Characterizing the behaviour of precipitation and river flow time series in the temporal domain was always a way to understand the complexity of the dynamical processes in hydrological systems. In order to characterize the intrinsic characteristic of the hydrological processes of the Rhiss and Nekkor basins, a power spectrum analysis was deduced from instrumental time series of precipitation and flow. On the background of flow and precipitation fluctuations, the power spectrum shows discrete components in the form of 1/f-noise. A power-law with 1/f β noise factor was found in precipitation and flow indicating a stochastic behavior with long-range persistence. The spectral exponent β for precipitation shows values ranging between 0.16 and 0.43. On the other, hand river flow shows a power-law dependence on frequency S(f) with an exponent of ½. The existence of long-range persistence was also evaluated by the analysis of Hurst exponent, where we have found a strong long-term persistence for precipitation (H>0.79) and flow (H>0.73) with slow decay. We noted that the river flow of a power-law with β=0.5, yields a power-law rescaled range with Hurst exponent close to H=0.73, indicating a universal power-law dependence on frequency. The existence of pink-noise energy signature in precipitation and river flow indicates that the climatologic and hydrologic systems are characterized by more low frequency components and operating in large scales and maybe related to large-scale climatic phenomena. Our results suggested that the two hydrologic systems play an important role in the generation of new characteristics of precipitation signal.

IL-17 has emerged as an important cytokine in protecting the host from mucosal infections, but also as a pathogenic determinant and therapeutic target in numerous autoimmune and inflammatory diseases (e.g. psoriasis, psoriatic arthritis and ankylosing spondylitis, inflammatory bowel disease and multiple sclerosis) [(1)](#ref-0001). The IL-17 family includes six members (IL-17A to IL-17F) that act through the IL-17 receptors [(1)](#ref-0001). The most studied IL-17A, as well as IL-17F, binds to IL-17RA and IL-17RC resulting in heterodimerization. Currently IL-17A, IL-17F, IL-17RA or IL-23, a cytokine produced by innate immune cells that promotes expansion of Th17 cell populations, are targetable by monoclonal antibodies (mAbs). These mAbs have been approved for the treatment of different autoimmune diseases, most notably psoriasis, where their efficacy has outperformed conventional non-steroidal anti-inflammatory and tumor necrosis factor (TNF) blocking drugs. However, clinical trials and real-life experience have shown an increase in fungal and bacterial upper respiratory tract infections in patients treated with mAbs that block IL-23/IL-17 signaling. Accordingly, single nucleotide polymorphisms in genes encoding IL-17A, IL-17RA, IL-17RC, IL-23, or NF-κB activator 1 (ACT1, an adapter protein downstream of the IL-17R) which abrogate cellular responsiveness to IL-17A, were associated with susceptibility to chronic mucocutaneous candidiasis (CMC), a persistent infection of the skin, nails, and/or mucous membranes with commensal Candida species [(2)](#ref-0002). So new effective targeted approaches in IL-17 signaling are desirable. Knizkova and colleagues identified a new adaptor molecule involved in the IL-17/IL-17R cascade [(3)](#ref-0003). Through murine and human cell models, the authors found that CMTM4 (CKLF Like MARVEL Transmembrane Domain Containing 4) constitutively bound to the subunit IL-17RC becoming integral part of the IL-17R signaling complex (IL-17RSC) upon IL-17A stimulation. CMTM4 promoted the surface expression of IL-17RC by regulating posttranslational modifications, especially IL-17RC glycosylation and trafficking to trans-Golgi up to plasma membrane. CMTM4 was required for the recruitment of adapter ACT1, for the activation of p38, JNK and transcription of genes encoding proinflammatory cytokines upon IL-17A stimulation (Figure 1A). Keratinocytes from the tail of Cmtm4−/− mice specifically express lower levels of IL-17RC respect to Cmtm4+/+ mice (Figure 1B). In vivo, when imiquimod (IMQ) was applied on the ears or shaven backs of Cmtm4−/− mice, they developed less severe psoriatic lesions and lower local expression of IL-17A target genes compared to Cmtm4+/+ mice (Figure 1C).

