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

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

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

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

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

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

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

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

Abstract Novel bimetallic-doped-MCM-41(Mobil Composition of Matter No. 41) (Zn/Ni-MCM-41 (ZNM)) and (Zn/Ag-MCM-41 (ZAM)) catalysts were synthesized and characterized for their structural, textural, morphological, and optical properties. XRD analysis confirmed metal incorporation into the MCM-41 framework, while N2 adsorption-desorption isotherms indicated a decrease in specific surface area (1210 in pure MCM-41 to 722.86 and 700.36 m2/g for ZNM and ZAM, respectively) due to partial pore filling. TEM images verified this finding. Boosted absorption extending into the visible light region was detected in the metal incorporated (ZNM and ZAM) samples with additional band gaps, related to transitions in Zn2+, Ag+ and Ni2+ ions. Photoluminescence studies revealed efficient charge carrier separation in ZNM and ZAM. Both catalysts exhibited superior tetracycline (TC) removal from aqueous solution with efficiency (95.59% and 95.30% within one hour for ZNM and ZAM, respectively) with pronouncing visible light photocatalytic capability compared to pure MCM-41. The degradation process followed pseudo-first-order kinetics. The enhanced photocatalytic activity of ZNM and ZAM is attributed to the synergistic effects of metal incorporation, increased light absorption, and efficient charge carrier dynamics. Additionally, a possible photocatalytic mechanism for degradation of TC over ZNM and ZAM has been proposed and involvement of superoxide radicals (O2 •−) and holes (h+) as reactive species is elucidated by radical trapping experiments. A distinct pH-dependent trend was observed in TC degradation efficiency using the ZAM photocatalyst. The efficiency gradually increased with increasing pH until reaching a maximum at pH 7, followed by a decline at higher pH values. These results demonstrate the potential of ZNM and ZAM as promising materials for removal of tetracycline antibiotic from water.

Abstract Medical education in Jordan has evolved rapidly in the last 50 years as successive governments and higher education leaders have responded swiftly to developing healthcare sector demands. Despite significant progress being made, there remain a substantial number of challenges for the Jordanian medical education system that require careful attention in the years and decades ahead. This article provides a historical summary of medical education in Jordan, outlines some of the important areas that require development, and describes plans for a new medical school and teaching hospital in Amman at the newly established Kingdom University of Health Sciences, due to open in 2026. This ambitious project is being funded by the Saudi Jordanian Investment Fund and is being supported by partnerships with high-ranking, well-established institutions in the UK and USA. This article highlights the significant value in a partnership approach to developing a medical education program as it strives to overcome some of the existing challenges facing medical education in Jordan.

Abstract Background The evidence on the effect of printing orientation on dimensional accuracy and properties of resinous dental models is unclear. This systematic review aimed to assess the impact of printing orientation on the accuracy and properties of additively manufactured resinous dental models, besides the cost, material consumption, and time efficiency at different orientations. Methods A comprehensive web search (PubMed, Scopus, Cochrane) was performed in July 2024 without language restrictions. The included studies were assessed using the modified consort statement for laboratory studies on dental materials. The outcomes were accuracy and surface quality, besides the cost and time efficiency of additively manufactured dental models printed in different directions. Results Following PRISMA guidelines, 14 records were included. Most records favored horizontally printed models with minor controversies regarding accuracy, material consumption, time, and cost efficiency. While orientation can influence surface quality, it is often more significantly affected by factors such as the printing technology used, the material properties, and the layer thickness. Conclusions Horizontal orientation has proven to be the most efficient for producing dental models, particularly for single-model manufacturing, due to its superior time and cost savings. However, large-scale and overnight massive production favors the vertical orientation since the platform accommodates twice to triple the models' numbers as horizontal orientation. The majority of studies favor horizontal orientation for its accuracy. Choosing the optimal orientation in additive manufacturing not only ensures precision of dental models, improving the fit of restorations and prostheses, but also leads to significant reductions in production time, material usage, and energy consumption, ultimately minimizing environmental impact. Trial registration Not applicable.

