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This study determines the effectiveness of a non-digital picture concept programme to treat cognitive deficits in pupils with dyslexia. Using a sample of 38 primary two pupils (aged 7-9 years) in Ebonyi State, Nigeria, a Picture Concept Activity and the traditional method of repetitive passage drill were administered for eight weeks and results were compared. Standard cognitive and reading measures were used and data were analysed with descriptive and inferential statistics. Results show that the experimental participants performed higher than the control group on the overall reading and cognitive proficiency performances. Improved cognitive proficiency was associated with improved reading tasks.

Implementing self-injection (SI) of subcutaneous depot-medroxyprogesterone acetate (DMPA-SC) is a key self-care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences-including those with and without experience using SI-view the benefits and challenges of SI as compared to other methods. We conducted 241 in-depth interviews with women across four sub-Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample. Through the benefits of privacy, easier access, and self-management, we found SI can promote greater control over the contraceptive experience by facilitating a woman's ability to act on her preferences and control who is involved in or aware of her contraceptive use. Interviews revealed SI's potential is, however, constrained by inherent limitations in the method; for example, it is often not private or accessible enough and many fear injecting themselves. SI has the most potential when implemented with programmatic solutions that mitigate challenges women experience or anticipate and allow more women to benefit from the privacy, easier access, and self-management that SI offers.

BACKGROUND The efficacy, effectiveness, and safety of the approved nirmatrelvir/ritonavir regimen for treatment of laboratory-confirmed mild/moderately severe COVID-19 remains unclear. METHODS We systematically identified randomized controlled trials (RCTs) and realworld studies (RWS; observational studies) of the efficacy/effectiveness and/or safety of the approved nirmatrelvir/ritonavir regimen for COVID-19. We pooled appropriate data (adjusted estimates for RWS) using an inverse variance, random-effects model. We calculated statistical heterogeneity using the [I.sup.2] statistic. Results are presented as relative risk (RR) with associated 95% CI. We further assessed risk of bias/study quality and conducted trial sequential analysis of the evidence from RCTs. RESULTS We included 4 RCTs (4,070 persons) and 16 RWS (1,925,047 persons) of adults (aged [greater than or equal to] 18 years). One and 3 RCTs were of low and unclear risk of bias, respectively. The RWS were of good quality. Nirmatrelvir/ritonavir significantly decreased COVID- 19 hospitalization compared with placebo/no treatment (RR = 0.17; 95% CI, 0.10-0.31; [I.sup.2] = 77.2%; 2 RCTs, 3,542 persons), but there was no significant difference for decrease of worsening severity (RR = 0.82; 95% CI, 0.66-1.01; [I.sup.2] = 47.5%; 3 RCTs, 1,824 persons), viral clearance (RR = 1.19; 95% CI, 0.93-1.51; [I.sup.2] = 82%; 2 RCTs, 528 persons), adverse events (RR = 1.41; 95% CI, 0.92-2.14; [I.sup.2] = 70.6%; 4 RCTs, 4,070 persons), serious adverse events (RR = 0.82; 95% CI, 0.41-1.62; [I.sup.2] = 0%; 3 RCTs, 3,806 persons), and all-cause mortality (RR = 0.27; 95% CI, 0.04-1.70; [I.sup.2] = 49.9%; 3 RCTs, 3,806 persons), although trial sequential analysis suggested that the current total sample sizes for these outcomes were not large enough for conclusions to be drawn. Real-world studies also showed significantly decreased COVID-19 hospitalization (RR = 0.48; 95% CI, 0.37-0.60; [I.sup.2] = 95.0%; 11 RWS, 1,421,398 persons) and all-cause mortality (RR = 0.24; 95% CI, 0.14-0.34; [I.sup.2] = 65%; 7 RWS, 286,131 persons) for nirmatrelvir/ritonavir compared with no treatment. CONCLUSIONS Nirmatrelvir/ritonavir appears to be promising for preventing hospitalization and potentially decreasing all-cause mortality for persons with mild/moderately severe COVID-19, but the evidence is weak. More studies are needed. Key words: nirmatrelvir/ritonavir; Paxlovid; laboratory-confirmed COVID-19; systematic review; quantitative methods: meta-analysis; trial sequential analysis; efficacy/effectiveness; safety https://doi.org/10.1370/afm.3120, INTRODUCTION The virus responsible for the COVID-19 pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains in circulation. It mutates and keeps infecting large proportions of populations, with attributable substantial [...]

