Search results for “TE”

Implementing Evidence-Based Occupational Therapy for Multiple Sclerosis Rehabilitation: Exploring Knowledge on Barriers, Facilitators and Strategies

Background A persistent gap remains between evidence-based health care and its application in routine practice. This challenge is particularly prominent in allied health professions like occupational therapy (OT), where interventions are complex, individualized and centred on patients' daily functioning. Objective To identify barriers, facilitators, and implementation strategies for integrating evidence-based OT interventions in multiple sclerosis (MS) rehabilitation. Methods A mapping review was conducted using searches in five databases. Eligible studies included adults with MS, examined OT interventions, and reported on factors influencing implementation. Data were extracted and categorized using Grol’s framework for barriers/facilitators and Mazza’s taxonomy for implementation strategies. Results Fifteen studies met inclusion criteria. Barriers and facilitators were identified at multiple levels of Grol’s framework: 1-Innovation-level: accessibility, feasibility, and perceived attractiveness supported implementation, particularly when interventions incorporated holistic approaches, gamification, or printed manuals. 2-Professional-level: therapists’ competencies and alignment between interventions and patients’ priorities. 3-Patient-related: facilitators included motivation, readiness to change, and peer support, whereas fatigue, pain, and cognitive challenges served as barriers. 4-Social and organizational: effective teamwork, resource availability, and flexible scheduling facilitated successful adoption. 5-Economic or political: no studies. Implementation strategies focused on using manuals, patient empowerment, gamification, and organizational supports. No financial or structural policy-level strategies were identified. Conclusion Successful implementation of evidence-based OT for MS requires multifaceted, context-sensitive strategies addressing innovation, professional, patient, and organizational determinants. Practical approaches enhance uptake, while substantial gaps persist at economic and policy levels. Strengthening these areas may improve longterm integration and sustainability of evidence-based OT in MS rehabilitation.

The Risk Factors, Complications, Management Strategies and Predictors of Morbidity & Mortality Among Pediatric Patients Presenting with Severe Diarrhea at Muhimbili National Hospital’s Emergency Medicine Department

Background Acute diarrhea is the major cause of health public problem among paediatric patients in Tanzania. And in Low income countries (LICs), studies have shown, Acute watery Diarrhea (AWD) is the cause of morbidity and mortality which can be prevented by immediate identification and treatment of complications. Methods A prospective cohort study was done between December 2021 and April 2022 to determine the risks, complications, management strategies and predictors of mortality among paediatric patients ≤12 years of age with severe diarrhea. We excluded those who arrived in cardiac arrest at the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH). Proportion was used to summarize the counts and frequency of participants who were at risk of complications and management strategies given and for predictors of outcomes. A Modified Poisson log linear model with a robust estimation test was used to test for significant associations between predictors and outcomes. Multivariate logistic regression was used to adjust for confounders. Results A total 6,570 paediatric patients presented to EMD during study period, and we recruited 144 (2.2%). The median age was 1 (IQR 0.7-2.0) years and most were male 86 (59.7%). Among the study participants with diarrhea, 120 (83.3%) had dehydration, acidosis 60 (42.3%), hypoglycemia 8 (5.6%), hypokalemia 76 (53.1%), and Acute renal failure 11 (7.6%). Those patients with complications received appropriate management, including IV crystalloid solution given to 131 (90.97%), and correction of acidosis 60 (42.3%), hypoglycemia correction with IV dextrose 10% 6 (4.2%), and hypokalemia and infections were corrected with IV potassium chloride 52 (36.1%) and IV antibiotic treatment 84 (58.3%) respectively. Conclusion Pediatric patients under 2 years of age are at high risk of severe diarrhea with dehydration as compared to other ages. Early referral and availability of point care tests are essential in early recognition of accompanied complications.

Outcomes of Differentiated Thyroid Cancer Patients Treated with Surgery and Radioactive Iodine at SQCCCRC

Objective To evaluate the treatment outcomes of patients with Differentiated thyroid cancer (DTC) who underwent total thyroidectomy followed by RAI therapy at the Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) in Oman. Methods This is a retrospective observational clinical study conducted at SQCCCRC. The study included all patients diagnosed with DTC who were admitted to SQCCCRC between June 2021 and November 2023. A total of 255 patients were identified and met the inclusion criteria for this study. Results The mean age at diagnosis was 39.9 ± 12.4 years (range: 14–79), with 78% of patients being female. The mean BMI was 30.3 ± 6.4 kg/m², with nearly half of the cohort (48.2%) classified as obese (BMI ≥ 30). Most patients had papillary thyroid carcinoma (92.9%), while follicular and Hürthle cell carcinoma accounted for 5.9% and 0.8% of cases, respectively. Based on the American Joint Committee on Cancer (AJCC) staging, 86.3% of the patients were classified as stage I and 3.9% as stage II. Six patients (2.4%) had stage IVB disease. According to American Thyroid Association (ATA) risk stratification the majority were low-risk. Patient age was strongly associated with disease stage. The distribution of metastatic cases varied by region, with the highest proportion observed in Dhofar. Most patients (87.1%) received a single dose of radioactive iodine (RAI), with a median cumulative dose of 3.7 mCi). At six months post-treatment, 70.2% of patients had a TG level < 0.2 ng/mL. Conclusion The outcome of therapy in majority of our patients is favorable with 72% having excellent biochemical response at last follow up. None of the patients with distant metastasis achieved excellent response and a high proportion of them came from the Dhofar governorate, a targeted intervention would be of benefit. Low risk patients require special attention and may need radioactive iodine during follow up, unlike other regions and hence warrant very close follow up and further review to establish the best practice guidelines in our region.

Secondary Hip Fractures among Aging Adults with a Previous Hip Fracture History: Cumulative 50 Year Overview, Analysis, and Possible Antidote as Observed from 1974-2026 Data Sources

Hip fractures, which remain an immense public health concern, have been subject to study and prevention efforts for many decades, but with limited success in averting either incident, second or subsequent hip fractures, commonly attributed to a combination of age related proclivity to fall, low bone and muscle mass. This review examines second hip fracture incidence rates and determinants of this serious functionally debilitating injury as observed over time remains a current 2026 public health concern. It specifically explores if more preventive efforts are currently warranted in this regard, and in what respect, if indeed, more frail older adults are living longer, but may be in excessively poor health, fearful of moving or falling, malnourished, weak with poor balance, or depressed. Based on what is published, it is concluded 1) second hip fracture incidence rates remain considerable, especially among those who are frail with osteoporotic bone disease, poor vision, heart/or cognitive conditions, plus those with muscle deficits of the lower limb, live alone and have a falls history; 2) studies to identify possible mitigation approaches appear promising in this regard, along with more routine efforts to minimize falls risk and bone attrition.

From Pelvis to Foot: A Functional Approach to Preventing Ankle Sprains in Athletes

Background Ankle sprains are among the most common injuries in sports, often characterized by high recurrence rates despite appropriate local treatment. Traditional approaches primarily focus on the injured joint, with limited attention to proximal biomechanical factors that may predispose athletes to injury. Objective To propose a functional, longitudinal kinetic chain model in which sacroiliac joint dysfunction may act as a predisposing factor for ankle sprain/strain injuries in athletes. Methods This paper presents a clinical hypothesis based on biomechanical reasoning and observational findings. The proposed model describes how sacroiliac joint dysfunction, particularly posterior innominate rotation (PI), may lead to pelvic obliquity and functional leg length discrepancy. These changes may induce compensatory femoral external rotation and foot toe-out, altering ground contact mechanics during gait and running. Results (Hypothesis) The altered alignment and loading pattern may increase the vertical impact force and modify the ground reaction vector on the functionally shorter limb, resulting in reduced mechanical stability at the ankle during heel strike or foot contact. Over time, this may increase susceptibility to inversion or eversion injuries, manifesting clinically as recurrent sprain/strain. Conclusion Ankle sprains in athletes may, in some cases, represent the distal expression of a proximal biomechanical imbalance. Incorporating assessment of the sacroiliac joint and the longitudinal kinetic chain into routine clinical evaluation may improve injury risk identification and contribute to more effective prevention strategies. Further research is needed to investigate this proposed relationship.

Apomorphine Subcutaneous Infusion is More Efficient Than foslevodopa/foscarbidopa Subcutaneous Infusion in the Treatment of Advanced Parkison´s Disease for the Spanish National Health System

Objectives Motor fluctuations and non-motor disorders not manageable by first-line treatments in advanced Parkinson's disease require continuous dopaminergic stimulation strategies such as subcutaneous infusions of apomorphine (APO) or foslevodopa/foscarbidopa (FLD/FCD). A Budget Impact Analysis (BIA) was performed to estimate the cost difference between both treatments assuming equivalent clinical efficacy and safety. Material and methods The efficacy results of pivotal clinical trials at 12 and 52 weeks of treatment and the safety profile of APO vs FLD/FCD were compared, based on latest scientific publications and other available clinical data. A comparative BIA was performed, based on estimated annual drug treatment costs at Spanish published prices. Results The efficacy of APO (16 h/day) and FLD/FCD (24 h/day) in reduction of OFF hours (2.47 vs 2.75, 12 weeks; 3.66 vs 3.50, 52 weeks; respectively) and increase of ON hours without disabling dyskinesias (2.77 vs 2.72, 12 weeks; 3.31 vs 3.80, 52 weeks; respectively) could be considered clinically equivalent, as well as their safety profiles. However, a significant discrepancy is observed in the costs of the aforementioned alternatives. Considering published prices and the average dose reported in the literature, in Spain the annual cost of APO would be €13,980 compared to €55,198 for FLD/FCD. Consequently, the financial resources required for the treatment of FLD/FCD would enable the treatment of approximately three to four patients with APO. The BIA indicated the potential for annual savings in more than €2,500 million, considering a total target population of over 60,000 patients per year. Finally, an univariant sensitivity analysis was performed, considering a scenario in which the hospital acquisition cost of FLD/FCD decreased between 20%-30% (€44,159- €38,638/year). In this scenario, the total annual savings range between €1,875-€1,532 million per year. Conclusions Overall APO is more efficient than FLD/FCD, as it provides similar clinical efficacy at a lower treatment cost. The selection of an appropriate treatment option is to be determined by clinical criteria and patient characteristics, but cost evaluation should be considered to select the most cost-effective therapeutic option.

Reduced Tissue Oxygenation and Altered Valsalva Hemodynamics in Young Adults with Type 1 Diabetes

Aims Cardiac autonomic neuropathy is currently an untreatable progressive complication of type 1 diabetes (T1D). Impaired microcirculation is a suspected cause of nerve degeneration in TID. We investigated whether cardiovascular autonomic reflexes often used as indices of nerve functions, are associated with indices of microcirculatory function in young adults with T1D compared with non-diabetic controls. Methods In a cross-sectional study, 15 adults with T1D and 15 age-matched controls (20-40 years) underwent standardized cardiovascular autonomic reflex tests. Continuous recordings of electrocardiogram, cardiac vagal tone, beat-to-beat blood pressure and transcutaneous tissue oxygen (tcpO₂) and carbon dioxide partial pressures (tcpCO2) were done. Results Despite preserved baroreflex, parasympathetic, and sympathetic functions assessed using cardiovascular reflex tests, the individuals with T1D exhibited reduced baseline tcpO2 compared to the controls (37.5±3.75 vs. 49.6 mmHg). During the Valsalva manoeuvre, individuals with T1D exhibited a reduced systolic blood pressure response in phase I (31±10 vs. 43±18 mmHg) and early phase II (-1±15 vs. -18±17 mmHg), and an increased systolic (31±15 vs. 18±14 mmHg) and diastolic (45±11 vs. 33±16 mmHg) response in late phase II compared to controls. The early phase II diastolic response was inversely associated with baseline tcpO2. Conclusion The altered hemodynamic response to the Valsalva manoeuvre is suggestive of possible reduced arterial elasticity, higher vascular resistance, and splanchnic sympatho-vagal imbalance in T1D despite normal autonomic reflex ratios. The concomitant evidence of reduced tissue oxygenation and altered hemodynamics may represent early signs of dysautonomia but require longitudinal validation.  

Climate Change Sustainable Net-Zero Emissions by Uptake Atmospheric Carbon Dioxide by Terrestrial and Aquatic Plants

A sustainable global net-zero carbon emission is when emissions are equivalent to the uptake of carbon by global terrestrial and aquatic plants. To meet that objective, an approximate 50% reduction of fossil-fuel emissions was estimated for net-zero by 2050 using carbon dioxide concentrations and mass emission monitoring by NOAA and related references. From that data, the initial target level of reduction to obtain net-zero was selected for year 2000 to minimise effects of climate change on environmental damage. The recent finding that about half global emissions are taken up from the atmosphere and increases global terrestrial and aquatic plant growth, including agriculture plants for food production, indicates it is important to maintain the year 2000 levels in the atmosphere. It was concluded as renewable energy was found to need support, it could be supplemented by electricity production remaining after obtaining net-zero, which also supports the atmospheric carbon dioxide levels for their important global ecological contribution.

A Solar Water Heater Using a Two-Stage Thermostat as a Pre-Heating System for a Feed Plant

Solar thermal heating is a mature technology for producing hot water in the domestic sector. Industrial processes require significant heat, so solar water heaters can be used for pre-heating. A forced- circulation solar water heater is installed in a feed plant that is located south of the Tropic of Cancer. The thermal efficiency of the system is closely related to the incident solar radiation. This study uses a two-stage setting for a thermostat to collect more solar energy if incident solar radiation is less intense. When the temperature difference between the water storage tank and the water outlet for the solar collectors (setting of a thermostat from 6° to 8°C) increases, there are more energy savings. The simple payback period for the system is 2.05 years, so it is financially viable to use a solar water heater for industrial heat processes. Excessive carbon emissions resulting from industry processes are a main cause of global warming. Carbon tax can be used as a central climate policy instrument for carbon reduction. The government of Taiwan stipulates the legal foundation for levying carbon fees in 2025. The carbon emissions and carbon tax for the feed plant are described to prompt the case for sustainability.

Histologic and Histomorphometric Evaluation of Implant Osseointegration of a Dental Implant Three Years in Function Removed Due to Abutment Fracture

For the edentulous patient, dental implant therapy is the accepted treatment to replace one or more missing teeth as implant survival rates are greater than 90%. Unfortunately, surgical removal of dental implants occurs for a variety of reasons. As human studies are limited, this case report provides an opportunity to evaluate the peri-implant characteristics in a dental implant removed from a patient using histology. In our patient, the implant was removed three years after completion of the prosthetic phase due to fracture of the abutment that could not be removed from the implant. Histological examination of the implant revealed mature lamellar bone in direct contact with the implant surface. Histomorphometric evaluation revealed a bone-to-implant contact (BIC) of 73.6%.

Diabetic Mouse Delayed Wound Model Following Treatment with the NerveStim™ Neuropathy System

Delayed wound healing in diabetes is characterized by impaired angiogenesis, persistent inflammation, extracellular matrix dysregulation, and peripheral neuropathy. A preclinical study was conducted using a diabetic mouse delayed wound model to evaluate the surrounding tissue of a wound, (its periwound) and its tissue responses following treatment with the NerveStim™ Neuropathy System, a combination topical gel and neuromuscular electrical stimulation platform. Periwound tissue was harvested at Day 14 and analyzed using NanoString gene expression profiling. Treated animals demonstrated visibly increased periwound tissue thickness compared to untreated controls. Differential expression analysis identified 76 significantly upregulated and 17 downregulated genes. Upregulated pathways included angiogenesis (Vegfa, Fgf2, Pdgfb, Nos3), neurotrophic signaling (Ngf, Bdnf, Scn9a, Trpv1), macrophage polarization (Arg1, Mrc1, Il10), and extracellular matrix remodeling (Col1a1, Col3a1, Mmp9, Timp1). Downregulation of select pro-inflammatory mediators (Nos2, Mif) was observed. These coordinated transcriptional changes are consistent with activation of reparative immune, neurovascular, and matrix remodeling pathways in diabetic periwound tissue.

