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Introduction: It is estimated that more than 200 million girls and women alive today have undergone female genital mutilation. Female genital mutilation still remains to be a serious problem for large proportion of women in most sub-Saharan Africa countries including Sudan, with a high prevalence of 88%. Objective: The main objective was to identify the factors associated with FGM among daughters of reproductive aged woman. Materials and methods: A community based cross-sectional study was conducted on 200 mothers, the total sample was collected in ACTH based on the number of reproductive age mothers with at least one daughter older than 5 years. A structured and interviewer administered questionnaire was used to collect data. The data obtained was analyzed by the use of the SPSS software. Results: Out of 200 mothers, 113 (56.5%) had at least one circumcised daughter. Knowledge about genital mutilation (AOR = 4.29, 95% CI: 1.13-15.37), attitude (AOR = 48.53, 95% CI: 14.45-198.69) and mothers circumcision status (AOR = 14.03, 95% CI: 2.81- 95.45) were the most significantly associated with FGM. Furthermore, having good knowledge, positive attitude, high socio-economic status, being literate, being of Christian religion and living in urban area had lower odds of having a circumcised daughter. Conclusion: In this study, more than half of the mothers had at least one circumcised daughter. Mothers’ knowledge, attitude, circumcision status, socio-economic status, age, residence, educational level and religion were significantly associated with female genital mutilation.

Naturally, microorganisms decompose the organic material existing in nature, both in the presence or absence of oxygen. The majority of materials such as poisonous chemical compounds, heavy metals, would prevent the treatment process from taking place, lead to the entry of these contaminants into the environment results in the emergence of numerous diseases. In the present study, using the TOXChem4.1 simulation model, attempts were made to simulate a wastewater treatment plant and then assess the dispersions of contaminants including 1,2-Dimethylnaphthalene, 1,3-Dinitropyrene, 1,6-Dimethylnaphthalene, 1,6-Dinitropyrene, and 17a-ethinylestradiol (EE2) in concentrations of a common scenario. The results of computer simulations showed that the EE2 contaminant is of the highest percentage of decomposition among others, due to its wider chemical structure. Consequently, it is clear that such contaminant is of the highest mass in the sludge exiting the treatment plant. In addition, the results of the simulations demonstrated that the highest volumes of gaseous pollutants take place in the modulation and initial sedimentation units.

A new design system is introduced to generate clean eco-friendly electricity from rain fall water. The majority of traffic roads in the world has constructed water ditches for one aim. This is for the accumulation of rain fall water from the roads.

Aim: This study calculated the effects on serum phosphorus (P) levels, after treatment with either of 2 drugs: the erythropoietin (Epo) and the antioxidant lazaroid (L) drug U-74389G. The calculation was based on the results of 2 preliminary studies, each one of which estimated the certain influence, after the respective drug usage in an induced ischemia reperfusion (IR) animal experiment. Materials and methods: The 2 main experimental endpoints at which the serum P levels were evaluated was the 60th reperfusion min (for the groups A, C and E) and the 120th reperfusion min (for the groups B, D and F). Specially, the groups A and B were processed without drugs, the groups C and D after Epo administration; whereas the groups E and F after the L administration. Results: The first preliminary study of Epo presented a non significant hyperphosphoremic effect by 2.46% + 2.02% (p - value = 0.2168). However, the second preliminary study of U-74389G presented a non significant hypophosphoremic effect by 1.09% + 2.01% (p - value = 0.5771). These 2 studies were co-evaluated since they came from the same experimental setting. The outcome of the co-evaluation was that L is at least 0.4455128-fold [0.4445589 - 0.4464687] more hypophosphoremic than Epo (p - value = 0.0000). Conclusions: The anti-oxidant capacities of U-74389G ascribe at least 0.4455128-fold [0.4445589 - 0.4464687] more effects than Epo (p - value = 0.0000). 

