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Background A novel modality of cancer treatment based on exposure to non-contact electric fields has been developed to reduce cancer incidence. However, the safety of the electric field exposure was not fully investigated. Therefore, This study aimed to observe the safety of electric field exposure on kidney and liver structures. Methods Female Sprague-Dawley rats were divided into one control group and three treatment groups. Animals were treated with 7,12-dimethylbenz[a]anthracene for mammary tumour induction and exposed to non-contact electric fields individually for 10 hours a day for three weeks. Fresh samples of the kidney and liver were collected for observation of structural damage in both organs. Both organs were prepared for histopathological cross-sectioning using the paraffin method and Hematoxylin and Eosin staining followed by histological scoring using the post-examination masking method. Results Damages found in the kidney were as follows: thickening of the Bowman capsule, karyolysis, karyorrhexis, pyknosis, cloudy swelling, epithelial sloughing, inflammation, haemorrhage, and congestion. In addition, the number of inflammation and haemorrhage in the kidney structure of healthy rats that were exposed to electric fields was significantly lower than that in the control group. All damages to the kidneys were also found in the liver, but each showed a different degree of damage. Exposure to this electric field can cause haemorrhagic damage to the livers of healthy rats, but not to rats with breast cancer. Conclusions Exposure to non-contact electric fields can cause haemorrhagic damage to the livers of healthy rats, however, in other liver tissues and the kidneys, exposure to this electric field was safe. It can even decrease the number of inflammations and haemorrhages in the kidneys.

Background There have been significant changes in the lifestyles of individuals in the past few decades, which has led to increased morbidity and mortality worldwide. Both smoking and chewing forms of tobacco are highly prevalent, especially in India, and are implicated as causes of diseases, including oropharyngeal carcinomas. Effective tobacco cessation techniques and sources can help overcome addiction and reduce the disease burden in society. The aim was to evaluate the quality and readability of contents of various sources on an internet website about tobacco cessation. Objectives i) To evaluate the readability of internet content (Google) regarding tobacco cessation using Flesch–Kincaid readability tests and the quality of internet content (Google) by using the JAMA benchmark, HONcode and DISCERN questionnaire. Methods A content review was employed to screen the content of the Google search engine for educational tobacco cessation websites, and the top 50 websites were selected according to criteria and reviewed by two reviewers. The readability of the internet content (Google) regarding tobacco cessation was evaluated using Flesch–Kincaid readability tests. The quality of the screened sites was evaluated by using the JAMA (Journal of the American Medical Association) benchmark, HONcode (The Health on the Net Code of Conduct) and DISCERN (Discerning the Quality of Information for Choosing Treatments) questionnaire, and the readability and quality of the screened websites were correlated using the above instruments. Results FK readability ease was found to be 49% standard and 30% easy. The FK grade test found that 33% of the content could be easily understood by < 5 th grade. All 4 JAMA benchmarks were met by 23% of websites, and authorship was the least fulfilled criterion. Correlation analysis revealed a significant association between FK ease score and FK grade score. Conclusions The Read-ability Ease and Read-ability Grade Levels of the websites related to tobacco cessation were not standard, and few websites fulfilled the JAMA benchmarks and had HONcode certification.

Nigeria is located south of the Sahara and is confronted with rapid desertification, with severe impacts in northern Nigeria with signs of desert encroachment and atmospheric warming southward of Nigeria. Therefore, this study assessed the rate of desert encroachment and atmospheric warming southwards in Nigeria. The climate of Imo State was studied using Nigerian Meteorological Agency (NIMET)data. The climatic variables studied were annual rainfall, maximum and minimum annual temperatures. The mean temperature was computed from the temperature data. Data from the 30-year period from 1987 to 2016 were used. The annual rainfall and temperature data were divided into three decades, from 1987 to 1996, 1997 to 2006, and 2007 to 2016, to study the variation in decades. Mean monthly variations were also studied. Land features were also assessed. Desert encroachment was assessed in the study area using the criteria for the evaluation of desertification status proposed by the FAO/UNEP (1984). The results revealed that annual rainfall in Owerri was highest in the first decade, with a mean of 2,526.2 mm and the lowest in the third decade, with a mean of 2,278.66 mm. This shows a drop in annual rainfall as the years progressed. The results also reveal that the annual rainfall totals in Imo State are reducing by 13.50 mm annually, indicating desert encroachment as evidenced in loss of vegetation and erosion menace. According to the FAO/UNEP (1984) rating of desertification, desert encroachment in the study area is rated as ‘moderate.’ The maximum temperature shows a mean of 32 °C for the first decade, 32.5 °C for the second decade, and 32.5 °C for the third decade. The mean annual temperature of Owerri was found to increase by 0.02 ° °C per annum. This shows the atmospheric warming of Imo State.

Background Given the high prevalence of tobacco use, India presents a significant challenge in tobacco control. Yet, the support received for tobacco cessation is suboptimal. Hence, the aim of this narrative review was to identify and heuristically evaluate ‘high-quality’ and ‘engaging’ tobacco cessation mobile apps using the Mobile Application Rating Scale (MARS). Also, to categorize and analyse their features with respect to engagement, functionality, aesthetics, and information quality. Methods A systematic search of tobacco cessation apps was done within app stores of prominent smartphone platforms developed by Apple and Android. The following search terms: ‘quit smoking,’ ‘smoking cessation, ‘stop smoking,’ ‘smoking therapy,’ ‘quit tobacco,’ ‘cigarette cessation,’ ‘cold turkey,’ and ‘quit cigarette.’ Pearson’s correlations were used to analyse correlations between app scores (Total score app-quality/mean score) and downloads/ratings and number of downloads with the overall MARS score. A Chi-square test was performed to analyse any association between app focus and app release dates. Results Total MARS scores ranged from 3.1 to 4.9. Quitsure app (4.9), Craving to Quit! app (4.8) and Stop Tobacco Mobile Trainer: Quit Smoking App (4.74) were ranked the highest according to the MARS overall mean score. Older apps focussed more on mere goal setting or substance use, as compared to behaviour change; whereas, recently developed apps are now focussing more on behaviour change. Conclusions The content and functionality of behaviour change-focused apps were of higher quality than those of other app categories. These recently developed mHealth apps can effectively supersede the traditional smoking cessation methods.

The co-infection of Pulmonary Tuberculosis (TB) and hydatid disease is rare. Diagnosis and treatment of this co-infection may be challenging as both diseases present with overlapping clinical manifestations, especially in war zones where the health system is destroyed. We are reporting a 45-year-old female police officer transferred to Sinnar Sudan due to ongoing conflict. She was admitted with chronic cough, shortness of breath, and weight loss. The preliminary diagnosis of pulmonary TB was made based on chest X-ray examination and sputum analysis. Further imaging showed cystic lesions in both the liver and the lungs, and thus a diagnosis of Echinococcosis was made. Surgical intervention was done successfully followed by the courses of Albendazole and anti-TB medication. The clinical condition of the patient improved, with the disappearance of all symptoms. This case represents the diagnostic dilemma of dual infections in the areas of their endemicity because of the symptomatology overlap that might occur and result in an erroneous diagnosis. It does demand an appropriate diagnostic approach, thus, with advanced imaging applications, and once more, emphasizes the interdisciplinary attitude in its treatment for the best possible result.

This article explores the determinants of the consumption of geographical indication agricultural products through a ten-year systematic review. In recent years, the demand for healthier and safer products from consumers has been continuously increasing owing to the influence of the geographical indication of agricultural products. Geographical indication products, a type of label that associates food with specific regions, occupy a certain position in the global food market. This article aims to answer research questions about the determinants of the consumption of geographical indication agricultural products and provide a comparative analysis of five literature reviews related to this topic. We collected and processed relevant research data through a systematic literature review and provided transparent, complete, and accurate explanations using the PRISMA criterion. The research results reveal the consumer response to the geographical indication of agricultural products and the determining factors of different responses. The research in this article is of great significance for understanding the consumption trends and important information of geographical indication of agricultural products, helping enterprises better understand consumer behavior, and improving the income of farmers, producers, and enterprises.