A document by Sunidhi Sharma. Click on the document to view its contents.

Multimodal studies evaluating associations between specific for Parkinson’s disease (PD) neuroimaging and neurophysiological biomarkers in revealing executive dysfunction mechanisms are scarce and needed to be validated. Hence, our study aimed to evaluate associations between electroencephalographic power spectral density (PSD-EEG), striatal [18F]Fluorodopa uptake and neuropsychological testing parameters in PD. Additional aim was to estimate PD diagnostic accuracy of the PSD-EEG parameters. We compared resting PSD-EEG, striatal [18F]Fluorodopa uptake ratio with positron emission computed tomography ([18F]FDOPA PET/CT), and neuropsychological test outcomes between PD patients and healthy controls, and then calculated correlations among these outcomes. Additionally we estimated PD diagnostic sensitivity and specificity (with the receiver operating characteristic curves) of the PSD-EEG parameters in reference to the gold diagnostic standard of the striatal [18F]FDOPA PET/CT uptake ratio.PD patients exhibited (i) increased power of the EEG theta and lower-alpha bands in the frontal lobe areas, (ii) decreased putaminal and caudate nuclei [18F]FDOPA PET/CT uptake ratios and (iii) longer performance times of part A and B of the Trail Making Test (TMT-A and TMT-B). Most of the PSD-EEG parameters negatively correlated with striatal [18F]FDOPA PET/CT uptake ratios and positively correlated with TMT-A and TMT-B. Furthermore, [18F]FDOPA PET/CT uptake ratios positively correlated with TMT-A and TMT-B. Theta and lower-alpha bands PSD-EEG were found to have high diagnostic accuracy. Our findings showed that slowing of EEG waves in the frontal lobe was correlated with striatal dopaminergic deficiency and executive dysfunction in mild PD patients, and appears to be a promising biomarker of PD-related executive dysfunction.

The higher elevation forests of Norfolk Island are regularly immersed in the clouds and scientific and anecdotal evidence suggests that in addition to rainfall, water is likely to be collected as cloud droplets are intercepted by the forest canopy. This water is likely to be important for the local hydrology and ecology, yet it has never been quantified. To address this, a field measurement campaign was established to measure hydrological inputs to the forest floor at two elevated forest sites in the Norfolk Island National Park. Instrumentation included throughfall and stemflow systems and measurements of rainfall in the open in nearby clearings. Sites exhibited very high stem density and basal area by international standards and delivery of water to the forest floor was dominated by stemflow because of the funnelling characteristics of the dominant palm and pine trees. Both sites showed similar hydrological behaviour with stemflow and throughfall of around 48% and 32%, respectively. Stemflow contributions of 48% far exceed observations from the literature which are typically less than 10%. Rainfall rarely occurred in the absence of low-level cloud and some cloud immersion events lasted for many days with hydrologic inputs continuing for extended periods despite rainfall not being observed in the open. Cloud interception accounted for approximately 20% of total water input at both sites which is equivalent to 25% extra water on top of rainfall measured in the open. From an island-wide perspective the calculated extra hydrological input is only small due to the limited spatial extent of elevated forest, however, the additional water is likely to be very important to local hydrological processes and the unique plants, insects and animals which inhabit the higher elevation forests of Norfolk Island.

Background: Theophylline was an orally administered xanthine used for the treatment of apnea of prematurity and Bronchopulmonary Dysplasia in the ambulatory follow-up of Low-Birth-Weight infants (LBWI) with oxygen-dependency in the Kangaroo Mother Care Program (KMCP). Theophylline’s main metabolic product is caffeine; therefore, it was an alternative due to the frequent lack of ambulatory oral caffeine in low and middle-income countries. Purpose: to assess the effectiveness of oral Theophylline in decreasing days with oxygen and to describe frequency of adverse related events. Method: quasi-experiment before and after withdrawal of Theophylline given systematically to LBWI with ambulatory oxygen in two KMCPs. Results: 729 patients were recruited; 319 with Theophylline and 410 after Theophylline withdrawn. The Theophylline cohort had less gestational age, less weight at birth, more days in Neonatal Intensive Care Unit, more days of oxygen-dependency at KMCP admission, and more frequencies of Intrauterine Growth Restriction and apneas. After adjusting with propensity score matching, multiple linear regression was done, and analysis showed that nutrition had a greater effect on days of oxygen-dependency than the fact of receiving Theophylline. No differences were found in readmissions up to 40 weeks, nor in the frequency of intraventricular hemorrhage or neurodevelopmental problems. The Theophylline group had more tachycardia episodes. Conclusions: we did not find evidence of oral Theophylline effect on the reduction of days of oxygen-dependency. For the current management of oxygen- dependency in newborns, the importance of KMCPs nutritional protocols based on exclusive breast feeding whenever possible, is the challenge for these fragile infants.

