Evidence shows limited use of routine data to support health actions in lower and middle-income countries. To address that, there are several ongoing efforts to strengthen routine health information systems which are largely crippled by the fragmented nature of the health system. This review determines factors influencing routine data use at different health system levels. We scoped up four literature sources, i.e., PubMed, IEEE Xplore, the Public Library of Science (PLOS), and Google Scholar for the article published between January 2019 and December 2023. Three reviewers independently screened article titles, abstracts, and full text against inclusion and exclusion criteria, following the Arksey and O’Malley and PRISMA framework to guide the review process. We classified our findings into three health system levels: i.e. facility, district, and national/sector-wide. Out of 387 articles retrieved from databases, 41 articles were selected for inclusion, where the majority of the articles (48.8%), were on the health facility level. The study found that factors influencing the use of routine data vary across health system levels, with human resource capacity and friendly data collection tools being more important at the facility level. In contrast, the availability, and capacity to use analytical tools and governance structures were more reported at the district and national levels. Further, capacity building in health information systems, IT infrastructure, and regular supervision, were identified as crucial across all health system levels. We argue for focused interventions to be designed to institutionalize routine data use practices for better healthcare outcomes across health system levels.

FeRh is an intermetallic magnetic compound featuring a B2-ordered structure and exhibiting a first-order antiferromagnetic (AFM) to ferromagnetic (FM) phase transition near room temperature. Here, we explore the magneto-thermoelectric properties encompassing the resistivity, Seebeck coefficient, and Thomson coefficient in near-equimolar FeRh thin films grown on three different substrates, namely Al2O3 (sapphire), SiO2/Si, and MgO. The substrate affects the phase transition temperature by inducing in-plane strain (compressive for MgO, tensile for sapphire and SiO2/Si), while film thickness shifts the transition to higher temperatures. At the same thickness of 80 nm, the MgO films have the highest phase transition temperature, the hysteresis loop of sapphire films starts at around 300K, and that of SiO2/Si shifts to 200K. While the Seebeck coefficient in the FM phase remains negative consistently, the Seebeck coefficient of the AFM phase varies in sign depending on the substrate, film quality, and thickness. The larger negative Seebeck coefficient values in the FM phase are attributed to the larger FM density of states around the Fermi level. We discuss the role of crystal quality in designing a pathway for heightened Thomson response in FeRh thin films. Within the monitored temperature range, Thomson coefficient values as large as -250 µV.K−1 were observed with non-negligible values in a 50 K temperature range. We also observe a larger Nernst thermopower in the FM phase, the lower-mobility phase, and an unusual sign change in the AFM phase.

Background: In recent years, digital thoracic drainage systems have been introduced. Limited studies address the benefits and risks in pediatric patients. We compared analog and digital systems using a high-fidelity 3D-printed phantom. Methods: Direct measurements as well as measurements on a 3D-printed phantom were conducted employing a digital and analog system for different suction pressures (-1 to -20 cmH 2O). The impact of a siphon and automatic flushes of the digital system were studied. Results: At pressure settings of -20 and -10 cmH 2O, direct and phantom measurements yielded significantly different results for the digital compared to the analog system. Set pressures below -10 cmH 2O in the analog drainage system were unreliable. For the digital system, the majority of measured points fell within the chosen settings. There were statistical outliers up to -30 cmH 2O attributed to the regular flushing performed by the system. Conclusion: This is the first experimental study objectifying the suitability of digital drainage systems for the pediatric and neonatal population. Our phantom produced accurate results where tests on patients are not possible. At suction pressures of -20 and -10 cmH 2O the digital and the analog drainage system yield satisfactory results. The digital system was able to maintain pressures as low as -5 cmH 2O. The analog drainage system is less flexible but remains a reliable tool for experienced users. The digital drainage system allows more freedom and can increase patient safety by neutralizing obstructions or a siphon. The increase in suction during flushing may pose a risk for neonatal patients.