Background The selling of Jamu Gendong (an Indonesian traditional herbal medicine), is closely associated with the informal work of women who migrate to different regions. In Sukoharjo Regency and Wonogiri Regency, Central Java Province, the pressing need to meet household necessities in their places of origin compels women to assume the role of breadwinners. Therefore, this research aimed to identify the livelihood capital and resilience of migrant women selling jamu gendong. Methods The study was conducted in Ciamis Regency, West Java Province, Indonesia, in November 2022, using quantitative and qualitative methods. Primary data were collected through structured questionnaires and in-depth interviews. The sample comprised 51 women selected through snowball sampling and actively involved in selling Jamu Gendong, along with six key individuals from relevant agencies. Results The research findings indicate that the households of migrant women who sell jamu gendong can survive and adapt during their migration to prevent poverty by implementing diverse livelihood strategies. They are the only ones who move without their family members renting a place to live with them. This research has identified various capital sources, including productive age and skills in preparing jamu gendong; physical capital, including road infrastructure, markets, and access to health and education facilities; and natural, social, and financial capital. This research provides an in-depth understanding of women’s roles in family economic resilience, diversification of life strategies, the importance of social capital in migrant networks, economic empowerment through migration, and the influence of cultural values on livelihood strategies. Conclusions The findings contribute to a comprehensive understanding of the resilience demonstrated by migrant women selling jamu gendong. However, further research should be conducted in areas beyond the city center to obtain a holistic view of their resilience.

Background Although the COVID-19 pandemic has diminished in intensity, the virus continues to circulate globally. The SARS-CoV-2 main protease (Mpro) is a key enzyme in the life cycle of the virus, making it important for the development of treatments against future variants of the virus. In this work, Peruvian natural compounds were evaluated against different mutations of the SARS-CoV-2 Mpro. Methods In silico techniques such as virtual screening, all-atom molecular dynamics simulations, and energy estimation analysis were applied. Results Of the tested compounds by virtual screening, rutin was identified as the best binding agent against the different proposed Mpro mutations. In addition, computational simulations and energy estimation analysis demonstrated the high structural and energetic stability between the Mpro-rutin systems. Conclusions Overall, our study identified rutin as the most promising compound with a strong affinity for various Mpro mutations, potentially playing a key role in the development of new treatments for emerging viral variants.

Low-stakes assessments (LSAs) are widely used in medical education to promote continuous learning by providing formative feedback and minimizing the high-stress environment associated with high-stakes assessments. While LSAs are recognized for their role in supporting student learning, questions remain about their reliability and validity. This scoping review aims to systematically identify and synthesize existing literature on the reliability and validity of LSAs within medical education contexts. This study aims to map the methodologies used to establish psychometric parameters, identify problems, and offer best practices. The review will use the Joanna Briggs Institute methodology, encompassing a comprehensive search across six academic databases and grey literature to identify relevant studies published from 2000 onward. Two reviewers will independently screen and extract data, using the Covidence tool for systematic screening and data extraction. Data will be analyzed using qualitative and quantitative approaches to provide an overview of reliability and validity evidence for LSAs in medical education. Insights into motivational and psychometric theories, such as Self-Determination Theory, Classical Test Theory, and Generalizability Theory, that inform LSA design and implementation will be used to analyse the findings in this review. Expected outcomes include a detailed map of the literature on LSA reliability and validity, identification of key challenges, theoretical underpinnings and recommended strategies for improving LSA practices in medical education. Findings will inform future research and provide guidelines for optimizing the use of LSAs to enhance student learning outcomes, assessment integrity, and the educational experience in medical training.

Background The provision of effective musculoskeletal physiotherapy and treatment outcomes are challenged by the shortage of resources, limitations in adherence to clinical guidelines, and client unacceptability. This study aims to evaluate the process quality of musculoskeletal physiotherapy service in the physiotherapy department of Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia, 2020. Method This is a health facility-based single-embedded case study design that involves both quantitative and qualitative methods to describe the service using a three dimensions assessment for quality service evaluation (compliance of the unit, technical compliance, and service acceptability). The quantitative data was collected through document review and observation of the musculoskeletal physiotherapy unit, direct observations of 20 client-physiotherapist interactions, and chart review on systematically selected 172 client charts. For qualitative data; in-depth interviews with five Key informants and 21 clients were conducted. The interviews were audio recorded, transcribed, translated, and analyzed thematically. The data were entered into Epi-Data version 3.1 and exported to SPSS v.25 for analysis. Descriptive statistics was done and data were presented using frequency and percentage. The calculated outputs were used to judge the overall service against the predetermined criteria (i.e. Excellent, Very Good, Good, Fair, and Poor). Results The compliance of the musculoskeletal physiotherapy unit, service providers’ technical compliance, and service acceptability by the users were judged poor (56.1%), fair (60.1%), and good (73.1%) respectively. The compliance of physiotherapists in recording patient information was concerningly poor (30.2%). The majority of clients were satisfied with the service and adhered to their treatment. Conclusion & recommendation The overall service process quality of physiotherapy service was judged as fair (62.55%). However, the assessed dimensions were not as per the expected standard. Therefore, the relevant stakeholders are recommended to improve the service provision gaps.

Background Atraumatic Restorative Treatment (ART) approach is considered as one of the minimally invasive interventions. The success of restoration depends on various clinical factors like material, patient and operator factor. Conjoint analysis is a technique for measuring individual’s preference structures via systematical variations of products attributes in an experimental design. Aim Assess Pedodontists’ perception of non-clinical factors and investigate influence of child’s age, level of cooperation and vulnerability status on their decisions to perform Atraumatic Restorative Approach (ART) approach using hypothetical patient scenario’s and conjoint design. Materials and methods A cross-sectional exploratory survey using a web-based questionnaire was performed among Pedodontists registered as life members under Indian Association of Pedodontic and Preventive Dentistry. Self-designed structured scenario-based questionnaire was prepared and validated. Three non-clinical factors Age of child, Cooperation level and Vulnerability status were considered. Using orthogonal design, SPSS software nine profiles were created randomly along with two holdouts. Final study proforma consisted of three sections with description of eleven clinical scenarios. It was administered to participants using Google forms. Using SPSS conjoint software relative utilities for each factor on decision for using ART was estimated. Results Four hundred and thirty-two pedodontists had completed the survey (35.9%). Pedodontists considered vulnerability status of the child as the most important factor for their decision to use ART treatment. For the vulnerability status, the factor vulnerable had the greatest utility (-0.364) compared to non-vulnerable factor (0.364). For cooperation level, factor uncooperative had greater utility (-0.343), as compared to moderately cooperative (0.066) and uncooperative (0.277). For the age factor, the age of 4 years had the greatest utility (-0.175) compared with age 6 (-0.013) and age 12 (0.19). Conclusion The most preferred scenario by pedodontists to consider ART as treatment of choice was child belonging to vulnerable section, being very young and uncooperative.

Background Many antidiabetic medications with distinct modes of action are available, The sodium glucose cotransporter-2 (SGLT-2) inhibitors are among the most recent oral antihyperglycemic medications. The American Diabetes Association recommends metformin, a biguanide medication, as the first option for oral control of type 2 diabetes because it has demonstrated promise in this regard. Aim of the study To evaluate and compare the effects of metformin and SGLT-2 inhibitors on general urine parameters in T2DM patients from Iraq. Method a prospective cohort study where 101 adult patients of both sexes aged under 70 years and newly diagnosed with T2DM, patients were divided into two groups, Metformin group (n=52), where metformin was prescribed as monotherapy by the clinician and SGLT-2 inhibitors group (n=49) where either dapagliflozin or empagliflozin were prescribed by the clinician, general urine examination was done for each patient in the first contact and after 12 weeks of treatment. Results The mean age was 57±9 years for the metformin group and 54±9 years for the SGLT-2 inhibitors group. There was no significant difference in leukocytes, erythrocytes, or epithelial cell counts between the metformin group and the SGLT2 inhibitor group before and after 12 weeks of treatment. There was a significant difference (p-value =0.043) in leukocytes and a non-significant difference in erythrocytes and epithelial cell counts before and after treatment in the SGLT-2 inhibitors group. Conclusions Diabetic patients on SGLT-2 inhibitors treatment demonstrated higher leukocyte count than metformin group patients, an indicator and predictor for higher susceptibility to urinary tract infections.

