All Articles in june, 2024

Introduction: Despite the benefits of Cardiac Rehabilitation (CR), local and national CR referral and participation rates remain low when compared to established cardiovascular therapies, especially amongst racial/ethnic groups. Objectives: This study investigated the effects of the implementation of a CR program and electronic order set (EOS) in a large health system on CR referral and participation rates among a diverse group of patients with Coronary Heart Disease (CHD). Methods: A total of 360 patients from UCSD Health who presented with ACS were prospectively evaluated during initial hospitalization and 6- and 12-weeks post-discharge. The multivariable logistic regression model assessed referral and participation rates by week 1 and -12 post-discharge, adjusting for gender, age, race, ethnicity, geography, and referring physician subspecialty. Results: UCSD CR program implementation led referral rates to increase at week 1 (Pre- 38.6% and Post-54.9%, p = 0.003) and week-12 (Pre- 54.1% and Post- 59.8%, p = 0.386). Post-CR referrals were more likely at week-1 (OR: 1.93, 95% CI 1.27-2.95) and week-12 (OR: 1.26, 95% CI 0.79-2.00). EOS implementation increased referral rates at week-1 (Pre- 40.3% and Post- 58.7%, p < 0.001) and week-12 (Pre- 54.9% and Post- 60.4%, p = 0.394) with referrals more likely at week-1 (OR: 2.1, 95% CI 1.35-3.29) and week-12 (OR: 1.25, 95% CI 0.795-1.98). Participation in CR following EOS was more likely at both week-1 and week-12. Multivariable analysis revealed disparities in referral based on race, geographic location, and referring physician subspecialty. Conclusion: A CR program and EOS implementation were shown to increase referral rates with long-term potential for increasing referral and participation rates. Condensed abstract: This prospective study investigated the implementation of a Cardiac Rehabilitation (CR) program and Electronic Order Set (EOS) within the same health system on CR referral and participation rates. 360 patients with ACS were evaluated over 12 weeks. UCSD CR program and EOS implementation led referral rates to increase at week-1 and -12. CR participation was more likely to increase at week-1 and -12 following EOS. Multivariable analysis revealed disparities in referrals disproportionally affecting racial and ethnic minority groups and rural communities. CR and EOS implementation may increase CR referral rates for diverse patients with CHD.

Urinary Tract Infection (UTI) is very common in our community most specifically in married females with numerous antecedent risk factors. The aim of the study was to find out about the current risk factors and clinical profile of urinary tract infections in patients admitted to the cardiology ward of Afghan Momand Medical Complex for various purposes.It was a cross-sectional descriptive hospital-based study including both male and female patients visiting the Afghan Momand Medical Complex from January 2022 to June 2022. Of all 960 patients, 202 (21%) patients had urinary tract infections with gender distribution as 69 (34.2%) males and 133 (65.8%) females. In fact, 33 (16.3%) patients with urinary tract infections were single while the rest 169 (83.7%) patients were married. In addition, regarding clinical profile, the following clinic was respectively more prevalent: Dysuria in 120 (59.4%) patients, flank pain in 73 (36.1%) patients, urine frequency in 67 (33.1%) patients, urgency in 36 (17.8%) patients, fever in 24 (11.8%) patients, and nausea and vomiting in 19 (9.4%) patients. Moreover, the following risk factors were respectively the most common ones: Diabetes mellitus 86 (42.5%), pregnancy 30 (14.9%), stones 15 (7.4%), 10 (4.9%) devices, 10 (4.9%) prostatic hyperplasia, and 4 (2%) anatomical anomalies.Urinary tract infection is a common disease in the admitted patients in Afghan Momand Medical Complex specifically being more common in females and early 20s of the age. In fact, diabetes, pregnancy, and kidney stones were the leading associated factors with UTI. Moreover, dysuria, bladder emptying irritative symptoms, and abdominal pain were the most prevalent clinical profile of the patients. Special attention should be paid to infectious diseases in cardiac patients since infection itself is a stress and a threat to such patients and authorities should design special measures to prevent UTI in the general population to avoid a sum of burden on the health system.

Background: Cervical Cancer poses a significant global health challenge, especially in lowresource settings. It is a significant health problem worldwide, with over half a million new cases diagnosed each year, accounting for approximately 6.6% of all gynecological Cancer cases and over 300,000 deaths each year. In Zambia, it is the leading cause of mortality and morbidity among women. The number of cases has increased by approximately 40%. This study explored the lived experiences of Cervical Cancer patients undergoing chemotherapy at the Cancer Diseases Hospital in Lusaka, Zambia, focusing on their subjective experiences. By examining their journeys through chemotherapy, the study aimed to highlight the subtle complexities in which treatment impacts patients’ lives and well-being.  Methods and procedures: Employing a qualitative descriptive phenomenological study design, in-depth interviews were conducted with 10 participants with diverse demographics. The sample size was determined by data saturation and saturation was reached at 10. Ethical protocols were ensured, and Study approval was obtained from UNZABREC and the National Health Research Authority. Thematic analysis was conducted on audio-recorded interviews with cervical cancer patients, ensuring confidentiality and accuracy while discerning significant patterns and themes in their narratives. Results/findings: Emotional experiences ranged from anxiety to gratitude. Psychological challenges encompassed coping mechanisms, stress management, emotional adjustments, and treatment-related fears. Socially, community support, workplace accommodations, and healthcare provider roles were key. Physical experiences revealed side effects managed through coping strategies. Financial challenges significantly impacted individuals and families.  Conclusions and recommendations: The study revealed that cervical cancer patients undergoing chemotherapy face complex challenges spanning emotional, psychological, social, physical, and financial domains, underscoring the imperative for comprehensive patient-centered care. Recommendations suggest focusing on financial aid for cancer patients and tackling treatment expenses and insurance issues. The Cancer Diseases Hospital should establish multidisciplinary teams for holistic care, and enhance patient education efforts. Nurses should adopt strategies integrating cultural competence and patient-centered care to address diverse challenges during chemotherapy. These aim to enhance the well-being and care quality of Cervical Cancer patients.

The topic of this paper is to describe the 3-D current density in the windings of a 3-D coil, which fills the volume between two coaxial cylinders at a precisely defined distance from each other, and which serves to generate a magnetic field gradient in the center of the cylinder axis. The 3-D current density is considered an unknown input quantity, which is calculated from the known gradient magnetic field output. It is an inverse problem in mathematics, where the direct problems are the calculation of unknown output quantities based on known input quantities. Fourier series expansion methods in the context of cylindrical coordinates were used to describe the 3-D current density. In that case, Bessel functions are used as development components. The current densities, at each point in space, were lined up to represent current lines. Each power line is associated with a coil winding through which a current of a certain strength flows. After that, the principle of discretization of coil windings was applied. Each winding is divided into a large number of elementary segments that were considered as current elements, which create, based on Bio-Savar's law, an elementary magnetic field. In this way, the total, continuous magnetic field is broken into many elementary components, which come from different current elements. An important result of this process is that each current element can be controlled independently by a current source. This means that the output magnetic field of the gradient can be controlled by current sources, which are the input sizes, and this is what is at the core of the topic of this paper.