Surface-functionalized magnetic iron oxide (F-Fe 3O 4) nanoparticles are receiving considerable research interest due to their exceptional chemical stability, strong magnetic responsiveness, and excellent biocompatibility. At present, F-Fe 3O 4 nanoparticles are widely used in many fields, including interfacial separation, catalysis, biosensing, and medical Nuclear magnetic resonance imaging. However, there are still cognitive blind spots regarding the application of F-Fe 3O 4 nanoparticles in different fields. Herein, first of all, the basic theories of magnetic Fe 3O 4 nanoparticles were systematically discussed, including structural characteristics, magnetic behavior, preparation methods, and characterization techniques. Then, based on the fundamental theories, the applications of F-Fe 3O 4 nanoparticles in important fields (such as oil-water interface separation, photocatalysis, thermal catalysis and electrocatalysis, biosensing and medical magnetic resonance imaging) were systematically reviewed. Finally, the paper delves into the scientific challenges faced by F-Fe 3O 4 nanoparticles in various application fields, thereby providing potential insights and directions for the further development of F-Fe 3O 4 nanoparticles. This review is helpful to deepen the understanding of the scientific issues faced by F-Fe 3O 4 nanoparticles and provide theoretical guidance for the development and application of F-Fe 3O 4 nanoparticles. Additionally, this review provides the necessary engineering theoretical guidance to accelerate the large-scale commercial application of F-Fe 3O 4 nanoparticles, which possess significant scientific value and profound social significance.

Dynamic adaptation in knowledge representation has emerged as a critical requirement for addressing the limitations of static embeddings in contemporary machine learning architectures. The Dynamic Neural Embedding Framework (DNEF) introduces a novel methodology for embedding generation, allowing for real-time contextual refinement and improved adaptability across diverse linguistic environments. Implemented within a state-of-the-art open-source language model, the framework demonstrated significant enhancements in predictive accuracy, computational efficiency, and robustness to noisy inputs. The proposed architecture leverages modular embedding layers and context-sensitive gating mechanisms to dynamically adjust representations based on evolving semantic patterns. Extensive experimentation across various tasks revealed superior performance in scalability, training convergence, and generalization to previously unseen domains, with minimal tradeoffs in computational overhead. These findings substantiate the potential of dynamic embedding mechanisms to transform the development of advanced language models, addressing critical challenges in flexibility, efficiency, and linguistic comprehension.

Experimental characterization of amino acid functions of Domains of Unknown Function (DUF) proteins is expensive, and time-consuming which could be complemented by computational methods. Cysteine, being the second most reactive amino acid at the catalytic sites of enzymes, was selected for functional annotation and characterization on DUF proteins. Earlier we reported functional annotation of Cysteine on DUF proteins belonging to the COX-II family. However, holistic characterization of Cysteine functions on DUF proteins was not known, to the best of our knowledge. Here, we annotated and characterized Cysteine post-translational modifications (PTMs) based on biochemical pathways, diseases, taxonomy, and protein microenvironment. The information on uncharacterized DUF proteins was initially obtained from the literature and the sequence, structure, pathways, taxonomy, and disease information were retrieved from the SCOP database using DUF IDs. Protein microenvironments (MENV) around Cysteine were computed using protein structures. The Cysteine PTMs were predicted using the in-house Cysteine-function prediction server, DeepCys (https:/deepcys.bits-hyderabad.ac.in). The information was consolidated in the database ([http://cysduf.bits-hyderabad.ac.in/](http://cysduf.bits-hyderabad.ac.in/) ), retrievable in downloadable formats (CSV, JSON, or TXT) using the following inputs, DUF ID, PFAM ID, or PDB ID. For the first time, we annotated Cysteine PTMs in DUF proteins belonging to seven different biochemical pathways. For the first time, the Cysteine PTMs in DUF proteins were elucidated in Viruses, namely, SARS-COV2. The nature of MENV around Cysteine from DUF proteins (reported for the first time) was mainly buried and hydrophobic in nature; however, in viruses, a significant number of Cysteine residues were embedded in the exposed and hydrophilic microenvironment.

The Old Yellow Enzyme from Ferrovum sp. JA12 (FOYE) displays an unusual thermal stability for an enzyme isolated from a mesophilic organism. We determined the crystal structure of this enzyme and performed a bioinformatic characterization to get insights into its thermal stability. The enzyme displays a tetrameric quaternary structure, but unlike the other tetrameric homologs, it clusters in a separate phylogenetic group and possesses unique interactions that stabilize the oligomerization. The thermal stability of this enzyme is due mainly to an unusually high number of intramolecular hydrogen bonds. Finally, this study provides a general analysis of the forces driving the oligomerization in Old Yellow Enzymes.