Background Non-small-cell lung cancer (NSCLC) is a highly morbid disease. Chemotherapy for NSCLC lacks specificity and efficacy mainly because of drug resistance. The current study aimed to explore computational tools to target allosteric epidermal growth factor receptor (EGFR) sites and screen for the top molecules in vitro and in vivo xenograft models. Methods Molecular docking, virtual screening, and molecular dynamic studies revealed that acenocoumarol and silodosin are the top two allosteric EGFR inhibitors. They were further tested for cytotoxicity, apoptosis, cell cycle, and gene expression by qPCR, western blotting, A549 cell xenograft anti-proliferative activity, and tumor regression efficacy analysis. Results Acenocoumarol and silodosin exhibited cytotoxicity in A549 and IMR-90 cells at concentrations below 50 and 80 μM, respectively. Acenocoumarol and silodosin induced S-phase and G2/M-phase arrest in A549 cells in the cell cycle analysis. Both drugs showed early apoptosis at their IC 50 doses (acenocoumarol 50 μM and silodosin 25 μM). KRAS (Kirsten rat sarcoma viral oncogene homolog) and ERK2 (extracellular signal-regulated kinase 2) gene regulation in A549 cells was confirmed using qPCR. KRAS and ERK2 activities were quantified by western blot analysis. In the xenograft study, tumor size, body weight, and organ weight were significantly attenuated by the test drugs compared with the standard cisplatin. Immunoblotting and western blot results of the A549-xenograft tissue indicated downregulation of KRAS and ERK2. Furthermore, the test drugs have upregulated caspase-3 gene expression. Conclusion The drugs acenocoumarol and silodosin downregulate KRAS and ERK2 both in cell line and in Xenograft model. KRAS and ERK2 are associated with EGFR inhibition. Hence, acenocoumarol and silodosin can be further explored for repurposing studies in human trials.

Delirium is a brain dysfunction characterized by attention and cognitive disturbances in a fluctuating manner. The international guidelines recommend daily screening for delirium. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) are the most commonly used methods for assessing delirium. This study aimed to identify barriers and gaps in knowledge and practice. This was a hospital-based Cross-Sectional study. Stratified random sampling was used in this study. 72 ICU doctors were randomly selected. Statistical analyses were performed using IBM SPSS version 23. Descriptive data were presented, and the chi-squared test was used to determine the associations among variables. Statistical significance was set at p < 0.05. More than 70% of the doctors were ≤ 30 years of age and female. A total of 69.4% of the participants had < 1year of experience. In total, 94.4% of the participants worked in medical ICUs. Less than 20% of the doctors used delirium assessment tools, with a statistically significant difference based on experience ( p=0.012). Delirium was not regularly assessed in 13.9% of the patients. Non-pharmacological management was applied by 76.4% of doctors, and communication with patients was the most frequent (75%). Haloperidol was the most commonly used drug (83.3%). A total of 40.3% of doctors did not stop delirium medication on ICU discharge. A regular delirium assessment was performed. However, the use of validated assessment tools is uncommon. Nonpharmacological management of delirium is important and is mostly performed. Our doctors prescribed antipsychotics for the treatment of both forms of delirium, and almost half of them did not stop the medications on ICU discharge. Medication reconciliation and contact with the next in-charge of the patients are important.

Consumer satisfaction is an outcome of business marketing activities, bridging the buying and usage phases with subsequent consequences such as attitude changes, recurring purchases, and brand loyalty. Most studies have utilized variations of the disconfirmation paradigm, which posits that satisfaction is influenced by the degree and type of disconfirmation experienced and initial expectations. Despite the importance of satisfaction, there remains a paucity of evidence on the cause and effect leading to expectation-confirmation and disconfirmation paradigm. This paper explores the reasons and the key factors in the perspectives of the relevant literature and aims to identify the intention of confirmation and disconfirmation in satisfaction theories. This conceptual paper also suggests various critical analyses based on the arguments for and against the paradigm in customer satisfaction. Consequently, the paper seeks to examine existing gaps in the literature regarding customer satisfaction theories for business sustainability and decision making, which may need to be more concise in the satisfaction generation process.

Background The impact and changes due to the COVID-19 pandemic on end-stage renal disease patients undergoing hemodialysis affect the patient’s fulfilment and quality of life. Objective This study aims to thoroughly investigate the experiences of end-stage renal disease patients undergoing hemodialysis during the COVID-19 pandemic. Methods This research uses a qualitative descriptive approach with in-depth interview methods. Participants numbered 15 people from Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital, which were selected using a purposive sampling technique. Result There are three themes produced in this research: 1) various responses to the COVID-19 pandemic, 2) various impacts, and 3) coping mechanisms developed. Conclusion These findings indicate that patients with end-stage renal disease who undergo hemodialysis have attempted to build adaptive coping strategies in this era of the COVID-19 pandemic. However, they still need support from healthcare providers in the hemodialysis unit to overcome various problems and impacts resulting from the COVID-19 pandemic. Hemodialysis nurses are expected to be able to carry out holistic assessments and continuous evaluation in order to provide comprehensive nursing care to meet patient needs for hemodialysis in the era of the COVID-19 pandemic.

Chronic kidney disease (CKD) is a persistent, devastating, yet neglected, non-communicable disease, particularly in developing and emerging countries. The traditional risk factors for CKD, such as hypertension and diabetes have received relatively ample attention but do not sufficiently explain the high burden of CKD. Ambient air pollution is an emerging environmental risk factor for CKD; however, epidemiological data and evidence are lacking for susceptible populations in developing countries. The Niger Delta region of Nigeria is a petrochemical hub known for environmental degradation, including air pollution, and thus, serves as a good case study for investigating the association between air pollution and CKD. This brief is based on an exploratory mixed-methods study conducted in four communities situated near an oil and gas refinery in Warri, Nigeria, to explore perceived and actual air pollution risks and determine whether long-term exposure to ambient air pollution is associated with CKD. Air pollutant concentrations measured in partnership with citizen scientists using portable air sensors, showed that all except one air pollutant (ozone) exceeded the WHO acceptable limits in all four communities. PM 2.5 ranged from 22.8 to 28.0 μg/m 3, PM 10, 40.6 to 55.5 μg/m 3, and CO 2, 584-652 ppm. The overall prevalence of CKD was 12.3% but even higher (18%) in a socially deprived semi-urban community closest to the oil refinery. Hypertension, diabetes, other behavioral risk factors, and exposures associated with CKD were prevalent in the four communities and environmental health information was lacking. A multifaceted approach is required to mitigate air pollution and the associated NCD risks in the region. The government needs to invest in air monitoring services, cleaner technologies, and environmental risk communication through various media channels. We strongly recommend public inclusion in planning, designing, and implementing educational interventions. Lastly, environmental risk factors such as air pollution should feature prominently in strategic plans for NCD prevention.

Background The zoonotic infection caused by tapeworms Echinococcus is a neglected tropical disease in poor regions with limited access to suitable sanitary conditions. Hydatid cysts produced by Echinococcus granulosus use fatty-acid-binding proteins (FABP) to obtain the fatty acids and cholesterol necessary for their survival from the host. In this work, we analyzed the behaviour of saturated, monounsaturated, and polyunsaturated fatty acids against EgFABP1. Methods We used computational biology and chemistry techniques and binding free energy estimations by molecular mechanics generalized Born surface area (MM/GBSA). Results This research has enabled us to clarify the EgFABP1 isoforms identified in the database, suggesting their potential involvement in diverse cellular activities of Echinococcus granulosus. Conversely, examining the global and local chemical reactivity of 14 fatty acids revealed that liposolubility is contingent upon the degree of unsaturation in the FAs. Additionally, FAs exhibited acceptable levels of oral absorption and bioavailability. The binding of EgFABP1 with FAs analyzed by molecular dynamics simulation showed us that these are highly stable, where the best affinity was with docosahexaenoic acid. Conclusions Our results suggest that the action of fatty acids could play an interesting role in detecting early Echinococcus granulosus.

Background The global prevalence of cancer is rapidly increasing, and patients often require ancillary non-clinical care during treatment. Caregivers, in turn, experience several mental health challenges as they fulfil their responsibilities. This study sought to estimate the prevalence of depression, anxiety, and stress among caregivers of cancer patients at a tertiary care hospital in Bhubaneswar; and explore the psychosocial factors contributing to their mental health. Methods For objective 1, a cross-sectional study design was employed to collect data from 230 caregivers accompanying cancer patients who attended a tertiary care hospital in Bhubaneswar, Odisha during February-April 2024. A licensed version of Hospital Anxiety and Depression Scale (HADS) was used to evaluate the levels of anxiety and depression, while the Perceived Stress Scale (PSS) was used to assess stress. For objective 2, ten in-depth interviews were conducted with caregivers, then recorded, transcribed and translated for thematic analysis. Results The prevalence of anxiety, depression and perceived stress among caregivers was found to be 45.2%, 43.4% and 44.8%, respectively. ‘Being the sole caregiver’ was identified as a significant predictor of caregivers’ mental health, affecting levels of depression, stress, and anxiety. Further, qualitative analysis identified factors like social support, financial hardships, emotional toll, personal wellbeing, communication with healthcare provider and transportation as key contributors to caregivers’ mental health decline. Conclusion Caregivers of cancer patients face significant mental health challenges that need focused attention. Integrating informal social networks, counselling services, creating support groups and offering financial assistance into cancer care programs can help address their needs.