The COVID-19 outbreak has restricted the freedom of ordinary people, resulting in less activity and more negative emotions. Consequently, we proposed a motor imagery training procedure to intervene in the mental health problems of people with freedom restrictions. We conducted two studies. Study 1 had 176 participants, including 93 in the freely restricted group (Mage=19.66, SD=1.16), and 83 in the non-freely restricted group (Mage=21.4, SD=1.16). The freely restricted group had more negative emotions than the non-freely restricted group. Study 2 had 106 valid participants who were randomly divided into two groups with 48 in the experimental group (Mage=19.46, SD=0.87), who received motor imagery training, and 58 in the control group (Mage=19.41, SD=0.94), who did not receive motor imagery training. The posttest positive emotion scores were significantly higher in the experimental group than in the pretest, while the posttest positive emotion scores were lower in the control group than in the pretest. This result confirms that motor imagery training can effectively promote positive emotions of sequestered individuals during a pandemic. Our study provides a solution to reduce psychological problems, particularly the promotion of positive affect, in personnel with restricted freedom in COVID-19 sequestration, and in other personnel with restricted activities.

Adaptation refers to the decreased neural response that occurs after repeated exposure to a stimulus. While many electroencephalogram (EEG) studies have investigated adaptation by using either single or multiple repetitions, the adaptation patterns under controlled expectations manifested in the two main auditory components, N1 and P2, are still largely unknown. Additionally, although multiple repetitions are commonly used in mismatch negativity (MMN) experiments, it is unclear how adaptation at different time windows contributes to this phenomenon. In this study, we conducted an EEG experiment with 37 healthy adults using a random stimulus arrangement and extended tone sequences to control expectations. We tracked the amplitudes of the N1 and P2 components across the first ten tones to examine adaptation patterns. Our findings revealed an L-shaped adaptation pattern characterized by a significant decrease in N1 amplitude after the first repetition (N1 initial adaptation), followed by a continuous, linear increase in P2 amplitude after the first repetition (P2 subsequent adaptation), possibly indicating model adjustment. Regression analysis demonstrated that the peak amplitudes of both the N1 initial adaptation and the P2 subsequent adaptation significantly accounted for variance in MMN amplitude. These results suggest distinct adaptation patterns for multiple repetitions across different components and indicate that the MMN reflects a combination of two processes: the initial adaptation in the N1 and a continuous model adjustment effect in the P2. Understanding these processes separately could have implications for models of cognitive processing and clinical disorders.

Aims: A phase I open-label study assessed the effect of multiple oral doses of a potent CYP3A4 inducer (rifampicin) on the pharmacokinetic profile of SHR2554, a novel enhancer of zeste homolog 2 inhibitor (EZH2) and CYP3A4 substrate. Methods: Eighteen adult Chinese healthy subjects were enrolled in this study. All participants received a single oral dose of SHR2554 (300 mg) on day 1, rifampin (600 mg) from day 4 to day 10 and day 12, the same dose was coadministered with SHR2554 (300 mg) and rifampicin (600 mg) on day 11. The primary endpoints were SHR2554 exposure parameters. Lack of drug–drug interaction was concluded if 90% confidence intervals (CIs) for the ratio of area under the plasma concentration–time curve (AUC) or maximum concentration (Cmax), with/without oral rifampicin, were within a pre-specified interval (0.80–1.25). Results: The Cmax, AUC0-t, and AUC0-∞ of administration alone and coadministration with rifampin were 177.265 ±127.9889 ng/mL, 17.001 ± 8.4759 ng/mL; 672.12 ± 507.390 h*ng/mL, 38.58 ± 19.495 h*ng/mL; and 721.50 ±514.386 h*ng/mL, 46.30 ± 20.750 h*ng/mL, respectively. Coadministration with rifampin decreased the least-squares geometric mean ratios of Cmax, AUC0-t, and AUC0-∞ by 89%, 93%, and 93%, respectively. Well tolerance and acceptable safety profile showed during the trial. Conclusion: The exposure of SHR2554 was significantly decreased when coadministered with rifampicin. It is recommended to avoid concomitant use of SHR2554 and strong inducers of CYP3A4.