Continuous noninvasive cuffless blood pressure (BP) monitoring is essential for early detection and treatment of hypertension. In this paper, we provide an overview of the recent advancements in cuffless BP sensors. These include contact wearable sensors such as electrocardiography (ECG), photoplethysmography (PPG), contact non-wearable sensors such as ballistocardiography (BCG), and contactless sensors such as video plethysmography (VPG). These sensors employ different measuring mechanisms such as pulse arrival time (PAT), pulse transit time (PTT), and pulse wave analysis (PWA) to estimate BP. However, challenges exist in the effective use and interpretation of signal features to obtain clinically reliable BP measurements. The correlations between signal features and BP are obtained by mechanism-driven models which use physiological principles to identify mathematical correlations, and data-driven models which use machine learning algorithms to analyze observational data to identify multidimensional correlations. On the one hand, applying mechanism-driven models to non-linear scenarios and incomplete or noisy data is challenging On the other hand, data-driven models require a large amount of data in order to prevent physically inconsistent predictions, resulting in poor generalization. From this perspective, this paper proposes to combine the strengths of mechanism-driven and data-driven approaches to obtain a more comprehensive approach, the physiology-informed machine-learning approach, with the goal of enhancing the accuracy, interpretability, and scalability of continuous cuffless BP monitoring. This holds promise for personalized clinical applications and the advancement of hypertension management.

Introduction: Hypertension is the strongest independent predictor of Coronary Artery Disease (CAD) identified by Computed tomography of coronary arteries (CTCA). In this study, CTCA-assessed Coronary Calcium Scoring (CCS) was studied in hypertensive subjects referred for CTCA.Methods: After excluding TAVI and graft assessment patients, the individual electronic health records of 410 consecutive patients who underwent CTCA between July and November 2020, were reviewed with a mean age of 58.7 years. Risk factors were recorded including smoking (38%), hyperlipidaemia (33%), positive family history (22%), systemic hypertension (48%), diabetes mellitus (30%), and male gender (46%). Referral criteria, ethnicity, cardiac, and past medical history were recorded. Patients were stratified into four groups according to CAD severity: absent, mild, moderate, and severe disease, as seen on CTCA. The mean CCS for each CAD category was compared between hypertensive and non-hypertensive patients. Mean CCS were further compared according to the number of coronary arteries affected and the severity of CAD in each artery. Results: Out of all CTCA reports, 200 (48.8%) CCS were interpreted in the very low-risk category, 80 (19.5%) low risk, 58 (14.1%) moderate risk, 23 (5.6%) moderately high risk and 49 (12.0%) high risk. A significant difference in mean CCS and CAD severity was observed between mild, moderate, and severe CAD (p = 0.015 and p < 0.001). Comparison of CCS between hypertensives and non-hypertensives, across the four CAD severity categories, revealed a significant difference in mean CCS in the severe CAD category (p = 0.03). There was no significant difference in the CCS between hypertensives with chest pain and hypertensives without chest pain. A higher number of affected coronary arteries was associated with a higher mean CCS and a significant difference in CCS was observed between hypertensive and non-hypertensive subjects for the number of arteries affected. Similar results were observed when comparing mean CCS in moderate-severely affected coronary arteries.Conclusion: Hypertensive patients with a high CCS were associated with a higher incidence of severe CAD independent of the presence of chest pain. These results suggest that the incorporation of CCS in the investigation of CAD on CT angiography may pose a powerful adjunct in proposing an alternative paradigm for the assessment of patients with hypertension, in the progress of coronary artery disease. 

A comprehensive approach to asymptomatic adults with Wolff-Parkinson-White (WPW) pattern discovered incidentally on routine electrocardiography (ECG) is debatable. The objective of this review article is to update the most recent evidence on the management of young patients with asymptomatic WPW patterns. A substantial proportion of adults with WPW patterns on ECG may remain asymptomatic but the lifetime risk for fatal arrhythmias still exists. The inherent properties of the accessory pathway determine the risk of sudden cardiac death. A low-risk pathway is considered when the pre-excitation is intermittent on ambulatory monitoring or when it disappears completely or abruptly during exercise testing. On the other hand, a high-risk pathway in EP study is suggested by the presence of the shortest pre-excited RR interval (SPERRI) during atrial fibrillation of ≤ 250 ms or accessory pathway effective refractory period (APERP) ≤ 240 ms. The cardiac evaluation may thus be considered in asymptomatic patients with WPW to determine the individual risk for future symptomatic arrhythmia. A shared-decision making must be performed before offering catheter ablation whose procedural success rate is high.