Background: Dyslexia is a learning disability that affects children of school-going age and exists in all cultures and backgrounds. Dyslexic children are deficient in phonological awareness, which makes the children to fail to attain the skills of reading, writing and spelling commensurate with their intellectual abilities. Inadequate knowledge about the nature of dyslexia by primary school teachers results in poor categorisation of at-risk children. Aim: This study sought to achieve two objectives. The first was to develop and validate the Teachers Awareness Questionnaire (TAQ), while the second goal was to use the validated TAQ to assess primary school teachers' level of awareness about dyslexia. Setting: Primary school teachers in Nsukka and nearby rural communities filled the TAQ and the Scale of Knowledge and belief about Developmental Dyslexia. Nsukka is called the university town and it is a slow-paced environment that is devoid of the usual hustle and bustle of most major towns in Nigeria. Methods: The cross-sectional design was employed to gather data for the measurement process. Data were analysed using bivariate correlations and descriptive statistics. Results: The TAQ has good internal consistency (r = 0.77) and an adequate convergent validity (r = 0.74, p < 0.01). Results also reveal that primary school teachers possessed low level of awareness about dyslexia. Conclusion: The study findings show that primary school teachers in Nigeria lack the requisite knowledge about dyslexia. The study suggests psycho-education for primary school teachers to empower them with information about the condition. Contribution: This study measured primary school teachers' level of awareness about dyslexia. The results showed that primary school teachers' awareness about dyslexia is poor, and this suggests that the use of labels (e.g., dullard) by some primary school teachers to describe their pupils may be incorrect. The study recommend to School Management Boards to take action to improve the teachers level of awareness about dyslexia, which would promote early identification of dyslexic pupils and possible intervention.

Addressing the imperative need for advancements in thermoelectric generation, this study pioneers an analysis of nanofluid-cooled solar segmented thermoelectric generators with non-uniform cross-sections. Insights into thermal management, structural integrity, and economic efficiency in thermoelectric systems are provided, employing a numerical model that accurately represents thermoelectric effects by accounting for temperature dependencies of semiconductor materials. Through research, exploration of diverse coolant strategies, including TiO2, Fe3O4, Al2O3, and graphene, offers key insights into their impact on cooling dynamics. Findings demonstrate that graphene nanofluid, operating at a flow velocity of 2 m/s, outperforms others, achieving optimal power generation of 221.77 mW and an exergy efficiency of 8.99 %. Additionally, at a concentrated irradiance of 595 kWm−2, graphene leads in environmental benefits, with the highest CO2 savings of 0.38 kgyr−1, and demonstrates economic advantages with a cost-effective dollar per mW value of 3.79×10−6 $mW−1. Furthermore, the study verifies the structural integrity of these systems, with graphene achieving an optimal von Mises stress of 1.35 GPa at a semiconductor height of 0.2 mm. These advancements contribute to environmentally friendly and high-performance generators for sustainable energy solutions, paving the way for future innovations in thermoelectric technology.

Background Progress in hernia surgery in Nigeria is hampered by poor health-seeking behavior, poverty, and ignorance. The disparity in the quality of health care deliveries between urban and rural areas led to the greater proportions of rural dwellers being grossly underserved. Medical aid programs offer ample opportunities to reduce the burden of hernias in Nigeria. This study aimed to analyze the early outcomes of elective hernia repairs performed during medical outreach programs. Methods This is a retrospective study of 186 patients who had hernia repair between September and November 2019. Patients were recruited from six consecutive medical aid programs held in Niger Delta (Southern) region of Nigeria. Results Overall, 186 patients were evaluated: 159 (855%) males and 27 (14.5%) females. Approximately three-fourths (141, 75.8%) harbored inguinal hernia. Nylon-darn was utilized to repair all inguinal hernias while a simple closure technique was used for all midline hernias. Majority (180, 96.8%) were discharged within 24 h of repair. Spinal anesthesia accounted for 51.6% of all anesthetic techniques used. The overall postoperative complication rate was 17.2%. The most common postoperative morbidity was scrotal edema (8.1%) followed by seroma (4.3%). Age >64 years (P < 0.001), large hernias >3 cm defect (P < 0.001), lower cadre of surgeon (P < 0.001), local anesthesia (P < 0.001) and comorbidity (P < 0.001) were significantly associated with raised morbidity. No mortality was recorded. All complications were managed conservatively. Conclusion Majority of the hernias were of inguinal origin. Scrotal edema was the most frequent postoperative complication, followed by seroma. Advanced age, large hernias, lower cadre of surgeon, comorbidity and local anesthesia were associated with raised morbidity rates.