The pressure ulcers are described to localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction,” by the National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel. Preventing anything from happening or emerging is referred to as prevention. [1], [2]. All healthcare professionals have a duty in prevention of pressure ulcers, but nurses have a particularly important responsibility.Each year, 700,000 patients worldwide suffer from pressure ulcers (PU). Each year, about 186,617 individuals receiving acute treatment acquire a new pressure ulcer. 2% of avoidable fatalities are caused by pressure ulcers. For pressure ulcers to be effectively prevented, three essential elements must be present: awareness of the problem’s importance, a proactive attitude toward prevention, and sufficient information. Furthermore, 4.32% of people in east Africa have pressure ulcers. Locally, there appears to have been little, if any, research on this illness[3].PU pose the significant problem for patients, caregivers, and family members. In addition to pain and suffering, patients may also become functionally impaired, which would result in higher costs and longer hospital stays. Treatment for PU in the United States cost roughly 10.2 billion USD in 2008, and it was linked to about 29,000 hospital fatalities. One’s daily routine and quality of life are directly impacted by PU. Living with pressure ulcers can have a number of detrimental effects, such as discomfort, fear, worry, social isolation, and decreased independence [4].A study conducted in Tanzania on individuals with spinal cord injuries revealed PU as a prominent consequence, with an incidence of 22.9%. There is little study information pertaining to nurses’ knowledge, attitudes, and practices surrounding pressure ulcers in Tanzania [6].Nursing described as a humanistic and humanitarian art and science in Roger’s philosophy of human beings. The science of unitary humans has two dimensions: the science of nursing, which is the knowledge particular to nursing that derives from scientific study, and the art of nursing, which is applying the science of nursing in inventive ways to improve patient outcomes. She stated that while talking about health and treatment, the patient and his surroundings cannot be separated.Nurses can apply their knowledge, attitude, and practice from the science of nursing to change patient outcomes in the prevention and treatment of PU in the hospital. The link between the patient and environment will facilitate the patient result of PU prevention and treatment. A patient’s mobility, health, nutritional status, age, and tissue perfusion, can all be assessed by nurses to help prevent and treat PU.It is also highly recommended that nurses engage in continuous professional development (CPD), and that its efficacy be regularly assessed. In order for nurses to provide the greatest nursing care in regards to PU prevention and treatment, which may result in the best patient outcome, protocols, guidelines, and assessment tools are also required and should be made available in services.

The growing prominence of large language models, such as GPT-4 and ChatGPT, has led to increased concerns over academic integrity due to the potential for machine-generated content and paraphrasing. Although studies have explored the detection of human-and machine-paraphrased content, the comparison between these types of content remains underexplored. In this paper, we conduct a comprehensive analysis of various datasets commonly employed for paraphrase detection tasks and evaluate an array of detection methods. Our findings highlight the strengths and limitations of different detection methods in terms of performance on individual datasets, revealing a lack of suitable machine-generated datasets that can be aligned with human expectations. Our main finding is that human-authored paraphrases exceed machine-generated ones in terms of difficulty, diversity, and similarity implying that automatically generated texts are not yet on par with human-level performance. Transformers emerged as the most effective method across datasets with TF-IDF excelling on semantically diverse corpora. Additionally , we identify four datasets as the most diverse and challenging for paraphrase detection.

