Search results for “age”

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.

Perceptions and Lived Realities of Women’s Engagement in Environmental Conservation in Patriarchal Communities of Northern Uganda: A Qualitative Inquiry

Background Women’s participation in environmental conservation within patriarchal societies is a critical factor for achieving sustainable development and improved community outcomes. Despite this importance, limited research has examined women’s perceptions of their roles and contributions to environmental conservation. The current study aimed to (1) explore women’s perceptions of their roles in environmental conservation within patriarchal structures, and (2) to document the effectiveness of strategies enhancing their participation. Methods This study followed a phenomenological design, using thematic data analysis. Information was gathered through semistructured interviews, focus group discussions (FGDs), and key informant interviews with technocrats, civil servants, local leaders, and NGO staff. The sample size of the study was 30 participants, obtained using the point of saturation principle. The focus group consisted of 24 participants and 06 Key Informants. The study tools were pretested with a small group before the main fieldwork. Participants were selected using purposive sampling. The size of the sample was guided by data saturation. Results The findings show that although women’s representation in local councils and environmental committees has grown due to the 30% quota requirement, their influence remains constrained by systemic barriers. Political interference undermines technical teams’ conservation efforts, while widespread community ignorance of environmental laws limits compliance. Weak enforcement and corruption, with leaders themselves implicated in destructive practices, further erode progress. Critically, inadequate financing such as subcounties allocating only 600,000 shillings for sensitization, leaves many activities unimplemented, forcing reliance on development partners. Conclusion The study concludes that sustainable environmental stewardship requires not only legal reforms and institutional accountability but also adequate financing and communitydriven strategies that amplify women’s voices and foster collective responsibility.

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.

Spiritual Blessing Energy Treatment as an Approach for Boosting Growth and Yield of Bottle Gourd (Lagenaria siceraria L.)

The objective of this study was to improve the growth and yields of bottle gourd plants after exposure with spiritual blessing energy treatment (SBET) to the seeds and land. Twenty-one morphological traits of leaves, fruit, seed, and twenty-eight phenological parameters were employed to evaluate bottle gourd’s growth and yields after SBET. Results of bottle gourd showed a diversifiable characteristic of leaves, fruits, and seeds. Nine qualitative traits exhibited with distinct differences in the biofield-energy treatment group compared to the control. At harvest, growth-related phenological parameters such as plant vine length, number of branches, internodal length, and leaf width were significantly improved in the treatment group by 65.43% (p ≤ 0.001), 51.78% (p ≤ 0.01), 49.40% (p ≤ 0.001), and 40.82% (p ≤ 0.001), respectively, compared to the control. Additionally, yield-related parameters such as number of female flowers, number of fruits per vine, and fruit yield per hectare were significantly increased by 47.73% (p ≤ 0.05), 26.52% (p ≤ 0.001), and 38.99% (p ≤ 0.05), respectively, with respect to the control. With distinct qualitative variations and high statistical significance, these results suggest that SBET may serve as a potent non-traditional intervention for optimizing phenological development and agricultural output of bottle gourd.

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.

Rehabilitation With Corticobasal and Compressive Implants with Polished Surface in Case of Failure with Two Stage Implants-Article

The aim of this article is to present alternative possibilities for corrective intervention using corticobasal implants, following the failure of treatment with two stage implant in cases of extensive edentulism, multi-segmented edentulism, and the development of peri-implantitis 1 at the level of these implants. For this purpose, a case was selected involving a patient treated with two stage implants in a multi-segmented manner, in the distal regions of the maxilla and mandible, where the implants were affected after 12 years by peri-implantitis in proportions ranging from 20% to 100% in different areas of bone, with a predominance in the vestibular area. The decision was made to remove the affected two stage implants, as well as the remaining deciduous teeth, with or without periodontal conditions, but whose position on the arch made improperly rehabilitation, both functionally and aesthetically impossible, and made the second rehabilitation with polished corticobasal and compressive implants in immediate loading 2. Function and aesthetics of the gnathological apparatus were restored through definitive fixed metal-ceramic prosthetics on the support of corticobasal and compressive implants within 4 days from the beginning of the treatment, with the result being monitored over a period of 3 years and 3 months, and this evaluation is to continue over time. From a surgical perspective, for secondary rehabilitation with polished corticobasal and compressive implants, strategic positions in the maxillary and mandibular bones were used as follows: the fusion area of the maxillary bone with the sphenoid bone, the nasal cortex, the sinus cortex the lingual cortex distal to the mylohyoid line, and the interforaminal mandible area.34 These areas correspond to methods described in Consensus Number 6 in the IF The Foundation of Knowledge 5. In conclusion, the treatment with corticobasal, compressive polished implants is successful even in the case of a difficult clinical scenario like the one described for this patient 6. The reduced treatment time, along with the absence of the need for sinus lifts or bone grafts, makes it the ideal solution in any situation. The use of corticobasal implants, with fixation in the second/third cortical layer and an immediate loading protocol, should represent the primary solution in treating cases with poor bone representation, and no only as a “Corrective Intervention with Corticobasal® Implants”7.

Uncovering the Gaps and Linkages: Exploring Postpartum Mood and Anxiety Disorders and Experiences for Clinicians and Parents within One Northern Community

The current research assessed gaps and barriers related to perinatal mental health service access by parents during COVID-19, as well as service providers’ knowledge and provision of PMAD services, in one Northern community, where rural and remote healthcare is a daily reality, and recruitment and retention of qualified professionals is a significant issue. Two mixed-methods surveys were designed, one to assess PMAD knowledge and service provision via a volunteer sample of service providers, and another to assess PMAD service need and access among a volunteer sample of new parents. Results indicated that many parents waited too long for services, and some parents in need of PMAD services didn’t receive them. Interestingly, higher-income parents were more likely than lower-income respondents to desire services and support for PMADs. Although most providers screened for, were trained in, and treated and/or referred patients with PMADs, they reported feeling as though they were working in silos, unaware of what other providers offered.

Lineage-Specific Disruption of Hematopoiesis by Oxaliplatin: Mechanisms of Erythropoietin Resistance and Immune Suppression

Background Oxaliplatin, a widely used chemotherapeutic agent, is associated with hematologic toxicities such as anemia, leukopenia, and thrombocytopenia. Despite their clinical relevance, the molecular mechanisms underlying lineage-specific bone marrow suppression remain poorly understood. Methods We administered oxaliplatin to mice over eight weeks and performed RNA-sequencing (RNA integrity >8) on bone marrow alongside peripheral blood analysis and cytokine profiling. Transcriptomic data were analyzed to identify differentially expressed genes (DEGs) and enriched pathways. For that, we applied a thematic Gene Ontology (thematicGO) enrichment method that groups GO terms into biologically meaningful categories, such as hematopoietic lineage disruption, cell cycle arrest, and cytokine signaling. Results Oxaliplatin induced broad transcriptional suppression of erythropoiesis and lymphopoiesis, with 3,691 DEGs identified (FDR<0.05, |FC|>1.5). Upregulation of Cdkn1a and downregulation of E2f2 suggest G1/S cell cycle arrest, correlating with repression of key erythroid maturation genes (e.g., Spta1, Slc4a1, Alas2) and hemoglobin subunits (Hba-a1/2, Hbb-bs/t). Despite a ~3000-fold increase in renal Epo expression, bone marrow Epor was reduced, indicating erythropoietin resistance. B and T cell markers were also significantly downregulated, signifying a collapse in adaptive immunity. Notably, neutrophil populations were largely spared. Cytokine analysis in plasma revealed a pro-inflammatory shift with elevated TNF-α and reduced TGF-β, potentially exacerbating hematopoietic dysfunction. Conclusions Oxaliplatin induces a lineage-dependent suppression of hematopoiesis, driven by coordinated cell cycle arrest, metabolic stress, and disrupted cytokine signaling. RNA-seq analysis enabled integration of transcriptomic findings into coherent biological themes. These findings provide mechanistic insights into oxaliplatin’s hematologic toxicity linking bone marrow failure (potentially reversible) via interconnected inflammatory and metabolic pathways and may inform therapeutic strategies to minimize or restore myelosuppression in cancer patients.

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.

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.

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.

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.

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.

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.

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.

Development of Municipal Decision-Making Strategies as Management Tools to Combat Waterborne Diseases

Waterborne diseases pose a significant global public health threat, particularly in sub-Saharan Africa, where frequent outbreaks occur. These diseases stemming from contaminated drinking water, poor waste management, and insufficient hygiene contribute to high morbidity and mortality in children under 5 years old. A study addressed waterborne diseases in N'Djamena, Chad's 3rd and 9th districts, through decision-making strategies. The research employed various methods, including a household survey using questionnaires, workshops, semi-structured interviews, and focus group discussions. Additionally, documentary research provided essential data for analysing the situation of diseases in the community. Epidemiological data from 2019- 2022 indicated a substantial prevalence of diseases such as diarrhoea, dysentery, skin infections, typhoid, abdominal pain, and malaria, with notable mortality, especially among children. Among surveyed households, 50% believed the consumed water was contaminated, attributing it to faecal matter, while 28% and 22% linked the diseases to inadequate hygiene and unsanitary conditions, respectively. The study advocates for comprehensive strategies, including improving water treatment efficiency, implementing safe waste management, promoting hygiene, and vaccination. Active involvement of all stakeholders, with municipal authorities leading, is crucial for effective implementation and combating waterborne diseases.

Changes in Cellular Morphology in Bronchoalveolar Lavage Fluid of Children with Mycoplasma Pneumoniae Pneumonia

Objective To study changes of cell morphology in BALF in children with Mycoplasma pneumoniae pneumonia (MPP). Methods From December 2021 to May 2022, a group of 32 children diagnosed with Acute MPP and admitted for treatment in the Pediatrics Department and PICU of the First Affiliated Hospital of Xinxiang Medical University were selected for our study. These patients underwent bronchoalveolar lavage as part of their clinical assessment. For comparison, we included a control group comprising 10 children who were not infected but had bronchial foreign bodies. We investigated the cellular composition in the bronchoalveolar lavage fluid (BALF) using Wright-Giemsa staining and microscopic evaluation, aiming to understand the relationship between shifts in cell proportions and extra-pulmonary symptoms associated with MPP. Results In this study, a total of 42 cases were enrolled, with 32 cases in the study group and 10 cases in the control group. There were no statistically significant differences in gender, age, height, weight, and BMI between the two groups (p > 0.05). The study group exhibited significantly higher levels of neutrophil percentage (GRA%), CRP, D-dimer, and LDH in blood routine tests compared to the control group (p < 0.05). Furthermore, the proportions of neutrophils (%) and macrophages (%) in BALF were significantly higher in the study group compared to the control group (p< 0.05), while the proportion of lymphocytes (%) in BALF showed no statistically significant difference between the two groups (p> 0.05). Conclusion In the acute phase of MPP in children, BALF is predominantly composed of neutrophils. A lower proportion of lymphocytes in BALF is associated with a higher incidence of extra-pulmonary manifestations and longer hospitalization duration.