Single food allergy and reasons for multiple exclusions: a prospective study.To the Editor,Food allergies (FA) present an increasing global challenge, influenced by factors such as genetic predisposition, ethnicity, age, and cultural dietary practices. Consequently, making predictions about future allergic reactions remains challenging and uncertain (1). For instance, in Brazil, it is estimated that approximately 6% of children under the age of three and 3.5% of adults suffer from FA, some studies even report a prevalence over 10% (1,2).Patients diagnosed with IgE-mediated FA must adhere to strict dietary restrictions to avoid potential life-threatening anaphylactic reactions. Such restrictions are crucial but come with significant consequences as increased nutritional risks, higher costs for special meal preparations and medical care with potential social and psychological impacts on both the individual and their family (3-6). The impact of FA on quality of life is frequently surrounded by persistent fear of adverse reactions after consuming certain foods (3).To better manage FA, it is important to understand the reasons behind the exclusion of additional foods beyond the primary allergen. This study aims to explore whether patients with confirmed IgE-mediated FA tend to exclude other foods and to identify possible reasons for such exclusions.This is a cross-sectional analysis conducted at a tertiary referral outpatient setting in Brazil with patients from 2011 to 2022. Were considered as truly FA patients with: recurrent clinical history consistent with IgE-mediated reactions or anaphylaxis, associated with positive specific IgE or a positive oral challenge test with IgE-mediated reactions. Patients with anaphylaxis due to non-food allergens, mixed or non-IgE-mediated food allergies, or comorbidities requiring restrictive diets unrelated to IgE-mediated reactions were excluded.Out of 305 patients followed,180 met the inclusion criteria. Data on the epidemiology and allergens excluded were extracted from institutional electronic medical records, with supplementary data obtained through telephone interviews when necessary for questionnaire completion. The primary diagnosticated allergen was categorized as F1, while additional excluded foods were classified as F2. Descriptive statistical analyses were taken via SAS 9.4 software. Qualitative variables were reported as frequencies and percentages, and quantitative variables as means and standard deviations. The study was approved by the local Ethics Commitee (Comitê de ética do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - CAAE number: 77471224.7.0000.0068) and  all persons involved had provided their informed consent to be a part in the study.Most of the patients, predominantly male, were diagnosed with allergies before six months of age. The most common F1 was milk (77.78%), followed by egg (17.22%). Anaphylaxis was reported in 70.56% of the patients, with a complete F1 epidemiological profile seen in Table 1 and 2.Of the patients, 55% excluded at least one F2, with an average of 1.57 exclusions per patient, ranging from 1 to 12, and 14 detected F2s. The primary reasons for excluding additional foods were an isolated positive specific IgE test (32.24%), and symptoms attributed to foods without diagnostic confirmation (21.86%), as detailed in Table 3. This can be considered a  pioneer study in Latin America, as it examines FA within the dietary diversity of this population, and addresses the existence of other food exclusions.As supported by international literature (4), there was a high number of secondary exclusions in patients with IgE-mediated allergies. However, new foods are becoming significant on this list, such as fruits, abundant on the local diet.Milk and eggs are prevalent in Brazilian dietary guidelines, both as whole foods and in preparations since the start of complementary feeding (1,2), which explains why milk was the most described F1, followed by eggs, a widely consumed protein. Peanuts, a food strongly associated with FA in the Northern hemisphere, was less common among the studied population, as they are less used in daily local diet (1,2).Among children with secondary exclusions, the most frequent was eggs. In this context, excluding such a common food from the daily diet increases the risk of impacting nutritional development and quality of life, especially for children in growth and neuropsychomotor development stages. This highlights the importance of understanding the reasons for food exclusions in order to mitigate the risks, as well as the consequences, associated with their removal from the diet (1,3,5,6).Surprisingly, the primary cause of excluding a second food was not a second IgE-mediated allergy but rather the presence of laboratory tests without symptoms or symptoms without laboratory confirmation/criteria for IgE-mediated FA, emphasizing the importance of accurate diagnosis, avoiding misdiagnosis through indiscriminate requests for unproven diagnostic tests or specific IgEs, which can by itself lead to the development of an IgE-mediated FA upon reinsertion, as demonstrated studies involving patients with atopic dermatitis (1,9)Although fatal anaphylaxis is rare, around 30% of individuals with IgE-mediated FA seek emergency treatment for allergy-related reactions (4). This ongoing fear can prevent patients and their families from trying new foods (neophobia) and may result in a cycle of unnecessary food exclusions, which could further exacerbate nutritional deficiencies and contribute to the development of additional allergies. In fact  the combination of fear and indiscriminate specific IgE testing can pose a risk of misdiagnosis, highlighting the importance of knowledge of diagnostic and screening criteria to reduce the findings of sensitization in asymptomatic patients or those without compatible IgE-mediated reactions and unnecessary exclusions.Based on the profile of secondary exclusions, it is increasingly important for the medical community to be aware that there are no reasons to alter the age and pattern of complementary feeding introduction, with no restriction of potentially allergenic foods, preventing unnecessary food exclusions, increasing the risk of selective eating, and neophobia (1,2,3,6,8). In this study’s case, patients who started excluding foods based only on sensitization, might become truly allergic to those foods upon re-insertion, increasing the risk of FA in a potentially preventable manner.Only about 20% of patients were truly F2 allergic, also suggesting the possibility of associations among some allergies, more than just antigenic similarity, but also syndromic other phenotypes as multiple FA. This needs to be explored in future research, like the association between milk and eggs or eggs and nuts allergies. It is important to understand IgE-mediated symptoms and to recognize when to value symptoms arising from non-immunological situations, such as food contamination, viral urticaria, worsening of atopic dermatitis lesions, among others, due to the risk of incorrect diagnosis and unnecessary food exclusions (2,9).The study has also several limitations: it was conducted at a single center and relied mostly on secondary data, which may introduce bias and limit the generalizability of the findings. The sample was limited by convenience, and not all excluded foods were diagnostically tested via oral food challenges (gold standard).This study demonstrates that patients with IgE-mediated FA frequently exclude additional foods usually based on non-confirmatory tests and fear of reactions. Such practices can lead to unnecessary nutritional, social, and economic consequences. A comprehensive approach to FA management, incorporating accurate diagnostic methods and careful consideration of clinical history and test results, is crucial for improving patient outcomes and quality of life.Kind Regards,Paula Mendonça P.S Gomes-MD1, Isadora C.M. Francescantonio-MD1, Beni Morgenstern-MD,PHD1, Mayra B. Dorna-MD,PHD1, Antonio C. Pastorino-MD,PHD1, Ana Paula M Castro-MD,PHD1Affiliations: 1- Allergy and Immunology Department - Instituto da Criança- University of São Paulo, São Paulo, SP, BrazilConflict of interest: the authors have no conflict of interest to declareWord Count: 1173Keywords : Food-Allergies, IgE Mediated, motivation

