Health, Primary Health Care Corporation (PHCC), Doha, Qatar; 2Department of Quality & Patient Safety, Primary Health Care Corporation (PHCC), Doha, Qatar; 3Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation (HMC), Doha, QatarCorrespondence: Sarah Musa, Email smusa@phcc.gov.qaBackground: The transition to electronic health records (EHR) has improved the quality of health-care delivery and patient safety. However, poor usability and incongruent workflow may impose a significant burden on documentation and time management, resulting in staff burnout. We aimed to (i) evaluate the effectiveness of personalized EHR training on wellness providers’ knowledge and practical competencies, and (ii) assess staff satisfaction regarding the EHR usage post-training.Methodology: An interventional study was conducted between July 15, 2021, and March 1, 2022, among 14 wellness staff (age: 38 ± 3.9 years; 7 males, 7 females) in the Wellness Center-Rawdat Al-Khail Health Center. Six months of blended training was delivered. The impact of training was assessed using a pre-post survey on the knowledge and practical competencies related to EHR usage. Staff satisfaction was assessed post-training.Results: Majority of respondents had improvement in identifying the advantages of EHR: improve confidentiality of care (pre = 35.7% vs post = 100%, p = 0.001), reduce medical errors (pre = 35.7% vs post = 85.7%, p = 0.02), improve quality of health care (pre = 35.7% vs post = 100%, p = 0.001), and reduce wait time (pre = 42.9% vs post = 85.7%, p = 0.03). Time performing these tasks by massage therapists/receptionists was reduced: viewing/editing ambulatory organizer (pre = 20± 0 s vs post = 10± 0 s), access PM office (pre = 155± 136 s vs post = 10± 0 s), selection/access patient chart (pre = 75± 30 s vs post = 30± 20 s), check-in/out (pre = 120± 0 s vs post = 60± 0 s), and view/edit massage form (pre = 135± 75.5 s vs post = 60± 0 s). For gym instructors, time to access ambulatory organizer (pre = 30± 0 s vs post = 10± 0 s), view/edit the gym form (pre = 101± 57 s vs post = 71± 36 s), view patients’ clinical data (pre = 60± 70 s vs post = 10± 3 s), and place referral orders (pre = 197± 144 vs post = 82± 23 s) was reduced. A mean percentage score of 65.4± 38.7 indicated very good staff satisfaction.Conclusion: This tailored, hands-on training has been well received and effectively improved wellness staff knowledge, competencies, and satisfaction relative to EHR functionalities.Keywords: Electronic health record, health care, health care providers, health care quality, health care safety, health informatics, health information technology

BackgroundEarly identification of a patient with infection who may develop sepsis is of utmost importance. Unfortunately, this remains elusive because no single clinical measure or test can reflect complex pathophysiological changes in patients with sepsis. However, multiple clinical and laboratory parameters indicate impending sepsis and organ dysfunction. Screening tools using these parameters can help identify the condition, such as SIRS, quick SOFA (qSOFA), National Early Warning Score (NEWS), or Modified Early Warning Score (MEWS). We aim to externally validate qSOFA, SIRS, and NEWS/NEWS2/MEWS for in-hospital mortality among adult patients with suspected infection who presenting to the emergency department.Methods and analysisPASSEM study is an international prospective external validation cohort study. For 9 months, each participating center will recruit consecutive adult patients who visited the emergency departments with suspected infection and are planned for hospitalization. We will collect patients' demographics, vital signs measured in the triage, initial white blood cell count, and variables required to calculate Charlson Comorbidities Index; and follow patients for 90 days since their inclusion in the study. The primary outcome will be 30-days in-hospital mortality. The secondary outcome will be intensive care unit (ICU) admission, prolonged stay in the ICU (i.e., ≥72 hours), and 30- as well as 90-days all-cause mortality. The study started in December 2021 and planned to enroll 2851 patients to reach 200 in-hospital death. The sample size is adaptive and will be adjusted based on prespecified consecutive interim analyses.DiscussionPASSEM study will be the first international multicenter prospective cohort study that designated to externally validate qSOFA score, SIRS criteria, and EWSs for in-hospital mortality among adult patients with suspected infection presenting to the ED in the Middle East region.Study registrationThe study is registered at ClinicalTrials.gov (NCT05172479).