The Application of Immunoglobulins Immune Response in the Discovery and Development of Safe Therapeutic Agents: A Review Article

Background Immunoglobulins are bio-receptors found embedded in the cell membrane with a biological role that detects the harmful molecules of a test compound. These bio-receptors interface between a biological system and its external environment that transduce information to the effector via intermediate messengers in which its response efficiency usually exhausts at high doses of exposure to external stimuli. The purpose of this review article is, therefore, to elaborate on the computational method for systemic biology which was designed to convert qualitative pharmacological data into the quantitative one that might help to determine the toxicity of a test compound. Methods First, acute toxicity studies using different levels of doses prepared from each test compound have been conducted on Balb c mice. Then, blood specimens from the tail and facial veins of each sampled Balb c mouse were collected 3 days before dosing as a reference test and 4 hr after dosing for comparison. The changes in the efficiency of immunoglobulins immune response (ΔIg) after dosing were determined using quantitative immunoassay and the body’s response against the dose as the toxic reaction rate (r) and the toxic severity (s) were finally determined using computational methods as r=d/t-ΔIg mg/sec and (s=r/w×100) %/sec respectively, where (w) represents the body weight of a study animal, (t) represents the period of time at which undesirable bio-physiological responses manifested on treated study animals and (ΔIg) represents the changes in the concentration of immunoglobulins in blood serum after dosing. Results The results of different studies revealed that the dose has never limited the toxic property of a test compound but the length of time at which the undesirable side effect was manifested on study animals. The period of time at which adverse effects manifested on treated Balb c mice was inversely related to the amount of dose administered in the oral route. The higher the dose of the administered test compound, the shorter the period of time at which the undesirable side effect was manifested on treated Balb c mice. This means that the adverse effect of test compounds was not because of the dose but rather due to its toxic reaction rate which ultimately determined the toxic severity in the natural process of treated Balb c mice. Balb c mice treated with a dose whose toxic reaction rate was ≤ 0 survived from death whereas Balb c mice treated with a dose that had a toxic reaction rate of > 0 died at different lengths of time after dosing depending on the toxic severity of a test compound. It could be a scientific fact to declare that a test compound is safe when the toxic reaction rate (r) and toxic severity (s) of a dose is ≤ 0 and toxic when it is > 0 in the natural processes of a study animal.

Molecular Diagnosis in Clinical Management and Diagnosis of Thyroid Cancer

The prevalence of thyroid cancer is rapidly increasing worldwide, majorly due to overdiagnosis and overtreatment methods of differentiated thyroid cancer. The emergent and potent preclinical models, high-throughput molecular techniques, and genetic expression microarrays have delivered deeper insights into understanding the molecular features in oncogenesis. Thus, molecular markers have become a promising tool in managing thyroid cancer for differentiating benign and malignant tumors, prognosis, recurrence, and determination of novel therapeutic targets. In differentiated thyroid cancer, molecular markers are majorly utilized for guiding the development of indeterminate thyroid nodules on fine needle aspiration (FNA) histologies. Dissimilar to this, in advanced thyroid cancer, molecular markers permit targeted treatment of a modified signaling cascade. Determining causal mutation of targeted kinase receptors in advanced thyroid cancer can depict a promising treatment strategy with mutation-targeted tyrosine kinase inhibitors to reduce progression and eradicate mutation effects when conventional methods fail to manage. This review will focus on the molecular landscape and discuss the impact of molecular markers on the prognosis, treatment, and surveillance of differentiated and anaplastic thyroid cancer.

Determinants of Exclusive Breastfeeding Among Mothers of Infants Less Than Six Months of Age in Mogadishu: A Facility-Based Cross-Sectional Study

Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.

Knowledge And Practice of Preconception Care Among Women of Reproductive-Age in Bheerkot Municipality, Nepal

Background Preconception care is a crucial aspect of maternal and child healthcare services that aims to mitigate adverse pregnancy outcomes and enhance the desired health outcomes for women, newborns, and children. Despite the continuous multi-sectoral efforts in preconception care, maternal mortality and morbidity remain significant health concerns globally. This study aimed to assess the knowledge and practice of preconception care and its associated factors among women of reproductive age in Bheerkot Municipality, Nepal.  Methodology A community-based descriptive cross-sectional study was conducted among 215 reproductive-age women to assess knowledge and practice regarding preconception care in Bheerkot Municipality, Nepal. Structured questionnaires were designed in the Nepali language and used in face-to-face interviews. We used a simple random sampling technique to collect quantitative data. In a statistical analysis, we employed the Chi-squared test and logistic regression analysis to identify possible predictors using the odds ratio and considered variables with p<0.05 statistically significant at a 95% confidence interval. Result Out of the 215 women who participated in the study, only 46.9% had a good knowledge of preconception care. Approximately half (43.7%) of the respondents had never practiced preconception care. Among respondents who had practiced preconception care before, 47.9% reported good practice, and 52.1% reported poor practice. Age of the respondent (χ2=14.2063, P=0.000823, df=1), marital status (χ2=17.9851, P=0.000022, df=1), time to reach a health facility (χ2=30.1371, P=0.00001, df=1), and age at first pregnancy (χ2=4.7975, P=0.0285, df=1) were statistically associated with knowledge about preconception care. Women who have foreign employment as a major source of family income and whose age is from 25 to 34 years were more likely to have a better practice of preconception care than their counterparts (COR 3.5000, CI 1.3343 to 9.1805, P = 0.0109) and (COR 3.4000, CI 1.1646 to 9.9265, P = 0.0252), respectively. Additionally, out of those who practiced preconception care, most respondents (93.4%) have practiced it in government health facilities. Conclusion Respondents had relatively poor knowledge and practice of preconception care. Collaboration of governmental health institutions between multiple sectors at local levels for more education and information and a specific national protocol or policy formulation would be beneficial in improving preconception care in Nepal.

An updated review: women's concerns following miscarriage on multiple social media platforms

This study explored concerns and unsolicited advice relating to miscarriage shared on multiple social media platforms for mentions of questions, advocacy, medical advice, conflicts of interest, and terminology used to describe miscarriage. Public social media posts in English from January 1st, 2019 to June 30th, 2021 were searched using keywords related to miscarriage. A dataset of questions, advice, conflicts of interest, and terminology used was created from eligible posts determined by inclusionary and exclusionary criteria. The dataset was analyzed to identify themes and calculate statistics. Approximately 1000 posts were reviewed and 149 posts were found eligible for analysis. Of the total, 116 posts included advice and a subset of 71 posts offered questions. A total of 152 mentions of advice were identified from the total eligible posts with 82.9% of advice related to advocacy for destigmatizing miscarriage, enhancing community support, or expressing grief. 17.1% of posts offered medical advice eligible for evaluation of which 73% were accurate across all platforms. From the dataset, 103 questions were analyzed for common themes. The four most common themes of questions included grief, self-blame, quality of post-miscarriage counseling in different care settings, and inadequate medical counseling.  This study indicates that women who experience miscarriage have many unanswered questions and powerful feelings relating to grief and self-blame that could have long-term impacts. Social media has become a place for women to self-advocate and connect with others for support, from which clinicians could increase their understanding of women’s unmet needs.  

Groundwater in Southwestern Algeria: An Essential Heritage and Keys to Development

A regional overview describes groundwater resources in Southwestern Algeria, assessing challenges and strategies for sustainable development under climatic and demand pressures.

Hybrid Limited Shoulder Surgical Management (HLSSM) Sayed Issa's Hybrid Shoulder Arthroscopic-Open Surgical Management

Introduction The idea of HLSSM2 is to get the least easy surgical intervention, as arthroscopic surgery begins with examining the shoulder joint, and the location and size of the lesion are determined, then open over the lesion with an open surgical approach that is very limited for surgical repair; not using arthroscopic instruments but conventional surgical instruments in the second step. Figure 1 Figure 1.   Methods Clinical experience with this technique consists of 44 cases over a period of thirty-one months, this study was from September 2020 to May 2023. All cases were done as outpatients and under general anesthesia. Results The mean duration of the operation was 35 minutes, and the minimum duration was 25 minutes. There was no major nerve or vascular injury in all cases. This technique is simple, safe, and good cosmetically satisfactory for all patients after full recovery about three months after the procedure, and it is cost-effective. One 43-year-old female patient suffered pain and stiffness during the first six months after surgery and was not very satisfied, she did not stop visiting us till now, she was not happy because of shoulder pain and tenderness. Conclusion It can be used by experienced hand surgeons in shoulder arthroscopy and in Mini Lateral Shoulder Approach (MLSA)3, especially in countries where shoulder arthroscopic release and repair with suture anchors are expensive4 or not available. This technique is not very simple but is available, safe, cosmetically satisfactory, and cost-effective.

Pyrexia And Liver Injury After A Second SARS-CoV-2 Vaccination: Macrophage Activation Manifested In Liver

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-Co V-2) has contributed to control of the coronavirus disease 2019 (COVID-19). On the other side, vaccination of SARS-CoV-2 could trigger autoimmune or inflammatory diseases. We present a 50-year-old female with well-controlled optic neuromyelitis with prednisolone (PSL) maintained at a dose of 2.5 mg/day. She ran a fever and liver injury was indicated 5 weeks after a second COVID-19 vaccination (BNT162b2 mRNA/Pfizer ). Liver biopsy showed accumulation of macrophages around the central veins, identified using anti-CD68 antibodies. As the treatment, cyclosporine A improved liver injury. COVID- 19 vaccination may have triggered liver inflammation due to cytokine storm via macrophage activation in the liver.

Improving Effective Screening and Management of Obesity in an Urgent Care Clinic

Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.

Distribution and Conservation Challenges of Diurnal Large Mammals in Bayo Community Managed Forest, Salamago Woreda, South Omo Zone, Southern Ethiopia

An ecological study on diurnal mammals was carried out in Bayo Community Managed Forest located in Salamago Woreda, South Omo Zone. The objective of the study was to investigate the distribution and conservation challenges of diurnal large mammals in the study area. Based on the habitat type and topography of the study area, total of 11 transect, i.e 7 in forestland, and 4 in Wooded Grassland were laid to collect the data. Besides direct methods, indirect methods such as faecal droppings, fresh tracks, carcass or shell count, den (burrow), hair, and digging were used. Questionnaire and focus group discussions were also used to assess anthropogenic threats in the study area. Data were analyzed using descriptive statistics, SPSS and QGIS software. A total of 20 species of diurnal large mammals belonging to six orders and eight families were identified. The species identified were Cercopithecus pygerythrus, Cercopithecus aethiops, Papio anubis, Erytherocebus patas, Cercopitheus neglectus, Colobus guereza, Equus quagga, Traglaphus strepsiceros, Traglaphus imberbis, Traglaphus scriptus, Medagua guentheri, Sylvicapra grimma, Kobus ellipsiprymnus defessa, Syncerrus caffer, Potamochoerus larvatus, Phacochoerus africanus, Hylochoerus meinertzhageni, Hystrix cristata, Orycteropus afer, and Phataginus temminckii smutus. Seasonal variation in the between habitat types (χ2 = 4.849, df= 1, p<0.05). Totally, 685 and 600 mammals were counted during wet and dry seasons, respectively. On habitat basis, 683 and 602 animals were recorded in forestland and wooded grassland habitats, respectively. Major threats in the study area include poaching, fire, grazing, fuelwood extraction, population growth, habitat modification, overharvesting of resources and invasive species. About 98.44% of respondents had a positive attitude towards Bayo Community Managed Forest. The interference of local community has had the impact on mammal’s species. Habitat based mammals’ management involving participation of Woreda and Zonal Government is recommended for sustainable. The local government should promote the study area and provide appropriate support for its conservation.

A Newer Approach in the Management of Cough: A Review on Levodropropizine

Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.

Spontaneous Subgaleal Hemorrhage in a Child with Autism

Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.

Stemming The Tide Of Hypertension In Women: Optimal Age For Obstetric Debut

Objective Women have continued to bear a heavy burden of cardiovascular disease morbidity and mortality with hypertension as the flagship. This is partly because as the modifiable cardiovascular disease risk factors are falling in rate, gender specific risk factors have persisted. One of them is age at first pregnancy and delivery. Methods In order to contribute to this discourse, we secondarily analysed data generated in a previous field study on risk factors for cardiovascular diseases in free living adults in Plateau State, Nigeria. The women were divided into four groups and we looked at blood pressure at the time of study from the perspective of age at first pregnancy. Reults It was found that those who had their first pregnancy in the late teenage years had the lowest mean arterial blood pressure many years down the line; better than those who started child bearing earlier and those who started later. There was also significant within and between group differences in the blood pressures (p = 0.000). Conclusion To stem the tide of female hypertension later in life, child bearing should not start in the early teenage years nor be unnecessarily delayed. Sociocultural conditions that promote early teenage marriage and pregnancy should be discouraged.

Visualization of Myocardial Damage Based on Surface Heart Model

The visual presentation of the results of the analysis of cardio graphic information is an important element of the diagnostic process. The article discusses the issues of visualization of the state of the heart, notes the importance of a visual representation of the processes of the functioning of the heart for diagnosis. The Delaunay triangulation is considered and it is proved that on its basis it is possible to approximate an arbitrarily complex surface. An algorithm for constructing a surface model of the heart based on Delaunay triangulation has been developed. The issues of texture generation are covered in detail. The texture is a convenient tool for displaying the state ofthe heart, as it allows you to visually show the place of possible damage on the surface of the heart.

