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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.

Background Cytoscape is an open-source software to visualize and analyze networks. However, large networks, such as protein interaction networks, are still difficult to analyze as a whole. Methods Here, we propose Clust&See3.0, a novel version of a Cytoscape app that has been developed to identify, visualize and manipulate network clusters and modules. It is now enriched with functionalities allowing custom annotations of nodes and computation of their statistical enrichments. Results As the wealth of multi-omics data is growing, such functionalities are highly valuable for a better understanding of biological module composition, as illustrated by the presented use case. Conclusions In summary, the originality of Clust&See3.0 lies in providing users with a complete tool for network clusters analyses: from cluster identification, visualization, node and cluster annotations to annotation statistical analyses.

Digital and financial literacy are changing the landscape of the globe in terms of its approach to development. These two literacies also help to achieve women’s empowerment and, consequently, the sustainable development goals (SDGs) more quickly. This systematic literature review looks at the two literacies and their effects, focusing on women’s participation and showing how digital literacy not only increases women’s access to knowledge and connectivity but is also a door to women’s entrepreneurship and financial independence. Likewise, financial literacy, when coupled with digital skills, can be a breakthrough to the traditional socioeconomic barrier – poverty – by assisting women in making informed economic decisions, increasing their financial independence and resilience in the face of a global crisis. Empirical realities that still hinder women’s education, such as cultural norms, infrastructural deficiencies and educational gaps, still exist. However, the paper points out that to have a more equal world based on the SDGs, the double literacy strategy for women’s empowerment should not be negotiable.

Background Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by pruritus and skin barrier dysfunction. This study aims to evaluate the therapeutic potential of Pelargonium graveolens (Geraniaceae) in managing AD symptoms through its essential oil. Methods The chemical composition of Pelargonium graveolens flower essential oil (PFEO) was analyzed using gas chromatography-mass spectrometry (GC-MS). Its antimicrobial, antioxidant, and anti-inflammatory properties were assessed, along with the inhibitory effects of PFEO on key enzymes involved in skin repair: tyrosinase, elastase, and collagenase. An in vivo evaluation of a gel formulation containing PFEO was also conducted to assess its anti-inflammatory and analgesic efficacy. Results GC-MS analysis identified major compounds in PFEO, including Geraniol (22.83%), beta-citronellol (19.51%), naphthalenemethanol (15.36%), and Geranyl tiglate (9.38%), with minor constituents such as linalool (3.81%) and neryl formate (1.31%). PFEO exhibited bacteriostatic activity against various bacterial and fungal strains, including Pseudomonas aeruginosa, Staphylococcus aureus, Methicillin-Resistant Staphylococcus aureus (MRSA), Bacillus anthracis, Streptococcus pyogenes, Staphylococcus epidermidis, Candida albicans, and Malassezia spp. The essential oil also demonstrated significant antioxidant properties and inhibited key enzymes linked to skin alterations in AD. Conclusions PFEO shows promising therapeutic potential for managing symptoms of atopic dermatitis due to its antimicrobial, antioxidant, and anti-inflammatory properties, as well as its analgesic effects. The findings support further exploration of PFEO as a natural alternative in the treatment of AD.

Background This study aims to contribute to a better understanding of the impact of the financial technologies (fintech) era on the performance in the banking sector, measured through non-performing loans (NPL) and their coverage by provisions for NPL. It is a question of knowing whether banking investment in fintech makes it possible to better evaluate the granting of credits, and therefore makes it possible to reduce overdue credits. Methods To this end, the method used consists of using a regression analysis and a Pearson correlation applied to the financial data of Moroccan banks observed during two distinct periods, namely 2007-2014, considered pre-fintech, and the period 2015-2022, considered as the fintech period. Results With the emergence of the fintech era, the Moroccan banking situation improved slightly compared to the pre-fintech period: bad debts did not increase despite the significant increase in net banking income and the size of banking assets during the fintech era. Conclusions The implementation of fintech has improved customer relationship management, credit risk analysis and loan monitoring services, which ultimately reduces non-performing loans and improves the coverage of non-performing loans by provisions. The main implication of the results allows us to deduce that the implementation of fintech makes it possible to have a positive impact on overdue credits, and they are also likely to serve as a lever for the inclusion of those excluded from banking services.