The psychological burden of physicians has been the focus of many researchers since the 1950s, and some papers have found a high prevalence of anxiety and depressive disorders among medical staff. Recent studies have shown that the coronavirus pandemic didn’t go easy on healthcare workers. The fact that it has been three years since the outbreak, has motivated our study. Which aims to evaluate the intensity of anxiety among medical personnel and the risk factors that could be incriminated post-COVID pandemic and if the level of anxiety is back to normal. This is a cross-sectional study, carried out with a survey split into 2 parts sociodemographic and work-related data, and the French version of the Hamilton anxiety scale, Statistical analysis was performed using Jamovi et Microsoft Excel. About half of the 116 physicians in our study had no anxiety (55.2%), while 21.6% had mild anxiety, 10.3% had moderate anxiety, and 12.9% had severe anxiety. The identified risk factors for anxiety were female gender, personal and family history of anxiety disorder, doing night shifts, and being a general practitioner. The anxiety rate of physicians is back to normal post-COVID pandemic. But we shouldn’t stop there. The mental health status of medical personnel depends on several of the factors listed above. Determining them would imply a call for the implementation of preventive measures for anxiety and depressive disorders among physicians. Because taking care of physicians is taking care of patients.

Non-small-cell lung cancer (NSCLC) accounts for 85% of lung cancer cases and is associated with different risk factors (smoking habits, gender, and age). In this scenario, many studies have been conducted to pursue improvement of survival, faster and better therapy response, reduced adverse events, and expanded available therapies and treatments against tumor resistance to drugs. These studies have focused on defining the most prevalent NSCLC biomarkers (EGFR, HER2, ALK, MET, ROS1, BRAF, KRAS G12C, HER3, NTRK, and NRG1) and their actionability. It is noteworthy that expressed kinase receptors can have overlapping mechanisms of activation of different pathways (JAK-STAT, MAPK, PI3K-AKT-mTOR, and PLC-c), which can lead to the same outcome of cell proliferation, migration, and survival resulting in increased tumor resistance to treatment. This review provides an overview of the latest findings regarding NSCLC treatment, emphasizing particular biomarkers and potential molecularly altered pathways implicated as targeted therapies. Additionally, it explores the clinical significance of the proposed treatments, their implication on progression-free survival, ongoing clinical trials, and their perspective of evolution so far.

A field study was carried out to evaluate the efficacy of pendimethalin 500 EC (trade name: Pendimight®) and oxyfluorfen 240 EC (trade name: Harris®) to control weeds in direct-seeded onion (Allium cepa L.). Pendimethalin and oxyfluorfen were applied solely at reduced rates (1.35 and 0.17 kg a.i. ha-1), and at the recommended rates (1.8 and 0.25 kg a.i. ha-1) as pre-and post-emergence herbicides, respectively. Both herbicides were also applied sequentially at the same doses. Ten weeks after sowing (WAS), the application of pendimethalin alone provided better weed control (62% - 65%) than oxyfluorfen alone (33% - 43%) when they were applied at the lower and recommended rates, respectively. Sequential applications of the two herbicides as pre-and post-emergence herbicides, outperformed applications of the two herbicides alone, and resulted in the best weed control (79% to 85%), lowest weed dry weight (18.35 to 35.60 g.m-2), significantly increased plant height and the number of leaves per plant, and resulted in a ten-fold higher onion yield (24.64 to 26.37 t. ha-1) compared with the Un-weeded control (2.27 t. ha-1). There were no significant differences observed between the treatments on the emergence (%) of onion seeds and the survival of onion seedlings. Sequential applications of pendimethalin and oxyfluorfen is a promising techniques for weed control in direct-seeded onions in Sudan.

The inflationary epoch, occurring shortly after the Big Bang, initiated an extraordinarily rapid exponential expansion of the universe. Following this period, the rate of cosmic expansion decelerated for approximately 9.8 billion years, until observations indicated a transition to an accelerated expansion of space-time. This paper aims to estimate the minimum possible deceleration of cosmic expansion during the post-inflationary epoch, addressing an unresolved aspect of cosmological studies. The observable universe is modeled as a spherical region defined by the particle horizon in the FLRW metric. The model operates on the principle that the speed of light cannot exceed the speed of space-time expansion, given that photons are bound by space-time constraints. This paper hypothesizes that at the end of the 9.8 billion years of deceleration, the expansion speed was at its lowest, nearly equating to the speed of light. Subsequently, this speed has increased, correlating with the current accelerated expansion. Through a graphical representation assuming a uniform rate of change in expansion speed (for minimum possible values), we apply concepts of onedimensional motion to derive our estimates. This novel approach provides a foundational calculation of the minimum deceleration, significantly contributing to the understanding of the dynamics of cosmic expansion and offering a basis for future research and observational refinement.

Autoclaved aerated concrete is becoming an increasingly popular building material, and for good reason. It is ecological, energy efficient, strong, and durable. Studies show that the production of autoclaved aerated concrete saves 85% of energy compared to the production of heavy concrete. However, the use of steel reinforcement in large-sized aerated concrete products leads to deterioration of thermal insulation properties, corrosion, and destruction of the material. Replacing steel reinforcement with discrete fiber strands can solve this problem. The fiber does not affect the thermal insulation properties, is not prone to corrosion, and can be evenly distributed over the entire volume of the product.

Introduction: Wet wrapping is a local care technique adapted to the treatment of severe forms of eczema. It is a good alternative for AD resistant to the usual local treatments. We report a case. Observation: A 5-month-old infant, with a personal history of allergic rhinitis has been seen in a dermatological for diffuse skin eruption and pruritus evolving in flare-ups since 4 months, without improvement after several courses of dermocorticoids, anti-H1, and emollient from several doctors. Clinical examination revealed erythematous plaques surmounted by vesicles with a crumbled border located on the convexities and extension face of the limbs and in the folds behind the ears and diffuse skin xerosis. The examination of the other devices was unremarkable. The evaluated SCORAD was 59.8. We carried out the treatment by the wet wrapping technique, a clear regression of the cutaneous lesions and pruritus with the decrease of the SCORAD from 59.8 to 8.8 in 1 month of treatment. Discussion: This observation further illustrates the effectiveness of the Wet wrapping technique in the management of recalcitrant atopic dermatitis. In resource-poor countries, Wet wrapping may be an alternative for recalcitrant forms of atopic dermatitis. For fostering critical nurse observation as a source of research topics, we propose four strategies. First, cultivating awareness through a culture of evidence-based practice and critical reflection on common practice. Second, stimulating persistence in addressing moral dilemmas concerning better care despite resistance. Third, facilitating interprofessional learning in an open culture, where diverse perspectives are valued, and it is psychologically safe to bring them in. Fourth, overcoming funding disparities and facilitating nurse-led research, acknowledging the underrepresentation of nurses in funding agencies. These measures aim to empower nurses to observe critically, use their unique perspectives, and bring in research topics.