AbstractBlack widow spider (Latrodectus renivulatus) envenomation is a toxicological emergency affecting Middle Eastern countries. Young children may experience greater morbidity due to their small size relative to the amount of venom delivered. We describe four pediatric cases of severe black widow spider envenomation in Saudi Arabia. The neurological effects predominated, and all patients needed morphine for pain relief. All patients required admission to the pediatric intensive care unit (PICU). The durations of PICU stay and total hospital stay were 1–3 days and 2–5 days, respectively. Although Latrodectus antivenom is safe and effective, Latrodectus antivenom was unavailable, and no patients received antivenom. We believe that Latrodectus antivenom would rapidly relieve symptoms and shorten hospital stays.

Background: The plant Bombax costatum (BC) has been used traditionally in Nigeria for the management of various ailments. The chloroform extract of BC bark was investigated for its potential effects against the induced seizures and depression in rats. Methods: Thirty Wistar rats were divided into five groups of six. Group I received normal saline, group II received pentylenetetrazole (PTZ, 35 mg/kg), group III received diazepam (5 mg/kg) plus PTZ at 35 mg/kg, group IV received 250 mg/kg of the BC extract, and group V received 500 mg/kg of the same extract. The above protocol was repeated on alternate days from the first to twenty 5th days. Results: Tukey’s post hoc test revealed a statistically significant increase in the seizure scores after using PTZ (3.38±0.29, P

Background: Recently, there has been a marked increase in the incidence of cancer, HIV, and other noncommunicable diseases globally. Thus, the demand for palliative care (PC), including end-of-life care, continues to grow worldwide. Physiotherapy has an important role in PC as it aims to alleviate symptoms and improve quality of life by optimising independent levels of function. Objective: To assess the level of knowledge, awareness and current practice of PC amongst Nigerian physiotherapists in clinical practice. Method: Our study used a cross-sectional descriptive census-based method and recruited practising physiotherapists in Nigeria. An electronic questionnaire was used to collect data over 12 weeks, comprising 36 semistructured questions in four domains: personal information, knowledge, awareness and current practices regarding PC. Data were analysed using a pragmatist paradigm. Results: Of the 426 physiotherapists who participated, 50% (n = 213) had a postgraduate degree, 49.5% (n = 211) had a bachelor’s degree and 0.5% (n = 2) had a Doctor of Physical Therapy degree. The results also indicate that 73.9% (n = 315) of the participants had sufficient knowledge about PC, 80.5% (n = 343) had a sufficient level of awareness about PC and 66.7% (n = 284) were using current clinical practices in the rehabilitation of critically ill patients or those with chronic conditions. Conclusion: It was concluded that most Nigerian physiotherapists had sufficient knowledge and awareness about PC and were involved in the management of patients requiring PC physiotherapy. Clinical implication: It can be understood that a large proportion of Nigerian physiotherapists have clinical experience managing patients requiring PC, despite inadequate formal training in this field.