Background Understanding the demographics, tumor characteristics, genetic mutations, and immune scores in colorectal cancer (CRC) patients may aid in tailoring treatment and predicting survival. Methods This retrospective cohort study assessed clinical parameters, immune scores, and their relationship with survival in patients with CRC. Results The study included 74 patients, mean age 53.7 years, mostly male (53.3%) and aged 41-70 (77.3%). Common comorbidities included cardiovascular diseases (29.3%) and hypertension (21.3%). Adenocarcinoma (74%) primarily affects the colon (73%). KRAS mutations and Microsatellite instability-High (MSI-H)/deficient mismatch repair (dMMR) were found in 1.3% and 16% of patients, respectively. Stage IV (77.3%) and liver metastases (52.7%) were prevalent. Immune score was influenced by cancer stage (p = 0.04) and metastasis (p=0.05). The immune score was not associated with survival (p = 0.181). Patients with comorbidities had lower one- (p = 0.027) and two-year survival rates (p = 0.037) survival rates. Cardiovascular comorbidities negatively impacted one-year survival (p = 0.047) and two-year survival (p = 0.037). The mean survival time was shorter for males (2.047±0.288 vs. 2.781±0.195 years, p = 0.041), patients with comorbidities (1.772±0.371 vs. 2.702±0.188 years, p = 0.017), and cardiovascular comorbidities (1.558±0.316 vs. 2.685±0.207 years, p = 0.038). Comorbidities (unadjusted hazard ratio [HR] 2.948, p = 0.023) and cardiovascular comorbidities (unadjusted HR 2.695, p = 0.046) were initially associated with survival but lost significance after adjusting for confounding variables. Conclusions This study provides insights into CRC patient demographics and their interplay with the immune score and survival.

Background Sustaining a ‘fit-for-purpose’ health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the hospitalization and case fatality rates, type of health care worker cadres affected, their demographic and clinical characteristics and hospital exit outcomes. Methods This was a cohort study using routine data extracted from hospitalization forms for health care workers in 24 designated COVID-19 treatment facilities. Results Of the 424 health care workers with COVID-19, hospitalization rates progressively declined between 2020 and 2023, (P Conclusions The hospitalized health care workers for COVID-19 were predominantly clinical and laboratory personnel who were mostly unvaccinated, and health facilities were hot-spots for contracting infections. The triage and referral system was weak with unnecessary hospitalization of mild infections. This study provides useful insights for outbreak preparedness including priority vaccination and improving health care worker safety in Liberia.

Background Table tennis presented a unique and accessible sport for people of all ages, particularly seniors compared to other sports. Methods This study utilized a quantitative with 136 Table tennis players those who registered for attending in the Thailand Master Table tennis Championships 2024 which hosted in January 2024 at Chiangmai. The questionnaire based on the measurement quality of life, WHOQOL Thai version, and analyzed using Descriptive statistics, Pearson Correlation. Results Pearson correlation coefficients between the scores of the quality of life in four dimensions and the overall score revealed significant correlations (p < 0.01) with all dimensions, including physical health, psychological health, social relationships, and environmental health. Conclusions Playing Table tennis for senior in the tournament level helped to improve the quality of life in all domains.

Background Studies have shown that perceived self-efficacy can influence teachers’ emotional state, thoughts and behaviours, and students’ learning. It’s also an important referential of professional satisfaction. In turn, teaching methodologies influence motor learning, as well as psychological, cognitive and social learning, with different impacts on human development and learning retention, levels of intrinsic motivation and continuity of practice in order to support a healthy lifestyle. Research on aquatic educators and teaching methodologies is scarce and at the same time necessary according to the view that aquatic literacy is an integral part of physical literacy and the only possibility of being more able to interact with this environment. Methods In this study we used an online questionnaire, aimed at aquatic professionals, which was answered voluntarily and anonymously to measure the prevalence of the use of different teaching methodologies, the comprehensive aquatic method and the perception of teacher self-efficacy. It has been deposited and can be consulted at https://doi.org/10.6084/m9.figshare.27316242.v1. Results All methods can generate a feeling of self-efficacy in teachers despite having different results, with the methodologies that involve students more actively (cognitivist and constructivist) being those that generate a greater feeling of self-efficacy in teachers. MAC is a method that is more closely related to methodologies focused on active student participation and, consequently, it is a method that generates a high perception of self-efficacy in teachers. Conclusions Levels of self-efficacy influence professional satisfaction, teacher physical, mental and emotional health, as well as student learning. Is recommended that aquatic professionals give prevalence to the cognitivist and constructivist teaching methodologies being MAC a privileged methodological approach for promoting active lifestyle habits throughout life.