Carfilzomib, a highly selective proteasome inhibitor, is commonly used in the treatment of multiple myeloma and AL amyloidosis. While its efficacy is well-established, there is increasing recognition of its association with cardiovascular adverse events, including hypertension, heart failure, and arrhythmias. However, cases of carfilzomib-induced pericardial disease remain rare. Here, we present a case of a 78-year-old female with multiple myeloma who experienced two episodes of hemorrhagic pericardial effusion following carfilzomib therapy, highlighting the importance of vigilant cardiovascular monitoring during treatment.

The current study included a variety of phytochemical substances that were extracted from Centaurium pulchellum and showed a wide range of medicinal properties from the plant's reproductive and vegetative parts against the pathogenic fungus Aspergillus flavus. The vegetative and reproductive components of Centaurium pulchellum were subjected to (GC-MS) analysis for phytochemical study. The data indicated that fungal activity was the highest. Four extract concentrations of 5, 10, 15, and 20 mg/ml were utilized in the investigation, and the diameter of the colonies measured at each concentration was 90.00, 36.00, 28.00, 18.00, and 0.00 mm, respectively.Nine bioactive phytochemical compounds were found in Centaurium pulchellum's vegetative and reproductive portions, according to GC-MS analysis of the chemicals. Another study reported phytochemical substances that: 1-H-Imidazole-2-carboxaldehyde, 1-methyl-;Acetaminophen; n-Hexadecanoic acid; Mercaptoacetic acid, 2TMS derivative; 1.2,3-Dimethyl-5-(trifluoromethyl)-1,4-benzenediol #; Mercaptoethanol, 2TMS derivative-; Bis-(3,5,5-trimethylhexyl) phthalate Tetrakis(trimethylsilyl) orthosilicate #;- 1.1-Isopropoxy-3,3,3-trimethyl-1-[(trimethylsilyl)oxy]disiloxanyl tris(trimethylsilyl) orthosilicate #.

Microbiome-gut-brain axis represents a complex, bidirectional communication network connecting the gastrointestinal tract and its microbial populations with the central nervous system (CNS). This complex system is important for maintaining physiological homeostasis and has significant implications for mental health. The human gut has trillions of microorganisms, collectively termed gut microbiota, which play important roles in digestion, immune function, and production of various metabolites. Some current research shows that these microorganisms strongly influence the brain function and behaviour of individuals, forming the basis of the microbiome-gut-brain axis. The communication between gut microbiota and the brain occurs via multiple pathways: neural pathway (e.g., vagus nerve), endocrine pathway (e.g., hormone production), immune pathway (e.g., inflammation modulation), and metabolic pathway (e.g., production of short-chain fatty acids). Dysbiosis, or imbalance of gut microbiota, has been linked to mental health disorders such as anxiety, depression, multiple sclerosis, autism spectrum disorders, etc, offering new perspectives on their etiology and potential therapeutic interventions. Artificial Intelligence (AI) has emerged as a powerful tool in interpreting the complexities of the microbiome-gut-brain axis. AI techniques, such as machine learning and deep learning, enable the integration and analysis of large, multifaceted datasets, uncovering patterns and correlations that can be avoided by traditional methods. These techniques enable predictive modeling, biomarker discovery, and understanding of underlying biological mechanisms, enhancing research efficiency and covering ways for personalized therapeutic approaches. The application of AI in microbiome research has provided valuable insights into mental health conditions. AI models have identified specific gut bacteria linked to disease, offered predictive models, and discovered distinct microbiome signatures associated with specific diseases. Integrating AI with microbiome research holds promise for revolutionizing mental health care, offering new diagnostic tools and targeted therapies. Challenges remain, but the potential benefits of AI-driven insights into microbiome-gut-brain interactions are immense and offer hope for innovative treatments and preventative measures to improve mental health outcomes.

Introduction: We aim to evaluate the performance of pre-treatment MRI-based habitat imaging to segment tumor micro-environment and its potential to identify patients with esophageal cancer who can achieve pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT).Material and methods: A total of 18 patients with locally advanced esophageal cancer (LAEC) were recruited into this retrospective study. All patients underwent MRI before nCRT and surgery using a 3.0 T scanner (Ingenia 3.0 CX, Philips Healthcare). A series of MR sequences including T2-weighted (T2), diffusion-weighted imaging (DWI), and Contrast Enhance-T1 weighted (CE-T1) were performed. A clustering algorithm using a two-stage hierarchical approach groups MRI voxels into separate clusters based on their similarity. The t-test and receiver operating characteristic (ROC) analysis were used to evaluate the predictive effect of pCR on habitat imaging results. Cross-validation of 18 folds is used to test the accuracy of predictions.Results: A total of 9 habitats were identified based on structural and physiologic features. The predictive performance of habitat imaging based on these habitat volume fractions (VFs) was evaluated. Students’ t-tests identified 2 habitats as good classifiers for pCR and non-pCR patients. ROC analysis shows that the best classifier had the highest AUC (0.82) with an average prediction accuracy of 77.78%.Conclusion: We demonstrate that MRI-based tumor habitat imaging has great potential for predicting treatment response in LAEC. Spatialized habitat imaging results can also be used to identify tumor non-responsive sub-regions for the design of focused boost treatment to potentially improve nCRT efficacy.

Ischemic Heart Disease (IHD) remains a significant cause of morbidity and mortality worldwide. We present a case report of a 54-year-old individual presenting with symptoms suggestive of IHD, including palpitations and chest heaviness. Utilizing a Spandan device at home, the patient detected anteroseptal and lateral wall ischemia, prompting consultation with a cardiologist. Subsequent diagnostic evaluations revealed Left Ventricular Hypertrophy (LVH), concentric LVH, regional wall motion abnormality, and Grade I diastolic dysfunction. Hypertension and dyslipidemia were identified as prominent risk factors, with additional findings of carotid artery disease. Management strategies included antihypertensive medications, lipid-lowering therapy, and lifestyle modifications. This case underscores the complexity of diagnosing and managing IHD, highlighting the importance of comprehensive assessment and multidisciplinary care in optimizing patient outcomes.