A c c ou ntab il it y "take responsibility" "indicate use" "approve content" Figure 1: A three-dimensional model of responsible AI usage (left) and the header of the AI Usage Cards template (right). ABSTRACT Given AI systems like ChatGPT can generate content that is indistinguishable from human-made work, the responsible use of this technology is a growing concern. Although understanding the benefits and harms of using AI systems requires more time, their rapid and indiscriminate adoption in practice is a reality. Currently, we lack a common framework and language to define and report the responsible use of AI for content generation. Prior work proposed guidelines for using AI in specific scenarios (e.g., robotics or medicine) which are not transferable to conducting and reporting scientific research. Our work makes two contributions: First, we propose a three-dimensional model consisting of transparency, integrity, and accountability to define the responsible use of AI. Second, we introduce "AI Usage Cards", a standardized way to report the use of AI in scientific research. Our model and cards allow users to reflect on key principles of responsible AI usage. They also help the research community trace, compare, and question various forms of AI usage and support the development of accepted community norms. The proposed framework and reporting system aim to promote ethical and responsible use of AI in scientific research and provide a standardized approach for reporting AI usage across different research fields. We also provide a free service to easily generate AI Usage Cards for scientific work via a questionnaire and export them in various machine-readable formats for inclusion in different work products at https://ai-cards.org.

In behavioural and neurophysiological pain studies, multiple types of calibration methods are used to quantify the individual pain stimuli. Often studies lack calibration procedure implementation, have a vague protocol description, do not provide quality quantification, and omit required control for gender pain differences, hampering study repetition and interexperimental comparisons. Moreover, typical calibration procedures require a high number of stimulations which may cause participants’ discomfort and stimuli habituation. To overcome those shortcomings, we present an automatic calibration procedure with a novel stimuli estimation method for intra epidermal stimulation adjusted to the magnetoencephalography environment. We provide an in-depth data analysis of the collected self-reports from seventy healthy volunteers (37 males) and propose a method based on a dynamic truncated linear regression model (tLRM). We compare its estimates for the sensation (t), and pain (T) thresholds, as well as for the mid-pain stimulation (MP), with those calculated using a traditional estimation method and standard linear regression models. Compared to the other methods, tLRM exhibits higher R2 and requires 36% fewer stimuli application and has significantly higher t and lower T and MP intensities. Regarding sex differences, t and T were found to be lower for females compared to males, regardless of the estimation method. The proposed tLRM method quantifies the calibration procedure quality, minimizes its duration and invasiveness, as well as provides validation of linearity between stimuli intensity and subjective scores, making it an enabling technique for further studies. Moreover, our results highlight the importance of control for gender in pain studies

A document by Nadia Paraskevoudi. Click on the document to view its contents.

The emergence of the crisis in Sudan has led to an overstretched healthcare system therein, which has negatively impacted the public health system of the nation. The WHO has noted the closure of roughly sixteen hospitals since the start of the conflicts due to staff safety concerns as well as a shortage of hospital supplies, consumables, and medication. Due to ongoing conflicts and persistent political instability, Sudan receives very little funding from donor organizations to maintain its healthcare system, which worsens the nation's general public health architecture. Thus, amidst the ongoing crisis recent floods in the country can further pose serious challenges like disease outbreaks, starvation, infectious diseases, deteriorating health infrastructure, and mental health issues. To successfully reduce the severity of negative impacts on public health, the crisis must be ceased and facilities reopened. A well-structured disease surveillance system for infectious diseases should be established, pregnant women and children under the age of five should be treated for free, and mental health awareness and examination should be prioritized. The global community must act expeditiously to mitigate the devastating effects of this crisis.