Background Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral artery disease (PAD) and has poor clinical outcomes. Recently, stimulating arteriogenesis has been proposed to improve clinical outcomes. Several studies have shown that miRNAs have beneficial effects on limb ischemia related to arteriogenesis. This study aimed to review the roles of therapeutic miRNAs in the arteriogenesis of limb ischemia. Methods A systematic search was conducted through July 2021 using the PubMed, Scopus, and ScienceDirect databases. Two authors independently assessed studies that investigated the role of miRNAs in the arteriogenesis of limb ischemia, both in vivo and in clinical studies. Results All selected studies were in vivo studies, with a total of 36 articles and 28 types of miRNAs. miRNAs potentially regulate arteriogenesis by targeting different targets. The following miRNAs were upregulated to enhance arteriogenesis: miRNA-126-3p, -93, -675, -143-3p, -130a, -210, -146b, -21, -let-7g, -132/212, -150, and 155. Meanwhile, microRNAs needed to be downregulated, namely: miRNA-939-5p, -503, -199a-5p, -146a, -92a, -14q32 microRNA gene cluster, -15a/16, -100, -133a, -139-5p, -223, -352, -615-5p, -15b/5p, -124-3p, and 29a. MiRNA-126 was the most studied miRNA, and SPRED1 was the most common target of microRNA. However, the included studies showed high heterogeneity in terms of inducing hindlimb ischemia, the timing of administration, and the method used for evaluating arteriogenesis. Moreover, most studies presented unclear or high-risk bias. Conclusion MicroRNA application in a preclinical model of hindlimb ischemia has beneficial effects on arteriogenesis. This result indicates that miRNAs might be potentially beneficial in patients with CLTI. Registration The review protocol was registered with PROSPERO under registration number CRD42024484988.

Background Breast cancer has become the most prevalent disease and its incidence has almost doubled in the Indian population. This increased burden demands new targeted therapies with novel compounds either synthetically produced or derived from indigenous plants, which could be a promising approach for the development of drugs. Euphorbia thymifolia L is a widely growing tropical herb that has been reported to have various ethnopharmacological properties. Although Euphorbia genus is reported to have anticancer properties, E. thymifolia is not reported to have anticancer properties to date. Therefore, the aim of the present study was to screen the phytoconstituents and identify the active compounds present in the methanolic extract of E. thymifolia (ME.ET) as ligands to inhibit human cancer cell lines with special reference to potential protein targets implicated in breast cancer using an In-silico approach. Methods ME.ET was subjected to GC-MS analysis to screen the phytoconstituents, and the identified compounds were docked with protein targets such as extracellular signal-regulated kinases (ERK1), a serine/threonine kinase-1(AKT1), human epidermal growth factor 2 (HER2), estrogen receptor (ER), maternal embryonic leucine zipper kinase (MELK), polo-like kinase-1(PLK1), and protein tyrosine kinase (PTK6). Compounds with good docking scores were further subjected to dynamic studies to understand the protein ligand binding stability, ligand pathway calculation, and molecular mechanics energies combined with Poisson-Boltzmann (MM/PBSA) calculations using the Schrodinger suite. Results GC-MS analysis revealed the presence of 245 phytoconstituents, 219 of which were unique. When subjected to docking, these phytocompounds, namely 3,6,9,12-tetraoxatetradecane-1,14-diyl dibenzoate (TTDB) and succinic acid, 2-(dimethylamino) ethyl 4-isopropylphenyl ester (SADPE), showed good docking scores. Molecular dynamics studies showed a high affinity and low binding energy for TTDB with HER2, ERK1, and SADPE with ER. Conclusions Hence, in this study, we identified two lead compounds in E.thymifolia linn. Further invitro and invivo anticancer studies can be performed to confirm these results and to understand the molecular mechanism by which they exhibit anticancer activity against breast cancer.