Prevalence of Sexually Transmitted Infections in the United Kingdom from Home-Collected Samples: A Cross-Sectional Laboratory Analysis of over 6000 Cases

Background Sexually transmitted infections (STIs) continue to rise globally, with >1 million new cases reported daily in 2020. In England, newly diagnosed STIs increased by 23.8% in 2022 compared to 2021. Many infections remain asymptomatic yet contribute to infertility, pregnancy complications, and neonatal morbidity. While routine screening often focuses on Chlamydia trachomatis, broader detection is limited by laboratory turnaround times and restricted test panels. Methods We analysed 6003 home-collected urine and/or swab samples submitted for sexual health screening in the UK. Samples were tested in the laboratory for 10 bacterial and viral pathogens. A total of 5859 urine and 1627 swab samples were processed, with paired samples assessed for diagnostic agreement. Results The most common infections detected in urine were Ureaplasma urealyticum (12.1%), Mycoplasma hominis (8.6%), and Chlamydia trachomatis (2.4%). Swabs showed similar prevalence, with Ureaplasma urealyticum (11.6%) most frequent, followed by Mycoplasma hominis (10.4%) and HSV-2 (4.4%). Paired urine–swab samples demonstrated strong agreement, though swabs improved HSV detection. Conclusions Ureaplasma urealyticum was the most prevalent STI detected, yet only Chlamydia trachomatis is routinely screened in England. Comprehensive laboratory testing of home-collected samples could reduce the hidden burden of STIs, infertility, pregnancy complications, and neonatal infections, while offering confidential and accessible diagnostics.

Honour and Shame as Moral-Emotional Identity Regulation in Diaspora: An Interpretative Phenomenological Analysis of Young British South Asian Women

Honour and shame are central moral constructs within many South Asian communities, yet their psychological internalisation in diasporic contexts remains underexamined. This qualitative study explored how young British South Asian women (aged 18–25; N = 6) understand and negotiate honour in relation to gender, religion, and identity. Semi-structured interviews were analysed using Interpretative Phenomenological Analysis. Six interrelated themes illustrated honour as a gendered and relational system sustained through anticipatory shame, behavioural surveillance, and sexual double standards. Participants described internalised self-monitoring, bicultural identity tension, and strategic resistance through selective compliance and religious reinterpretation. We propose that honour and shame in minority diaspora contexts function as a moral-emotional identity-regulation system characterised by anticipatory shame, relational accountability, and boundary maintenance under racialisation. This conceptualisation advances acculturation and bicultural identity frameworks by arguing that moral emotion, particularly anticipatory shame, functions as a primary mechanism of cultural internalisation, rather than merely an outcome of value endorsement. The findings further illuminate how moral surveillance shapes identity negotiation and psychological wellbeing, with implications for culturally responsive community and clinical practice.

Characterization of People Receiving 2-Drug Regimens (2DR) for HIV Management in Italy

Objective To describe the clinical features and real-world treatment of people living with human immunodeficiency virus (PLHIV) using fixed-dose or free combinations of 2-drug regimens (2DR) of antiretroviral therapy (ART). Design Italian retrospective cohort study. Methods Data were extracted from PLHIV who initiated or switched to 2DR: Group 1 (fixed dose), Group 2 (free combination). Results Group 1 was younger and more predominantly male, and had shorter time from AIDS-defining diagnosis to 2DR-ART and from diagnosis to baseline, a lower prevalence of resistance, and fewer comorbidities than Group 2. Median baseline viral load was <50 copies/mL in both groups, but Group 1 had a higher mean due to outliers. The most common ART classes before switching to 2DR were Integrase Strand Transfer Inhibitor (INSTI)-based (48.97%), Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)-based (22.73%), and Protease Inhibitor (PI)-based (16.53%). Distribution varied: Group 1: INSTI-based (53.13%), NNRTI-based (24.31%), and PI-based (15.04%); Group 2: INSTI-based (29.41%), PI-based (23.53%), and NNRTI-based (15.29%). After switching, Group 1 was on dolutegravir/lamivudine (79,33%) and dolutegravir/rilpivirine (20,67%); Group 2 mostly on INSTI-PI (52.81%), followed by NNRTI combinations, mainly with doravirine (19.10%). Duration of ART after switching was shorter in Group 1. Conclusion Italian PLHIV on 2DR fixed-dose combinations were younger, virologically suppressed individuals at baseline, with a shorter lead time from diagnosis, lower prevalence of resistance and lower comorbidity rate compared to those on free combinations. These findings underscore an unmet need for 2DR fixed-dose combinations, as the free combinations were predominantly utilized for more challenging populations.

Efficacy and Safety of Pulsed Magnetic Therapy in Sleep related Disorders: A Remote, Randomized, Double-Blind, Placebo-Controlled Trial

Background/Aim Sleep disturbances are common and are associated with impaired daytime functioning, reduced quality of life, and increased health risks. Non-pharmacological neuromodulatory interventions have gained interest as alternatives to hypnotic medication. Pulsed electromagnetic field (PEMF) therapy has been proposed as a non-invasive approach to improve sleep quality and recovery, but evidence from large, well-controlled trials remains limited. The objective of this study was to evaluate the efficacy and safety of pulsed magnetic field therapy (PMT) on sleep quality, sleep-related symptoms, daytime functioning, and well-being in adults with heterogeneous sleep complaints.  Materials and Methods In this remote, randomized, double-blind, placebo-controlled trial, 217 adults reporting non-restorative sleep, difficulties initiating sleep, or frequent nocturnal awakenings were assigned to active PMT using a PEMF device (Night Harmony Female/Male protocol) or a sham application for three weeks. Primary outcomes were changes in the Pittsburgh Sleep Quality Index (PSQI) global score and self-rated sleep satisfaction, restfulness, and sleep initiation difficulties. Secondary outcomes included sleep diary measures, daytime functioning, well-being (WHO-5), symptom burden (MYMOP), and daytime sleepiness (Epworth Sleepiness Scale). Analyses followed the intention-to-treat principle using ANCOVA with baseline values of the respective parameter as covariate.  Results Both groups showed significant improvements over time in global sleep quality and most secondary outcomes (p < 0.001). Between-group differences in PSQI global score were not significant (p = 0.314). However, active PMT resulted in significantly greater improvements in subjective sleep satisfaction (p = 0.02) and restfulness (p = 0.02), particularly among participants with moderate to severe baseline sleep disturbances (p < 0.001 for both). Sleep continuity measures improved similarly in both groups. No serious adverse events were reported.  Conclusions PMT produced modest but significant improvements in subjective restorative aspects of sleep beyond placebo effects and was well tolerated. Further studies using objective sleep measures and longer follow-up are warranted.

Morphological Attributes and Yield of Momordica charantia (Bitter Gourd) Under the Application of Spiritual Blessing/Biofield Energy Treatment (BET)

Objective Bitter gourd (Momordica charantia L.) is a widely consumed vegetable. This study aimed to assess the impact of spiritual blessing (biofield) energy treatment (S/BET) known as the Trivedi Effect® on a plant’s growth and yield when applied to both seeds and soil. Methods Seeds were split into two groups: an untreated control group (CONBIGG) and a BET-group (BTBIGG). Soil texture was checked by hand, and mineral contents were measured using standard procedures. An experienced scholar noted plant morphological, phenological, and yield-related parameters. Results The S/BET group showed improvements in stem length, fruit colour, and seediness compared to the control. Other phenological parameters, such as vine length (38.78 %; p ≤ 0.001), branch number (54.03 %; p ≤ 0.01), inter-nodal length (42.94 %; p ≤ 0.001), fruit length (33.27 %; p ≤ 0.001), seed length (40.32 %; p ≤ 0.001), seeds per fruit (52.50 %; p ≤ 0.001), and fruits per vine (66.88 %; p ≤ 0.001), were significantly increased in the BTBIGG group compared to the CONBIGG. Yield per hectare rose by 61.31 % in the S/BET group compared to the control. Conclusion The study results suggest that the spiritual blessing/prayers/BET-Trivedi Effect® significantly improved morphological, phenological, and yield-related parameters compared to the control group. This study provides useful scientific research data and information for producing stable, high-quality bitter gourds.

A Review and Update on the Biochemical Basis of Conscious Breathing (Pranayama)

Breathing has long been recognised as a vital process in Eastern traditions such as YOGA and Ayurvedic medicine, where Pranayama is regarded as a transformative practice that harmonises body and mind. While the East developed sophisticated systems of breath regulation for health and self-awareness, the West largely overlooked their significance until the late 19th and early 20th centuries. A group of pioneering physicians, sometimes referred to as "the pulmonauts", including Christian Bohr, Konstantin Buteyko, and Peter M Litchfield, explored the physiological foundations of respiration. They emphasised the benefits of slow, nasal breathing and its relationship to both physical and emotional well- being. In the 21st century, contemporary researchers and practitioners such as James Nestor, J. Patrick McKeown and Anders Olsson have expanded this understanding through the fields of biochemistry, physiology, and biomechanics. Their work has clarified the mechanisms underlying conscious breathing and refined ancient pranayama techniques. Integrating insights from both Eastern and Western traditions reveals that breathing is a central factor in maintaining homeostasis and emotional balance.

Acquired Haemophilia: A Case Report and Literature Review

Acquired haemophilia (AHA) is a rare coagulation disorder secondary to autoantibodies against coagulation factor, most commonly factor VIII with potential for life threatening bleeding episodes. We report a case of an 88-year-old female presenting with frank haematuria three weeks after catheter insertion. Her background was of Alzheimer’s Dementia, Asthma and Bullous Pemphigoid for which she was on low dose maintenance prednisolone (5mg). Laboratory tests showed haemoglobin 98g/dl and partial thromboplastin time (PTT) of 60s, with corrected prothrombin time 52s. Fibrinogen 5.39. As such coagulation factors were tested which revealed factor VIII of 0%. Her case was complicated by urinary tract sepsis, as such she was treated with oral prednisolone 60mg without immunosuppressive agent usage. A pan-CT scan revealed likely mesothelioma for which she declined further investigation. This case report will describe a rare presentation of AHA associated with bullous pemphigoid and mesothelioma, complicated by infection and frailty.

Activation of Transcription Factor EB Protects Against Proinflammatory Insults Through NF-κB Inhibition in Keratinocytes

Keratinocytes are pivotal in mediating cutaneous inflammation. Identifying anti-inflammatory factors within these cells holds promise for developing novel therapeutic strategies to manage skin inflammation. Transcription factor EB (TFEB) has recently emerged as a key regulator linking cellular energy metabolism to inflammatory processes, primarily through its influence on autophagy and NF-κB signaling. However, whether TFEB activation exerts anti-inflammatory effects in keratinocytes remains unclear. In vitro inflammation model was established in HaCat cells by incubation with proinflammatory mediators LPS and IL-1β. Cell viability and TFEB expression and phosphorylation were measured. The effect of TFEB activation by C1 and adenoviral TFEB overexpression on the expression of proinflammatory genes including COX-2, MCP-1 and IL-6 were detected. Also, IκBα protein level were determined. TFEB phosphorylation is increased while TFEB total protein expression is inhibited by treatment with LPS and IL-1β. Pharmacological activation of TFEB by compound C1 and TFEB overexpression suppressed the expression of COX-2, MCP-1 and TNF-α induced by LPS and IL-1β. TFEB overexpression increased basal IκBα expression and restored IκBα level under LPS treatment. TFEB knockdown reduced TFEB expression and lowered basal expression level of COX-2, MCP-1 and TNF-α. Our findings indicate that TFEB activation can mitigate inflammatory gene expression in keratinocytes triggered by LPS and IL-1β. This implicates TFEB as a significant novel modulator of cutaneous inflammation, highlighting its potential as a therapeutic target. Targeting TFEB could thus be a viable strategy for developing new treatments for chronic inflammatory skin conditions.

Evaluation of Combined Ultrasonography and Cone Beam Computed Tomography for Clinical Imaging: A Negative Results Study

The combination of ultrasonography (US) and cone beam computed tomography (CBCT) has been proposed as a multimodal imaging strategy capable of uniting realtime softtissue assessment with highresolution threedimensional visualization of osseous structures. This study critically evaluated whether such integration provides measurable diagnostic or workflow advantages in mandibular imaging. Despite strong theoretical justification, the combined use of US and CBCT failed to demonstrate clinically meaningful improvements in diagnostic accuracy, confidence, or efficiency when compared with CBCT alone. Fundamental physical mismatches, hardware incompatibilities, geometric constraints, and operatordependent variability limited the anticipated synergistic benefits. These negative findings underscore the importance of reporting unsuccessful integration attempts to guide future research and prevent premature clinical adoption of technically incompatible imaging paradigms.

Rooted Resistance: Women’s Socio-Cultural Roles in Environmental Conservation in a Patriarchal Society in Northern Uganda

Background In Northern Uganda’s patriarchal communities, women play vital yet underrecognized roles in environmental conservation. There is limited research examining the socio-cultural roles women play in society in northern Uganda. This study, conducted in Gulu District, examined the socio-cultural functions performed by women in safeguarding natural resources. Methods This study employed an analytical cross-sectional design involving 395 women aged 18–49 in Gulu District, selected for its patriarchal context. Data were collected using structured questionnaires and analyzed with SPSS, applying descriptive and inferential statistics. Key variables included women’s roles in environmental conservation and barriers to participation. Ethical approval and informed consent were obtained to ensure research integrity. Results The study found that women in Gulu District play vital socio-cultural roles in environmental conservation, particularly as custodians of indigenous knowledge (Mean = 4.42), active participants in tree planting (Mean = 4.11), and conservers of ecosystems (Mean = 4.04). However, their involvement in advocacy (Mean = 3.46) and decision-making (Mean = 3.20) was perceived as limited, reflecting the constraints of a patriarchal society. Additionally, evolving gender roles have negatively impacted women’s engagement, with 47.6% citing excessive domestic workload and 44.1% reporting reduced participation in conservation activities. These findings highlight both the significance of women’s contributions and the structural barriers that hinder their full involvement in environmental governance. Conclusion Despite these challenges, women’s contributions remain central to sustainable environmental stewardship. The study recommends targeted sensitization and training programs to promote gender equality and community acceptance of women’s leadership in environmental governance.

Interactions Between Natural Nuclear Reactors and Microbial Evolutionary Processes

The impact of ionizing radiation on genetic change is well established, yet the extent to which naturally occurring radiation fields have influenced evolutionary trajectories remains incompletely understood. This study examined correlations between microbial evolution and the radiation and geochemical environments associated with natural fission reactors, with emphasis on the Oklo–Bangombé system in present-day Gabon, Africa. The current paper compares plausible doserate regimes adjacent to reactor zones with published observations of radiationinduced phenotypes, geneexpression changes, and repair strategies in model organisms and complex biotas. This study further considers indirect mechanisms (e.g., water radiolysis, redox restructuring, tracemetal mobilization) by which natural reactors could have modulated ecological selection pressures over long timescales. The synthesis supports the plausibility of three interacting pathways: (i) increased mutation supply under low, chronic dose rates; (ii) selection in oxidantrich, redoxstratified niches; and (iii) metabolic subsidies (e.g., H₂) from radiolysis that support chemotrophic guilds. Although temporal–spatial associations exist between reactor activity and biological innovations preserved in Paleoproterozoic strata of Gabon, current evidence remains correlational rather than demonstrably causal. The study further outlines testable predictions and experimental designs capable of discriminating among these mechanisms.