Background Falls affect 40-70% within the first year and contributing to increased morbidity and reduced quality of life. Dual-task assessments, such as the Walking While Talking (WWT) and Stops Walking While Talking (SWWT) tests, are potential tools for predicting fall risk, but their comparative effectiveness remains underexplored. Methods This cross-sectional study included 68 stroke survivors who completed WWT-Simple (WWT-S), WWT-Complex (WWT-C), and SWWT assessments, as well as the Berg Balance Scale (BBS) and Falls Efficacy Scale (FES). Spearman correlations assessed relationships between balance, fear of falling, and dual-task performance. Logistic regression identified predictors of fall risk, and Receiver Operating Characteristic (ROC) analysis evaluated predictive accuracy. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results BBS scores were strongly negatively correlated with WWT-S (r = -0.734, p < 0.0001) and WWT-C (r = -0.737, p < 0.0001), indicating poorer balance with slower dual-task completion. Positive correlations were found between WWT-S and FES (r = 0.668, p < 0.0001) and WWT-C and FES (r = 0.610, p < 0.0001), linking slower completion times with higher fear of falling. SWWT was significantly negatively correlated with BBS (r = -0.625, p < 0.0001). WWT tests had higher sensitivity (97.8%) and specificity (99%) than SWWT (sensitivity = 68.9%; specificity = 91.3%). Logistic regression identified SWWT (Positive) as a significant predictor of fall risk (p = 0.009), and ROC analysis showed an AUC of 0.911, indicating excellent predictive power. Conclusions Findings highlight the superior predictive value of WWT tests over SWWT in assessing fall risk among stroke survivors. Incorporating dual-task measures into clinical practice may enhance fall risk evaluation, supporting targeted stroke rehabilitation.

Introduction Transomental hernias are a rare type of internal hernia, accounting for less than 1% of all internal hernias. They occur when abdominal contents protrude through a defect in the omentum, leading to bowel obstruction and potential strangulation. We report the case of a young male admitted for the management of an acute bowel obstruction. Case report A 38-year-old male patient with no significant medical or surgical history presented with a proximal bowel obstruction syndrome. Upon physical examination, he exhibited mild abdominal distension, tenderness in the right iliac fossa, and tympanism. Laboratory tests indicated elevated inflammatory markers. An emergency computed tomography (CT) scan suggested the presence of a congenital band or an internal hernia. A laparoscopic procedure was performed, which identified a transomental hernia with a segment of the ileum protruding through an omental defect adjacent to the transverse colon. The herniated loop of small intestine was found to be compromised and gangrenous. Due to the severity of the condition, a midline incision was made to convert the procedure, allowing for resection of the affected segment of the small intestine while preserving 2.5 meters of viable bowel distal to the duodenojejunal junction. The remaining small intestine was exteriorized as a double-barrel ileostomy, and the transomental defect was subsequently repaired. The postoperative recovery was uneventful. Conclusion Although internal hernias account for a relatively small percentage of cases, they are frequently overlooked as a cause of bowel obstruction. Diagnosis this condition is challenging, both clinically and radiologically. Facilitating prompt surgical intervention to mitigate high mortality is essential.

Rationale The efficacy of vaccination programs, particularly for diseases like HPV, hinges on widespread acceptance and uptake within communities. However, vaccine hesitancy and inadequate healthcare infrastructure pose significant barriers to achieving optimal vaccination coverage in Nigeria. Recognizing the pivotal role of community engagement in overcoming these challenges, this study aims to explore the potential of leveraging the ward health system (WHS) to enhance HPV vaccination acceptance in Nigeria. Objective The primary objective of this study is to assess the impact of community-based approaches facilitated by the WHS on HPV vaccination demand and acceptance in Nigeria. Specifically, the study seeks to evaluate the effectiveness of ward development committees (WDCs) in mobilizing communities, addressing vaccine hesitancy, and fostering positive attitudes towards HPV vaccination. Method A comprehensive search strategy using various scholarly search engines and sources was employed to gather relevant material. Keywords such as “Boosting Community Engagement” and “Leveraging Ward Health System Approach” guided the search process. Methodical content analysis was used to examine the texts, focusing on identifying emerging trends in community engagement related to HPV vaccination. Discourse analysis further explored the linguistic features of scholarly publications to reveal implicit content through critical thinking. This rigorous approach aimed to extract trustworthy data aligning with the study’s goals, providing a robust foundation for enhancing HPV vaccination strategies in Nigeria. Results The results of the study provide comprehensive insights into the effectiveness of community-based interventions facilitated by the WHS in driving HPV vaccination demand and acceptance. Quantitative data offer valuable information on vaccination coverage rates and factors influencing vaccine acceptance, while qualitative findings provide deeper insights into community perceptions and the role of the WHS in addressing vaccine hesitancy. Conclusions Based on the findings, conclusions drawn regarding the effectiveness of leveraging the WHS to enhance HPV vaccination acceptance in Nigeria. The study highlights the importance of community engagement and the potential of the WHS in overcoming barriers to vaccination uptake. Recommendations The study conclude with recommendations for policymakers, healthcare providers, and community leaders on strategies to optimize the role of the WHS in promoting HPV vaccination acceptance. Recommendations include strengthening WDC functionality, enhancing community outreach efforts, and fostering partnerships to support vaccination programs. Significance Statement This study holds significance as it addresses a critical gap in understanding the role of community-based approaches, particularly through the WHS, in promoting HPV vaccination acceptance in Nigeria. By providing evidence-based insights and recommendations, the study aims to inform policy and practice, ultimately assisting Nigeria in achieving universal health coverage and better health outcomes.

Background Misconduct in the academic community remains poorly understood among post-graduate dental students (PGDSs) in North Africa. Data on the knowledge of misconduct (KoM) level in this population is lacking. This brief report assessed KoM of Tunisian PGDSs’. Methods A cross-sectional study was conducted at the Faculty of Dental Medicine of Monastir, involving 147 PGDSs registered in 2022. Students were recruited via email invitations and convenience sampling at a medical congress. A French survey with 11 questions on KoM, offering three-choice answers (yes/no/maybe) was administered. Each correct answer received one point, and a total score below six indicated a low-level of KoM. Results The mean±SD KoM score of the 106 students who accepted to participate in the study was 4.4±1.8, indicating a low-level of KoM. The majority of PGDSs (85.85%) demonstrated a low-level of KoM. A comparison between subjective and objective assessments of KoM levels revealed that a significant percentage of PGDSs underestimated their knowledge (62.26% vs. 85.85%, respectively). Conclusion This study identified a low-level of KoM among North-African PGDSs. This emphasizes the need for further efforts to enhance awareness and promote better KoM in this population.

Background One of the main goals of the government is to ensure a development that would enhance the living standard of the people in the society. In this regard, capital expenditure that would promote infrastructure is most desired. However, in Nigeria, the government spends more on administrative cost (recurrent expenditure) than capital expenditure. Under such condition, contributions to economic growth and national development become an illusion. Methods This study employed Augmented Dickey Fuller Test (ADF) with Bound testing procedure, time series data that covers the period from 1990 to 2020 in Nigeria were used. Results The result from the analysis showed that governmental expenditure has a significant effect on the national development of Nigeria. All the variables have a long-run relationship with economic growth (RGDP), according to the ARDL model’s results. If the government poor policies on education, health services, and infrastructure etc. are addressed, in the long-run, Nigeria will achieve monumental development. Conclusion The study adopted indices such as expenditure on Social and Community Services, Economic Services and Administrative Services to reflect the dynamics of government expenditure coupled with the yearly data garnered from the Central Bank of Nigeria spanning from 1990 to 2020.