Background This study examines the growing trend of ethnicized leadership in Ethiopian higher education institutions and advocates for a shift toward merit-based governance to improve institutional integrity and performance. Since 1991, with the introduction of ethnic federalism, leadership appointments in Ethiopian universities have increasingly been based on ethnic identity rather than qualifications. This has led to governance challenges, weakened academic standards, and reduced institutional efficiency. The study highlights the need for governance reforms prioritizing meritocracy to enhance the quality and sustainability of Ethiopia’s ethnically diverse higher education system. Methods The study utilizes a qualitative research approach, combining both primary and secondary data. Primary data were collected through semi-structured interviews with university administrators, faculty, and governance experts, while secondary data were gathered from institutional reports, government policies, and academic literature. Institutional theory, principal-agent theory, and meritocratic theory frame the analysis, providing insights into how ethnic-based leadership appointments affect university governance and performance. Results The findings reveal that ethnicized leadership has eroded governance structures, lowered academic quality, and compromised institutional efficiency. Leadership appointments based on ethnicity rather than merit have led to poor decision-making, weakened accountability, and reduced transparency. In contrast, merit-based governance improves accountability, decision-making, and institutional performance. The study emphasizes that transitioning to a meritocratic leadership model is vital for restoring institutional integrity and academic excellence in Ethiopian universities. Conclusions Ethnic federalism, while initially designed to empower regions, has politicized federal institutions, including universities, reducing them to regional entities rather than national institutions. This system of ethnicized leadership has fostered a culture of favoritism, rampant corruption, and ineffective governance, ultimately weakening Ethiopia’s higher education system. Recommendations Governance reforms that prioritize merit-based appointments are urgently needed. Legal reforms, transparent leadership selection processes, depoliticization efforts, and capacity-building initiatives are recommended to foster a meritocratic culture and improve institutional performance in Ethiopian universities.

Background Glioma is the second most common type of brain tumor, accounting for 24% of all brain tumor cases. The current diagnostic procedure is through an invasive tissue sampling to obtain histopathological analysis, however, not all patients are able to undergo a high-risk procedure. Circulating microRNAs (miRNAs) are considered as promising biomarkers for glioma due to their sensitivity, specificity, and non-invasive properties. There is currently no defined miRNA profile that contributes to determining the grade of glioma. This study aims to find the answer for “Is there any significant miRNA that able to distinguish different grades of glioma?”. Methods This study was conducted to compare the expression of miRNAs between low-grade glioma (LGG) and high-grade glioma (HGG). Eighteen blood plasma samples from glioma patients and 6 healthy controls were analyzed for 798 human miRNA profiles using NanoString nCounter Human v3 miRNA Expression Assay. The differential expressions of miRNAs were then analyzed to identify the differences in miRNA expression between LGG and HGG. Results Analyses showed significant expressions in 12 miRNAs between LGG and HGG, where all of them were downregulated. Out of these significant miRNAs, miR-518b, miR-1271-3p, and miR-598-3p showed the highest potential for distinguishing HGG from LGG, with area under curve (AUC) values of 0.912, 0.889, and 0.991, respectively. Conclusion miR-518b, miR-1271-3p, and miR-598-3p demonstrate significant potentials in distinguishing LGG and HGG.