The new diprotic ligand 3,5-di-tert-butylsalicylaldehyde 4-ethyl-3-thiosemicarbazone, abbreviated H2(3,5-t-Bu2)-sal4eT, exists as the thio-keto tautomer and adopts the E-configuration with respect to the imine double bond, as evidenced by single-crystal X-ray analysis and corroborated by spectroscopic characterisation. Upon treatment with Cu(OAc)2·H2O in the presence of either 2,9-dimethyl-1,10-phenanthroline (2,9-Me2-phen) or 1,10-phenanthroline (phen) as a co-ligand in MeOH, this thiosemicarbazone undergoes conformational transformation (relative donor-atom orientations: syn,anti → syn,syn) concomitantly with tautomerisation and double deprotonation to afford the ternary copper(II) complexes [Cu{(3,5-t-Bu2)-sal4eT}(2,9-Me2-phen)] (1) and [Cu2{3,5-t-Bu2)-sal4eT}2(phen)] (2). Crystallographic elucidation has revealed that complex 1 is a centrosymmetric dimer of mononuclear copper(II) complex molecules brought about by intermolecular H-bonding. The coordination geometry at the copper(II) centre is best described as distorted square pyramidal in accordance with the trigonality index (τ = 0.14). The co-ligand adopts an axial–equatorial coordination mode; hence, there is a disparity between its two Cu–N coordinate bonds arising from weakening of the apical one as a consequence of the tetragonal distortion. The axial X-band ESR spectrum of complex 1 is consistent with retention of this structure in solution. Complex 2 is a centrosymmetric dimer of dinuclear copper(II) complex molecules exhibiting intermolecular H-bonding and π-π-stacking interactions. The two copper(II) centres, which are 4.8067(18) Å apart and bridged by the thio-enolate nitrogen of the quadridentate thiosemicarbazonate ligand, display two different coordination geometries, one distorted square planar (τ4 = 0.082) and the other distorted square pyramidal (τ5 = 0.33). Such dinuclear copper(II) thiosemicarbazone complexes, which are crystallographically characterised, are extremely rare. In vitro, complexes 1 and 2 outperform cisplatin as antiproliferative agents in terms of potency and selectivity towards HeLa and MCF-7 cancer cell lines.

Sarah Musa, Ismail Dergaa Department of Preventative Health, Primary Health Care Corporation, Doha, QatarCorrespondence: Sarah Musa, Department of Preventative Health, Primary Health Care Corporation, P.O. Box 26555, Doha, Qatar, Tel + 97455666457, Email smusa@phcc.gov.qaBackground: COVID-19 and the measures stemming from efforts to control it have affected the psychosocial wellbeing of children and adolescents. The increasing trend of challenging behavior has exerted further pressure on parents and schools. Understanding socioemotional development and interrelating triggers is the key to management. Early interventions prevent the future threat of mental illness and risky acts. Effective strategies are ones that primarily focus on strengthening parent–child interactions.Aim: The purpose of this paper is to review the literature on the (i) psychosocial and behavioral impacts of COVID-19 on children/adolescents and (ii) approaches to identify determinants of challenging behaviors as a principal guide to effective interventional strategies for children and their families.Methodology: Electronic database searches of PubMed, ScienceDirect, Medline, and Scopus were conducted to identify studies meeting the inclusion criteria that address the impact of COVID-19 on behaviors, contributing factors, and management in the context of families/schools. The content of the selected articles was themed under five categories, namely the developmental milestones, the Pyramid Model, the Positive Behavioral Support, the management strategies, and the impact of COVID-19 on children/adolescents’ behavior.Results: The present review demonstrates considerable influence of COVID-19 on children and adolescents’ behavior and mental wellbeing. It stresses the importance of early family-based interventions focusing on the triggers of challenging behavior. Functional Behavioral Assessment and Behavioral Intervention Plan provide a systematic analysis with a strategic plan that support children’s self-regulation and socioemotional intelligence. Regular behavioral screening is vital to promote prevention and early management.Conclusion: Managing behavioral difficulties remains an area of deficit for parents, teachers, and health care providers. With a quality support, parents and schools will be able to clearly characterize the challenging behavior, understand the causes, reinforce parent–child interactions, and consequently, gain the strategic skills required to apply it within natural settings. Timely interventions will limit the risk of future misconduct and mental disorders.Keywords: COVID-19, psychosocial wellbeing mental health, Pyramid Model, family-centered intervention, children, adolescents