Immunotherapy Usage Has Not Increased Sub-Lobar Pulmonary Resections Despite Reduced Pneumonectomies

Objective The landscape of non-small cell lung cancer (NSCLC) has changed due to liberalized utilization of computed tomography, developments in immunotherapy and targeted treatments, and guidelines encouraging sublobar resections. We analyzed the implications of these advances for surgical procedures over a 16-year period. Methods The National Cancer Database was used to identify NSCLC incident cases from 2004 to 2020. Histology, stage, grade, and treatment were analyzed using descriptive statistics and logistic regression. Results 2,028,553NSCLC patients were identified. Each year was associated with an increase in Stage I for NSCLC (OR1.05, 95%CI 1.05-1.05) and histological subtypes (adenocarcinoma: OR1.03, 95%CI 1.03-1.04; squamous: OR1.02, 95%CI 1.02-1.02; neuroendocrine: OR1.11, 95%CI 1.11-1.12), with no change in adenosquamous histology. A similar increase was observed for well- or moderately-differentiated histology (OR1.04, 95%CI 1.04-1.04). The proportion of patients receiving chemotherapy decreased (OR0.98, 95%CI 0.98-0.98), while more patients were treated with immunotherapy or targeted therapy, including an increase of 14% using immunotherapy or targeted therapy as first-line treatment. There was a decrease in the likelihood of receiving pneumonectomy (OR 0.91, 95%CI 0.91-0.91). Despite guidelines advocating sublobar resections, these procedures only increased by 1.1% per year. Conclusions Over the 16-year study period, there was a significant trend towards diagnosis of Stage I NSCLC. The most pronounced change in treatment patterns has been more patients receiving immunotherapy and less chemotherapy. Despite a promising decrease in pneumonectomies, the frequency of sublobar resections remains stagnant, indicating limited uptage in current practice.

Core and activating Symptoms of Depression in Chinese Teachers and Comparison between Different Gender and Stage of Teaching: A Network Analysis Approach

Background Depression, increasingly recognized as a critical factor impacting mental health, notably affects various populations, including teachers. This study aimed to delineate the specific characteristics of depressive symptom networks among Chinese teachers, identify the core symptoms of depression within this demographic, and examine the variations in depressive symptom networks across different genders and teaching stages. Method The study encompassed 1,670 teachers. Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Central symptoms were identified through centrality indices. Network stability was examined via a case-dropping procedure. Directed Acyclic Graphs (DAG) was used to identify the activating symptoms. Results “Personal devaluation” exhibited the highest and most stable centrality values in the network. “Depressed Affect” and “Emptiness of Life” were identified as the activating symptoms in the network. No significant differences were observed in the network structure and global strength of depression between teachers of different genders. However, significant differences in the network’s global strength were found between junior and senior high school teachers. Conclusion “Personal devaluation” emerged as the core depressive symptoms among teachers in China. “Depressed Affect” and “Emptiness of Life” serve as the gateways that activate the entire teacher depression network. Paying close attention to these symptoms could potentially alleviate the experiences of depression in this demographic.

On Terms: Maladaptive Behavior

There is no shortage of terms that are used to describe and articulate the strategies, practices, and underpinnings associated with the work engaged in by behavior analysis. Two terms that a clinic-focused behavior analyst may hear often are maladaptive behavior and problem behavior. These terms are not only common within our everyday practice, but they are also peppered throughout behavioral literature. Despite their permanency in the behavior analyst's repertoire, their meanings remain inconsistent, interchangeable, and conceptually unclear. For over a century, this lack of precision has gone unchecked, despite extensive research on undesirable or clinically significant behaviors. This article offers individuals a recount of the history, definitional limitations, and functional implications of these terms. From the perspective of early psychological scholarship and contemporary behavior-analytic sources, I argue that the field of Applied Behavior Analysis (ABA) will benefit from distinguishing maladaptive behavior as the presence of behavior that adversely affects the individual, while problem behavior should refer to the absence or inhibition of adaptive responses in relation to others' social behaviors. Furthermore, I propose that both terms be used to describe the effects on the person engaging in the behavior, instead of others around the individual, as a method of improving directionality and functional clarity. As a field focused on verbal behavior, becoming more conceptually precise with our own verbal behavior will lead to a more coherent basis for interpreting and treating behaviors that interfere with individuals' adaptation and well-being.

Osteoarthritis Falls Origins, Risks, and Prevention: Do we Need an Ecological Guiding Explanatory Framework?

Lower limb osteoarthritis, a widespread age related chronic condition is often accompanied by an increased tendency to fall and thereby various degrees of intrinsic and extrinsic injury. Falls, in turn may provoke the disease alone and in turn a high falls risk and cycle of recurrent falls and heightened disability. This report which updates what is known about falls in the context of disabling osteoarthritis argues for a possible future ecological orientation rather than a focal uni dimensional approach to addressing this costly health problem. It examines osteoarthritis falls risk factors, falls injury prevention attempts, and recommendations to advance research and practice using an ecological analytic approach in this regard. Using the PUBMED data base and others, lower limb osteoarthritis linkages and falls interaction studies were sought and examined. The data revealed osteoarthritis can lead to the chances of incurring one or more falls and further health and disability challenges, while falling can provoke the onset of osteoarthritis in its own right. Although many factors appear to be involved, these are rarely viewed through a broad multi dimensional ecological perspective, thus are confusing or overwhelming to apply to the active community dwelling elderly subject.

A Decision Tree Ensemble Approach to Diabetes Prediction using the Framingham Heart Dataset, Exploring the Role of AI-Associated Interventions in Reducing Diabetes-Related Adverse Outcomes Between Men and Women

Objective Diabetes poses significant public health challenges, with many individuals remaining undiagnosed and at risk of complications. This study aimed to evaluate the performance of decision tree ensemble methods for predicting diabetes onset using the Framingham Heart Study Teaching Dataset and to explore sex-specific risk patterns relevant to AI-driven interventions. Methods We analyzed data from 11,627 participants, incorporating demographics, vital signs, smoking status, medication use, and laboratory measures. Random Forest classifiers were developed to predict diabetes incidence at approximately 6-year (Period 2) and 12-year (Period 3) follow-ups. Class imbalance was addressed using undersampling, oversampling, and the Synthetic Minority Over-sampling Technique (SMOTE). Results The models demonstrated robust performance, achieving an Area Under the Curve (AUC) of 0.856 in Period 2, and moderate predictive ability in Period 3 (AUC = 0.732 in males, 0.786 in females). Key predictors included glucose level, BMI, systolic blood pressure, age, and heart rate. Notably, differences emerged in predictive accuracy between men and women, suggesting potential sex-specific vulnerabilities that merit further study. Conclusion Machine learning approaches, particularly Random Forests, show promise for medium- and long-term diabetes risk prediction, supporting early identification and intervention efforts. Future work should focus on hyperparameter tuning and explainability techniques, such as SHapley Additive exPlanations (SHAP) values, to improve model precision, interpretability, and fairness. Equity-focused strategies remain critical to ensure AI-driven tools benefit diverse populations and do not exacerbate existing disparities in diabetes care.

Maxillary Sinus Lift Using the Lateral Window Technique with Hydroxyapatite and Beta-Tricalcium Phosphate (β-TCP) Graft

This narrative literature review investigates the clinical feasibility of maxillary sinus lift using the lateral window (or traumatic) technique, employing a grafting material composed of hydroxyapatite associated with beta-tricalcium phosphate. The study is based on the premise that bone resorption and sinus pneumatization—common in edentulous posterior maxillae—pose a challenge to achieving primary stability during dental implant placement. Given the limitation imposed by reduced residual bone height, bone-grafting surgical techniques become necessary to enable implant-supported rehabilitation. The objective of this work is to analyze, through a literature review, the efficacy of combining synthetic biomaterials as an alternative to autogenous bone grafts, which are considered the gold standard in implant dentistry. A bibliographic search was conducted in the PubMed and LILACS databases and through the VHL portal, prioritizing articles addressing the biological properties of alloplastic grafts, the indications of the lateral window technique, and the clinical success rates of implants placed in previously grafted areas using such materials. The findings demonstrated that hydroxyapatite associated with beta-tricalcium phosphate exhibits favorable osteoconductive characteristics, such as adequate porosity and gradual resorption, while allowing the formation of viable bone within a clinically acceptable timeframe. The combination of these materials eliminates the need for a second surgical site, reduces morbidity, and maintains treatment predictability. It is concluded that the lateral window technique associated with synthetic biomaterials is a safe and effective alternative for patients with maxillary bone atrophy, capable of promoting suitable bone beds for dental implant placement and stabilization, with lower surgical risk and satisfactory clinical outcomes.

The Dose Modulates the Body’s Physiology: Literature Review

The body interacts with endogenous and exogenous molecules through various receptor networks at the cellular and organismal levels by which the different physiological processes of the organ systems get activated. Life could no longer exist without the body’s interaction with these signaling molecules. The number of molecules interacted with a receptor type within the body determines the efficiency of biological processes that would determine the biochemistry and anatomy behind the basic body functions. The dose plays a complex role in multiple physiological processes by modulating the natural processes of the different biological systems. It is always connected to the physiological and anatomical aspects of the biological sciences in which it manifests the biological sensitivity that would determine the efficiency of biological responses of the body systems. There are always physiologic and non-physiologic doses for every compound administered into the biological systems. The does that facilitated the body to manifest that biological sensitivity which has maintained the physiological processes of the body systems was noted as physiologic dose, whereas the dose that has suppressed the biological sensitivity of the body that became inefficient in maintaining the physiological processes of the different biological systems was termed non-physiologic dose. It is important to adjust the dose or dosage based on physical and biological factors such as the efficiency of the different organ systems, body weight, and the timing of the dose triggering a biological response to maintain the natural processes of the body systems. This means that integrated biological data is required in order to be able to identify the physiologic and non physiologic doses for biological or pharmacological use.

How Intensive Short-Term Dynamic Psychotherapy Merges with Hypnotism and Solution- Focused Methods

Intensive Short-Term Dynamic Psychotherapy (ISTDP) has proven effective in over 120 outcome studies, particularly for anxiety, depression, and personality disorders. This conceptual paper proposes a theoretical integration of ISTDP with Solution- Focused Brief Therapy (SFBT) and clinical hypnosis. Each modality offers unique strengths—ISTDP enables rapid emotional processing, SFBT builds client resilience and solutions, and hypnosis enhances neuroplasticity and emotional receptivity. Drawing on existing empirical and neuroscientific literature, this paper synthesizes these modalities into a unified clinical framework. The integrated model emphasizes accelerated change through emotional access, strategic future orientation, and unconscious facilitation. Case examples illustrate the framework's practical applications across complex clinical presentations. The integration addresses gaps in single-modality treatments and provides a cost-effective, neurobiologically supported method of intervention. This article offers clinicians structured decision- making strategies and practical tools for real-time integration, while outlining future directions for empirical research.

The Effects of L Carnitine on in Vitro Maturation of Immature Bovine Oocytes

L-Carnitine (Lc) acts as an antioxidant that neutralizes free radicals, especially superoxide anions and protects cells against oxidative damage-induced apoptosis, as following ovulation, intracellular reactive oxygen species (ROS) accumulation increases in oocytes, Oocytes exhibit an intracellular defense mechanism against an oxidative attack. This outcome adversely affects fertilization and subsequent embryonic development, thereby increasing the risk of an early miscarriage and abnormal development of offspring. The purpose of this study was to see how adding LC to either maturation or fertilization medium affected the developmental competence of immature bovine oocytes. In this study, Ovaries from apparently normal reproductive organs of cattle were collected within 30 minutes from slaughter and evisceration of animals. Cumulus oocyte complexes (COCs) were collected by aspiration of medium sized ovarian follicles (4-8 mm). COCs of acceptable quality were selected, washed and incubated in tissue culture media 199 (TCM199) supplemented with 10% heat inactivated fetal calf serum, 5 μg/ml luteinizing hormone (LH), 0.5 μg/ml follicle stimulating hormone (FSH) and 1 μg/ml estradiol-17β for 20:22 hour at 38.5 C◦ under 5% CO2 in air with 90% humidity. different concentrations of LC (1.25,2.5 and 5mM) were used. The results were consistent for both maturation and fertilization and there is a significant increase in maturation, fertilization., cleavage and blastocyst rate. In conclusion, LC has important role in IVEP through addition of LC to maturation media or culture media it improved nuclear maturation and blastocyst formation rates in bovine oocytes.

Correlation of Fast Food Consumption and Overweight/Obesity among Undergraduate Students at the University of Hargeisa in Hargeisa, Somaliland

Background Fast food consumption is the major cause of obesity and overweight in worldwide affecting more than 2 billion people, especially developing countries and low income countries. It can lead to hyperinsulinemia and development of insulin resistance, high energy density, high glycemic index, and fatty acid composition of fast foods may increase the prevalence of obesity and cardiovascular risk factors Objectives The main aim of this study was, to assess fast food consumption and its association with overweight /obesity among undergraduate students of University Hargeisa, Somaliland, 2023. Methods The study was carried out from May 01 to July 20, 2023 at University of Hargeisa using an institutional based cross-sectional study design to among 260 students. The study participants were selected using a simple random sampling technique. A structured questionnaire was prepared based on review literatures and dig out from related studies. The anthropometric data was taken by data collectors to measure weight and height using a stadiometer. Data was entered and checked for errors using EPI-info version 7.1.5.0 and then, data were exported to statistical package for social sciences (SPSS) software version 21 and STATA software version 14 for data processing and analysis. Descriptive statistics such as; frequencies, means and proportion was used for present the findings. A variable with P-values of less than 0.25 in the binary logistic regression analysis was entered into a multivariable logistic regression analysis to identify the independent predictors of stunting. Finally, variable at P-value less than 0.05 in multivariable logistic regression analysis was considered as a statistically significant variable. Results In this study, the majority 235 (90.4%, CI: 86.5- 93.8) of the study participants were fast food consumers. The study revealed that, from the total study participants 46(17.7%),127(48.8%),84(32.3%), 3(1.2%) were underweight, normal, overweight and obese respectively. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. On multi-variable logistic regression model educational level of the students (AOR = 12.45 (95% CI: 1.7, 14.6)) and frequency of fruit (AOR = 0.76, 95% CI (0.7, 0.8)) and vegetable consumptions (AOR = 0.51, 95% CI (0.47, 0.575)) were found to be significantly associated with fast food consumptions (p < 0.05). Conclusion In this study, of the total 90.4% number of fast food consumers. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. Educational level of the students and frequency of fruit and vegetable consumptions were found to be significantly associated with fast food consumptions. Effort should be made to increase access to fast food-related information and counseling.