Dual Energy Computed Tomography and Effect on the Management of Uric Acid Renal Calculi

Attenuation differences from 2 x-ray sources allow differentiation and characterization of stone types with similar radiation dose compared to single-energy CT scan. The difference is shown in colours, allowing preoperative prediction and management of stones. We determined the effect of DECT-KUB on urological management of patients with uric acid stones since it was first introduced in our centre. 50 patients with uric acid stones were selected from 2 year groups, each with 25 patients and their urological managements were reviewed retrospectively. We concluded that DECT-KUB is an accurate way of determining the chemical characteristics of renal calculi and can alter patients’ management. It has gained wide acceptance among clinicians in our centre and is now widely used to plan urological management of patients with renal calculi. Based on urological management comparison of patients who presented in the year 2011 with uric acid stones and patients in the year 2020, we concluded that patients with uric acid stones based on DECT-KUB findings can start dissolution therapy instead of surgical extraction or lithotripsy prior to biochemical analysis results become available. Although utility of DECT-KUB is widely accepted among clinicians in our centre it may not be available worldwide and this is the limiting factor in its universal use.

The trajectory of immunoglobulins immune response against the different amounts of xenobiotics matches the trajectory of biological changes associated with ageing: A systematic review

Background Ageing is a life process in which progressive molecular, cellular, physiological and anatomical changes manifesting in humans and animals including other organisms lead to the decline of biological functions. Immunoglobulins (Igs) are glycoprotein molecules produced by white blood cells mainly B lymphocytes following signal transduction as a result of their interaction with pathogenic microbes or poisonous substances introduced into the body systems. They elicit responses against the side effects of pathogens and poisons in which their response efficiency usually declines as we are ageing. Objective Thus, the similarities between Igs’ immune response against the different amounts of xenobiotics and the biological changes associated with ageing have been systematically assessed using the reports of different study results on humans and animals. Methods First, a literature search was carried out in google, PubMed and google scholar using planned search terms related to the title of this study. Review and original articles were retrieved, downloaded and saved on a computer. And then the effects of different factors i.e. xenobiotics, age, sex and lifestyle-based practices on the levels of serum Igs (IgG, IgA and IgM) in animals and humans have been studied using a systematic review of different literature sources. Finally, the relationship between the findings of various studies has been assessed and judgment on the possible cause of ageing has been made. Results The findings of different research have demonstrated that the signaling efficiency of immunoglobulin M (IgM) has been limited by the amount of test compounds administered to study Balb c mice in the oral route. The response efficiency of IgM immune response against the lower doses of test compounds were high compared to the higher doses of test compounds which was low. The results of different other studies also demonstrated that the decline of serum IgM levels was associated with ageing. The relationship between alcohol consumption and the concentration of serum Igs was also described in the report of different studies. These studies have shown that there was lower level of IgG in the blood serum of alcohol consumers compared to non-consumers. The study has also demonstrated a lower level of serum IgM with higher alcohol consumption and higher serum concentration with moderate beer consumption. Conclusion The trajectory of Igs’ immune response against different amounts of xenobiotics was highly associated with the trajectory of biological changes during ageing. These research findings might be the possible evidence to conclude that ageing is caused by the foodstuffs and non-foodstuffs we usually consume, the lifestyles we usually experience and the way of life we usually live in the environment which gradually defiling the natural processes of the body.

Risk Management: Emerging critical issues during the hospital administration of drug therapy

Interruptions during pharmacological therapy in a hospital ward can be a source of error. We therefore considered two Operating Units of a hospital by asking the following questions: are the nursing staff who administer drug therapy at the set times able to do so with maximum concentration and without interruptions? If yes, how? If not, why and what for? Furthermore, are there organizational and non-organizational improvement strategies so that nurses are less interrupted during therapy and therefore do not cause adverse drug events that could cause harm to the patient? The results that emerged from the data analysis make us reflect considerably on how much interruptions during therapy are to be paid attention to as a problem to which solution proposals can be found.

Barriers and Opportunities to Improve the Implementation of Patient Screening and Linkage to Pre-Exposure Prophylaxis in Primary Care

Although pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV infection, only around 25% of at-risk individuals in the United States have accessed a prescription. One way to increase PrEP uptake is through the sexual health screening of patients and linkage to PrEP in primary care settings. The objective of this analysis was to assess the barriers and implementation strategies during a screening and linkage to PrEP pilot intervention. Primary care patients were screened for PrEP indication during routine primary care visits. Of the 1,225 individuals screened, 1.8% (n=22) were eligible for PrEP and from those, 77.3% (n=17) attended the specialist appointment and were prescribed PrEP. Primary care patients (n=30) and providers (n=8) then participated in semi-structured interviews assessing their experience with the pilot intervention. Using an applied thematic analytic approach, patients and providers identified barriers and related improvement strategies that could be classified into four main categories: 1) Financial Barriers: Individual- vs. Clinic-level Considerations 2) The Role of Stigma, Discomfort, and Cultural Factors 3) Logistical Hurdles and Streamlining the Intervention, and 4) The Lack of PrEP Knowledge and the Need for Education. Findings support the accepatability and feasibility of screening for PrEP in primary care along with appropriate implementation strategies. This study suggests that because of the high volume of patients seen in primary care, sexual health screenings and linkage to PrEP interventions have the potential to reduce new incident HIV infections among diverse sexual minority men.

Improved Latrine Coverage and Associated Factors Among Rural Community in Gicumbi Gistrict, Rwanda

This study aimed at determining improved latrine coverage and associated factors among rural community in Gicumbi district. A cross-sectional study was employed using mixed methods with quantitative and qualitative data collection approaches. The quantitative approach of data collection method was conducted and then qualitative approach followed. A structured questionnaire was used to collect quantitative data and Focus Group Discussions (FGDs) was conducted to collect the qualitative data. The study population consists of household heads or their representatives and key informants from the study area of Gicumbi district. For quantitative the total sample size was 236 households while for qualitative data, a total of three FGDs with eight (8) participants was conducted among twenty four (24) rural community members of Gicumbi district. Raw data from the questionnaire were entered into EPI data and transported into SPSS version 22 for analysis. Descriptive statistics was used to tabulate and describe the data. The strengths of the associations were determined with multiple logistic regressions. The results shows that 69.1% of respondents were male, 30.1% were farmers, 16.9% had formal employment while 57.2% completed secondary education. The prevalence of improved latrine in Gicumbi District was 65.3%. Tertiary education was also 4.3 times more likely to have improved compared to those who did not have formal education (AOR=4.3CI: 95%: 1.027-7.032. P=0.005). Respondents with average monthly income Between 50,000 and 100,000 Rwfs are 2.7 times more likely to have improved latrine (AOR=2.7 CI at 95%:1.009-4.120, P=0.022).

Socio-Demographic Factors Responsible for Uptake of Intermittent Preventive Treatment and Health Seeking Behaviours for Malaria in Pregnancy among Women of Reproductive Ages in Nigeria

Introduction Malaria in pregnancy is a serious public health concern that could result in detrimental health outcomes for pregnant women and their foetuses. In Nigeria, there is still a significant risk of the disease epidemic and adverse effects especially in pregnancy. The aim of this study is to assess the socio-demographic factors associated with Intermittent Preventive Treatment and health seeking behaviours for malaria in pregnancy among women of reproductive ages in Nigeria Methods Using the National Demographic Survey (NDHS) 2018 data, a cross sectional study was conducted to assess socio-demographic factors associated with Intermittent Preventive Treatment (IPT) for Malaria among Nigerian women of reproductive ages. Result Majority were between ages 30-39 years (39.5%), married/cohabiting (91.8%), Muslims (59.5%), from the north (68.9%), uneducated ( 49.9%), poor (47.5%), and grand parous (65.7%). 63.4% of the women had taken fansidar for malaria in pregnancy while only 6.1% had received healthcare for malaria from informal sources. Except for marital status, all socio-demographic variables (regions, highest educational level, wealth index, age group, religion and parity) were significantly associated with intake of IPT. Additionally, region, education, wealth index, age group, marital status and religion were associated with health seeking behaviour for malaria in pregnancy (P<.05). After control for other variables, wealth index, highest educational level, married/cohabiting marital status and religion was significantly associated with intake of IPT while region, primary and secondary education, poorer and richest wealth index, widowed/separation influenced health seeking for malaria in pregnancy (P<.05). Conclusion The National Malaria Elimination programme should evaluate existing policies that develop interventions that are centred on high risk population in order to prevent malaria in pregnancy while improving health seeking behaviours of women of reproductive ages.

COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications

Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.

Integrated Management of Sclerotinia Sclerotiorum, An Emerging Fungal Pathogen Causing White Mold Disease

Sclerotiniasclerotiorum, the causal agent for white mold (Sclerotinia stem rot), is a devastating fungal pathogen. Currently, Sclerotinia is most commonly managed using the chemical fungicide which can lead to Sclerotinia resistance development, impacting biodiversity and interfering with key ecosystem services. In this regards, field experiments were conducted during 2017-18 planting seasons to evaluate the efficacy of different components viz. sawdust burning, stable bleaching powder, fungal and bacterial bio-control agents, chemical fungicide Rovral 50 WP and integration of different components for the management white mold disease of bush bean, mustard and garden pea in three different locations viz. in the field of Plant Pathology Division, Bangladesh Agricultural Research Institute, Joydebpur, Gazipur, Regional Agricultural Research Station (RARS), Burirhat, Rangpur and RARS, Ishurdi, Pabna, respectively. The results showed that different treatments displayed varying levels of effectiveness against the disease. All the treatments gave satisfactory reduction of white mold disease development and increased plant growth as well as yield of bush bean, mustard and garden pea. Among the treatments, integration of saw dust burning + soil amendments with Trichoderma based bio-fungicide + bacillus based bio-control agents + application fungicide Rovral 50 WP is the best treatment which reduced 97.49%, 77.72%, 72.26% white mold disease incidence and 84.61%, 81.14%, 71.01% white mold disease severity of mustard, bush bean and garden pea, respectively and increasing plant growth parameter as well as 52.16%, 27.74%, 36.97% yield of mustard, bush bean and garden pea, respectively. Application of only fungicide Rovral 50 WP also better treatment in reduction of white mold disease incidence and disease severity and increasing plant growth parameter as well as increasing yield of mustard, bush bean and garden pea. Soil amendment with fungal or bacterial bio-control agents also gave satisfactory results in reduction of white mold disease incidence and disease severity and increasing plant growth parameter as well as increasing yield of mustard, bush bean and garden pea. It could be concluded from the obtained results that integration between bio-control agents as a soil treatment and foliar application chemical fungicide might be useful as a good tool for controlling white mold disease caused by S.sclerotiorum and obtained higher yield of bush bean, mustard and garden pea under field condition.

Adopting a Wider Approach for Fisheries Management

Many marine and freshwater fisheries are now in a very poor state, and many fish stocks are close to collapse. There is a need to manage fisheries more carefully, especially since fishing can affect other aspects of the environment. It is also important to reduce the adverse effects of climate changes upon the marine and freshwater environments, fishes, and other animals, and the need to manage other human activities taking place in the sea, to improve the marine environment and protect the wildlife and the fishing activities. Marine pollution, includes human waste materials, chemicals and plastics, and there is also noise and substrate vibration, from industrial and other activities that may affect both the abundance and quality of fishes and other marine animals. This paper deals with fisheries management, and environmental protection, and concludes that fishermen, fisheries scientists, fisheries managers and environmental interests must work closely together, if fishes are to be adequately protected, and fisheries are to be better managed. It describes current systems of management. It especially draws attention to the importance of moving towards an ecosystem-based approach to fisheries management. Such an approach aims to manage all those human activities that have an impact upon the marine environment and its life forms.