Introduction: Dermatofunctional Physiotherapy is an area of physiotherapeutic specialty that aims to promote, prevent, and treat integumentary injuries. However, this field of action is usually erroneously limited to aesthetic and cosmetic procedures. However, the scope of Physical Therapy goes beyond aesthetic procedures. Objective: To identify the scope of dermatofunctional physiotherapy beyond aesthetics. Methodology: This is an integrative literature review with the objective of summarizing and exploring the proposed theme. For this, the PRISMA guidelines were used, as well as the PICOT strategy for a better delineation of the research question and research theme. Results and discussions: It was observed that the role of the physiotherapist in this field is directly related to aesthetics, which is one of the most prosperous segments within the health area, due to the great demand for aesthetic procedures. Among the main resources evidenced in this study, lymphatic drainage, electrothermophototherapeutic resources, myofascial release, and manual techniques were observed. Final considerations: The area of physical therapy is not exclusively dedicated to the aesthetic environment, it was observed that this specialty acts strongly in the promotion, and prevention of rehabilitation of patients with metabolic, integumentary, and musculoskeletal alterations, in addition to promoting and preventing diseases related to obesity, scars, geloid edema, flaccidity, and other integumentary dysfunctions.

Introduction: The practice of plastic surgery began in the field of reconstructive surgery, in an attempt to recover the functionality of some area of ​​the body or give it a more natural appearance. In this sense, the role of the physical therapist is recommended in various aesthetic surgeries that, through physical therapy resources and techniques, promote tissue healing, reduce the appearance of adhesions, and reduce or eliminate pain, bruises, and edema. Objective: to identify the effects of physical therapy in the postoperative period of plastic surgery. Methodology: This is an integrative literature review, in which there will be a review of articles related to the study of the effects of physical therapy assistance applied to the postoperative period of plastic surgery. Articles related to the proposed theme were included, published between 2011 and 2024, available in full, without language restriction; in addition to theses, dissertations, and monographs. Exclusion criteria were literature review articles, articles or abstracts that had been published in conference proceedings; as well as letters from editors and preprints. Results and discussions: it can show that physiotherapy in the postoperative period of plastic surgery is essential in reducing recovery time, reducing edema, improving the healing process, and preventing the risk of complications in the postoperative period. The main physiotherapeutic resources and techniques were: lymphatic drainage, ultrasound, radiofrequency, laser, and high frequency. Regarding plastic surgeries, the most frequent in the literature were: abdominoplasty, blepharoplasty, rhytidectomy, and liposuction. Final considerations: Dermatofunctional physiotherapy is of paramount importance in the postoperative period of plastic surgery. It is essential in reducing recovery time and reducing the risks arising from surgery.

Background: Post-infarction ventricular septal rupture (VSR) is a rare but lethal mechanical complication of an acute myocardial infarction (AMI). It results in 90% - 95% mortality within two months of diagnosis without any kind of intervention. Given high surgical mortality, transcatheter closure has emerged as a potential strategy as an alternative to high-risk surgical closure. Indian data on percutaneous device closure of post-AMI-VSR is limited hence we report our resource-limited single-centre experience with different kinds of occluder devices for closure of post-AMI VSR.Methods and results: In this single-centre, retrospective, cohort study, patients who underwent transcatheter closure of post-MI VSR between 2018 and 2024 at Health World hospitals, in Durgapur, West Bengal, were included. The primary outcome was a mortality rate of 30 days. The study population was eleven primary cases of post-MI VSR. The mean age of the population was 61 years. The majority of the patients had anterior wall MI (54.5%) and the remaining had inferior wall MI.  Different kinds of devices (ASO, PostMI VSD device, Konar MFO) were used to close VSR. Successful closure was performed in 9 patients (81%) with minimal residual shunt in 2 patients. Out of 9 cases 3 patients expired, one was lost to follow up and the rest are doing well at 30 days follow-up. Conclusion: Transcatheter closure of PMIVSRs can be performed with different kinds of devices with high technical success, relatively low procedural complication rates, and 30 days survival even in a resource-limited setup as an alternative to high-risk surgical closure.

Aim: To evaluate the effectiveness of an ayurvedic gel in tooth pain reduction due to dental caries. Materials and methods: This in vivo cross-over design study enrolled adults with at least one tooth with caries and a symptom of pain after the application of an ice stimulus. Two hundred patients were screened and eligible patients were enrolled in the study. Forty-five subjects completed washout phases before each recall visit. During each recall visit, subjects evaluated pain relief following an ice bar stimulus and one random finger-tip application of a treatment i.e. Ayurveda Herbal gel containing clove oil, camphor, and menthol (Ayurveda Herbal Gel Group), and two control formulations: a gel without active ingredients and commercial olive oil as a surrogate of home remedy. At each assessment, subjects used a stopwatch to record the onset of pain relief and tooth pain using visual analog scores (VAS), dental pain scores (DPS), and relief from tooth pain by dental pain relief scores (DPRS). After each treatment, subjects recorded their satisfaction with the provided treatment using a four-point satisfaction index. Data were tabulated and statistical analysis was performed with (ANCOVA) and two-way ANOVA with a p - value of 0.05 considered statistically significant. Results: Forty-five subjects (28 males and 17 females) completed the entire study without any adverse events. Application of the Ayurveda gel resulted in a significantly faster onset of pain relief (2.47 min) in comparison to the onset of pain relief after 4 minutes recorded with the controls (p < 0.05). Subjects reported lower VAS and DPS scores over the study period of evaluation when using the Ayurveda gel compared to the application of each control formulation. Subjects also reported greater relief of pain and greater satisfaction after the application of the Ayurveda gel as compared to the controls. Conclusion: Significantly better tooth pain relief from caries was observed from an Ayurveda Herbal gel than from controls.

Pushing forward with leveraging water resources, promoting international cooperation, and ensuring transparency in deep-sea mining operations. There is also a concern about where to discharge the toxins of unpurified water. Artificial Intelligence has created a dominance in the applications field with a totally automated system.Out of a thorough analysis completed with indicators, satellite radar, and A Journals, there are 30 years of research and 8 years of monitored testing to achieve accuracy and relevance. The patents in place are, Oceanic Mining System (4446636), Flexible Solar Skin in Combination with an Airplane (4768738), Cargo Torpedo (4421050), Oceanic seaplow system (4398362), and previous articles like “Is Extracting Lithium and deep-sea mining more sustainable?”, “AI as a Means of Water Purification Protection”, “Global Water Distribution”, and “Can Deep Sea Water be Processed into Potable Water and Distributed into the Middle East’?To report some ballpark numbers on the proposal and how we would navigate these projects, there will be an exact location of where the plant will be built as well as a water/salinity report of the water being treated. There are still issues with analyzing the cost of desalination compared to other alternatives. Deep Sea Water proves to be a higher quality water and the investment is well worth it. The surveys lean toward clients preferring the International Standards Operating Procedure. All recipients agree there should be a sense of urgency on water shortages. Currently, AI has proven to be a vital asset in eliminating biases and expenses.