Climate change is rapidly transforming ecosystems and reshaping the landscapes of animal health, with profound consequences for public health, food security, and biodiversity. Rising temperatures, shifting weather patterns, and increased frequency of natural disasters are driving the emergence and spread of infectious diseases, particularly zoonotic and vector-borne diseases. These environmental shifts endanger the health and welfare of animals and the delicate balance between human populations, livestock, and wildlife. As the stewards of animal health, veterinarians are uniquely positioned to lead the change in addressing these complex challenges at the nexus of human, animal, and environmental health and well-being. This article calls for urgent actions to integrate climate adaptation and mitigation strategies into veterinary practice and education. It underscores the critical need for veterinarians to embrace the One Health approach to tackle climate-driven disease outbreaks and the growing threat of antimicrobial resistance to safeguard human and animal populations while protecting natural ecosystems. The article further explores the role of veterinarians in fostering sustainable agricultural practices, reducing the environmental impact of livestock production, conserving biodiversity and advocating for policy reforms that protect both animal and planetary health. As we face an era of unprecedented climate disruption, this call to action aims to inspire the global veterinary community to actively get involved in combating climate change and its worst impacts. By building climate-resilient practices, enhancing disease surveillance, and championing environmental stewardship, veterinarians can contribute significantly to a healthier, more sustainable future for all species on Earth.

Background Undescended testes (UDT) is a condition where one or both testes is absent in the scrotum. The general age recommendation in which the treatment should be performed is before 18 months old due to the infertility risk and malignancy in later life. In post-pubertal UDT, the current guideline recommends orchiectomy; however, the strength rating of this recommendation is weak. Therefore, this study aimed to provide a systematic review of post-pubertal UDT treatment, focusing on the malignancy risk point of view. Methods A systematic search was performed using PubMed, Wiley Online Library and the Cochrane Library up to 5 March 2023. Any study with either post-pubertal orchiectomy or orchidopexy in patients with UDT and reporting the testicular malignancy was included. The exclusion criteria were studies with lack of information of UDT correction time, no history of correction and the full text wasn’t available. The data collected were the occurrence of testicular malignancy in post-pubertal UDT patients corrected with any method. Quality and bias assessment was assessed with Newcastle-Ottawa scale and Joanna Briggs Institute tools. Results Seven articles (three case reports and four observational studies) were reviewed with a total of 42 patients who underwent post-pubertal correction of either unilateral or bilateral UDT. The correction age ranged from 13 to 34 years old, with follow-up of 48.7–252 months. Among those who developed malignancies, the most common were seminoma, teratoma and carcinoma in situ of the testes. In addition, this study was able to propose an algorithm for post-pubertal UDT treatment strategy. Conclusions The scarce resource was the main limitation of this study. Nevertheless, this review showed that post-pubertal UDT management should be tailored individually. Several factors that should be considered include the condition of the contralateral descended testis, UDT location, serum testosterone level, patient’s age, comorbidities, and interest in fertility.

Background Traditional dietary assessments are often inaccurate and prone to self-reporting biases. Tracking the physiological responses associated with eating and digestion events via wearable technologies may provide an effective approach for continuously monitoring food intake and estimating energy consumption. Eating and digestion are accompanied by a series of changes in the heart rate, skin temperature, blood oxygen saturation, and blood pressure. These changes can be tracked by wearable devices, such as smartwatches, which have been widely accepted in the market. This systematic review is the first to evaluate the effectiveness of tracking such physiological biomarkers in differentiating between high- and low-calorie meals, potentially paving the way for more accurate dietary monitoring. Methods Following the PRISMA-P guidelines, we will conduct a systematic literature search through MEDLINE, EMBASE, and PubMed for clinical trials that investigated physiological responses following meal intake in healthy subjects. Two independent reviewers will screen and select articles based on pre-defined eligibility criteria, with a third review to resolve any discrepancies. This will be followed by data extraction and quality assessment of the included studies. Statistical analyses, including meta-analyses, will be performed using R Studio software. Our primary outcome will be the comparison of physiological biomarkers before and after meal intake, while secondary outcomes will include comparisons of physiological biomarkers between high- and low-calorie meal consumption and the correlation between the caloric content of consumed meals and postprandial physiological changes. Discussion This systematic review and meta-analysis will identify physiological indicators for eating events and inform the design of wearable sensors that estimate food intake in healthy subjects. Systematic Review Registration PROSPERO Registration ID: CRD42024544353

Appendicularians are planktonic tunicates abundant all over the world. Currently, only two complete annotated mitochondrial genome assemblies are available for appendicularians, both for cryptic species of Oikopleura dioica. This underrepresentation of available appendicularian mitochondrial genomes limits environmental DNA sequencing (eDNA) studies that rely on mitochondrial markers as a taxonomic barcode. We report the complete mitochondrial genome assembly and annotation of an unknown appendicularian species isolated from the Amami Oshima island, Kagoshima prefecture, Japan, that has significant sequence difference with other currently available assemblies and will serve as a useful resource for ecological studies and further mitochondrial studies of appendicularians.