Impact of Intestinal Helminth Infections on Malnutrition and Haematological Indices of School-Age Children in Gondar Town, Ethiopia

In Ethiopia stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthes and schistosomiasis on malnutrition, anaemia and haematological indices in the school age children of Azezo Elementary School in Gondar town. Kato Katz technique was performed to determine infection and intensity of intestinal helminth infections. AnthroPlus software version 1.04 was used to get malnutrition indices while fully automated haematological analyzers were used to determine haematological and biochemical parameters. A total of 384 school children were recruited in this study. The overall prevalence of helminth infection was 45.8% (178/384) with the leading Ascarislumbericoides infection (20.6%) compared to the second leading Schistosomamansoni (17.4%) and third leading hook worm infections (13.3%). The prevalences of body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) very sever thin, 17.2% (66) sever thin, 38.3% (147) thin, 34.4% (132) normal and 0.5% (2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2% (47) stunt, 87% (334) normal and 0.8% (3) over height. Of the total 384 school age children, 335 (87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259 (67.4%) while the remaining 125 (32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1% (127). Intestinal helminth infections were statistically significantly associated (p = 0.000) with hypo-proteinaemia, anemia and number of lymphocytes compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected, was 148 times higher for both Ascaris lumbericoides-Schistosoma mansoni co-infection, 38 times for Hookworm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infections. Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children.

Two-Phase Lung Damage Mechanisms For COVID-19 Disease, and Driving Force and Selectivity in Leukecyte Recruitment and Migration

To understand lung damages caused by COVID-19, we deduced two phases lung damage mechanisms. After the lungs are infected with COVID-19, the affected lung tissue swells and surface properties of pulmonary capillaries change, both contributing to an increased flow resistance of the capillaries. The initial damages are mainly fluid leakage in a limited number of involved alveoli. The increased vascular resistance results in retaining more white blood cells (“WBCs”) in pulmonary capillaries. Some of the WBCs may get into interstitial spaces. When more and more WBCs are dynamically retained, the vascular resistance of pulmonary capillaries further rises; and thus the overall vascular resistance of the lungs rises and pulmonary pressure rises. The rise in the pulmonary pressure in turn results in elevated capillary pressures. When pulmonary capillary pressures around the alveoli are sufficiently high, the elevated pressure causes interstitial pressures to change from normally negative values to positive values. The positive pressures cause fluid leakage to the alvoeli and thus degrade lung function. Tissue swelling, and occupation of WBCs in interstitial spaces and occupation of alvoelar spaces by leaked water result in reduced deformable and compressible spaces, and thus causes a further rise of the vascular resistance of the lungs. When the pulmonary pressure has reached a critical point as in the second phase, the blood breaks capillary walls and squeezes through interstitial spaces to reach alveolar spaces, resulting in irreversible lung damages. Among potential influencing factors, the available space in the thorax cage, temperature, and humid are expected to have great impacts. The free space in the thorax cage, lung usable capacity, and other organ usable capacities are the major factors that determine the arrival time of last- phase irreversible damage. The mechanisms imply that the top priority for protecting lungs is maintaining pulmonary micro-circulation and preserving organ functions in the entire disease course while controlling viral reproduction should be stressed in the earliest time possible. The mechanisms also explain how leukecytes are “recruited and migrated” into inflamed tissues by dynamic retention.

Expression of Concern: Potential Risks and Unknown Effects of mRNA Vaccines on Population Health (6th Rev). Damages Are Being Materialized

Several mRNA vaccines are used on the population in the U.S. I started predicting the dangers of mRNA vaccines before March 2021 and update my findings periodically. My prior model study enabled me to identify many flaws in clinical trials, side-effect evaluation methods and mechanism studies, and I also considered consistent failure in predicting drug side effects in the past and systematic failure of FDA in keeping out dangerous drugs from market. I found that the risks of vaccination cannot be determined by experiments alone and must be determined by using a combination of methods. By studying mRNA expression dynamics and kinetics, I predict that vaccination with mRNA vaccines may increase cancer risks, multiple organ failure risks, earlier death risks, genome alteration speeds by one or more mechanisms, alter the normal selection process for viral evolution resulting in more virulent viruses, and aggravate chronic diseases or cause healed diseases to relapse. Two root problems are practical inability to control expression sites and severe adverse reactions from repeated vaccination. Based on mRNA bio-distribution, the mRNA mainly strikes the liver and other vital organs, and poses grave dangers to persons whose vascular functional reserves are relatively small, or whose vascular systems are temporarily burdened by other causes such as viral infections or life activities. If an mRNA vaccine is administered on a pregnant woman by second or booster shots, spike protein synthesis in fetus brain disrupts the highly regulated protein synthesis processes, resulting in potential brain damages. In less than a year, most of my early predicted damages are being materialized or are on the track to hit the population. In this update, I present a benefits-and-risks map to show how the number of deaths caused by mRNA vaccines is grossly underestimated and why claimed benefits like 95% effectiveness rate and 90% death rate reduction are meaningless and misleading.

RETRACTED: Development of Biorational Management Package of Root Knot Nematode Disease of Country Bean

This article has been retracted on 10 November 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2639-3166.jar-25-5841) A field experiment was conducted with a view to test the efficacy of Tricho-composts and integration of Tricho-composts, poultry refuse (PR), neem oilcake (NOC), saw dust burning (SDB) with chemical nematicide Furadan 5G (Carbofuran) for controlling root knot nematode of country bean through which growers will be benefited. The root-knot nematode infested soils were treated with Tricho-compost-1 @ 2 kg/pit, Tricho-compost-2 @ 2 kg/pit, Tricho-compost-1 @ 2 kg/pit + Furadan 5 G @ 20 g/pit, Tricho-compost-2 @ 2 kg/pit + Furadan 5 G @ 20 g/pit, poultry refuse @ 5-6 kg/pit + Furadan 5 G @20 g/pit , neem oil cake @ 500 g/pit + Furadan 5 G @ 20 g/pit and saw dust burning + Furadan 5 G @ 20 g/pit. It was revealed that all the treatments performed well in reducing root-knot nematode infestation and increasing plant growth and yield country bean compared to farmers’ practices. Among the treatments, integration of poultry refuse with Furadan 5G or Trichoderma based bio-fungicides Tricho-composts with Furadan 5G or neem oil cake with Furadan 5G are the best treatments in reducing root-knot nematode infestation and increasing plant growth as well as yield of country bean. Soil treatment with only Tricho-composts or integration of saw dust burning with Furadan 5G also performed better in reduction of root knot nematode disease and increasing plant growth as well as yield of country bean.

Retraction Note: Development of Biorational Management Package of Root Knot Nematode Disease of Country Bean

Use of Tactile Contact Accompanying Health Promotion Messages During Routine Health & Physical Examinations: A Technique for Improving Compliance

A daunting challenge for health providers and medical practitioners is communicating the vital importance of health promotion and medical treatment adherence and compliance. This article is an evidence-based, best-practices commentary advocating the use of touch-accompanied verbal suggestions during the touching portions of routine, near-universal Health & Physical examinations. Notional case examples are presented; based on the professional literature, underlying Behavioral Mechanics are discussed. Touch-accompanied verbal health promotion messages skillfully deployed in routine Health & Physical examinations offer a non-harmful and efficient technique to synergistically and substantially enhance the probability of patient compliance with health improvement and medical treatment regimens. Though it is not a magic panacea, the public health applications, extensions and benefits are incalculable in terms of healthy behavior adoption. Additionally, if deftly conducted in accordance with best practices, it has the potential to greatly improve practitioner-patient relations and increase patient satisfaction. Further avenues of research inquiry are considered.

Challenger and Propose Novel Methods and Techniques for Prevention, Prognosis, Diagnosis, Imaging, Screening, Treatment and Management of Lung Cancer

Using samples of small cell lung tumors, a research team led by biologist Dr. Raymond discovered two new ways to induce tumor cell death. By activating ferroptosis, one of two subtypes of tumor cells can be targeted: first, iron-dependent cell death due to oxidative stress, and second, oxidative stress. Therefore, cell death can also be induced in a different way. Both types of cell death must be caused by drugs at the same time to eliminate the majority of the tumor mass. It is currently in clinical trials for cancer treatment. Auranofin, which inhibits the production of protective antioxidants in cancer cells, has been used to treat rheumatoid arthritis for decades. Future clinical trials using this combination therapy will determine the extent to which this targeted treatment option improves the prognosis of small cell lung cancer patients. It is currently in clinical trials for cancer treatment. Lung cancer is the leading cause of cancer death in the United States. Despite evidence of molecular abnormalities in biological specimens, progress in this disease is hampered by the lack of diagnostic markers useful for clinical practice. The majority of patients with lung cancer are still diagnosed at an advanced stage, when prognosis is poor. This article reviews new strategies being studied for the early detection of lung cancer. These strategies involve new methods of imaging (including low-dose computed tomography CT scanning), DNA analysis, and proteomic-based techniques. These strategies have not only improved our understanding of lung cancer but show promise in offering better survival to patients with this deadly disease. Of paramount importance in the search for methods of early detection is the need for the identification of the ideal population to screen, a multidisciplinary approach, and validation of promising techniques.

Stem Cell Differentiation Stage Factors (SCDSFs) Taken from Zebrafish Embryo during Organogenesis and their Role as Epigenetics Regulators able to Reverse Neurosensory Hearing Loss

This translational paper discusses differentiation‑stage factors from zebrafish embryos as epigenetic regulators with potential to reverse neurosensory hearing loss. It outlines experimental evidence, delivery concepts, and research gaps.

Cytokine Expression in Peripheral Blood Mononuclear Cell Cultures Obtained from Cattle with Different Stages of Natural Mycobacterium bovis Infection

In bovine tuberculosis (bTB), cellular, humoral, or both types of immune responses have been observed. The purpose of this study was to examine the immune status of tuberculous cows based on the differential cytokine gene expression associated with Th1 (IFN-γ, IL-2), or Th2 (IL-4, IL-10) responses. Twenty-three (23) cows belonging to a dairy herd located in a rural region of the State of Hidalgo, México, were selected for the study. Single Intradermal Comparative Cervical Tuberculin (SICCT) Test, Interferon-Gamma (IFN-γ) Release Assay (BOVIGAM), and Enzyme-Linked Immunosorbent Assay (ELISA) were used for detection of cattle infected by M. bovis. Thirteen cows were positive to all the tests (Group 1); ten cows were positive only to ELISA (Group 2), and the remaining Group (Group 3, control) included cows negative to all the tests. Peripheral blood mononuclear cells (PBMC) from animals were in vitro stimulated by bovin purified protein derivative (PPD), avian PPD, and Concanavalin A (Con A) mitogen for 72h. Changes in the levels of expression of mRNA of the respective cytokines was measured by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) using β-actin gene as internal control. In group 1, PPD bovis and Con A-stimulated cells exhibited high production of IFN-γ, IL-2 and IL-4, but not IL-10. In contrast, PPD avium-stimulated cells displayed a low production of cytokine transcripts. In group 2, cells showed a significant production of IL-10 in response to bovine PPD (P< 0.001). In the control group, a high production of IFN-γ and IL-2 was observed only in Con A-stimulated cells. Post-mortem examinations in animals of group 1 showed slight and medium lesions in lymph nodes, whereas in group 2, the lesions were more extensive. Results indicate differences on gene expression levels of cytokines considered to determine balance in Th1/Th2 response among the evaluated groups. In addition, high levels of antibodies against M. bovis and high IL-10 expression in PBMC together are indicators of progressive bTB when both tuberculin test and IFN-γ assay are negative in tuberculous anergic cattle. Inclusion of serology and IL-10 cytokine expression in in the diagnosis checklist improves detection of infected cattle to help control bovine tuberculosis.