WhatsApp, a widely used instant messaging application, has become a valuable source of digital evidence in forensic investigations. This review article explores the forensic analysis techniques, challenges, and future directions associated with WhatsApp. It covers the extraction and analysis of data from various sources, including mobile devices, cloud backups, and network traffic. The article discusses the challenges faced by forensic examiners, such as encryption, data volatility, and the need for proper validation of tools. It also highlights the importance of keeping up with the latest updates and changes in WhatsApp’s features and security measures. The future directions for WhatsApp forensics are explored, focusing on the development of more advanced and efficient analysis techniques, the need for standardization, and the importance of international cooperation in addressing cross-border investigations. This review provides insights for forensic examiners, researchers, and legal professionals involved in cases requiring WhatsApp evidence.

The mainstays of nuclear substance radiation and isotopic synthesis are nuclear-powered power plants, however effective safety evaluation is made tougher by the complicated construction topologies and physical connection effects. This work proposes a multiphysics-linked technique for evaluating both the kinetic and steady-state behaviors of the MPRR and LVR-15 laboratory reactors. To represent complicated member geometries, homogenized assembling sections are generated using two-dimensional whole-core computational simulations. It is discovered that the steady-state findings and the so-called Monte Carl solution comparisons correspond quite nicely. The greatest assemble power mistakes for LVR-15 and MPRR are 6.49%/10%, and the highest command rod value mistakes are 31 pcm/136 pcm, and the mistakes are 377 pcm/383 pcm, accordingly. Meanwhile, the study is done on transitory procedures, such as reactivity-initiated disasters and exposed loss-of-flow mishaps. Both units' modeling findings show plausible adverse feedback events. Furthermore, it is shown that the two reactors' accident-related behaviors are comparable though having different core architectures since they employ the exact same kinds of water as a fluid. The technique for studying nuclear power plant kinetics known as Multi-Physics Simulation (MPM) is explained. Drawing on many research and verification efforts conducted at Politecnico di Milan, Italy, MPM is shown to be a valuable instrument for managing reactors' security and oversight. It may be viewed as a holistic analytical tool that is implemented during the reactor architecture design phase. The capacity to concurrently answer the interrelated equations that control the many physical processes taking place in a nuclear plant inside the same simulated setting is a core characteristic of MPM.

As healthcare systems develop, there is an explicit call towards interprofessional learning and working, valuing observations and perspectives of all disciplines. Such a multi-perspective is pivotal for innovation, leading to optimal and sustainable health care. In such an interprofessional work environment, it is obvious that the nurses engage in the formulation of research questions within clinical practice settings. This case report describes a case in which nurses observed important issues that no physician or midwife on the team would have noticed. In collaboration with other team members, the nurses subsequently engaged in research which resulted in new information to improve care. The aim of this paper is to explore strategies to promote nurse participation in at least the formulation of research questions based on their observation and perspectives.For fostering critical nurse observation as a source of research topics, we propose four strategies. First, cultivating awareness through a culture of evidence-based practice and critical reflection on common practice. Second, stimulating persistence in addressing moral dilemmas concerning better care despite resistance. Third, facilitating interprofessional learning in an open culture, where diverse perspectives are valued, and it is psychologically safe to bring them in. Fourth, overcoming funding disparities and facilitating nurse-led research, acknowledging the underrepresentation of nurses in funding agencies. These measures aim to empower nurses to observe critically, use their unique perspectives, and bring in research topics.

Renal angiomyolipoma (AML) is a rare tumor with an incidence of 0.3% - 3%.We reported a case of a 41-year-old male patient who presented with gross hematuria and hemorrhagic shock, due to a right giant angiomyolipoma he underwent urgent right nephrectomy by subcostal laparotomy, total weight of the mass was 6 Kg, histological examination concluded in a renal angiomyolipoma.Treatment of renal AML depends on the clinical presentation, tumor size, and single or multiple lesions: single small (< 4 cm) asymptomatic lesions require only clinical and radiological follow-up, however giant symptomatic (hematuria), life-threatening masses require urgent multidisciplinary treatment and especially surgery.Giant renal bilateral AML is very rare, conservative treatment in the absence of hemorrhage should always be first proposed to preserve renal function as possible.

Background: Marine resources have diverse biological and beneficial entities for human beings. Among them, microalgae are one of the eukaryotic photosynthetic organisms found in freshwater and marine environments with an immense source of metabolites. They consist of high nutraceutical and value-added compounds for health concerns. Objective: Most microalgal species like- chlorella, spirulina, Isochrysis, Nannochloropsis, etc. are found to synthesize biologically active secondary metabolites which are having high pharmaceutical and nutraceutical value. Some of the purely extracted compounds are Lecithin, fucoxanthin, astaxanthin, and most important Sulphur polysaccharides- fucose, galactose, xylose, rhamnose, etc. are providing anti-microbial, anti-fungal, anti-viral, anti-cancer and anti-diabetic activities.Methods: Many of the prior studies demonstrated the compilation of naturally derived secondary metabolites for their potential application in most fields. Because of their wide-ranging potential for use in biopharmaceutical and nutraceutical industries, microalgae have recently gained significant interest on a global scale.Result: Microalgae are both parts of the dietary ingredients and bioactive pharmaceuticals. A number of microalgal species have been explored for their significance towards their high-value products with their exceptional pharmacological and biological properties.Conclusion: This current review discussed the uses and benefits of microalgae for the manufacture of nutraceuticals and the medicinal use of diverse bioactive compounds.

Intracranial meningiomas are usually non-cancerous tumors that develop from arachnoid cells in the meningeal envelope. However, there are rare forms called intraosseous meningiomas, which present unique challenges for diagnosis and treatment. In this report, we describe a rare case of a giant sphenotemporal meningioma in a 72-year-old male with diabetes. The patient experienced progressive exophthalmos and visual impairment over a period of five months. Radiological imaging confirmed the diagnosis, showing extensive infiltration into the infra-temporal region. Histopathological examination confirmed a plaque-type meningothelial meningioma. The patient underwent surgical management, which involved maxillofacial surgery. Intraosseous meningiomas are rare but are increasingly being recognized, accounting for about two percent of all meningiomas. The spheno-orbital region is a common site for these tumors. Histologically, there are various subtypes, with meningothelial meningioma being the most common. The differential diagnosis includes Paget’s disease and osteomas. The optimal treatment approach involves extensive surgical resection, followed by adjuvant radiotherapy for any remaining or symptomatic tumors. The prognosis depends on the extent of resection and tumor progression, underscoring the importance of regular monitoring. Early intervention is crucial to preserve visual function and achieve favorable outcomes.