Objectives: This novel study explores the leadership traits held by people with substance use disorder. The purpose of this study is to help advance understanding of the positive qualities people with substance use disorder possess which can produce positive societal and organizational benefits once that person enters recovery. Additionally, this understanding can provide insight into effective treatment approaches that incorporate personal attributes that are present within active addiction. Methods: A qualitative methodology was used which included semi-structured interviews, observations, and a focus group which allowed the researcher to conduct a thematic coding analysis. The participants came from diverse backgrounds and included participants from multiple regions across the United States. Leadership was defined as having various dimensions of effective leadership that are found in both Transformational and Authentic Leadership Theories. Results: The findings revealed that people in addiction possess numerous leadership traits which position them for effective leadership and are further enhanced during their recovery journey. The top three traits which emerged from the data indicate that people in recovery from addiction are authentic, tenacious, and empathetic. Additionally, those in recovery have strong abilities to empower and inspire others and demonstrate posttraumatic growth which helps establish significant bonds of trust and commitment among followers. Conclusion: The impact of this study will change how people view addiction. Identifying the hidden treasures of leadership which are present in those struggling with addiction could illuminate recovery pathways that help identify purpose and value. This would not only advance treatment opportunities but greatly assist organizations that need strong leadership. People with substance use disorder have all the right tools to become effective leaders, and this understanding can help mitigate the stigma associated with addiction and paint it in a more positive light. 

Cystic fibrosis (CF) is a hereditary syndrome composed of exocrine gland dysfunction involving multiple systems which if untreated may result in chronic respiratory infections, pancreatic enzyme deficiency and failure to thrive. The association between CF and other inherited diseases or congenital anomalies is rare. We describe a rare case of CF with concomitant congenital adrenal hyperplasia (CAH). 21- Hydroxylase deficiency accounts for most CAH cases. Varity in clinical phenotypes depends on the amount of enzymatic activity which in turn depends on different combination of gene mutations. The genes of CAH and CF are located in different locations. The chance of these diseases coexisting in our patient would be a rare combination. However, such a case will be more frequent in our population than others because of consanguineous marriage and common ancestors. There are diagnostic difficulties, similarities and contradictions between two diseases and they are pointed out.

To investigate the associated an inappropriate development of the 9-month-old-baby with the Matched Case-Control Study on five categories and three factors including predisposing, contributing, and complementary through the babies’ malfunction development with the Analysis Research Method was analyzed. The babies’ developing crisis was enhanced as the guidelines for promoting healthy babies’ development via the DSPM in the future of Thailand. Creative the Interview Factor Questionnaire analyzed the 130-child caregivers’ parenting matching 65-pairs-case-control group into 5 parts: the Predisposing Factor Questionnaire, the Positive Interview Form; the Baby-Self-Efficacy Form; the Inappropriate Contributing Interview Form; the Inappropriate Development Interview Form for assessing the motor skills, self-efficacy, predisposing, contributing, and complementary factors of the 9-month-old-baby, respectively. Highest, Middle, and Lowest means levels are indicated. The child caregivers’ are presenting responses, overall on the Predisposing Factor Questionnaire on five categories’ motor skills, and the Inappropriate Development Interview Form showed off at the Middle Levels. The Positive Interview Form, the Baby-Self-Efficacy Form, and the Inappropriate Contributing Interview Form comprised at the Highest Levels for the predisposing, self-efficacy, and contributing factors for developing the 9-month-old-baby, respectively. To help professionals assess the factors affecting a child’s development into environmental factors, biological factors, interpersonal relationships, and early environments and experiences that identified in contributing to growth, brain, emotional, social developments at early childhood are the GM, FM, RL, EL, and PS motor skills practices with the DSPM for Thai’s children are also more likely to have health problems all child ages with the knowledge and skills.