Background Interest in alternative sources of tubers and legumes has increased in recent years because of the constant search for raw materials that provide bioactive compounds with antioxidant potential benefits for consumers. The functionality of new raw materials is sought through physical and/or chemical modifications to develop and innovate new foods. The objective of this study was to characterize taro (TF) ( Colocasia esculenta) and sacha inchi ( Plukenetia volubilis) flours, obtained by the wet (SIF-WM) and defatted method (SIF-DM), as an alternative for the formulation of new functional foods. Methods The free polyphenols of the different mixtures were analyzed, and the antioxidant properties of the extracts obtained were measured using ABTS .* (2,2′-Azino-bis(3-ethylbenzthiazoline-6-sulfonic acid). The ABTS radical method, which reacts with the phenolic compounds of the food matrix, using Trolox as a standard. The blends were subjected to pasting analysis, flow profile tests, determination of viscoelastic properties (temperature sweep). Characterization of common microorganisms in these foods was performed. Results The highest protein value was obtained in the sacha inchi flour obtained by the defatted method (72.62%). The majority of components in taro were carbohydrates (85.4%). About antioxidant and determination of free polyphenols, taro flour obtained values of 2.71 μmol ET/g and 7.47 mg EAG/g, higher than sacha inchi flours. In the rheological analysis (pasting properties, flow profile, and viscoelasticity), we observed that adding taro flour in different mixtures increases the viscosity peak and a lower breakdown, while there was an increase in setback. Except for defatted sacha flour, the others presented a flow index >1 before heating, showing a dilatant fluid behavior. The presence of taro flour improves gel formation and stability. Staphylococcus aureus and Salmonella were present in the taro flour. Conclusions The flours analyzed represent a raw material with great potential for the development of products such as protein snacks due to the contribution of sacha inchi, with good expansion due to taro starch, and naturally gluten-free for people with celiac disease.

Background The growing incidence of chronic diseases such as cancer and the emergence of drug-resistant microorganisms constitute one of the greatest health challenges of the 21st century. Therefore, it is critical to search for new therapeutic alternatives. Moringa oleifera is a plant well known for the properties of its phytocomponents and its role has been analyzed in a variety of fields, from medicine to biotechnology. Methods In this work, the biological activity of Moringa oleifera in human health was explored through a review of 129 original articles published between 2010 and 2021 related to antitumor activity and its potential uses against chronic and infectious diseases. Results Moringa oleifera extracts showed antioxidant, hypoglycemic, antihypertensive and cytoprotective properties at neuronal, hepatic, renal and cardiac levels. Besides, cytotoxic effects, apoptotic and antiploriferative activity against several cancer cell lines has been demonstrated. On the other hand, the antimicrobial potential of M. oleifera was also evidenced, especially against multidrug-resistant strains. Conclusions Hence, it is supported that there is a wide range of clinical entities in which Moringa oleifera exhibits significant biological activity that could contribute to counteracting metabolic, infectious and chronic diseases in a similar or improved way to the drugs traditionally used.

Background The discovery spurred further exploration, leading to the expansion of opal mining into neighboring districts. Numerous cooperative groups, composed of small-scale miners, traditionally explore, develop, and extract significant amounts of rough opal gemstones. This study tries to investigate the challenges and economic impacts of traditional opal mining practice in wollo province of Ethiopia. Methods The study used in this study is primary data collected from rural households, which are living in five districts of north wollo zone, in Amhara regional state. The data was collected using field observation, focus grouped discussion, interview, and questionnaire from sampled households. The study uses both descriptive and econometric methods of data analysis to achieve its objective. Results Among the challenges of traditional opal mining, primitive way of exploring and extraction, limited access to market and low institutional support in terms of training and finance are identified. The probit model reveals that, increased education, access to training, and access to credit positively influence the likelihood of engaging in opal mining. The ESR model shows that, the average treatment effect on the treated (ATT) indicates that participating in opal mining increases monthly income by 31,380 ETB, while the average treatment effect on the untreated (ATU) shows a potential income increase of 31,625 ETB for non-miners if they engaged in mining. Conclusion The study identifies three main categories of challenges faced by traditional opal miners: exploration and extraction issues, market limitations, and regulatory and institutional shortcomings. Exploration and extraction challenges include the lack of modern mining tools and knowledge, as well as difficult terrain, leading to inefficient and hazardous mining practices. Market-related challenges involve limited access to broader markets and lack of value addition, resulting in miners selling raw opals at significantly lower prices compared to polished ones.

Background The Indian government is committed to addressing various manifestations of malnutrition, including overweight and obesity, inorder to improve individual health and well-being. The scoping review aims to map existing national policy instruments (programmes, schemes, regulations and guidelines) addressing overweight and obesity in India and analysing them for Social and Behaviour Change Communication (SBCC) strategies. Methods Systematic identification and selection of policy instruments using ‘Arksey and O’Malley’ framework was conducted from central government ministry websites, between March and June 2023. These instruments focused on nutrition and/or physical activity, targeting specific demographic groups like pregnant women, lactating mothers, children (0-5 years and 5-9 years), or adolescents (10-19 years); excluding those focusing on specific diseases like micronutrient deficiencies, wasting, and stunting. Based on search strategy six policy instruments were included and analysed for SBCC strategies. Results While many policy instruments incorporated SBCC plans; the ‘National Programme for Prevention of Non-Communicable Diseases (NP-NCD)’ stands out as a significant policy initiative specifically targeting the prevention of overweight and obesity within the broader context of Non-Communicable Diseases. It adopts a comprehensive approach addressing key drivers contributing to overweight/obesity across multiple levels of behavioural influence i.e., individual, interpersonal, community and organisation for health promotion. However, there’s need to strengthen SBCC strategies related to prevention and management of obesity, especially screening and counselling, to cover all age groups with a particular focus on adolescents and youth. SBCC strategies can also be incorporated into India’s Integrated Nutrition Support Programme (POSHAN 2.0) and/or Reproductive, Maternal, New-born, Child, Adolescent Health and Nutrition (RMNCAH+N) under the National Health Mission. Conclusion This paper underscores the necessity for comprehensive strategies to address multifaceted origins of overweight and obesity. The NP-NCD stands out as a noteworthy initiative, and there is considerable potential for other programmes to emulate SBCC strategies to bolster their overall effectiveness. Note : *Policy instruments throughout the paper have been used to cover programmes, schemes, regulations and guidelines.

Background The demand for online education promotion platforms has increased. In addition, the digital library system is one of the many systems that support teaching and learning. However, most digital library systems store books in the form of libraries that were developed or purchased exclusively by the library, without connecting data with different agencies in the same system. Methods A hybrid recommender system model for digital libraries, developed from multiple online publishers, has created a prototype digital library system that connects various important knowledge sources from multiple digital libraries and online publishers to create an index and recommend e-books. The developed system utilizes an API-based linking process to connect various important sources of knowledge from multiple data sources such as e-books on education from educational institutions, e-books from government agencies, and e-books from religious organizations are stored separately. Then, a hybrid recommender system suitable for users was developed using Collaborative Filtering (CF) model together with Content-Based Filtering. This research proposed the hybrid recommender system model, which took into account the factors of book category, reading habits of users, and sources of information. The evaluation of the experiments involved soliciting feedback from system users and comparing the results with conventional recommendation methods. Results A comparison of NDCG scores, and Precision scores were conducted for Hybrid Score 50:50, Hybrid Score 20:80, Hybrid Score 80:20, CF-score and CB-score. The experimental result was found that the Hybrid Score 80:20 method had the highest average NDCG score. Conclusions Using a hybrid recommender system model that combines 80% Collaborative Filtering, and 20% Content-Based Filtering can improve the recommender method, leading to better referral efficiency and greater overall efficiency compared to traditional approaches.

The varied geography (Bekele, 1996) and rapid economic growth of Ethiopia (World Bank, 2020) might have impact its air pollution patterns, with topography, elevation, and climate variability (Lemma Gonfa, 1996) playing significant roles. Environmental challenges, including deforestation and climate change, also affect air quality. This study offers a systematic review of air pollution research in Ethiopia, providing a thorough analysis of its health, environmental, and economic impacts, regional variations, and policy suggestions. It addresses both indoor and outdoor air pollution, assessing their wide-ranging effects. Data were gathered through an extensive search of peer-reviewed articles, policies, and guidelines using Google Scholar and reputable sources, following PRISMA guidelines. The review highlights critical sources of air pollution in Ethiopia, including indoor biomass fuel combustion and outdoor emissions from traffic and industries. Indoor air pollution, particularly from traditional biomass fuels like wood and dung, affects rural and peri-urban areas, leading to high levels of particulate matter and carbon monoxide. Outdoor pollution, driven by urbanization, industrial expansion, and vehicle emissions, worsens health issues and environmental damage. The study identifies severe health consequences, such as respiratory infections and cardiovascular diseases, with air pollution contributing to premature deaths and rising healthcare costs. Economic analysis highlights the significant costs related to healthcare, lost productivity, and infrastructure damage. Environmental impacts include harm to plant health, soil degradation, and contributions to climate change. Despite initiatives to improve air quality monitoring and regulation, challenges persist due to outdated policies, limited infrastructure, and insufficient data. The study emphasizes the need for more comprehensive research and regulations to tackle air pollution crisis.