The fracture of structures under mixed-mode loaded cracks is usually assessed using stress intensity factors (SIF). Domain integrals, specially the \J-integral and the interaction integral, are widely used for SIF extraction and provide high accurate estimations with finite element methods, although the \J-integral does not allow the separation of the SIF components. However, interaction integral definition implies hypothesis that are not fulfilled in generic non-planar cracks and therefore other methods can be an option to solve this problem. A different path independent integral, the neutral action integral, was introduced in 2010 by Kienzler et al. The application of the \J-integral and the neutral action integral allows the computation of the SIF in a mixed mode situation and separate the SIF components. The presented study considers the applicability of the neutral action integral and investigates its limitations. The research is performed using well known and basics problems, that can be considered as a basis for other more complicated cases, in order to obtain an convergence analysis without introducing further errors

Background: Controversy surrounds the routine use of urine culture (UC) in febrile neutropenic children. We aimed to evaluate the need for routine urine studies in febrile neutropenic children with cancer. Procedure: We conducted a prospective study of pediatric cancer patients with urinary continence who presented to the emergency department with febrile neutropenia between 2019 and 2021. Epidemiologic data and clinical and laboratory findings were collected. Urinary tract infection (UTI) was defined as urinary signs/symptoms and positive UC with or without pyuria. Study data were analyzed using descriptive statistics. The diagnostic performance of urinalysis was calculated using positive UC as the gold standard. Results: Positive UC was found in seven of the 205 children included (3.4%; 95% CI 1.4-6-9%), 2 presenting urinary symptoms. UTI prevalence was 1.0% (95% CI 0.1-3.5). A 23.8% prevalence of positive UC was found in patients with urinary symptoms and/or history of urinary tract disease (95% CI 8.2-47.2%) as compared to 1.1% of those without symptoms or history (95% CI 0.1-3.9%) (p<0.001). The sensitivity, specificity, negative predictive value, and area under the curve for urinalysis was 16.7% (95% CI 3.0-56.4), 98.4% (95% CI 95.3-99.4), 97.3% (95% CI 93.9-98.9), and 0.65 (95% CI 0.51-0.79), respectively. Conclusions: UTI is an infrequent cause of infection in these patients. Urinalysis is indicated only in febrile neutropenic children with urinary signs/symptoms and in asymptomatic patients with a history of urinary tract disease. When urine is collected, UC should be requested regardless of the result of the urinalysis.

Background: Malignant renal neoplasms are rare before the age of 45. Age, gender, and certain genetic and modifiable risk factors can influence the development these cancers. However, the risk in survivors of childhood cancer is not well established. Methods: Using the SEER registry, we identified survivors of childhood cancer who developed a renal cancer as a subsequent malignant neoplasm (SMN). Original childhood cancer was diagnosed under 20 years of age. We evaluated the clinical characteristics of the survivors of childhood cancer who developed SMNs of the kidney. We calculated standardized incidence ratios and performed Kaplan-Meier estimates to assess survival after SMN of the kidney. Results: We found 53 survivors developed a SMN of the kidney (one patient had 2 subsequent kidney cancers). Of the 54 subsequent kidney cancers, 47 occurred as a second cancer (43 carcinomas, 3 Wilms, and 1 Ewing sarcoma), 6 renal carcinomas occurred as a third cancer and 1 renal carcinoma occurred as a fourth cancer. Of the 53 cancer survivors with SMN of the kidney, 29 were female (54.7%), 47 were white (88.7%) and 7 were Hispanic (13.2%). The most common primary cancers were Hodgkins lymphoma (n=9) and neuroblastoma (n=7). Primary malignancy occurred at a mean age of 10.1 years and SMNs occurred at a mean age of 31.1 years. The overall SIR of developing a subsequent renal cancer was 4.52 (p<0.05; 95%CI 3.39-5.89). The 5-year overall survival after development of a SMN of the kidney was 73% (95%CI: 58%-83%). Conclusions: Subsequent malignant cancers of the kidney are rare but occur ~4.5 times more frequently in survivors of childhood cancer compared to the general population. This increased risk should be considered when providing long-term care for survivors of childhood cancer.