Background: Since its discovery in late 2019, COVID-19 has claimed approximately three million lives worldwide, causing a significant economic burden and strain on health care delivery and services. Therefore, the COVID-19 vaccine may offer the potential to promote global recovery. Objective: To determine the acceptability of the COVID-19 vaccine among Nigerian doctors and the factors influencing the acceptance.Methods: Using a cross-sectionaldesign, an anonymous online survey was administered to medical doctors across the six geopolitical zones in Nigeria between 13 January and 31 January 2021, using the health belief model (HBM). Results: Out of 830 respondents, 38.8% were willing to take the COVID-19 vaccine, 36.0% were unsure, while the remaining 26.5% refused to take the vaccine.Following adjustments, males were more likely to take the vaccine (OR = 3.357; 95% CI 2.009-5.610; p = 0.0001), whereas increasing age, higher perceived viral virulence and perceived viral infectivity were observed to be significantly associated with less likelihood of accepting the vaccine. Respondents who believed in the efficacy of ivermectin were much less likely to receive the vaccine (OR = 0.217; 95% CI 0.108-0.436; p=0.001). Concerns on vaccination safety were themain barriersto vaccine acceptability. Hypothetically addressing these concerns increased vaccine acceptance rates by approximately a third (34.6%) (p < 0.001). Conclusion: The proposed nationwide distribution of the COVID-19 vaccine may be met withpoor vaccine acceptability among Nigerian medical practitioners. Measures specifically addressing vaccine safety concerns should be provided to allay fears and enhance the acceptability of the vaccine.

The central location, the size, and instability of saddle pulmonary embolism (PE) have raised considerable concerns regarding its hemodynamic consequences and the optimal management approach. Sparse and conflicting reports have addressed these concerns in the past. We aimed to evaluate the clinical presentation, hemodynamic and echocardiographic effects, as well as the outcomes of saddle PE, and compare the results with those of non-saddle type. This was a retrospective study of 432 adult patients with saddle and non-saddle PE. Overall, 432 patients were diagnosed with PE by computed tomography pulmonary angiography (CTPA). Seventy-three (16.9%) had saddle PE, and 359 had non-saddle PE. Compared to those with non-saddle PE, patients with saddle PE presented more frequently with tachycardia (68.5% vs. 46.2%, P= .001), and tachypnea (58.9% vs. 42.1%, P= .009) on admission, required more frequent intensive care unit (ICU) admissions (45.8% vs. 26.6%, P= .001) and thrombolysis/thrombectomy use (19.1% vs. 6.7%, P= .001), and were at more risk of developing decompensation and cardiac arrest after their initial admission (15.3% vs. 5.9%, P= .006). On echocardiography, right ventricular (RV) enlargement (60% vs. 31.1%, P= .000), RV dysfunction (45.8% vs. 22%, P= .000), and RV systolic pressure (RVSP) of greater than 40 mmHg (61.5% vs. 39.2%, P= .003) were significantly more observed with saddle PE. The two groups did not differ concerning the rates of hypotension (17.8% vs. 18.7%, P= .864) and hypoxemia (41.1% vs. 34.3%, P= .336) on admission and mortality rates. A logistic regression model indicated that the use of oral contraceptive pills (OCP), RVSP > 40 mmHg, and development of hypotension and decompensation following admission were associated with an increased likelihood of having saddle embolus. Saddle PE accounts for a higher proportion among all PE cases than previously reported. Patients with saddle PE tend to present more frequently with adverse hemodynamic and echocardiographic changes and decompensate after their initial presentation. OCP use, development of hypotension, and decompensation following admission and RVSP > 40 mmHg are significant predictors of saddle PE. These characteristics should not be overlooked when managing patients with saddle PE.

Background: Mental health in medical students is well researched, with physiotherapy students receiving less attention even though psychiatry is a recognised specialty within physiotherapy. Objectives: To assess the prevalence and correlates of depression, anxiety and stress among physiotherapy clinical students. Methods: A descriptive cross-sectional study design was employed on 402 physiotherapy clinical students aged 17–40 years using a convenience sampling method. The data were collected using the self-administered 42-items Depression, Anxiety and Stress scale (DASS) and the data were analysed using a Chi-square test and binary logistic regression analysis. Results: The prevalence of depression, anxiety and stress among these students was 79.9%, 85.6% and 81.6%, respectively. The results indicate that financial status and social life influenced depression by 20.6% (odds ratio [OR] [95%] = 1.206 [1.110, 1.311]) and 36% (OR [95%] = 1.360 [1.050, 1.764]), respectively. Fear of repeating a class influenced anxiety by eight times (OR [95%] = 8.330 [6.643, 10.422]). Fear of repeating a class, financial status and academic performance influenced stress by eight times (OR [95%] = 8.360 [6.677, 10.470]), 17.5% (OR [95%] = 1.175 [1.083, 1.275]) and 18.1% (OR [95%] = 1.181 [1.083, 1.276]), respectively. Conclusion: Our study concluded that there was a high prevalence of depression, anxiety and stress among physiotherapy clinical students. These outcomes suggest that more attention needs to be given to improving physiotherapy clinical students’ mental health, which will ultimately improve learning outcomes. Clinical implications: The long-term effects of psychological distress could potentially impact students’ academic performance. It may also have long-lasting effects after graduation. Therefore, students who are at risk of developing psychological symptoms are needed to be thoroughly examined and then receive early required interventions.