A thorough knowledge of the stationary characteristics of the nuclei of atoms, their stimulation wavelengths, how they react to outside factors, and how they disintegrate is the aim of nuclear structural science. Although achieving these objectives within just one structure is difficult and prevents the existence of a nuclear "standard model," it is evident that radioactive Density Functional Theory (DFT) offers perhaps the broadest variety of applications to date. We attempt to place DFT in a larger perspective in this study by making frequent allusions to electrical DFT. We also provide a brief overview of the numerous uses and an explanation of the connections between beginning techniques and Useful Field Concepts (EFTs) in particular. The article tries to promote collaborations with different scientific fields while being published from a subjective and perhaps biased point of view.

The article deals with such issues as storage of industrial waste, causes, examples and prevention of accidents, NGO operation and reclamation, and methods of dealing with the consequences of accidents. When storing industrial waste in large volumes, various complications arise, including accidents in waste storage facilities. The article provides examples of accidents for specific objects and analyzes their causes and consequences. The methods of dealing with the consequences of accidents and their prevention are considered. The materials of the article can help specialists improve the design and operation of waste storage facilities.

The stem cell secretome is a collective mixture of soluble and insoluble factors released by stem cells during paracrine communication and/or autocrine signaling. In addition to intracellular communication, these paracrine factors play an integral role in tissue development and generation, acting as the primary driving force in the regenerative properties of stem cells. Despite such great potential of stem cell secretome in therapeutic applications, the lack of secretome-based treatments available for the public at the time of writing is odd and puzzling. Hence, this review aims to provide insights into recent advancements in understanding the stem cell secretome, as well as discuss future possibilities and current limitations that must be overcome for the proper development of secretome-based therapies. Through utilizing the MEDLINE database from the National Library of Medicine® (NLM), we found that while there is much evidence of the therapeutic effects of secretome-based therapy, flaws involving regulations and standardization hinder it from revolutionizing regenerative medicine at present. It is cardinal to emphasize that while secretome-based therapy may be the solution for many untreatable conditions, much research is still required before it is approved for clinical practice.

An empirical framework that accurately describes radioactive binding energies is the Somewhat Empirical Mass Equation (SEMF). They showcase many implementations and uses of the idea that rely on graphics and printed objects. A key new addition is a contrast with real experiments, as well as a visualization of the energy environment as supplied by the SEMF. The shortcomings of the empirical theory are shown by our visualization of this differential energy scenery, which also highlights the significance of what is known as magic numbers—an explanation provided by the outermost approach, which was developed much more recently than the water drop theory. This provides a great chance to talk about the advantages and limitations of simulations everywhere within the framework of science teaching.

Chemical submission is a crime where criminals use substances to impose their will on victims. A 44-year-old woman comes to the Health Center disoriented in the temporal sphere, stating that “she does not remember what happened.” Her brother, the companion who brings her to the health center, says that he has found her in a place he does not usually frequent. The patient missed a bag she was carrying and could not locate her mobile phone. The patient and companion suspect that she may have been “drugged” in order to rob them. Given the suspicion that the patient may have been a victim of chemical submission, the Emergency Service is called to inform that the victim is going to be referred. The detection of biological samples of the substances used for submission is of vital importance.

The study on the remote effect of fascial manipulation on knee pain presents a case report of a patient with knee pain who underwent a single session of fascial manipulation to reduce pain and improve daily activities. The report explains the anatomy of the knee joint and the potential causes of knee pain, including bony and soft tissue involvement. Fascial manipulation is a technique that involves applying mechanical force to areas of fascial dysfunction to stimulate the body’s natural inflammatory response. The therapy is based on applying physical friction to the densified connective tissue with an elbow or knuckle to raise the temperature and change the consistency of loose connective tissue rich in hyaluronic acid. The locations picked were proximal and distal to the problematic area, and no point was treated over the painful region, which is consistent with the notion of pain being caused by aberrant fascial tensions. Manipulation of the connective tissue is thought to cause mechanical stress and heat, resulting in less macromolecular crowding and defragmentation of the Hyaluronic Acid (HA) polymers and normalised fascial gliding across the connective tissue. Reduced discomfort and enhanced range of motion are two more regularly reported effects of Fascial Manipulation. The patient was urged to resume his everyday activities after each treatment session to favour typical physiological motions that would align collagen fibres along normal lines of force. The report concludes that fascial manipulation can be a beneficial technique for managing knee pain, and it can be complemented with exercises and stretches to improve outcomes.

Background: Stillbirth (SB), either because of intrauterine or intrapartum fetal death, is amongst the most devastating pregnancy complications, hardest to predict, real challenge for health systems. India probably accounts for the highest SB numbers in the world.Objectives: A community-based prospective study was carried out to know the burden, and causes of SBs in rural women of remote region.Material methods: After approval of the ethics committee of the Institute in Maharashtra for broader research, which was service-oriented, the present study was conducted in 100 villages around the village with health facilities. These villages were included keeping in mind future services. After obtaining the consent of women, information was prospectively recorded on their predesigned tool (which was for broader work), by asking women and seeing their records of antenatal and intranatal care on a regular basis. The study subjects were selected after obtaining information from nurse midwives, Accredited Social Health Activists (ASHAs), and Aaganwadi workers. As the plan was to serve, there was excellent cooperation. The tool was made for broader work. Villages were visited 5 days a week. Study was community-based in villages in remote, hilly region with various local issues so any information the women gave conclusion and was in the record was used.Results: A total of 3905 births occurred over two years, 3635 (93%) term, and 270 (7%) preterm. Amongst 3635 term births, 3474 (95.6%) were live births, 161 (4.4%) SBs, amongst 270 preterm births, 239 (88.5%) were live births, 31 (11.5%) SBs. Of 192 SBs, 48 (7.2%) SBs were amongst 2690 women with anaemia, (16 (2.4%) SBs amongst women with very severe anaemia, 12 (1.8%) SBs were amongst 667 women with severe anaemia, 12 (1.8%) SBs were amongst 664 women with moderate anaemia, 8 (1.2%) SBs were amongst 680 women with mild anaemia). Overall of 192 (4.9%) SBs, 31 (18.1%) SBs were among 517 women with hypertensive disorders of pregnancy (HDsP) 8 (4.4%) SBs amongst 280 women with moderate HDsP, 12 (6.9%) SBs amongst 175 women with severe HDsP, 11 (6.8%) SBs in 62 women with eclampsia. Overall of 192 SBs, 6 (3.1%) babies had weight < 1 kg, 8 (4.1%) of ≥ 1 to < 1.5 kg, 50 (26.0%) ≥ 1.5 to < 2 kg, 64 (33.3%) ≥ 2 to < 2.5 kg, 64 (33.3%) 2.5 kg and more, obviously fewer babies more deaths in birth weight less than 1. 5 kg, more so less than 1 kg.Conclusion: Overall SBs were in women with disorders but 4.5% SBs did occur in women with no disorder. SBs were significantly higher amongst babies weighing less than 1 kg, beyond this weight, numbers were similar.