Background Cystic fibrosis (CF) is a multi-system disease that causes chronic respiratory failure, malnutrition and poor growth as a result of a negative energy balance due to maldigestion and malabsorption. Achieving linear growth and height above the 50 th percentile is associated with improved lung function. In October 2022, the use of Elexacaftor/Tezacaftor/Ivacaftor (ETI) was approved for children with CF from the age of 6 years. Analyses on the effect of ETI on height velocity (HV) are not usually available from trial and real life data and our work aims to study growth pattern by HV. A secondary aim was to check for any differences according to the CFTR variants severity. Methods We conducted a single-center prospective study at the CF Unit of the Bambino Gesù Children’s Hospital, including children aged 6-11 years who were eligible for ETI. The whole population of 24 people with CF (pwCF) underwent evaluation of height, weight, body mass index (BMI), bone mineral density (BMD), body composition analysis with bioelectrical impedance analysis (BIA), and muscle weakness using the one-minute sit-to-stand test (1STST) before starting the new drug. Height, weight, height velocity (HV), BMI standard deviation scores (SDS) were calculated for both 6 months before and 6 months after the start of ETI treatment. Results The mean age of the population was 8.7 years (SD 1.87), with a balanced gender distribution (F/M 12/12) and majority naïve to previous CFTR modulators. We found a significant difference in the growth rate achieved when comparing the calculated mean HV between T (-6 months) and T0 (4.2±2.0 cm/year; -1.96±2.4 SDS) with the HV between T0 and T (+6 months) (7.1±3.0 cm/year; +1.5±3.7 SDS) (p<0.0001). The group with F508del/minimal function mutations (F/MF) – 15 pwCF – had a higher average speed than those with homozygous F508del (F/F) – 5 pts – and those with F508del/residual function mutations (F/RF) – 4 pts – ( p< 0.0001). We found no significant differences in the three different genetic groups concerning BMD and initial lean mass. Conclusion The results highlight the benefit of ETI in the pediatric CF population, particularly by increasing the HV in children aged 6-11, especially those with the F/MF genotype. This study further emphasizes the impact of CFTR restoration on a fundamental aspect of the CF child’s well-being, growth.