Background Temporomandibular disorders (TMD) are diseases of the stomatognathic system characterized by various signs and symptoms. TMD treatment must be multidisciplinary because its causes are multifactorial. Noninvasive conservative treatment strategies should be carried out before considering invasive treatment options that may lead to irreparable damage. Physical therapy is an effective noninvasive therapy for managing the signs and symptoms of TMD. To date, the most effective therapeutic approach for managing TMD pain remains controversial. Therefore, this study aimed to evaluate the most effective physical therapy for pain management, symptom control, and quality of life improvement in patients with TMD. Methods Data search was performed using the PubMed, SCOPUS, and Web of Sciences databases. The results are reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews. Interventions based on physical therapy, including physical exercise, manual therapy, myofacial muscle manipulation, and postural therapy, with pain relief, increased mouth opening, or improved quality of life as primary outcomes, were examined. Results Twenty eligible articles were analyzed. Most interventions demonstrated statistically significant improvements as measured by the study outcomes. Conclusions Most types of physical therapy demonstrated positive effects on patients with TMD. Furthermore, physical therapy for both cervical and regional TMJ manipulation can be an alternative long-term treatment for TMD.

Background of the study This research examines how psychological and social biases affect individual investors’ investing decisions. Investor sentiment significantly influences financial markets, frequently causing stock prices to deviate from their intrinsic values. In rising economies such as India, where retail investors are significantly affected by psychological factors, comprehending these attitudes is crucial. Methods This study analyses data from a comprehensive questionnaire that was conducted throughout the nation and included 552 retail investors. The investigation employed structural equation modelling (SEM) to identify the elements that influence the decision-making of individuals who invest in the Indian stock market. Findings The research offers insight on the influence that investor attitude has on investment decision-making as well as the factors that precede it. The study demonstrates that investors make financial decisions based on sentiment. In addition to assessing the efficacy of the Indian financial market, this study sought to ascertain the rationality of investors’ choices by exploring the factors that influence their decision-making process. Conclusion The outcome of the study shows that information seeking, anchoring, herding, representativeness, and overconfidence all have a big impact on investors. Moreover, the study has proven investors’ irrationality and stock market inefficiency. The findings may be employed to further examine the trading practices of international investors and encourage further study in the field of behavioural finance.

The global energy sector is a primary contributor to greenhouse gas (GHG) emissions, predominantly through fossil fuel combustion for electricity, heating, and transportation (IEA, 2021). This study systematically reviews Ethiopia’s energy sector mitigation approaches, focusing on renewable energy strategies and energy efficiency initiatives. While Ethiopia has made significant progress in hydropower, accounting for over 90% of its electricity generation, challenges remain in diversifying its energy mix to include geothermal and wind energy (Ethiopian Ministry of Water, Irrigation, and Energy (2019) and African Development Bank, 2020). The Climate Resilient Green Economy (CRGE) strategy sets ambitious targets for achieving carbon neutrality by 2030, challenges remain in diversifying its energy mix to include geothermal and wind energy (Benti, Woldegiyorgis, et al., 2023 and Federal Democratic Republic of Ethiopia, 2011), yet its implementation faces barriers, including financial constraints, technological gaps, and weak institutional capacity (Silitonga et al., 2020). The study highlights the potential of Ethiopia’s vast renewable energy resources, such as geothermal and wind, to enhance energy security and foster economic growth through job creation. Despite the hurdles, opportunities exist for scaling up mitigation efforts, particularly through public-private partnerships and improved policy frameworks. This review underscores the importance of addressing barriers to achieve a sustainable energy transition in Ethiopia, contributing to local and global climate mitigation goals. Thus, the policymakers should boost investments in solar, wind, and geothermal energy, reduce reliance on hydropower through incentives, and establish an inter-agency task force for policy alignment. And also, exploring green bonds and fostering human capital development through training and partnerships are essential. A strong monitoring and evaluation framework is crucial for tracking progress towards energy sustainability goals.

Background Various problems, such as a shortage of teachers, especially in certain outlying and underdeveloped provinces, unequal distribution of teachers, low teacher competency, and mismatch between educational qualifications and scientific fields, as well as the demands of increasingly dynamic developments in science and technology, resulting in the need for professional development for elementary school teachers to improve teacher professionalism in Indonesia. These background as a basis for the government to create teacher professional education program for elementary school teachers continuously. It is hoped that it will be able to answer the educational problems facing the Indonesian nation. This research explores the opinions of elementary school teachers who have participated in teacher professional development activities through the in-service teacher professional education program. Methods We collected data through a written survey of 24 elementary school teachers, as well as article documents relevant to the research topic. Data were analyzed using thematic analysis. Result The research produced two main themes: increasing teacher competencies and sustainable teacher development programs. Increasing teacher competency related to social competence, pedagogical competence and professional competence. The sustainable teacher development program is related to the guaranteeing the instructional quality of post-program and multi-sectoral collaboration Conclusion Developing teacher professionalism through teacher professional education program in elementary schools in Indonesia positively impacts teachers’ becoming professional teachers. Teacher professional education program is an indication of improving teacher professionalism, especially in developing teaching skills, improving the quality of instruction, teacher motivation and individual development in dealing with various problems in instruction in the classroom, especially in elementary schools, so that the instructional objectives that have been set can be achieved. The professionalism of elementary school teachers will improve if there are sustainable programs such as mentoring programs from the government, universities and parties that focus on improving the quality of education in Indonesia

Wearable sensors have become integral tools for monitoring biomechanical and physiologic aspects of athletic training and performance. A prominent trend in fitness technology, wearable devices now measure a variety of health characteristics, including movement and posture, physiologic measures (eg, heart rate and energy expenditure), and fluid and electrolyte losses, to understand an athlete’s physiologic responses during activity. Sleep has proven integral to athletic performance, and sleep monitoring wearable devices (eg, watches, rings, and headbands) use various measures, such as actigraphy and pulse oximetry, to analyze sleep quality. Young athletes benefit from wearable devices during training sessions, where multimodal data are collected and analyzed to assess performance. Wearable devices are also useful for resistance training, biofeedback, and electrical muscle stimulation, providing athletes with tools to optimize their training regimens. Moreover, these devices play a crucial role in athlete safety by monitoring cardiac physiology, head impacts, and muscle rehabilitation after injury. We provide a comprehensive review of current wearable technology and its application in youth athletics, describe where and how these sensors are used to help enhance physiologic, biomechanical, and performance parameters, and discuss future directions for wearable devices to advance sports science and athlete management.

Background Multiple medical conditions arising from reduced physical and physiological functioning, including cognitive decline, manifest in older persons. This study aims to examine the relationship between cognitive function and associated risk factors in older persons living in long-term care facilities in Indonesia. Methods This study involved 350 elderly individuals residing in long-term care institutions. A cross-sectional design utilizing an analytical survey methodology was implemented. Data were gathered via interviews employing a demographic questionnaire and the Montreal Cognitive Assessment (MoCA). Statistical analysis was conducted using SPSS (version 23). Results Univariate analysis demonstrated significant correlations between cognitive performance and gender, ethnicity, level of education, medical history, subjective memory issues, smoking habits, alcohol consumption, dietary intake of fruits and vegetables, and employment history (p < 0.05). Higher education (OR = 0.69, 95% CI: 0.56–0.84) and reduced subjective memory complaints (OR = 0.29, 95% CI: 0.20–0.44) correlated positively with enhanced cognitive function, but alcohol intake (OR = 6.79, 95% CI: 2.42–19.1) correlated with impaired cognitive function. Conclusions the level of education, subjective memory complaints, and alcohol intake are substantially correlated with cognitive performance in older persons residing in long-term care facilities. Evaluating demographic characteristics in elderly individuals can assist healthcare professionals in the early detection of cognitive impairment, facilitating prompt interventions in long-term care environments.

Background COVID-19 disease has spread rapidly worldwide, causing high mortality. Accessible biomarkers capable of early identification of patients at risk of severe form are needed in clinical practice. The aim of the study was to determine the biological markers that predict a critical condition. Methods Retrospective study including patients with confirmed COVID-19 hospitalized between September 2020 and June 2021. The primary endpoint was progression to critical status within 7 days from admission. We defined two groups: Critical group: Patients who developed a critical condition or died or transferred to the ICU before or at 7 th day. Non-critical group: Patients who remained in non-critical respiratory status until 7 th day or discharged before or at 7 th day. Results Our study included 456 patients, with a sex ratio of 1.32 and an average age of 62 years. At the 7 th day of hospitalization, 115 (25.2%) patients were in the critical group and 341 (74.8%) patients were in the non-critical group. The univariate logistic regression indicated that laboratory findings between non-critical and critical groups showed that C-reactive protein (CRP) (p=0.047), D-Dimer (p=0.011), creatinine (0.026), creatine kinase (p=0.039), lactate dehydrogenase (p=0.04), and troponin (p=0.001) were all higher among patients in critical group. However, lymphocyte (p71.5 (OR=1.598, 95% CI=1.042-2.45, p=0.032) were associated to critical group. Conclusions Our results show the predictive value of lymphopenia, thrombocytopenia, high NLR and CRP levels to evaluate the prognosis of COVID-19 pneumonia. A prognostic score could be proposed for guiding clinical care and improving patient outcomes.