Historical buildings have inhabited every epoch of history. Some of these built legacies are now in ruins and dying whilst others are somewhat undamaged. Knowledge of conservation techniques available today has allowed us to understand more innovative ways of conserving the built heritage. Such techniques are, however, incompatible with the building materials available in our historical epoch and environment. People seek to reclaim the forgotten cultural heritage in the midst of the heritage conservation era while bearing in mind that previous work seldom takes into account the inventive preservation methods of today. This study aims to explore the innovative built heritage conservation practice in the Kano metropolis, to detect deterioration and incorporate traditional wisdom and contemporary innovation according to modern urban development. The study adopted qualitative research with a descriptive approach. The descriptive research explains, examines, and interprets prevailing practices, existing situations, attitudes, reasons, and on-going processes, while the qualitative research approach uses spatial analysis methods (direct assessment of physical characteristics of the selected buildings) and focus group discussion (FGD) sessions with the custodians, prominent elderly persons, or ward head (Mai Unguwa) from each of the selected buildings. In this work, we found it necessary to survey 29 historical buildings of which three of the historic buildings from pre-colonial, colonial, and post-colonial architecture were purposively sampled for inclusion. This is on the basis of their value formation, processes, phenomena, and typology. The findings reveal that deterioration is due to decaying plaster and paint, moist walls, deformed openings, sagging roofs, wall cracks, roof leakages, exit spouts, stains, and corrosion. Other factors include microbes and termite attacks, inappropriate use and neglect, civilization, and inappropriate funding. Conservation was performed to avert the amount of decay while the techniques in practice are documentation methods and treatment interventions with no implementation of diagnostic methods. It further unveils the potential benefits of local treatment, as evidenced by the intervention at the Dorayi palace segment, the use of “makuba” (milled locust bean pod) to stabilize the geotechnical performance of “tubali” (local mud bricks) to improve its potency. This milled locust bean pod also serves as the water repellent consolidant in “laso” (local) plaster, which has proven to be eco-friendly, non-toxic, and effective in wall rendering. The need for immediate implementation of diagnosis techniques in the conservation of architectural heritage in the municipality and elsewhere in Nigeria and beyond is eminent. Intervention and implementation of policies, appropriate funding, and mobilization, raising awareness and sensitization on the value, significance, and state of affairs of our cultural heritage is also paramount.

Since disinfection by-products are a growing concern, it is important to know their quantities in water treatment plants before they are released to the public. As a result, there is a requirement for constant monitoring of disinfection by-products (DBPs), which can have major consequences for human health and productivity. Consequently, in previous studies, several models for predicting disinfection byproduct formation in drinking water have been developed which were either linear/log-linear, hybrid or neural network (radial basis function). In this study, an adaptive neuro-fuzzy inference system (ANFIS) is proposed for predicting trihalomethane levels in real distribution systems. To train and verify the proposed model, 24 sets of data were used, including THMs levels (TCM, BDCM, DBCM and T-THM levels) and five parameters (pH, temperature, UVA254, residual chlorine, and dissolved organic carbon). As compared to response surface modeling (RSRM) coefficient of determination, R2 is between 0.727