Psychosocial Interventions in Bipolar Disorder

Bipolar disorder is a chronic condition marked by episodes of mania and depression, significant functional impairment, and challenges with treatment adherence. Current guidelines highlight the importance of both medication and psychosocial approaches in treatment. This review explores the primary psychosocial interventions for bipolar disorder. Psychoeducation helps recognize early symptoms, improves medication compliance, and prevents relapses. It is simple to implement and cost-effective. Family-Focused Therapy (FFT) enhances family communication, reduces emotional expression, and lowers the frequency of depressive episodes. Interpersonal and Social Rhythm Therapy (IPSRT) supports maintaining social stability by addressing disturbances in biological rhythms. Cognitive Behavioral Therapy (CBT) decreases depressive symptoms and boosts treatment adherence by restructuring automatic thoughts. Additionally, cognitive and functional rehabilitation programs improve attention, memory, and executive functioning. Peer support groups and digital e-health tools, though supportive, have limited evidence of effectiveness. In summary, multicomponent psychosocial interventions serve as a valuable addition to medication, helping to prevent relapses, improve functioning, and enhance quality of life in individuals with bipolar disorder.

Mathematical Modelling of Typhoid Fever Transmission Dynamics and Intervention Impact in Harare, Zimbabwe (2018–2020)

Background Typhoid fever remains a significant public health issue in Harare City, Zimbabwe, exacerbated by recurrent outbreaks between 2018 and 2020. Key challenges, including inadequate water supply and sanitation infrastructure, high population density, and limited healthcare access, have intensified the disease burden. Understanding the key transmission drivers and assessing the impact of various interventions are essential for informing policy and health strategies. Objectives This study aimed to: 1: To predict future trends in typhoid fever cases Harare City typhoid hot areas. 2: To develop a mathematical model to simulate the spread of typhoid fever incidence under different intervention scenarios and recommend evidence-based strategies for reducing the disease burden in Harare City. Methods A dynamic compartmental SIR-based model, adapted from the Pitzer Vaccine Effectiveness (VE) framework, was employed to simulate disease transmission. This model accounted for both short-cycle (human-to-human) and long-cycle (environmental) transmission pathways. Data from Harare City (2018–2020) were used for model calibration and forecasting, and sensitivity analysis was performed to assess the impact of different intervention levels. Findings The model identified inadequate sanitation, contaminated water sources, and low health- seeking behaviors as primary drivers of typhoid transmission. In the absence of interventions, the model projected a sustained high rate of transmission. However, treatment and WASH interventions could reduce the disease burden by 50–60%, while combined strategies incorporating vaccination and education led to an 80% reduction in cases. Sensitivity analysis indicated that treatment and WASH interventions were particularly impactful at moderate coverage levels. Conclusion Mathematical modeling effectively demonstrated the multifactorial drivers of typhoid fever transmission in Harare. Integrated interventions that combine WASH, vaccination, treatment, and education present the most promising approach for long-term control of the disease. The findings offer a solid, data-driven foundation for public health decision-making and resource allocation.

Reproductive Ability of Currant–Gooseberry Hybrids After Cryopreservation of Pollen in Liquid Nitrogen

The present study of the reproductive ability of currant and gooseberry hybrids after long-term cryopreservation of pollen in liquid nitrogen is of enormous importance for organizing the conservation of the diversity of this crop. Four distant interspecific hybrids of currant and gooseberry served as objects of the study. The pollen fertilizing ability was studied by pollination of allotetraploid Jošta with pollen of tetraploid hybrids stored for a year at ultra-low temperatures (–196°C) and freshly collected pollen (control pollination). Berry set in 2022, when pollinated with cryopreserved pollen, averaged 56.4% and was higher than in the control pollination (38.2%). In 2023, the number of berries set on average for all cross combinations in the experiment was also quite high (59.6%), but lower than in the pollination control (81.4%), which can be explained by unfavorable weather conditions during pollen collection in the year of establishment (2022). The obtained data specify that pollen of the allotetraploids does not lose its high fertilizing ability during its long-term cryopreservation. Berry setting, average berry weight and seed production are quite high and comparable to pollination with freshly collected pollen (control pollination variant). Seed germination and values of morphometric parameters of seedlings obtained from pollination with cryopreserved and freshly collected pollen in most cases have close values. Cryopreservation of pollen of currant-gooseberry hybrids for a year and more allows to preserve pollen for successful pollination and berry formation and is a reliable way to preserve germplasm.

Prevalence and Risk Factors of Intestinal Parasitic Helminths among Primary School Children in Oru West Lga, Imo State, Nigeria

Intestinal parasitic helminths pose a significant public health burden, particularly among children. This cross-sectional study investigated the prevalence and risk factors of intestinal parasitic helminths among 550 school children aged 4-12 years in Oru-West L.G.A, Imo State, Nigeria. Stool samples were examined using parasitological techniques, and questionnaires were administered to collect data on risk factors. The overall prevalence of intestinal parasitic helminths was 49.1% (270/550), with Ascaris lumbricoides being the most prevalent (30.37%). Multivariate analysis revealed significant associations between intestinal parasitic helminths and lack of hand-washing, insufficient toilet facilities, consumption of unwashed vegetables, and poor environmental sanitation. Males had a significantly higher infection rate than females (P < 0.05). Age-related prevalence was highest among children aged 4-6 (51.85%). Occupational status and educational level of parents were also significant predictors of infection. These findings highlight the need for public health education, provision of basic sanitation facilities, and regular de-worming as preventive measures.

Integrating Analgesic Doses and Pain Trend Analysis: A Novel Clinical Support System

Background Prescribing appropriate analgesics with optimal dosages based on patients' pain severity is challenging, especially when multiple painkillers are involved. Tracking and analyzing the effectiveness of analgesics and their dosages over time is crucial for pain management. Existing systems lack the ability to integrate analgesic equivalent doses with temporal trends in pain scores, hindering effective decision-making. Methods We developed a Clinical Support System that calculates the daily oral morphine equivalent dose and analyzes trends in consumed equivalent doses of analgesics. The system provides a graphical user interface that displays medication prescriptions, actual medication usage, and pain scores. It offers features such as correlating analgesic drug usage with pain intensity, trend analysis of analgesic drug usage and pain intensity, and identification of effective oral morphine equivalent doses. Results The system overcomes previous barriers in drug analysis by providing real-time calculation of oral morphine equivalents and trend analysis of pain duration. It assists physicians in prescribing appropriate and safe medication dosages, enhancing medication safety for patients. Conclusions Our clinical support system offers a comprehensive solution for analyzing trends in consumed equivalent doses of analgesics. It integrates medication prescriptions, actual usage, and pain scores, providing decision-making support for pain management.

Recruitment Strategies and Challenges in a Pilot HIV Prevention Study among Cisgender Black Women in Houston, Texas

Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.

Toward Better Care for Sickle Cell Disease in Nigeria: A Review of Challenges and Interventions

With more than 150,000 affected infants annually, Nigeria bears the largest burden worldwide of sickle cell disease (SCD), making it a significant public health concern. The management of SCD in Nigeria is challenging, despite advancements in medical research and increased knowledge. This review examines the numerous issues surrounding SCD in the nation, including the financial burden on affected families, the lack of specialized care facilities, the absence of newborn screening programs, the sociocultural stigmatization of SCD, and restricted access to high-quality healthcare. Additionally, inadequate public health education and a lack of coordinated national policies result in delayed diagnosis and suboptimal treatment outcomes. We also highlighted recent efforts and recommendations aimed at improving early detection, comprehensive care, and community support. Addressing these challenges through expanded health education and enhanced healthcare infrastructure is essential to reducing morbidity and mortality associated with SCD in Nigeria.

Menopausal Symptoms Affecting Productivity and Occupational Needs of Peri-Menopausal Women in a Private University, Philippines

Objective This study aimed to explore the respondents’ reproductive health profiles, examining the physiological and psychosocial perimenopausal symptoms affecting productivity, and identifying occupational needs. It also determined the relationship between menopausal symptoms and the productivity and occupational needs of peri-menopausal women. Methodology A descriptive cross-sectional design was used, surveying 50 women over 40 years old with a validated four-point Likert scale instrument. The instrument undergone content validation, reliability test, and ethical approval. Survey was administered personally and online using purposive sampling. Statistical treatments included weighted mean, F-test, T-test, Pearson r correlation, and ranking. Key results The majority of participants had their first menstruation between 11 to 15 years old and experienced regular menstrual cycles. Most had one child, with an equal number of cesarean and normal deliveries, and reported no pregnancy complications. The study found that participants seldom experienced physiological and psychosocial menopausal symptoms. They agreed on the occupational needs during the perimenopausal period. It was found that physiological symptoms were influenced by factors such as early menarche, cesarean delivery, and pregnancy complications. Additionally, psychosocial symptoms varied based on menstrual status, the number of children, and pregnancy complications, with those experiencing earlier menstruation or complications reporting more intense symptoms. The study revealed a significant relationship between both physiological and psychosocial perimenopausal symptoms, which negatively impacted productivity and increased occupational needs. Women with higher menopausal symptoms expressed a greater need for workplace policies that support perimenopausal women, highlighting the need for tailored workplace interventions for this demographic. Future Direction The study recommends including pap smears and mammograms in annual exams for peri-menopausal women, offering awareness seminars on managing perimenopausal symptoms to reduce workplace disruptions, and suggests future research exploring additional variables affecting perimenopausal women’s health and productivity

Retrospective Evaluation of Well Differentiated Thyroid Cancer Treatment Outcomes: 50 year experience at the University of Puerto Rico

Our study gathered information on the diagnosis, treatment, and long-term outcome in adult and pediatric Hispanic patients with Well Differentiated Thyroid Cancer. Methods We performed a retrospective review of the clinical and imaging nuclear medicine records of cases of WDTC evaluated and treated in the Nuclear Medicine CLINICc. Evaluation included the clinical PROFILE, histology, radioiodine (RAI) therapies and treatment response, long-term outcome and survival. The data was ASSESED using the 2015 ATA Risk level guidelines and recommendations. Results Three hundred eleven cases were reviewed, 81% females, 19% males, median age of 41 years. Eleven percent (34 patients) of the patients were in the pediatric group and 49% were between 16-45 years. The tumor histology was 60.5% Papillary, 28.2% Papillary-Follicular variant and 11.3% Follicular type. All patients had a total thyroidectomy. A total of 287 (92%) of the patients were treated with RAI. The median RAI dose was 128 mCi. Patients in the low risk group received a dose range of 25-105 mCi, 73 cases in the intermediate RISK group received 106-160mCi and 104 cases in the high-risk group received doses greater than 160 mCi. The overall median cumulative dose was 151 mCi (55-926 mCi). Annual follow up was done in all cases , WITH A median follow-up OF 5-10 years. Residual functioning tissue in the neck was found in 52% of the cases by US and/or RAI imaging. of those, 43% belonged to the low risk group, while 57% were in the intermediate and high-risk groupS. The mean treatment dose received by those with persistent functional thyroid tissue in the neck was 157 mCi. Recurrent disease was found in 15% of the patients, 85% of them belonged to the intermediate and high-risk GROUPS. Forty-seven percent of the patients with recurrent disease had residual disease. Conclusion We believe ablative and/or adjuvant RAI treatment early in the disease is important to decrease residual thyroid tissue and/or residual disease, and to improve disease-free survival. We recommend total thyroid surgery in all tumors above 1 cm, post-operative evaluation with RAI Whole Body (with 123-I or 131-I), planar and SPECT/CT imaging and RAI ablation to remnant tissue. Follow-up post treatment evaluation is also recommended.

Potential use of Ginger (Zinger officinale Rose) Extracts as Biopesticide against Myzuspersicae Sulzer (Hemiptera, Aphididae) on Pepper Crops

Chemical insecticides have been the primary method used by farmers to control pests. However, their negative environmental impacts, harmful effects on beneficial insects and human health, and prohibition in organic farming systems have driven the search for natural alternatives with insecticidal properties. These alternatives provide a safer and more sustainable way to control insect pests. Medicinal plants and their constituents play an important role in pest management. For example, ginger (Zingiber officinale) extracts contain bioactive compounds with insecticidal activities. The objective of this work was to track the population of the green peach aphid (Myzuspersicae) on pepper crops in a greenhouse, identify the active ingredients in ginger extracts, and evaluate the insecticidal effects of three concentrations of ginger-derived aqueous and essential oil extracts against M. persicae on pepper plants under laboratory and greenhouse conditions. The results demonstrate that M. persicae grows rapidly on pepper crops under greenhouse conditions, reaching high densities on leaves. The ginger extract contains two active ingredients with insecticidal effects against this pest. The significant reduction in aphid (M. persicae) populations indicates that Z. officinale aqueous extract (150 mL/L) and essential oil (2 mL/L) have strong potential for the biological control of this pest under greenhouse conditions. Thus, the use of ginger plant extract emerges as a promising alternative for reducing M. persicae infestations on pepper plants.  

Efficacy of Neemraj and Beauvitech on Abundance and Distribution of Arthropod Pests in Soil and Hydroponically Grown Strawberry

Strawberry is a commercially important crop which has gained global significance in terms of production and consumption. The strawberry farmers have been faced with economic losses due to attack from arthropod and phytophagus pests. To overcome this challenge, management of pests is important with reduced impact on beneficial organisms and the environment. Use of non-chemical approaches as an alternative to insecticide driven management is highly gaining popularity. Identification of the non-chemical production for management of strawberry pest such as entomopathogenic fungi and botanicals is critical. The need for compatibility of entomopathogenic fungi in crop production techniques with other insecticides to enhance efficacy is required. The interaction between these control agents could be synergistic, additive or even antagonistic. Synergistic interactions usually lead to enhanced effectiveness of the microbial control agents while reducing the adverse effects of the pesticides in combination. In this review a description of the compatibility of entomopathogenic fungus Beauvaria bassiana and botanical neem in strawberry pest management is given. The experiment involved five treatments: Neemraj, Beauvitech, Neemraj and Beauvitech, Ampligo and control. These treatments were allocated in a completely Randomized design in two separate greenhouse setups one with soil and other with pumice. The treatments were replicated four times. The data was subjected to analysis of variance (ANOVA) using the general linear model (GLM) procedure of the statistical analysis system (SAS) program, version 9.1. Tukey’s (HSD) test at P≤ 0.05 was used to separate significant means. The combination of Neemraj and Beauvitech was most effective in the management of pests in both hydroponics and soil grown media. Pest populations were reduced significantly as follows; thrips, Frankliniella spp 2.1, red spider mites Tetranychus species 11.5, tarnished plant bug Lygus species 3.0, there was 0% cricket Gryllus species damage and 0 number strawberry weevil in hydroponics cultures while in soil culture pest mean populations were: thrips 5.6, spider mites Tetranychus species 18.2, strawberry weevil (Otiorhynchus species) 7.0, tarnished plant bug 3.0 and there was 13.8% cricket Gryllus species damage on strawberry plants.

HIV-Associated Peripheral Neuropathy and Antiretroviral Therapy: A Prospective Study from a Tertiary Care Centre in South India

Background Peripheral neuropathy (PN) is a common and debilitating complication in people living with HIV (PLHIV). While HIV itself contributes to neuropathy, certain antiretroviral therapy (ART) drugs, particularly nucleoside reverse transcriptase inhibitors (NRTIs) such as stavudine (d4T) and zidovudine (AZT), are known for their neurotoxic effects. Objectives To evaluate the impact of ART on HIV-associated peripheral neuropathy (HIV-PN) and to determine whether certain ART regimens increase the risk or severity of neuropathy. Materials and Methods A cross-sectional study was conducted among 158 HIV-positive patients. Neuropathy was diagnosed using clinical criteria, Total Neuropathy Score (TNS), and nerve conduction studies (NCS). Patients were grouped based on their ART regimen, and statistical analysis was performed to assess the association between ART type and peripheral neuropathy severity. Results It was noted that patients on older NRTIs (stavudine, zidovudine) had significantly higher rates of peripheral neuropathy (p=0.002) and tenofovir-based regimens were associated with lower peripheral neuropathy prevalence (p=0.01). There was a significant correlation between the duration of ART exposure and peripheral neuropathy severity (p<0.001), suggesting a cumulative neurotoxic effect. Conclusion Older ART regimens, particularly stavudine and zidovudine, significantly contribute to HIV-PN. The study supports the WHO recommendation to phase out neurotoxic ART and highlights the importance of early ART regimen optimisation to prevent long-term neurological complications.