Abstract Background Women living with HIV (WLWH) in low- middle-income countries (LMICs) face increased mortality risks from comorbidities despite progress in antiretroviral therapy. Palliative care (PC) is vital for these patients, yet its integration in LMICs, such as Nigeria, is suboptimal due to unique challenges. Objective This study investigated the knowledge, perceived barriers, and facilitators influencing PC integration into routine HIV care within healthcare (HC) settings. Methodology A cross-sectional survey was conducted among WLWH in twelve HC facilities throughout Nigeria. Data collection involved surveys focused on PC knowledge, attitudes, facilitators, and barriers. Logistic regression analyses were employed to examine the data. Results This study revealed significant gaps in knowledge and attitudes towards PC among HIV + women at NISA-MIRCs. Over 90% were unaware of PC services, but many saw its potential to offer hope (55%) and improve quality of life (56.5%). The key predictors of PC knowledge included education, occupation, religion, having fewer children, urban residence, type of residence, and having a high income (p

Living with chronic health conditions such as HIV has implications for health-related quality of life (HRQoL) and improving the HRQoL of people living with HIV (PLWH) is becoming increasingly important for researchers, policymakers, and health practitioners. However, there is limited research on factors that help to explain HRQoL among persons with HIV in sub-Saharan Africa. We examined the contributions of emotion regulation and self-compassion in the HRQoL of 187 PLWH (56.1% female) drawn from the HIV clinic in a specialist hospital in southeast Nigeria. They completed the Brief Version of the Difficulties in Emotion Regulation Scale (DERS-18), Self-compassion Scale, and Patient-Reported Outcome Quality of Life-HIV (PROQOL-HIV). While controlling for participants’ demographic variables, the regression results showed that self-compassion was positively associated with HRQoL. Higher difficulties in emotion regulation were not associated with HRQoL in the presence of self-compassion. The findings extend the outcomes of previous research in other parts of the world and support the notion that enhancing self-compassion interventions may shore up the HRQoL of people living with chronic health conditions. HRQoL interventions that embody culturally informed self-compassion strategies and developmental level approach are needed for the health system in sub-Saharan Africa.

Abstract Drug resistance remains a significant challenge in cancer treatment. Recently, the interactions among various cell types within the tumor microenvironment (TME) have deepened our understanding of the mechanisms behind treatment resistance. Therefore, this review aims to synthesize current research focusing on infiltrating cells and drug resistance suggesting that targeting the TME could be a viable strategy to combat this issue. Numerous factors, including inflammation, metabolism, senescence, hypoxia, and angiogenesis, contribute to drug resistance could be a viable strategy to combat this issue. Overexpression of STAT3 is commonly associated with drug-resistant cancer cells or stromal cells. Current research often generalizes the impact of stromal cells on resistance, lacking specificity and statistical robustness. Thus, future research should take notice of this issue and aim to provide high-quality evidence. Despite the existing limitations, targeting the TME to overcome therapy resistance hold promising and valuable potential.

This study aimed at determining the diversity of forage plants utilized for small ruminant feeding in rural and peri-urban sites in Imo state, Nigeria. The survey was carried out at rural and peri-urban sites in Aboh Mbaise and Mbaitoli Local Government Areas (LGAs), respectively. Ten small ruminant farmers were purposively selected from each LGA across the study communities. Data on fodder diversity, proximate composition, and mineral concentration were collected and analyzed using descriptive statistics such as frequency counts, percentages, means, and standard deviation. It was observed that a higher diversity of fodder plants existed at the rural sites compared to the peri-urban sites and 43.4% of the fodder plants were common to both sites. Respondents identified 60.8% of the fodder plants also as food-bearing plants, with 55.6% and 80% of these found at the rural and peri-urban sites, respectively. There were no significant differences (p > 0.05) between the relative proximate or mineral supplies to the animals at the two sites. It was, therefore, concluded that despite the diversity and differences in forage selection at the two sites, the relative nutrient supplies to small ruminants will be similar if the cafeteria system of forage provision practiced at the sites is adhered to.

Background: Diarrhoea is one of the major causes of morbidity and mortality among infants and young children in developing countries. More than half of the deaths due to diarrhoea results from dehydration and/or excessive loss of essential nutrients including micronutrients such as zinc, copper and vitamin A These micronutrients are essential for immunological protection, as well as the proper growth and development of children. Objective: To determine the serum and stool levels of zinc, copper and vitamin A in children presenting with diarrhoea. Methods: This was a comparative cross-sectional study. Thirty consecutive infants with diarrhoea from the Diarrhoea Training Unit (subjects) and thirty without diarrhoea (controls) from the Infant Welfare clinic of the Jos University Teaching Hospital (JUTH], were studied. The feeding practices, diarrhoeal history, and anthropometric measurements of the study and control groups were noted. Their sera and stool samples were analyzed for zinc and copper using Vernox Elmer Atomic Absorption spectrophotometer and for Vitamin A using spectrophotometer Pye Unicain PU 8600. The data obtained were analysed statistically. Results: The age, body mass index (BMI), mid upper arm circumference MUAC] and sex distribution of children in the two groups were similar but their mean weight, and length/ height were significantly different (p