Surface displacement measurements collected using continuous Global Positioning System (cGPS) stations include the contribution of both endogenic processes (e.g., plate tectonics, isostasy) and exogenic processes that show seasonal variation (e.g., climate). These seasonal variations distort the tectonic signals and limit the usefulness of short-term investigations. This paper explores cGPS and meteorological time series collected in southern Africa and investigates whether the usefulness of cGPS time series can be improved by accounting for the seasonal effects of the dominant meteorological processes. The study is carried out using time, frequency, and time-frequency domain signal processing (inferential) analysis techniques. It was found that from the considered atmospheric processes, thermally-induced effects, which are not corrected for in the cGPS data, are the most prominent meteorological contributors in the vertical annual deformation component observed in cGPS time series. The effects of heave action (due to seasonal subsurface water infiltration and absorption, as well as changes in the water table) and changes of water mass distribution (caused by infiltration, transportation, extractions, and evaporation) on the displacement time series are much smaller. This suggests that correcting for thermal expansion, contraction, and thermal-induced errors could reduce the annual seasonal deformation component observed in cGPS position measurements in southern Africa and, most probably, in other parts of the world subjected to large seasonal variations in atmospheric temperatures. Reducing the magnitude of the seasonal components would increase the usefulness of short-term cGPS campaigns.

The discovery and characterization of layered intrusions around the globe have been predicated to a large degree on the imaging capabilities of the reflection seismic method. The ability of this tool to detect mineralization zones and structural controls such as faults and folds has been critical in unlocking the economic potential of igneous complexes, most notably the Bushveld Complex in South Africa. In this study, we present novel seismic constraints on the lesser-known Trompsburg Complex in South Africa. Two yet-unpublished seismic profiles were conducted end-to-end in the early 1990s, with a southwest-to-northeast trend through the centre of the ∼2,400 km2 Trompsberg potential field anomaly in South Africa, attributed to a 1915 ± 6 Ma buried layered intrusion complex. The complex was first detected by magnetic and gravity measurements near the town of Trompsburg in 1939 and was subsequently confirmed as a layered intrusion by borehole cores drilled thereafter. The combined length of the two profiles is 108 km. Both profiles have been reprocessed and interpreted to further constrain the subsurface expanse of the Trompsberg Complex along the seismic traverse. Processing and interpretation of the seismic profiles were aided by a handful of studies found in the literature: stratigraphy and physical property measurements of borehole cores that were drilled into the complex in the 1940s; pre-Karoo (∼317 Ma) lithological maps that were constructed based on boreholes in and around the investigation area; and potential field maps of the intrusion area near the town of Trompsburg. Most of the seismic reflection energy is concentrated within the top 1 km in both profiles, where localized reflectors with strong amplitudes are observed, due likely to the dolerite sills that permeate the Karoo cover. These sills obstruct seismic illumination of underlying structures due to their high acoustic impedance contrast with the surrounding soft rock sediments, rendering underlying reflections challenging to identify and enhance. The base of the Karoo is confidently identified to be at an average depth of 1.5 km and several reflection packages have been identified thereunder. These are linked to Proterozoic supracrustals associated with the Witwatersrand, Ventersdorp, Transvaal/Griqualand West, and Kheis Supergroups, as well as the Trompsburg Complex that intruded into them. The geometry of the Trompsburg Complex along the seismic traverse has been constrained with a moderate degree of confidence. It comprises a series of 30° northeasterly dipping reflectors near its southwestern boundary, flat reflectors near its centre at the town of Trompsburg, and 45° southwesterly dipping reflectors near its northeastern boundary. The lateral sub-Karoo extent of the complex is 60 km and its total thickness is difficult to constrain due to lack of deep reflections, but is likely between 6.6 and 7.5 km. The complex subcrops against the Karoo cover except near the southwestern region, where it is overlaid by Waterberg Group sediments.

Background: HIV-associated peripheral neuropathy (PN) is a common neurological complication associated with HIV infection. Distal symmetrical polyneuropathy (DSPN) is the most commonly occurring type, which is associated with symptoms such as numbness, unsteady gait and, in some cases, muscle atrophy and weakness when myelinated nerve fibres are affected. If unmyelinated nerve fibres are affected, a painful neuropathy and autonomic symptoms may occur. Objectives: This research study assessed the effects of a strength exercise intervention on balance impairment and gait disturbance amongst individuals living with HIV-associated DSPN. Method: The study was a single-blinded, randomised controlled trial (RCT) with participants sourced from four HIV centres in Kano metropolis, Nigeria. The intervention was supervised and included progressive resistance exercise (PRE) (three 40-min sessions per week for 12 weeks) using a quadriceps bench (n = 44). The control group (CG) included the non-exercise group (n = 47). The two groups continued to receive routine care. Data were summarised and analysed using inferential statistics (SPSS version 20 program) with the alpha level set at 0.05. Results: At 12 weeks, the results revealed significant improvement with regard to balance performance (p = 0.001) and walking ability (p = 0.001) in the training group. In contrast, no significant differences in balance (P = 0.677) or gait (P = 0.578) were observed in the CG. Conclusion: The findings suggest that PRE is beneficial for balance impairment and gait disturbance caused by neuropathy in persons living with HIV and receiving antiretroviral drugs.