Background Celiac disease (CD) is an autoimmune disorder in which genetically susceptible individuals cannot digest gluten (wheat) and its homologs such as Scalin (rye) and Hordein (barley). Aim This systematic review and meta‐analysis aimed to investigate the measures of associations between CD and psychiatric disorders, specifically anxiety and depression, and explore the relationship between adherence to a Gluten‐Free Diet (GFD) and the psychiatric aspects of the disease. Methods We searched PubMed, Scopus and Web of Science for articles investigating anxiety and depression in CD patients. The following inclusion criteria were implemented: Primary research articles (either observational or experimental) that include participants with a CD diagnosis ‐confirmed either serologically, with anti‐endomysial antibodies, anti‐tissue transglutaminase antibodies, or with duodenum biopsy, whether on a GFD or not,—who have depression or anxiety symptoms identified through self‐report or clinician‐administered scales. Results CD patients are at a higher odds of developing anxiety, as the odds ratio was (OR: 2.26, 95% CI: [1.10, 4.67]) and depression symptoms (OR: 3.36, 95% CI: [1.36, 8.32]). Results of both State‐Trait Anxiety Inventory Y‐1 and Y‐2 improved after 1 year of GFD with mean difference of 3.48, 95% CI: (0.26, 6.71), and MD: 3.45, 95% CI: (1.39, 5.52), respectively. Conclusion Anxiety and depression are prevalent among adults and children CD patients as they are observed to have high odds of anxiety and depression as expressed by various scales. It is reported that GFD is associated with decreased levels of anxiety and depression, however, further studies are required to confirm these findings and to investigate the main mechanism of psychiatric disorders among CD patients.

Cancer has a high rate of incidence and mortality throughout the world. Although several conventional approaches have been developed for the treatment of cancer, such as surgery, chemotherapy, radiotherapy and thermal therapy, they have remarkable disadvantages which result in inefficient treatment of cancer. For example, immunogenicity, prolonged treatment, non-specificity, metastasis and high cost of treatment, are considered as the major drawbacks of chemotherapy. Therefore, there is a fundamental requirement for the development of breakthrough technologies for cancer suppression. Polysaccharide-based drug delivery systems (DDSs) are the most reliable drug carriers for cancer therapy. Polysaccharides, as a kind of practical biomaterials, are divided into several types, including chitosan, alginates, dextran, hyaluronic acid, cyclodextrin, pectin, etc. Polysaccharides are extracted from different natural resources (like herbal, marine, microorganisms, etc.). The potential features of polysaccharides have made them reliable candidates for therapeutics delivery to cancer sites; the simple purification, ease of modification and functionalization, hydrophilicity, serum stability, appropriate drug loading capacity, biocompatibility, bioavailability, biodegradability and stimuli-responsive and sustained drug release manner are considerable aspects of these biopolymers. This review highlights the practical applications of polysaccharides-based DDSs in pharmaceutical science and cancer therapy.

Abstract Medical and health science students are among the demographics most at risk from Methicillin-resistant Staphylococcus aureus (MRSA), which is a serious hazard to public health. The main reservoir for MRSA is the nasal cavity, and colonization of this area can raise the risk of infection and transmission in healthcare settings. This study aimed to assess the nasal carriage rate of MRSA among clinically affiliated students at Haramaya University, College of Health and Medicine Sciences, Ethiopia, from July to August 2022. An institution-based cross-sectional study of 250 study participants was conducted using a stratified random sampling methods. The data were collected via structured questionnaires. Nasal swabs were cultured on mannitol salt agar and blood agar at 37 °C for 24 h. Staphylococcus aureus was identified using catalase and coagulase tests. The MRSA was screened using the cefoxitin disk diffusion method on Muller Hinton agar. The data were entered and analyzed by SPSS version 25. Pearson’s chi-square test was performed to predict associations between variables. A p value less than 0.05 was regarded as statistically significant. The nasal carriage rate of S. aureus was 8% (95% CI: 4.6-11.3%). The Nasal carriage rate of MRSA was 4.8% (95% CI: 2.1-7.4%). Overall, 4.8% of all the students were identified as MRSA carriers. MRSA carriage was high among medical students (33.3%). Nose-picking habit (X2 = 16.7, P = 0.001) and dormitory occupancy (X2 = 3.6, P = 0.045) were significantly associated with the MRSA rate. All the MRSA strains were resistant to penicillin and ampicillin. However, all the MRSA strains were susceptible to chloramphenicol and clindamycin. This study revealed that MRSA is a threat due to significant resistance. Nasal carriage is associated with nose picking and dorm occupancy. Encourage practices such as avoiding nose picking and maintaining personal cleanliness. Regular cleaning and disinfection of shared spaces can reduce the presence of MRSA.