A Review of Attempts to Improve Cow Fertility Through Reproductive Management: Estrous Synchronisation

This review focused on the various methods for controlling estrous cycles in well-managed dairy cows. Because up to 70% of dairy cows may stay non-pregnant after an AI procedure, an effective approach for identifying and reinseminating open cows is essential for dairy herds to achieve optimal reproductive performance. Overall, well-managed dairy farms with effective estrus detection programs inseminate 50% or more of non-pregnant cows after behavioral estrus is detected. Cows not detected in estrus are admitted in a resynchronization of ovulation procedure to receive a timed AI (TAI) service to avoid a long interbreeding interval. In Egypt, a widely used program involves starting the Ovsynch protocol (GnRH-7 d-PGF2-56 h-GnRH-16 to 20 h-TAI) 32 days after an initial AI, regardless of pregnancy status. Previous studies have proven that there was no difference in pregnancy/artificial insemination (P/AI) between Ovsynch+P4 and Presynch-Ovsynch, both protocols were equally effective in improving the fertility of cows with a CL 15 mm. The review also addressed different methods for synchronization of ovulation and different factors affecting the selection of the management program.

Effect of Hours of Use and Age in Years in Estimating Repair and Maintenance Costs for Two Sizes of Agricultural Tractors in Northern Sudan

Repair and maintenance cost is considered as one of important items for machinery management and selection. The present study was carried out in Dongola area for tractor repair and maintenance costs estimation. The data was collected from records of Elshimalya Company for Agricultural Inputs. Forty four tractors rep resenting two sizes of tractors, 75hp and 150hp used in the area were selected for this study. Based on the data collected, regression correlation analysis was carried out and mathematical models were derived to predict the accumulated repair and maintenance (R and M) costs as percent of purchase price in relation to accumulated hours of use and age (years) for each tractor size, and also for the two sizes collectively. Five model forms (linear, logarithmic, polynomial, power and exponential) were derived and the power function was found the best fit to explain the relation. The accumulated Rand M costs as percent of purchase price (Y) was increased as the accumulated hours of use (x) and age (g) of the tractor in years were increased. A high correlation was found between the accumulated R and M cost and both accumulated hours of use and tractor age in years (Average R2 = 0.93). It was concluded that the power function was the best fit for repair and maintenance cost estimations and the following relations may be used as an average for estimation of the accumulated R and M costs as percent of purchase price (Y) with accumulated hours of use (x) and age (g) of the tractor: Y=0.028x0.662 (mean) Y=12.294g1.276 (mean).

Proportion of WaterBorne Diseases in Children Aged 0 To 5 Years in the Health Area of the Urban Dispensary in Ebolowa - Cameroon

Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.

COVID-19 Pandemic: The Causative Agent is New, The Problem is Old

A perspective situates SARS-CoV-2 within longstanding public health challenges, emphasizing preparedness, surveillance, and the recurrent lessons of outbreak management with examples for practice.

The Dynamic Changes of White Blood Cell Count and Lymphocyte Count and Compare their Levels in the Early Stage of Covid-19

COVID-19 is a new infectious disease, which needs to explore the clinical value of white blood cell count and lymphocyte to provide help for diagnosis and treatment.COVID-19 cases were Selected that admitted to 2 hospitals in Guizhou, China. WBC and LYM in the 1st day, in the 4th day and in the 7th day after onset were collected. There were not any differences in The WBC and LYM in the 4th day and the 7th day between the two groups.WBC and LYM in the 1st day in the moderate group were lesser than in the mild group. WBC and LYM were no dynamic changes in the mild group. In moderate group, WBC and LYM in the 1st day were lesser than in the 4th day. The levels in the 4th day and the 7th day were no differences. The conclusion was In the early stage of COVID-19, the WBC and LYM in moderate patients were significantly decreased within 4 days after onset, and could be restored to normal level after 4-7 days. However, no dynamic changes were observed in mild patients within 7 days.  

Prevalence and Factors Associated with Under Nutrition among Children Aged 6 to 59 Months in Ngoma District, Rwanda

In Rwanda, 38% children aged 6-59 months are stunted. In Ngoma District, stunting rate is estimated at 41% among the children aged below 5 years. The study objective was to evaluate the prevalence and factors contributing to under nutrition among children aged 6- 59 months in Ngoma District. Cluster sampling was used to determine the study participants for each sector within 14 sectors by considering the sample size of 442. The WHO Anthro software version 3.2.2 was used to determine the nutritional status of the children. SPSS version 24 was used for analysis. Of 442 children participated in the study 50.9% of them were females, 24.4% were aged 15-23 months and the majority of children (89.8%) born with normal birth weight. Study findings revealed that the prevalence of under nutrition was 33.7% for stunting, 3.6% for wasting and 6.6% underweighted. Poor sanitation facility (AOR: 4.1, 95%CI: 1.83-9.3, p=0.001), poor diet (AOR: 1.9, 95%CI: 1.18-3, p=0.008) were significantly associated with stunting. Factors such as lack of hand-washing facilities (AOR: 2.5, 95% CI: 1.013-6.3, p=0.047), not eat vegetables (AOR: 4.4, 95%CI: 1.7-10.96, p=0.001), and not eat fishes (AOR: 4.1, 95%CI: 1.6-10.6, p=0.003) were associated with wasting. Short breastfeeding duration (AOR: 4.5, 95%CI: 2.9-7.2, p=0.001), not eat vegetables (AOR: 1.9; 95%CI: 1.1-3.05, p=0.008), and not eat eggs (AOR: 2, 95%CI: 1.3-2.9, p=0.001) were associated with underweight. Poor families with under-five children need continuous support that will assist them to improve nutritional status of their children.

“Happy Village” Concept Helping Villages to Face COVID-19

“Health Promoting Village” concept named as “Happy Villages” started in 2007 in Badulla District in Uva Province was a community mobilization process through which village communities have been empowered to look after their community health. The areas included were Early Childhood Care and Development (ECCD), Non-Communicable Diseases (NCD) prevention , Alcohol and drug abuse. Gender Based Violence. The programmed used many interactive tools as “Mood Chart” or “Happiness Calendar” which was giving a visualizing effect. Continuous assessments done from 2009 to 2013 showed that the Health promotion strategies used in the Happy Village concept in the Uva Province can effectively and efficiently be utilized for improvement of nutrition and achievement of milestones in children. From 2017 a National program is launched named “Happy Villages”. During the Covid 19 outbreak health promotion approaches were initiated to change in lay communities successfully. Villagers had actively engaged, collectively acted in responsible manner, and identified measures to prevent COVID-19 transmission in their households, neighbourhood and community. The use of village empowerment had become a fruitful source to face the Covid pandemic in Sri Lanka. Almost 300 “Happy Villages” around the country have made facing the Covid epidemic their chief task. Many innovative ideas and practices in facing Covid 19 pandemic at village level including a visualizing calendar to identify the risk behaviours of the family members as well as the Happiness calendar to identify the family stress levels are among them. Health promotion concept is getting rooted around the country with active participation of the villages with a multisectoral support. Continuous monitoring and evaluation and sharing best practices will show the world the effectiveness of Health Promotion and the ability of empowered people in facing pandemic situations

Factors and Conditions that Influence Teenage Pregnancy among In-school Adolescents in Umuahia North Local Government Area (L.G.A) of Abia State, Nigeria

Introduction Adolescence is a critical stage in human development that is characterized by peer pressure, confusion, exuberance and experimentation, particularly with sexual relationships. This is why attention should be paid to adolescents’ reproductive health issues so as to reduce their exposure to aggressive sexual activities which could expose them to sexually transmitted diseases, unwanted pregnancies and others. This study aimed at reducing the factors and conditions that influence teenage pregnancy among in-school adolescents in Umuahia North LGA of Abia State. Materials and Methods The study used a cross sectional descriptive study. A randomly selected sample of 416 adolescents between the ages of 13-19 years were studied. Structured self-administered questionnaire was used for data collection. Descriptive statistics, using frequencies, percentages and means were utilized for data analysis. Results The study found that 198 (47.6%) of the respondents were sexually active and that 89 (45%) of them had been pregnant. More than half 103 (52%) of the study group indicated that peer pressure influenced their sexual activities. About 46(51.7%) of the adolescents said they were pregnant so as to keep the new born baby with motherless babies homes. Conclusion Therefore, there is need for increased sex education for in-school adolescents so as to highlight the effects of teenage pregnancy on adolescents.

The Sweet and Sour of the Sugar-Sweetened Beverage Tax

Obesity is a common and preventable Non-Communicable Disease that is of great importance. Population-based interventions are recognised to have a profound effect on improving health outcomes. One of these approaches includes the adoption of the Sugar-Sweetened Beverage (SSB) Tax. Objectives There were three objectives, 1) explore the associations between gender, age, nationality, and change in SSB consumption, 2) explore SSB consumption during Covid-19 lockdown, and 3) inform policy decision making. Methods A cross-sectional survey in the United Arab Emirates. We performed descriptive analysis and chi-square for independence to test the difference between the expected and the observed frequencies in one or more categories. Results Since the introduction of SSB tax, change in SSB consumption by gender, age or nationality was not statistically significant. Further analysis of the proportion of sugar intake per day was statistically significant (P-value <0.001) by nationality. There was no statistically significant change in SSB consumption by age, gender, or nationality during the Covid-19 lockdown. Further analysis within the group that reported change in SSB consumption suggests a majority (80.5%) reported a reduction in SSB consumption. Conclusions Change in SSB consumption by gender, age or nationality was not statistically significant since the introduction of SSB tax, or during Covid-19 lock-down; thus, we accept the Null Hypothesis. Imposing a levy on frequently consumed SSB or revisiting levy by the gram, volume, or type of added sugar (or in combination) may prove to be more effective in reducing SSB consumption. Further research is needed to determine the extent other demographic factors influence SSB consumption as well as the enablers and barriers associated with SSB consumption. 

Connecting the use of Biofertilizers on Maize silage or Meadows with Progress in Milk Quality and Economy

A systematic use of biofertilizers can improve both the quality of a farming system and the parameters of milk. Some issues related to biofertilization experiments on six farms in the Po Valley (NW Italy) involved in the production of milk from dairy cattle fed maize silage or grazed on hay produced from permanent meadows are reported in this paper. Biofertilized maize was found to lower the live stem pH by about 2.3%, and NIR spectroscopy foreshadowing major changes in the composition. Overall, the plant silage was improved in quantity (+10%) but also in quality, as shown by the delayed maturity stage of the leaves (crop maturity index -4%), the lower indigestible NDF content (-7%), and the higher digestible carbohydrates and protein in the whole plants. Such favorable feeding conditions, together with the improved palatability of the feed ration, boosted the nutrient values of the protein (+4.6%) and fat contents (+5.7%) in the milk. Moreover, the functional properties of the milk were ameliorated, as testified by the higher levels of vitamin A (+27%) and vitamin E (+25%) and the reduced levels of saturated fatty acids (-6%), especially myristic (-18%) and stearic (-32%) acids, while the unsaturated acids increased by 15%. As far as economy aspects are concerned, the biofertilization of maize for silage has led to consistent rewards pertaining to the marginal price of the milk, which in turn has led to a value chain increase of about 9%, because of the fields cultivation, but mainly of the cow transformation in milk quality issues. On another farm, intensive maize was substituted with permanent biofertilized meadows, over a greening path, and a + 17% value chain increase was obtained that already derived mainly from the best price for milk quality parameters. Such an evolutionary leap toward a new vision of sustainable agriculture for the environment and for animals, in which a better quality of products, animal welfare and company budget are combined with soil biofertilization, can be considered a bonanza.

The factors for Limited use of Gastric Emptying Scintigraphy in the Management of Diabetic Gastroparesis

A practice review discusses factors limiting the use of gastric emptying scintigraphy in diabetic gastroparesis, including protocols, access, and patient preparation, with suggestions to improve utility.

How Africa Should Engage Ubuntu Ethics and Artificial Intelligence

Automation of human tasks has taken place for a long time now. Humans have in earlier periods dreamed of a world where machines capable of mimicking decision making would be created with some works of fiction describing in caricature, how machines would take over the human space in the world. Artificial intelligence has come to fruition in the last few decades following the development of fast computing capability and vast chip memory. Discussions of how the human space will look and feel when artificial intelligence have taken place at various levels of global organization geared towards ensuring that the new “thinking machines” do not rock human society in ways to render them obsolete. This article looks at the ethics of AI considering the issues that have been outlined by others in the light of communitarian ethics as seen in Africa. It describes the possible impact of thinking machines on society and how individuals would relate with each other and with AI systems.