Sickle cell anemia is highly prevalent in Central Africa. The disease causes severe manifestations in children requiring treatment. Hydroxyurea is currently the most effective drug treatment. Therefore, we evaluated the use of HU in children living in rural Central Africa. We conducted a clinical trial with HU from November 2017 to February 2020 in the Hôpital Saint Luc de Kisantu in the DR Congo. Patients aged 6 months to 18 years with a moderate or severe form of SCA (Adegoke score) were treated with an initial HU dose of 15mg/kg per day, which was increased gradually in increments of 5mg/kg per day every six months, to a maximally dose of 30mg/Kg/day. To determine the clinical and biological response to the treatment, we compared the clinical and biological data from the first and second year of treatment with the baseline. From the 136 SCA children followed at KSLH, 69 (37 boys and 32 girls; sex-ratio M/F 1.15) started the clinical trial with HU. Of them, 39 patients reached the end of the clinical trial (56.5%). We observed a mean increase in the HbF rate of 3-fold at 12 months and 3.3-fold at 24 months, with a significant difference from the baseline. Thirty-seven (80.4%) patients presented a good clinical response, and 9 (19.6%) did not respond. In conclusion, our clinical trial showed the effectiveness of HU treatment clinically and biologically. Despite tremendous logistical difficulties, HU treatment in a rural area offers the prospect of improving the quality of children with SCA’ life.

In the current investigation, a macrofungus was collected from Quaid-i-Azam University Islamabad. The collected fungus was identified as Ganoderma multipileum, and further exploited for the synthesis of nanoparticles using zinc metals. Chemical and morphological characterization of synthetized nanoparticles was through Fourier Transfer InfraRed spectroscopy analysis (FTIR), X-ray diffraction analysis (XRD), Energy dispersive X-ray analysis (EDX), Scanning Electron Microscopy analysis (SEM) and UV-Vis spectrum showed a broad absorption between 350 and 380 nm, which indicates the synthesis of ZnO NPs. ZnONPs have been used in a variety of biomedical studies including such as biocompatibility, antifungal, antileishmanial, and antibacterial studies. abilities, antifungal, antileishmanial, and antibacterial studies. The ZnO nanoparticles showed a strong antibacterial effect against gram-positive (Klesbsilla pneumonia and Staphylococcus aureus) and gram-negative (Eschericia coli and Pseudomonas aeruginosa) bacteria. Furthermore, the ZnO nanoparticles also showed a high antifungal effect against different fungus. The current study concludes that Ganoderma multipileum works as a novel and eco-friendly source for the synthesis of ZnO NPs with prominent biological application that can be further applied in different fields.

Zuclopenthixol decanoate is a dopamine antagonist licensed for human use to manage schizophrenia and paranoid psychosis. It is in the same drug class (thioxanthene) as fluphenazine decanoate, a drug with reported use in horses to provide long-acting sedation. This case study describes severe extrapyramidal signs seen in a thoroughbred colt after zuclopenthixol decanoate administration. The colt was presented to a referral hospital for an unusual manifestation of colic signs. On admission, the colt began to show clear extrapyramidal neurological signs. Initial suspicion was of fluphenazine decanoate toxicity, therefore treatment as reported in the literature for this syndrome was commenced. The limited available literature regarding treatment options includes use of intravenous formulations of diphenhydramine hydrochloride and benztropine mesylate, which were unavailable without an import licence in the UK at the time of publication. The closest alternative option, oral diphenhydramine (Nytol) 1mg/kg was administered alongside intravenous atropine (0.01mg/kg) and pergolide (2mcg/kg/q 24 hours). Improvements in the colt’s demeanour and neurological status was noted within 24 hours. Ongoing supportive treatment was continued and slowly tapered in line with clinical improvement. The colt was hospitalised for a total of 26 days and at time of discharge was clinically normal. Follow-up communication 3 months after discharge confirmed that the colt had remained neurologically normal. Crucially, toxicology testing submitted to Cornell University was negative for common toxins, including fluphenazine decanoate. Specific secondary testing was performed after suspicion of the use of zuclopenthixol decanoate was raised, and this was positive for this compound. Routine drug testing would therefore not identify the use of this behaviour modifying drug. Clinical data regarding the use of zuclopenthixol in animals is limited to its use in translocation of wildlife to relieve stress and aid acclimatisation. To our knowledge there is no available literature describing administration of zuclopenthixol decanoate in equine patients.