Abstract Background The purpose of this study was to evaluate the efficacy of selective laser sintering (SLS) against the traditional casting method in fabricating customized Co-Cr dental posts, employing 3D coordinate metrology for analysis. Methods A 10 mm post space was prepared in a transparent acrylic block using a red ParaPost XP drill (1.25 mm diameter). An impression of this cavity was taken with a 1.143 mm diameter ParaPost impression post and auto-polymerizing acrylic resin. The resin patterns obtained were digitized with a Straumann Cares scanner, generating STL files, which were forwarded to Renishaw for the production of 10 Co-Cr posts through SLS. Simultaneously, the original resin patterns underwent investment and casting in Co-Cr alloy. The dimensional accuracy of the posts produced by both methods was evaluated using the triple scan method. Results The mean discrepancy was − 0.048 mm when comparing the dimensions of scanned resin posts to those of the conventionally cast posts, and − 0.067 mm between the scanned SLS-produced posts and the original resin patterns. Statistical analysis indicated no significant difference between the two sets of mean values (P = 0.107). Conclusion SLS technology is a viable alternative to the conventional casting technique for the manufacture of customized Co-Cr posts. Furthermore, SLS offers advantages in terms of cost and time efficiency without compromising the accuracy of the end product.

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

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

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

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

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

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

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

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

The study examines the impact of sustainable energy production on the sustainable development of Organization of Islamic Cooperation (OIC) countries from 1990 to 2020. Focusing on integrating sustainability concepts into economic and Islamic law realms, the paper investigates directional relationships among key variables, analyzing their effects on sustainable energy consumption, renewable energy, and overall sustainable development. Robust associations are identified between energy consumption (non-renewable and renewable), economic growth, gross domestic product, trade openness, greenhouse gas emissions, and foreign direct investment. Employing the panel ARDL model for OIC countries and subgroups, the findings reveal a positive and significant impact of sustainable energy consumption on sustainable development indicators. Despite positive outcomes, challenges persist, particularly in economic diversity among studied countries, with high-income nations, primarily oil producers, struggling to address environmental concerns. Low-income countries face hurdles in achieving balanced progress toward sustainable development, as indicated by the analysis.

Background:. Phalloplasty represents a challenging complex genital reconstruction surgery. Phalloplasty should result in an aesthetic composite phallus, with the ability to void while standing, allowing placement of an implantable prostheses and preserving both tactile and erogenous sensation with minimal donor site morbidity. Methods:. A bilateral superficial epigastric artery flap was design in the supra pubic area, extending upward till the lower boarder of the umbilicus. Two triangular flaps were designed at the base of the main rectangular flap to facilitate further mobilization of the neophallus. A penile prosthesis was implanted at the same stage in some patients. Finally, the lateral abdominal flaps were dissected and mobilized to be closed primarily in the mid line. Results:. Twenty patients who were candidate for first stage of penile reconstruction were included in our study. The average flap dimensions were 18 × 15 cm; the largest was 32 × 18 cm, whereas the smallest flap was 15 × 113 cm. Eleven patients had immediate implantation with 2 failures due to impaired sensation. Four patients had tissue expansion before flap harvesting. Three patients developed partial flap loss during the first 2 weeks postoperatively. Conclusions:. The modified bilateral superficial epigastric artery flap is a convenient flap for neophallus reconstruction. Flap design and harvesting is simple with a minimal learning curve. The flap has good color match with well-hidden donor site morbidity. Also, the bilateral triangular flaps permit adequate caudal repositioning of the neophallus, which gives a more natural position.