Background Low Back Pain (LBP) is the most common musculoskeletal disorder in the world. Medical students, particularly those who use computers for study purposes, are more vulnerable to LBP due to prolonged sitting times and improper sitting posture during lectures. However, prior research showed that the prevalence of LBP among medical students appeared lower when they were enrolled during online pandemic learning. Hence, this research is performed to determine the correlation between the duration of sitting and sitting posture on the incidence of LBP among medical students in Universitas Sumatera Utara, Indonesia. Methods A cross-sectional study with an analytical descriptive design was conducted in September 2023 among randomly selected 147 medical students at Universitas Sumatera Utara, Indonesia. The inclusion criteria of the research sample are students with BMI< 23 kg/m2 while the exclusion criteria are students who have abnormalities and a history of trauma or spinal fractures. Data was obtained from filling out questionnaires of The Pain and Distress Scale (PAD) and Body Awareness of Postural Habit in Young People (BAPHY). A Chi-square test and logistic regression were used to analyze data with a p-value < 0.05 was regarded as statistically significant. Results The study’s findings revealed that 40.1% of students reported having LBP problems, 72.1% reported sitting for more than seven hours each day, and 33.3% reported having a bad sitting posture. Chi-square analysis revealed a significant correlation between sitting duration and posture on complaints of lower back pain (RR = 1.69, p = 0.041 and RR = 1.69, p = 0.009). At a risk of 2,438 times, sitting posture is the main factor contributing to LBP among medical students at Universitas Sumatera Utara, Indonesia. Conclusions This research showed a significant correlation between duration and sitting posture on the incidence of low back pain.

Background Conventional multi-port laparoscopic cholecystectomy (CMLC) has become the current ‘gold standard’ technique in gallbladder disease. Single-incision laparoscopic cholecystectomy (SILC) has gained attention due to its benefits in improving patient cosmetic results and pain reduction. We aim to assess the latest evidence on the feasibility, safety and surgical outcomes of SILC and CMLC. Methods We conducted searches for randomized controlled trials (RCTs) in PubMed, PubMed Central (PMC), and Europe PMC between December 2011 and 2021. The latest search was conducted in January 2022. We analyzed several outcomes, including perioperative complications, estimated blood loss, operation time, conversion to open surgery, hospital stay, pain score, cosmesis, and days of return to work. Cochrane Risk of Bias (RoB) 2.0 tool was used to evaluate quality of studies. Mantel-Haenszel’s formula and Inverse Variance method were conducted to synthesize results. This study was accomplished in accordance with the PRISMA guidelines. Results A total of 37 studies were eligible, with a total of 2,129 and 2,392 patients who underwent SILC and CMLC. Our study demonstrated a superiority of SILC for the visual analog score (VAS) at six hours post-operation [mean difference (MD) -0.58 (95% CI -1.11, -0.05), p=0.03], cosmesis one-month post-operation [standard MD 2.12 (95% CI 1.10, 3.13), p Conclusions SILC is a safe, feasible and favorable procedure in terms of pain reduction and cosmetic results. The option between both procedures is based on surgeon preferences. Registration: PROSPERO ( CRD42022306532; 23 February 2022).

Background Third molar extraction is one of the most common oral surgical procedures globally. This study assessed patients’ knowledge of third molar extraction procedures. Methods A self-administered questionnaire was administered to patients (N=384) of the dental hospital at Imam Abdulrahman bin Faisal University in the eastern province. The questionnaire covered demographic data, knowledge of third molar extraction, and patients’ perception questions. SPSS Version 24 was used for statistical analysis. Chi-square and Fisher’s Exact test were used. P-values less than or equal to 0.05 were considered statistically significant . Results According to the demographical characteristics of the patient who received 3rd molar removal surgery. As per the history of the extraction, 45% had previous 3rd molar extraction experience, whereas 55% had no previous dental surgical experience. There was no significant difference between the groups with the knowledge about the extraction (p-0.187). Patients with no previous history were more aware of the correct time for 3rd molar extraction at 27% vs 19%, respectively (P=0.046*). Patients with a previous history of third molar extraction showed significant results of knowledge in terms of taking medication prior to 3rd molar surgical procedure. Conclusion The patient with previous experience with third molar extraction showed low misconceptions. However, further studies should consider increasing the knowledge and correcting the patients’ perceptions.

Systematic reviews of health economic evaluations play a crucial role in informing evidence-based healthcare decisions, yet they lack standardized reporting guidelines. A project has been initiated that aims to extend the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for systematic reviews of health economic evaluations (PRISMA-EconEval). This scoping review forms a foundation for the PRISMA-EconEval project, aiming to identify, map, and extract candidate reporting items from the methodological literature. The scoping review will follow the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist and involve comprehensive searches in databases such as PubMed MEDLINE, Embase, and Web of Science, covering the period from 2015 to 2024. Supplementary searching, reference checking and citation searching will target grey literature, overlooked studies and evidence prior to 2015. Inclusion criteria will focus on methodological papers that provide frameworks or recommendations for reporting systematic reviews of health economic evaluations and enhanced case studies that critically discuss methods and reporting structures. The extracted data will be coded and analyzed to produce an initial list of candidate reporting items, structured according to conventional sections of a systematic review (e.g., title, abstract, methods, results). This initial list will be used in the subsequent stages of the project and disseminated through a peer-reviewed publication and presentations at international conferences. The outcome of this scoping review will significantly contribute to the development of a comprehensive PRISMA-EconEval reporting guideline, aimed at enhancing the transparency, consistency, and quality of systematic reviews of health economic evaluations, and provide an essential tool for authors, editors, peer-reviewers, and stakeholders.

In this paper, we apply the concept of bipolar fuzzy sets to pseudo-UP ideals in pseudo-UP algebras. We prove that the intersection of two bipolar fuzzy pseudo-UP ideals is also a bipolar fuzzy pseudo-UP ideal, while the union of two such ideals does not always result in a bipolar fuzzy pseudo-UP ideal. Additionally, we discuss the concepts of bipolar fuzzy pseudo-UP ideals under homomorphism and explore several related properties. The homomorphic image and inverse image of bipolar fuzzy pseudo-UP ideals in a pseudo-UP algebra are also examined in detail. Furthermore, we study the notion of a bipolar fuzzy pseudo-UP ideal under the Cartesian product of pseudo-UP algebra. The Cartesian product of any two bipolar fuzzy pseudo-UP ideals is also the bipolar fuzzy pseudo-UP ideal of pseudo-UP algebra, and then some related results are obtained. MSC: 03G25, 06D30.

Background The cestode Hymenolepis diminuta is a cosmopolitan parasite, which in the adult stage is usually found in the small intestine of rats and accidentally in humans. Case report We describe the finding of eggs of this parasite in an asymptomatic 3-year-old child. The child had extremely high IgE values of 1,376 IU/ml. After receiving treatment with Albendazole suspension 400mg/20mL, on the 10th day post-treatment, he showed no H. diminuta eggs in his fecal matter Conclusions Detailed morphological review of Hymenolepis nana-like eggs is recommended to distinguish them from H. diminuta eggs.

As post-hoc analyses show, interactive marketing in the new media age has served as a fragmented technique for transitioning from traditional modes of operation to dynamic and customized environments that blur the lines between brands and consumers. Several research papers have been published on interactive marketing, the impact of social media engagement, and brand loyalty. However, they remain fragmented because most produce different results based on different samples at various stages of business development. Nonetheless, there are no systematic reviews that combine all these findings into a comprehensive framework. However, many interactive marketing studies focus on short-term outcomes and do not take into account long-term effects such as brand equity and customer lifetime value. Selected articles were understudied with the requirement of a rigorous review process, which includes a thorough examination of the relevant literature. The implementation of this process is expected to result in the absence of a room for subjective judgment, as all selected studies were carefully evaluated using predetermined criteria. It was determined that the use of these technologies allows brands to interact with their customers in novel and creative ways, resulting in more engaging and dynamic experiences. That is, evaluating the effectiveness of marketing initiatives is critical to understanding their impact.