Systematic Review on Peri-Operative Intravenous Fluid: ‘Restrictive vs Liberal’ Fluid use on Major Abdominal Surgical Patients

Background Intravenous Fluids use during surgery is a common practice for many reasons. However recent evaluation of perioperative abdominal surgery patients have poised many issues. Mostly on the type of fluid and quantity of volume usage on major abdominal surgery. Many studies into this aspect of perioperative fluid usage have been done, and volume definition have been accrued either restrictive (Maintenance fluid of less than 1.75 Liters) or liberal or standard (Maintenance fluid between 1.75 Liters to 2.75 Liters) usage. The outcome was assessed to ascertain the best patient recovery without complications from the two fluid regime. Result/Discussion After PRISMA exclusion criteria, there were eight randomized control studies assessed to provide a summary, comparing all the studies using either restrictive fluid or liberal fluids used in major abdominal surgery. Post operative complications and the length of hospital stay were assessed as the major outcomes end points and the cumulative result favored those with restrictive fluid usage. Conclusion Although the restrictive use of fluids in abdominal surgery is favored from the measured outcomes, there are inherent cofounders and heterogenicity in the eight studies that require more detail studies involving multiple study centers and population.

Molecular Approaches for Assessing Some Iranian Freshwater Fish Species

Monitoring fish biodiversity and its changes over time and their ecological research is one of the important sources of information in their protection. They can be used to find fish biodiversity at different times, such as the capture and maintenance of whole fish, genetic samples, or the use of scales. In this regard, to check the prepared sample, 10-15 scales were prepared from the area of the lid, dorsal fin, and tail stem. Then, they were treated in 5% potassium solution and settled on a slide using a loop microscope equipped with a camera. Among the examined species, Luciobarbusbraczcephalus, Luciobarbuscapito and Capoetasaadispecies could be distinguished from other species with the highest accuracy. In the genetic studies conducted using the cytochrome oxidase subunit 1 gene, the patterns observed in the neighbor joining genealogical tree were consistent with the differences in the genera and species studied. The results of this investigation show that the origin of species can be determined with more than 50% accuracy using genetic data.

The Energy–Matter–Behavioral Model of Mental Health Hygiene: A Systems-Based Framework for Sustainable Well-Being

The Energy–Matter–Behavioral (EMB) model offers a systems-based lens for understanding and maintaining mental health hygiene. This framework integrates stress reduction, biological resilience, and behavioral reinforcement into a coherent triad, addressing not only symptoms but underlying energetic and material dynamics. By aligning practices such as exercise, meditation, social connection, sleep, and diet with EMB principles, this model presents a transdisciplinary, evidence-informed approach to mental health in an overstimulated world.

Uptake of Cervical Cancer Screening and Its Determinants among Refugee Women in Uganda: Insights from the Uganda Refugee Population-based HIV Impact Assessment

Cervical cancer is the fourth most common cancer in women globally, with 660,000 new cases and 350,000 deaths in 2022. The burden is disproportionately high in low- and middle-income countries (LMICs), particularly sub-Saharan Africa. Despite proven interventions like HPV vaccination and screening, uptake remains low. While cervical cancer screening has been studied in the general population, little is known about uptake among refugee women in Uganda, which hosts approximately 1.7 million refugees. This study examines cervical cancer screening uptake and associated factors among refugee women in Uganda. Methods We conducted a cross-sectional secondary analysis of the 2021 Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) survey, focusing on women aged 21–49 in refugee settlements in the West Nile and South-Western regions, which host 90% of Uganda’s refugee population. The primary outcome was self-reported cervical cancer screening status. We used descriptive statistics and logistic regression to identify factors associated with screening uptake. Results Among 731 women, only 72 (9.8%) reported undergoing cervical cancer screening. The mean age of screened women was 37 years (±7), compared to 32 years (±8) for unscreened women. Screening uptake was significantly higher among women aged 31–39 years (AOR = 2.67, 95% CI: 1.32–5.52, p = 0.007), married women (AOR = 12.0, 95% CI: 1.76–163, p = 0.03), and those in polygamous relationships (AOR = 4.76, 95% CI: 1.96–11.1, p < 0.001) Conclusion Cervical cancer screening uptake among refugee women in Uganda is critically low. Integrating culturally sensitive screening programs into refugee health services and addressing socio-economic barriers could improve access and utilization.

Water Quality Analysis on Public and Household Water Sources – A Case Study of Sunyani-West District, Fiapre

Access to potable and quality water in most rural communities is low such that over 2.2 billion people worldwide are negatively affected. The increasing population in Fiapre and the inconsistent water supply by the Ghana Water Company Limited (GWCL) have forced most residents to resort to alternative groundwater sources such as boreholes, wells, etc. Yet, many residents use these sources of water unaware of the quality of the water and its potential health implications. This study assessed drinking water quality in Fiapre by calculating its Weight Average Water Quality Index (WAWQI) and investigating potential risk factors associated with contamination through a cross-sectional study and laboratory analysis of various physicochemical and microbiological water quality parameters. WAWQI was used to compute parameters using 10 factors including pH, electrical conductivity, temperature, TDS, phosphate, chloride, total hardness, nitrate, alkalinity, and faecal coliform. The findings revealed that the pH level of water, phosphate concentration, and fecal coliform count surpassed the recommended thresholds set by the World Health Organization (WHO) for safe drinking water. Although levels of electrical conductivity, TDS, nitrate, total hardness, and chlorine kept changing from one water source to another, the difference was not significant apart from phosphate and fecal coliform which shows a significant difference between the sachet water sources and other water sources (P<0.05). The study outcomes demonstrated that the overall water quality is predominantly categorized as good to fairly good, with the highest Water Quality Index (WQI) value reaching 87.84% and the lowest recorded at 54.81%. Therefore, to improve the water quality in the municipality, local management agencies should pay attention to the microbiological quality of the water sources. The study recommends regular handwashing practices, hygienic surroundings of the water source, and drinking water treatment to reduce the possible risk factors associated with the contamination of the water sources.

Risk Factors and Control Strategies for Cattle Tick Infestations in Nigeria: Influence of Acaricide Application Methods, Hand-Picking Frequency, and Herd Mobility in Plateau State

Background Tick infestations severely impair cattle health and productivity in Nigeria through blood loss, hide damage, and transmission of tick-borne pathogens. Objective This study assessed key risk factors influencing tick infestation and evaluated control methods among Fulani pastoral herds in Plateau State. Methods A cross-sectional survey involving 250 cattle from ten herds was conducted across five Local Government Areas. Tick burden was analyzed against acaricide application methods (pour-on vs. hand-spray), hand-picking frequency, and herd mobility (sedentary vs. migratory). Data were collected via owner interviews and manual tick counts. Statistical analyses were performed using generalized linear models in R software. Results Cattle treated with pour-on acaricides had significantly lower tick burdens compared to those treated via hand-spray (P<0.05). Herds that practiced hand-picking five times weekly had fewer ticks than those hand-picking thrice weekly (P<0.01). Migratory herds recorded significantly lower infestations than sedentary herds (P<0.05). Conclusion Effective tick control requires the integration of optimized acaricide application, frequent manual removaland consideration of herd mobility patterns. Education, capacity building, and policy support are necessary to enhance adoption of effective tick control measures among pastoralists.

Efficacy and Safety of Lercanidipine Combination in Hypertensive Patients

Calcium channel blockers (CCBs) are widely used for the treatment of arterial hypertension, but they differ in terms of pharmacology, tolerability, and pleiotropic actions. Lercanidipine, a highly lipophilic third generation dihydropyridine, reduces blood pressure (BP) effectively as monotherapy and in combination without inferiority to other major antihypertensive classes. We systematically searched PubMed and the Cochrane Library (last update: September 1, 2025) and screened reference lists for additional studies. Evidence from dose finding trials, randomized controlled studies, large observational cohorts, and meta analyses shows clinically meaningful reductions in office, home, and ambulatory BP with lercanidipine, including in patients with diabetes, obesity, chronic kidney disease, or high cardiovascular (CV) risk. Fixed- dose combinations with renin angiotensin system blockers (e.g., enalapril) provide greater BP reductions than monotherapy and are associated with favorable neurometabolic profiles. Beyond BP control, lercanidipine improves central hemodynamics and arterial stiffness, favors endothelial biology, and contributes to left ventricular hypertrophy regression. Across comparative trials, lercanidipine is generally better tolerated than older dihydropyridines. Presents lower rates of vasodilatory adverse events, less sympathetic activation, while discontinuations due to adverse events are uncommon. Overall, lercanidipine particularly within single pill combinations offers effective, durable BP lowering across diverse patient profiles with a favorable safety and tolerability profile and pleiotropic benefits that extend beyond BP reduction. Figure 1. Graphical Abstract: Pleiotropic effects of Lercanidipine

Monitoring of Insect Species Richness and Abundance in Sudan Semi-arid Ecosystem (Case study: Khartoum State/Sudan)

Sudan's ecological landscape is characterized by various zones, including deserts, semi-deserts, and savannas, which host a diverse array of forests, rangelands, and numerous plant and animal species. However, the sustainable management of these resources is becoming increasingly challenging due to human activities and the impacts of climate change. This article presents the results of a research project focused on monitoring and documenting biodiversity in Sudan's semi-arid regions, particularly emphasizing insect diversity. Insects are vital for maintaining ecosystem health through processes such as nutrient cycling, decomposition, pollination, and acting as natural predators to pests. Field surveys were conducted across three Sudanese states—North Kordofan, Gezira, and Khartoum—to assess the diversity of flora and fauna. Specifically, El Rawakeeb semi-arid land in Khartoum state was investigated, which comprised three sites with varying soil elevations: a hilly site at 420 meters above sea level, a flat site at 416 meters, and a valley site at 411 meters. Researchers utilized direct collection methods and butterfly nets to gather insect specimens, which were subsequently preserved and identified for further analysis. Diversity indices, including Simpson’s Diversity Index, Shannon-Wiener Index, and Margalef Richness Index, were computed to compare the biodiversity of these sites, along with metrics for evenness and species richness. Permanova analysis was carried out for insect variation between the study sites. A total of 1541 insect specimens were gathered from El Rawakeeb, encompassing 34 species distributed across 21 families and 9 orders. The order Lepidoptera exhibited the greatest number of species (35.29%), followed by Coleoptera (20.59%). The orders Neuroptera, Orthoptera and Thysanoptera recorded the fewest species (2.94% each). From the hilly site, 514 insect specimens were collected, representing 9 orders, among which Hymenoptera included 4 species, while Lepidoptera had 3 species, and Odonata, Orthoptera, and Thysanoptera each had 1 species. The highest individual counts were recorded for Copriniklobe (dung beetle), Dacus longistylus (fruit fly), Camponotussp. (carpenter ant), and Anax ephippiger (dragonfly). In a flat site, 484 insect specimens were collected, classified into 15 species, 12 families, and 7 orders. The highest individual counts were noted in four species: Onthophagusnuba (dung beetle), Dacus longistylus (fruit fly), Camponotussp. (carpenter ant), and Anax ephippiger (dragonfly). In a valley site, 543 insect specimens were collected, categorized into 17 species, 16 families, and 9 orders. Insect Diversity in three research sites. Simpson's Diversity Index revealed varying levels of insect diversity across the three sites. The valley site exhibited the highest diversity level with an index score of 0.857, followed by the flat site at 0.826, and the hilly site at 0.819. The Shannon diversity index of 2.22 indicated the highest diversity among the three sites, suggesting a relatively diverse insect community. The relative abundance of insects was greatest in the valley site at 35.24%, followed by the hilly site at 33.35%, and the flat site at 31.41%. The Margalef Richness Index indicated a moderate level of richness in the insects collected from the three locations. Certain insect species were found in some sites but were absent in others. The PERMANOVA revealed notable variations among the three study sites (F = 2.24, p-value = 0.035).

Existential Therapy and the Contextual Model: Unified by Presence, Flexibility, and Meaning-Making

This article offers a literature review and theoretical synthesis and application of existential therapy and the contextual model. It reviews the contextual factors that may be predictive of positive therapy outcomes in general, identifies distinct types of existential therapy, highlights core commonalities in these existential branches, and explores how the main aims of the existential therapy approach may be foundational in facilitating improved mental health treatment outcomes and well-being. The author asserts that presence-both intrapersonal and interpersonal are at the heart of the contextual factors, along with flexibility, and meaning-making. This assertion has implications for therapist education, development, training, and supervision.

Proteomic and Genomic Techniques in Medical Research: Applications in Cancer, Diagnostics, and Personalized Medicine

Advancements in proteomic and genomic technologies have transformed molecular biology by enabling comprehensive analysis of biological systems at the molecular level. This literature review explores the evolution, methodologies, and practical applications of key proteomic and genomic techniques. In proteomics, tools such as two-dimensional electrophoresis, mass spectrometry, Western blotting, Edman degradation, and functional protein microarrays have facilitated high-throughput protein identification, post-translational modification analysis, and biomarker discovery. Similarly, genomic methodologies like PCR, recombinant DNA technology, gel electrophoresis, and Southern blotting have revolutionized gene detection, manipulation, and expression profiling. The review also highlights the interdisciplinary impact of these technologies across clinical diagnostics, oncology, autoimmune disorders, infectious disease surveillance, cardiovascular research, and personalized nutrition. Integrative approaches combining proteomics and genomics are enabling the discovery of novel therapeutic targets, improving disease classification, and advancing precision medicine. Despite current limitations, such as the absence of amplification techniques for proteins and challenges in data interpretation, ongoing innovations promise to bridge these gaps. This synthesis underscores the pivotal role of molecular techniques in deepening our understanding of human biology and accelerating biomedical advancements for improved healthcare outcomes.

Persistent Neovascular Exudation in Patients with Exudative Age-Related Macular Degeneration who have Choroid Imaging Biomarkers of Non-Neovascular Choroidal Pathology: Simultaneous Choroidal Hyperpermeability and Angiogenesis

Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.

Systematic Review of Spinal Cord Injuries in Equestrian Athletes: Incidence, Risk Factors, and Outcomes

Objective The goal of this systematic review is to identify common themes amongst acute spinal cord injuries (SCI) in equestrian athletes. Design A systematic review was performed using PubMed, CINAHL Plus with Full Text (EBSCO), Cochrane Library, and Scopus with pre-determined MESH terms. The initial search returned 354 studies. Following PRISMA guidelines, 13 articles were included. Exclusion criteria included injuries to the horse only, non-English language, cauda equina, and case reports. Data extraction was completed, and common findings were evaluated narratively due to heterogeneity of data. Results Seven manuscripts listed specific horse-related activities that caused SCI, with fall from horse as the highest percentage of injury. Nine articles identified the injury region, with large variations and no clear dominant area of injury. Five articles identified the length of hospital stay with ranges from 1 to 82 days. Four articles looked at the association of professional vs non-professional riders. Only two articles evaluated helmet use at time of injury, with one article showing 81% of those with SCI used helmets, and the other showing only 35.6% utilized this safety measure. Conclusion SCI in equestrian athletes can have a wide presentation, with large variation on location of injury, length of stay, and other factors. However, non-professional riders are at greater risk of SCI and individuals are more likely to sustain injury from a fall from a horse rather than a kick or another modality of injury. Future study can elicit presenting symptoms, types of surgical intervention used, and long-term outcomes and recovery.