Sexually transmitted infections (STIs) are a major global public health concern, with human papillomavirus (HPV) being one of the most common STIs affecting both men and women worldwide [1]. It is estimated that about 75% of sexually active people will contract HPV at some point in their lives [1]. The impact of HPV on health can be severe, causing various health problems such as genital warts, cervical, anal, penile, and oropharyngeal cancers [2].Several studies conducted in Africa have shown significant HPV prevalence rates among men who have sex with men (MSM). In sub-Saharan Africa, HPV was detected in a range of 19.1% to 100% of men, with a pooled prevalence of 78.2% among HIV-positive men and 49.4% among HIV-negative men [3]. Another study in South Africa found that HPV genotypes were detected in 72.8% of anal, 11.5% of oro-pharyngeal, and 15.3% of urine specimens of MSM, with multiple HPV types being more common in the anal canal [4]. Additionally, a study in Nigeria reported a higher prevalence of anal high-risk HPV (HR-HPV) among HIV-positive MSM compared to HIV-negative MSM [5], while another study in Mali found that a significant percentage of MSM had anal HPV infection of any genotypes, with a large portion being HR-HPV positive [6]. The increasing prevalence of anal HR-HPV among MSM in Africa highlights the urgent need for increased HPV screening and prevention measures targeted at this population, particularly HIV-positive MSM.HPV vaccination programs are highly effective in reducing the burden of HPV and associated diseases in both men and women [3]. The vaccine offers long-lasting protection against HPV infections that are most commonly associated with cancer [7]. Although the vaccine is primarily known for preventing cervical cancer in women, it can also prevent HPV-related cancers in men, such as anal, penile, and oropharyngeal cancers [7]. Moreover, vaccinating men can lead to herd immunity, which can protect women from HPV-related diseases [2]. Therefore, it is essential to prioritize the HPV vaccine for MSM who engage in anal sex to prevent HPV-related cancers and reduce the overall burden of HPV in Africa.However, the low uptake of the HPV vaccine in Africa, especially among high-risk individuals, is concerning despite the vaccine’s effectiveness in preventing HPV-related diseases. Only 14 of the 54 African nations have included the HPV vaccine in their national immunization programs for girls as of 2021, and no countries in western and central Africa have included widespread HPV vaccination in their national immunization programs [8 10]. Furthermore, currently, no countries in Africa offer HPV vaccination to men [8]. This means that individuals engaging in anal sex, who are at a higher risk of developing anal cancer, are not receiving the protection they need, despite the high prevalence of HPV infection among MSM. This underscores the urgent need to prioritize the inclusion of the HPV vaccine in national immunization programs in Africa, and to ensure equitable access to the vaccine for all persons, including MSM.To improve access to healthcare services and HPV vaccination for MSM in Africa, it is crucial to address both the structural and social barriers that hinder their access to these services. Some of the barriers that HPV-infected MSM face include a lack of information, general vaccine hesitancy, a lack of advice from healthcare professionals, expense and logistics, and the perception that HPV vaccination may encourage promiscuity [9]. Furthermore, discrimination and the criminalization of same-sex behavior can further prevent MSM from accessing healthcare programs [10].A comprehensive approach is necessary to overcome these barriers and improve access to healthcare services and HPV vaccination for MSM in Africa. This includes community-based interventions [11], and healthcare professional training to increase awareness about HPV, the benefits of vaccination, and to reduce vaccine hesitancy among MSM [12]. Healthcare professionals should also receive training to provide culturally competent care to meet the unique healthcare needs of MSM in a non-judgmental manner [12]. Policy changes are also necessary to eliminate discrimination and criminalization of same-sex behavior and enable MSM to access healthcare services without fear of stigma or persecution [10]. Moreover, to increase vaccine coverage in Africa, the HPV vaccine should be made affordable and accessible to all individuals, regardless of their socioeconomic status [10]. This can be achieved by implementing community-based vaccination programs, mobile clinics, and school-based vaccination programs. Overall, these interventions can help to improve vaccination rates and increase access to healthcare services for MSM in Africa, ultimately leading to better health outcomes and reducing health disparities.

A document by Tejash Shahi. Click on the document to view its contents.

A Series of Unfortunate Events: Long-neglected Malpositioned Pacemaker and its ConsequencesAbdelrahman Osman, BS and Ali Ahmad, MD.