Restriction of Antimicrobial Usage in a Tertiary Care Neonatal Unit in South India: A Before After Trial

Background Overuse and abuse of antibiotics resulted in emergence of multidrug-resistant organisms (MDRO), increased rates of invasive candidiasis, prolonged hospital stay, NEC (Necrotizing enterocolitis), LOS (Late onset sepsis) or death. Restriction of the prescription, switching to a narrower spectrum and stopping antibiotics when not needed are some of the major approaches to antibiotic stewardship. Methods We identified restricted antimicrobials and devised an antimicrobial justification form. Clinicians needed to fill the form before prescribing restricted antimicrobials thereby comparing the antimicrobial usage pattern before and after the introduction of form. Babies enrolled before the introduction of the justification form were labelled as Group 1, and as Group 2 after justification form. The HIC (hospital infection control) staff nurse paid daily visits to NICU to monitor number of babies started on restricted antibiotics and whether the forms were duly filled or not. Any lag would be intimated to the Head HIC team for rectification. Any change of antibiotic within the restricted group also warranted justification. Culture report notified within 48 – 72 hrs so as to facilitate the stoppage of antibiotics in case of negative culture. Results There was a statistically significant reduction in the usage of restricted antimicrobials in the Group B as compared to Group A 150 (40.54%) vs 190 (49.35%) (p = 0.01). There was a statistically significant increase in the % of babies de-escalated from high end antimicrobials in Group B as compared to Group A 90 (60%) vs 56 (29.47%) (p = <0.0001). Duration of restricted antimicrobials reduced from 13.78 ± 2.7 days in Group A to 9.9 ±1.8 days in Group B (p = <0.0001). No difference in the number of babies started on any antibiotic between both the groups (p = 0.1). Conclusion Introduction of the antibiotic justification form as a part of antimicrobial stewardship program resulted in an overall reduced usage of restricted antimicrobials along with rapid de-escalation.

A Case Report on Challenging Management of Multiple Neoplasms in Elderly

Multiple primary malignancies especially in the head and neck region is no longer a rare occurrence and the prevalence is increasing. They were described as synchronous when the malignancies present within 6 months of another or metachronous tumors if the subsequent malignancy presents 6 months later. Many etiologies had been hypothesised including similar carcinogens exposure, genetic susceptibility and mutation, immunodeficiency or treatment of the index tumor. Among the hypotheses, the most accepted theory was field cancerisation in which the occurrence of multiple primaries in the aerodigestive tract was due to persistent exposure of similar carcinogens through inhalation or oral intake . However the co-incidence of thyroid and aerodigestive malignancies is relatively low. Hereby we would like to report a case of a 74 years old lady with known esophageal squamous cell carcinoma presented with metachronous laryngeal squamous cell carcinoma and papillary micro carcinoma of thyroid.

Awareness of Cervical Cancer Screening test Among Women of Child Bearing age in the Rural Area of Awo-Omamma, Imo State, Nigeria.

Introduction This study assessed the awareness of cervical cancer screening test among women in the rural area of Imo State. Cervical cancer is the fourth most common cancer and the cause of death in women. The need to ascertain the level of awareness of cervical cancer screening test and the level of uptake among rural women motivated this study. Materials and Methods The study design was cross sectional descriptive survey. The sample for the study, which was statistically determined by Taro Yamane formula was 420. Administered structured questionnaire was used for data collection. Data were analyzed using frequency distribution tables. Results The result showed that 270(64.3%) of the respondents were aware of cervical cancer screening test and only 135(32.1%) used cervical cancer screening test . Majority of the respondents, 400(95.2%) have never taken vaccination for human papilloma virus . The main place where 234(55.7%) of the respondents learnt about cervical cancer screening was the hospital. A good number of the respondents 225(53.6%), had low uptake services because of the views that cervical cancer screening is mainly for the elderly women, and also 140(33.3%) felt that the investigation process is painful. Conclusion Therefore, adequate and substantial measures should be taken to health educate women on benefits of cervical cancer screening tests.

Risk Management and Organizational Resilience: Analysis of the Italian Scenario During Covid-19 Pandemic, with A Look at the Challenges of Technology and Sustainability

The Coronavirus emergency represents an epochal challenge for all world health organizations. In these times of profound destabilization of healthcare organizations, become urgent some thoughts on how to deal with the organization and re-engineering process as well as on concepts, relatively new, such as "resilience" and "business continuity". The company management need having to predict, design and plan a profound process of change in their Clinical and Corporate Governance. With the implementation of phases 2 and 3 of management of the pandemic and the coexistence of doctors and citizens with the new Coronavirus, it has become a priority to develop territorial models of assistance to established or suspected Covid patients, starting with the creation of monitoring networks based on the model of the “sentinel” general practitioner. One of the main concerns of Healthcare, since the beginning of the Covid-19 emergency has been to get closer to the citizen-patient. It is therefore necessary to find stimuli to restart with new methods of care, new health and social-health services, moving the current care paradigm for Covid-19 from the hospital to the territory, optimizing the constituent elements of the districts, primary care and general practice in a multidisciplinary approach.

Childhood Overweight, Social Media, and Osteoarthritis: Is there a Possible Emergent, yet Unrecognized Linkage?

Background Osteoarthritis, a serious and increasingly prevalent disabling global health condition found largely among older adults, has been linked to the presence of excess body weight. But what contributes to this growing health epidemic of excess weight, which is increasingly observed in children? Moreover, can a case be made for predicting a possible negative linkage between the pervasive use of social media from the earliest point in time and possible subsequent childhood overweight or obesity and late life osteoarthritis that may be amenable to intervention? Methods To examine the most probable answers to these questions, the EBSCO, Scopus and PUBMED data bases were sourced for relevant data. The extracted data were carefully reviewed, categorized and documented in narrative format. Results While one cannot readily carry out research to answer the above questions, prevailing data imply that there is more risk of being overweight in childhood, as well as acquiring possible later life disabling osteoarthritis, or a more serious manifestation of this disease, through the prolonged, unfettered and frequent use of social media in early and middle childhood. Conclusion Those in the realm of developing preventive strategies against childhood overweight or obesity as well as osteoarthritis are strongly encouraged to examine the role of the media environment and messages children are exposed early on in this regard. Alternately, children who already have disabilities, joint pain due to arthritis or other health conditions, and who may have to rely more on social media than others who are active- may suffer more readily from an energy imbalance and become overweight if due precautions against this are not taken.

Assessment of Self Medication Practice and Drugs Storage Among South Sudanese Community in Addis Ababa, Ethiopia

Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.

Sustainable Municipal Solid Waste Management - A case study of Kanpur, India

Municipal solid waste generation and disposal is a problem not only in India but all over the world. Presently majority of such waste is being dumped indiscriminately over vacant lands causing problems of odor, methane generation leading to air pollution, leaching effect polluting ground water and runoff polluting water bodies. Technological options are available to treat this solid waste and convert it into usable products but the biggest problem is its segregation preferably at the source of generation or even at the disposal area. Municipal solid waste generated in India consists of 15 percent non biodegradable which has high calorific contents and can be converted into power generation. Remaining 85 percent is degradable which can either be converted into compost or bio fuels. Under the present context, sustainable municipal waste management strategy needs to be evolved and put in place with effective implementation to address the issue of environmental pollution. An attempt has therefore been made by the authors of the present paper to take up a case study of Kanpur, India for managing such wastes having sustainable approach. The authors have worked out trends of population starting from the year 1951 and projected to 2051. Similarly waste generation trends established on the lines of population. An effort has also been made as to how much compost, bio fuel and power can be generated along with economic value to make it sustainable on a time scale.

NNC55-0396 Reduces SH-SY5Y Cell Damage Induced by Bupivacaine Hydrochloride

Background Local anesthetic neurotoxicity is a common complication in clinical anesthesia, which can cause permanent nerve damage in severe cases. The T-type calcium channel is an important channel for regulating the excitability of neurons. Normally, extracellular calcium ions enter the cell through the T-type calcium channel to change the excitability of neurons. When the intracellular calcium is overloaded, it can cause cell damage. Aims To investigated the roles of T-type calcium channel in the SH-SY5Y cells injury induced by the bupivacaine. Methods The SH-SY5Y cell culture model was used to observe the effect of T-type calcium channel blocker NNC55-0396 on the neurotoxicity of bupivacaine hydrochloride by MTT methold,flow cytometry, Western blotting and other methods. Results The results show that NNC55-0396 can block the T-type calcium channel of SH-SY5Y cells, improve the decrease of cell viability caused by bupivacaine hydrochloride, reduce the level of intracellular calcium ion, reduce the expression of Cleavedcaspase-3, and reduce cell apoptosis. Conclusion The above results indicate that the T-type calcium channel is involved in the SH-SY5Y cell damage caused by bupivacaine hydrochloride, and blocking the T-type calcium channel can reduce the neurotoxicity of bupivacaine hydrochloride.

Awareness about the Importance of Nutrition During Pregnancy Among Women in Child Bearing Age: A Quantitative Study Among Urban Women.

Introduction An adequate nutrition pattern is of major importance for one’s health and well-being, especially during pregnancy when a woman undergoes major biological, physical, psychological and social transformations. Macronutrient and micronutrient deficiencies predispose the fetus to preterm birth, neural tube defects, and low birth weight for gestational age. This study was conducted to determine the nutrition awareness of women in childbearing age in order to provide a greater understanding of the life course perspective (LCP) in relation to nutrition behaviors and pregnancy. Methods A cross-sectional study was conducted on based on our conceptualization of nutrition awareness and questionnaire based studies of a face-to-face interview. The participants were women with age group of 17 years to 45 years participate in studies in Jeddah city. Data collection procedures A Semi-structured questionnaires prepared in English language were translated in to Arabic and then translated back to English to check for consistency. The questionnaires were pretested Human ethical committee; the questions assessed respondents’ nutrition knowledge. Results and Discussion Different questions were asked to 175 selected pregnant women to be included in this study assess knowledge of pregnant mothers on nutrition and determinant factors in the study area. Most of the respondents (34.85.2%) were in 19-25 years of age group.69.1 % (n=121) women says they pay attention to the number of soft drinks they drink each day. There would be fascinating to study awareness of specific nutrients and related issues, like consumption folic acid, non-vegetarian diet, minerals and life style such as mental stress and physical exercise.

The Nutrition Route following Esophagectomy

Esophagectony remains a high-risk surgical procedure. Esophageal cancer is often associated with a weight loss. The best nutritional condition is crucial for successful oesophageal surgery. The increased septic complications and costs have limited the wide use of total parenteral nutrition. Currently, enteral nutrition is the preferred nutrition method following esophagectomy. However; jejunostomy-tube was associated with rare major complications that may lead to discontinuing nutrition. Choosing an enteral feeding route after esophagectomy depends greatly on the surgeon preference. The safety and benefits of early oral feeding on outcomes after major gastrointestinal surgery have been well documented. However, the surgical community is still reticent about initiating early oral feeding after esophageal surgery. Despite the limited number of published reports, comparative trials have clearly shown the feasibility, safety with no increase in morbidity rate.In this brief review, we tried to discuss the different routes of nutritional support after oesophagectomy with providing the current insights on early oral feeding.

Daily Grape Juice Consumption Promotes Weight Loss, Improved Stability and Reduced the DNA Damage in the Elderly

The aim of this study was to determine the influence of chronic supplementation with grape juice (400ml), in modulating the anthropometric and biochemical parameters. Thirty-nine seniors participated and were evaluated at baseline after 30 days. The chronic consumption of grape juice reduced weight, BMI and waist circumference. Indeed, the consumption modulated biochemical parameters, decreased the total cholesterol levels, Low-density lipoprotein (LDL) cholesterol, Urea and GGT. In addition, the intake of juice improved the performance in the TUG test, and caused more stability in the elderly. The levels of protein oxidation declined and the antioxidant potential significantly increased as well as SOD and the ratio SOD / CAT. In contrast, levels reduced sulfhydryl groups to consumption. In nuclear changes there are  a decrease in the frequency of MN and picnosis. In conclusion, grape juice could be an excellent option to improve quality of life in elderly.