Vulnerabilities in Environment and Health Due to Climate Change and Extreme Hydrological Events: Determinants for Risk Reduction

This short communication/mini-review immensely emphasizes human health to explicate and elucidate management of the global scourge associated with the determinants and impact of vulnerabilities to extreme hydrologic events and climate change in the absence of risk reduction and their concomitant sequelae. The most effective approach for risk reduction associated with biodiversity, environmental, and health vulnerabilities due to climate change and extreme hydrological events, an ecological framework must take into cognizance exposure, vulnerability, and resilience. This framework emphasizes the significance of understanding the inextricable linkage between ecosystems and human communities are exposed and susceptible to hazards, sensitivity to these hazards, and capacity to cope, adapt and recuperate. Risk reduction incorporates structurally attenuating exposure, strengthening resilience, and sustainably enhancing overall vulnerability management. Extreme weather and climate-associated incidents impinge on human health with consequential morbidity, mortality and socioeconomic challenges and constraints. Climate change and extreme event have altered the frequency, intensity, geographic distribution, and propensity as drivers for change in the future. The indicted variables include hydrological events, such as precipitation, floods and droughts as well as heat waves, wildfires, global warming, extreme temperatures, and hurricanes. The pathways inextricably-linked with extreme events to economic dissipation, human health prognosis and outcomes remain inexplicably diverse and complex; and thus, difficult to predict due to their emergence and reemergence from local, societal and environmental factors which influence disease burden.

Prevalence of Burnout, Secondary Traumatic Stress, Anxiety, and Depression Among Maternal and Neonatal Healthcare Staff in Two Tertiary Hospitals in Zambia

Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.

Traumatic Maculopathy (Berlin´S Edema) Treated with Enhancement of Human Photosynthesis®

Commotio retinae (CR) is a condition frequently observed in clinical practice, particularly following closed globe trauma (CGT) due to sport, labor, or traffic accident injuries. It is the main cause of unilateral vision loss in male patients aged between. It is characterized by transient gray-white retinal coloration and reduction of visual acuity (VA). Symptoms depend mainly on the location and severity (deep) of the injury, with less complains when only the superficial or peripheral retina is affected. It may be confined to the posterior pole, when it is also called Berlin’s edema, after the first hypothesis of Berlin (1873). There is no specific treatment since the treatment depends on the region of the retina and choroid affected. In this work we report a case of Berlin edema, treated with ǪIAPI 1®, to restore the balance of oxygen, which is generated at the intracellular level.

Standardizing Use of Mepiquat Chloride for Higher Productivity of Densely Planted Bt Cotton Variety

Standardizing use of mepiquat chloride for higher productivity of densely planted Bt cotton variety” was carried out at the Regional Research Station, Abohar and Regional Research Station, Faridkot during the kharif season of 2021 on Btcotton variety PAU Bt3. The soil of experimental field was silty loam at Abohar and sandy loam at Faridkot. The experiment was laid out in a split plot design with four plant spacings (67.5×15 cm, 67.5×30 cm, 67.5×45 cm and 67.5×60 cm) as main plots and five Mepiquat chloride levels (MC (5%) @ 375 ml ha-1 at squaring, MC (5%) @ 375 ml ha-1 at flowering, MC (5%) @ 750 ml ha-1 at squaring, MC (5%) @ 750 ml ha-1 at flowering and after 15 days and Control (No MC)) as sub plots with three replications. Lowest plant density (67.5×60 cm) and MC (5%) @ 750 ml ha-1 at squaring resulted in significant reduction of plant height, LAI (Leaf Area Index) and dry matter as compared to control at both the locations. Higher boll retention and opened bolls were observed in 67.5×60 cm and MC (5%) @ 750 ml ha-1at flowering. There was no significant effect of both the treatments factors on node count, monopods and sympods. Highest seed cotton yield was obtained with 67.5 ×30 cm (at Abohar) and 67.5×15 cm (at Faridkot) although these two spacing levels were at par with each other. MC (5%) @ 750 ml ha-1 at flowering resulted in 22.9% and 21.3% increase in seed cotton yield over control at Abohar and Faridkot, respectively. Different plant spacings and mepiquat chloride applications showed a non-significant effect on different fibre quality parameters except halo length at Faridkot. At both the locations, highest B:C ratio was observed in 67.5×30 cm and MC @ 750 ml ha-1 at flowering.

Electromagnetic Fields and Osteoarthritis 2025

This mini review examines the potential efficacy of applying electromagnetic field therapy for purposes of reducing osteoarthritis pain and other related disease features such as frailty, muscle sarcopenia, obesity, bone loss and fragility, and cartilage derangements and degradation in the older adult. Based on selected English language literature published largely on PUBMED between January 2000 and October 2025, papers describing the impact and potential synthetic and disease modifying impact of electromagnetic stimuli are explored. These data reveal a high degree of promise in fostering joint tissue reparative efficacy trends post electromagnetic stimulation. Its usage may allay the extent of the disease and its degree of disablement, while facilitating function.

Effectiveness of The Luo Yuan Technique in Patients with Hyperuricemia, Case Report

Significance This case report describes the alternative management of hyperuricemia through acupuncture using the Luo Yuan technique. Case presentation A 53-year-old Mexican man was diagnosed with secondary hyperuricemia. The patient began to experience arthralgia in the metatarsophalangeal joint of the first toe on his left foot after consuming a high amount of purine-rich foods, with a 10-year history. The symptoms were sporadically controlled with the use of colchicine and indarzone. In a six-element blood chemistry test, serum uric acid was 8.7 mg/dL before acupuncture treatment and 8.3 mg/dL at the end of treatment, without applying dietary restrictions on purine consumption. Conclusions and relevance This report demonstrates the potential efficacy of acupuncture at the Luo and Yuan points of the Spleen and Stomach meridians in reducing elevated blood uric acid levels. This suggests its potential as an alternative treatment for patients with hyperuricemia and other metabolic disorders.

Prevalence of Hypertension Among Adolescents in Benue South, Nigeria

Background Hypertension in adolescents has been shown to tracks into adulthood, as well as causing premature cardiovascular and renal diseases. Objectives To determine the prevalence of elevated blood pressure and hypertension among adolescents of ages 10-19 years old attending secondary schools in Benue South, Nigeria; characterise their demographics and determine factors associated with the development of high blood pressure. Materials and Methods A cross-sectional descriptive study of secondary school adolescents selected through multistage sampling from across three Local Government Areas of Benue South, Nigeria. All the participants had their blood pressure measured using mercury sphygmomanometer and their height and weight taken for the calculation of their body mass index. A dipstick urinalysis with was carried out on their urine samples. Data analysis was with SPSS version 25. Results Atotal of 260 adolescents were studied, males were 132 (50.8%) and the mean age was 13.65 ±2.01 years. The prevalence of elevated blood pressure and hypertension was 5.4% and 2.3% respectively. Fifteen females (75.0%) had elevated blood pressure/hypertension as against five males (25%) and it was statistically significant. Adolescents in mid-adolescence age (60.0%) and lower social class (70.0%) had higher rate of high blood pressure. Significant proteinuria (+) was found among eleven (55.0%) of those with high blood pressure. Conclusion The prevalence of elevated blood pressure and hypertension among the adolescents was 5.4% and 2.3% respectively; being female, within mid-adolescence age and from lower social class are associated factors. Recommendation Regular blood pressure measurement should be part of school health programme.

Applying Cultural Humility During an International Collaboration Seeking to Optimize A Peaceful Coexistence Intervention in The Kingdom of Bahrain: Lessons Learned

The World Health Organization emphasizes the importance of international collaboration to save lives and improve health at national and global levels. However, significant challenges face those engaged in international collaborations such as language barriers, cultural differences, different rules and regulations, and limited resources. This paper discusses the use of cultural humility theory to support an international collaboration between stakeholders from different countries with diverse cultural backgrounds working together to optimize a novel middle and high school curriculum intended to promote peaceful coexistence in the Kingdom of Bahrain. We use the attributes of cultural humility as a framework to reflect on lessons learned while navigating cultural differences, conclude by recommending the use of this framework during international collaborations, and provide practical examples about how to operationalize the attributes of cultural humility to inform international collaborations attempting to promote global public health.

Retracted Article

Artificial Intelligence in Healthcare: Enhancing Efficiency, Ensuring Equity, and Restoring Empathy

Artificial Intelligence (AI) is emerging as a transformative force across many sectors, with healthcare representing both one of the most promising and most challenging areas of application. This review summarizes current and future applications of AI in healthcare, focusing on its potential to improve diagnosis, therapy, chronic disease management, and overall patient care, while also alleviating physicians’ workload. Recent literature demonstrates that AI systems can reduce diagnostic errors/delays by mitigating cognitive biases, support imaging and pathology through improved accuracy and speed, and prevent prescribing errors by integrating pharmacogenomic and clinical data into decision-support systems. In chronic disease management, AI-powered wearable devices enable continuous monitoring and early detection of conditions such as atrial fibrillation, thereby reducing the risk of stroke and long-term disability, particularly in elderly people. Therapeutic applications include AI-driven drug discovery, personalized oncology, and tailored medicine that integrates multi-omics and lifestyle data. Beyond direct medical intervention, AI contributes by automating routine tasks, optimizing workflows, and facilitating greater patient–clinician interaction. Despite these benefits, significant challenges remain, including issues of data quality, privacy, security, equity, and the need for transparency and trust in “black box” systems. Looking ahead, the integration of multimodal data, digital twins, and robotics is expected to advance more comprehensive, equitable, and human-centered care. We conclude that, when applied ethically and responsibly, AI should not replace clinicians but rather serve as a powerful partner that enhances medicine by restoring empathy and humanity.

The Brainstem Auditory Evoked Potential: A Reinterpretation of its Electrogenesis

Depending upon the species, the brainstem auditory evoked potential (BAEP) consists of four or five major high frequency components. According to longstanding doctrine, each wave represents the sequential activation of successively higher nuclei and tracts from the 8th (auditory) nerve to the midbrain (inferior colliculus). Although this conceptual framework has acquired the status of near dogma, surprisingly little evidence exists in support. In the present analysis, a new interpretation of the electrogenesis of the BAEP is proposed which is simpler although it retains skeletal elements of the older explanation. The revised model is mostly derived from two distinct sources. In the first, the timing of the BAEP waves is compared with that of cortical activity for a range of mammals including humans, monkeys, cats, rats and guinea pigs. It is demonstrated that for each of these, the conduction time of the acoustic signal to the cortex from the putative midbrain component (wave IV or V) is so unrealistically long that it implies that the entire waveform must arise in the peripheral pathways of the auditory system. In the second, a retrospective analysis is made of click repetition rates on the BAEP using extradural electrodes. It was shown that at high rates of stimulation (about 100/sec), the behavior of the waveform is almost totally at variance with the expectations of the conventional model. The essence of the revised conception is that all BAEP waves are just variations of the compound action potential of the 8th nerve, albeit generated or regenerated via separate routes and different methods. Such an explanation would thereby account for their near uniform sharp morphology as well as creating the impression of a composite neuronal response. More specifically, in the case of a four component BAEP, wave I is assumed to be generated by the normal air conduction route in an identical manner to the conventional explanation. In contrast, wave ll is assumed to be generated via bone conduction in the temporal skull thereby bypassing the transduction process in the middle ear. Wave lll is assumed to be generated by the first echo of the bone-conducted sound wave. Likewise, the second rebound within the temporal bone serves as the stimulation to evoke wave lV. As the energy of the auditory stimulus gradually dissipates, it may still continue to generate a train of lower amplitude potentials. It is concluded that the BAEP may contain little or no brainstem or midbrain activity and therefore the term BAEP may be a misnomer. A more appropriate epithet might therefore be the auditory nerve evoked potential or ANEP.

A New Model of Body Composition Detects Association Between Severe Obesity and Increase in Skeletal Muscle Mass

Obesity is associated with functional limitations in muscle performance. The true effect of obesity on skeletal muscle mass, including any interactions with aging effects, remains to be elucidated. The present study investigated the impact of obesity on the stimulation of muscle growth, based on a new model of body composition. A dataset of 44 men and 64 women was analysed. Body weight (Wt), body height (Ht), hand circumference (HdC) and waist circumference (WC) were measured. Processed by the Dahlmann-Body-Analysis (DBA) system, a new model of body composition, the increase of skeletal muscle mass (ΔSMM) compared to the individual reference weight was calculated. Muscle mass data derived by the DBA model are compared with DXA-derived predictive equations of studies representing different countries and ethnicities estimating the appendicular skeletal muscle mass. Means of these groups are tested by ANOVA. Age ranged from 18 to 72 years. All subjects had a BMI ≥ 29.7 (kg/m²). The mean values of ΔSMM as an estimate of muscle mass gain calculated by the DBA-system were 11.8 ±3.6 kg for men and 8.9 ±2.6 kg for women, respectively, demonstrating a linear, significantly rising relationship with BMI (ß > 0, p<0.001). The study population did not show a decrease in muscle mass with age in either men or women up to an age of 65 years. The results suggest that the present model has satisfactory prediction qualities to detect an increase in skeletal muscle mass associated with a growing burden of body fat.

Bridging Gaps in Blood Transfusion Services through Collaborative Healthcare Systems in Cameroon: The Cornerstone University Blood Management System version 1.0

The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.

Translation, cross-cultural adaptation, and validation of the sino-nasal outcome test (SNOT)-22 for Georgian patients

Purpose The objective of this prospective case-control study was to perform translation, cross-cultural adaptation, and validation of the sino-nasal outcome test 22 (SNOT-22) into the Georgian language. Methods The translation and validation of the SNOT -22 questionnaire was performed using the forward-backward translation technique. After proper translation, the translated questionnaire was completed by chronic rhinosinusitis (CRS) patients before and after functional endoscopic sinus surgery (FESS) and by healthy individuals as controls. Results SNOT22 was translated into the Georgian language; the pilot study involved 34 patients, the test–retest group consisted of 30 patients with CRS and the control group of 71 patients without CRS complaints; 34 patients were evaluated before surgery and 3 months after surgery. The results showed a good internal correlation with Cronbach’s alpha - 0.88 at the initial examination, and 0.93 at the retest examination; both values suggest good internal consistency within SNOT-22. Pearson’s correlation coefficient was 0.72 (p<0.001), revealing a good correlation between initial scores and retest scores. Our sample of healthy individuals had a median score of 10,11 points and the instrument was able to differentiate between the healthy and the patient group, demonstrating its validity (p<0.0001). Conclusions The Georgian version of the SNOT-22 questionnaire is a valid outcome measure for patients with CRS.

Pancreatic cancer in a Non-Tertiary Center: CEA and Bilirubin More Predictive than CA 19-9 at Initial Presentation

Background This study was undertaken to delineate the most predictive pattern at presentation for patients with non-metastatic pancreatic cancer compared to patients with metastatic pancreatic cancer who present to a medium sized hospital. Methods Data were collected at a medium sized hospital from 2009-2014 for patients with newly diagnosed pancreatic adenocarcinoma. Laboratory values, CT scans, pathology reports and ERCP results were obtained. Data are presented as mean (median +/- standard deviation). Results Fifty-two patients met the criteria for inclusion and were clinically diagnosed with pancreatic cancer. The median age was 71 years old. CEA levels for metastatic pancreatic cancer were 107.9 (20.6 +/- 166.7) ng/dl and 9 (6 +/- 11.6) ng/dl for non-metastatic cancer (P-value<0.05). Bilirubin levels for metastatic pancreatic cancer were 4.1 (0.7 +/- 6.6) mg/dl and 10.3 (10.4 +/- 8.1) mg/dl for non-metastatic cancer (p=0.009). CA19-9 levels for metastatic pancreatic cancer were 37,529 (644 +/- 88,352) U/ml and 5,150 (668 +/- 16,985) U/ml for non-metastatic cancer. Conclusion Elevated total bilirubin alongside low CEA appears to be a stronger predictor of non-metastatic disease at presentation compared to CA 19-9 alone.