Excess phosphorus in water body will lead to eutrophication. This study investigated the phosphate removal efficiencies of unaerated and aerated filter systems using high composition of Calcium (Ca) steel slag as the filter media at different pH values of the wastewater influents. Lab-scale filters were developed using 25 mg/L synthetic wastewater and weekly sampling was done to monitor the phosphate removal efficiencies together with the concentration of metals (Calcium (Ca) and Magnesium (Mg). The results show that both unaerated and aerated systems have excellent phosphate removal efficiency at all acidic, neutral and alkaline pH feed, though unaerated systems removed slightly better compared to aerated systems; 76-98% and 69-97% respectively. The dominant phosphate removal mechanism for aerated systems was adsorption, meanwhilefor unaerated systems; both adsorption and precipitation for acidic and neutral pH, whileprecipitation was more dominant at basic pH. The performance of unaerated systems are slightly better compared to aerated systems, however, aerated systems are recommended to be applied when simultaneous removal of nutrients (phosphorus and nitrogen) are concerned.

Water is absorbed by the roots of a plant and transported subsequently as a liquid to all parts of the plant before being released into the atmosphere as transpiration. In this study, seven(7)selected plant species collected from urban, rural and forested areas were studied and characterized. The water was collected using transparent plastic bag that being tied to the tree branches. Then, the vapouris water trapped inside the plastic bag and through the condensation process, it become water droplets. Water quality parameters such as temperature, pH value, DO, turbidity, colour, magnesium, calcium, nitrate and chloride were analyzed. The analysis was compared to drinking water quality standard set by the Ministry of Health Malaysia. Based on the results, it shows that banana leaf has a higher rate of water extraction compared to others. Thus, the plant can be categorised as a helpful guide for emergency use of water or as an alternative source to survival.

Food drying methods nowadays are mostly in high use of electricity and fuel which lead to high operational cost. This has resulted in a waste of energy and money due to the use of modern tools requires significant costs for implementation. Meanwhile, the traditional food drying process only uses sun rays in their process, where the process is far more efficient than the modern drying method. In this study, the test was conducted to determine the trapped solar heat energy requirements for the process of drying foods such as agricultural products, particularly bananas. The solar trap test by using solar trap container was carried out include determining the thermal energy requirement for drying, preparing equipment (solar trap container) to trap solar energy, handling and drying tests on samples of bananas. The percentage amount of water removal and energy required for the drying process was found to be 48% and 134 J. The results of this study can determine that solar trap drying method is easier, quicker and more effective than the usual method of drying because it use natural solar energy. Several proposals have been suggested for improvement for future study, such as controlling the solar trap air in the container, replacing the trap solar wall with a darker color, examining the floors slope so that more solar traps collected and installing a small hose on the base of the container so that the water evaporated in the solar trap may exit through the route.