Management of Plastıc Bronchıtıs in Chıldren: A Case Report and Lıterature Revıew

Plastic bronchitis (PB) is a rare disease characterized by the presence of mucofibrinous plugs which may occlude and conform the shape of tracheobronchial tree. These casts are exteremely cohesive. Most common presenting symptoms include cough, fever and dyspnea and if the cohesive casts occlude the airway totally life-threatening complications and even death may occur. The aim of treatment is to remove the casts and adress the symptoms. In this study a 6-year-old boy with PB is presented. In addition to medical treatment obstructing casts were removed via rigid bronchoscope. It is aimed to review the clinical and radiographic features and choices of treatment in this disease.

Management of Fruit Flies Using Environmentally Safer Pesticide (Spinosad) in Shendi, Sudan

The fruit flies of familyTephritidae are considered as serious pests of Mango in Sudan. They cause substantial damage to Mango in all Mango production areas. The application of various pesticides appeared to be ineffective. Therefore, this study was carried out to investigate the efficacy of Spinosad as new promising control measure to the fruit flies. This study was carried out at Shendi area, River Nile State during the period from April 2012 to August 2014, where Pheromone and food bait traps were used for detection and monitoring the fruit flies species in the study area. Spinosad (0.24g\L) was applied as a partial spraying pesticide. Results indicated that; the application of Spinosad highly decreased the fruit flies numbers. The average number of fruit flies collected in April was (947.22 and 1001.67) for the treated and untreated orchards respectively. The numbers of fruit flies in the treated orchards had decreased gradually during May, June, July and August, 904.7, 760.22, 609.6 and 452.7, respectively, but in untreated orchards for the same months had increased to 1003.67, 1103.67, 1336.67and 1468.67 respectively. However, the infestation level in mango fruits in the treated orchards was found to be 2% compared with 64% for untreated one.

Patient Safety and Clinical Risk Management for General Practice

General practitioners are the first contact between the person, the family and the community with the health system. The philosopher and epistemologist K. Popper (1902-1994) recommended the need to register errors, in order to know them, catalog them and therefore prevent them. J.Reason in 1963 introduced the systemic approach to the study of errors with the theory of latent errors. The knowledge of the causal factors, or which in any case contribute, of possible errors, as well as of the latent gaps in the system, is a fundamental prerequisite for the construction of paths aimed at improving the quality of assistance, structures and organizational aspects.

Firefighters are Heroes of Modern Age

Fire is an uncontrolled combustion that causes material damage and endangers human lives. Combustion is a chemical process that causes the oxidation of the fuel constituents of a some kind fuel. It is a process between fuel and oxidants in which heat is generated due to changes in chemical constituents. By releasing heat, it may occur light in the form of annealing or flame. There are accidental and arson fires. This work is dedicated to all firefighters in the world who very often find themselves in situations where they save the lives of others while neglecting their own safety. Firefighters are the heroes of modern times.

Pharmacological Importance of Sage and Oregano 

Sage and Oregano, both are well-known culinary herbs with potential medicinal uses. Sage is mostly used to cease wounds bleeding, treating sores, swelling, cough and ulcers back in the first century and was called as the fertility drug since it reduces excessive bleeding during menstruation. On the other hand Oregano was found to be effective in treating stomach discomforts, bacterial/fungal infection, inflammatory bowel disease etc. Therefore due to their therapeutic and native applications, Sage and Oregano is of high economic worth.

Clinical Landmarks of COVID-19 in Newborn, Children and Teenagers

This review catalogs clinical landmarks of COVID‑19 across newborns, children, and adolescents, including MIS‑C, risk factors, and considerations for vaccination and school policies.

Geoscience and Remote Sensing on Horticulture as Support for Management and Planning

The importance of horticulture around the large cities, called green belt (GB), or proximity food production area is related to its contribution to the provision of food as well as its role on social, cultural and ecological aspects. Geoscience and Remote sensing (GRS) are tools that should aid in gathering and updating the information to develop science-based management plans of this areas. Recently, the improvement in terms of spatial, temporal and radiometric resolutions has changed the performance and the approach to the horticulture remote sensing. In this work, we make a brief review on the literature exploring the use of GRS techniques in horticulture, and future trends in order to exploit the available techniques for efficient crop management in the way to improve territorial planning and management. Specifically we found a lack of academic production in this area. In addition we examine the importance of this landscape areas from different points of view (food security, health, ecology, etc.). A systematic revision of published studies on remote sensing on horticulture including different platforms, sensors and methodologies are briefly presented. Finally some aspect related with future trends are discussed.

Risk Factors of Persistent Diarrhoea in Children below Five Years of Age

Background Persistent diarrhoea is a commonly observed phenomenon both in Bangladesh and all over the developing countries. It is the single most important cause of diarrhoea related deaths in the community, accounting for over half of them. If associated factors are properly identified & treated, it is possible to prevent most cases of persistent diarrhoea. Objective This study was undertaken to find out the possible risk factors associated with persistent diarrhoea in children below 5 years of age. Methods This was a prospective analytical case control study carried out in a tertiary care hospital, Dhaka. A total of 30 consecutive cases of persistent diarrhoea and 60 consecutive acute diarrhoea controls (matched for age and sex) under 5 comprised the study subjects in this study. Children beyond the age and whose parents didn’t give written consent were excluded from the study. Data were collected using a structured questionnaire and a standered case definition of acute & persistent diarrhoeawere adopted. Data were later processed and analyzed using SPSS (Statistical Package for Social Science version 12) in the year 2012. Results were considered statistically significant when p value was <0.05. Results According to the study, 56.6% of cases and 63.3% of controls were in the ‘6 to 12 months’ age group and about two-third of the participants in both cases 20 (66.7%) and controls 39 (65.0%) were males.Strong association was found with ‘bottle feeding’ RR=2.2556; 95% CI: 1.259, ‘presence of blood/mucus’ RR=2.5038; 95% CI: 1.4129, ‘WAZ≤ 2)’ RR=2.8867; 95% CI: 1.7202 and ‘early complementary feeding [RR=4.67; 95% CI: 2.5017-8.7175 and OR=7.8858; 95% CI: 3.6791-16.9 Conclusion In the present studyfour factors showed some association with persistent diarrhoea, namely: ‘use of animal milk’; ‘antibiotic use during acute diarrhoea’; ‘history of diarrhoea in previous 3 months’ and ‘pre-lacteal feed’. Strong association was found with ‘bottle feeding practices’ ‘presence of blood &/or mucus in stool’, WAZ <-2 and ‘early complementary feeding

Comparison of Dipper and Non-Dipper Hypertension Patterns According to Chronic Kidney Disease Stage

Introduction Hypertension is a major cardiovascular risk factor. There is a strong relationship between blood pressure (BP) elevation and stroke, myocardial infarction, heart failure and mortality due to kidney disease. It is known that the loss of the dipping pattern in hypertension is associated with increased target organ damage. In our study, we aimed to investigate the prevalence of dipper hypertension (DHT) and nondipper hypertension (NDHT) and related factors in patients with stage 1 and 2 chronic kidney disease (CKD). Materials and Methods A total of 158 patients diagnosed with stage 1 or stage 2 CKD were included in the study. Demographic characteristics, anthropometric measurements, physical examination findings and laboratory results of the patients were recorded. Ambulatory BP monitoring was performed in all patients. Results Of the 158 patients (female n: 98), 78 (49%) were in the stage 1 CKD group and 80 (51%) were in the stage 2 CKD group. No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The rate of NDHT was 59.5% (94/158 patients). Female patients had more DHT in the general population and in the stage 1 group than male patients (p=0.05, p=0.01, respectively). Conclusion No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The prevalence of DHT in female patients was significantly higher in both groups than in men in both groups, but especially in the stage 1 CKD group.

Interdisciplinary Orthodontic and Surgical Management of Class III Malocclusion in Adult Patients

The treatment of class III malocclusion differs depending on the age of the patient. In adult patients, alternatives include either orthodontic dentoalveolar compensation treatment or a combined ortho-surgical approach. The aim of this paper is to present the orthodontic and surgical treatment of a 24 year old adult patient with increased anterior face height, a class III skeletal pattern and mandibular asymetry. Previous orthodontic treatment with removable appliances obtained a 1 mm overbite and overjet. Intraorally, class III molar relationship was observed, proclined upper incisors, retroclined lower incisors and a deviated lower midline. The main complaint was facial esthetics which required surgical intevention. After pre-surgical orthodontic preparation the maxilla was repositioned by a Le Fort I osteotomy and the mandible was set back using the Obwegeser-Dal Pont method. Final assesment revealed both functional and esthetic dentofacial results. A combination of orthodontic treatment and orthognathic surgery is often required in adult patients with dental malocclusion and skeletal discrepancies.

Knowledge and Practice for Bio-Medical Waste Management among Healthcare Personnel at Kabgayi District Hospital, Rwanda

Background Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement. Objectives To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda. Materials and Methods A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05. Results The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001). Conclusion/Recommendations The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.

Age-Dependence of Some Trace Element Concentrations and their Ratios in Human Prostatic Fluid

The effect of age on Br, Fe, Rb, Sr, and Zn concentrations as well as on Zn/Br, Zn/Fe, Zn/Rb, and Zn/Sr content ratios in human prostatic fluid was investigated by 109Cd radionuclide-induced energy dispersive X-ray fluorescent microanalysis. Specimens of expressed prostatic fluid were obtained from 51 men (mean age 51 years, range 18-82 years) with apparently normal prostates using standard rectal massage procedure. Mean values (M ± SΕΜ) for concentration of trace elements (mg·L-1) in human prostate fluid were: Br 3.62±0.58, Fe 9.04±1.21, Rb 1.10±0.08, Sr 1.19±0.14, and Zn 573±28. Mean values for ratios of trace elements in human prostate fluid were: Zn/Br 523±103, Zn/Fe 105±16, Zn/Rb 661±63, and Zn/Sr 719±95. An age-related increase in Zn content and decrease in Br and Fe concentration was found. Moreover, the strongly pronounced increase in Zn/Br and Zn/Fe ratios was also observed.

A Case Series of Resolving Vitreous Haemorrhage in the Setting of Diabetic Retinopathy

This case series presents 2 patients (67 and 58 year old females) with resolving vitreous hemorrhage in the setting of diabetic retinopathy. Both patients had around 50% of the retina still visible and the hemorrhage was confined at the posterior vitreous cavity near the retina, hence, a partial pan retinal photocoagulation (PRP) was feasibly applied. On B-scan, both cases showed a liquified vitreous with posterior vitreous detachment (PVD). For both patients, vitreous hemorrhage resolution occurred at less than 4 months from onset and consequently PRP was completed. Vitreous hemorrhage differs with bleeding in other tissues due to the presence of vitreous collagen matrix which promotes rapid clotting and hinders resolution of hemorrhage by preventing passive diffusion and delay in inflammatory cellular response. The prognosis for clearing hemorrhage was better when the fundus reflex was brighter and the retina adjacent to the ora serrata was visible. Clearing occurred sooner when hemorrhage was retrohyaloid rather than in the vitreous gel. In diabetic eye, the vitreous undergoes metabolic derangements resulting in premature liquefaction and abnormal vitreoretinal adhesion leading to traction and membrane formation. Partial PVD has also been associated with higher rate of diabetic retinopathy progression since it serves as scaffold for growth of neovascular tufts.