Osteoarthritis Depressive, Loneliness and Social Isolation in Later Life and the Robotic Companion

Background Older adults with disabling osteoarthritis may be severely impacted by negative emotions and pain, especially if they feel isolated. Review Aims 1) To summarize the research base concerning the presence of depression in older adults suffering from osteoarthritis; 2) To examine the degree to which mitigating loneliness is desirable in this regard and may be helped by one of the many emergent robotic social devices offering companionship; and 3) To provide directives for professionals who work or are likely to work with this population in the future. Methods Reviewed were current publications detailing some aspect of osteoarthritis in the older adult, depression, emergent loneliness and social isolation, and the role and impact of robotic personal ‘friends’ in this realm. Results Collectively, these data reveal efforts to reduce and mitigate different degrees of depression in older adult osteoarthritis cases are needed and that social robots may help quell isolation. Implication Those older adults with osteoarthritis suffering from depression and emergent loneliness and social isolation may benefit from robotic human or pet like contacts and interactions regardless of cause and overall health status, but the key is still loneliness prevention.

Exploring the Correlation between Glucose and Apoptosis Levels in Stored Platelets

Background and Objectives Platelets are small, anucleate blood cells produced in the bone marrow, primarily involved in blood coagulation. Platelet concentrate is a vital blood product with extensive applications. However, its short lifespan and limited donor availability pose global challenges. This study aimed to follow the trend of platelets 5 during days of storage. Material and Methods We studied on 40 platelet bags and analyzed glucose levels, lactate dehydrogenase (LDH), bacterial culture, and apoptosis using flow cytometry with Annexin V-PI over three consecutive days (first, third, and fifth) post-blood collection. Data were analyzed using SPSS. Results No significant correlations were found between age, blood group, or gender and the variables studied. No bacterial growth was detected. Glucose levels decreased significantly from day 1 (382 mg/dl) to day 5 (298 mg/dl). The average platelet apoptosis increased significantly from 3.65% on day 1 to 9.06% on day 5. Significant correlations were observed between glucose levels and apoptosis on days 3 (p<0.05) and 5 (p<0.01). No correlation found between LDH and apoptosis or necrosis, although a significant relationship between necrosis and apoptosis was noted on day 5 (p=0.003). Conclusion These findings suggest that while demographic factors do not influence the studied variables, the significant decrease in glucose levels correlates with increased platelet apoptosis over time, highlighting potential metabolic interactions that warrant further investigation.   Highlights 1. The study revealed subtle variations in metabolic markers related to donor demographics, particularly gender and age. Understanding these differences can inform targeted donor selection strategies to optimize platelet quality. 2. A significant negative correlation was found between glucose levels and apoptosis rates, indicating that as glucose decreases, platelet viability declines. This relationship highlights the need for careful monitoring of glucose levels during storage to maintain platelet function. 3. Fluctuations in lactate dehydrogenase (LDH) levels were correlated with increasing rates of apoptosis, suggesting that LDH could serve as a valuable biomarker for assessing platelet quality throughout the storage period. This finding could lead to improved storage protocols and enhanced transfusion safety.

Synthesis of N-Glycosyl Amides via Hydrolysis of Protected Glycosyl Oxazolines and Ritter-like Reactions of Native Carbohydrates

A stereoselective synthesis of N-glycosyl amides was studied from available N-glycosyl oxazolines prepared by Ritter-like reactions of protected sugar acetonides. Hydrolysis reactions of the protected pentofuranosyl and hexafuranosyl oxazolines, as precursors of glycosyl amine derivatives, were carried out in the presence of silica gel in chloroform to giveN-α- and β-glycosyl amides in good yields after column chromatography on silica gel. Access to selectively blocked N-α-xylo-, -ribo-, β-arabino-furanosyl, α-glyco-, α-allo-furanosyl, α- and β-galactopyranosyl amides (twelve examples) useful for preparing modified N-glycosides was accomplished through a mild hydrolysis of sugar oxazolines with 2-alkyl substituents in acidic and neutral conditions. To further explore the scope of the BF3.Et2O-mediated approachdeveloped for N-furanosyl oxazolines, a stereoselective synthesis of protected N-α-hexopyranosyl oxazoline was fulfilled in a high yield from d-galactopyranose diacetonide derivative. The Ritter-like promoted reaction between D-arabinose and benzonitrile afforded 2-phenyl-β-d-arabinofurano-(1,2-d)-2-oxazoline as the main product. In acetonitrile the BF3.Et2O-KHF2-assisted reactions of unprotected native sugars were found to result in the formation of mixtures of N-furanosyl and pyranosyl acetamides.

Perceptions and Suggestions Towards Adolescent Sexuality Education Among Secondary School Teachers in Region 1, The Gambia

Comprehensive Sexuality Education (CSE) is a school-based intervention aimed at correcting misinformation surrounding sexual education among youth, often influenced by social media, peer groups and misleading online content. In The Gambia, the Ministry of Basic and Secondary Education has developed and introduced a national framework to integrate CSE from Grade 4 (primary school level) to Grade 12 (senior secondary school level). This study explores the perceptions and recommendations of 50 secondary school teachers from 43 public and private schools in Region 1 on the implementation of CSE in schools. While some teachers expressed concerns that CSE might promote perverted and lewd early sexual behavior, others saw it as essential for increased awareness and youth well-being. Cultural, religious, and societal norms pose significant implementation barriers towards the implementation of CSE in schools. Teachers’ insights are vital for successful CSE delivery and educational strategy improvements.

Extended Bioethics as a Response to Global Biological Consciousness

Humanity is persistently threatened by global pandemics- exemplified by the Black plague, the Spanish flu, and COVID-19, which reveal a continual absence of concern in real-time prevention. To forecast biological threats in the future and spur proactive human response, the term Global Biological Consciousness (GBC) is introduced.GBC requires an Extended Bioethics, a dynamic ethical framework for conscious management mediated by GBC. This perspective will enable preventive actions and will seek global biological resilience through the algorithmic responsibility of AI and systemic justice, as will be explained in the work. The GBC, through Extended Bioethics, will provide an ability to analyze biological data as it occurs using AI and quantum computing, expect outbreaks before they happen and attenuate their effects, here creates a new ethical contract for all humankind as they co-exist in a biological world.

Impact of Agricultural Land Use Practices on Water Quality in Lubigi Wetland

Wetland encroachment due to agricultural land use practices (LUPs) adversely affects water quality in wetlands mainly through agricultural runoff. This study was conducted in Lubigi wetland in Uganda to (1) determine the effect of the agricultural LUPs on water quality and (2) understand the relationships between different water quality indicators and different agricultural LUPs existing in the wetland. The eight LUPs included in this study were perennial crops i.e. banana farming and sugarcane farming, annual crops i.e. maize farming and tomato farming, livestock farming which included a mixture of cows, goats, and sheep, undisturbed dense natural vegetation, reference wetland and the river. Water samples collected from the different LUPs were analyzed in the laboratory for selected physicochemical and biological water quality parameters. The water samples were analyzed for a variety of properties, including pH, electrical conductivity, total hardness, Ca-hardness, Mg- hardness, and concentrations of dissolved oxygen, calcium, magnesium, fluoride, total nitrogen, nitrates, ammonium, phosphates, potassium, total coliform, and Escherichia coli (E. coli), chemical oxygen demand, biological oxygen demand, total organic carbon, total dissolved solids, chlorides, sulphates, total phosphorus, and turbidity levels. The results suggested that the different LUPs influenced several water quality parameters. Dissolved oxygen was lowest in banana fields and the river at 2.57 mg/L and 3.44 mg/L respectively than other LUPs which limits survival of aquatic organisms. Biological oxygen demand, chemical oxygen demand and total organic carbon were high in the river water with values = 69.67 mg/L, 351.67 mg/L, 117.33 mg/L respectively indicating high organic pollution. We detected nutrient pollution in water from tomato and sugarcane fields which showed high concentrations of nitrates. The concentration of ammonium in river water (10.40 mg/L) was high, indicating nitrogen contamination. In all LUPs, Escherichia coli and total coliforms had high counts exceeding 2000 CFU/100mL which indicated elevated microbial pollution from livestock waste and agricultural runoff. Cluster analysis revealed distinct clusters influenced by varying water quality parameters. These findings show that agricultural LUPs in Lubigi wetland are significantly contributing to water pollution through microbial contamination, nutrient, and organic matter accumulation, which increases the potential for eutrophication and renders the water unsafe for drinking and domestic use. Implementing best management practices (BMPs) is essential for the sustainable use and management of the wetland.

Retracted Article

Impact of Phytase-Supplemented Palm Kernel Cake on Growth, Feed Efficiency, and Economic Viability in Poultry

The rising costs of conventional poultry feed ingredients, such as soybean, maize, and fish meal, have prompted the search for more affordable and sustainable alternatives in poultry production. This study investigates the use of phytase-supplemented Palm Kernel Cake (PKC) as a replacement for soybean meal to improve feed efficiency, nutrient absorption, and growth performance in poultry. White Leghorn layers, Rhode Island Red layers, broilers, and cockerels were fed three different feed formulations: conventional feed (CF), Moderate PKC with Phytase (MPP), and High PKC with Phytase (HPP). The results showed that PKC-based diets significantly reduced feed costs while maintaining satisfactory growth, although CF led to higher body weight gain and feed efficiency. The MPP formulation struck an optimal balance between cost savings and nutritional quality, making it a viable option for layers and cockerels, while CF remained the most effective for broilers. While the HPP formulation resulted in lower feed costs, it compromised weight gain and overall profitability. These findings highlight the potential of phytase-enhanced PKC as a sustainable, cost-effective alternative to conventional feed, particularly in regions with high feed costs. However, the study emphasizes the importance of balancing cost reductions with feed quality to maximize profitability. Future research should focus on optimizing PKC inclusion levels and exploring additional enzyme supplements to further enhance feed efficiency and support sustainable poultry farming practices. This study provides valuable insights into how strategic feed formulation can support both economic and production goals in the poultry industry.

A Comparative Study of Temporalis Fascia Graft and Cartilage - Perichondrium Graft in Tympanoplasty

Objective The repair of the tympanic membrane has been attempted with large variety of synthetic, homologous and autologous tissue; however, temporalis fascia and cartilage-perichondrium are used most commonly today. Study Design This is a prospective study of patients confirmed to have CSOM and operated during the years of 2012-2013 at Al Nahdha Hospital, Muscat, Sultanate of Oman. The patients were followed up postoperatively at which we compared the graft success rate and level of hearing improvement. Setting ENT clinic at Al Nahda hospital Subjects Patients who presented to the ENT clinic at Al Nahda hospital, operated in the period between 2012 and 2013, diagnosed as CSOM and meeting our inclusion criteria. Methods We compared the outcome of the repair of the tympanic membrane perforation using temporalis fascia graft versus cartilage perichondrium grafts. Results 100% of the cartilage-perichondrium group showed a successful graft uptake in comparison to 98.9% in the temporalis fascia. Our data did not show significant differences in the average air bone gap change in both groups. Conclusion Both cartilage-perichondrium and temporalis fascia provide viable autograft material. Both achieve comparable and excellent graft uptake. Completion of our study is needed to study the hearing restoration in both groups.

Global importance of supporting the krill to whale component of the pelagic food web associated with migrations following deep sea seamounts

The main diet of baleen whales is krill in the Arctic, Antarctic and during migrations in the Atlantic, Pacific and Indian Oceans. Hence, the aim of this paper is to quantify the global importance of the krill to baleen whale component of the pelagic food web and possible feedback loops. That was undertaken by comparing the results of Ecopath Models in the Antarctic and Arctic Oceans and to migration areas in the North Atlantic and Alaska, was well as the large Seamount area from the Antarctic and Arctic. Biological production transfer is the essential component of the prey to predator pelagic food web, which maintains the production of predators. The importance of sustaining global baleen whale migrations is to support ecosystem production by whale defecation contribution to nutrient recycling. It is important to sustain krill and fish abundance in whale migration feeding areas using ecosystem-based fishery management (EBFM) fishing rates. It was shown by the literature that migrations tended to followed deep-sea seamounts, and baleen whale defecation and nutrient cycling at seamounts led to the effects of nutrient upwelling by deep sea currents at seamounts. Hence, it is suggested seamounts be protected as important marine ecosystems. Therefore, those processes indicate sustaining krill and whale abundance is likely to support global marine ecosystem stability in open ocean migration areas.

Factors Influencing HIV Status Disclosure Among People Living with HIV/AIDS in Mukono District, Uganda: Beyond Health System Support

Background HIV status disclosure is a complex process influenced by multiple factors beyond health system support. Understanding these factors is essential for developing comprehensive interventions to promote disclosure and improve HIV prevention and care outcomes. Methods A descriptive cross-sectional study was conducted in 10 health facilities offering comprehensive HIV/AIDS care in Mukono district, Uganda. Data was collected from 317 clients through interview-guided questionnaires. Data was entered using EPI data and analyzed using SPSS version 16, including logistic regression to identify factors associated with disclosure. Results Multiple factors influenced HIV status disclosure. Individual factors included knowledge about HIV (OR=2.34, 95% CI: 1.45-3.78), self-efficacy (OR=3.12, 95% CI: 1.87-5.21), and psychological readiness (OR=2.89, 95% CI: 1.76-4.75). Relationship factors included relationship quality (OR=3.56, 95% CI: 2.13-5.94), communication patterns (OR=2.78, 95% CI: 1.65-4.69), and anticipated partner reaction (OR=4.23, 95% CI: 2.54-7.05). Community factors included perceived stigma (OR=0.34, 95% CI: 0.21-0.56), cultural norms (OR=0.45, 95% CI: 0.27-0.75), and religious beliefs (OR=1.87, 95% CI: 1.12-3.14). Structural factors included economic dependence (OR=0.38, 95% CI: 0.23-0.63) and access to support services (OR=2.45, 95% CI: 1.47-4.08). Conclusions HIV status disclosure is influenced by a complex interplay of individual, relationship, community, and structural factors. Effective interventions to promote disclosure must address these multiple levels of influence, going beyond health system support to create enabling environments for disclosure at the individual, relationship, community, and structural levels.

Intramuscular Fat Deposition and Osteoarthritis Pathology: A Possible Overlooked Pathogenic Correlate?

Osteoarthritis, the most prevalent joint disease and one affecting many aging adults is strongly associated with various degrees of disability and high health costs. Commonly deemed largely incurable and progressive, it appears muscle fat deposition and its encroachment on muscle tissue may account for multiple adverse health outcomes, especially the osteoarthritic disease process. This mini review examines whether contemporary evidence supports a role for efforts towards preventing excess fat infiltration into vulnerable muscles as one means of reducing osteoarthritic pain and disability. To this end, research on this theme and reported as of June 2025 on this issue was sought. We found that with few exceptions and regardless of joint examined a role for muscle mass infiltration in osteoarthritis disability appears of high clinical significance.