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

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

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

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

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

Background: : Gynecomastia (GM) is the most common breast condition in males. The clinical evaluation and surgical management of different grades of Gynecomastia are described extensively throughout several previous literatures. Objectives: The objective of our present study is to assess the epidemiological, clinical presentation, and the preferred type of surgical intervention along with evaluation of aesthetic outcomes of each procedure. Patients and methods: This is a prospective descriptive case series study conducted on 30 patients who was presenting with different grades of true gynecomastia admitted to the Plastic Surgery department in Qena university hospital from the outpatient clinic and seeking surgical correction. Results: Fifty eight breasts were operated upon in 30 patients; two cases (6.67%) had unilateral Gynecomastia and 28 cases (93.33%) had bilateral lesion.Based on surgical intervention, periareolar excision was performed in ten cases, liposuction was performed in six cases, periareolar excision combined with liposuction was done in 4 cases. While, circumareolar excision combined with liposuction was performed in two cases and, circumareolar concentric mastopexy without liposuction was performed in four cases. Four cases of grade III gynecomastia were treated with free nipple grafts. Conclusion: Gynecomastia is a persistent growth of breast tissue in men and the most successful course of management is surgery. Liposuction and surgical resection and/or combined procedures are three main types for surgical alternatives.

Background: Infants and toddlers have intussusception. Uncontrolled peristalsis or lymphoid hyperplasia after gastrointestinal disease produces ileo-colic, the most frequent kind. Pathologic lead points induce intussusception. Intussusception causes stomach discomfort, bloody feces, and vomiting. Early treatment reduces intestinal blockage, mesenteric vascular dysfunction, and bowel ischemia. Studying paediatric intussusception epidemiology and comorbidities. Objectives: To analyses the epidemiologic features of pediatrics intussusception using the public health data base we also identified comorbidities associated with intussusception. Patients and methods: This prospective observational study documented comprehensive records of 40 cases of intussusception admitted to General Surgery Department, Qena University, and associated hospitals over a period of ten months. Patient information including age, sex, address, presenting symptoms, severity of presentation, investigations performed, laboratory tests, and associated conditions were collected. Management was determined for every case. Results: Fever, vomiting, and abdominal discomfort were the most prevalent symptoms in an intussusception research. 10% had COVID-19. All individuals had ultrasounds, with 42.5% having CT confirmation. 10% had exploration/surgery, 57.5% had conservative management, and 32.5% had hydrostatic reduction. Conservative and hydrostatic treatment had similar rates of recurrence (13 cases). Only 2 recurrences required surgery. Conclusion: This work illuminates pediatric intussusception's epidemiology and comorbidities. Abdominal discomfort and vomiting are most prevalent. Our results emphasize the significance of rapid detection and therapy of intussusception in pediatric patients, particularly those with comorbidities. Explore the pathophysiological causes and risk factors of intussusception in children to guide preventive and early intervention techniques.

Abstract A low level of work autonomy is the bottleneck for the health service delivery and the quality of the service. Although work autonomy is the pillar of organizational commitment and a means of employee retention mechanism, information about the magnitude of work autonomy among health professionals is limited in Ethiopia. Therefore, this study aimed to assess work autonomy and its predictors among health professionals working in public hospitals of Northeast Ethiopia. Institution-based cross-sectional study was conducted from March 24 to April 24, 2021, among health professionals using a stratified sampling technique. Variables with a p-value of

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

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

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

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

Introduction: The fibularis quartus (FQ) or peroneus quartus (PQ) is a supernumerary muscle occasionally seen in the lateral compartment of the human leg. It is a weak evertor and has a role in pronation and lateral stabilization of the foot. FQ arises from the fibularis brevis (FB) in most instances and distally gets attached to the lateral aspect of the base of the fifth metatarsal or the cuboid or the calcaneus bone. The muscle has been implicated in a variety of clinical problems ranging from ankle pain to subluxation and tear of peroneal tendons. We report here a rare bitendinous variant of FQ which might provide new insight to clinical problems related to the presence of this muscle and its possible utility as an autograft in reconstruction. Methods: Institutional guidelines for use of human cadaver were followed. Routine dissection was performed on a 71-year-old male donated cadaver in both the lower limbs. Gross anatomical features were meticulously noted, photographed and measurements were recorded with digital Vernier callipers. Results: A bitendinous muscle was observed in the lateral compartment of the left leg and identified as FQ. The FQ was proximally attached to the FB and adjacent distal third of the fibula, which then formed a flat fusiform muscle belly and eventually terminated through a rounded tendon via its attachment to the peroneal trochlea of the calcaneus. The dimensions of the proximal tendon, muscle belly and the distal tendon were 4.2 cm x 0.7 cm, 5.6 cm x 1.9 cm and 2.6 cm x 0.3 cm, respectively. Conclusions: Clinicians should be aware about all possible variants of the supernumerary FQ muscle considering its role in several lateral ankle pathologies. FQ can prove as an excellent autograft for peroneal tendon tear and can be utilized for strengthening weakened peroneal tendons.