Background: Contemporary understanding of the pattern of congenital anomalies is both important in its clinical management as well as in improving the overall health of the community. Methodology: All infants presenting from January to December 2102 at the centre were prospectively studied. Results: A total of 5010 infants were screened, of which 108 have congenital anomalies giving a prevalence of 2.2%. Major anomalies were noted in 101 (93.5%) infants. Only two (1.9%) were preterm. Consanguineous relationship was observed in 2 (1.9%) cases. Pre natal Ultrasound scan was done in 33(30.8%), but in only 7 (6.5%) was any anomaly detected Onitsha, a densely populated urban area contributed 45(42%) of the cases. Only 7(6.5%) of the mothers took herbal prescriptions in the first trimester of pregnancy. Risk of anomaly progressively rises, reaching a peak of 48% in the maternal age group of 26-30 years and drops steadily after. Gastrointestinal tract anomalies were most common (no. =28, 25.9%). Residences close to dump sites, telecom masts/base stations, electricity cables, industries and heavy motorised highways contributed to risk factors in 9-12 % of cases. Conclusion: More of younger mothers were affected with gastro intestinal malformations predominating. The location of home environment is a potential risk factor that will require further characterisation.

Abstract Parasites negatively affect the fitness of ungulate hosts directly, and in wild ungulates, these effects may be synzootic with other stressors, such as limited nutritional resources. In the Arctic, muskoxen (Ovibos moschatus) occur in a highly seasonal environment and must rely on finite energetic resources for survival and productivity. We investigated the costs of gastrointestinal nematodes on the body condition and reproductive status of 141 muskoxen, on Banks Island, Canada, when the population was at a peak in numbers and density. Using a Partial Least Squares Path Modelling approach, we found that high adult nematode abundance was associated with lower body condition, and high parasite abundance was associated with female reproduction including the indirect effect through on body condition (n = 87). These findings suggest that individuals prioritize energetic reserves for reproduction over parasite defence. In fall 2003, a severe icing event that restricted access to forage was associated with high overwinter mortality of muskoxen and a population crash. Through direct and indirect costs of parasite infection on body condition and reproduction, the high abundance of parasites may have contributed to the effects of this extreme weather event. Understanding the mechanisms in which parasites impact fitness can help explain the ecological drivers of ungulate populations and predict the interactions between the environment and populations.

ABSTRACT Background The literature on fatigue in children and adolescents undergoing cancer treatment is highly variable, creating uncertainties about its prevalence and identifying those at higher risk. Objectives The primary purpose was to describe the prevalence of fatigue among patients (

Purpose: The purpose of the study was to produce compost and compare the effect with other fertilizer types on scent leaf vegetative growth, yield, nutrient contents and heavy metal accumulation for safety of consumers. Method: Cow dung, compost, NPK fertilizer and urea were applied to scent leaf stem cuttings at 2 weeks after planting. Control was zero application of fertilizer. Treatments were replicated four times in a completely randomized design. Concentrations of Cu, Fe, Pb, Cd, Zn and Ni in the leaves were determined at 8 weeks after treatment application (WATA). Results: Compost increased plant height from 32.40 to 66.25 cm while zero application of fertilizer increased plant height from 20.75 to 38.25 cm between 2 to 8 WATA. Compost (3.88 tha-1) significantly (p

The study evaluated the land productivity of root crop farmers amidst pesticide application in southeast, Nigeria. 358 root crop producers were chosen using a multi-stage sample and given a questionnaire. The analysis of the data included the use of mean, frequency, percentage, total factor and partial factor productivity, analysis of variance, multiple regression model, and local average treatment effect (LATE). Data were acquired using primary means. The results show that root crop growers were mostly women (76.9%), married (85.1%), educated (mean=12.0), and in their prime working age (51). Estimates of total factor productivity (TFP) and partial factor productivity (PFP) gave 7.69 and 177.25, which indicates higher land productivity values across Imo, Abia, and Ebonyi State. Education, access to farm inputs, soil/land improvement practices, size of farm, and extension relations were important components of land productivity across the States. Use and application of pesticides according to specified recommendation increased land productivity by (727.07%) and (880.28%). Erosion problems (99.7%), pests and disease (96.9%), high cost of inputs (99.1%), climate change (99.4) and land fragmentation (93.0%) constrained land productivity in the States. Study recommends farmers to practice more of land improvement practices and adhere to specified pesticide use and application to increase land productivity

The rise of Black maternal mortality rates throughout the country demonstrates a great need to utilize innovative frameworks to craft solutions that improve health outcomes for Black birthing people. Previous research and interventions have examined individual- and policy-level factors to reduce maternal mortality; however, these methods may lack a true community-centered approach to understanding the experiences of Black birthing people in local communities that have been disproportionately impacted. In addition, certain research methods may not recognize other marginalized intersectional identities (e.g., Black transgender men) who experience inequities in Black maternal health. This commentary aims to provide recommendations for utilizing community-centered strategies on Black maternal mortality informed by community-based participatory research principles.