Degradation assessment of Vinyl Ester Matrix Fiber Reinforced Plastics Exposed to Cyclic Hydrochloric Acid Concentrations using Gravimetric Analysis for Chemical Storage Tank use

The roof of an HCl fiber-reinforced plastic (FRP) chemical tank failed by accident after it had been operated for less than its expected lifetime. A possible cause is the change in day and night temperature, which lead to the cyclic change in the concentration of HCl vapor in contact with roof part. To investigate this possibility, a detailed analysis on the durability of the material exposed to cyclic solution concentration is required. In this research, vinyl ester-glass fiber composite specimens were exposed to 35 mass % and 0 mass% of HCl alternately at 40°C to replicate cyclic concentration exposure in both the vapor and liquid phases. The mass uptake and penetration depth of HCl as well as the strength loss of the material were investigated. Mass uptake and thickness change in vapor phase shows two times higher than liquid phase, at 3.5% and 6% respectively. This occurs due to differences in the concentration of solutions that diffuse to the specimen in the vapor phase and liquid phase. This phenomenon arises from variations in the concentration of solutions that diffuse to the specimen in both vapor and liquid phases. The diffusion process is facilitated by osmotic pressure, leading to material swelling and contributing to their degradation. The result of flexural strength measurement of specimens indicated a decreasing trend as exposure time increased. The flexural strength decreases by up to 36% due to plasticization. The Cl and water content profile in specimens that obtained from elemental mapping of cross-sections using Energy-Dispersive X-ray Spectroscopy (EDS) are enhancing the study on how materials degrade, which may be a reason for damage to FRP tank roofs.

Iatrogenic Extra-Capsular Extension of Knee Septic Arthritis Via Intra-Articular Joint Injection

Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.

Soil Fertility Dynamics and Xanthomonas Wilt Incidence in Enset (Ensete Ventricosem) Based Farming at Chencha, Southern Ethiopia

Enset (Ensete ventricosum) is a vital food security crop cultivated in South and South-western parts of Ethiopia. However, enset production and the farming families have been threatened by Xanthomonas wilt and its spread in the farming system. Thus, this study was conducted to investigate the soil fertility and plant management practices association on the incidence of Enset Xanthomonas wilt. Data on soils fertility and diseases from enset based farming clustered into inner, outer and outfield farm zone were sampled and surveyed. The result indicated that soil chemical properties significantly (p≤0.05) varied from inner to outfield farm zone. Significantly maximum nutrients store revealed in inner enset farm zones. Disease incidence reduced from inner to the outfield enset farm zone. Disease prevalence and disease incidence scored 28.5% and 11.6%, respectively depending on altitude and genotypes. Soil fertility levels in the enset inner and outfield plots were varied purposely to cultivate enset products as kocho, bulla or amicho (cooking type). The variations in soil fertility and Xanthomonas wilt incidence was associated with management practices applied for desired enset products. Therefore, management practices in enset based farming, soil fertility and location of enset planting zones found to be major indicators for disease incidence addressing to device control interventions.

Ecosystem-Based Fishery Management of Antarctic Krill (Euphausia superba) to Support Baleen Whales and other Predators Production Adapted for Potential Climate Change Effects

Antarctic krill is an important component of the zooplankton production in the Southern Ocean and is a major food source for baleen whales. The role of commercial fishing and predation by whales on Krill abundance has been investigated here using the innovative ecosystem-based fishery management, EBFM which maintains the krill to whale food web ecosystem stability. The literature indicates the Krill fishery may have been overfished, so it was reduced to the current annual upper limit of 0.62 million tonnes for support other predators of krill, such as seals, penguins and flying sea birds. However, recent literature suggests a moderate reduction in krill catch in the Antarctic Peninsula area due to its importance for whale migration to temperate areas. The Peninsula area catch was estimated to be reduced by about 10% due to additional concerns about climate change effects on krill abundance in the Southern Ocean, reducing overall catch to 0.556 million tonnes, moderately higher than the maximum taken in 2022. Hence, the krill biomass fishing was reduced to allow for predation by baleen whales and other predators, giving a full ecosystem-based fishing mortality similar to that previously estimated to maintain krill production in the Southern Ocean.

Comparative Study of Deep Learning Techniques for Detecting Corn Plant Leaf Diseases Using Transfer Learning

Plant leaf diseases pose significant threats to crop yield and agricultural sustainability, making early and accurate detection crucial for effective disease management. In current years, deep neural network (DNN) techniques have shown remarkable potential in the field of image classification, including plant disease detection. The study aims to investigate the performance of two popular deep learning architectures, namely, VGG16 and InceptionResNetV2, for the detection of tomato plant leaf disease. The proposed methodology involves acquiring a diverse dataset comprising high-resolution images of healthy and diseased leaves from the target crops. Preprocessing techniques such as image augmentation and normalization are applied to enhance the generalization ability of the models and mitigate overfitting. Transfer learning is employed to initialize the deep learning architectures with weights pre-trained on large-scale image datasets to accelerate convergence and improve the models' performance in limited data scenarios. To evaluate performance of proposed networks various metrics such as validation and test accuracies, precision and recall, F1 score, and the area under the curve (AUC) are considered. From the investigations, the classification accuracy of the finest architectures is as follows: 99.8 percent for VGG16 and 99.4 percent for InceptionResNetV2 on Corn Leaves. The results suggest that the models developed during the investigation phase to identify the leaf disease were superior to any existing Deep Neural Networks (DNNs).

Health Practitioner Burnout, Safety Implications, and Programmatic Fixes: A Systematic Literature Review of Current Literature Reviews—200 Proof*

High rates of workplace psychological stress and burnout have been chronic among Healthcare Practitioners. Research shows that Healthcare Practitioner psychological stress / burnout is related to poor quality of care and a high probability of making medical errors and mishaps resulting in harm to patients and even workers themselves. In response, relatively impactful programs have been developed to address Practitioner burnout. To derive a better understanding of the subject and inform best practices and policy regarding the problem and its fixes, this article reports findings from a novel study of a systematic (PRISMA-based) literature review of current (circa ~10 years <) literature reviews; or a distillation of reviews already at 100 proof then undergoing a further distillation into a review of 200 proof.* This study employed a grounded theoretic qualitative methodology to iteratively generate and enumerate descriptive themes from the study’s literature review articles. This article reports on what is currently known regarding the precipitants of Health Practitioner Burnout, Burnout itself, its relationship to Safety lapses and mishaps, and Programmatic Interventions (i.e., Fixes). The primary conclusion is that Health Practitioners are the foundation of healthcare organizations and key to quality care and management / leadership should be concerned for their wellbeing; and this article provides a general blueprint in terms of addressing burnout and safety. Study Limitations and Future research are also discussed.

Intersecting Epidemics: Intimate Partner Violence, Stress, and Diabetes Among South Asian Women in the United States

South Asian women in the United States face disproportionate health challenges, including higher rates of intimate partner violence as well as higher rates of Type 2 diabetes and gestational diabetes compared to other racial and ethnic groups. This cross-sectional study examines the association between intimate partner violence (psychological, physical, and sexual) and the diagnosis of gestational diabetes and type 2 diabetes. A web-based survey recruited 2,634 South Asian women in the U.S., collecting data on socio-demographics, intimate partner violence experiences, stress levels, and diabetes diagnosis. Logistic regression models adjusted for significant sociodemographic factors revealed that women with a history of intimate partner violence were 5.82 significantly more likely to report a type 2 diabetes diagnosis and 3.91 more likely to report a gestational diabetes diagnosis. Furthermore, stress as measured by the perceived stress scale, was also higher among women with intimate partner violence, potentially moderating the relationship between intimate partner violence and adverse health outcomes through cortisol dysregulation. Despite high levels of educational attainment and employment, the prevalence of intimate partner violence was alarmingly high (66.7%), highlighting its pervasive impact on socioeconomic strata. These findings underscore the urgent need for culturally tailored interventions addressing intimate partner violence and its health consequences within South Asian communities. Further research is warranted to elucidate causal pathways and inform integrated public health strategies to mitigate disparities in chronic disease and intimate partner violence-related health outcomes.

RETRACTED: Association of Body Mass Index (BMI) and Severity of COVID- 19: A Multicentric Study from Maharashtra, India

This article has been retracted on 30 August 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-7835.ijn-25-5842) Objective The COVID-19 pandemic has led to the global research efforts to identify the risk factors which would lead to severe COVID-19 disease. This study aimed to investigate the relationship between body mass index (BMI) and severity of coronavirus disease 2019 (COVID-19). Methods A total of 2820 patients hospitalized with COVID-19 disease in nine Government Medical Colleges, COVID hospitals or COVID care centers of Maharashtra were included in the study. Interviews were conducted on the telephone and counselling was done. Results Among 2820, 2442 (86.60%) were asymptomatic or had a mild or moderate illness. More than half of the total COVID- 19 positive cases, 1591 (56.41%), were in the normal BMI range, and of these only 183 (11.50%) had severe COVID-19 disease. On the other hand, 647 (22.94%) patients were overweight and 106 (16.38%) had Severe COVID- 19 disease. Similarly, the patients who were obese, 363 (84.03%) were asymptomatic and 69 (15.97%) had severe COVID- 19 disease. Odds ratio for this association was found as 1.5, which indicates that patients who were obese (BMI ≥ 27.5) had one and half times increased odds of progression to severity as compared to patients having normal BMI. This association was found to be statistically significant (p- value < 0.05). Conclusion Our findings highlight the significant role of BMI in clinical progression of COVID-19 disease. Patients with underweight and obesity experienced more severe outcomes than those of normal weight when being hospitalized with COVID-19 disease.

Retraction Note: Association of Body Mass Index (BMI) and Severity of COVID- 19: A Multicentric Study from Maharashtra, India

Parasitological Examination of Fecal Samples from Sheep, Goats, and Cattle at the Techiman Slaughterhouse

This study investigates the parasitological examination of faecal samples collected from sheep, goats, and cattle at the Techiman Slaughterhouse. Initially, 341 samples were collected, which were subsequently sorted to 327 for analysis due to the loss of data for 14 samples. The primary aim was to identify the prevalence of parasitic infections and assess the health implications for livestock and public health. The samples were analyzed using qualitative and quantitative parasitological techniques, including flotation and sedimentation methods, to detect nematode and cestode eggs. Descriptive statistics were used to summarize the data and the prevalence of each parasite type. The findings reveal significant levels of parasitic infections, particularly strongyle ova and Moniezia expansa, highlighting the need for better management practices in livestock health.

Research Study Reveals Factors That Impacted Ohio Funeral Director Attrition and Retention Rates

A phenomenological qualitative study was conducted to obtain facts and details about the lived experiences of Ohio funeral directors during their first five years of licensure. The goal of the study was to understand these lived experiences as told by funeral directors to understand better the factors that impact the attrition and retention of new licensees. The data was analyzed using the Colaizzi 1978 method. The collected data aided in professional development programs offered to Ohio funeral directors and embalmers which increased the discussion and interest in factors that impact attrition and retention rates of new funeral director licensees at the local and national levels. The information from the study can be applied to allied helping professions such as healthcare, ministerial, and education. The stories and experiences as told by Ohio funeral directors provides new insight into the factors that impact attrition and retention rates of new licensees.

A Study on the Feasibility and Utility of Continuous Glucose Monitors in Elite Football

Physiological performance may be limited by reduced systemic glucose availability to working muscles. Continuous glucose monitors (CGM) measure interstitial glucose every 1-15 minutes, offering a practical way to assess glucose during sporting activity. However, empirical research has predominantly focused on endurance-based sports, whereas glucose responses during professional competitive football matches remain unknown. This study evaluated the feasibility and utility of CGM in professional football. Eight professional, male outfield footballers from the English third tier participated in the study. Participants completed a 14-day food diary control period, followed by a 28-day observation period wearing CGM devices during six matches and sixteen training sessions. CGM devices remained in situ for 98% of training sessions and matches. Mean glucose concentrations were 6.5 ± 1.2 mmol/L during training sessions, 7.5 ± 2.1 mmol/L during match play, and 5.4 ± 0.3 mmol/L overnight. No significant differences were found between glucose concentrations during match play (p = 0.060) or training (p = 0.510), compared to overnight fasted glucose concentrations. There was also no difference between training and match-play glucose concentrations (p = 0.788). Glucose concentrations were highly individualised, with one player displaying minimal change throughout match play (-0.2 mmol/L) whereas another experienced increases of up to 5.8 mmol/L. Non-nutritional factors appeared to influence glucose concentrations; participants (n=3) who used nicotine pouches displayed an transient increase in blood glucose in the 10-55 minutes after administration. This study concludes that CGM use in professional football is feasible for assessing individual glucose responses to  training and match-play.

The Relationship Between Abnormal Sleeping Patterns and ADHD

The objective of this focused literature review includes establishing and explaining the high correlation between sleep issues and ADHD. Through a systematic review of sources, a high correlation between sleep issues in those with ADHD was established with multiple theories lending explanation to this comorbidity. Neurological pathways in the brain already afflicted by the disorder of ADHD may cause direct effect on sleep pathways in their dysfunction. Other comorbid sleep conditions were found to occur in high frequency with ADHD however, a common etiology of these issues is yet to be established. The major conclusion of this study includes that there are multiple mechanisms through which sleep disturbances may be caused in ADHD patients, all of which must be considered in future research.

Retracted Article

Enduring Struggles and Protracted War: Hatred as a Multi-Faceted Construct

This paper examines the concept of conflict- and war-related hatred as a multifaceted construct. Drawing upon various theoretical frameworks, we hypothesized that hatred in the context of conflict and war would encompass five distinct dimensions: Groupthink (Contagious Hatred), Destructiveness, Exposure, Chronicity, and Extreme-Severe Affect. To empirically validate this conceptual framework, we conducted a second-order factor analysis using data from 709 questionnaire responses collected from citizens in the Gaza Strip. The findings revealed that the optimal model comprises three primary constructs: Contagious Hatred, Chronicity, and Extreme- Severe Affect. Based on these results, we argue that collective existential threats in contexts of protracted conflict and war amplify groupthink, foster a sense of chronicity, and evoke intense negative affect. These findings underscore the complexity of hatred as a psychological and social phenomenon in conflict zones.

Documenting Interspecific Predation in Odonata: Observations of Ischnura Senegalensis Preying on Agriocnemis Pygmaea in Rice Fields of Faculty of Agriculture, Rajarata University of Sri Lanka, Puliyankulama, Anuradhapura District

Interspecific predation within Odonata is a critical yet underexplored aspect of their ecological interactions. This short communication reports a novel observation of Ischnura senegalensis preying upon Agriocnemis pygmaea in rice fields at the Faculty of Agriculture, Rajarata University of Sri Lanka. Documented on March 22, 2024, during the reproductive stage of the rice field, the predatory event involved a female I. senegalensis feeding on the head of a female A. pygmaea. Predation, characterized by the use of mandibles and lasting at least 15 minutes, reveals significant predatory efficiency and behavioral specialization. This observation fills a gap in the understanding of I. senegalensis feeding behavior in Sri Lanka and contributes to the broader knowledge of Odonate predator-prey dynamics. The findings highlight the importance of these interactions in maintaining ecological balance and suggest further research into the impacts of such predatory behaviors on agricultural ecosystems.

Burden of Unintentional Childhood Injuries in Pre-School Children (2-6yrs) and Knowledge of Primary Caregivers on Early Management: A Descriptive Observational Study in Urban Slums of Bhubaneswar, Odisha

Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.