Resource Management Domains of Kharif and Rabi Season Fallows in Central Plateau Region of India: A Strategy for Accelerated Agricultural Development

Over last few decades, acreage of total fallow lands (Kharif and Rabi seasons) in India has remained almost unchanged around 25Mha. The acreage of Kharif (summer) and Rabi (winter) Fallows in Madhya Pradesh (MP) are 1.98Mha and 5.51Mha, respectively. In the semi-arid agroclimatic zones of the states, Fallow-Wheat/Gram/Indian-Mustard cropping systems are practiced. After harvest of Kharif rice, kodo-kutki, maize or sorghum, farmers generally practice post-rainy season Rabi fallows in the sub-humid regions, south of Narmada River. Kharif fallowing is largely the result of the inability of the farmers to make planting dates independent of monsoon forecasts, and make efficient use of rain water. It appears that factors responsible for Kharif and Rabi fallows are distinctly different and a general consequence of distinctly different soil moisture regimes prevailing in the two crop seasons. Kharif and Rabi fallows have two distinct resource management domains. Whereas, Kharif fallows can be tackled with “PMP-dry seeding” agronomy, production constraints of Rabi fallows can be substantively tackled by shifting from tilled to zero-till agriculture with residue management to make efficient use of the conserved rain water. Some irrigation support will prove useful to tackle mid-season droughts in both situations. Conservation agricultural practices can significantly improve and stabilize crop yields in black soils and other associated soils of in the semi-arid tropics region of the Central India.

Surgical Site Infection in Cesarean Section Operation: Risk and Management

Cesarean sections (CS) are one of the most commonly performed surgical procedures worldwide. There is great variability in the percentage of cesarean sections between countries, varying from 3% to 42.9%5. In the US, approximately 32% of deliveries occur through a cesarean section. Overall, a drastic increase in cesarean section rate has been reported reaching its highest level at the present time. In Brazil, considering the types of births by live births from 2006 to 2016, the national percentage of cesarean section was 52.37%. The variability in this percentage can still be perceived within Brazilian territory. The highest cesarean rate occurred in the Southern region, representing 58.33% of births, while the lowest rate occurred in the Northern region, with 41.79%. It is possible to see the steady increase in the percentage of CS over time, from 45.01% in 2006 to 55.39% in 2016.

High-Resolution SD-OCT and EDI-OCT in the Evaluation and Management of Multifocal Serpigenoed Choroditis

Purpose To describe spectral domain optical coherence tomography (SD-OCT) and enhanced depth image OCT (EDI-OCT) findings of multifocal serpiginoid choroditis (MSC) , including affected layer of retinal involvement, changes at the vitreoretinal interface, and response to therapy. Methods A retrospective review of 20 eyes (14 patients) with MSC. Each patient underwent a complete ophthalmologic examination, fundus photography, fundus autoflorecence (FAF) and OCT imaging of the affected retina at the initial visit and on each follow-up. Results In acute stage, SD-OCT showed hyperreflective areas involving the outer retinal layers which include retinal pigment epithelium (RPE), photoreceptor outer segment tips (POST), inner segment–outer segment (IS/OS) junction, external limiting membrane (ELM), and outer nuclear layer (ONL) with choroidal and intraretinal layer cells infiltrate. EDI-OCT showed increase choroidal thickness. As the lesions began to heal, irregular, knobby elevations of outer retinal layers appeared (RPE, POST, IS/OS junction, and ELM could not be distinguished) with significant decrease in choroidal and intraretinal cells. On complete healing, loss of RPE, POST, IS/OS junction, and ELM in SD-OCT scan and absent of the choroidal and intraretinal cells and continous hyperreflactivity of the choroid (increased penetrance). Conclusion SD-OCT and EDI-OCT provides high-resolution detail regarding ultrastructural changes in vitreoretinal interface, outer retina and choroid during the course of the lesion. Serial SD-OCT and EDI-OCT also provides further insight into response to therapy by observing choroidal and intraretinal cells.

Massive Left Atrium from Severe Mitral Stenosis due to Rheumatic Heart Disease: Clinical Images Not Usually Seen in Modern Radiology and Ultrasound

Rheumatic heart disease is becoming far less common in the developed world, and therefore expsoure to its complications are been seen less by clinicians. With the increasing ease of world travel, patients with less commonly seen medical conditions are increasingly presenting to Hospitals requiring management of their complications. We present a case of an elderly lady who was a tourist in Australia, who presented with complications of her rheumatic heart disease, and her subsequent radiological and echocardiographic investigations were a significant surpirse for her treating clinicians.

Relationship Between Body Composition and Nutritional Status in Brazilian Nonagenarians

Introduction Brazil has undergone considerable changes in age distribution, particularly in nonagenarians. Allied to this reality, there is a series of nutritional disorders in this population segment. An important factor related to quality of life and healthy aging is good nutrition throughout life. Objective To observe the possible relationship between nutritional status and body composition in nonagenarians. Methodology This is a descriptive, cross-sectional and analytical study, with participants aged 90 years or older, evaluated using the Mini Nutritional Assessment (MNA), anthropometric parameters, and Bioimpedance. Results The sample consisted of 72 nonagenarians, averaging in age 93.7 years, most female (72%), white (82%) and widowed (64%), 19.4% were in nutritional risk, based on the MNA criteria. All anthropometric parameters presented lower averages among nonagenarians in nutritional risk. Regarding the bioimpedance parameters, in general the risk-free nonagenarians presented higher averages of weight, maximum ideal weight, minimum ideal weight, BMI, lean-mass, fat-mass, percentage of fat-mass and minimum percentage of fat-mass. Conclusions Most nonagenarians were in good nutritional status. Both anthropometric and bioimpedance parameters were effective to discriminate between normal and at nutritional risk nonagenarians. We also concluded that nutritional risk assessment in nonagenarians patients requires a joint analysis of the several existing methods for the nutritional evaluation, in order to obtain global diagnosis and accurate analysis of the nutritional status of the nonagenarians.

Geomatic Tools for Water Management in a Community Irrigation System, Cruz del Eje, Córdoba.

An integral and efficient management of water for irrigation requires the adoption of new technologies to respond to the challenges imposed by the agricultural sector, in particular to stabilize production through the adequate use of water resources. In this sense, it is vital to characterize and know the amount of area which is under irrigation in such agricultural systems. In this paper we show the use of satellite information data in a GIS environment with the objective of characterizing the productive areas under irrigation in Cruz del Eje, Córdoba, Argentina in 3 types: A) irrigation region B) irrigable area and C) actually irrigated area. Multitemporal image indices and segmentation were used for this characterization and then maps of these 3 types of agricultural land cover were generated. Additionally, we present simple satellite images processing and classification procedures to increase the knowledge about the land cover over this irrigated area. Finally, we discuss how this geographically explicit information generated could be useful for the decision-making process on current irrigated areas and on the potential of productive systems through community irrigation systems.

Nutritional Impact of Storage Containers on Macronutrient Integrity of Breastmilk

This study compared the effect of container material type on macronutrient changes in human breast milk (HBM) during frozen storage. HBM was collected from breastfeeding mothers and baseline macronutrients were analyzed and recorded. The HBM was aliquoted into milk storage containers of five commonly used materials (low-density polyethylene (LDPE), polypropylene (PP), glass, stainless steel, and silicone). The samples were frozen in a standard freezer (-20°F) for 30, 60, and 180 days prior to thawing and retesting macronutrient values. In the 155 samples analyzed, macronutrient changes among different types of storage materials were insignificant at 30 and 60 days of frozen storage. When comparing macronutrients at baseline to 180 days, there was a significant decrease in protein value over time in LDPE containers as compared to silicone containers (p=0.001). Likewise, there was a significant decrease in total calories from baseline to 180 days in both PP and LDPE containers compared to silicone (p=0.046 and 0.013, respectively). While not significant for short-term storage, HBM has losses of macronutrients (protein) with long-term storage in LDPE and PP plastics. These differences could have major nutritional impact on growth, particularly to infants born prematurely.

Design Support to steer Creative Wicked Problem Solving Processes with Knowledge Management and Artificial Intelligence

As the complexity of building tasks and requirements increases, designers often find themselves confronted with interdisciplinary problems that go beyond the specific challenges and methods of architecture. The iterative nature of the design process results in a continuous exchange between creative, analytical and evaluative activities, through which the designer explores and identifies promising design variants. The ability to compare and evaluate relevant reference examples of already built or designed buildings helps designers to assess their own design and informs the design process.

Implant Anchorage in Orthodontic Retrusion: A Case Report

Mini screws represent a new treatment modality in orthodontic biomechanics. They provide absolute anchorage, no secondary movements and reduced orthodontic treatment time. Futhermore, the surgical procedure for mini implants placement is quite simple and this type of treatment requires no patient compliance. We selected a clinical case in order to emphasize one of the most important indications of the mini implants: retrusion of the upper incisors for a incresed overjet case in a young patient. Two mini implants were placed in order to obtain the correction of the overjet and the retrusion of the anterior teeth. The retrusion was obtained in a reduced period of time using retraction devices on crimpable hooks.

Image Guided Ablations for Thyroid Tumours

Image guided ablations might be regarded as a promising effective and safe alternative for treatment of recurrent thyroid cancer in particular in patients with high surgical risk or refusing surgery. Furthermore, image guided ablations seems to represent a promising alternative to surgery or observation for micropapillary thyroid carcinoma, with the aim of providing an effective treatment with minimal invasiveness. Further studies are necessary to confirm the role in this setting

The Australian Royal Commission into the Aged Care Industry 2019

In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.

Insight into Management Issues modeling for Perfect Business Simulation

In this paper, I try to focus on widely growing field of Management Science; and that, “Modeling of Management Issues “. Now days Business Simulation techniques are used to earn more profit from Business and this is only issues control future course of actions properly. By using models we can predict & control future course of action & situation. Modeling is not a new subject. It’s oldest technique, but widely used in Physical Sciences, like Chemistry, Physics, Electronics, Engineering field, But it’s again become vital after some time in Life Sciences, like Botany, Zoology, Bio-Chemistry, Bio-Tech and Medical field problem modeling and now in current world it’s also become very vital in Information Technology and Management subjects. Here one question is always arise, why such a modeling is needed, and where and when needed, and answer of this simple question is, considering some simple problems like ‘ to find out the width of a river (But your are not allowed to cross it), find out the temperature (but you are not allowed to use thermometer), means try to find out any Quantity or parameter/variable without existence or entity of that, and if virtual situation satisfied by using modeling technique, we implement that virtual model for actual situation. In last I want to conclude modeling is the heart of any branch of Education, weather its science, Arts, Commerce, Medical, Information Technology, Engineering or Management and in summaries form I want to say this paper is nothing but one of the theoretical model, which is for modeling of Management issues for perfect Business Simulation.

Star Excursion Balance Test (SEBT): Comparison of Results with and without Neuromuscular Ankle Bandage

Study Design: Prospective study, simple crossover design. Background: Proprioception is a cornerstone for maintaining joint and postural stability. Dynamic stability is particularly emphasized within these components. This feature is important in the rehabilitation field. Therefore, the quest for elements to improve these values ​​can bring advantages in sports. Objectives: Evaluate if there are advantages in the performance of a Star Excursion Balance Test (SEBT) using Kinesio taping. Methods: We evaluated 10 professional soccer players from the Chilean women’s national team. They were randomly divided into 2 groups. One group had Kinesio taping and their SEBT performance was evaluated. The other group performed the measurements without the use of Kinesio Taping. Afterward, each group performed the evaluation they did not do during the first stage. We then compared the performance achieved with and without the use of Kinesio Taping Results: There were significant differences in the performance achieved by the players who had the SEBT bandage applied in comparison to the players that did no. This was confirmed by using the non-parametric Wilcox test for each of the SEBT positions. Conclusions: Kinesio taping has positive implications in the SEBT. We can extrapolate that its use can improve the dynamic balance and thus become an important pillar in sports rehabilitation.

Health Literacy and Osteoarthritis Self-Management

Background: Osteoarthritis is a disabling joint disease with no known cure that negatively effects life quality among high numbers of aging adults. Aim: To examine the concept of health literacy as a potentially overlooked, but highly salient, disease correlate among this older chronically disabled group. Method: A literature search using the key terms osteoarthritis and health literacy was conducted using the major data bases. Results: Although almost no work has focused on health literacy and osteoarthritis, the concept of health literacy is clearly linked to health status and health outcomes. Varying from marginal to high, health literacy is not always assessed or recognized as being clinically relevant, however, despite a large volume of related literature. Conclusion: Acknowledging the possible role of limited health literacy in the context of osteoarthritis disease progression, and applying carefully tailored directives for overcoming any related health literacy limitations may offer a novel approach for improving the outcomes for older people with this condition.