BackgroundAlthough proper latrine utilization is one of the best ways to reduce the risk of infection, it remains a challenge in the majority of rural communities in developing countries such as Ethiopia. Studies have demonstrated the link between individual behavior and latrine use, but there is a paucity of evidence on individual risk perception, perceived social pressure norms, social identity, and perceived ability, which plays an indubitable role in health and behavior change, especially in rural communities.ObjectiveThis study aimed to identify contextual and psychosocial factors associated with latrine utilization among rural communities in Lomabosa district, Ethiopia.MethodsA rural community-based cross-sectional study was conducted in June 2022 among rural households (HHs) in Lomabosa district, Ethiopia. A systematic random sampling method was used to select participant households. Data were collected using a pretested structured questionnaire via face-to-face interviews and on-the-spot observations. Stata version 14.1 software was used for statistical analysis. A binary logistic regression model was used to run the bivariable and multivariable analysis of the data. Variables with p

The study of the polyopisthocotylan parasites of marine fishes in the western Mediterranean is carried on using an integrative approach combining morphology and DNA barcodes. Ktarius patrickbrueli n. gen. n. sp (Polyopisthocotyla, Microcotylidae), from the gills of the pink dentex Dentex gibbosus (Teleostei, Sparidae) from the western Mediterranean Sea off Tunisia, is described. Anatomical and morphological features of the new genus are described, and the molecular barcodes for nuclear and mitochondrial markers (28S rRNA and cox1) are generated. The new genus is closely related to Microcotyle by sharing a symmetrical haptor, inverted question mark-shaped ovary and unarmed vagina. However, Ktarius n. gen. can be distinguished from Microcotyle and other Microcotylinae taxa by an unarmed male copulatory organ, formed by a long muscular cirrus, a basal layer of concentric muscles, and an elongated thick-walled ejaculatory bulb. A partial 28S rDNA sequence of K. patrickbrueli n. gen. n. sp. was obtained and found to be distinct from all known microcotylid sequences, with a p-distance of 5–13%. A phylogenetic tree constructed from available microcotylid sequences revealed that K. patrickbrueli n. gen. n. sp. clustered in a strongly supported clade of Microcotylinae, containing species of Omanicotyle, Bivagina, and Microcotyle confirming its belonging to the Microcotylinae subfamily. The cox1 sequences of K. patrickbrueli n. gen. n. sp. were highly divergent from the closely related genus Pauciconfibula and confirmed its distinction. This new genus is the third polyopisthocotylan genus to be described from sparids of Dentex.

The demand for protein has increased over last few years. Plant-based proteins are appreciated to meet the increasing demand of proteins than animal protein with the growing population worldwide. Pulses are one of the good sources of protein. Chickpea is one of the oldest and most cultivated legume crops consumed as source of protein. Chickpeas can be classified into two types named as ‘kabuli’ and ‘desi’ on the basis of their physical parameters. They are recognized as a valuable dietary protein source due to their sufficient biological value, and protein bioavailability. Chickpeas contain a variety of bioactive compounds, including isoflavones and phenolic acid. Generally, chickpea and pulses serve as viable options for functional and nutritional proteins. Chickpea proteins are considered as the best alternative to animal proteins with high amino acid profile and cost effectiveness. They are significant in academic and food business domains. Chickpea protein isolates are commonly identified as having a minimum protein content of 90% on a dry weight basis. They offer excellent functional and therapeutic potential in mitigating various health ailments. Chickpea protein is also used in production of value-added products in various food industries including baking industries, meat industry, infant formula and nutraceutical industries. This review explores the production, nutritional composition, health perspectives and industrial applications of chickpea protein.

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

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

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