There are a number of key issues that matter to patients and General Physicians (GPs) in the primary care treatment system for severe depression. Patient and doctor narratives can contribute by highlighting these key issues. Various systems are employed in treating severe depression. However, there needs to be an investigation using systems failure methodology and how this methodology is applied which can help identify how and why the NHS treatment system for severe depression can fail patients in terms of provision of effective care.

The aspects that affect the well-being of patients after neurosurgery are diverse. While most contemporary research argues that well-being is multidimensional and related to how individuals, communities, and societies feel when they are successful, there is no single agreed-upon definition [1]. Well-being is defined in the Oxford Dictionary as the state of feeling healthy and happy (Cambridge Dictionary). Well-being is a term used synonymously with a wide range of concepts including self-esteem, self-efficacy, self-determination, resilience, quality of life, improved mood, positive mental health, life satisfaction, and value [2]. 

Introduction: Total hip arthroplasty is a procedure widely performed in orthopedics, as it is capable of restoring function in the hips, severely affected by orthopedic diseases, such as osteoarthritis and consequently reducing pain and restoring function. Objective: To identify the effects of physical therapy in the postoperative period of total hip arthroplasty. Method: This is an integrative review, of an exploratory and descriptive nature, carried out between January and May 2024 and guided by the recommendations of the Joanna Brigs Institute. The Pubmed, LILACS, and SciELO databases were used. The following descriptors were used for the search procedure: “Physiotherapy and hip arthroplasty”. For the operationalization of the search, the Boolean descriptor “AND” was used to cross the descriptors. Articles were included in randomized clinical trials, published in full, without restriction of language and/or year of publication, which dealt with the theme addressed and that responded to the objective of the study. On the other hand, editorial letters, any type of literature review, articles unavailable at the time of search, abstracts and/or full articles published in annals of scientific events, preprints, and articles without abstracts were excluded. Results: After searches in the databases, 108 articles were identified on the platforms, subsequently, all had their titles and abstracts read, then 58 articles were excluded for not meeting the eligibility criteria, leaving 50 articles carefully read in full, after complete reading, only 7 articles composed the final sample. Final considerations: based on the reading and analysis of the articles that were previously selected, it was observed that there is no pre-established protocol among the authors for the postoperative period of hip arthroplasty, but that physical therapy techniques associated with therapist support and an early start are responsible for improving functionality, quality of life, pain reduction and increased muscle strength.

Background: To assess the association between neurocognitive functioning, adaptive functioning, and health-related quality of life (HRQoL), in Children and Young Adults with Severe Chronic Kidney Disease (CKD).Methods: We included patients with severe CKD (stages 4 and 5), aged 8-30 years, on different therapy modalities (pre-dialysis, dialysis, and transplanted) and healthy controls matched on age, sex, and parental education. All patients and healthy controls performed tasks to assess neurocognitive functioning (WISC/WAIS and a comprehensive neuropsychological test battery), and completed questionnaires to assess adaptive functioning (WFIRS or WHODAS) and HRQoL (PedsQL). Group differences were explored using MANCOVA. Mediation analyses were done to explore whether the relation between neurocognitive functioning and HRQoL was mediated by adaptive functioning. Results: 28 patients with severe CKD and 21 healthy matched controls were included. CKD patients had worse HRQoL (p < .001) than healthy controls. Adaptive functioning problems increased with age in the CKD patient group but not in the healthy control group (significant interaction effect: p = .024). Significant mediation effects were found, where impaired adaptive functioning mediated the relation between both low estimated Full Scale Intelligence Quotient (eFSIQ) and worse Processing Speed & Working Memory, and impaired HRQoL (eFSIQ: 95% confidence interval = .01-.58; Processing Speed & Working Memory: 95% confidence interval = 2.31-16.36).Conclusion: We found that impaired neurocognitive functioning is associated with worse HRQoL, which is conditional to impaired adaptive functioning. Especially towards young adulthood problems in adaptive functioning are more likely to be reported than when patients are younger.

The outbreak of COVID-19 has created an unprecedented situation that has accelerated online education in areas like nephrology, which are traditionally served by onsite training. Efforts to educate clinicians remotely provide convenience and flexibility but may leave many open questions when it comes to how well-trained professionals maybe after completing their programs online. This review paper has emphasized the deleterious effects of online nephrology education and identified a number of ways in which it can be problematic such as lack of hands-on training, less patient interface, lack of proper supervision, and inconsistent quality of programs. The ability to make a difference, however, is further restricted by technological barriers and resource constraints. Whilst these programs tend to focus on creating knowledgeable graduates, they often fail to provide the clinical exposure necessary for preparedness. Hybrid programs - which combine online courses with clinical training in person are required to deliver high-quality nephrology care.

The Gaussian computational chemistry software package was employed to investigate the molecular structure and energetics of benzothiazole, a compound known for its anti-tumor properties. Density functional theory (DFT) calculations were conducted using the Becke, 3-parameter, Lee-Yang-Parr (B3LYP) method, coupled with the LanL2DZ basis set. Molecular structure optimization was carried out to determine the most stable configurations of the benzothiazole compound. Furthermore, thorough analyses of molecular orbital energies, molecular properties, and molecular electrostatic potential surface maps were performed on the optimized molecular system. Our current research suggests that the compound 2-(4-aminophenyl) benzothiazole, containing benzothiazole, maybe a potential drug candidate for free radical species on cells due to its anti-cancer properties.

This study presents a novel approach to calculating the average change in kinetic energy of galaxies exhibiting non-relativistic motion. The methodology integrates the dynamics of total observed motion, which encompasses both peculiar and recessive motion, with the gravitational influence of neighboring galaxies. The peculiar motion is quantified through peculiar redshift, while recessive motion is described by Hubble’s Law. The total observed velocity is the sum of these two components. The research derives an expression for the average acceleration of a galaxy based on the change in its total observed redshift wavelength over time. Utilizing Newton’s Second Law of Motion, the average observed force and subsequent work done by this force is calculated. The work done by conservative forces, primarily gravitational forces exerted by neighboring galaxies, is also considered to determine the total work done on the galaxy. Results indicate that the average total observed force causing the motion of a galaxy is a non-conservative force, resulting from the combined effects of non-conservative forces responsible for peculiar and recessive motion. The change in potential energy due to gravitational interactions with neighboring galaxies is accounted for, leading to the formulation of the average change in kinetic energy. The conclusion of the paper provides a comprehensive expression for the average change in kinetic energy of a galaxy, factoring in the mass of the galaxy, the speed of light, the total observed redshift, the change in distance with respect to Earth, and the gravitational constant. This expression is significant for understanding the dynamics of galactic motion and the forces at play in a non-relativistic context.