Background: Asthma rates are rising globally, posing a significant public health challenge. In Qatar, childhood asthma affects 34.6% of children, making it a common chronic condition.The global scope of existing literature on the association between childhood asthma and perinatal and neonatal risk factors may not fully account for Qatar’s distinctive socio-cultural, genetic, and healthcare aspects. Therefore, this research aims to emphasize the importance of considering regional variations in health outcomes. Objectives: To investigate the association between childhood asthma development and mode of delivery, gestational age, and birthweight in Qatar. Methods: A hospital-based case-control study was conducted in Qatar across Hamad General, Al Wakrah, and Al Khor hospitals from January 2020 to July 2023, including 830 asthma cases and 1,512 non-asthma controls aged 6-14 years. Secondary data from Electronic Medical Records were analyzed using logistic regression, with odds ratios (ORs) and adjusted odds ratios (aORs) calculated for each factor. Confounders were managed through Directed Acyclic Graphs (DAG), and multiple imputations addressed missing data. Results: Asthma prevalence was 35.4%. Compared to controls, asthma cases were more likely to be males (65% vs 41%) and have a family history of asthma (31.3% vs 1.7%). In addition, Cesarean delivery (aOR 1.15, 95% CI 0.92, 1.44), preterm birth (aOR 1.07, 95% CI 0.79), and low birth weight (aOR 1.03, 95% CI 0.61, 1.73) showed slight increases in asthma risk. However, none of these associations reached statistical significance. Conclusion: Despite non-significant associations, findings underscore the importance of considering regional variations and context-specific research.

Clinical correspondence

Sepsis is characterized by life-threatening organ dysfunction caused by dysregulated host response to infection. An underlying cause of sepsis is dysregulation of neutrophil-endothelial interactions. To date, therapeutic approaches are supportive, and there are no effective drugs that target immune dysregulation and alter neutrophil-endothelium function. In our prior investigation, three distinct neutrophil functional phenotypes (i.e., Hyperimmune, Hypoimmune and Hybrid) were identified in sepsis patients through a comprehensive analysis encompassing clinical, organ-on-chip and proteomic assessments. In this study, we utilized bioinformatics to elucidate cellular processes impacting each neutrophil phenotype. These findings were leveraged to identify potential FDA-approved therapeutics that could be repurposed to target proteins within each phenotype highlighting the impact in normalizing altered neutrophil-related responses such as adhesion and migration. A protein-protein interaction network was employed to prioritize these target proteins. Finally, we identify several FDA approved therapeutics for treating sepsis including a (pre)clinical trial therapeutic targeting VTN in the Hybrid phenotype, a therapeutic targeting TRPV2 in the Hypoimmune phenotype and a (pre)clinical trial therapeutic targeting H2AC21 in the Hyperimmune phenotype. Thus, we not only identified critical cellular processes impacting each neutrophil phenotype but also reveal those protein targets that could be prioritized for future validation in the treatment of sepsis.

As a collection of all the genetic variants in the gene pool, the pangenome is a concept that will become fundamental to conservation genomic studies. Unfortunately, most pangenomic approaches developed for humans and model organisms are financially impractical for conservation genomic studies of threatened or endangered species due to the high costs associated with deep sequencing multiple individuals using long read platforms. Here, by integrating metagenomic and iterative map-then-assemble approaches, we (1) propose novel workflows to construct graph pangenomes from multiple low-coverage short-read datasets; (2) benchmark these short-read pangenomes (both linear and graph) against a previously published long-read graph pangenome of the barn swallow; and (3) evaluate the utility of our workflows in population and conservation genomics. Our results indicate that economical short-read graph pangenomes can recover the vast majority of the variants identified through expensive long-read graph approaches, and that these variants accurately detect important biological signals (e.g., spatial structure and independent taxonomic delineations). These results mean that researchers can utilize their limited, conservation-oriented funding to more fully characterize all the variants in a particular gene pool for population-level analyses.