Introduction Dengue fever poses a significant public health threat, particularly in tropical regions like Malaysia. The rising incidence of dengue outbreaks challenges healthcare systems and highlights the urgent need for effective preventive measures. Climate change, with rising temperatures and shifting rainfall patterns, is expected to worsen the dengue situation in the coming years. Methods . This is a cross-sectional study conducted among adult residents of low-cost housing apartments in an urban poor community in Kuala Lumpur, Malaysia involving approximately 16,000 residents. A representative sample of 1,636 residents was calculated using the Krejcie and Morgan formula, and stratified random sampling was used to ensure proportional representation across the various floors of each PPR community apartment block. Data were collected using a structured questionnaire adapted from a validated Malay version. The questionnaire assessed respondents’ knowledge, attitudes, and practices (KAP) related to dengue prevention, categorising KAP scores as “Good” (≥80%) or “Poor” ( Results In this community, 76.7% of participants exhibited poor knowledge and 83.1% had a negative attitude towards dengue, despite 66.7% demonstrating good preventive practices. The PPR location significantly predicts dengue knowledge, attitudes, and preventive practices, with p-values of less than 0.001 for all domains. Marital status also predicts dengue knowledge (p = 0.007) and preventive practices (p = 0.023), while prior infection with dengue is a predictor of preventive practices (p = 0.047). Conclusion Despite the community’s good dengue prevention practices, likely influenced by environmental expectations, there remains a critical need for education to sustain and strengthen these efforts, as climate change continues to worsen in the coming years. It is crucial to help residents grasp the relevance of these practices, so they can apply them more effectively as climate-driven risks intensify. Targeted interventions should de designed differently for each of the four PPR communities as their levels of knowledge, attitude and practices vary significantly, taking into account independent factors like marital status and prior dengue infection, which shape preventive behaviors.

Background Polypharmacy is common among hospitalized patients with infectious infections owing to comorbidities or concomitant illnesses. This raises the likelihood of drug-drug interactions and creates uncertainty for healthcare providers. This study aimed to assess the potential drug-drug interactions (pDDIs) among hospitalized patients with infectious diseases in a secondary care hospital. Methods A prospective observational study was conducted in the internal medicine ward for six months after the ethics committee’s approval. Data were collected from patient case records, and prescriptions were screened for pDDIs from a portable electronic physician information database (PEPID) resource analyzed using SPSS, version 27.0. Results In total, 148 patient case records were analyzed, and 549 pDDIs were identified, with 66.8% having at least one or more DDIs. The mean number of drug interactions was 3.70 ± 4.58 per prescription. The most frequently encountered drug interactions were drug combinations such as bisoprolol with atorvastatin and aspirin with tazobactam/piperacillin. Bivariate analysis showed that age, comorbidities, length of hospital stay, and the number of drugs prescribed were risk factors associated with DDIs (p Conclusions This study observed the prevalence of DDIs in hospitalized patients with infectious diseases of ‘moderate’ severity. Prescription screening using a drug information database assists in early identification and prevention of DDIs, enhancing drug safety and quality of patient-centered care.