Background Forensic age estimation is not difficult when the body is found in good condition, but in cases of severe decomposition or damage, such as burnt or separated body parts, then the analysis can only be done with bones and teeth. There has been abundant research and development in the field of related biochemistry over the years. Various molecular changes occur in hard tissues and long-lived proteins, such as those in bones and teeth during the physiological process of aging. Aspartic acid racemization and DNA methylation are still the most frequently used age estimation methods because of their advantages in accuracy. Method This study aimed to compare the accuracy of DNA methylation and aspartic acid racemization methods for age estimation. Journal articles were searched in the electronic databases PubMed, Scopus, and Semantic Scholar of 2017-2022 according to PRISMA guidelines. Result Twelve journal articles were eligible for review. The DNA methylation method is quite simple to use because of commercially available methylation kits. Furthermore, the results can be obtained relatively quickly without requiring many samples, and the method is less sensitive to thermal and other damage than the aspartic acid racemization method. Conclusion The aspartic acid racemization method for age estimation has high accuracy, especially in determining age at death. However, temperature and the condition of the teeth affect the racemization of aspartic acid. Given that DNA methylation is generally stable in a wide range of temperatures, it provides a better approach to determining the chronological age even from charred remains.

Background This paper examines the impact of financial inclusion on bank stability within Ethiopian context, using panel data from 17 commercial banks over the period 2015-2023. Given the scarcity of research focused on the relationship between financial inclusion and bank stability in Ethiopia, this paper seeks to address a crucial gap by analyzing both conventional and digital aspects of financial inclusion in relation with bank stability. Methods A two-stage principal component analysis (PCA) was conducted to construct a composite financial inclusion index, integrating 10 conventional and 5 digital indicators. The study applied a two-step robust system generalized method of moments (GMM) to examine the effects of financial inclusion on bank stability, complemented by Granger causality testing to examine the directionality of this relationship. Results The result reveals a significant positive effect of financial inclusion on bank stability and Granger causality tests confirms a bi-directional relationship between financial inclusion and stability, indicating that improvements in financial inclusion foster greater stability and vice versa. Our results also highlight that while bank efficiency and GDP growth rate positively effect stability, total assets and income diversification exhibit detrimental effects. Conclusions It is essential to capitalize policy synergies to promote bank stability and to enhance financial inclusion through conventional and digital channels, while carefully managing the implications of risks associated with income diversification and asset distribution. Ensuring inclusive financial system is vital for maintaining bank stability, thus positioning it as a key priority for financial institutions.

Elizabethkingia meningoseptica is an uncommon nosocomial pathogen that causes meningitis, pneumonia, and sepsis in neonates and in immunocompromised individuals. It exhibits resistance to many commonly employed first-line antibiotics used to treat gram-negative pathogens. Herein, we present three cases of late-onset sepsis with multi-drug resistant (MDR) Elizabethkingia meningoseptica in high-risk neonates. Case 1 was a one-day-old preterm low-birth-weight infant who presented with respiratory distress syndrome and septic shock. The patient was intubated and administered empirical broad-spectrum antibiotics and antifungal agents. Blood culture grew Candida krusei, hence Amphotericin B was initiated. Repeat blood culture on day 27 showed gram-negative bacilli, identified as Elizabethkingia meningoseptica by MALDI-TOF . Antibiotic susceptibility testing (AST) revealed resistance to Piperacillin/Tazobactam, but sensitivity to Vancomycin, Levofloxacin, and Minocycline. IV Vancomycin was administered, which resulted in clinical improvement and negative blood culture results. Case 2 was an eleven-day-old preterm, low-birth-weight baby who presented with fever. Initial investigations revealed normal complete blood counts (CBC) parameters and elevated CRP levels. Blood and CSF cultures isolated Elizabethkingia meningoseptica with a similar AST pattern. Intravenous Ciprofloxacin was initiated with clinical improvement and negative follow-up blood cultures. Case 3 was a one-day-old preterm baby, appropriate-to-gestational age, presenting with respiratory distress syndrome. The infant was intubated and started on inotropic support and intravenous antibiotics. Blood cultures on day 4 showed Elizabethkingia meningoseptica and Vancomycin was started. Follow-up cultures on days 6 and 14 grew Acinetobacter baumannii. A combination of Levofloxacin and Colistin was added, and blood cultures were negative after seven days, with clinical improvement. Elizabethkingia meningoseptica is a significant cause of hospital-acquired infections, especially in Neonatal Intensive Care Unit (NICU), leading to outbreaks. Clinicians must have a high degree of suspicion of E. meningoseptica for gram-negative bacilli causing sepsis and meningitis in high-risk patients. Recent technological advances have enabled accurate speciation to guide therapy and reduce morbidity and mortality rates.

Background/Objective Weight stigma has significant psychological and social implications, yet studies on perspective-taking as an intervention strategy remain scarce. This study aimed to investigate the effect of perspective-taking on weight stigma among Chinese university students and examine the potential mediating role of common ingroup identity. Methods A randomized controlled experiment with 202 Chinese university students (experimental group, perspective-taking group: n = 102; control group: n = 100) was conducted. Weight stigma was measured pre- and post-intervention using the Anti-Fat Attitudes Test. The study employed a 2 × 2 mixed design with ANCOVA and mediation analysis. Results The experimental group showed significantly lower post-test weight stigma when controlling for pre-test scores ( F(1, 199) = 25.69, p < .001). Perspective-taking engagement was significantly higher in the experimental group ( t = 3.13, p = .002). Common ingroup identity negatively correlated with post-test weight stigma ( r = -.28, p < .001) but did not significantly mediate the perspective-taking and weight stigma reduction relationship. Conclusion Perspective-taking effectively reduces weight stigma among Chinese university students, contributing to stigma reduction strategies in university settings. Further research on underlying mechanisms is warranted.

Background Central serous chorioretinopathy (CSCR) is a common retinal condition with an increased risk of recurrence. Traditional approaches have made choroidal visualization challenging, but recent advances in optical coherence tomography (OCT) innovation have permitted the collection of more accurate choroidal visualizations. This study aimed to measure choroidal thickness in eyes with active CSCR as well as in the unaffected opposite eyes of these same individuals. Methods This research was conducted at the ophthalmology division in Ghazi Al-Hariri Hospital from the 1 st of October 2019 until the 31 st of March 2020. A total of 49 people, corresponding to 65 eyes, were included in the study. Among these participants, 16 individuals presented with central serous chorioretinopathy (CSCR), affecting a total of 32 eyes. The CSCR individuals were further split into two groups: “Group A” consisted of 20 eyes with active CSCR, and “Group B” encompassed the remaining 12 unaffected opposite eyes. Additionally, the right eyes of 33 individuals who were age and gender-matched served as controls assigned as “Group C”. Results The choroid exhibited a substantial rise in thickness across each of the nine sectors in group A as compared to group C. Similarly, group B showed a significant increase in choroidal thickness in relation to group C. The mean subfoveal choroidal thickness (SFCT) was measured as follows: 474.55μm, 437.5μm, and 292.03μm among groups A, B, and C, correspondingly. These differences were identified as clinically significant for both A vs. C and B vs. C. Conclusions This study’s findings indicate a thickening of the choroid in both eyes exhibiting active CSCR, as well as in the unaffected opposite eyes of those with the disease.

Introduction Low and middle-income countries account for the largest proportion of women’s deaths as a result of pregnancy or childbirth-related complications. The sub-Saharan region is the most affected with approximately 70% (202 000) of maternal deaths between 2000 and 2020. These deaths could have been prevented if expectant mothers were prepared for childbirth. Birth preparedness is perceived as a better strategy that helps attain a substantial reduction in maternal mortality. This is achieved by attending early antenatal classes, receiving skilled care during childbirth, and care and support right after birth. The latest survey on antenatal class attendance conducted in South Africa provides an estimated 30.8% of expectant mothers in public healthcare facilities. Methods This study employed a qualitative approach to collect data, as a result, one focus group discussion with five (N=5) participants and two others with six (N=6) participants each (n=6X2=12) and twenty individual interviews were conducted. The study sought to explore and describe the knowledge and attitudes of healthcare professionals regarding the birth preparedness of women in labour at selected hospitals in Durban KwaZulu-Natal. Results Expectant mothers were unprepared for both labour and postnatal care. The unprepared expectant mothers were uncooperative and made the task of midwives difficult to the extent of endangering the life of their expected newborn babies and their own. Factors such as finance, heterogeneity, staff shortage, language barrier, lack of family support, lack of interest, cultural beliefs, and confusion caused by various sources of information were responsible for birth unpreparedness. Conclusion The synergy between expectant mothers and midwives appears to be an important factor in achieving better birth preparedness.