Population genetic clustering methods are widely used to detect hybridization events between closely related populations within species, as well as between deeply diverged lineages across phylogenetic time-scales. Their strengths and limitations in the latter cases, however, remain poorly explored. This study presents a systematic evaluation of the performance of the most popular population clustering method, STRUCTURE, under a variety of cross-species hybridization scenarios, including hybrid speciation, as well as introgression involving ghost (i.e., extinct or unsampled) lineages or otherwise. Our simulations demonstrate that STRUCTURE performs well in identifying hybrids and their parental donors when admixture happens very recently between sampled extant lineages, but generally fails to detect signals of admixture when hybridization occurs in deep time or when gene flow stems from ghost lineages. We find that symmetrical parental contribution in cases of hybrid speciation will often be revealed as extremely asymmetrical in STRUCTURE, especially when the admixture event occurred a long time ago. Our results suggest that population-genetic clustering methods may be inefficient for detecting ancient or ghost admixtures, which may partly explain why ghost introgression has escaped the attention of evolutionary biologists until recently.

We investigated the ferroelectric properties of 10nm BaTiO 3 (BTO) nanocubes formed by dispersing them on the surface of an Nb-doped SrTiO 3 (Nb:STO) substrate. The microwave synthesis procedure produced BTO nanocubes with a size of approximately 10 nm, and the BTO nanocubes were dispersed in ethanol before being spin-coated on the surface of the Nb:STO substrate. From the piezoelectric d33 hysteresis loops measured by a piezoresponse force microscope, it was confirmed that the 10 nm BTO nanocubes exhibited canonical ferroelectric properties. External voltages were applied to switch the polarization of the 10 nm BTO nanocubes, providing further evidence of their ferroelectric behavior. In particular, it was experimentally confirmed that the BTO nanocubes with a size of about 10 nm can be utilized as tunnel ferroelectric junction memory devices.

Introduction: Timely commencement of antenatal care (ANC) improves maternal outcomes by reducing complications that often result in death. According to the World Health Organization, 800 women died daily in 2020 from preventable complications related to pregnancy and childbirth, with 95% occurring in developing countries. Despite efforts by the Rwandan government to promote maternal health, delayed ANC visits remain prevalent in rural areas. This study aimed to determine the prevalence and predictors of delayed first ANC visits in rural Rwanda . Methods: This cross-sectional study used Rwanda Demographic and Health Survey (RDHS) data, enrolling 4039 women who had been pregnant within five years before the survey. Logistic regression modeling identified socio-demographic and maternal characteristics associated with delayed first ANC visits . Results: The prevalence of delayed first ANC visits was 40.2%. After adjustment in a multivariate regression model, factors associated with delay included low wealth index, marital status, maternal age (25-34 and 35-49), having 2-4 or more than 4 children, and occupation. Health insurance coverage was a protective factor against delays . Conclusion: The findings highlight the need for interventions at multiple levels to increase timely uptake of first antenatal care visit, as the study revealed that socio-demographic and maternal factors significantly influence delays in initiating ANC .

This study reviewed the use of Low-Level Laser Therapy (LLLT) to accelerate bone fracture healing. Despite inconsistent results regarding callus formation and fracture line consolidation, LLLT showed benefits in pain and edema reduction and lower medication use. Methodological discrepancies, such as variations in dosage, duration, and laser parameters, hinder definitive conclusions. Studies suggest that dosages around 10 J/cm 2 have higher therapeutic potential. While effects on bone mineral density and content are limited, LLLT improves motor functionality and enhances recovery comfort. Future research should explore optimized parameters and conduct megatrials with longer durations and larger samples. The study concludes that LLLT is promising as an adjunct therapy but requires standardization for effective clinical application.

The conventional method of screening for anemia requires the pathologist or technician to manually focus the microscope and examine one slide at a time, making the process tedious, especially in health emergencies. Therefore, the research work aims to design and develop an automated high-throughput optical digital microscope-based device for scanning and capturing blood smear images using Laplacian based auto focusing algorithm of 10 peripheral blood smear slides sequentially in a batch focusing on a particular field of view at an objective lens magnification of 40x. The acquired images are segmented using YOLO(You Only Look Once) algorithm to analyze the morphology of red blood cells (RBC) to screen for anemia. with a multilayer perceptron (MLP) classifier images are categorized into macrocytic, microcytic, normocytic subclasses and normal class. The trained model is embedded in a smartphone application to map classified anemic images by geographic location, creating anemia clusters.