Introduction This research is a systematic review aimed at synthesizing scientific evidence on the causes of university dropout, focusing on the subcategories of vocational guidance, academic performance, socioeconomic status, and institutional aspects between 2020 and June 2024. Methods Only articles addressing university dropout were considered, analyzing dimensions such as vocational guidance, academic performance, socioeconomic status, and institutional aspects. Articles published in indexed scientific journals with double-blind, double-blind peer, or open reviews between 2020 and June 2024 were included. The main databases used were Scopus, Web of Science, and Google Scholar. To assess the risk of bias in qualitative studies, the criteria from the article “Validity criteria for qualitative research: three epistemological strands for the same purpose” were used. For quantitative studies, the criteria from the article “Evaluating survey research in articles published in Library Science journals” were followed. For mixed-method studies, both sets of criteria were combined. Results A total of 23 studies were included: 15 quantitative (65.22%), 3 qualitative (13.04%), and 5 mixed-method (21.74%). All studies (100%) addressed the subcategories of socioeconomic status and institutional aspects. Regarding the academic performance subcategory, 86% of the studies addressed it, while the vocational guidance subcategory was covered by 73.91% of the studies. Conclusions Vocational guidance, academic performance, socioeconomic status, and institutional aspects are crucial for reducing university dropout. Providing adequate professional guidance, academic support, financial assistance, and strong institutional support is fundamental to improving student retention and academic success.

Through its wide-ranging effects on human physiology and behaviour, daily light exposure is an important environmental modulator of healthy ageing. Integrating mobile health (mHealth) technology with behaviour change strategies offers a promising approach to optimise light exposure and positively impact sleep, rest-wake cycles, cognitive function, and mood at scale. This study aims to develop the LightSPAN mHealth behaviour change intervention to optimise light exposure across the lifespan. Employing a co-design methodology, the study comprises two distinct workstreams. The first focuses on conceptualising the theoretical framework and implementation strategies through a comprehensive review of light exposure interventions, behaviour change theories, mHealth user personas, and recommendations for designing mHealth interventions for older adults. The second workstream centres on co-designing the intervention, involving consultation with community service providers and engagement with older adults at ageing community centres (≥60 years of age). Community service providers will be consulted through open-ended discussions (target n=5). Older adult participants (n=20) will engage in telephone interviews, focus group discussions and prototyping workshops to explore older adult participants’ characteristics, needs, preferences, and mHealth intervention design elements and co-design the LightSPAN mHealth behaviour change intervention. The insights generated in these co-design components will ensure that the intervention addresses the needs of its future users.

Background Inflammatory idiopathic myopathies (IIM) are a heterogeneous group of complex connective tissue diseases (CTD), primarily characterized by inflammatory involvement of skeletal muscles. Several other organs may also be affected, including lungs, heart, skin, gastrointestinal tract, and joints. Objective Describe the clinical and immunological characteristics of IIM among Tunisian patients. Method A retrospective study conducted in the internal medicine department at the Rabta Hospital over 22 years, including adult patients with IIM according to the ACR/EULAR classification criteria, and anti-synthetase syndrome (ASS) according to Connors’ criteria. Inclusion body myositis was excluded. Demographic, clinical, and immunological characteristics were analyzed. Results Ninety-seven patients were included (Male/female ratio= 0.36, mean age = 48.4 +- 13.8 years). The ACR/EULAR criteria enabled the inclusion of 88% of the patients. Dermatomyositis (DM) was the most frequent entity (47%), followed by Polymyositis (PM) (36%) and Amyotrophic dermatomyositis (ADM) (4%). Connors criteria allowed the inclusion and classification with ASS of 33 patients, including those excluded by the ACR/EULAR criteria (12%). Muscular involvement was present in 88% of patients, affecting locomotor (88%), gastrointestinal (43%), laryngeal (10%), cardiac (8%), and respiratory (1%) muscles. Myolysis was observed in 77% of patients, and histological evidence of myositis in 73%. ILD was reported across all subgroup: ASS (85%), PM (57%), DM (17%), and ADM (100%). NSIP was the most common radiologic pattern (59%). Skin involvement (85%), consistently present in DM and ADM, affected 91% of ASS patients. Joint involvement (48%) was predominantly polyarticular (68%). Myositis-specific antibodies (MSAs) were detected in 52% of patients, with a predominance of anti-synthetase antibodies (ASAs). Another CTD was noted in 24% of patients and cancer in 17% of patients. Conclusion Our study underscored the clinical diversity among IIM patients and the systemic nature of these diseases, where muscular involvement is not always uniform.