The radioactive isomer was initially used to characterize persistent excited atomic states, much like molecular isomers, more than a century ago. Otto Hahn made the first atomic isomer discovery in 1921.  Subsequently, it was gradually discovered that there are several kinds of nuclear isomers, such as spin isomer, K isomer, seniority isomer, and “shape and fission” isomer.  Isomers are essential to the nucleosynthesis of astrophysical materials. High-accuracy nuclear reaction rate inputs are anticipated while carrying out a celestial nucleosynthesis net computation, even though a single reaction rate can have a significant impact on the whole astronomical evolutionary network. The isotopes are often considered to be in their initial state or to have levels populated in accordance with the thermal-equilibrium distribution of chances when computing nuclear synthesis rates. After all, certain isomers may have lives that reach millions of years or perhaps beyond the age of the cosmos. Thus, in an astrophysics event, such isomers might not be thermally equilibrium. Some atomic isomers—that is, astrometry—should be considered special isotopes since they are crucial to nucleosynthesis. Nuclear batteries can also be produced using nuclear isomers. Similar to the weak force, in certain specific cases such as isomer decays, the electromagnetic force could be crucial for nuclear changes. It is important to note that radioactive isomer states and radioactive ground states are not the same thing.  Durable nuclear states of excitement provide insight into the nuclear framework and potential uses. Atomic and molecular changes become interconnected when the connection to the electrons in atoms is made possible by the existence of em decay routes from isomers. Notably renowned chemical decay process is inner conversion. Its inverted, nuclear excitement by free capture of electrons has been observed; however, it is debatable and needs more investigation. This study describes the connection connecting radioactive and molecular changes and discusses instances of manipulating nuclear moves related to isomers using external electromagnetic fields.

Introduction: Inflammatory or suppurative ringworm is a rare form of dermatophyte damage to the hair scalp. The aim is to describe the epidemioclinical profile of inflammatory ringworm in children at the Koulikoro Reference Health Centre (Csref).Methodology: This was a 12-month descriptive cross-sectional study of all cases of Kerions diagnosed in children at the Koulikoro Csref.Results: Over 12 months, 25 cases were recorded among 1,200 consulting patients, representing a hospital frequency of 2%.Males were 22 and females three, with a sex ratio of 7.33. The mean age was 7 years, ranging from 2 to 13 years.Conclusion: Celse kerions appear to be common in school-age boys, and contact with domestic animals is described in the majority of cases. Further work is needed to describe the fungi responsible and the risk factors.

Sawdust is a by-product or waste product of woodworking such as cutting, sanding, machining, planning, and routing. Saw dust consists of small woodcutting intending to study the structural morphology of organic waste fiber derived in an X-band frequency and synthesis of the rice dust and sawdust. The solid-state method was employed to mix the husk, to obtain the fine power, and the Fourier-transform infrared spectroscope was used to determine the sample absorption rate. The FTIR results show that the best samples are 6.5 g and 6.5 g rice bark and sawdust, with an absorbance rate of 86% and 14% transmission, which will be used for the manufacture of electronic and communication devices.

Pollinators are very critical when it comes to the reproductive success of plants. They promote outbreeding which holds immense significance in the era of global climate change. It allows the plants to become fertilized, to produce seeds, fruits, and eventually new plants. They are instrumental in the sustainability of our ecosystem. Thus, there is an essential need to study these pollinators to understand how, during the course of evolution, they have co-evolved with the flowering plants to shape floral architecture and community dynamics thriving in the vicinity. In this mini-view, we shall focus our discussion on some of the animal pollinators, the dwindling diversity of animal pollinators, and various associated pollination syndromes.

Introduction: Immune checkpoint inhibitors (ICI) have significantly improved cancer treatment outcomes, but cardiovascular complications such as ICI-associated myocarditis are a major concern. Diagnosing myocarditis requires integrating biomarkers, electrocardiogram (EKG), cardiac imaging, and endomyocardial biopsy. We present a case illustrating these diagnostic challenges, involving a female patient treated with pembrolizumab who developed fatal acute myocarditis mimicking infiltrative cardiomyopathy.Case report: A 54-year-old woman with mucosal melanoma, treated with pembrolizumab, was hospitalized in May 2023 due to dyspnea and elevated troponin levels. Initial cardiac workups were normal, but subsequent tests revealed borderline cardiac magnetic resonance imaging findings. In late May 2023, the patient was admitted with worsening dyspnea, elevated NT-pro-BNP, and severe hyperlactatemia. Imaging and endomyocardial biopsy confirmed acute myocarditis with atypical presentation, mimicking infiltrative cardiomyopathy. Despite aggressive immunosuppressive therapy, the patient’s condition deteriorated, resulting in cardiogenic shock and death seven days post-admission.Conclusion: This case underscores the diagnostic and management challenges of ICI-associated myocarditis, particularly with atypical presentations. It highlights the need for vigilant, comprehensive monitoring and further research to improve diagnostic and therapeutic strategies for managing these severe side effects in patients undergoing ICI therapy.

The present study investigated the effects of colchicine treatment on leaf length, leaf width, and leaf area index (LAI) in two species of Acha (fonio), namely Digitaria exilis and Digitaria iburua. Colchicine, a potent mitotic inhibitor, has been widely used to induce polyploidy and in studying the effects of genome duplication on various morphological traits. This study aimed to explore if colchicine treatment could alter the leaf morphology of the two Acha species. Seeds of the two species were treated with colchicine solution at various concentrations (0.05, 0.10, 0.15, and 0.20 g/dL), while a control group was maintained without any treatment. Leaf length and width were measured using a meter rule, and LAI was calculated by multiplying the leaf length and leaf width with the constant for both species. Statistical analysis was performed using the Analysis of Variance on SPSS to determine significant differences between treated and control groups. The results showed that colchicine treatment had a significant effect on leaf morphology in both Acha species. Leaf length and width increased significantly in response to colchicine treatment, with the degree of increase depending on the concentration. Moreover, the LAI also exhibited a significant increase in treated plants compared to the control group. Colchicine concentration level of 0.10 g/dLproduced the best results that can be exploited to enhance the morphological characteristics of both Acha species. The findings suggest that colchicine-induced polyploidy can enhance leaf growth and overall leaf area in Acha plants, leading to potential implications for agricultural productivity and yield improvement. Further studies are needed to elucidate the underlying mechanisms and long-term effects of colchicine-induced polyploidy on other growth parameters, reproductive traits, and yield in Acha. Understanding the genetic and physiological changes associated with polyploidy in Acha species will contribute to the development of improved breeding strategies and cultivation practices for this important cereal crop.