Reappraisal of legacy reflection seismic data has shown to deliver value in mineral exploration, particularly in brownfield settings. In this work, we demonstrate how the reappraisal and processing of legacy reflection seismic data can be advantageous in the mineral exploration industry. We use today's standard seismic processing tools to improve the imaging of deep and complex geological structures that host mineral deposits. The recovered and processed 25.3 km long legacy seismic profile in this study was acquired in 1983 by the Gold Division of Anglo‐American as part of the Witwatersrand Gold Fields exploration program. This study aims to improve the imaging of the Ventersdorp Contact Reef gold‐bearing horizon (termed reef), a world‐class gold deposit (2 m thick) situated at depths between ∼2400 and ∼4100 m below the ground surface near South Deep Gold Mine in Fochville, South Africa. The final processing results from the pre‐stack time and phase‐shift migration approaches clearly reveal a dipping reflection associated with the gold‐bearing horizon and major steeply dipping faults that crosscut and displace the deposit. The final results are integrated with borehole information, 1D synthetic modelling and aeromagnetic data to constrain the structural interpretation. In particular, 1D synthetic simulation and borehole data constrain the depth position of the gold deposit. The magnetic data provides additional constraints on the complex faulted blocks of the host rocks such as the intrusions that may have a direct impact on ore resources and evaluation. The mining companies, such as South Deep Gold Mine, operating closer to the seismic profiles can use this new structural information to update the current geological models and improve future mine planning and designs, thus providing some insight into the prospectivity of unmined ground. [ABSTRACT FROM AUTHOR]

We reprocessed a 50‐km long legacy 2D reflection seismic profile acquired in 1986, under a project funded by the National Geophysics Program to improve the delineation of complex geological structures that host the platinum‐bearing horizons (known as the UG2 reef; a chromitite horizon) on the south‐eastern edge of the Western limb of the Bushveld Complex and to investigate the continuity of the reef below the thick cover. The pre‐stack seismic data quality was improved through conventional processing steps. We applied standard Kirchhoff pre‐stack depth migration as well as advanced coherency migration techniques. Both imaging techniques yielded good structural images of the platinum deposits, their hanging wall and footwall rocks. In particular, the coherency migration technique has provided significantly better images in complex faulted regions, yielding a better understanding of the interrelationship between fault activity and platinum deposit distribution, and the relative chronology of tectonic events. Moreover, the regional geological structures (Crocodile River fault and Chaneng structure) that crosscut the profile are clearly defined. [ABSTRACT FROM AUTHOR]

Corrosion of metals is a persistent challenge in various industries, leading to significant economic losses and safety hazards. Conventional corrosion inhibitors often face limitations such as environmental toxicity, low efficiency, and short-term protection. Nanoparticle-based corrosion inhibitors have emerged as a promising alternative due to their unique properties and versatile applications. This paper provides a comprehensive review of the recent advances in nanoparticle-based corrosion inhibition strategies from 2015-2024 by harvesting data from secondary sources. The fundamental mechanisms underlying the corrosion inhibition by nanoparticles are discussed, including adsorption processes, passivation mechanisms, and synergistic effects with other inhibitors. Various types of nanoparticles, including metallic nanoparticles, metal oxide nanoparticles, polymer nanocomposites, carbonbased nanoparticles, and organic-inorganic hybrid nanoparticles, are explored for their corrosion inhibition potential. Furthermore, the applications of nanoparticle-based corrosion inhibitors in industries such as oil and gas, aerospace, automotive, marine, and infrastructure are highlighted. Despite significant progress, challenges such as stability, compatibility, and environmental concerns remain to be addressed. Future directions in nanoparticle-based corrosion inhibition research are also discussed, aiming to guide further developments in this promising field. [ABSTRACT FROM AUTHOR]

A new series of chiral 4,5-dihydro-1H-[1,2,4]-triazoline molecules, featuring a β-ᴅ-glucopyranoside appendage, were synthesized via a 1,3-dipolar cycloaddition reaction between various hydrazonyl chlorides and carbohydrate Schiff bases. The isolated enantiopure triazolines (8a–j) were identified through high-resolution mass spectrometry (HRMS) and vibrational spectroscopy. Subsequently, their solution structures were elucidated through NMR spectroscopic techniques. Single-crystal X-ray analysis of derivative 8b provided definitive evidence for the 3-D structure of this compound and revealed important intermolecular forces in the crystal lattice. Moreover, it confirmed the (S)-configuration at the newly generated stereo-center. Selected target compounds were investigated for anti-tumor activity in 60 cancer cell lines, with derivative 8c showing the highest potency, particularly against leukemia. Additionally, substituent-dependent anti-fungal and anti-bacterial behavior was observed. [ABSTRACT FROM AUTHOR]