This study examines the impacts of oil thefts and artisanal refining on landuse/landcover and food security in Ahoada-East Local Government Area of Rivers State, South-South, Nigeria from year 2002 and 2022 covering a twenty years’ period. Landsat images with path 189 and roll 56 for the years 2002 and 2022 were acquired for this study; Landsat 7 image was used for 2002 while Landsat 8 image was used for 2022. Results of the analyses showed that agricultural land decreased from 61.60km2 in 2002 to 29.40km2 in 2022 indicating a huge decreased with its far-reaching agricultural and environmental consequences. Bare soil which was 0km2 in 2002 increased to over 10.3km2 in 2022 showing the extent of devastations emanating from the activities linked to oil thefts and artisanal refining activities in the area. Degraded land increased from 0km2 in 2002 to 5.15km2 in 2022. Dense wetland vegetation decreased from 286.27km2 in 2002 to 219km2 in 2022 representing a 70 percent change within a twenty years’ period. Settlement increased from nearly 52.82km2 in 2002 to over 138km2 in 2022. Waterbody decreased from 5.56km2 in 2002 to 4.2km2 in 2022 representing a 1.37percent change within the period of twenty years. The combined effects of population growth and activities linked to oil thefts and artisanal refining of hydrocarbon in Ahoada-East have tremendous impacts on agriculture, food security, biodiversity conservation, deforestation and forest degradation, among other environmental consequences. We therefore call on all stakeholders including community leaders, youth, government at all levels, oil companies, and non-governmental organizations to actively get involved in providing sustainable livelihoods for the local populace, and sensitization on the protection of forest and forest resources.

Objective: To highlight risk factors affecting outcomes of vocal cord paralysis (VCP) in patients with Arnold-Chiari malformations (ACM). Methods: A systematic review was conducted according to the 2020 PRISMA checklist. The authors comprehensively searched multiple databases from inception till August 2023 for both keywords and medical subject headings pertinent to ACM and VCP. Data from 33 studies were obtained by applying predetermined inclusion and exclusion criteria and quality assessment of the chosen articles. Meta-analysis using Chi-squared test and binary logistic regression was performed to determine the association between age and other variables. Results: The 33 studies included a total of 165 patients with a mean age of 15.31 months. The predominant type of Chiari malformation was type 2, observed in 120 cases. Bilateral vocal cord paralysis was confirmed in 103 patients while 12 patients had unilateral disease. The most common treatment modality was ventriculoperitoneal shunt placement in 108 patients (65.45%), followed by posterior fossa decompression surgery in 86 patients (52.12%). Regarding airway status, most patients were not intubated (65.45%), however more than one third of patients underwent tracheostomy (38.79%) following VCP. There was a significant association between the age of VCP onset and both recovery and survival in both the overall cohort and the ACM II cohort. Conclusion: Age at onset of VCP is a critical factor associated with both recovery and survival rates in pediatric patients, with younger age linked to partial symptom resolution and worse survival.

Objectives Luc’s abscess (subperiosteal collection beneath the temporalis muscle) is a rare complication of acute otitis media. We aim to contribute a case report to the existing literature and to provide an up-to-date review on all the existing publications to offer more standardised clinical features and surgical management of these patients. Design A systematic review of the literature was carried out for published cases describing a Luc’s abscess which complicated a presentation of otitis media, confirmed through radiological investigations, written in the English language. The collected data were merged and clinically appraised. Results A total of 36 cases were include. The different surgical treatment approaches can broadly be divided into three groups: abscess drainage alone, abscess drainage with myringotomy and grommet insertion, or abscess drainage with mastoidectomy. Only one patient opted to be treated medically with intravenous antibiotics without any surgical intervention with subsequent clinical improvement. Conclusions The clinical picture of patients with Luc’s abscess overlaps and certainly help to confirm suspicions of the diagnosis prior to radiological confirmation. Although intracranial complications such as intraoperative evidence of purulent mastoiditis have been sufficiently reported, the limited pool of data is not sufficient to advocate for mastoidectomy in all cases with radiological evidence of disease over a more conservative surgical approach for drainage of the abscess. The decision to avoid or perform a mastoidectomy first line should be considered on a case-by-case basis, carefully considering factors such as clinical assessment and radiology, especially when the case concerns a paediatric patient.

Objective: To investigate the clinical characteristics, diagnostic methods, and treatment of sudden deafness caused by inner ear hemorrhage. Methods: MRI 3D-FLAIR was used to diagnose inner ear hemorrhage in patients with sudden sensorineural hearing loss(SSNHL). The clinical data, hematological examination, audiological examination, vestibular function test, and prognosis were analyzed. The results were compared with those of patients without inner ear hemorrhage. Results: 25 patients with inner ear hemorrhage showed high signal intensity in different parts of the inner ear (cochlea, semicircular canal, vestibule). According to the frequency and degree of hearing loss, 19 cases (76.0%) were total deafness type. According to the average hearing threshold classification, 24 cases (96.0%) were extremely severe deafness. 21 cases had persistent vertigo. Treatment outcomes were poor, and 3 cases (12.0%) were ”aggravated.” Compared with the control group (40 cases) without inner ear hemorrhage, there were significant differences in the degree of hearing loss, accompanying symptoms, and vestibular function. There was no significant difference in the efficacy between the two groups. Conclusion: The clinical manifestations of sudden deafness due to inner ear hemorrhage are serious, with poor prognoses. MRI 3D FLAIR is the preferred diagnostic method for inner ear hemorrhage. T1WI and 3D FLAIR sequences show abnormally high signal intensity. Hemorheological therapy should be used with caution before MRI diagnosis.

Background: A malignant tracheoesophageal fistula (mTEF) is a complication of primary tumor growth or the recurrence of esophageal tumors or lung carcinoma. Patients with mTEF have lower survival and quality of life than those who do not develop this complication. Esophageal cancer (EC), a common gastrointestinal malignancy, ranks among the world’s leading causes of cancer-related death. The low survival rate in patients with EC is attributed to malnutrition, repeated aspiration, and severe infection, and the mean survival duration of 2 to 4 months after diagnosis. This study investigated the clinical characteristics of patients with EC complicated with mTEF and the efficacy of various treatment regimens. Methods: This study was a retrospective analysis of the clinical data of 51 patients with EC complicated with mTEF hospitalized at Guangdong Provincial People’s Hospital from February 2007 to May 2021. Patients were divided into three groups according to their treatment regimen: a traditional medical (TM) treatment group, an esophageal intervention (EI) treatment group, and an airway intervention (AI) treatment group. Results: Of the 51 patients, 22 received TM treatment, 13 received AI, and 16 received EI. The overall median survival duration was 87 days (TM group, 42 days; AI group, 108 days; EI group, 104 days) and the overall mean survival duration was 130.1 days (TM group, 88.1 days; AI group, 153.5 days; EI group, 166.1 days). Cox regression analysis revealed that the treatment regimen was an independent predictive risk factor for increased survival 1 month after treatment in patients with EC complicated with mTEF, and most symptoms were relieved in the EI and TI groups. Conclusions: Interventional treatment of the esophagus and airway in patients with EC complicated with mTEF is an effective approach to improve symptoms and increase short-term survival.

Papaverine (PV) has been previously identified as a promising candidate in SARS-CoV-2 repurposing screens. In this study, we further investigated both its antiviral and immunomodulatory properties. PV displayed antiviral efficacy against SARS-CoV-2 and influenza A virus (IAV) H1N1 and H5N1 in single infection as well as in co-infection. We demonstrated PV´s activity against various SARS-CoV-2 variants and identified its action at post-entry stage of the viral life cycle. Notably, treatment of air-liquid interface (ALI) cultures of primary bronchial epithelial cells with PV significantly inhibited SARS-CoV-2 levels. Additionally, PV was found to attenuate interferon (IFN) signaling independently of viral infection. Mechanistically, PV decreased the activation of the IFN-stimulated response element (ISRE) following stimulation with all three IFN types by suppressing STAT1 and STAT2 phosphorylation and nuclear translocation. Furthermore, the combination of PV with approved COVID-19 therapeutics molnupiravir and remdesivir demonstrated synergistic effects. Given its immunomodulatory effects and clinical availability, PV shows promising potential as a component for combination therapy against COVID-19.